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Examples of plan
information is listed followed by a sample plan for a child.
Child’s Name
STRENGTHS
1. Positive assets (examples: good vision, alert, etc.)
2. Personality traits (examples: sociable, persistent, good natured)
3. Has received good medical treatment
4. Parent / Family Involvement (as advocates, getting services, care)
NEEDS AND RECOMMENDATIONS
1. Child needs to:
It is
recommended that the child receive physical therapy on a regular basis.
2. Child needs to:
-
use hands
functionally in daily living activities
-
develop oral
motor skills
-
increase texture
of food that is eaten
-
decrease
sensitivity to touch or texture
It is
recommended that the child receive occupational therapy on a regular basis.
3. Child needs to:
-
express his/her
wants and needs
-
increase
vocabulary
-
develop language
concepts
-
follow simple
verbal directions
It is
recommended that the child receive speech therapy on a regular basis.
4. Child needs to have a physician monitor:
-
seizures
-
heart
-
shunt
-
hyperactivity
-
vision
-
lungs
-
hearing
-
allergies
-
....
It is
recommended that the child continue to see or consult with (neurologist,
cardiologist, pediatrician, neonatologist, urologist, orthopedist,
ophthalmologist, etc)
5. Child family needs financial assistance in paying for medical and therapy
expenses.
It is recommended that the Deeming Waiver be granted so that this child
will receive Medicaid.
SAMPLE: INDIVIDUAL HABILITATION PLAN
Lucy Marie Jones
STRENGTHS
1. Lucy has a pleasant personality.
2. Lucy loves to play with children.
3. Lucy has had educational services since she was a preschooler.
4. Lucy had a supportive family.
5. Lucy takes responsibility of caring for her dog.
6. Lucy’s seizures have been under control for a year.
NEEDS AND RECOMMENDATIONS
1. Lucy needs to have her eyes working together properly. It is
recommended that Lucy continue under the care of her ophthalmologist. She
should wear her glasses and should have the surgery that is scheduled this
summer.
2. Lucy needs to be free from upper respiratory infections. It is
recommended that Lucy have immediate medical attention when she gets a cold.
She should not be given penicillin due to an allergy.
3. Lucy needs to develop a tolerance to different textured foods. It is
recommended that Lucy have occupational therapy on a regular basis to work
on oral motor skills.
4. Lucy needs to improve her articulation and her vocabulary. It is
recommended that Lucy have speech therapy on a regular basis.
5. Lucy needs a positive learning environment where she can interact with
typical children. It is recommended that part of Lucy’s school day be in
regular education classes.
6. Lucy needs to be free from seizures. It is recommended that Lucy
continue under the care of a neurologist. She should have blood levels done
every three months to make sure her anticonvulsant medications are within
therapeutic range. It will be especially important to monitor her seizure
activity as she reaches puberty because of growth spurts and hormonal
changes.
7. Lucy needs assistance to complete her daily living activities. It is
recommended that Lucy’s parents, sisters, and teacher assist Lucy in
toileting, dressing, and bathing. She should be encouraged to do as much as
possible of each task.
8. Lucy needs to be free from dangers. It is recommended that Lucy’s
environment be free from poisons and that she have adult supervision to keep
her safe.
9. Lucy’s parents need a break from the 24 hour responsibility of caring for
Lucy. It is recommended that Lucy’s parents have respite care on a
monthly basis so that they can do things with their other daughters and have
some time alone.
10. Lucy’s parents need financial assistance to help them pay for her
medical and therapy expenses. It is recommended that the Katie Beckett
Waiver be granted to provide Lucy with Medicaid coverage.
Date: _______________
Signature:_____________________
Dottie Adams, MEd
Human Service Provider, Sr.
Community Support Services
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A special needs
trust is the only estate planning option that protects assets, enables the
beneficiary to receive goods and services from the estate, and still
preserves eligibility for government benefits. |
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