Independent Living Skills Training (ILST)
Definition
Independent Living Skills Training Services (ILST) are individually designed to improve or maintain the ability of the waiver participant to live as independently as possible in the community. ILST assists in recovering skills that have decreased as a result of onset of disability. Also, ILST will primarily be targeted to those individuals with progressive illnesses to maintain essential skills. ILST may be provided in the waiver participant's home and in the community. This service will primarily be provided on an individual basis; only in the unique situation where the waiver participant will receive greater benefit from other than a 1:1 situation, will a group method of providing service be approved.
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 ADL and IADL related to his/her established goals. The Provider will use the results of the assessment to develop an ILST Detailed Plan. The Detailed Plan will identify milestones to be met during the six (6) month period. The assessment must also include a determination of the participant's best manner of learning new skills and responses to various interventions. This comprehensive and functional assessment must be conducted at least annually from the date of the last assessment.
ILST services may include assessment, training, and supervision of an individual with self-care, medication management, task completion, communication skills, interpersonal 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 must be provided in the environment and situation that will result in the greatest positive outcome for the waiver participant. It is expected that this service will be provided in the waiver participant's environment; for example, in the participant's kitchen as opposed to a provider's kitchen. This expectation is based on 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 wavier participant's environment.
ILST services may also be used to assist a participant in returning to, or expanding the waiver participant's involvement in meaningful activities, such as paid or unpaid (volunteer) employment. The use of ILST for vocational purposes must occur only after it is clear that the waiver participant is not eligible for these services through either the Vocational and Educational Services for Individuals with Disabilities (VESID) or the Commission for the Blind and Visually Handicapped (CBVH); that VESID and CBVH services have been exhausted; or the activity is not covered by VESID or CBVH services.
It is expected that ILST providers will train the waiver participant's informal/natural supports, paid staff and waiver providers to provide the type and level of supports that allows the waiver participant to act and become as independent as possible in ADLs and IADLs. This service may continue only when the waiver participant has reasonable goals. It is used for training purposes and not ongoing long term care supports. Reasons to provide or continue this service must be clearly stated in the SP within the context of clearly defined and reasonable goals.
Provider Qualifications
ILST may be provided by any not-for-profit or for profit health and human services agency.
An ILST must be a:
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- Registered Occupational Therapist - licensed by the NYS Education Department;
- Registered Physical Therapist - licensed by the NYS Education Department;
- Licensed Speech-Language Pathologist - licensed by the NYS Education Department;
- Registered Professional Nurse - licensed by the NYS Education Department;
- Certified Special Education Teacher - certified by the NYS Education Department;
- Certified Rehabilitation Counselor - certified by the Commission on Rehabilitation Counselor Certification;
- Master of Social Work; or
- Master of Psychology.
These individuals must have, at a minimum, one (1) year of experience completing functionally based assessments, developing a comprehensive treatment plan and teaching individuals with disabilities and/or seniors to be more functionally independent; OR
- An individual with a Bachelor's degree and two (2) years of experience completing functionally based assessments, developing a comprehensive treatment plan and teaching individuals with disabilities and/or seniors to be more functionally independent; OR
- An individual with a High School Diploma and three (3) years experience completing functionally based assessments, developing a comprehensive treatment plan and teaching individuals with disabilities and/or seniors to be more functionally independent.
The following individuals must be supervised by individuals identified in section (A) to perform ILST services:
- Individuals with the educational experience listed in section (A) but who do not meet the experience qualifications;
- Individual with a Bachelor's degree and one (1) year of experience;
- Individuals with a High School Diploma and two (2) years of experience; and
- Individuals who have successfully completed two (2) years of providing Home and Community Support Services or Residential Habilitation under the Office of Mental Retardation and Developmental Disabilities HCBS waiver.
The supervisor is responsible for:
- Meeting any potential waiver participants prior to the completion of the Detailed Plan developed by the ILST under their supervision;
- Working with the ILST on completing the functional assessment of the participant;
- Working with the ILST to reevaluate the participant as needed, but not less than at the completion of the Revised Service Plans and whenever Addenda to the SP are written;
- Have supervisory meetings with staff on at least a bi-weekly basis;
- Provide ongoing supervision and training to staff; and
- Review and sign-off on all Detailed Plans.
Reimbursement
ILST services must be provided by a DOH approved provider and must be included in the SP to be reimbursed.
ILST is reimbursed in one hour units. Participation in Team Meetings is reimbursed at the hourly rate for this service.
If ILST is provided in a group setting, the hourly rate is divided evenly among the participants.
