SECTION 28: OLDER BLIND AND LIFE SKILLS PROGRAMS

OLDER BLIND PROGRAM

The Older Blind Program is a federally funded program that provides independent living services to visually impaired individuals, aged 55 and older to assist them in maintaining their independence.

Application Process:

To generate a new case, the Rehabilitation Technician will enter the Caseload Browse screen through the Participant Module. By clicking the “New Case” button, it will bring you to the New Case screen titled “New Case” form. Participant information is then entered into all required fields. When information is saved, you will automatically be brought to the “New Case Verification” form, where you can check the accuracy of the entered information and either “Confirm” or “Cancel” the data. After the information is confirmed, you will go to a “New Case Completed” screen, where you can continue with the application process, or exit. Exiting will bring you back to the Participant Caseload Browse. Usually the Rehabilitation Technician will continue to enter the following fields: “Personal Information” and “Application Information”, including the “Basic”, “Financial”, “Education”, “Employment”, and “Work History” forms. The Rehabilitation Counselor will then complete the “Application Documentation” form, “Disability” form, and “Special Programs” form.

Assessment of Eligibility

Determination of eligibility is required and must be completed within 60 days from the date of the receipt of the application.

The determination of eligibility for the Older Blind Program services is based to the maximum extent possible on a review of existing information. If additional data is necessary, assessments will be scheduled. Medical documentation of the visual impairment is required to determine eligibility.

Process: RAISON has a screen entitled “Eligibility Completion Status” that indicates the completion of a participant’s eligibility status in a check box format. Once completed, the participant can be moved to eligible status by entering the eligibility date on the Determination form. In RAISON, enter Caseload Browse, select the “forms” menu, select ‘Eligibility and Eligibility determination”. Complete the “Determination” form.

Eligibility Determination

An individual is eligible for Older Blind Program services if the individual:

a. Is legally blind or severely visually impaired, (severely visually impaired defined as: “20/70 best corrected and/or 50% or less field”), and

b. Is age 55 or older, and

c. Is no longer able to obtain or retain gainful employment or is retired, and

d. Is in need of Independent Living Rehabilitation services to maintain their independence.

Process: Completion of the Eligibility Determination (GEN) form is required. To complete this form go to the “Determination” tab, then complete the narrative for the box titled “Can Benefit from the following services” and the box titled “Other Comments”, as necessary. Then go to tab “Eligibility

PARTICIPANT SERVICES POLICY AND PROCEDURES MANUAL

Bureaus of Vocational Rehabilitation & Services to the Blind and Visually Impaired

Revised: June 15, 2007

Page 125

Completion Status” and review and ensure that all check boxes have been marked. (Information is taken from the application). If the boxes are not checked, it will be necessary to go back to the appropriate tab, such as “Participant Personal Information” tab and the “Application Disability Browse” tab to enter missing information.

LIFE SKILLS PROGRAM

The Life Skills Program is a state funded program that provides independent living services to visually impaired individuals, aged 55 and under to assist them in maintaining their independence.

An individual is eligible for services if the individual:

a. Is in need of independent living (IL) rehabilitation services to maintain their independent status in the community or (if a child) in the family

b. Is legally blind or severely visually impaired, (severely visually impaired defined as: “20/70 best corrected and/or 50% or less field”)

c. Is no longer able to obtain or retain gainful employment

d. Is an adult, legally and/or functionally visually impaired, under age 55, or

e. Is a child who is not eligible for comparable services

Assessment of Eligibility

Determination of eligibility is required and must be completed within 60 calendar days from the date of the receipt of the application.

The determination of eligibility for the Life Skills Program services is based to the maximum extent possible on a review of existing information. If additional data is necessary, assessments will be scheduled. Medical documentation of the visual impairment is required to determine eligibility.

Process: Completion of the Eligibility Determination (GEN) form is required. To complete this form go to the “Determination” tab, then complete the narrative for the box titled “Can Benefit from the following services” and the box titled “Other Comments”, as necessary. Then go to tab “Eligibility Completion Status” and review and ensure that all check boxes have been marked. (Information is taken from the application). If the boxes are not checked, it will be necessary to go back to the appropriate tab, such as “Participant Personal Information” tab and the “Application Disability Browse” tab to enter missing information. In RAISON, enter Caseload Browse, select “forms” menu, select “Application”, then “Application Documentation” and complete the required forms.

Assessment of Independent Living Needs for Older Blind and Life Skills

As soon as eligibility has been determined and to the extent necessary, the identified staff person, as designated by the district manager, conducts an assessment of independent living needs to determine the nature and scope of needed services.

Both programs will work together through collaborative application processes to create opportunities to share resources to maximize the benefits to their mutual clients.

The following guide will be used for BSBVI and Independent Living staff.

1. When a client applies and is found eligible for the Older Blind or Life Skills program, the BSBVI staff will evaluate the needs of the client. If the client can benefit from assistive technology, BSBVI staff will obtain a signed release of information from the client and contact Independent Living staff to facilitate a referral for Independent Living assistive technology services:

2. When a client applies and is found eligible for Independent Living services, if the client needs evaluative, counseling or mobility instruction, Independent Living staff will obtain a release of information from the client and contact BSBVI staff to facilitate a referral for BSBVI services:

Referrals and shared client process will be focused on securing necessary services across both programs. It is the responsibility of both BSBVI and Independent Living to ensure that the client does not get lost between the two programs.

Procedures:

The assessment should consist of a comprehensive assessment of the participant's unique strengths, resources, priorities, interests and needs. A comprehensive assessment is limited to information that is necessary to identify the participant’s independent living needs and to develop the individualized plan of service. For the Life Skills program, an Orientation &Adjustment assessment is required to determine the participant’s Activities of Daily Living needs.

Assessments completed by Bureau Rehabilitation Instructor or Orientation and Mobility Instructors will be submitted to the identified staff person, as designated by the district manager, within 10 working days upon completion of the assessment.

Scope of Services for Older Blind and Life Skills Programs

It is a Division policy that all services

? Must be pre-authorized for payment;

? Are subject to the spending and signature authorities noted in the Program Services Policies and Procedures Manual;

? Are subject to the financial participation guidelines included in the Program Services Policies and Procedures Manual;

? Must be part of the individualized plan for service and relate to the goal of increased independence and self-sufficiency; and

? Must be performed by personnel qualified, and/or licensed, and/or certified in their respective professional disciplines.

? Surgeries are not offered in these programs although they are allowed for in federal regulation.

Financial Need and Determination of the Availability of Comparable Services and Benefits

The Bureau considers the financial need of participants for the purpose of determining the extent of their participation in the costs of independent living services. If comparable services and benefits are available, they must be utilized to meet in whole or in part the cost of independent living services.

Individual Plan of Service

Policy: A written, signed individual plan of service will be developed utilizing RAISON for each eligible participant of the Older Blind and Life Skills programs. Services provided will be developed jointly by the designated staff person and the participant. Guardians, authorized representatives, and other suitable professionals and informed advisors may also be included. A copy of the plan and any amendments will be provided to the participant and/or representative. To the maximum extent possible the plan should be provided in the participant's native language or mode of communication in accessible formats such as Braille, large print or audiotape.

Procedures:

Plan Rationale: Defines how the individualized plan of service identifies and meets the nature and scope of needed services in support of independent living and self-sufficiency outcome.

From Caseload Browse, enter the Forms menu, go to Plan, and then select Plan. Using the insert buttons, complete all forms. When all required fields are completed, RAISON will allow you to change case form Eligible to Service by a entering a date.

Content: The plan will include the following:

a. Specific services recommended related to attainment of independent living and self-sufficiency. Services are limited to:

1) Orientation and mobility evaluation and training

2) Daily living skills evaluation and training

3) Communication skills and devices

4) Low vision evaluation

5) Special independent living aids

6) Initial diagnostic examination for visual problems or related medical problems,

7) Transportation for IL services in accordance with the plan,

8) Leisure services, and

9) Education and counseling to family members.

b. Projected dates for the initiation of each service and anticipated duration of each service.

c. Evaluation criteria

d. Participant and BSBVI staff responsibilities

e. Participant and BSBVI staff signatures

Case File Review: If the anticipated length of the case extends beyond 12 months, it requires supervisory review. For Rehabilitation Instructor and Orientation & Mobility services extending beyond 6 months requires supervisory review. If future reviews are specified, and follow up activity is required, an “Activity Due” case note must be entered by the Rehabilitation Instructor.

Closures

Closure for reasons other than ineligibility:

A case may be closed when the participant is unavailable to participate or to complete an assessment of eligibility and the designated staff person has made a minimum of two attempts to contact the individual. Attempts to elicit participant response include letters, phone messages, personal contact or missed appointments.

Procedure: When a case is closed prior to a determination of eligibility the closure reason must be documented in a progress review note.

Closure from applicant status when eligibility requirements are not met

Ineligibility determinations must be based on the following:

a. The individual does not have a visual disability

b. The individual cannot benefit from services

c. The individual has an unfavorable medical prognosis

d. The individual is able to obtain or retain gainful employment

e. The individual does not meet age criteria

Procedure: A closure reason must be documented in a progress review note and case closed immediately. Ineligible participants should be referred to other appropriate programs.

Successful Closures—Institutional Diversion:

Successful closures occur when a participant has received services resulting in institutional diversion. Institutional diversion criteria are:

a. The participant must have severe vision impairment and be responsible for self-care.

OR

b. Have a secondary disability requiring regular home care or treatment that cannot be taken care of appropriately due to visual problems.

AND

c. The participant must live alone and have decreased reliance on assistance from outside sources through provision of IL services

OR

d. Have a spouse or other family member who has difficulty caring for them and whose difficulty has been relieved through provision of IL services.

OR

e. Have a spouse or other family member who has difficulty caring for them or have decreased reliance on assistance from other outside sources.

The closure reason must be documented in a progress review note and the case closed within 30 calendar days of completion of the plan.

Successful Closures - Other

Other successful closures occur when a participant has successfully completed the services on the individualized plan of service.

Procedure: A closure reason must be documented in a progress review note and the case closed within 30 calendar days of completion of the plan.

Unsuccessful Closures

Policy: Cases may be closed unsuccessfully when:

1. The participant refuses services

2. Evidence indicates the individual cannot benefit from services

3. Relocation so that they are no longer able to participate

4. Whereabouts unknown

5. Medical condition rapidly progressing or terminal

6. Death

7. Institutionalization

Procedure: A closure reason must be documented in a progress review note and the case closed immediately, once the determination has been made.

Case Record

A written case record for each applicant and/or recipient of services will be established and maintained by the designated staff person.

Procedure:

1. The written case record will contain, as applicable:

a. Assessment of eligibility

b. Assessment of independent living needs

c. Rationale for IL services

d. Financial participation form

e. Individual plan of services

f. Documentation and analysis of any evaluations and training provided by staff or outside consultants

g. PRN's of participant progress in plan at least every 90 calendar days

h. Case closure documentation.

2. A closure letter sent to the participant and/or their representative, explaining the reason for closure and their options if the closure is disputed.

PARTICIPANT SERVICES POLICY AND PROCEDURES MANUAL

Bureaus of Vocational Rehabilitation & Services to the Blind and Visually Impaired

Revised: July 2006

Page 130