North Star Oregon

If you are supporting a loved one with an intellectual or developmental disability in Oregon, the annual Individual Support Plan (ISP) meeting is one of the most important dates on your calendar. It is the formal conversation where the person you love, their team, and their Services Coordinator or Personal Agent sit down together to answer a simple but weighty question: what is the plan for the next year? Done well, an ISP meeting is empowering. It puts the individual at the center of their own life, names the supports that will help them thrive, and documents the services Oregon will fund through the K Plan or a 1915(c) Medicaid waiver. Done poorly — rushed, form-driven, dominated by clinical language — it can feel like a box-checking exercise that leaves families more anxious than reassured. The good news is that a little preparation changes the whole experience. This guide walks Oregon families through what to do before, during, and after the ISP meeting so that the plan truly reflects the goals, strengths, and dreams of the individual at the heart of it. What the ISP Is and Why It Matters The Individual Support Plan is the document that drives everything Oregon's developmental disability system funds for your family member. It is person-centered by design — meaning it starts from who the individual is, what matters to them, and what kind of life they want — and it lists the specific services, hours, goals, and providers that will support that life over the coming year. At minimum, the ISP captures: The individual's strengths, preferences, interests, and communication style Their goals for the year (things like learning a new skill, building friendships, contributing to the community, or gaining more independence at home) The types and amounts of paid services authorized — for example, hours of In-Home Attendant Care, days per week of Day Support Activities (DSA), relief care, employment supports, or assistive technology Health, behavioral, and safety considerations the team needs to be aware of Who is on the support team and how they communicate How progress will be measured and reviewed The plan is reviewed at least annually and can be updated any time there is a significant change — a move, a new diagnosis, a new goal, a provider change, or a shift in the level of support someone needs. Your Services Coordinator (through the County Developmental Disabilities Program, or CDDP) or Personal Agent (through a brokerage) is responsible for facilitating the meeting and writing the plan, but the document belongs, in every meaningful sense, to the individual it is about. Before the Meeting: Build the Foundation The most common mistake families make is treating the ISP meeting as a one-hour event. It is really a season of reflection that happens to culminate in a meeting. Starting a few weeks out dramatically changes the quality of the conversation. Reflect on the past year — honestly Pull out last year's ISP. Read the goals. Ask yourself: What went well? What did your loved one actually enjoy and grow from? What was written in the plan but never really happened? Why? What changed — in health, schedule, relationships, abilities, interests? What new strengths have emerged that nobody has named yet? Where did a service fall short, and what would make it better? Write these reflections down. Honest notes from the family — including the messy parts — are far more useful than a rosy summary. Talk with your loved one, in their way The plan is theirs. Even if your family member uses few words or communicates with pictures, gestures, a device, or behavior, their voice must anchor the meeting. Over the weeks leading up to it, build in conversations about: What do they want more of this year? Less of? Who do they love spending time with? What makes a good day? A hard day? Are there new places they want to go, new skills they want to try, new things they want to buy, earn, or contribute? Is there anything about their current services they would change if they could? For nonspeaking individuals or those who use augmentative and alternative communication (AAC), pay attention over time — not just in a single sit-down. Watch what they light up around. Notice where they resist. Ask their Direct Support Professionals and teachers what they have observed. All of that is data your loved one is sharing with you. Gather input from the whole circle of support Reach out to the people who know your loved one well — Direct Support Professionals, teachers or transition specialists, therapists, medical providers, family members, chosen family, employers, and friends. A quick email or text message with two or three questions can surface insights that nobody would remember to mention in the meeting itself: What strengths do you see that the plan should celebrate? What goals would you love to see prioritized this year? What supports or accommodations make the biggest difference? Bring a short summary of what you hear into the meeting. Review documentation — and bring what is useful Assemble any recent documents that the team should see or that may inform the plan. Examples include: Recent medical evaluations or changes Behavioral assessments or positive behavior support plans School IEPs, transition plans, or progress reports Current medications and any recent changes Employment or post-secondary records Provider progress notes you have received A current communication profile, if your loved one uses AAC or nonstandard communication You do not need to come with a stack of binders. A one-page snapshot and a short list of specific documents you want referenced is plenty. Draft your goals list — in plain language Write down, in your own words, what you hope this year's plan will accomplish. Keep it concrete. Instead of "more social activities," try "at least two community outings per week with peers, with a focus on music and art." Instead of "better independence," try "learning to prepare three simple meals with minimal prompting." Clear goals lead to clear services and clear ways of measuring progress. Confirm the logistics A week or two before the meeting, confirm with your Services Coordinator or Personal Agent: Date, time, and location (or video link) Who will be invited from the team How long the meeting is scheduled for Whether sensory, mobility, or language accommodations are needed Whether your loved one will attend part of the meeting, all of it, or provide input a different way If the meeting time or place does not work for your loved one's rhythms — mornings versus afternoons, quiet spaces versus busy offices — say so. The meeting should be designed around the person at its center. During the Meeting: Be a Partner, Not a Passenger A good ISP meeting is collaborative. The Services Coordinator or Personal Agent facilitates, but families, providers, and above all the individual are expected to shape the conversation. A few practical tips: Start with strengths and the person Ask for the meeting to open with a "who is this person" section before jumping into any service numbers. A few minutes spent naming strengths, interests, relationships, and what makes the person unique resets the tone of the entire meeting. Ask for plain language If someone uses jargon — "residential ratio," "natural supports," "plan of care," "K state plan hours" — it is completely reasonable to ask, "Can you walk me through what that means in practice for our family?" You are not being difficult. You are doing your job as an advocate. Slow down on service levels When the team discusses hours of Attendant Care, days of DSA, relief care allocations, or any other funded service, make sure the numbers match the life you are planning. A few questions worth asking: How were these hours calculated? Do they account for realistic scenarios — a sick day, a medical appointment, a school break, a summer schedule? What do we do if our needs change mid-year? What happens if a provider cannot consistently staff the approved hours? Keep the goals tied to real life For every goal in the draft plan, ask: Whose goal is this, really? Does our family member agree it matters? Is the goal written in specific, observable language? Who is responsible, what are the supports, and how will we know progress is happening? Name gaps and preferences If a service area is under-addressed — for example, if relief care is listed at a level that will not actually let a parent-caregiver rest, or if community access is not reflected — say so. If your loved one strongly prefers certain activities, settings, peers, or staff, it belongs in the plan. Invite your loved one to lead what they can Even short participation matters. Some individuals will attend the whole meeting; others will join for the portion about their goals and then leave; some will share through a video they recorded earlier, a picture board, or a trusted person reading their words. Every version counts. Take notes — or ask someone to Even with a skilled facilitator, it is hard to track every decision, service number, and action item in real time. Bring a family member or trusted friend to take notes, or ask the team if you can record the audio for your own reference. After the Meeting: Don't File It and Forget It The ISP is a living document. What happens in the weeks after the meeting matters as much as what happens in the room. Read the written plan carefully Once you receive the finalized ISP, read it closely. Common things to check: Are the correct service types, hours, and providers listed? Do the goals match what the team agreed to? Are important accommodations, communication needs, and medical considerations captured? Are start and end dates correct? Is there anything written that you did not agree with, or that does not reflect the meeting? You have the right to ask for revisions if the written plan does not match what was discussed. Share it with the people who need it With appropriate permissions, share relevant portions of the ISP with Direct Support Professionals, employers, teachers, or therapists so that the plan actually shapes day-to-day support. A goal that lives only in a binder is not a goal; it is a wish. Track progress in small, regular check-ins Set a quarterly rhythm to look at the plan with your loved one and the team. Are the goals moving? Are services being delivered as written? Has life changed in ways that call for an update? Small check-ins throughout the year prevent the annual meeting from becoming the only time anyone looks at the plan. Call for an update when life changes You do not have to wait twelve months to change the plan. If your loved one moves, starts a new school or job, has a health change, develops a new interest, or if family circumstances shift significantly, request a plan update. Oregon's system is built to flex around real lives. A Few Rights Worth Knowing Families sometimes walk into ISP meetings unsure of what they are entitled to ask for. A short, non-exhaustive list: The right to a person-centered planning process that starts from your loved one's goals, not a pre-set service menu The right to bring anyone you want to the meeting — family, friends, advocates, attorneys, cultural or spiritual support people The right to request an interpreter, sensory accommodations, or an accessible meeting format The right to a written copy of the plan and to request revisions The right to disagree, to document your disagreement, and to pursue a grievance or fair hearing if a needed service is denied or reduced Your Services Coordinator or Personal Agent can explain the specific procedures; a Family Support Specialist or advocacy organization can also help. How North Star Oregon Partners with Families Around the ISP At North Star Oregon, we view the ISP meeting as one of the most important conversations in our work together. As a provider of In-Home Attendant Care and Day Support Activities across Oregon — including our DSA locations in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent — we bring observations, progress notes, and honest input to the team so that the plan is grounded in what we see day to day. We also help families prepare. If you are new to the process or feel unsure about how to shape the conversation, we are happy to talk through what to expect, how our services are described in plan language, and how to connect goals in the ISP to the activities and supports we provide. Most importantly, we believe the person at the center of the plan should be the loudest voice in the room — and when they need support to make that voice heard, we are proud to stand beside them. Learn More or Get in Touch If you are in Oregon and considering services, preparing for an ISP meeting, or wondering how our in-home and DSA programs could fit into your loved one's plan, we would love to hear from you. Visit northstaroregon.com to learn more about our services, our direct-employment model, and the communities we serve, or reach out through our contact page to start a conversation. The ISP is not just paperwork. It is a plan for a life — and with the right preparation, your family can step into that meeting knowing your loved one's story will be heard, their goals will be honored, and their future will be built on their own strengths.

This June marks 27 years since the United States Supreme Court handed down its decision in Olmstead v. L.C. — one of the most consequential disability rights rulings in American history. If you're a family member of someone with an intellectual or developmental disability, or a person with I/DD yourself, you may not have heard the name Olmstead. But you have very likely lived inside the world it created. Every time someone with I/DD lives in their own apartment instead of an institution, attends a community-based day program instead of a sheltered workshop, joins a public school class instead of being segregated, or gets to choose where, how, and with whom they live — Olmstead is part of the reason that's possible. As we approach the anniversary of this landmark ruling, we want to take a moment to share what Olmstead is, what it has changed, what it has not yet changed, and why it remains the legal and moral foundation of community-based services like the ones we provide at North Star Oregon. A Brief History: Two Women in Georgia The story of Olmstead begins not with policy but with two women — Lois Curtis and Elaine Wilson — who were living at Georgia Regional Hospital, a state-run psychiatric institution, in the mid-1990s. Both women had intellectual disabilities and mental health diagnoses. Both had been institutionalized for years. And both had been told by their treatment teams that they no longer needed to be in the hospital — that they could live successfully in the community with appropriate supports. But the community supports they needed weren't available, or weren't being offered. So they remained in the hospital, year after year, even though everyone agreed they didn't need to be there. With the help of the Atlanta Legal Aid Society, they sued the state of Georgia, arguing that the unjustified institutionalization of people who could live in the community violated Title II of the Americans with Disabilities Act (ADA). Their case made its way to the U.S. Supreme Court. In June 1999, the Court ruled in their favor. What the Court Actually Said The Olmstead decision is technically narrow but philosophically vast. In a 6-3 ruling, the Court held that under the ADA, states are required to provide community-based services to people with disabilities when: Such services are appropriate. The individuals affected do not oppose community-based treatment. The placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others receiving disability services. In plain language: if a person with a disability can live and receive services in the community rather than in an institution, and they want to, the state must make that possible — except in narrow circumstances. Unjustified segregation, the Court ruled, is itself a form of discrimination prohibited by the ADA. That last sentence is the heart of it. Unjustified segregation is a form of discrimination. For decades before Olmstead, the default response to disability — particularly intellectual and developmental disability — was to separate people from the rest of society. Large state institutions warehoused tens of thousands of people with I/DD across the country. Children were taken from their families and placed in these settings, sometimes for life, often based on doctors' recommendations to parents that they should "let go" and "move on." Olmstead didn't end that history overnight. But it did establish, in the highest court in the country, that the practice was wrong — and that doing the opposite (supporting people in their communities) wasn't just kind or progressive but legally required. What Olmstead Has Changed In the 27 years since the decision, the landscape of disability services has shifted dramatically. Institutional populations have continued to decline. In 1967, there were nearly 200,000 people with I/DD living in state institutions in the United States. Today, that number is under 16,000 nationally and continues to drop. Oregon closed its last state institution for people with I/DD, Fairview Training Center, in 2000 — the year after Olmstead. The state has not built another one. People who previously would have lived in institutions now live in their own homes, with family, in foster care, or in small group homes — supported by community-based services. Community-based service systems have grown. Medicaid Home and Community-Based Services (HCBS) waivers — like the ones Oregon uses to fund North Star's services — were expanded and strengthened in the years following Olmstead. The 1915(c) waivers and Oregon's K Plan are direct descendants of the Olmstead mandate. Without them, the kind of in-home attendant care and community-based DSA programs we provide simply wouldn't exist at this scale. Person-centered planning has become the standard. The Individual Support Plan (ISP) process — where a person's preferences, goals, and choices drive the services they receive — owes its prominence to Olmstead's emphasis on integration and individual choice. Sub-minimum wage and sheltered workshops have come under scrutiny. Oregon, in particular, has been a national leader in transitioning away from segregated employment settings toward integrated, community-based work. The state's Employment First initiative, formalized through executive orders and legal settlements in the 2010s, was driven in significant part by Olmstead obligations. Day services have moved into the community. The North Star Oregon DSA model — community outings, volunteering, real workplaces, public libraries, museums, parks, neighborhoods — is itself an Olmstead-era model. Day services that take place primarily in segregated buildings, with the same group of people every day, doing activities that wouldn't be available to non-disabled adults in the same age range, are increasingly being phased out as inconsistent with the integration mandate. What Olmstead Has Not Yet Changed It would be inaccurate to say Olmstead has fully delivered on its promise. Twenty-seven years on, gaps remain. Waiting lists for community-based services remain long. In many states, including Oregon at times, the demand for HCBS waivers has exceeded the supply. Oregon does not currently maintain a waiting list for I/DD waiver services, which is something the state should be commended for. But the workforce shortage in direct support — caused largely by stagnant wages — has created a different kind of access problem: services are authorized but providers can't be found to deliver them. People in nursing homes are still under-served by Olmstead. A significant share of the Olmstead litigation in recent years has focused on people with disabilities living in nursing facilities who could be supported in the community but aren't, because the state's system is structured around institutional rather than community placements. People with the most complex needs sometimes still struggle. The integration mandate is for everyone, but the rhetoric of community-based services can sometimes leave behind people whose support needs are intensive, especially when funding doesn't keep pace with the cost of high-quality community supports for those individuals. Segregation can take subtler forms. A person can technically live "in the community" while still being functionally segregated — going from a group home to a sheltered workshop and back, with little real participation in community life. Olmstead requires not just physical placement in the community but meaningful integration. Living in a community is not the same as being part of one. The work is not done. Why Olmstead Matters at North Star Oregon We think about Olmstead often, even when we're not naming it. When a parent-caregiver chooses to be hired as a W-2 employee to care for their own adult son in a shared-home setting — that's Olmstead. The person isn't being moved into an institution; they're being supported at home with their family. When a young woman in our Eugene DSA program decides she wants to spend her Tuesdays volunteering at the humane society and her Thursdays taking a community college painting class — that's Olmstead. Her day looks like the day of any other young adult in Eugene with similar interests, not a clinical setting. When a man in our Salem program rides the bus to work, eats lunch at a downtown café where the staff know his name, and goes home to an apartment he shares with a friend — that's Olmstead. He is not in an institution. He is a member of a community. When we reject the term "clients" in favor of "the individuals we support," that's a small linguistic choice rooted in a much larger philosophical one: the people we work with are people first, with their own preferences, dreams, and rights, not subjects of a service. What This Means for Families If you are a parent, sibling, spouse, or family member of someone with I/DD, the Olmstead decision gives you legal grounding for some of the things you instinctively want for the person you love: They have a right to live in the most integrated setting appropriate to their needs. They have a right to participate in planning their own services and lives. They have a right to refuse institutional placement when community-based services would meet their needs. They have a right to providers who treat them as members of the community, not as patients to be managed. If you ever feel like you are being pushed toward a more segregated, more institutional, more restrictive setting than your loved one needs — you have legal and moral standing to push back. Olmstead is part of the bedrock you can stand on. If a service system is not working for your family, you can advocate for change. You can contact your CDDP services coordinator. You can reach out to advocacy organizations like Disability Rights Oregon, which is Oregon's federally designated Protection and Advocacy agency. You can talk to your state legislator. You can connect with other families who have walked similar paths. Looking Forward A generation ago, the future for many people with I/DD was institutional. That future is no longer the default — and that is largely because of the women and men, like Lois Curtis and Elaine Wilson, who refused to accept it as inevitable, and the courts and legislatures that listened. The next chapter of disability rights is being written now, by today's self-advocates, today's families, today's direct support professionals, and today's policymakers. The work is incomplete, but the direction is clear: more inclusion, more choice, more community. At North Star Oregon, we consider it a privilege to be part of that work. The people we support are not "served" by us; they are walking through their own lives with us walking beside them, and we are better for the company. To learn more about our community-based services — In-Home Attendant Care across Oregon and Day Support Activities in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent — visit northstaroregon.com or reach out to our team. We'd be honored to be a part of your community.