5.3 Independent Living Services (Individualized Skills Training Only)

5.3.1 Job Function

Independent living (IL) services are designed to accommodate for the consumer's vision loss in daily living activities.

5.3.2 Qualifications

Education, Training, and Experience

All independent living trainers must

  • have a bachelor's degree from an accredited college or university in rehabilitation, education, psychology, sociology, or related field supplemented with
    • one year work experience in rehabilitation teaching, rehabilitation, or education of people with disabilities, or
    • two years' work experience in general education or other related field; and
  • participate in a presentation of written scenarios and/or hands-on demonstration of skills in providing independent living skills training, preferably with experience in "hands-on" individual training to people who are elderly or who have visual disabilities and/or other disabilities.

 

Provider Authorization

Services must not begin until DBS has issued a service authorization and/or purchase order.

Providers must have written authorization from DBS before the provider's employee provides services to DBS consumers. No service will be paid if the service is provided before DBS written authorization is received.

For additional information, seeChapter 1: Basic Standards, 1.6.4 Additional Requirements/Documenting Staff Changes of this manual and Chapter 4: Service Delivery Guidelines, 4.2 Staff Information Sheets.

5.3.3 Service Delivery

Scope of Services

Independent living skills vendors provide the following services in the consumer's residence or local community. The independent living skills vendor may provide one or more of the following services as authorized by the DBS IL worker (ILW):

  • Application Assessment—the process of gathering referral data and information about the consumer’s preliminary need for services. Along with eye medical report(s), this information is used by the ILW to determine eligibility for the Independent Living Program.
  • Comprehensive Assessment—the process of working with the consumer to identify the issues that prevent him or her from functioning independently. This process, which occurs after the ILW determines eligibility, can also help a consumer maintain or increase his or her independence and includes listening to the consumer describe problems related to loss of vision, conducting an in-depth interview to gather information, observing skill demonstrations at home, and talking with family members or caregivers to gather any additional information. The Comprehensive Assessment is used by the ILW to develop the ILP.

Note: Information and referral (I&R) services help the consumer identify and use alternative resources, such as Meals on Wheels, the Texas State Library, and the How To Guide, to meet his or her individual needs. These services can be provided at any point in the independent living process.

  • Independent Living Skills Training—training in techniques that enable a consumer to perform daily living skills in alternative ways. These skills are divided into the following categories:
    • personal management—including grooming, eating, health, safety, clothing identification and coordination, and medication systems;
    • home management—including sewing, cleaning of clothing, housekeeping, meal preparation and kitchen safety skills, planning for grocery shopping, and minor home maintenance;
    • communication—including telling time and time management, using the telephone, money management, writing, organization, and using adaptive devices; and
    • information access and technology—including training on use of magnifiers, CCTVs, and other low-vision devices, as well as adaptations of computers and other types of technology.

 

Designation of Independent Living Worker

The ILW, who is designated by the DBS field director, provides case coordination, direction to the IL skills vendor on service provision, as well as the following services:

  • sends referrals to the IL skills vendor for initial contact and application assessment;
  • enters application information into the electronic case management system;
  • determines consumer eligibility for IL services;
  • refers eligible consumers to the IL skills vendor for comprehensive assessment;
  • develops the ILP with the consumer and enters it into the electronic case management system;
  • authorizes IL skills training hours;
  • manages DBS case records;
  • reviews documentation of services provided by the IL skills vendor;
  • authorizes the purchase of recommended equipment and services;
  • documents the purchase of equipment and services in each consumer's ILP; and
  • arranges or provides more complex services including (but not limited to) braille instruction, orientation and mobility training within the consumer's community, and diabetes education and training.

 

Case Management

The case manager is responsible for:

  • determining consumer eligibility for IL services,
  • referring eligible consumers to the IL trainer for specific IL services,
  • managing DBS case records for eligible consumers,
  • reviewing and approving individual training programs jointly developed by the IL trainer and the consumer,
  • incorporating approved individual training programs into each consumer's Independent Living Plan (ILP),
  • reviewing documentation of IL services provided by the IL trainer,
  • authorizing the purchase of recommended equipment and services,
  • documenting the purchase of equipment and services in each consumer's ILP, and
  • arranging or providing more complex services including (but not limited to) Braille instruction, orientation and mobility training within the consumer's local community, diabetes education and training, etc.

 

IL Skills Vendor Responsibilities

The IL skills vendor

  • completes the application assessment
  • provides the correct services as directed by the ILW and as described under the Scope of Services above,
  • conducts a comprehensive assessment,
  • submits the appropriate documentation for each type of service to the ILW for review and approval,
  • provides training in basic independent living skills as described in the comprehensive assessment and ILP,
  • periodically assesses each consumer's progress toward goals and timelines with the ILW,
  • submits appropriate recommendations for purchasing products and services for each consumer to the ILW, and
  • provides the ILW with a written report of each contact that includes details of the assessment or service provided and the outcome.

 

Initial Contact

The IL skills vendor must make the initial contact with a DBS consumer who is referred for independent living skills training within 15 working days of the referral.

Initial Contact and Application Assessment

All initial contacts and application assessments must be conducted individually and documented using the following forms:

 

Comprehensive Assessment

The IL skills vendor must contact a DBS consumer who is referred for a comprehensive assessment within 30 calendar days of the referral.

The vendor must document the comprehensive assessment on the DARS2954, Comprehensive Assessment for Independent Living Program. The recommendations section of the form must contain a summary of IL skills training and services that the vendor has identified for inclusion on the Independent Living Plan (ILP).

 

Independent Living Skills Training

After the ILW has developed the ILP, the IL skills vendor provides monthly training services as authorized by the ILW. The services are documented monthly using the DARS2891, Independent Living Services Progress Report. The monthly report must

  • detail the services provided to the consumer,
  • document the outcome of each service, and
  • include any recommendations for changes to the ILP.

5.3.4 Performance Measures

DBS considers the following questions in measuring vendor performance:

  • Did the IL skills vendor meet the consumer's independent living needs as requisitioned by the IL worker?
  • Has the IL skills vendor met DBS contract specifications?
  • Has the IL skills vendor performed all contractual services in a professional manner in accordance with the requirements detailed in this manual?
  • Was initial contact with DBS consumers accomplished in a timely manner after receipt of the referral?
  • Has the IL skills vendor adhered to DBS confidentiality standards?
  • Has the IL skills vendor submitted all required reports in accordance with DBS specifications or standards?
  • Has the IL skills vendor submitted fully completed invoices (including required attachments such as travel logs if applicable) no later than 35 calendar days following service completion?