It is the responsibility of the ILST provider to conduct a comprehensive functional assessment of the waiver participant, identifying the participant's strengths and weaknesses in performing Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) related to his/her established goals. The assessment is the basis for developing an ILST plan that describes the milestones and interim steps necessary to attain these goals. The assessment must also include a determination of the participant's manner of learning new skills and responses to various interventions. This comprehensive and functional assessment must be conducted at least annually from the data of the last assessment.
ILST services may include assessment, training, and supervision of, or assistance to, an individual with issues related to self-care, medication management, task completion, communication skills, impersonal skills, socialization, sensory/motor skills, mobility, community transportation skills, reduction/elimination of maladaptive behaviors, problem solving skills, money management, pre-vocational skills and skills to maintain a household.
ILST services are individually designed to improve the ability of the participant to live as independently as possible in the community. ILST may be provided in the participant's home or in the community. This service is provided on an individual basis.
ILST must be provided in the environment and situation that will result in the most positive outcome for the participant. It is expected that this service will be provided in the real world, such as in the participant's kitchen as opposed to an agency's kitchen. This requirement addresses the difficulty many participants experience with transferring or generalizing knowledge and skills from one situation to another. However, it is recognized that there is need for some practice of skills before using them in the environment.
ILST services may also assist a participant with "real world" paid or unpaid (volunteer) employment. The use of ILST for vocational purposes may occur only when the services of Vocational and Educational Services for Individuals with Disabilities (VESID) and the Commission for the Blind and Visually Handicapped (CBVH) have been fully explored and it is determined that either the participant is not eligible for VESID or CBVH services or VESID or CBVH does not provide the needed service.
ILST providers are responsible for training the participant's informal supports and waiver and non-waiver service providers to provide the type and level of supports that allow the participant to become as independent as possible in ADLs and IADLs. ILST is a time limited service used to assess a participant's needs, develop a plan, and train others to assist the participant. ILST is not intended as a long-term support. The reasons to provide or continue ILST must be documented in the Service Plan.
CIC is an individualized service designed to assist the waiver participant to effectively manage the emotional difficulties associated with adjusting to and living in the community. It is a counseling service provided to a participant coping with altered abilities and skills, the need to revise long term expectations, and changed roles in relation to significant others. It is available to participants and/or anyone involved in an ongoing significant relationship with the participant when the issues to be discussed relate directly to the participant.
While CIC is primarily provided in a one-to-one counseling session, there are times when it is appropriate to provide this service to the participant in a family counseling or group counseling setting.
Regarding client confidentiality, the sharing of information obtained during a CIC session can only be disclosed in accordance with accepted professional standards regarding client confidentiality.
CIC must NOT be used to assist the participant to become physically integrated into his/her environment. This function is the responsibility of other service providers, such as Service Coordinators, ILST and HCSS.
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PBIS services are provided to participants who have significant behavioral difficulties that jeopardize their ability to remain in the community of choice due to inappropriate responses to events in their environment. The primary goal of PBIS services is to decrease the intensity or frequency of targeted behaviors, and to teach more socially appropriate behaviors.
PBIS services include but are not limited to: