Chapter 6: Eligibility

In applying for Independent Living Rehabilitation (ILR) services, the following criteria must be met:

• have severe vision loss or blindness; or
• either be aged 55 or older, or have a severe mental, cognitive, physical or other sensory impairment; or
• experience a severe limitation in ability to function independently in the family or community, or to obtain, maintain, or advance in employment due to vision loss or blindness and have a secondary disability; and
• there must be a reasonable expectation that independent living rehabilitation services will improve the individual’s ability to function, continue functioning, or move toward functioning independently in family or community, or to continue in employment.

Status 08 Ineligibility Criteria and Guidance

It has been determined that the case is Closed at Application for Independent Living Services. The individual does not meet at least one of the following Basic Criteria for Eligibility:

• Individual has severe loss of vision and is at least age 55, or has documented disabilities in combination with a severe loss of vision or blindness
• As a result of these disabilities, the individual’s ability to function in family, or community, or to engage or continue in employment is severely limited.
• Due to significant needs in the area of independent living, the individual does not choose to participate in Vocational Rehabilitation at this time.
• There is a reasonable expectation that the individual will benefit from Independent Living Rehabilitation Services.
• Note: Exception to policy can be considered for any applicant under Status 08.

The ILR teacher may prepare the statement and send the exception statement to the IL program administrator in writing (i.e., email). The ILR teacher and IL program administrator shall follow-up to discuss the case. A decision will be provided to the teacher in writing (via email) by the IL program administrator. The ILR teacher will inform the applicant of the IL program administrator’s decision to the exception to policy regarding his or her application eligibility.

Status 10 Eligibility and Guidance

To be eligible for independent living rehabilitation services from the Iowa Department for the Blind, an individual must meet the following criteria as outlined in federal regulations:

• Have severe vision loss or blindness, OR
• Either be aged 55 or older, or have a severe mental, cognitive, physical, or sensory impairment, OR
• Experience a significant limitation in ability to function independently in the family or community, or to obtain, maintain, or advance in employment due to vision loss or blindness and have a secondary disability; AND
• There must be a reasonable expectation that independent living rehabilitation services will improve the individual’s ability to function, continue functioning, or move toward functioning independently in family or community, or to continue in employment.

Eligibility certification process

These items will be needed to complete Eligibility Determination within the CMS and paper files or with an exception to policy that will be approved by the supervisor:

• Best corrected acuity and/or visual fields are documented. A current eye report needed for file.
• The individual’s age at the time of eligibility determination.
• Any co-disability information.

An IL assessment and analysis that describes disability-related limitations experienced by the individual in the home, family, community, or employment as a result of severe vision loss or blindness and any other known or documented secondary disability in combination with blindness or severe vision loss.

Indication as to whether the applicant wants to participate in VR services (select “yes” or “no” from the box drop down).

Detailed information about how IL services will benefit the individual.

Next, inform the applicant that they are eligible for IL services and training, then document the conversation in the case record. Where a guardian is assigned, send a written statement indicating the same.

Ensure eligibility certification has been made after consultation with the applicant, or as appropriate, their parent, guardian, or other representative or after affording a clear opportunity for such consultation and the individual has been notified in writing of the action taken and has been informed about their rights and remedies, including procedures for formal appeals and to whom appeals may be filed and referral to other agencies and facilities, as appropriate, 34 C.F.R. 364.51, 364.58.

A determination of eligibility shall be made within 60 days from the date of application. The 60-day period begins on the date the application is entered into the electronic CMS by the RS or when assigned accordingly by the ILR teacher.

• A delay in determining eligibility for services may be extended if exceptional or unforeseen circumstances beyond the control of the agency preclude making the eligibility determination within 60 days and IDB and the individual agree to a specified extension of time.
• The agreement and the extension shall be documented and the documentation must reflect the reason for the extension, the date on which the eligibility determination will be made, and that the individual agrees with the extension.
• Extensions shall not be more than 60 additional calendar days; if an unusual situation arises with an applicant that requires an additional extension, the IL teacher shall obtain an exception to policy from the program administrator outlining the reason for the exception the amount of time needed to make the determination.
• If eligible, move to Status 10; if not move to Status 08.

The ILR teacher is responsible to certify the Eligibility Determination Certificate in the electronic CMS, print this same certificate and sign the document which must be placed in the applicant’s paper file at the IDB office.

Blind Journal

Completing the Blind Journal section is required. There are options to select from example Blind or Visually Impaired within a Blind Code combo box. If the “Blind” option is listed in the Blind code and a date does not appear in the Blind Journal Date field, enter today’s date. If the election is Visually Impaired as the code, do not enter the Date field.

Within this same location, there are a medical information fields that require new information required for a new applicant or updated information for a returning applicant. As the individual self-reports their respective medical information or that information is found in their medical records then is confirmed through a conversation, the appropriate medical or disability information must be documented within this location as well as case noted.

See Blind Journal Appendix Q for additional information regarding visual acuity and visual field measurements.


Guidance: Case Management Processes in Moving an IL Case From Status 02 Application to Eligibility Determination of Either Status 08 Ineligible or Status 10 Eligible

Case Move From Status 02 to Status 08

If after reviewing the application and information gathered it is determined that the applicant does not meet one of the eligibility criteria below, the applicant’s case must be closed.

Eligibility Criteria:

1. The Individual has a severe loss of vision and is at least age 55 or has disabilities in combination with a severe loss of vision.
2. As a result of these disabilities, the individual’s ability to function in family, or community, or to engage or continue in employment is severely limited.
3. Due to significant needs in the area of independent living, the individual does not choose to participate in Vocational Rehabilitation at this time.
4. There is a reasonable expectation that independent Living Rehabilitation Services will benefit the individual.

Other reasons for closure include Unable to locate, refused further services, failure to cooperate, or death.

If an applicant is determined to be ineligible due to any of the circumstances listed above, the case record must receive thorough documentation before moving the case to Status 08. The ILR teacher may consult with the IL Program Administrator whenever needed.

Process to complete Status 08 with the electronic CMS in eFORCE:

• Complete Eligibility Determination in CMS
• Record the best corrected acuity or visual fields if available
• Record any co-disability information if available or applicable. Note, if none, then write “none”
• If the ILR teacher is able to assess the situation, provide a short analysis that describes disability-related limitations experienced by the individual in the home, family, community, or employment, if applicable. If nothing is applicable, then write “none”
• Complete a question related to the individual’s views regarding his or her needing IL services and choosing not to participate in VR services; and
• Record information about how IL services will benefit this individual if applicable. Note, if nothing is applicable, then document “none.”
• Complete a Closure Case Note in eFORCE to justify reason for the Status 08
• Complete a Closure Letter to IL applicant and/or legal guardian:
  • Use an appropriate supplied IL program template letter which can be found in Appendix, choosing one from I through M.
  • When death is the reason for the closure, do not send a Closure Letter and the Closure Amendment to the individual’s home address or guardian unless the guardian requests those documents for their records. The ILR teacher signed Closure Amendment will still be placed in the individual’s IL paper file.
    Certifying a Status 08 case closure requires that a letter be mailed to the IL applicant or the legal representative. The letter must state that the closure has been made after thorough consultation with the applicant or the applicant’s personal representative, if applicable, and that the applicant was afforded a clear opportunity for the consultation,
    constitute verification that the applicant has been notified in writing of the action and that he or she has been informed about his or her rights and remedies, including ICAP, IL Teacher contact information, IL Program Administrator contact information, procedures for formal appeals and to whom appeals may be filed, and referral to other agencies and facilities, as appropriate. 111 I.A.C. Section 111–11.10(216B).
• Ensure all closure documents requiring signatures are sent to the individual and the individual’s physical address.

Status Moves From 02 Application to Status 10 Plan Development

Once eligibility determination is made, inform the applicant they are eligible, inquire if they are ready to move forward and if affirmed, then move the IL case to a Status 10.

Moving the case to Status 10 certifies that the IL applicant intends to achieve an IL outcome consistent with his or her unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice. Presume that the individual can achieve the outcome with the provision of IL services.

The next step is to work with the client on developing an Independent Living Rehabilitation Plan (ILRP) or ILRP Waiver which is discussed in Chapter 8.

ILR teachers have up to 10 business days to enter IL program case notes into the CMS. Any case note related to VR must be entered within 5 business days.