ISP at a Glance
A parent-friendly map for understanding Arizona DDD planning: what belongs in the plan, how goals connect to services, what happens at planning reviews, who is responsible for what, and what to do when a need is not being addressed.
What is an ISP / PCSP?
The PCSP is the planning document DDD uses to organize a member's goals, support needs, authorized services, natural supports, risks, follow-up, and other information needed to coordinate care and help the person live the life they choose.
Start with the person
The plan should reflect the member's strengths, preferences, routines, relationships, culture, communication, priorities, and vision—not just a list of services.
Identify the real need
What does the member want or need to do? What can they do now? What support is needed for safety, health, participation, independence, or quality of life?
Connect support to outcome
Goals, paid services, unpaid supports, provider responsibilities, risks, and follow-up should all connect back to an identified need.
The plan should change when the person changes.
Beginning October 1, 2025, most ALTCS-eligible DDD members complete one full PCSP each year and review it at the three other 90-day Planning Review meetings. The PCSP can be updated more often when needs change.
Full PCSP
The Support Coordinator and planning team complete the full person-centered plan and reassess the member's needs, goals, risks, supports, and authorized services.
Planning Review
Review what changed, whether services are in place, whether goals and supports are working, and whether the plan needs revision.
Planning Review
Revisit current needs, progress, providers, risks, services, and follow-up items. Some members must continue to meet in person.
Planning Review
Continue reviewing the existing PCSP so the next annual full plan is based on current information rather than a once-a-year snapshot.
What should the plan actually tell me?
The current Arizona DDD PCSP is a long form. You do not need to memorize its page order. Instead, make sure the plan answers the important questions below.
Profile + preferences
Who is the member? What matters to them? What are their strengths, routines, communication needs, relationships, and preferences?
Ask: “Does this sound like the actual person?”Medical + behavioral information
Relevant health supports, medications, screenings, behavioral health needs, and coordination information should be current.
Ask: “What health information changes how support should be provided?”Home + community setting
The plan should reflect where the member lives, spends time, receives supports, and participates in community life.
Ask: “Are we planning for real environments, not just the meeting room?”Individualized goals
Goals should describe meaningful changes in skills, participation, independence, health, safety, relationships, or other areas important to the member.
Ask: “What will be different if this goal is successful?”Activities of daily living
Current abilities and support needs in everyday activities help explain why assistance or skill-building may be necessary.
Ask: “What can the member do independently, with prompts, or only with hands-on help?”Paid + unpaid supports
The plan identifies authorized paid services as well as unpaid or natural supports that are part of the member's actual support system.
Ask: “Who is realistically providing each support?”Risks + risk planning
Identified risks should connect to prevention, supervision, backup plans, training, supports, or other actions—not simply be listed.
Ask: “What are we doing about this risk?”Restrictions
If a plan restricts a member's rights, the restriction should be treated as a serious individualized decision with appropriate justification, documentation, safeguards, and review.
Ask: “Why is this necessary, and how will we know when it can be reduced or removed?”Action items + follow-up
Unfinished tasks should identify what needs to happen, who is responsible, and when the team will follow up.
Ask: “Who owns this next step, and by what date?”A good goal starts with a functional baseline.
Before writing the goal, identify what the member can currently do and what kind of help is required. That gives the team something concrete to measure against later.
Need → service is not automatic.
The planning team identifies the member's needs. For ALTCS services, DDD evaluates whether requested home and community-based services are medically necessary and authorizes approved services through the planning process.
What support is required?
Start with function: supervision, hands-on assistance, teaching, health support, transportation, respite, communication, employment, or another identified need.
What is already available?
Document the member's own abilities, natural or unpaid supports, community resources, school supports, health-plan services, and other systems actually involved.
What paid service addresses the remaining need?
Examples can include habilitation, attendant care, respite, therapy, day services, employment supports, transportation, or other authorized services when criteria are met.
Is the approved service actually in place?
Authorization on paper is not the end. The plan should be monitored for provider availability, implementation, effectiveness, and changing need.
The member is not a guest at their own planning meeting.
The person at the center
The member's goals, choices, preferences, strengths, needs, relationships, culture, and desired life should guide planning to the greatest extent possible.
Decision support + advocacy
Participates according to the member's legal decision-making arrangement and helps the team understand needs, history, priorities, and concerns.
Plan + coordinate + follow up
Develops and updates the PCSP with the team, coordinates services and care, assesses ALTCS service needs, helps resolve problems, and explains rights, grievances, and appeals.
Implement + report
Service providers carry out authorized supports within their scope and should provide useful information about implementation, barriers, progress, and changing needs.
Real-world context
Family, friends, caregivers, advocates, and other important people may be part of the planning team when the member chooses or when appropriate.
Coordinate across life
School, behavioral health, physical health, CRS, employment, housing, and community supports may need coordination so plans do not operate in separate silos.
Before, during, and after
Before
During
After
Who do I contact next?
DDD's current Support Coordination guidance gives families a clear internal escalation route. You can also use the Customer Service grievance process or an appeal when the issue fits those processes.
Support Coordinator
Clarify the need, the PCSP, authorization, provider issue, follow-up item, or service concern.
Support Coordinator Supervisor
Ask for supervisory help when the issue cannot be resolved through the assigned Support Coordinator.
Area Program Manager
DDD identifies the Area Program Manager as the next support level for unresolved Support Coordination concerns.
District Program Manager
May assist when an issue remains unresolved after lower support-coordination levels have been involved.
DDD Customer Service Center
Customer Service can help with questions, unresolved concerns, Support Coordinator contact information, and grievances. Phone: 1-844-770-9500, Option 1.
“I am dissatisfied with how this is being handled.”
DDD allows members, guardians, providers, and community members to file grievances about issues or concerns. A grievance is different from an appeal of a service decision.
Current DDD process: the complainant is contacted within 24 hours to gather information, and DDD states it will provide notice of the grievance decision within 10 business days after receiving the grievance.“DDD denied, reduced, suspended, or ended a covered service.”
A Notice of Adverse Benefit Determination explains the decision and how to appeal. The appeal route can differ depending on the service involved.
Very time-sensitive: for an appeal involving termination or reduction of an existing DDD-authorized service, continuation during appeal can depend on requesting continuation and appealing before the intended change date or within 10 calendar days of the notice mailing, whichever is later, along with the other applicable requirements.Red flags worth asking about
Where this page gets its backbone
Accessible Hive independently creates its educational content using publicly available information from Arizona DDD and AHCCCS. We translate complex policies and guidance into clear, practical information families can use.