Below is a list of frequently asked questions (FAQs) about the integration of the Texas Department of Assistive and Rehabilitative Services (DARS) Independent Living program for individuals who are blind or have visual impairments and the Independent Living Services program for individuals who have a significant disability, as well as the outsourcing of the integrated Independent Living program to Centers for Independent Living or other entities.
This list will be updated with additional questions and answers when more information becomes available. Email questions to: BlindandGeneralIndependentLiving@hhsc.state.tx.us.
Below is a list of acronyms used throughout the FAQ and each acronyms meaning.
- CILsCenters for Independent Living
- DARSTexas Department of Assistive and Rehabilitative Services
- DHHSDARS Office for Deaf and Hard of Hearing Services
- HHSCHealth and Human Services Commission
- IL or ILSIndependent Living services
- TWCTexas Workforce Commission
Will the consulting process be exclusionarymeaning will a CIL that the consultant finds to lack capacity to administer an IL contract be denied an IL contract?
The consulting/evaluation process is not intended to be exclusionary. We anticipate that the consultant will identify gaps in capacity in specific areas and make recommendations for capacity building needs. DARS will utilize this information for how to proceed with the outsourcing of IL services.
For those CILs that want to contract with HHSC to provide IL services, but are found not to have the capacity, will DARS/HHSC provide technical assistance? If so, what would that entail?
The evaluation process and stakeholder input will identify areas where technical assistance is needed by CILs. Technical assistance will be developed to address these identified needs and made available to CILs. The development and provision of technical assistance will be ongoing as the outsourcing model is developed and implemented.
Will CILs have the discretion to structure their own IL programs, which will most likely differ from how DARS currently administers the program (that is, utilizing refurbished equipment, determining how to maintain their own waiting/interest lists, number of full time equivalents, etc.)?
IL services delivered by CILs must comply with federal regulations and state rules, including but not limited to U.S. Department of Health and Human Services Administration for Community Living (ACL) and Rehabilitation Services Administration (RSA) regulations. DARS is currently seeking stakeholder input for the promulgation of new IL rules which will determine how IL services are provided in an outsourced model.
Will CILs have the discretion to subcontract IL services out to other organizations, including subcontracts with other CILs that do not want the administrative responsibility, lack the administrative capacity/structure or choose to form a regional collaboration?
CILs, per House Bill (HB) 2463, will have the ability to subcontract IL services out to other organizations. These organizations must meet the requirements for service providers set forth in contracts and contracting standards. The CILs will be responsible for oversight and monitoring their subcontractors work and ensuring that all federal, state and contracting requirements are met.
What entities or individuals make up the IL Transition Team?
DARS has established an internal Outsourcing Project to successfully facilitate integration of the Independent Living program for individuals who are blind or have visual impairments and the Independent Living Services program for individuals with significant disabilities no later than September 1, 2016. DARS operates these programs under Title VII of the federal Rehabilitation Act of 1973. The Outsourcing Project is sponsored by the assistant commissioner of the DARS Division for Rehabilitation Services (DRS) and interim assistant commissioner of the DARS Division for Blind Services (DBS) and is being managed through the DARS Deputy Commissioners office. The project team is made up of subject matter experts from all areas within DARS, HHSC and the TWC who have a current or future role in the administration and delivery of IL services. This includes financial services (budget and accounting), DARS operations (contracting and contract oversight), and DRS and DBS staff who facilitate the direct delivery of services to consumers. DARS will include stakeholder input from outside the agency to inform activities performed by the project team.
Since Title VII, Chapter 2 funding will fall under TWC, will CILs have to have separate contracts with TWC to ensure IL services are available for the older blind population?
It is unclear at this time how Chapter 2 services, IL services for individuals who are older and blind, will be provided. On November 16, 2015, the TWC board accepted a staff recommendation to enter into an interagency contract with HHSC to administer Chapter 2 services in 2017. There are a number of options that are currently being explored between DARS, TWC and HHSC regarding the delivery of these services.
Since the Resource Specialist Program under the DARS Office of Deaf and Hard of Hearing Services (DHHS) will remain under HHSC and is also being assessed to potentially run through the CILs, how will DARS/HHSC now justify the intense focus of this program on vocational rehabilitation goals and activities? Will the CILs have the discretion to structure this program in a way that addresses the IL needs of the deaf and hard of hearing more comprehensively?
The Sunset Management Action directed DARS to determine whether the services currently provided through DHHS could be better provided through CILS. DARS is working with the consultant to complete this evaluation of these services as they currently exist. Whether these services will outsourced or changed will be determined after the evaluation.
Is the Specialized Telecommunications Assistance Program (STAP) included in the CIL evaluation process, since it is currently tied to the Hearing Loss Resource Specialist (HLRS) contract administered by DARS DHHS?
The STAP Outreach contracts that assist consumers with appropriate device selection and certification are included in the assessment process. The processing of STAP applications and issuance of vouchers would remain with HHSC.
Will DARS/HHSC be establishing a consistent service area for each IL contract (for example, service areas that follow HHSC Regions)?
Contracting specifics will be developed through the Outsourcing Project. At this time no decisions have been made regarding the configuration of service areas. The configuration of the service areas will ensure that consumers in all 254 counties in Texas will have access to IL services.
ARCIL recommends changes to provisions in "5.2 Application for Services" of the program draft Program Standards, particularly the requirements to: 1) initiate eligibility determination within 30 days of initial contact and 2) conduct a face-to-face meeting for all eligibility determinations. Such requirements create administrative activity and costs for contractors and put the state in the role of monitoring process instead of outcomes. There is no reason this contract should micro-manage eligibility processes more closely than the state uses for Medicaid, SNAP and CHIP. Medicaid MCOs have contracts at hundreds of millions of dollars each year, without a requirement of face-to-face contact for enrollment. The initial contact serves only to secure a spot on the interest list. There is no benefit to completing eligibility determination months or even years before the consumer has gone through the interest list and will be in line for purchased services. ARCIL will collect basic information through any communication format for purposes of adding an applicant to the Interest List, with no signature required. The process to determine eligibility will begin when funding for purchased services becomes available as indicated by position on the Interest List. ARCIL will inform the applicant about other services and complete intake and service planning for other services the applicant is eligible for.
The face to face eligibility requirement and eligibility determination timeline will not be waived or changed. The draft contract standards require an application to be processed within 30 days of initial contact. This requirement is intended to ensure services are initiated in a timely manner and a consumer may begin achieving their independent living goals as quickly as possible. Realizing that certain circumstances may require delays, such as a consumer is not available to meet within that time frame, the draft standards allow the delay to be noted in the consumer service record.
As stated in a previous response, a consumer's first contact with a service provider is a critical point in the independent living services process. It is not only a time for an information exchange that will provide the consumer information regarding available services; it is also an opportunity for the service provider to connect with the consumer and develop a rapport that is vital to moving an individual toward independence. The provider standards allow various locations for face-to-face meetings to ensure this requirement is not a burden to the service provider.
There will be no interest list in the outsourced ILS program. Once a consumer is determined eligible for ILS program services, they should be initiated according to the consumer's plan. If the plan includes the purchase of a good or service for which the provider does not have available funding, the consumer may be placed on a wait list for that plan service.
Section 6.1., page 28, allocation of funds for complex rehab tech as percentage by type of equipment. We request a policy clarification regarding the "performance targets" described in the draft standards, to specify the anticipated corrective actions if targets are not met. ARCIL intends to follow a waiting list for priority to provide purchased services, and does not anticipate moving consumers up and down the list to meet arbitrary targets for type of disability/technology. If state monitors conclude that specific populations or individuals requiring specific technologies are somehow not afforded appropriate access to services, standards should state corrective actions.
The performance targets are set to ensure that sufficient funds are available for all types of complex rehabilitation technology available in the ILS program. They were developed based on historical purchases in the DARS IL programs across the state and the service area population.
Section 18.104.22.168, page 20, requiring documentation of expenses paid for the past 12 months to calculate fee-for-service amount. Recommendation for Rent, allow submission of current lease or other written statement on amount of rent paid.
Rent is currently an allowable deduction in the draft contract standards. This deduction is used in the calculation of household size and adjusted gross income used to determine the consumer participation fee. (Chapter 22.214.171.124)
We request a policy clarification to add listings of other types of vendors and specify a process for the IL Services provider to establish additional qualified additional vendors.
The vendor list provided includes all vendors that the agency has used in the past year to provide IL services to consumers. Other vendors may be used, but would require individualized attention to credentials and best value for the delivery of services. Each CIL would create their own process for recruiting service providers depending on the Centers purchasing policies and processes.
Are we expected to get bids on some types of purchases?
Yes. The draft contract standards require the CIL to adopt and implement procurement policies that address the criteria and situations for obtaining bids or proposals (Chapter 6.1).
Are there established rates for all types of purchases?
No. Each CIL will have to establish rates with providers while complying with contract standards.
Is there a known shortage of vendors for some services in some areas?
DARS is aware that psychiatric services have been difficult to find in all areas of the state. However, the availability of vendors will vary depending on geographic location.
Are vendors considered sub-contractors?
For the purpose of Historically Underutilized Business (HUB), a vendor is defined as a supplier of goods and services to the state, and a subcontractor is defined as a person who contracts with a prime contractor to work or contribute toward completing work for a governmental entity. Therefore, a vendor could be a subcontractor if they are subcontracting with the prime contractor.