Revision 23-1; Effective Nov. 20, 2023 

1.1 Overview

Revision 23-1; Effective Nov. 20, 2023  

The Independent Living Base/Operational Grant Standards for Service Providers (ILBOGS) is specific to the centers that receive state funding for the provision of Independent Living Core Services. The Standards focus is business practices, processes, and policies that are necessary for HHSC and the contractor to comply with federal, state, and agency laws, rules and requirements. Section 101(A)(6) of the Rehabilitation Act of 1973 provides that any state agency or contract service provider who receives federal funds must take affirmative action to employ, and advance in employment, qualified individuals with disabilities.

Contracted service providers must be in full compliance with the IL BOGS, 45 CFR parts 75 and 1329, Texas Administrative Code (TAC) Title 26 Chapter 357 and with all applicable clauses in the contract.

The Independent Living Services Program does not license or certify providers.

Service providers and their staff and sub-contractors, if any, are not employees of the Texas Health and Human Services Commission (HHSC).

HHSC contracts for the services described in this manual only with providers who are in full compliance with the applicable standards. Each provider is required to undergo a review process and to comply with periodic monitoring activities to ensure continued compliance with the ILBOGS.

1.2 Purpose

Revision 23-1; Effective Nov. 20, 2023  

ILBOGS helps to ensure that people receive quality services to help them achieve a successful outcome to their independent living goals. See 1.22 

In addition, the ILBOGS helps to ensure taxpayer funds are spent wisely and each purchase paid for with public funds represents full value to the taxpayer. Each contractor is responsible for maintaining compliance with the most recent ILBOGS.

1.3 Definitions

Revision 23-1; Effective Nov. 20, 2023  

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise, per the Administration for Community Living’s Annual Program Performance Report, Part II, Reporting Instructions.

Abuse – The negligent or willful infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical or emotional harm or pain. Examples are, sexual abuse, including any involuntary or nonconsensual sexual conduct that constitutes the offenses of indecent exposure or assault, committed by the person's caretaker, family member, or other individual who has an ongoing relationship with the person.

Act – The Rehabilitation Act of 1973, as amended.

Advocacy and Legal Services – Assistance or representation for a person in obtaining access to entitled benefits, services and programs.

Assistive Technology Services – Providing or helping with the selection, acquisition, or use of any assistive technology. This means, any piece of equipment, product, or software or hardware system used to increase, maintain, or improve functional capabilities of people with disabilities and any assistive technology service that helps a person with a disability.

Bilateral Contract – A legally binding document issued by HHSC that includes all terms and conditions and is signed by both HHSC and the contractor.

Billing Question Contact – The person authorized to make billing decisions for the contracted service provider.

Children's Services – Providing specific independent living (IL) services designed to serve people under 14 years with significant disabilities.

Communication Services – Services that enable people to better communicate, such as interpreter services, training in using communication equipment, braille instruction and reading services.

Confidential Information – Any communication or record. It can be oral, written, or electronically stored or transmitted, or any other form of communication or record. It can be provided to, or made available to, the service provider or that the service provider may create, receive, maintain, use, disclose or have access to on behalf of HHSC that includes any or all the following: 

• protected health information in any form, including without limitation, electronic protected health information or unsecured protected health information;
• sensitive personal information, defined by federal tax information, personally identifiable information, Social Security data, Medicaid information, all privileged work products, and all information designated as confidential under the constitution and laws of the state of Texas and of the United States, including the Texas Health and Safety Code and the Texas Public Information Act.

Conflict of Interest – A situation that creates a risk that personal interest or relationship will influence professional judgment or actions. These actions could create conflicts with discharge of duties required by this contract and the public interest. 

Consumer Service Record (CSR) – Maintained for an eligible person receiving IL services and meeting the requirements of 45 CFR Section 1329. In cases where IL services are provided to the parent or guardian of a person, the CSR is established for the person. The services provided are reflected in that CSR. Active CSRs are those corresponding to people who were served during the reporting year.

Contract Manager – Manages the service provider contracts for the Independent Living Services Program. Providers may contact the contract manager for any questions about their contract.

Contractor – An entity or person holding a written agreement with a purchasing entity to provide goods and services or a recipient or sub-recipient holding a written agreement with a grantor or sub-recipient to carry out all or part of a program. Sometimes used interchangeably with the terms "provider" or "service provider."

Core Services – IL services defined in Section 7(17) of the Act, which include information and referral services, IL skills training, peer counseling including cross-disability peer counseling, transition, and individual and systems advocacy.

Counseling and Related Services – Services that include information-sharing, psychological services of a non-psychiatric, non-therapeutic nature, parent-to-parent services and related services.

Designated State Entity (DSE ) – Units identified under Section 101(a)(2)(B) of the Act. In Texas, HHSC is the DSE.

Enrollment Contracts – The result of the process where HHSC awards contracts for the same or similar goods or services to all entities that meet qualifications established by HHSC.

Entity – The business requesting, or that has been granted, a bilateral contract with HHSC to provide services. 

Exploitation – The illegal or improper act or process of a caretaker, family member, or other individual who has an ongoing relationship with a person with a disability, using the resources of a person with a disability for monetary or personal benefit, profit or gain without the informed consent of the person with a disability.

Family Services – Services provided to the family members of a person with a significant disability, when necessary for improving the person’s ability to live and function more independently or to engage or continue in employment. Such services may include respite care.

Formal Competitive Procurement – A competitive procurement process for contracts with an estimated value of more than $25,000.

Headquarters – The location where an entity stores records and performs administrative responsibilities, as required by a bilateral contract with HHSC. Each entity must have a designated headquarters location.

Housing, Home Modifications and Shelter Services – Services for securing housing or shelter, adaptive housing services, including appropriate accommodations to, and modifications of, any space used to serve or occupied by people with significant disabilities. Note: A Center for Independent Living (CIL) may not provide housing or shelter as an IL service either temporarily or long term.

Independent Living Plan (ILP) – A written plan where the person and service provider have collaboratively identified the services needed to achieve the person’s goal of living independently.

Independent Living Skills Training and Life Skills Training Services – Services that may include instruction in developing independent living skills in personal care, coping, financial management, social skills and household management. These may also include education and training necessary for living in the community and participating in community activities.

Information and Referral Services – Services such as information about available services, as well as referrals to other agencies or resources relevant to independent living.

Legally Authorized Representative – A person who is authorized to sign contracts and official documents for the entity and to otherwise bind the entity.

Liaison – An HHSC staff member assigned to work with the provider to be the first point of contact when questions arise about the Independent Living Services Standards. Liaisons assigned to the provider will routinely monitor the provider to ensure compliance with the Standards.

Mental Restoration Services – Psychiatric restoration services including maintenance on psychotropic medication, psychological services, and treatment management for substance abuse.

Mobility Training Services – A variety of services that involve helping people get around in their homes and communities.

Neglect – The failure of a person or their caretaker to provide the goods or services, including medical services, necessary to avoid physical or emotional harm or pain of the person.

Noncompetitive Procurement Process – A process where competitive procurement process solicitation methods are not required. They typically involve a direct application or enrollment process.

Peer Counseling Services – Counseling, teaching, information-sharing and similar kinds of contact provided to people by others with disabilities.

Person - A person who has requested, applied for or is receiving services identified in these standards. Previously referred to as “Consumer” or “Individual” in older versions of the standards but changed to reflect person-centered language. Any remaining references to “Consumer” are either referring to groups of people, such as consumer satisfaction survey, or consumer was the wording originally used in the Act.

Personal Assistance Services – Services that include:

• help with personal bodily functions; 
• communicative, household, mobility, work, emotional, cognitive, personal and financial affairs; 
• community participation; 
• parenting; 
• leisure; and 
• other related needs. 

Physical Restoration Services – Services including medical services, health maintenance, eyeglasses and visual services.

Preventive Services – Services intended to prevent additional disabilities or to prevent an increase in the severity of an existing disability.

Program Director – The person responsible for HHSC Independent Living Program operations, including oversight and supervision of the review schedule and any changes to be made public, and responsible for approval of changes and change process steps. Manages all staff in the Independent Living Services Program and should be contacted to discuss any issues that cannot be resolved with the supervisors in the Independent Living Services Program.

Prostheses, Orthotics and Other Appliances – Providing or helping a person get an adaptive device or appliance that substitutes for one or more parts of the human body.

Provider – A term used to represent entities, either agencies or individuals, approved to provide services to people with disabilities served by HHSC. Use the term provider may be used interchangeably with the terms service provider or contractor.

Provider Mailbox-A centralized mailbox that the HHSC ILS program sends messages to and receives messages from service providers. The provider mailbox address is IL_Provider_Inquiries@hhsc.state.tx.us.

Recreational Services – Providing or identifying opportunities for people to participate in meaningful leisure time activities. These may include such things as participating in community affairs and other recreation activities that may be competitive, active or quiet.

Rehabilitation Technology Services – Providing or helping people obtain adaptive modifications, such as wheelchairs and lifts, that address the barriers confronted by individuals with significant disabilities, including barriers to education, rehabilitation, employment, transportation, IL or recreation.

Service Authorization – The way HHSC authorizes a contractor to supply goods or services based upon specified terms and conditions. A service authorization is the only valid authorization by which purchases are made. No goods or services can be provided to a person without a service authorization for the specific good(s) or service(s) approved to be provided only for the start date and end date of the specific service authorization. Previously known as a "purchase order (PO)."

Service Provider – A term that represents entities, either agencies or individuals, approved to provide services to people with disabilities served by HHSC. Sometimes interchanged with the terms provider or contractor.

Significant Disability –  a severe physical, mental, cognitive or sensory impairment which substantially limits the  ability to function independently in the family or community or whose ability to obtain, maintain or advance in employment is substantially limited. The delivery of IL services will improve the ability to function, continue functioning, or move toward functioning independently in the family or community or to continue in employment. 

Sub-Contractor – An independent contractor performing services that can be controlled by the employer. See Independent Contractor Defined on the IRS webpage for more information. Anyone who is issued an IRS1099 is considered a sub-contractor.

Therapeutic Treatment – Services provided by registered occupational, physical, recreational, hearing, language or speech therapists.

Training and Technical Assistance Supervisor – A primary role for contribution of content changes, field level feedback and communication of changes in training updates, as required.

Transportation Services – Providing or arranging for transportation.

Youth Transition Services – Any service that develops skills specifically designed for youths with significant disabilities between 14 and 24 years old, to promote self-awareness and esteem, develop advocacy and self-empowerment skills and explore career options, including transitioning from school to such activities as post-secondary education, vocational training, employment, continuing and adult education, adult services, independent living or community participation.

Other Services – Any IL services not listed above.

1.3.1 Professional Standards

Revision 23-1; Effective Nov. 20, 2023  

Service providers must not discriminate because of age, race, color, creed, religion, sex, national origin, disability or veteran's status in the procurement of products or services.

Service providers must develop and maintain written policies to ensure best value purchasing practices based on a balance of quality, timeliness, cost and service after the sale.

Service providers must ensure consumer products and services are provided per the individual plans jointly developed with each person.

Service providers must use appropriate procurement methods per the federal and state laws and regulations.
Service providers must maintain procurement procedures designed to ensure provider performance meets the terms, conditions and specifications of each purchase.

Service providers must offer each person the opportunity to make informed choices regarding the product or service being purchased and the provider who will supply the product or service.

Full consideration of comparable services and benefits available to consumers must be considered by service provider staff and used before HHSC funds can be expended to purchase consumer products and services.
 

1.4 Organizational Structure

The service provider's organizational and administrative structure must contribute effectively to the achievement of its goals.

A provider that is organized as a corporation must have a board of directors that establishes policy on property, funds management and operations. The corporation must maintain articles of incorporation and a certificate of incorporation (a charter) and must provide copies of all relevant documentation to HHSC upon request.

A provider that is organized as a not-for-profit entity must maintain documentation of non-profit status and must provide copies of all relevant documentation to HHSC upon request.

A provider that is organized as a sole proprietorship or partnership must provide copies of all relevant documentation to HHSC upon request. A provider may also be a partnership, limited partnership, limited Texas corporation, professional association, out-of-state corporation, limited liability corporation (LLC), state agency or university, or government agency.

1.5 Contracting with HHSC 

Revision 23-1; Effective Nov. 20, 2023  

HHSC may choose not to contract with an entity because of a history of non-compliance with HHSC or another state agency.

HHSC will not award a contract to entities that are debarred or excluded by the state of Texas from doing business with the state.

HHSC will not award a contract to entities listed on any of the following:

• HHS Office of Inspector General Exclusion Program website;
• System for Award Management website;
• Texas Comptroller of Public Accounts Debarred Vendor List; or
• HHSC Debarment and Suspension Log.

The contractor, contractor's employees, representatives, agents, and any sub-contractors serve as independent contractors with respect to HHSC in providing services under a contract. As such, the contractor's employees are not employees of HHSC, are not eligible for HHSC employee benefits and shall not represent themselves as HHSC employees.

The contractor is responsible for providing all legally required unemployment and workers' compensation insurance for the contractor's employees. The contractor accepts liability and retains responsibility for the performance of sub-contractors providing services under the terms of the contract. Sub-contractors providing services under the contract shall meet the same requirements and level of experience as required of the contractor. No sub-contract under the contract will relieve the contractor of the responsibility of ensuring the requested services are provided. The contractor accepts responsibility for compensating any party with whom they enter a sub-contract relationship. If the contractor uses a sub-contractor for any or all the work required, the following conditions will apply:

• HHSC must provide permission in writing for the use of a sub-contractor;
• Form 3455, Provider Staff Information, must indicate the person is an approved sub-contractor by attaching the written approval granted by HHSC; 
• contractors planning to subcontract all or a portion of the work to be performed shall identify the proposed sub-contractor;
• subcontracting shall be conducted solely at the contractor's expense;
• HHSC retains the right to check a sub-contractor's background and approve or reject the use of submitted sub-contractor;
• the contractor is the sole contact for HHSC; and
• the contractor lists a designated point of contact for all HHSC inquiries.

Each service provider's contract(s) includes terms and conditions. Many HHSC contracts will offer the opportunity for renewals. Awarded contracts will describe the services and counties where the provider has been approved to provide contracted goods or services. HHSC can terminate a contract for cause at any time. To view specific terms and conditions, providers should refer to their contract(s).

1.5.1 Data Use Agreement (DUA)

Revision 23-1; Effective Nov. 20, 2023  

All contracts include a requirement that the contractor and any sub-contractors who access, create, or maintain confidential information must execute a Data Use Agreement (DUA). Find a copy of the DUA here.  

1.5.2 Service Provider Orientation

Revision 23-1; Effective Nov. 20, 2023  

HHSC requires all newly enrolled providers to attend a service provider orientation session as a condition of their contract.

Upon completion of the orientation session, each provider is provided with a copy of their contract, signed by both the provider and HHSC.

HHSC will not initiate contracted services until the provider completes the service provider orientation.

Service providers are responsible for keeping all forms on file with HHSC up to date. HHSC may require service providers to update forms to ensure current information is on file.

The liaison can provide a list of the forms that must be updated.

1.6 Renewals

Revision 23-1; Effective Nov. 20, 2023  

HHSC decides if renewing a contract is in the best interest of people receiving services and HHSC.
The renewal decision is based on an evaluation of the:

• contractor's past and current performance;
• contractor's past and current compliance with the terms of the contract;
• contractor's past and current compliance with the Independent Living Base/Operational Grant Standards for Service Providers; 
• contractor's past and current provision of goods or services;
• need for the service or good based on changes in state or federal laws, rules or regulations;
• availability of funds to support the use of the contract; and
• availability of other providers providing the same or similar goods or services.

Service providers may not begin providing services or request funds until a contract has been signed by both parties and a notice to proceed has been issued by HHSC.

1.7 Amendments

Revision 23-1; Effective Nov. 20, 2023  

Any changes, deletions, extensions or amendments to a contract must be made in writing and signed by both parties, except for unilateral amendments issued by HHSC. A unilateral amendment may be provided in writing from the HHSC contract manager to the contractor under the following circumstances, including, but not limited to:

• correct an obvious clerical error in the contract;
• incorporate new or revised federal or state laws, regulations, rules or policies;
• change the name of the contractor to reflect the contractor’s name, as recorded by the Texas Secretary of State; or
• amend the contract name and address.

Amendments may be made if HHSC approves a change to the Independent Living Base/Operational Grant Standards for Service Providers (ILBOGS) that apply only to providers meeting an identified need for a group of consumers that will not benefit from the services as currently described in the ILBOGS. When this occurs, the amendment outlines the scope, definitions, staff qualifications, deliverables or fees, as applicable, to which the contractor must adhere. The authorized representative of each party included in the amendment must sign the amendment.

1.8 Adherence to Standards

Revision 23-1; Effective Nov. 20, 2023  

Contractors must comply with all ILS standards. Each contractor is required to be compliant with the most recent content in the Independent Living Base/Operational Grant Standards for Service Providers (ILBOGS).  It is suggested that the contractor visit the ILBOGS website every 30 days to review any changes.

Revisions to the ILBOGS are made periodically.

Failure to follow applicable standards and contract requirements may have adverse consequences for the provider, such as denial of payments, recoupment of payments, suspension of service provisions to HHSC consumers, or loss of an awarded contract.

1.9 Contractors Standards of Conduct

Revision 23-1; Effective Nov. 20, 2023  

Contractors must maintain and implement written standards of conduct for the contractor's staff members. The Independent Living Base/Operational Grant Standards for Service Providers must incorporate all professional standards of conduct and ethics required by the licensing or credentialing entity for positions held by the contractor's staff.

1.9.1 Professionalism

Revision 23-1; Effective Nov. 20, 2023  

Contractors are expected to always perform contractual services in a professional manner to include:

• interaction with HHSC consumers and staff in a professional, courteous, respectful and timely manner;
• appropriate dress which is generally business casual attire, when providing services;
• maintaining the confidentiality of all consumer information in full compliance with state and federal regulations per the sound professional practices;
• obtaining a confidentiality release for any person attending the meeting with the consumer who is not the person’s legal guardian;
• accepting liability for the actions or contract performance of all people, sub-contractors, and other personnel who may be working for the contractor; and
• not performing acts which are or could be perceived as being inappropriate behavior with any person or person’s  family member, including, but not limited to:
  • abuse of any person or person’s family member;
  • negative impacts to the health, safety or welfare of any person or person’s family member;
  • relationships with people or HHSC staff that would impair the contractor's objectivity in performing their duties or that would endanger confidentiality;
  • allowing the presence of any third party when meeting with the person at their home or business unless that third party is an attendant to the contractor; or
  • contacting the liaison for verification of confidentiality releases when other parties are present.

1.9.2 Conflict of Interest

Revision 23-1; Effective Nov. 20, 2023  

Contractors and potential contractors may not offer, give or agree to give HHSC staff anything of value. This includes, but is not limited to, prepared foods, gift baskets, promotional items, gift cards or meals. If a violation occurs, corrective action may be required, up to and including contract termination or disqualification from receiving a future contract.

Real or apparent conflicts of interest may occur when a former employee of HHSC becomes an employee or a contractor of an entity that has a bilateral contract with HHSC.

Each contract must have a Conflict of Interest Certification  on file.

1.10 Insurance Coverage

Revision 23-1; Effective Nov. 20, 2023  

1.10.1 General or Business Liability

Revision 23-1; Effective Nov. 20, 2023  

The contractor must have general or business liability insurance coverage that protects people, employees and visitors when the contractor conducts business in a building it owns, leases or uses in kind while providing services to HHSC consumers. The contractor is required to keep a current and accurate insurance form or its equivalent on file with HHSC. For HHSC to recoup its losses in the event of a liability claim, each service provider must maintain liability coverage of at least the total amount of all its contracts with HHSC. 

1.10.2 Professional Liability

Revision 23-1; Effective Nov. 20, 2023  

It is highly recommended that the contractor have professional liability insurance, also called professional indemnity insurance or errors and omissions insurance. Professional liability insurance protects service-providing people and companies from negligence claims made by a client and damages awarded in such a civil lawsuit. The contractor should keep a current and accurate insurance form or its equivalent on file with HHSC if this type of insurance is in place. 

1.10.3 Motor Vehicle Insurance

Revision 23-1; Effective Nov. 20, 2023  

Contractors are not required to transport consumers. Contractors electing to transport people in motorized vehicles must meet the minimum liability requirements set forth by the Texas Department of Insurance. Contractors must maintain records of any staff who have transported or may transport people in vehicles. These records must provide evidence of a valid driver license, personal injury protection (PIP) and auto liability insurance coverage.

1.10.4 Workers' Compensation

Revision 23-1; Effective Nov. 20, 2023  

The contractor must keep records showing evidence of compliance with current workers' compensation law.

1.11 Safe and Secure Environments

Revision 23-1; Effective Nov. 20, 2023  

Contractors must support a safe and secure environment for their employees, HHSC consumers and visitors. The contractor must record all incidents per the entity's policies and procedures.

An incident is defined as an unusual or unexpected event that may compromise the health or safety of people or the security of property. The contractor is responsible for reporting any incident that involves a person served by the Independent Living Services program, a contractor's staff, including sub-contractors and the public. Examples of incidents include, but are not limited to:

• violence, including domestic violence situations where the abuser seeks out the victim;
• an automobile accident;
• physical or sexual assault;
• serious medical emergency, death or suicide;
• threat of harm to self or others;
• breach of confidential information;
• theft or loss or mischievous or malicious destruction of property on loan from, or purchased by, HHSC;
• theft, loss, or mischievous or malicious destruction of property or other negative behaviors displayed by HHSC consumers;
• fire or a hazardous materials event;
• a service interruption that is due to an emergency or disaster;
• suspected consumer substance abuse or other behaviors which could substantially impede a person’s ability to complete independent living goals;
• threats by personal contact, letter, phone or email; and
• abuse, neglect or exportation of a person with a disability.

Report all incidents within one business day to the HHSC provider mailbox, IL_provider_inquiries@hhsc.state.tx.us. 

HHSC has a system to ensure employees do report incidents, as required by Texas Health and Human Services (HHS) policies.

1.12 Physical Locations

Revision 23-1; Effective Nov. 20, 2023  

All service providers must maintain a physical location for serving people, whether through owning, leasing, or using dedicated space. The providers must notify, within one business day when moving to a new location, adding another location, or emergency closures of the current location.

1.12.1 Occupation Permit or Building Permit

Revision 23-1; Effective Nov. 20, 2023  

Environmental safety must comply with local building occupancy codes. Providers must provide documentation of compliance to HHSC at application and to the liaison whenever the physical location changes. Renters should contact their landlords to obtain such documentation.

1.12.2 Fire Safety

Revision 23-1; Effective Nov. 20, 2023  

Each provider must:

• comply with the local fire code to gain a fire inspection report, or gain an inspection by the fire marshal with local jurisdiction; and
• provide a copy of the appropriate certificate of compliance at application and to the HHSC liaison when updated.

Providers who rent must contact their landlords for appropriate documentation.

Most fire departments conduct inspections but need advance notice to schedule an inspection. If the contractor's local fire department does not conduct inspections, the contractor may request an inspection from the Texas Department of Insurance, State Fire Marshal's Inspection Services Division, in writing at 333 Guadalupe, Austin, Texas 78701, or by phone at 512-305-7900.

In each physical location where services are provided, the provider must have:

•  working smoke detectors;
• visible (flashing) and audible fire warning signals;
• fire extinguishers that are in date with annual inspections placed in accessible locations; and
• identified accessible fire escape routes free and clear of obstructions.

Each entity must have a policy that requires all fires to be reported to the HHSC liaison within one workday.

1.12.3 General Building Safety

Revision 23-1; Effective Nov. 20, 2023  

Aisles and work safety zones must be accessible.

Hazardous or flammable materials must be appropriately identified, used and stored in a safe manner. These materials should be stored in a secured metal cabinet.

Machinery with moving parts must be equipped with appropriate protective guarding and instructions for safety.

1.12.4 Accessibility

Revision 23-1; Effective Nov. 20, 2023  

Each facility and the entity headquarters must maintain a paper copy of the completed ADA Checklist for Existing Facilities. HHSC staff may inspect the physical location for accuracy of responses provided on the ADA Checklist for Existing Facilities, and for compliance with meeting a person’s needs related to accessibility. HHSC may also request access to the completed checklist at any time, such as at liaison visits and monitoring reviews.

If an item or location on the checklist is found not to be accessible, describe how the physical location will ensure services are provided to HHSC consumers that will be using the area(s) found not accessible.

1.12.5 Safety Plan

Revision 23-1; Effective Nov. 20, 2023  

Each provider must have a safety plan for each physical location that ensures the safety and health of staff, people, and the visiting public. The plan must include:

• quarterly fire drills;
• emergency evacuation procedures;
• emergency exit diagrams;
• procedures for obtaining emergency medical services from a doctor, hospital or emergency medical service unit; and
• special procedures for people with disabilities who require particular attention or action, including those whose behavior may be detrimental to the health, safety or require assistance from others to successfully engage in services.

Each provider must have an incident reporting system in place. A form for staff reporting of incidents must be developed.

The minimum information required on the incident report form must include:

• date, time, and place of the incident;
• nature of the incident;
• names of HHSC consumers, witnesses or others involved;
• name of the person making the report;
• description of the incident; and
• actions taken and planned by the provider because of the incident.

Upon request, copies of incident reports pertinent to HHSC consumers must be made available to HHSC staff members.

The following incidents must be reported to the referring HHSC liaison and program manager by close of business the next working day:

• emergency evacuations;
• emergency medical services (EMS);
• emergency room treatment;
• hospitalization; or
• death.

1.13 Allegations or Incidents of Abuse, Exploitation or Neglect of People with Disabilities

Revision 23-1; Effective Nov. 20, 2023  

Texas law requires that allegations or incidents of abuse, exploitation or neglect of persons with disabilities be immediately reported to the appropriate investigatory agency (see the table below) or, if taking place in a location other than a residential setting, the local law enforcement agency. If a licensed professional is involved, report to the appropriate professional licensure agency and the local law enforcement agency.

The provider must develop policies and procedures regarding the recognition and appropriate reporting of such allegations or incidents. These procedures must also require notification to the appropriate HHSC program manager and the liaison within one workday if an HHSC consumer is involved in an allegation of abuse, exploitation or neglect. Procedures must also ensure cooperation with investigations conducted by HHSC.

The appropriate investigating agency's toll-free number and the HHSC liaison's office number must be posted in a location that is readily accessible to consumers and the staff.

1.14 Confidentially Consumer and Employee Information

Revision 23-1; Effective Nov. 20, 2023  

All staff members of the contractor must maintain confidentiality of personal and employee information. The contractor must have policy and procedures that address access to confidential records. The contractor must provide physical safeguards for confidential records and ensure that confidential records are available only to authorized staff members. Case records must be stored in a secured location where there is maximum protection against fire, water damage, theft and other hazards.

1.14.1 Data Encryption

Revision 23-1; Effective Nov. 20, 2023  

HHSC policy and federal law mandates all emails containing personal or agency confidential information must be sent under encryption. Contractors must send confidential information in a secure manner when emailing information to HHSC employees or to any other person.

HHSC requires FIPS 140-2 level of encryption. If a contractor does not have this level of data encryption, the provider asks HHSC staff to send an encrypted email related to the person or to the contractor's email address. This email can be used to send encrypted information back to HHSC if the directions are followed accurately.

1.15 Records

Revision 23-1; Effective Nov. 20, 2023  

Upon request, the contractor must make available to HHSC any documents, papers, and records that are directly pertinent to the goods or services being provided to HHSC consumers.

Examples include, but are not limited to:

• invoices;
• service authorizations;
• service reports;
• company financials;
• insurance certificates;
• staff information sheets; and
• any documentation required under the:
  • entity's contract; and
  • HHSC Standard Procurement Terms and Conditions and/or Independent Living Base/Operational Grant Standards for Service Providers.

1.15.1 Record Storage

Revision 23-1; Effective Nov. 20, 2023  

All original records must be maintained in:

•    original format
•    a secure location
•    climate-controlled conditions 

If records are maintained on company or personal server(s) or computer(s), these records must be protected in a secure manner.

1.15.2 Record Retention

Revision 23-1; Effective Nov. 20, 2023  

All records must be maintained in their original format for seven years from the date of submission of the final bill or until all billing-related questions are resolved, whichever is later. Local servers and personal computers may be used to complete records and to store copies of records. All local servers and personal computers must maintain a level of security that ensures records are maintained in a safe and confidential manner, as defined in the Information Security and Privacy Initial Inquiry (SPI).

1.16 Consumer Orientation

Revision 23-1; Effective Nov. 20, 2023  

Any person referred to a provider must receive orientation and materials, such as handouts or manuals, addressing the following:

• information on services;
• appropriate rules and regulations;
• consumer responsibilities;
• safety information;
• HHSC service number;
• Client Assistance Program, and
• additional services for veterans.

1.17 HHSC Office of the Ombudsman

Revision 23-1; Effective Nov. 20, 2023  

Each facility-based provider must post the HHSC Office of the Ombudsman toll-free phone number, 877-787-8999, specifying that the number is for HHSC applicant and consumer use, or Relay Texas, 7-1-1 or 800-735-2989, for people with a hearing or speech disability.

1.18 Client Assistance Program

Revision 23-1; Effective Nov. 20, 2023  

The Client Assistance Program (CAP) is federally funded and mandated under the Act to provide information, help and advocacy for people with disabilities seeking or receiving services from programs, including the Independent Living Services Program. CAP services can include:

• informing the person of his or her rights;
• providing information about services and benefits of the program;
• advocating for people in their relationship with the program;
• assisting the person in understanding and using the appeals process;
• helping the person and systemic advocacy for the program, which may include policy issues and changes; and
• resolving issues at the lowest level possible.

CAP is implemented by Disability Rights Texas (DRTx), a legal services organization whose mission is to protect the human, service and legal rights of people with disabilities in Texas.

DRTx advocates are not employees of any state agency. There are no fees for CAP services, which are provided by advocates and attorneys when necessary.

Services are confidential. Service providers must use accessible formats to notify people with disabilities who are prospective or current consumers about:

• the availability of CAP;
• the purposes of the services provided under CAP; and
• how to contact CAP.

Service providers should notify a person of CAP upon application, during the development of the independent living plan, and at any time services are reduced, suspended or terminated.

A person or their representative may file a complaint with DRTx alleging that a requirement of independent living services was violated. The complaint need not be filed with the service provider.

A complaint may be filed by:

• phone: 800-252-9108; or
• videophone: 866-362-2851.

More information about the complaint process is available by calling DRTx at 800-252-9108 or videophone at 866-362-2851.

1.19 Veterans Services

Revision 23-1; Effective Nov. 20, 2023 

Each provider must include the following statement created by HHSC, based on Texas Senate Bill 1677, in the consumer orientation process:

Men and women who serve or have ever served in any branch of the United States Armed Forces, including Army, Navy, Marines, Air Force, Coast Guard, Reserves or National Guard may be eligible for additional services. For more information, visit www.tvc.texas.gov, the Texas Veterans Portal, or call TexVets at 800-252-8387.

1.20 Noncompliance and Performance Deficiencies

Revision 23-1; Effective Nov. 20, 2023  

HHSC may temporarily suspend a contract provider from providing services for reasons such as:

• suspected fraud;
• suspected abuse; and
• failure to perform services according to the specifications and terms of the contract.

The contractor is required to return to compliance before providing further services.

HHSC may take further adverse actions in conjunction with, or instead of, requesting a corrective action plan. In serious noncompliance situations, HHSC may terminate a contract or debar a provider from future HHSC service contracts without allowing the provider to take corrective action.

1.21 Provider Policy and Procedures

Revision 23-1; Effective Nov. 20, 2023  

To protect consumers and consumer interests, the contractor must develop and adhere to the following policies and procedures about:

• access to confidential records;
• fraud, waste and abuse;
• availability and purpose of the Client Assistance Program;
• allegations or incidents of abuse, exploitation or neglect of persons with disabilities;
• posting of the HHSC toll-free phone number, 800-628-5115, specifying it is for HHSC applicant and consumer use; and
• reporting of observations or evidence of a person's use of alcohol or drugs.

The contractor must develop a written implementation plan within their organization to educate staff and people served by the contractor.

1.22 Provider's Evaluation of Service Provision

Revision 23-1; Effective Nov. 20, 2023  

Each provider must have an ongoing self-evaluation system designed to assess the person’s satisfaction and effectiveness of services provided to HHSC consumers. The system should measure outcomes against pre-established goals. HHSC may ask for proof and the results of the evaluations. Due to the variety of services provided, the method of evaluation is left to the discretion of the provider but must, at a minimum, include the following sections.

1.22.1 Goals and Service Objectives

Revision 23-1; Effective Nov. 20, 2023  

Entity goals are desired results of the program, and what the provider plans to accomplish. The service objectives are the entity's measurable objectives that define the entity's plans to accomplish stated goals.

1.22.2 Outcomes and Results

Revision 23-1; Effective Nov. 20, 2023  

Outcomes mean how the provider achieves each service objective, including the criteria that they measure the actual performance. Measures are stated in general terms, and they explain how to achieve results. Include outcomes and results in a report format.

1.22.3 Consumer Satisfaction

Revision 23-1; Effective Nov. 20, 2023  

Consumer satisfaction measures input from people about benefits received from provider services.

Each provider may develop its own survey instrument and procedure. However, at a minimum, the survey instrument must use a Likert scale and include the following statements:

• I was treated in a friendly, caring and respectful manner by the staff of [insert provider name].
• Services were provided in a timely manner.
• The services met my needs.
• I was satisfied with the services provided.

Likert Scale

Give all people the chance to respond to the survey at least annually and at closure.

The provider must calculate an average consumer rating on the Likert scale for each of the four required statements.

1.22.4 Quarterly and Annual Reports of Evaluation Data

Revision 23-1; Effective Nov. 20, 2023  

Entities must tally collected data quarterly (September – November, December – February, March – May, June – August) and summarize a final report. When data indicates improvements are necessary to enhance the entity's performance and consumer satisfaction, an action plan must be created and monitored until improvement is made to a successful level measured by goals in the action plan.

1.23 Monitoring

Revision 23-1; Effective Nov. 20, 2023  

The contractor agrees to permit on-site monitoring visits and desk reviews, as deemed necessary by HHSC. This is to review all financial or other records and management control systems relevant to the provision of goods and services under this contract.

1.23.1 Ongoing Monitoring

Revision 23-1; Effective Nov. 20, 2023  

HHSC staff members, including the program manager, compliance staff and contract manager, continuously monitor services provided to HHSC consumers. Monitoring may include ongoing dialogue, onsite visits and reviews of case files.

1.23.2 Compliance Monitoring

Revision 23-1; Effective Nov. 20, 2023  

All contractors are subject to periodic program schedule and financial compliance monitoring by HHSC staff members. Risk assessment tools are used at the state and regional level each fiscal year to identify HHSC contractors who will be monitored on site or as a desk review during a 12-month period. As HHSC determines the need, contractors not identified on the risk assessment may also be monitored.

1.23.3 Unscheduled Compliance Monitoring

Revision 23-1; Effective Nov. 20, 2023  

HHSC staff members may conduct a special unscheduled compliance monitoring review upon request, if HHSC management determines such a review is necessary.

1.23.4 Monitoring Team

Revision 23-1; Effective Nov. 20, 2023  

A monitoring team consists of representatives from HHSC staff. When a contractor is selected for an announced monitoring review, the lead monitor sends a letter announcing the review and provides information about the scope of the review and instructions on how to prepare for the review.

1.23.5 Monitoring Review

Revision 23-1; Effective Nov. 20, 2023  

The monitoring review typically consists of three parts:

• entrance conference;
• records review; and
• exit conference.

At the entrance conference, the lead monitor:

• introduces the monitoring team members;
• briefly explains the monitoring process, purpose and scope of the review;
• requests that the contractor assign a person to be accessible for, and work with, the team; and
• ensures the team has an acceptable work area to use while conducting the review, if conducted at the contractor's facility.

During the records review, the monitoring team:

• completes appropriate monitoring tools;
• reviews the contractor's files;
• compares information in the contractor's files with information in the HHSC files; and
• may conduct interviews or observations.

The exit conference is held at the conclusion of the review. At the exit conference, the lead monitor verbally provides the contractor with:

• preliminary review results;
• any anticipated recoupment amount;
• notice that HHSC will send the contractor a findings report, if applicable; and
• information on the time frames and process for the contractor's response and the importance of meeting deadlines.

1.23.6 Report of the Monitoring Results

Revision 23-1; Effective Nov. 20, 2023  

For routine monitoring reviews, the lead monitor sends the contractor written notice of the results of the monitoring review through either a monitoring review closeout letter or a findings report, if instances of noncompliance were noted.

The findings report:

• includes findings of noncompliance with program or financial standards; and
• asks the contractor to either:
  • offer a corrective action plan; or
  • provide more documentation to help resolve the findings.

1.23.7 Corrective Action Plan

Revision 23-1; Effective Nov. 20, 2023  

If HHSC has requested the contractor submit a corrective action plan, the contractor must, by the date requested in the report of findings:

• submit a corrective action plan, including financial restitution, if required; or
• rebut a finding and submit documentation that substantiates the rebuttal.

HHSC reviews the corrective action plan and may accept the corrective action plan or recommend changes.

If the contractor does not submit an acceptable corrective action plan or make financial restitution when required, HHSC may take adverse action against the contractor, including contract termination.

1.23.8 Monitoring Closeout

Revision 23-1; Effective Nov. 20, 2023  

If there are no findings, or when the monitoring team accepts the corrective action plan, HHSC sends the contractor a letter to close the monitoring review.

1.23.9 Contract Noncompliance and Performance Deficiencies

Revision 23-1; Effective Nov. 20, 2023  

HHSC may temporarily suspend a contractor from providing services for reasons such as:

• suspected fraud;
• suspected abuse;
• failure to meet contract specifications; or
• failure to perform per the terms and conditions of the contract.

Depending on the type and severity of the noncompliance, HHSC may require the contractor to take corrective action to return to compliance, before the contractor is allowed to resume providing services.

HHSC may impose adverse actions along with, or instead of, requesting a corrective action plan. For example, HHSC may recoup overpayments from a contractor as part of a corrective action plan. Some situations may require HHSC impose more serious adverse action, such as contract termination and debarment, without allowing the contractor to take corrective action.

Revision 23-1; Effective Nov. 20, 2023 

2.1 Overview

Revision 23-1; Effective Nov. 20, 2023 

The U.S. Health and Human Services Administration for Community Living (ACL) requires HHSC to develop and implement standards for Centers for Independent Living (CILs). This is to ensure compliance with Title VII of the Rehabilitation Act of 1973, as amended. The Independent Living Base/Operational Grant Standards for Service Providers (ILBOGS) is based on:

• Section 725 of the Rehabilitation Act of 1973, as amended (the Act);
• 45 Code of Federal Regulations (CFR) Part 1329; and
• 45 CFR Part 75.

A CIL that receives funds from HHSC must meet the standards in applicable state and federal regulations, as well as those described in this chapter and in the following sections of Chapter 1, Basic Standards for Centers for Independent Living (CILs), of the ILBOGS:

• 1.1, Overview;
• 1.11, Safe and Secure Environments;
• 1.13, Allegations or Incidents of Abuse, Exploitation or Neglect of People with Disabilities;
• 1.17, HHSC Office of the Ombudsman; and
• 1.23, Monitoring.

A CIL must promote and practice an independent living philosophy including commitment to consumer control of the CIL, and:

• decision-making;
• service delivery;
• management;
• establishment of the policy and direction of the CIL;
• self-help and self-advocacy — for example, by train people with significant disabilities in self-advocacy;
• peer relationships and peer role models — for example, have people with significant disabilities who have achieved independent living goals as instructors in its training programs or as peer counselors; and
• equal access for people with significant disabilities to all public or private services, programs, activities, resources and facilities.

2.1.2 Guiding Principles

Revision 23-1; Effective Nov. 20, 2023 

A CIL is a consumer-controlled, community-based, cross-disability and nonresidential private nonprofit organization. It is designed and operated in the local community by people with disabilities and provides an array of IL services.

A CIL must have written documentation that its board is the CIL's principal governing body and has a majority of members who have significant disabilities.

2.1.3 Access to Community Services

Revision 23-1; Effective Nov. 20, 2023 

Each CIL has written documentation that they promote increased availability and improved quality of community-based programs that serve people with significant disabilities, and removal of any existing barrier that prevents the full integration of these people into society. Existing barriers may include architectural, attitudinal, communication or environmental.

This documentation must demonstrate that the CIL performed at least one activity in each of the following categories:

• community advocacy;
• technical help for the community on making services, programs, activities, resources and facilities in society accessible to people with significant disabilities;
• public information and education;
• strong outreach to members of populations of people with significant disabilities that are unserved or underserved by programs under Title VII of the Act in the CIL's service area; and
• collaboration with service providers, other agencies and organizations to help improve the options available for people with significant disabilities to take advantage of the services, programs, activities, resources and facilities in the CIL's service area.

2.1.4 Coordination with State IL Council (SILC)

Revision 23-1; Effective Nov. 20, 2023 

Each CIL must submit to the State Independent Living Council (SILC) a copy of its Annual Performance Report for the State Independent Living Services Program (Administration for Community Living Program Performance Report). See Chapter 4, Reporting. The SILC uses this information for reports including to the Texas Legislature, and to monitor information in the State Plan for Independent Living (SPIL).

2.2 Board of Directors

Revision 19-0; Effective March 1, 2019 

The CIL must be chartered by the state of Texas as a nonprofit organization and must have a board of directors.

2.2.1 Board Responsibilities

Revision 19-0; Effective March 1, 2019 

The board must:

• ensure that the CIL maintains the organization's focus on its mission and purpose;
• hire the executive director;
• outline the responsibilities of each position and each member in the board's organization;
• either as a whole or by means of the CIL's finance committee, regularly review actual revenue and expenditures and compare them with budgeted revenue and estimated costs;
• meet at least quarterly;
• review and approve programs and budgets;
• periodically review policies and procedures for the organization's operation; and
• review and approve changes and revisions to policies and procedures before implementation.

2.2.2 Board Orientation and Training

Revision 19-0; Effective March 1, 2019 

Each board member must receive training that covers board responsibilities and applicable CIL policies, to be provided within 90 days of his or her board appointment.

2.2.3 Board Minutes

Revision 19-0; Effective March 1, 2019 

Board meeting minutes must include, at a minimum, the following:

• meeting date and location;
• names of all attendees and visitors;
• agenda;
• progress made on grant work plan goals and objectives;
• all items voted upon;
• results of votes; and
• date the board approved the minutes.

2.2.4 Insurance or Bonding

Revision 19-0; Effective March 1, 2019 

The CIL must observe sound business practices in securing bonding and insurance to provide adequate coverage for HHSC-funded projects.

Board members and staff members must be insured or bonded when required:

• by the organization's bylaws;
• by law or regulations;
• as a condition of the grant award; and
• to protect HHSC's grant interests.

2.3 CIL Organization

Revision 23-1; Effective Nov. 20, 2023 

2.3.1 Organizational Policies

Revision 23-1; Effective Nov. 20, 2023 

A CIL must develop and follow policies and procedures that comply with:

• 45 CFR;
• The Rehabilitation Act of 1973, as amended; and
• Independent Living Base/Operation Grant Standards for Service Providers.

The CIL board must ensure that organizational policies and procedures include:

• personnel policies which CIL management and staff members follow;
• financial management and procurement standards; and
• program service guidelines that comply with federal and state requirements.

Organizational policies and procedures must be:

• written;
• periodically reviewed by the board; and
• published and distributed or made available to all board and staff members.

Any changes or revisions must have board approval before becoming effective.

2.3.2 Organizational Budget

Revision 23-1; Effective Nov. 20, 2023 

The CIL organizational budget:

• reflects monetarily, the organizational goals and objectives for the coming year;
• provides an opportunity to review the prior year's actual expenditures against the initial budget; and
• allows assessment of differences to determine if they are likely to recur in the coming year and should be reflected in the new budget.

The CIL must maintain an organizational budget that:

• is prepared at least annually;
• is approved by the board;
• identifies all anticipated funding sources; and
• identifies planned use of all financial resources.

2.4 CIL Grant Information

Revision 23-1; Effective Nov. 20, 2023 

2.4.1 CIL Responsibilities

Revision 23-1; Effective Nov. 20, 2023 

The CIL must:

• accept full legal responsibility for the program, including fulfilling grant requirements;
• direct all program and administrative aspects through effective and sound management practices and policies; and
• provide fiscal and program management of the grant.

2.4.2 Grant Work Plan

Revision 23-1; Effective Nov. 20, 2023 

The CIL prepares a grant work plan with goals, objectives, activities, and measurable outputs and outcomes and has the responsibility to fulfill the plan. The plan must be consistent with the State Plan for Independent Living (SPIL) at the time the grant application is prepared. If a new SPIL becomes effective after the grant application is prepared and requires changes to the work plan, the CIL must consult the Grant Award and Contract section to see if a contract amendment is required. See 2.4.4, Grant Award and Contract. Addition of new counties to a CIL’s service area or changes to the scope of work would also require a new work plan.

2.4.3 Grant Budget

Revision 23-1; Effective Nov. 20, 2023 

A budget must be prepared for each year of the grant period. The grant budget reflects anticipated costs related to the goals, objectives, activities and outcomes outlined in the grant work plan. Costs are budgeted under seven cost categories, described later in this section.

2.4.4 Grant Award and Contract

Revision 23-1; Effective Nov. 20, 2023 

After approving the application, HHSC develops a bilateral contract. The basis of the agreement between HHSC and the CIL include:

• the approved application;
• the contract; and
• any amendments and updates to the application and the contract.

Any commitment or expenditure of grant funds must be based on the approved application and signed contract, as well as on amendments and updates to the contract and application.

An amendment to the contract is required when a substantial change to the contract or work plan is made.

Changes to goals or objectives in the work plan require an amendment. Major changes to activities such as deleting an activity, adding a new activity or substantially altering an activity, may require an amendment. The CIL should consult with the contract manager when making such changes.

CILs are reimbursed for allowable budgeted expenses incurred and paid while providing services consistent with the terms of the contract.

2.4.5 Special Grant Conditions

Revision 23-1; Effective Nov. 20, 2023 

A CIL may be considered higher risk if HHSC determines that the CIL:

• demonstrates poor performance in the conduct of grant requirements;
• is not financially stable; or
• does not comply with:
  • Independent Living Base/Operational Grant Standards for Service Providers; 
  • provisions of the grant application;
  • the contract; or
  • applicable state and federal rules, regulations or laws.

Based on these factors that indicate higher risk, the HHSC grant may include special conditions or restrictions, such as:

• more approvals of grant decisions;
• required training or technical help;
• payment on a reimbursement basis instead of cash advances;
• more frequent financial or program performance reports; and
• increased grant or project monitoring.
   

2.5 Financial Management

Revision 23-1; Effective Nov. 20, 2023 

All CILs must comply with applicable Office of Management and Budget (OMB) and Generally  Accepted Accounting Principles (GAAP) fiscal and accounting requirements. CILs must adopt those fiscal control and fund accounting procedures, as necessary, to ensure proper disbursement of, and accounting for, CIL funds.

The CIL maintains a sound fiscal management system that:

• discloses financial results;
• maintains accurate and complete records of funding sources and uses of all grant funds;
• complies with grant rules and regulations;
• maintains system-generated reports required by the board, executive director and funding agencies;
• evaluates progress toward objectives; and
• has an internal control structure that separates funds, authorizes expenditures, addresses separation of duties, includes adequate checks and balances, records financial transactions and limits access to assets.

The CIL's policies and procedures for financial management should include methods for making payments, accounting for program income, approving budget revisions, determining legitimacy of costs and establishing fund availability.

The CIL must follow all state laws regarding prompt payment to its vendors.

2.5.1 Accounting System

Revision 23-1; Effective Nov. 20, 2023 

2.5.1.1 Financial Information

Revision 23-1; Effective Nov. 20, 2023 

The CIL must maintain an accounting system and records that:

• record revenue and expenditures using generally accepted accounting principles;
• include a chart of accounts that lists all accounts by an assigned number;
• contain a general ledger and subsidiary ledgers;
• identify all funding sources and expenditures by separate fund type; and
• use a double-entry accounting system such as the cash, the accrual or the modified accrual system.

2.5.1.2 Fund Accounting

Revision 23-1; Effective Nov. 20, 2023 

Fund accounting is a system where separate records are maintained for each funding source. When fund accounting is used, the chart of accounts must be carefully structured and must account for each program separately. For example, HHSC reimburses the CIL for specific line-item costs.

The CIL must define circumstances where the chart of accounts may be revised and the frequency of board approval.

2.5.2 Financial Administration Authority

Revision 23-1; Effective Nov. 20, 2023 

CILs must designate people who have financial administration authority to:

• enter into contracts;
• request and expend funds;
• seek and pursue funding sources; and
• administer and manage all fiscal matters on behalf of the CIL.

CIL policy approved by the board must indicate positions and areas of responsibility for financial administration. Positions with financial administration authority may include:

• the CIL board chair, president or a board member with relevant expertise;
• the CIL executive director or chief executive officer; and
• other staff members or contractors with financial responsibilities.

Those given financial administration authority must have sufficient experience in grant expenditures, including:

• keeping financial records;
• preparing financial statements;
• budgeting;
• anticipating financial needs;
• safeguarding and managing financial assets;
• complying with federal and state reporting requirements;
• establishing and monitoring a system of internal controls;
• participating in long-range planning to secure permanent funding for projects that provide services; and
• signing financial documents to certify their accuracy and validity per HHSC reporting requirements and CIL policy approved by the board.

2.5.3 Funds Management

Revision 23-1; Effective Nov. 20, 2023 

2.5.3.1 Request for Payment

Revision 23-1; Effective Nov. 20, 2023 

CIL contracts are classified as cost reimbursement contracts, which means that CILs are reimbursed for allowable incurred costs. The CIL may request operating funds for up to 30 days in advance or to be reimbursed for allowable costs already incurred.

CILs that meet the contract requirements may request advance payments, certifying that the amount requested will not exceed 30 days' operating funds. If advanced funds are not expended during the month of the request, they must be adjusted on the next request.

CILS must complete form 3470, Request for Advance or Reimbursement (RAR), at least every 90 days for the base grant contracts. If the CIL does not meet the requirements of the contract, HHSC may:

If the CIL does not meet the requirements of the contract, HHSC may:

• adjust payments;
• reimburse based on actual costs already incurred;
• require more supporting documentation to make payments; and
• take other action, as appropriate.

2.5.3.2 Recoupment of Funds Paid

Revision 23-1; Effective Nov. 20, 2023 

A contractor must respond promptly in settling claims when HHSC discovers an overpayment. If a contractor discovers an overpayment from HHSC, the contractor should self-report the overpayment to the contract manager immediately and arrange for reimbursement.

2.5.3.3 Payments Due

Revision 23-1; Effective Nov. 20, 2023 

HHSC must pay only for goods and services that meet the requirements in the Independent Living Base/Operational Grant Standards for Service Providers and on the service authorization.

2.5.3.4 Interest Income

Revision 23-1; Effective Nov. 20, 2023 

The CIL must ensure that no more than $500 earned in interest on advance payments is retained for administrative expenses over the grant year.

2.5.3.5 Cash Management

Revision 23-1; Effective Nov. 20, 2023 

CIL cash management policies must address:

• check and cash receipting;
• petty cash funds if used; and
• check processing.

Cash receipts and checks must be deposited promptly and recorded in the accounting system per CIL policies. Also:

• a cash-receipts log must be maintained; and
• checks must be restrictively endorsed.

Petty cash disbursements must be:

• approved;
• adequately safeguarded; and
• properly recorded.

Checks for CIL purchases must be processed by completing an order or request. CIL policy must identify those with authority to approve expenditures and sign checks.

The CIL must maintain proper custody over checks, including voided checks.

2.5.3.6 Bank Reconciliation

Revision 23-1; Effective Nov. 20, 2023 

Bank accounts must be reconciled monthly by someone who does not disburse, receive or record receipt of funds.

Records must include:

• initialed and dated monthly reconciliation;
• bank statement;
• check register;
• canceled and voided checks;
• electronic funds transactions; and
• any other applicable accounting records.

All adjusting entries must be approved by management and promptly recorded by appropriate staff members. Expenditures recorded on the general ledger must be compared to the bank or credit card statements. If any expenditures are not included on the statements due to vendor delays in depositing payment or payment not being submitted by the CIL, the reconciliation must document efforts to resolve the discrepancy.  

2.5.3.7 Disbursements

Revision 23-1; Effective Nov. 20, 2023 

Verify and enter all cash disbursements into the CIL's accounting system.

2.5.4 Other Sources of Funds

Revision 23-1; Effective Nov. 20, 2023 

In the grant application, the CIL provides information about other sources of funds used to support the CIL program, in addition to HHSC grant funds. These other sources of funds may include:

• RSA federal funds and other grant money;
• donated volunteer services and goods; and
• program income.

The CIL must determine the value of donated goods and volunteer services and show them as other sources of funds in the grant application. The value of donated goods must reflect the cost that would be incurred if the CIL purchased the items and was not reimbursed as either a direct or indirect cost. Donated goods and volunteer services must be allowable, reasonable, and necessary to the program to be reported. See 2.6.7, Volunteer Program for guidance on how to value volunteer time.

See 45 CFR Part 75 for more information about funding. 

Program Income

Program income is gross income earned by the CIL that is directly generated by a supported activity of the CIL grant award.

The CIL must ensure that program income is:

• used during the current fiscal year as a deduction from total allowable costs charged to the grant; or
• an addition to the grant funds to be used for other allowable program expenditures; and
• accounted for separately for each fiscal year.

The CIL must maintain policies that:

• document resources used in generating program income;
• ensure that earned and used program income is accounted for separately in the chart of accounts; and
• address the process to carry forward program income.

Records must include:

• sources of program income;
• amount of program income received; and
• quarterly financial reports consistent with accounting records.

2.5.5 Cost Principles and Approval

Revision 23-1; Effective Nov. 20, 2023 

2.5.5.1 Authorization

Revision 23-1; Effective Nov. 20, 2023 

All costs must be reasonable, necessary, allowable and allocable to the contract per 45 CFR Part 75.  Costs allowable under 45 CFR Part 75 are determined to be allowable unless stated otherwise in the ILBOGS or the contract.

If the CIL has questions about a specific cost that is not addressed in 45 CFR Part 75, the CIL should seek technical assistance from the contract manager.

2.5.5.2 Cost Allocation Plan

Revision 23-1; Effective Nov. 20, 2023 

When costs are distributed between multiple programs or cost centers, a CIL must submit a cost allocation plan with the grant application to ensure that all costs are allocated properly. The CIL must pay particular attention to personnel, building costs and equipment. See 45 CFR 75.417 and appendices IV, V and VI for details about cost allocation plans. 

The CIL must:

• get board approval of the cost allocation plan;
• update the cost allocation plan as needed — for example, when new funding sources are obtained;
• document application of the cost allocation plan to shared costs to ensure that the correct share is requested from the HHSC grant; and
• submit the cost allocation plan to the contract manager when the grant application is submitted and when revisions are made.

2.6 Personnel

Revision 23-1; Effective Nov. 20, 2023 

2.6.1 Staff Members with Disabilities

Revision 23-1; Effective Nov. 20, 2023 

The CIL's organizational and personnel assignment practices, as documented in written board policy, must comply with Section 503 of the Rehabilitation Act, including taking affirmative action to employ and promote qualified people with significant disabilities.

A CIL must also document that the most of its staff members, including members in decision-making positions, are people with disabilities.

2.6.2 Staff Qualifications

Revision 23-1; Effective Nov. 20, 2023 

CIL staff members must include specialists in developing and providing IL services and developing and supporting a CIL. To the greatest extent possible, personnel should be available who can communicate:

• with people with significant disabilities who rely on alternative modes of communication, such as manual communication, nonverbal communication devices, braille or audiotapes;
• with people who apply for or receive IL services under Title VII of the Act; and
• in the native languages of people with significant disabilities whose English proficiency is limited and who apply for or receive IL services under Title VII of the Act.

2.6.3 Required Staff Documentation

Revision 23-1; Effective Nov. 20, 2023 

Each provider must have the following documents on file for all personnel who provide services directly to HHSC consumers, including the director:

• Form 3455, Provider Staff Information;
• supporting evidence of qualifications and experience, such as:
  • professional credentials;
  • copies of college transcripts;
  • certificates of specialized training;
  • statements from former employers or other documentation;
• completed I-9, U.S. Department of Justice Employment Eligibility Verification Form, as applicable and see the U.S. Citizenship and Immigration services website for more information; and
• signed IRS W-4 form.

2.6.4 Staff Information Form 3455

Revision 23-1; Effective Nov. 20, 2023 

Form 3455 must be updated and submitted to HHSC within 30 days after any of the following:

• hiring staff;
• a significant change in a staff member's job duties or time spent on the grant;
• a change in staff qualifications; or
• termination of a staff member.

The service provider is responsible for ensuring all staff maintain qualifications and sign this form verifying the staff member's qualifications, as documented in the Independent Living Base/Operational Grant Standards for Service Providers. Staff qualifications are listed within the chapter where the service is defined.

Form 3455 must be submitted both to the HHSC contract manager and the contract manager who manages the provider's contract.
 

2.6.5 Temporary Waiver of Director and Staff Services Credentials

Revision 23-1; Effective Nov. 20, 2023 

When a service provider loses a credentialed staff member, a temporary exception to use a non-credentialed staff member to act as director or to provide contracted services may be approved. The waiver is specific to the provider and staff member named in the Temporary Waiver of Credentials. The Temporary Waiver of Credentials is submitted by sending an email to the provider mailbox with the following information:

• position that the temporary waiver is being requested to fill;
• name of the person to temporarily fill the position;
• resume and verification of any credentials of the person who will temporarily fill the position; and
• anticipated length of time the waiver will be required.

The Temporary Waiver of Credentials is allowed only when:

• a provider's director leaves the entity;
• there are no other qualified credentialed staff available to provide the service;
• it is necessary to avoid a break in essential services being provided by the service provider to an HHSC consumer; and
• the waiver is in the best interest of the consumer.

HHSC will only approve the Temporary Waiver of Credentials for individuals who fail to maintain their credentials on rare occasions. The Temporary Waiver of Credentials was developed to assist with the time needed to gain credentials for new staff.

A copy of the approved email requesting the Temporary Waiver of Credentials must be kept in the contractor’s file by the HHSC contract manager and by the service provider.

The Temporary Waiver of Credentials must be approved before the non-credentialed staff person provides any direct services to HHSC consumers.

2.6.6 Staff Training and Development

Revision 23-1; Effective Nov. 20, 2023 

CILs must establish and maintain a program of staff development for those involved in providing IL services and, if appropriate, in administering the CIL program. Staff development programs should emphasize improving the skills of staff members directly responsible for providing IL services, including knowledge and practice of the IL philosophy. A CIL must provide training to its staff on how to serve unserved and underserved populations, including minority groups and urban and rural populations, as evidenced by in-service training records.

2.6.7 Human Resources Policies and Procedures

Revision 23-1; Effective Nov. 20, 2023 

CILs must comply with federal and state employment laws in their human resources policies.

CIL policies must address:

• Fair Labor Standards Act (FLSA) minimum wage and maximum hours provisions;
• definitions of full-time, part-time and temporary positions;
• wage and salary schedule;
• approved job descriptions, including duties and functions of each position;
• minimum knowledge, skills and abilities to perform the job;
• hiring;
• employee performance appraisal;
• employee separation or termination; and
• professional conduct.

The CIL must maintain an organization chart outlining the current structure of the CIL organization. The chart must:

• identify all staff and volunteer positions by job title, including supervisory positions; and
• define reporting relationships among positions, which must be approved by the board.

The CIL must maintain personnel files that include, at a minimum:

• current application or résumé;
• current job description;
• documents that support payroll deductions including a W4 and court orders;
• proof of citizenship or right to work in the United States 
  • Form I-9; or 
  • other state or federally recognized form;
• proof of professional credentials, if applicable; and
• current driver license and evidence of automobile insurance if applicable.

Annual performance evaluations may be either kept in the personnel file or in a separate secure location. The performance evaluations must be made available at the request of HHSC.

2.6.8 Time and Effort Reporting

Revision 23-1; Effective Nov. 20, 2023 

Base time reporting on documented payrolls approved by responsible officials of the organization. Salaries and wages must be supported by personnel activity reports reflecting the distribution of activity of each employee charged to the grant. The reports must:

• reflect an after-the-fact determination of the actual activity of each employee;
• account for the total activity that employees are compensated which is required in fulfillment of their obligations to the organization;
• be signed by each employee and by a responsible supervisory official having first-hand knowledge of the activities performed by the employee, assuring the distribution of activity represents a reasonable estimate of the work the employee performed during the periods covered by the reports; and
• be prepared at least monthly and coincide with one or more pay periods.

Policy must address:

• work hours;
• attendance; and
• leave reporting.

2.6.9 Fringe Benefits

Revision 23-1; Effective Nov. 20, 2023 

The following are considered benefits if the costs are absorbed by all organizational activities in proportion to the amount of time or effort devoted to each:

• regular compensation paid to employees for authorized absences, such as vacation leave and sick leave; and
• employer contributions to Social Security, workers' compensation, insurance and pension plans.

Policy must address:

• accrual, balance and carryover of leave;
• holidays;
• insurance;
• retirement;
• deferred compensation;
• workers' compensation; and
• unemployment compensation.

2.6.10 Volunteer Program

Revision 23-1; Effective Nov. 20, 2023 

When a CIL uses a volunteer to fill a position that fulfills a critical function of the IL program, the CIL must provide:

• an approved job description;
• time sheets signed by the volunteer and supervisor; and
• documented valuation of the hourly rate assigned to the volunteer's time.

These requirements do not apply to one-time, spontaneous or informal volunteer activities.

The value of volunteer services in positions that would otherwise require hired staff members is based on the work performed. CILs that already have employees performing these activities may use their own rate of pay to assess the value of volunteer services. If a CIL does not have employees in a similar position, it may use standard local compensation for such positions. 

2.7 Procurement

Revision 23-1; Effective Nov. 20, 2023 

CIL procurement policies must address:

• conflict of interest situations;
• planning for procurement needs;
• criteria and situations for getting bids or proposals;
• purchasing of supplies and equipment;
• contracts for goods or services; and
• maintenance of procurement records.

2.7.1 Procurement Procedures

Revision 23-1; Effective Nov. 20, 2023 

CILS must have written procurement procedures that address the requirements of 45 CFR 75.327-335, including:

• avoiding the purchase of unnecessary items;
• where appropriate, analyzing lease and purchase alternatives to determine which would be the more economical and practical procurement for the CIL;
• ensuring that solicitations for goods and services provide for all the following:
  • a clear and accurate description of the technical requirements for the material, product or service to be procured. In competitive procurements, the description must not contain features that unduly restrict competition;
  • requirements that the bidder must fulfill and all other factors used in evaluating bids or proposals;
  • a description, whenever practicable, of technical requirements in terms of functions to be performed or performance required, including the range of acceptable characteristics or minimum acceptable standards;
  • the specific features of "brand name or equal" descriptions that bidders are required to meet when such items are included in the solicitation;
  • the acceptance, to the extent practicable and economically feasible, of products and services dimensioned in the metric system of measurement;
  • preference, to the extent practicable and economically feasible, for products and services that conserve natural resources, protect the environment and are energy efficient;
• making efforts to use small businesses, minority-owned firms and women's business enterprises, whenever possible;
• clarifying the type of procuring instruments used, for example, fixed price contracts, cost reimbursable contracts, service authorization or purchase orders, and incentive contracts); 
• ensuring that contracts are made only with responsible contractors who have the potential ability to perform successfully under the terms and conditions of the proposed procurement; and
• monitoring the performance of all contracted vendors in writing at least annually.

CILs must, on request, make available to HHSC pre-award review and procurement documents, such as requests for proposals or invitations for bids, independent cost estimates, etc.

2.7.2 Asset and Inventory Management Policies

Revision 23-1; Effective Nov. 20, 2023 

CILs must develop and follow policies and procedures that address asset purchase and inventory records, safeguarding assets, periodic conduct of inventory and disposition of HHSC-funded assets.

2.7.3 Disposition of Depreciable Assets

Revision 23-1; Effective Nov. 20, 2023 

CILs must:

• dispose of equipment by following the current edition of the American Hospital Association's (AHA’s) Estimated Useful Lives of Depreciable Assets, except when federal or statutory requirements supersede; and
• request approval from the HHSC program staff before disposing of equipment with a fair market value of $5,000 or more, or a controlled asset before the end of that item's useful life, or as otherwise required by contract.

Get the AHA Estimated Useful Lives of Depreciable Assets through:

• Health Forum, Inc., at 800-242-2626; or
• on the AHA Web site in the Online Store.

The requirements in the Uniform Grant Management Standards must be followed if an item of equipment or a controlled asset is not:

• contained in the AHA Estimated Useful Lives of Depreciable Assets;
• governed by contract; or
• superseded by federal or state requirements.

If approval for disposition is not required, or approval has already been obtained from HHSC program staff members, sub-recipients must ensure that disposition of any equipment or controlled asset is per the terms of the contract, such as compliance with Generally Accepted Accounting Principles and any applicable federal guidance.

2.8 Budget Categories

Revision 23-1; Effective Nov. 20, 2023 

2.8.1 Salary and Wages

Revision 23-1; Effective Nov. 20, 2023 

Employee compensation costs or compensation for personal services must be calculated in compliance with 45 CFR Part 75, and meet HHSC requirements.

A CIL must:

• compensate employees:
  • as per policies, programs and procedures that effectively relate individual compensation to the person's contribution to the performance of the contract work;
  • follow policies that result in internally consistent, equitable treatment of employees; and
  • pay employees a wage or salary that is comparable to that paid for similar services outside the organization in the labor market in which the CIL competes for the kind of employees involved;
• review and approve salaries by position or function; and
• ensure that employees who work:
  • solely on a single award or cost objective are supported by periodic certifications that employees worked solely on the IL program; or
  • on multiple activities or cost objectives and record the actual time spent on each funded activity on a timesheet or personnel activity report. Time sheets or personnel activity reports must reflect an after-the-fact distribution of actual activity.

A CIL must not bill and receive reimbursement from funding sources for more than 100 percent of an employee's total salary or work time.

Individual salaries may be increased permanently for merit, to account for cost-of-living, or when an employee is promoted. One time salary increases may only be provided for merit rather than as a distribution of unspent funds. HHSC may request unredacted performance evaluations to support a one-time merit increase.

2.8.2 Fringe Benefits

Revision 23-1; Effective Nov. 20, 2023 

Fringe benefits are allowances and services that the CIL provides to employees as additional compensation. Employer contributions for employees' health insurance, life insurance and retirement plans are examples of fringe benefits. Also included are items required by law for the benefit of employees, the employer's portion of the Federal Insurance Contributions Act tax (FICA, also known as Social Security), workers' compensation insurance and unemployment insurance.

A CIL must determine its responsibilities and comply with applicable state and federal laws and regulations, including the following:

• workers' compensation — questions may be addressed to a qualified local insurance agency, the State Board of Insurance or the State Industrial Accident Board;
• FICA — questions may be addressed to the IRS;
• federal unemployment taxes — questions may be addressed to the IRS;
• state unemployment taxes — questions may be addressed to the Texas Workforce Commission.

The percentage of costs for an employee's fringe benefits charged to the contract must not exceed the percentage of time or effort the employee devotes to the contract.

2.8.3 Travel

Revision 23-1; Effective Nov. 20, 2023 

Travel-related expenses are budgeted and allowed on a cost-incurred basis if the costs are reasonable, necessary, allocable and substantiated by adequate documentation. Travel costs are limited to the rates and line items approved in the contract.

Travel expenses are allowable if they are incurred by the CIL's employees while performing official contract business. Travel expenses for consumers are included in the Other Costs category.

Travel-related expenses include:

• meals;
• lodging;
• personal vehicle mileage;
• airfare;
• parking fees;
• toll fees;
• taxi fare; and
• other travel-related costs.

Reimbursement for meals and lodging is allowed only for approved, overnight travel outside the designated headquarters (city limits). HHSC reimbursement for meals, lodging and mileage may not exceed the comptroller's established Travel Reimbursement Rates. If the CIL has a policy that sets travel reimbursement rates lower than the current state rates, budgeting and contract reimbursement cannot exceed the rate set by the CIL's policy.

If the CIL has a policy that sets travel reimbursement rates higher than the current state rates, the difference between the state's allowable contract reimbursement and the CIL rates may be made up from other funding sources.

Per 45 CFR 75.474, airfare costs more than the customary standard commercial airfare of coach or its equivalent, or of the lowest commercial discount airfare, are unallowable except in special circumstances, which must be documented.

All out-of-state travel requires prior written approval from HHSC, whether through the budget workbook or a separate budget request. The purpose and destination must be stated, and if available, supporting documentation must be maintained to justify the expense, including meeting or conference agendas.

Budgeting and reimbursement requests for out-of-state travel must not exceed out-of-state per diem rates in the Comptroller's established travel reimbursement rates. Allowability of out-of-state travel costs is determined based on comparing total costs for similar or comparable travel purposes available within the state.

Travel policy for local, in-state and out-of-state travel must address:

• allowable travel;
• required documentation;
• reimbursement rates; and
• circumstances where an advance may be issued and procedures for reconciliation of actual costs.

Records must include:

• a travel report signed by the traveler that includes:
  • certification that the employee incurred travel expenses while performing official contract business;
  • the purpose of the trip;
  • points of departure and arrival; and
  • dates and times of departure and arrival;
• receipts, invoices, travel and mileage logs, travel vouchers and any other documentation that supports the CIL's travel-related costs (receipts for meals are required if the CIL's policy includes this requirement);
• a canceled check or other documentation that indicates:
  • the amount reimbursed for travel; and
  • reconciliation of actual costs if an advance was issued; and
• accounting system entries that detail the amount of travel paid

Employees may not be reimbursed more than the actual allowable expenses incurred during travel. Any amounts exceeding the actual expenses must be returned to the CIL or covered by another funding source.

2.8.4 Equipment

Revision 23-1; Effective Nov. 20, 2023 

Equipment includes articles of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost that:

• is $5,000 or more; or
• exceeds the capitalization level established by the organization for financial statement purposes, if lower.

The CIL must get prior HHSC approval to buy equipment. Equipment bought through the contract is owned by the CIL but is subject to an equitable claim by the state when closing or terminating the contract. The CIL is accountable for equipment purchased through the contract. The CIL must bill equipment per federal regulations found in 45 CFR Part 75.

The CIL must:

• define equipment as stated in the applicable law, regulation or condition of the grant award;
• require that all purchases covered by the above definition be capitalized; 
• maintain a capitalization and depreciation schedule; and
• specify requirements for insurance coverage.

A CIL may include equipment rental or lease in the grant budget if:

• the cost is reasonable; and
• the cost of leasing over the life of the contract is less than the purchase price.

Note: The authorized rental or lease of items classified as anything other than equipment should be included in the "Other Costs" line item of the contract budget.

2.8.5 Supplies

Revision 23-1; Effective Nov. 20, 2023 

A consumable material or supply is any article that is not classified as equipment or intangible personal property and has a useful life of less than one year. Consumable materials and supplies charged by a CIL as a direct cost must include only the materials and supplies used to carry out the contract.

Material and supply items usually fall into one of the following categories:

• office supplies — such as pens, paper, notebooks, staplers and binders;
• program supplies — such as training materials and outreach materials; and
• maintenance supplies — such as soap, paper towels, mops and cleaning products.

The CIL must:

• ensure that supplies are approved by authorized staff members;
• ensure that supplies are purchased competitively per the 45 CFR Part 75;
• ensure that purchased supplies will be used during the current budget period to avoid stockpiling supplies; and
• get approval from HHSC before disposing of supplies whose average fair market value exceeds $5,000.

Controlled Assets

Controlled assets are items of real or personal property with an estimated life of greater than one year, but an acquisition cost of less than $5,000. These items are considered high risk and have a high potential for loss. Therefore, controlled assets must be maintained in a contractor's inventory system and tagged based on specified acquisition costs.

CILs should review the Comptroller's State Property Accounting (SPA) User Manual for the most current listing of controlled assets. CILs must add items classified as controlled assets to their inventory list based on the acquisition costs in the SPA Manual.

2.8.6 Contractual

Revision 23-1; Effective Nov. 20, 2023 

This budget category may include consumer services that are either subcontracted or else are janitorial, or accounting and maintenance services, that are addressed by a contract. CIL contracting policy must be followed to determine which services should be contracted.

2.8.7 Other Costs

Revision 23-1; Effective Nov. 20, 2023 

Other costs are those that are not covered by the preceding cost categories. These typically include items such as building rent, utilities, postage and insurance. In addition, any travel costs such as bus passes, mileage or reimbursement paid to or on behalf of consumers are included in this cost category. Each cost must conform to federal and state regulations.

2.9 Records Management

Revision 23-1; Effective Nov. 20, 2023 

CILs must establish records management policies and procedures that ensure compliance with the HHSC contract and 45 CFR Part 75. CIL records must fully disclose and document:

• the amount and disposition by the CIL of grant funds;
• cost of the project where grant funding is given or used;
• the amount of project cost funding supplied by other sources; and
• compliance with the requirements of Chapter 1 of Title VII of the Act and Title 45 of the Code of Federal Regulations.

2.9.1 Recordkeeping

Revision 23-1; Effective Nov. 20, 2023 

The CIL record-keeping system must contain data concerning the grant program's funds, including information necessary to receive payment.

The CIL must ensure that funds are being spent and used per the grant award.

2.9.2 Required Documentation

Revision 23-1; Effective Nov. 20, 2023 

Records must include, but are not limited to:

• up-to-date ledgers and journals;
• logs of management-approved adjusting journal entries;
• supporting documentation for all journal entries;
• bank and credit card statements;
• canceled checks;
• deposit slips;
• records of electronic transactions;
• approved invoices;
• receipts;
• leases;
• contracts;
• time sheets;
• inventory;
• capitalization and depreciation schedule; and
• cost allocation sheets.

CILs must maintain the security and confidentiality of grant records including the adoption and implementation of policies and procedures that meet the requirements of the HHSC Data Use Agreement to safeguard the confidentiality of all personal information, including photographs and names.

2.9.3 Review of Records

Revision 23-1; Effective Nov. 20, 2023 

The CIL must:

• maintain correct administrative, program or consumer, and fiscal records reflecting the grant's performance; 
• use a staff member not involved in the direct delivery of services to conduct written reviews at least 10 percent of active cases annually; and
• provide HHSC or others authorized by law or regulations to conduct reviews or audits access to its grant-related records for programmatic or fiscal purposes during the grant budget and retention period.
   

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 

Revision 23-1; Effective Nov. 20, 2023 

4.1 Self-Evaluation and Performance Measurement

Revision 19-0; Effective March 1, 2019 

A CIL must:

• conduct annual self-evaluations;
• prepare required reports, as described below; and
• maintain records adequate to measure performance as compared with the Independent Living Base/Operational Grant Standards for Service Providers (ILBOGS).

Information must be available about the:

• extent to which the CIL is in compliance with the ILBOGS;
• number of individuals with significant disabilities, reported by demographic group and type of services received through the CIL;
• sources and amounts of funding for the operation of the CIL; number of individuals with significant disabilities who are employed by the CIL and in management and decision-making positions; and
• when appropriate, description of the CIL’s activities in previous years, as compared with its activities in the most recent year.

4.2 CIL Responsibility to Inform HHSC of Changes

Revision 19-0; Effective March 1, 2019 

The CIL must inform the HHSC contract manager when any of the following conditions occur:

• problems, delays or adverse conditions that arise that materially impair the CIL's ability to meet the grant objectives. This disclosure must include a statement of:
  • action(s) taken or contemplated; and
  • assistance needed to resolve the situation;
• favorable developments that enable the CIL to:
  • meet time schedules and objectives sooner, or at a lesser cost than anticipated; or
  • produce more beneficial results than originally planned;
• legal or financial difficulties (e.g., lawsuits, IRS issues) that could affect the program;
• change in location – the CIL must notify the HHSC contract manager in writing of any proposed change in physical location for grant-related work at least 30 days in advance of the change; or
• any changes in key grant personnel.

4.3 Budget Revision

Revision 19-0; Effective March 1, 2019 

The service provider prepares a work plan with activities for carrying out the Independent Living Base Grant Program. Work plan activities are required for all service providers. The service provider has the responsibility to fulfill the approved work plan and comply with the Independent Living Base/Operational Grant Standards for Service Providers requirements.

The contract budget shall reflect anticipated costs associated with the activities outlined in the work plan.

Costs are to be budgeted under the following cost categories:

• Salaries and Wages
• Fringe Benefits
• Travel
• Equipment (capitalized)
• Supplies and Materials
• Contractual
• Other

Funds budgeted by cost category cannot be moved to other cost categories without requesting and receiving approval from HHSC through a formal budget revision.

To request a budget revision, the service provider must submit an HHSC Centers for Independent Living Program Contract Budget Revision, reflecting the revised budget request (with the justification included) for review and approval by the contract manager.

4.4 Required Reports

Revision 23-1; Effective Nov. 20, 2023 

A CIL that receives HHSC funding must submit reports as described below. CIL records must support all data reported, including that amounts in fiscal reports match amounts in accounting records.

Program Reports

Financial Reporting

4.5 Program Reports

Revision 23-1; Effective Nov. 20, 2023 

Consumer Demographic Information

Each month, CILs use Form 3161, Consumer Demographic Information, to list the number of people served, and the number of services and the types of services  provided.

Quarterly Program Performance Report

Each quarter, CILs use Form 3160, Quarterly Program Performance Report, to report progress and achievements on goals and objectives contained in the work plan as part of the CIL grant.

Annual Performance Report for the State Independent Living Services Program, Administration for Community Living Program Performance Report, Part II 

All HHSC-funded CILs must submit a copy of the Administration for Community Living Program Performance Report Part II report to HHSC and the State Independent Living Council (SILC). This report should be submitted electronically, preferably as an electronic file that can be edited, or alternatively, scanned and emailed to the HHSC provider mailbox. 

Consumer Satisfaction Survey Results

The Consumer Satisfaction survey measures consumer satisfaction about benefits received from services. The CIL must provide the results of the consumer satisfaction survey to the HHSC provider mailbox no later than 30 days after the end of the fiscal year. 

4.6 Financial Reports

Revision 23-1; Effective Nov. 20, 2023 

Financial reports including the original annual budget, quarterly financial report, program income report, and budget revision request are included in the budget workbook, an Excel workbook. When a report is due, it should be saved separately, named appropriately and submitted to the contract manager.

4.6.1 Request for Advance or Reimbursement (RAR)

Revision 23-1; Effective Nov. 20, 2023 

HHSC will process an RAR to advance up to 30 days of operating funds if the CIL meets the requirements of the contract and requests to use advances. If the CIL selects reimbursement of actual costs, the payment reflects the allowable costs for the period billed. HHSC must approve an RAR before payment. The RARs must be submitted at least every 90 days.

4.7 Audit Requirements

Revision 23-1; Effective Nov. 20, 2023 

All CILs must get annual financial audits conducted by an independent auditor in compliance with 45 CFR Part 75, Subpart F.

Each year, the HHSC Single Audit Unit notifies service providers they must submit a determination form to the single audit portal to identify if a single audit or annual audit is required. All audit reports must be submitted to the single audit portal within nine months after the end of the service provider’s fiscal year or within one month after the service provider receives the audit report, whichever is less. Direct questions about audit requirements or the single audit portal to Single_audit_report@hhs.texas.gov.  

Audits must be charged to the fiscal year that the audit was conducted not the fiscal year being reviewed in the audit.  

Single Audit if Applicable

The CIL must arrange for a financial and compliance audit (single audit) if required by 45 CFR Part 75. The resulting single audit report must be approved by the CIL board and, if necessary, a corrective plan must be developed. The CIL must comply with the following requirements:

• the audit must reflect the CIL's fiscal year;
• the audit must be conducted by an independent certified public accountant (CPA) and must be in line with 45 CFR part 75;
• the CIL must procure audit services in compliance with 45 CFR Part 75;
• the CIL must submit a copy of its audit report:
  • including the management letter, to HHSC and to the Health and Human Services Office of Inspector General (OIG) within 30 calendar days after receipt from an independent CPA; or
  • nine months after the end of the audit period, unless a longer period is agreed to in advance by HHSC OIG; or
  • a different period is specified in a program-specific audit guide; and 
• HHSC and HHSC OIG will communicate with the CILs to provide instructions on submission.

Audited Financial Statements

If a single audit is not required, the CIL still must obtain an annual financial audit. All CIL financial statements must be audited annually, regardless of grant size.

Audited financial statements must include:

• an independent auditor's report;
• statements of:
  • financial position;
  • activities;
  • functional expenses; and
  • cash flows; and
• notes to financial statements.

ES = form also available in Spanish.

For technical or accessibility issues with this handbook, email: form.handbook.request@hhs.texas.gov.

For questions about the Independent Living Base/Operational Grant Standards for Service Providers, email: blindandgeneralindependentliving@hhsc.state.tx.us.