107 CMR 10.00: INDEPENDENT LIVING SERVICES

Section

10.01: Scope and Purpose

10.02: Meaning of Terms in 107 CMR 10.00

10.03: Application for Services

10.04: Process for Determining Eligibility for Services

10.05: Certification of Eligibility

10.06 Certification of Ineligibility

10.07: Order of Selection Priority Categories

10.08: Waiting Lists

10.09: Independent Living Service Plan

10.10: Objectives in the Independent Living Service Plan

10.11: Measuring Achievement of Objectives in the Living Service Plan

10.12: Independent Living Rehabilitation Services

10.13: Determination of Financial Need

10.14: Comparable Benefits

10.15: Appeal Process

10.16: Case Closure

10.01: Scope and Purpose

(1) 107 CMR 10.00 establishes the policy and procedures to be followed to provide access to comprehensive Independent Living Rehabilitation Services (ILRS), which are available only through Title VII Part B of 29 USC Sec. 701 et seq.

(2) Independent Living Rehabilitation Services through this program are designed to meet the current and future needs of individuals whose disabilities are so severe that they do not presently have the potential for employment, but who may benefit from Independent Living Rehabilitation Services which will enable them to maintain or improve their ability to function independently in family and community.

10.02: Meaning of Terms in 107 CMR 10.00

The terms used in 107 CMR 10.00 shall, unless the context otherwise requires, have the following meaning or the meanings ascribed in 107 CMR 3.00 et seq.

Attendant Care means the assistance provided to an individual with a severe disability in performing a variety of tasks required to meet essential personal needs in such areas as bathing, communicating, cooking, dressing, homemaking, toileting and transportation.

Consumer an individual referred to the Commission through the statewide network of Independent Living Centers for Independent Living Rehabilitation Services and certified by the Commission as eligible to receive services under Title VII Part B.

Comparable Benefits refers to resources, services or benefits which are available from another program or source that will enable the consumer or the consumer's family to receive, pay for or appropriately substitute for the services specified in the ILSP.

Diagnostic Evaluation means the collection of sufficient current and relevant data which is necessary to determine whether an individual is eligible to be provided independent living services and to determine which independent living services are needed by those individuals who meet the basic criteria of eligibility. The evaluation takes into consideration any relevant case record materials available from files of the Commission or from the files of other agencies. Data obtained through this diagnostic evaluation will also be utilized to determine an appropriate Order of Selection category. A special diagnostic study is conducted specifically for the purpose of determining eligibility for independent living services only if already available information is not complete, relevant or current.

Health Maintenance means the provision of those health care services which are necessary for an individual with a severe disability to maintain or improve his or her functional capabilities and those services which may contribute to avoiding complications or reactivation of the severely disabling impairment or the development of additional impairments.

Improvement in One's Ability to Function Independently in Family or Community refers to a demonstration in functional and behavioral terms of an individual's greater independence or maintenance of independence in such areas as self-care, activities of daily living, driving, using public transportation, shopping, housekeeping, communicating or living more independently.

Independent Living Center (ILC) means a community-based, consumer controlled center that is staffed and managed by a majority of persons with disabilities and approved by the Commission to provide independent living rehabilitation services to eligible consumers.

Independent Living Rehabilitation Objectives means those objectives and goals, the attainment of which will enable the individual to function more effectively in family or community. These include:

Aids, Benefits and Services refers to IL objectives which relate to acquiring the aids, benefits and services that enable individuals to live as independently as possible in society.

Daily Living Goals refers to goals which involve the application of independent living skills and practices that result in an individual having more control over his/her own life, managing independent living opportunities and situations and participating in society.

Knowledge Goals refers to goals which involve the basic knowledge and information that enable individuals to understand, seek and obtain independent living opportunities and situations.

Personal/Social Skills and Behaviors refers to IL objectives which relate to personal goals such as developing self-confidence and the social behaviors and contacts that enable individuals to participate fully in society.

Situational Factors and Status Indicators refers to IL objectives which improve consumer situations with respect to legal rights, education, employment, housing and transportation.

Independent Living Rehabilitation Services or ILRS means any service that will enhance the ability of an individual with a severe disability to maintain or improve their ability to live independently and function within their family or community, and if appropriate, secure and maintain employment, or any appropriate vocational rehabilitation service (as defined under Title I of 29 USC Sec. 701 et seq. Services currently being provided are enumerated in the state plan which can be obtained through the Administrative Office of the Commission.

Independent Living Service Plan (ILSP) means an individualized written rehabilitation plan, periodically updated, for each eligible individual who receives independent living rehabilitation services.

Individual With A Severe Disability means an individual whose ability to function independently in family or community or whose ability to engage or continue in employment is so limited that independent living rehabilitation services are required in order to achieve a greater level of independence in functioning in family or community or engaging or continuing in employment.

Program Coordinator means the Commission employee in the Independent Living Division of the Commission who is responsible for determining whether an individual with a severe disability is eligible for Independent Living Services and who may also be designated to authorize the purchase of approved services which are specified in an individual's Independent Living Service Plan.

Title VII Part B refers to the Independent Living Rehabilitation program which is authorized under Part B of Title VII of the Rehabilitation Act of 1992, as amended, and is administered by the Massachusetts Rehabilitation Commission in accordance with the procedures established in the State Plan, as it has been approved by the Secretary of the U.S. Department of Education.

10.03: Application for Services

A consumer applies for ILRS by filing an application with the community based Independent Living Center in his/her area.

10.04: Process for Determining Eligibility for Services

(1) Individuals with a severe disability who apply for services under Title VII Part B will be provided a diagnostic evaluation to determine their eligibility for independent living services. This evaluation is limited to the collection of that information which is necessary to determine whether the individual is eligible for independent living services, to determine which independent living services are needed and to establish the individual's Order of Selection category. A special diagnostic study, for the purpose of determining eligibility, is conducted only if available information is not complete, current or relevant.

(2) Eligibility for independent living services is based only on:

(a) the presence of a severe physical or mental disability;

(b) the presence of a severe limitation in one's ability to function independently in family or community or to engage or continue in employment; and

(c) a reasonable expectation that independent living rehabilitation services will significantly assist the individual to improve his or her ability to function in family or community or to engage or continue in employment.

(3) Individuals with a severe disability who have been determined eligible for services may receive paid or unpaid services as described in their Independent Living Service Plan.

(4) Eligibility for paid services is determined by one's designated order of selection category, one's position on an established waiting list, a determination of one's financial need and the availability of any needed service through a comparable benefit resource.

10.05: Certification of Eligibility

When the Commission Program Coordinator makes a determination that an individual has met the eligibility criteria specified in 107 CMR 10.03, a certification of eligibility will be completed and a copy sent to the appropriate Independent Living Center (ILC). This certification will state the individual has met the basic requirements of eligibility specified in 107 CMR 10.03. The Commission Program Coordinator shall assure this certification is dated and signed.

10.06: Certification of Ineligibility

(1) When the Commission Program Coordinator makes a determination that an individual does not meet the eligibility criteria specified in 107 CMR 10.03, a certification of ineligibility shall be completed and a copy sent to the individual and to the Independent Living Center (ILC) to which the individual applied for services. The certificate of ineligibility shall be dated and signed by the Commission Program Coordinator, and shall contain a statement of the reasons for the finding of ineligibility. Whenever possible, the determination of ineligibility shall be made only after full consultation with the individual, or as appropriate, his or her parent, guardian, or other representative, or after giving a clear opportunity for this consultation.

(2) A finding of ineligibility shall be based on a determination that:

(a) there is insufficient evidence to support a finding of the presence of a severe physical or mental disability; or

(b) there is insufficient evidence to support a finding of the presence of a severe limitation in the individual's ability to function independently in family or community or to engage or continue in employment; or

(c) there is no reasonable expectation that the provision of independent living rehabilitation services will significantly assist the individual to improve his ability to function in family or community or to engage or continue in employment.

(3) The individual who is determined to be ineligible, shall be advised of his/her rights to appeal the decision and shall be advised of the appropriate method to contact the Client Assistance Program for assistance.

(4) A review of all findings of ineligibility shall be made by the Massachusetts Rehabilitation Commission within one year of the date of the determination of ineligibility. The review need not be conducted in situations where the individual has refused the review, the individual is no longer present in the State, or the individual's whereabouts are unknown.

10.07: Order of Selection Priority Categories

(1) When the Commission Program Coordinator makes a determination that an individual with a severe disability is eligible for services, the Commission Program Coordinator shall simultaneously make a determination of the individual's order of selection priority category. The priority category determines the general priorities that govern which eligible consumers shall be provided paid independent living services when the Commission has determined that funds are insufficient to provide services to all eligible individuals.

(2) The priority categories are:

(a) Priority Category I: This category includes consumers who are not presently receiving vocational rehabilitation services under the State vocational rehabilitation service program under Title I of the Act because of the severity of their physical or mental disability, and those individuals with a severe disability who are institutionalized, have been institutionalized in the past, or are at risk of becoming institutionalized.

(b) Priority Category II: This category includes all consumers not eligible for Priority Category I who need Independent Living Services to maintain or improve their independent living situation.

(c) Priority Category III: This category includes all consumers not eligible for Priority Categories I and II, who need Independent Living Services to enter into, or continue to engage in employment.

(3) Purchase of ILRS shall be determined by the availability of comparable benefits from other resources, the individual's financial need and the allocation and availability of funds, with individuals assigned to Priority Category I receiving the highest priority. Eligible individuals in all priority categories may receive non-purchased services such as counseling, guidance and referral.

10.08: Waiting Lists

In the event that funds for the Title VII Part B program are insufficient to serve all eligible individuals, the Commission shall institute a waiting list for purchased ILRS. The name of each individual who is eligible for services shall be placed on a statewide waiting list that is subdivided according to the priority categories described in 107 CMR 10.07. Placement of each individual's name shall be determined according to their priority category and by the date when the Commission Program Coordinator approved the specific services on the ILSP. When funds become available to provide purchased services to eligible individuals in a specific priority category, individuals on the waiting list in that category shall be served based on the chronological order of their ILSP approval date, so that individuals with earlier ILSP approval dates are served before those with later ILSP approval dates. The requirement for pursuit of comparable benefits continues during the time that the individual is on the waiting list for ILRS.

10.09: Independent Living Service Plan (ILSP)

(1) Eligible consumers must have an approved Independent Living Service Plan (ILSP). This plan shall state the long-term goals and intermediate objectives.

(2) The ILSP shall be developed jointly by the consumer and an appropriate Commission staff member or designee. The consumer may be represented by a parent, guardian or other representative.

(3) The plan shall be based on the individual's objectives and shall include:

(a) services to be provided and expected duration;

(b) a statement of measurable goals and objectives;

(c) achievement indicators and evaluation plans; and

(d) dated signatures of the consumer or his/her authorized representative and approval by the Program Coordinator and an indication that the consumer has received a copy.

1. The dated signatures, shall indicate the ILSP and the specified services are approved.

2. The signature of the consumer may be omitted when the consumer and the Program Coordinator have thoroughly discussed the matter, the consumer is not available and waiting for the signature will delay the provision of a needed service. In such situations, the Program Coordinator must document the reason that the consumer's signature is not affixed to the ILSP.

10.10: Objectives in the Independent Living Service Plan

Measurable and realistic objectives, which are also referred to as "outcomes", shall be specified in the ILSP to reflect the specific measure of independence which is intended to be accomplished. These objectives may be either long-range or short-range and shall incorporate one or more of the following goals:

(a) knowledge goals;

(b) daily living goals;

(c) aids, benefits and services;

(d) situational factors and status indicators; or

(e) personal/social skills and behaviors.

10.11: Measuring Achievement of Objectives in the ILSP

For each objective designated on the ILSP, there must also be an accompanying statement which establishes an objective evaluation procedure and the criterion which will be used to determine whether the specified goal or objective has been reached.

10.12: Independent Living Rehabilitation Services (ILRS)

(1) Independent Living Rehabilitation Services (ILRS) under Title VII Part B include any appropriate vocational rehabilitation service as defined under Title I of the Rehabilitation Act, and any other service that will enhance the ability of an individual with a severe disability to live independently and function within family or community, and, if appropriate, to secure and/or maintain employment.

(2) No purchased ILRS is available through Title VII Part B, if the same, or essentially the same, service is available from an alternative resource. (See 107 CMR 15.00 et seq. and 107 CMR 10.14).

(3) Services which may be available through Title VII Part B from the Massachusetts Rehabilitation Commission are those services defined in the State Plan, as it has been approved by the Secretary of the U.S. Department of Education.

10.13: Determination of Financial Need

(1) Prior to the authorization of any paid service from Title VII Part B funds, the Commission Program Coordinator shall complete a financial needs analysis to determine the ability of the consumer to participate, in whole or in part, toward the costs of the services.

(2) A copy of the current financial needs guidelines shall be provided to the consumer in the process of that analysis.

(3) No determination of financial needs analysis is required for individuals receiving SSI, AFDC or EAEDC. Eligibility for these programs has established that financial need exists.

10.14: Comparable Benefits

(1) While the proposed ILSP and its supporting documentation for services from Title VII Part B is being developed, a thorough examination must be made of resources through which identical or comparable benefits can be obtained at no cost to the Commission. (See 34 CFR 361.47).

(2) The Commission shall fully consider any comparable benefits, available to the consumer or to members of a consumer's family, under any program to meet, in whole or in part, the cost or provision of the independent living rehabilitation services that are delineated in the ILSP.

(3) The consumer shall be required to apply for and utilize any comparable benefits for which they appear to be eligible. If a State program has a waiting list for comparable benefits the consumer must apply to be put on such list but may also apply for services under Part B. In the event that Part B funds are not available, the individual would be placed on the waiting list for Part B services.

10.15: Appeal Process

(1) The Commission Program Coordinator is responsible for the approval or denial of all independent living rehabilitation services, including services provided by or through the IL Centers.

(2) Any dissatisfaction with the service delivery, or dissatisfaction with the reason for a denial of services should be expressed in writing to the Commission's Deputy Commissioner for Independent Living.

(3) If the consumer's dissatisfaction cannot be mutually resolved within 20 working days, the statement of dissatisfaction shall be considered a request for an appeal and shall be automatically referred to the Client Appeals Coordinator.

(4) Appeals concerning services under 107 CMR 10.00 shall follow the procedural regulations and guidelines for Administrative Reviews and Fair Hearings specified in 107 CMR 1.00. Information about the availability of assistance from the Client Assistance Program shall be provided to any individual who requests an appeal.

(5) The remedies available for any waiting list placement issues under 107 CMR 10.00 which are appealed by a consumer are limited to:

(a) Situations where a consumer can demonstrate that there was undue delay on the Commission's part in implementing an ILSP prior to the inauguration of a waiting list for services. If such an instance occurs, that consumer would move up on the waiting list and be among those served first when funds were available; or

(b) Situations when a consumer can demonstrate that there was a clerical or other error concerning the date when the Commission Coordinator approved the specific services on the ILSP, and those services were unavailable because of funding limitations. In such a situation, that consumer would be placed on the waiting list, based on the actual date when the ILSP was approved.

10.16: Case Closure

(1) When all objectives of the independent living service plan, which are related to Title VII Part B services, have been achieved, there shall be a record describing the ways in which the consumer has benefited from independent living rehabilitation services. This record shall include evidence of significant improvement in the individual's ability to engage or continue in employment or in the ability to function independently in his or her family or community. It shall also document referral of the individual to other agencies and facilities, as appropriate.

(2) In instances where case closure occurs prior to the ILSP initiation the record should document the reason for closing the case. In cases of closure due to an ineligibility determination the case record shall include the ineligibility certification, written notification to the individual of the closure action and an indication that the individual was provided an explanation of his/her rights to appeal.

REGULATORY AUTHORITY

107 CMR 10.00: M.G.L. c.6, ss. 75 and 78A; and 129; 29 USC 721 (a) (10); 34 CFR 361.58; CFR 361.15 (h).


This information is provided by the Massachusetts Rehabilitation Commission.