Current through 2024-38, September 18, 2024
1. Application for
ILS Program Services
Any person who applies for services shall undergo an
eligibility determination, the results of which shall be shared with the
individual. An applicant is anyone who signs a dated application or letter
requesting IL Services. An evaluation(s) will take place, at no cost to the
consumer, to provide information for the eligibility decision. At any time in
this process that it is determined the individual is not eligible for IL
Services, the evaluation shall cease. Appropriate notification will be provided
to the individual.
2.
Eligibility Criteria and Evaluation
An individual is eligible for ILS Program services if an
evaluation documents the following:
A.
That the individual has a significant physical or mental disability which for
that individual constitutes or results in a severe limitation(s) in ability to
function independently in family or community setting;
B. That IL Services may reasonably be
expected to assist the individual to function independently in a family or
community setting; and
C. The
consumer's ability to direct the IL service planning and selection with or
without assistance.
D. The
evaluation(s) shall take into consideration any relevant case record materials
available from the ILS Program or other sources. A special diagnostic
study(ies) shall be conducted for purposes of determining eligibility for IL
Services only if already available information is not complete, relevant, or
current. The evaluation(s) shall be sufficient in scope to determine which
services will best meet the current needs of the individual for functioning
more independently in family or community setting.
3. Eligibility Decision and Documentation
Upon completion of the evaluation, the ILS Program staff
responsible for determining eligibility shall make one of the following
decisions: The applicant is eligible; or, The applicant is ineligible.
A. Certification of Eligibility
For each individual determined eligible for IL Program
services, the case record must include documentation of the presence of a
significant disability and a Certification of Eligibility which is signed and
dated by the authorizing ILS Program staff and which documents:
(1) how the disability(ies) result in
significant limitations in ability to function independently in family or
community settings;
(2) how there
is a reasonable expectation that ILS Program services will assist the
individual's ability to function independently in a family or community
setting; and
(3) how the consumer's
direct and active participation in the process will be accomplished.
B. Certification of Ineligibility
In all cases where the authorizing ILS Program staff
documents that IL Services cannot be expected to assist an individual to
function more independently in family or community setting, there must be a
certification dated and signed by the authorizing ILS Program staff. If an
applicant has been determined to be ineligible, then the certification must be
documented as follows:
(1) Reason(s)
for Ineligibility
(a) The service provider
may determine an applicant to be ineligible for IL Services only after full
consultation with the applicant or duly authorized representative, or after
providing a clear opportunity for this consultation;
(b) The applicant or duly authorized
representative shall receive written, or by other appropriate media,
notification of the agency action, appeal rights, and the availability of
advocacy services through the Client Assistance Program;
(c) The service provider shall provide a
detailed explanation of the availability and purposes of the Client Assistance
Program including information on how to contact the program; and
(d) If appropriate, the service provider
shall refer the applicant to other agencies and facilities, including the
state's vocational rehabilitation program.
(2) Review of Ineligibility Determination
(a) If an applicant for IL Services has been
found ineligible, the service provider shall review the applicant's current
status no later than twelve (12) months after the determination has been
made;
(b) The review need not be
conducted in situations where the applicant has refused the review, the
applicant is no longer present in the state, or the applicant's whereabouts are
unknown; and
(c) All review efforts
will be documented in the case record.
4. Order of Selection
A. At any time services cannot be provided
within a reasonable time to all eligible individuals, the ILS Program Order of
Selection shall be implemented. A reasonable time will be determined by the
Director of DVR in consultation with the Statewide Independent Living
Council.
B. After determining
eligibility, ILS Program staff shall follow the Order of Selection in
purchasing services.
C. A Statewide
waiting list shall be established by the ILS Program provider in consultation
with the DVR Grant Manager. The waiting list will be organized by Priority
Status and chronological order of the Eligibility date.
Eligible individuals shall be served in the following
priority order:
(1) Priority 1 Status
Those eligible adults who will lose their current level of
independence and would be required to move to more restrictive setting
immediately and permanently, unless they receive the assistance of a specific
service or set of services which the ILS Program can provide.
(2) Priority 2 Status
Those eligible adults who, with the assistance of a specific
service or set of services which the ILS Program can provide, can immediately
move to a less restrictive and more independent setting.
(3) Priority 3 Status
Those eligible adults, who, with the provision of a service
or set of services which the ILS Program can provide, will be able to overcome
a specific barrier or set of barriers to independent living.
(4) Priority 4 Status
All other eligible individuals.
D. All individuals in each priority shall be
served before serving those in the next succeeding priority status.
