ࡱ> OQN#` l>bjbjmm vB;$PB<~LrHHHH#=X;======h( =QU##UU=HHUXHH;U;H wVd0D!~D!D!AL6,fAAA==XAAAUUUU D Rehabilitation Services for the Blind Independent Living Plan (ILP)  FORMCHECKBOX  Original  FORMCHECKBOX  Amendment Name  FORMTEXT      Case Number #  FORMTEXT      You have been determined eligible for Independent Living Services.Service Objectives/ Goals: 1. FORMTEXT       2. FORMTEXT       3. FORMTEXT       4. FORMTEXT      Plan Initiation Date:  FORMTEXT      Program Projected Completion Date:  FORMTEXT      ILR Services required: 1.  FORMTEXT       2.  FORMTEXT       3.  FORMTEXT       4.  FORMTEXT       Funding Source 1. FORMTEXT       2. FORMTEXT       3. FORMTEXT       4. FORMTEXT      Plan Review Date: FORMTEXT      Client Signature: __________________________ Date:  FORMTEXT      Rehab Teacher Signature: ______________________ Date:  FORMTEXT        INDEPENDENT LIVING PLAN (ILP) Missouri Rehabilitation Services for the Blind provides Independent Living services to individuals with disabilities which allow them to improve their ability to function independently in family or community. Services that the agency can provide depend on the availability of State and Federal funds. RIGHTS You have the right to have your independent living plan reviewed as often as necessary but at least on an annual basis to determine whether services should be continued, modified or discontinued. It is your right to fully discuss all amendments to your plan with your agency representative. You must be given the opportunity to take part in any decision about changing your status from eligible to ineligible, and you are entitled to have an ineligibility decision reviewed within one year. If you are an individual who is receiving services under the Developmental Disabilities Assistance and Bill of Rights Act or Part B of the Education For All Handicapped Children Act your Independent Living Plan (ILP) will be coordinated to the maximum extent possible with your IHP or IEP. When you have achieved your Independent Living Plan Service Objectives/Goals the case will be closed. CONFIDENTIALITY All information which you provide to Rehabilitation Services is confidential. Rehabilitation Services will share this information only in the management of your plan unless you give written permission for it to be shared with other persons. RSB will manage all personal information in compliance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996. RESPONSIBILITIES It is your responsibility to check with Rehabilitation Services before beginning any service to be sure that necessary funding has been arranged. You may not proceed with a service unless funding has been previously authorized. It is your responsibility to inform Rehabilitation Services about any changes in your program, family income or living arrangements. Depending upon your financial situation, you may have to meet the cost of some of the services you will receive. You may need to apply for benefits from other sources in order to help meet the costs of your plan. APPEAL PROCEDURES You are encouraged to request an appeal of your case if you feel that you are being denied services that you need or if you are being given services that you do not think are necessary. To request the review write the District Supervisor in the office from which you receive services. You are entitled to a  z  4 6 8 > P R b d x z | ɷɚɈvkkY#jh2Nh2NCJ UaJ hwhIJCJ aJ "jh2NCJ UaJ mHnHu#jh2Nh2NCJ UaJ #jhhTZCJ UaJ hwhECJ aJ #jhV+hTZCJ UaJ h2NCJ aJ jh2NCJ UaJ hd 7CJ aJ h*CJ aJ hECJ aJ hwhd 7CJ aJ "LR b V m|kd8$$Ifs0"}D%[ t0")44 sayt\Y $IfgdW<gdE$a$gdHh L>k> R T V z |     & ( < ø˰˰˨tb#jh2Nh2NCJ UaJ #jh2Nh2NCJ UaJ #jh2Nh2NCJ UaJ h2NCJ aJ h^CJ aJ hyQCJ aJ hECJ aJ hwhIJCJ aJ hFCJ aJ hwhd 7CJ aJ hwh2NCJ aJ "jh2NCJ UaJ mHnHujh2NCJ UaJ %V X " N $IfgdF $IfgdW<ikd$$Ifs"D%") t0")44 sayt\Y< > @ J L N     6 L P R Z \ p r t ~ ĹᱟĹᱍĹąskhIJCJ aJ #j, h2Nh2NCJ UaJ hFCJ aJ #jh2Nh2NCJ UaJ #jh2Nh2NCJ UaJ h2NCJ aJ hwhd 7CJ aJ hwhIJCJ aJ "jh2NCJ UaJ mHnHujh2NCJ UaJ #jh2Nh2NCJ UaJ $N P $ikd$$Ifs"D%") t0")44 sayt\Y $IfgdW<ikdb$$Ifs"D%") t0")44 sayt\Y   R B p {{{ $IfgdF $Ifgdd 7ikd $$Ifs"D%") t0")44 sayt\Y $IfgdW<     p t v ῭ǥΐ|tb|P|"jh.YCJ UaJ mHnHu#j h.Yh.YCJ UaJ h.YCJ aJ jh.YCJ UaJ hwhd 7CJ aJ #j h2Nh2NCJ UaJ hyQCJ aJ #j h2Nh2NCJ UaJ h2NCJ aJ hFCJ aJ "jh2NCJ UaJ mHnHujh2NCJ UaJ #j h2Nh2NCJ UaJ   "DFZ\^hj῭Ίᐅ}k]ThG->*CJ aJ jhG->*CJ UaJ #jh2Nh2NCJ UaJ hFCJ aJ hwhd 7CJ aJ hFhd 7CJ aJ #jLh2Nh2NCJ UaJ #jbh2Nh2NCJ UaJ h2NCJ aJ hFCJ aJ "jh2NCJ UaJ mHnHujh2NCJ UaJ #jxh2Nh2NCJ UaJ  "lz $IfgdW<|kd6$$Ifs0"D% t0")44 sayt\Yln4b{ $IfgdIJ $IfgdW< $Ifgdd 7ikdZ$$Ifs"D%") t0")44 sayt\Y4lnpKRrQUޤވraraOarara#h*h@V5CJOJQJ^JaJ hUGh@VCJOJQJ^JaJh@VCJOJQJ^JaJh@VCJ aJ hwCJ aJ &jhG-hG->*CJ UaJ hG->*CJ aJ h2NCJ aJ hwhIJCJ aJ hwhd 7CJ aJ %jhG->*CJ UaJ mHnHujhG->*CJ UaJ &jhG-hG->*CJ UaJ JKRwx~vvnnnnnnnn$a$gd@V$a$gd@VgdW<|kdf$$Ifs0"}D%[ t0")44 sayt\Y xABdeTUf<<<L>N>O>Q>R>T>U>W>$a$gd@VYZ}SUf<7<O<V<<<==K>L>M>O>P>R>S>U>V>X>\>]>h>i>j>k>l>ӿӮhUx hhUxCJOJQJ^JaJhUxCJOJQJ^JaJh'+jh'+U h*h@VCJOJQJ^JaJU#h*h@V5CJOJQJ^JaJ hUGh@VCJOJQJ^JaJh@VCJOJQJ^JaJh*CJOJQJ^JaJ0review by the RSB Deputy Director following an appeal. A written request for a review must be sent to the Deputy Director, FSD/Rehabilitation Services for the Blind, PO Box 2320, Jefferson City, Missouri 65102. CLIENT ASSISTANCE PROGRAM If you are an applicant/client of Independent Living Rehabilitation Services, there is a resource to help with any problems you may have with services provided by the Agency. You may contact Missouri Protection and Advocacy Services, 925 South Country Club Drive - B-1, Jefferson City, Missouri 65109. You may call them toll-free at 1-800-392-8667.     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