Chapter 3, Service Delivery

Revision 23-1; Effective Nov. 20, 2023  

Required and optional services must be addressed in the grant work plan goals, objectives and activities.

3.1 Required Services

Revision 19-0; Effective March 1, 2019 

A CIL must provide the following independent living core services:

  • information and referral;
  • IL skills training;
  • peer counseling;
  • individual and systems advocacy; and
  • services that facilitate transition from nursing homes and other institutions to the community, provide assistance to those at risk of entering institutions, and facilitate transition of youth to postsecondary life.

3.2 Optional Services

Revision 19-0; Effective March 1, 2019 

A CIL must provide a combination of any two or more of the following IL services:

  • psychological, psychotherapeutic and related counseling;
  • services related to securing housing or shelter (including community group-living and services supportive of the purposes and titles of the Rehabilitation Act of 1973, as amended);
  • services related to obtaining adaptive housing services (including appropriately accommodating and modifying any space used to serve individuals with disabilities);
  • rehabilitation technology;
  • mobility training;
  • services and training for people with cognitive and sensory disabilities, including life skills training and interpreter and reader services;
  • personal assistance, including attendant care and the training of personnel who provide such services;
  • directories, surveys, and other activities to identify appropriate:
    • housing;
    • recreation opportunities;
    • accessible transportation; and
    • other support services;
  • consumer information programs on rehabilitation and IL services available under this Act, especially for minorities and other individuals with disabilities who have traditionally been unserved or underserved by programs under the Act;
  • education and training necessary for living in the community and participating in community activities;
  • supported living;
  • transportation, including referral and assistance for such transportation;
  • physical rehabilitation;
  • therapeutic treatment;
  • provision of needed prostheses and other appliances and devices;
  • individual and group social and recreational activities;
  • training to develop skills specifically designed for youths with disabilities to:
    • promote self-awareness and self-esteem;
    • develop advocacy and self-empowerment skills; and
    • explore career options;
  • services for children;
  • services under other federal, state or local programs designed to provide resources, training, counseling or other assistance of substantial benefit in enhancing independence, productivity and the quality of life of individuals with disabilities;
  • preventive services to decrease the need of individuals assisted under the Act for similar services in the future;
  • community awareness programs to help individuals with disabilities integrate into society; and
  • other services as necessary and consistent with the Act.

3.3 Services to Individuals with Significant Disabilities

Revision 19-0; Effective March 1, 2019 

A CIL must document that it serves people with a wide range of significant disabilities, including people who are unserved or underserved, such as people with significant disabilities who:

  • have cognitive and sensory impairments;
  • are members of racial and ethnic minority groups;
  • live in rural areas; or
  • have been identified by the CIL as unserved or underserved within the CIL's catchment area.

3.4 Outreach for Special Populations

Revision 23-1; Effective Nov. 20, 2023  

A CIL must conduct a strong outreach for services done through the center to reach populations of people with significant disabilities who are unserved or underserved, especially minority groups and urban and rural populations. An outreach log must be kept up-to-date documenting all outreach efforts for the grant. This log may be requested by HHSC at any time.  

3.5 Consumer Eligibility

Revision 23-1; Effective Nov. 20, 2023  

An appropriate CIL staff member must sign and date an eligibility statement certifying that the person is determined eligible for IL services. This decision must be:

  • based on the person having a severe physical, mental, cognitive or sensory impairment that substantially interferes with the ability to function independently in the family, home or community; and
  • made without regard to age, color, creed, gender, national origin, race, religion, or type of significant disability of the person applying for services, or any state or local residence requirement.

3.5.1 Consumer Ineligibility

Revision 23-1; Effective Nov. 20, 2023  

If an applicant for IL services is determined ineligible for IL services, the CIL must provide the applicant with documentation of the ineligibility determination. It must be dated and signed by an appropriate CIL staff member.

3.5.2 Review of Ineligibility Decision

Revision 23-1; Effective Nov. 20, 2023  

If an applicant for IL services is found ineligible, the CIL must review the applicant's ineligibility at least once:

  • within 12 months after the ineligibility determination has been made; and
  • when CIL staff determine the applicant's status has materially changed.

There is no need to conduct the review if the applicant:

  • has refused the review;
  • is deceased;
  • is no longer present in the state; or
  • has unknown whereabouts.

3.6 Termination of Services

Revision 23-1; Effective Nov. 20, 2023  

If the CIL intends to terminate services to a person with a Consumer Service Record (CSR), the CIL must notify the person, provide information on the Client Assistance Program (CAP) and, refer the person to any agencies or facilities that may benefit them.

Early termination is when a person’s case is closed before successfully completing the active goals of their Independent Living Plan. Providers should address behaviors a person exhibits before early termination from a program. Documentation should include efforts to contact a person both by phone and by mail if they become unreachable. If a person’s behaviors are dangerous to them or others, HHSC must be notified within one business day. The service provider may consult with HHSC if they are unsure if a person is a candidate for early termination. 

Reasons for early termination include:

  • behaviors dangerous to self or others;
  • serious infraction of the provider's rules;
  • frequent unexcused absenteeism;
  • frequent unexcused tardiness; or 
  • lack of cooperation on assigned tasks. 

3.7 Independent Living Plan or Waiver

Revision 19-0; Effective March 1, 2019 

A CIL must provide the consumer with the choice of:

  • developing an Independent Living Plan (ILP) in collaboration with CIL staff members; or
  • signing a waiver, leaving the planning process to CIL staff members.

If the consumer chooses to develop an ILP, the CIL staff member and the consumer must develop a mutually agreed-upon ILP. The ILP must be signed by the consumer, or his or her representative, and the appropriate staff member.

If the consumer chooses to sign a waiver form, waiving his or her right to participate in plan development, CIL staff must develop the plan of services.

The plan must include:

  • the consumer's goals and objectives;
  • services the CIL will provide;
  • the anticipated duration of each individual service (start and end dates);
  • the anticipated duration of the service program (start and end dates);
  • the planned frequency of consumer contact; and
  • documentation that the consumer or his or her representative was given a copy of the signed ILP or waiver.

Services entered on the ILP or waived plan must:

  • clearly support achievement of consumer goals or objectives; and
  • be time-limited.

CIL staff must review the consumer plan or waived plan as often as necessary, but at least annually, to determine whether services should be continued, modified or discontinued.

3.8 Consumer Service Record

Revision 19-0; Effective March 1, 2019 

A Consumer Service Record (CSR) must be maintained for each applicant for IL services and each recipient of IL services (other than information and referral). The CSR must contain:

  • documentation concerning eligibility or ineligibility for services;
  • the IL plan developed with the consumer, or a waiver signed by the consumer waiving the consumer's participation in plan development;
  • services requested by the consumer;
  • services provided to the consumer;
  • frequency of consumer contact; and
  • the IL goals or objectives established with the consumer, whether or not in the consumer’s IL plan and achieved by the consumer.

A CSR may be maintained electronically or in printed form. However, the IL plan or waiver must bear signatures of the consumer, or the consumer's representative, and the CIL staff member.

3.9 Independent Living Goals

Revision 19-0; Effective March 1, 2019 

A CIL must ensure that it facilitates development and achievement of suitable IL goals. IL goals relate directly to addressing the consumer's functional needs and what the consumer wants to achieve to access his or her home, family and/or community.

IL goals address significant life achievements that:

  • enable the consumer to become more, or to remain, independent in the home, family or community; and
  • are made possible through IL services.

A consumer may have more than one goal listed on the Independent Living Plan or waived plan.

Goals may be related to:

  • communication;
  • community-based living;
  • community and social participation;
  • education needed for independent living;
  • information access and technology;
  • mobility and transportation;
  • personal resource management;
  • relocation from a nursing home or other institution;
  • self-advocacy and self-empowerment;
  • self-care; and
  • other areas leading to independent living.

3.10 Examples of Goals and Outcomes

Revision 19-0; Effective March 1, 2019 

GoalsOutcomes
Communication

Improve the consumer's ability to:

  • understand and acknowledge communication by others through gestures or verbal response (receptive); or
  • produce verbal language, sign language or other nonverbal communication (for example, gestures and facial expressions).
Community-based living

Change the consumer's living situation to enable the consumer to remain in his or her home or apartment or get around better. Examples include:

  • obtaining accessible housing;
  • modifying a home or apartment;
  • attaining self-directed assisted living; and
  • attaining self-directed living with family or friends.
Community and social participation

Help the consumer participate in such community activities as:

  • worship services;
  • recreation activities;
  • community affairs; and
  • government functions.
Education needed for independent living

Achieve non-degreed and non-vocational training goals that are expected to improve the consumer's knowledge or skills in order to expand his or her independence. Examples include:

  • literacy training; and
  • training to do his or her own income taxes.
Information access and technology

Help the consumer obtain or use information necessary for independence and community integration. This may include:

  • using a computer or assistive technology, devices or equipment; and
  • developing information technology skills, such as using computer screen-reading software.
Mobility and transportation

Improve the consumer's access to his or her environment or community by:

  • improving the consumer's ability to move or transport himself or herself;
  • allowing the consumer to be moved or transported by another person; or
  • training the consumer to use public transportation.
Personal resource management

Help the consumer learn such skills as:

  • establishing and maintaining a personal or family budget;
  • managing a checkbook; and
  • obtaining information about resources for income, housing, food, medical or other benefits.
Relocation from a nursing home or other institutionAchieve goals related to relocating from a nursing home or other institution to community-based living.
Self-advocacy and self-empowerment

Help the consumer:

  • represent and advocate for himself or herself with public and/or private entities;
  • make key decisions involving himself or herself; or
  • organize and manage his or her own activities to achieve desired objectives.
Self-care

Help the consumer function more independently by:

  • improving or maintaining the consumer's autonomy in activities of daily living such as:
    • personal hygiene;
    • meal preparation;
    • shopping;
    • nutrition;
    • money management; and
    • technology access; and/or
  • decreasing the amount of help and/or supervision the consumer needs to perform daily activities.
Other goals leading to independent livingAchieve other goals, including obtaining, maintaining or retaining employment that are not already included in this section, but are necessary for the consumer to become or remain independent.