Older Individuals Who Are Blind Program Manual

Chapter 1: Foundations, Roles, and Responsibilities

1.1: Introduction

This policy manual serves as the guiding document for administering the OIB program. Managed by TWC’s VR Division, this manual is the primary resource for OIB Services Specialists, staff members, and other TWC professionals. It ensures the delivery of services and goods necessary for OIB customers to achieve success while adhering to federal and state regulations.

The OIB program provides services to customers age 55 and older who:

• experience substantial limitations in their ability to function independently in the home, family, and/or community due to a visual impairment; and
• would benefit significantly from the delivery of independent living services to improve or maintain their ability to function independently.

An OSS is required to become familiar with each chapter of this manual and stay updated on any amendments.

This manual is designed to guide OIB staff in employing best business practices and approaches that empower customers to achieve their independent living goals. OIB customers face diverse needs and circumstances that an OSS must address throughout the customers’ case. Consistent with TWC’s policy framework, an OSS must be understanding, resourceful, and creative to contribute to the customers’ success.

OSSs and other professionals using this manual are encouraged to foster meaningful partnerships with customers and all parties involved in the case progression, including vendors, family members, medical professionals, friends, and contacts from other participating organizations. The OSS’s commitment, knowledge, and perseverance are critical to achieving positive outcomes for customers. Additionally, customers often require a variety of training, which the OSS identifies, discusses, and coordinates. These types of training are addressed in this manual. 

1.2: Legal Authority

• Section 752 of the Rehabilitation Act of 1973, as amended; 29 USC 796k(a) and (d)
• CFR Part 367 Independent Living Services for Older Individuals who are Blind
• Title 40, TAC, Part 20, Chapter 853 Independent Living Services for Older Individuals Who Are Blind

1.3: Nondiscrimination Policy

TWC’s OIB program does not deny services because of age, sex, race, color, disability, religion, or national origin. 

All discrimination complaints received by the VR Division, either directly from a customer or through an external compliance agency, must be forwarded immediately to the TWC Equal Opportunity (EO Officer at eo.complaint@twc.texas.gov (use “Attn: EO Compliance Department, Fraud Deterrence and Compliance Monitoring Division” in the subject field) by the OSS receiving the complaint. Customers can also be referred immediately to the EO hotline at (512) 463-2400.

Detailed information about policies, services, and procedures may be found on TWC’s Equal Opportunity is the Law web page. 

1.4: Section 504 Compliance 

The OIB program does not deny services to any individual in Texas—who is otherwise qualified—because of a disability.

1.5: Ethical Conduct 

The VR Division expects all OIB program staff members to demonstrate adherence to ethical standards and rules of conduct in alignment with their professional competence, integrity, and objectivity consistent with their education, experience, expertise, and assigned position. 

1.5.1: Ethical Violations

OIB staff members who violate provisions of the ethical conduct authority in this policy are subject to disciplinary action, up to and including dismissal from employment. Furthermore, any employee who violates the ethics policy is subject to any applicable civil or criminal penalty if the violation also constitutes a violation of another statute or rule.

1.5.2: Ethical Procedures

OIB program staff members must:

• adhere to the ethical standards stated in all policy, procedure manuals, and agency standards;
• be accountable to organizational standards;
• be transparent and accountable in all decisions and actions related to OIB responsibilities; and
• document any ethical dilemmas or conflicts of interest, approvals, consultations, and solutions in RHW.

OIB program staff also adheres to all ethics policies outlined in the Vocational Rehabilitation Services Manual (VRSM) Part A, Chapter 7: Ethical Conduct. 

1.6: Appropriate Touch Procedure Guidance for Older Individuals Who Are Blind Staff

OIB staff must adhere to this guidance regarding physical touch with customers. This guidance outlines why physical touch may be needed to participate in OIB services, identifying appropriate and inappropriate forms of touch, procedures for facilitating conversations and training regarding appropriate touch, and procedures for reporting and documenting inappropriate (or perceived inappropriate) touch.

Individuals receiving training services through the OIB program have a visual impairment and/or legal blindness, which poses challenges to training and learning necessary skills to achieve successful outcomes. A common practice during such training involves the use of physical touch when meeting in person to facilitate tactile learning and/or proper body alignment or positioning.

1.6.1: American Printing House for the Blind Definitions

The following definitions are provided by the American Printing House for the Blind:

• Hand-Under-Hand Technique—“When you use the hand-under-hand technique, your hands perform the activity while your student’s hands rest on top of yours—in this way, they can feel what your hands are doing. If the activity is new to your student, they’ll be able to focus their energy on feeling the movements of your hands. They may also feel more comfortable and in control because they can freely remove their hands if they want to. As you perform the activity, verbally describe what you are doing with your hands.”
• Hand-Over-Hand Technique—“When you use the hand-over-hand technique to help your student do an activity, you place your hands over their hands. Your student is the one who is touching the materials, and your hands guide them as they manipulate the materials to complete the activity. As you find they can do small parts of the activity, you can lessen the support your hands are providing by either pulling your hands away or moving them to their wrist or arm. This way, your hands are ready to come back and lend support if they need assistance.”

1.6.2: Areas of the Body that May Need To Be Touched

Areas of the body that may need to be touched during training are detailed below. 

The shoulder and/or upper back may need to be touched:

• to facilitate proper orientation and body alignment or human guide technique during O&M training (such as positioning the person to face the correct direction); or
  • in case of emergencies (such as ensuring the person does not step into the street at a dangerous or incorrect time during O&M training).

The hands may need to be touched to facilitate proper skills via Hand-Over-Hand or Hand-Under-Hand Techniques (for example, typing position on a keyboard, use of adaptive equipment, proper grip on a white cane, and so on).

Note: The proper etiquette and safety technique is to use the back of the hand or fingers tucked under to locate items or shake hands, thus reducing injury to fingers.

The forearms, wrists, and/or elbows may need to be touched when providing or teaching the human guide technique.

1.6.3: Procedures for Addressing Appropriate Touch with Customers

Prior to the start of training with OIB customers, staff, or vendors, OIB staff must:

• explain the potential need for physical touch during in-person interactions with customers using the provided definitions as part of training services;
• discuss with customers the possibility of unintended or accidental touch during training (such as bumping into each other or accidentally touching during a lesson) due to the nature of vision loss; 

Note: This risk may be heightened when both the customers and staff members have vision loss.

• clarify that customers can offer and rescind consent at any time;
• remind customers of the appeal process explained in the Can We Talk? brochure, which is provided during the intake appointment by the OSS (the OSS or staff can provide an additional copy if requested); 
• explain that any concerns regarding inappropriate touch (or perceived inappropriate touch) should be addressed through the appeals process; and
• document the conversation and the customer’s consent via a case note in RHW.

OIB staff must adhere to the following throughout the duration of the training services:

• Consent—An OSS will obtain consent before each instance of physical touch, accompanied by a clear announcement of the intent and location.
• Auditory Cues—Use auditory cues if necessary to help the person in locating the position of the reach.
• Training—Provide coaching on appropriate touch, tailored to individual training needs, including techniques like the Hines Break, handshake etiquette, and locating physical items.
• Respect for Consent—The customer may withdraw consent for physical touch at any moment, and this decision must be respected by all OSSs and vendors.

1.6.4: Reporting Inappropriate Touch During Training

Inappropriate touch may include, but is not limited to:

• touch that lingers past the necessary duration of time and purpose; 
• any touch that is not necessary for engaging in training services;
• touch to any other area of the body other than identified; and
• any other touch that is perceived to be inappropriate or uncomfortable by either the customer or the OSS.

If an inappropriate touch or perceived inappropriate touch occurs, an OSS must:

• document in a case note in RHW describing the series of events that took place;
• share the Can We Talk? brochure, which explains the appeals process; and
• report the incident to the appropriate manager.

1.7: Basic Rights, Appeals Procedures, and Hearings Procedures

Applicants and individuals currently receiving services provided by the OIB program are afforded certain rights, which include:

• the right to be informed in writing of their rights; 
• the right to participate in services that are nondiscriminatory; 
• the right to have protection of personal information contained in program records; and 
• the right to appeal decisions regarding planned services or their eligibility for such services. 

Customers have a right to appeal decisions made about their OIB cases. Detailed information about the appeal procedure is outlined in the Can We Talk? brochure. For further information on the steps for appeals procedures for the VR Division, including the OIB program, refer to VRSM Part A, Chapter 4: Appeals and Due Process.

The Can We Talk? brochure should be provided to the customer:

• at the time of application for OIB services;
• if the customer is determined ineligible for services;
• when discussed during the development of the ILP;
• upon customer request; and
• when discussed at case closure (in the closure letter). 

Note: The OSS must document in a case note in RHW that the brochure was provided to the customer at application or any other time listed above, if applicable, and discussed at case closure in writing. 

The OIB program aims—within policy and fiscal constraints—to satisfy every OIB customer. However, not every decision will be satisfactory to every applicant or customer. When an applicant or a customer is dissatisfied, they may consider a complaint, an appeal, or both. OIB staff must provide information to customers about their rights to appeal and options for appeal procedures as outlined in the Can We Talk? brochure and in VRSM Part A, Chapter 4: Appeals and Due Process.

1.8: Confidentiality and Use of Customer Records and Information

A “customer” is a person who applies for or receives OIB services. A “customer representative” is a person designated by an applicant or eligible individual to represent them, including a parent, guardian, other family member, or advocate. If a court has appointed a guardian or representative for an applicant or eligible individual, the court-appointed person is the applicant or eligible individual's representative.

For TWC to safeguard a customer’s confidentiality, the customer or customer representative must provide documentation of customer representation to TWC. The customer representative will have responsibilities related to the provision of TWC services until TWC is notified by the customer or the customer representative that the customer representative is no longer serving in that role.

The customer’s case file must include documentation as detailed in the table below.

Table 1: Representative Types and Documentation Requirements

1.8.1: “CONFIDENTIAL” Markings on Released Customer Records

Any customer records released must have a “CONFIDENTIAL” stamp imprint on each file, assuring that the information will:

• be safeguarded; 
• be used only for the purpose provided; and 
• not be released to unauthorized individuals. 

An exception occurs if more than 10 pages are released. In that instance, the pages may be stapled together with the stamp imprint on a cover page, or if appropriate, use the following:

• Form VR1515, Notice for Release of Confidential Records Pursuant to Legal Process or Investigation; or
• Form VR1516, Notice for Release of Confidential Records for Audit, Research, Evaluation, or Other Program Purposes

OIB staff members are required to: 

• ensure that customer information is secure at all times; 
• be familiar with and adhere to all applicable sections of VRSM Part A, Chapter 5: Protection, Use, and Release of Personal Information; and 
• maintain the highest standards of ensuring that customer information is kept secure and confidential. 

At the time of application, customers are required to sign Form VR5054, Signature Form for OIB Program Applicants. When signed, this form is the customer’s acknowledgment that, by law, personal information may be shared with other governmental entities.

Customers may request information from their case files. When the customer or their authorized representative submits a valid release—a properly completed written request for information—the OSS is obligated to provide the requested information from the customer’s case file in a timely manner. The following are valid releases accepted by VR:

• A properly completed Form VR1517-2, Authorization for Release of Confidential Customer Records and Information
• Social Security Administration (SSA) Form SSA-827, Authorization to Disclose Information to the Social Security Administration (SSA), version dated April 2009 or later 

Note: Versions of Form SSA-827 dated before April 2009 are not valid and cannot be honored.

• An authorization or form provided by the customer, that after evaluation on a case-by-case basis, has been found to meet the criteria set forth below.

To qualify as a valid release, a customer’s authorization form must:

• be in writing (either handwritten or typed);
• identify the records or other information to be released;
• be signed by the customer or a representative;
• be dated;
• identify the individual (as appropriate, by name, telephone number, and address) or entity to whom VR is authorized to release the information; and
• be specifically directed to VR. 

Note: An exception for release forms that are not addressed, or releases addressed “To Whom It May Concern” or “To Custodian of Records,” are valid if the releases identify OIB records to be released.

1.9: Customer Assistance Number and Client Assistance Program

Per CFR §367.68, “The Designated State Agency (TWC) and all other service Vendors under this part shall use formats that are accessible to notify individuals seeking or receiving services under this part about (a) the availability of CAP authorized by section 112 of the Act; (b) The purpose of the services provided under the CAP; and (c) How to contact the CAP.”

The Can We Talk? brochure contains information about the Texas Workforce Solutions customer assistance number and the CAP.

Applicants and customers may contact Texas Workforce Solutions Customer Assistance at (800) 628-5115 for information about appeals and mediation of their cases. 

For more information about their rights, applicants and customers can contact the CAP at (800) 252-9108.

1.10: Release for Administration of the Customer’s Older Individuals Who Are Blind Program

The scope of a customer’s rehabilitation is determined by the provisions of the customer’s ILP. Releasing customer information for a purpose directly connected with the customer’s rehabilitation usually poses no problem. This release does not legally require express or written customer consent. At the time of application, the customer signed the VR5054 Signature Form for OIB Program Applicants. When it is difficult to ascertain whether the purpose of the release is “directly connected with the customer’s rehabilitation program,” the OSS obtains the customer’s written authorization on a valid release to provide information to an organization or individual through Form VR1517-2, Authorization for Release of Confidential Customer Records and Information.

1.11: Release of Information for Research Purposes

Pursuant to 34 CFR 367.69, under certain circumstances, TWC is authorized to release personal information to an organization, agency, or individual engaged in audit, evaluation, or research but only for purposes directly connected with program administration or for purposes that would significantly improve the quality of life for individuals with disabilities. Release of information can only be made in accordance with a written agreement between TWC and the organization, agency, or individual engaged in audit, evaluation, or research. Among other things, any such written agreement must ensure that the released information: 

• is used only for the purposes for which it is being provided; 
• will be released only to persons officially connected with the audit, evaluation, or research; and 
• will be safeguarded for confidentiality. 

When such a request is received, the customer should sign Form VR1516, Notice for Release of Confidential Records for Audit, Research, Evaluation, or Other Program Purposes, and OIB staff should obtain a valid release from the customer. The OSS also contacts TWC’s OGC to determine whether OIB would be authorized to provide the information and to obtain the documentation that must be signed by the recipient when such information is released.

1.12: Reporting Allegations of Abuse, Neglect, or Exploitation

Any OIB staff member who suspects or witnesses abuse, neglect, or exploitation must notify authorities and complete required documentation. 

1.12.1: Documenting the Report

To report allegations of abuse, neglect, or exploitation, the individual who has cause to believe that abuse, neglect, or exploitation has occurred:

1. immediately contacts law enforcement if the incident is a threat to health or safety; 
2. immediately reports the incident to the appropriate investigatory agency, as listed in the table below;
3. documents which investigatory agency was contacted in the customer’s RHW case file, including the reference number provided by the investigatory agency; and
4. notifies their manager, supervisor, or the appropriate contract manager of the allegation.

Any staff member who has cause to believe that a minor, an adult with a disability, or an individual 65 years of age or older is at risk of (or in a state of harm due to) abuse, neglect, or exploitation must immediately report the information to the appropriate investigatory agency (refer to the table below), and, if the incident is a threat to health or safety, the local law enforcement agency. 

Reporting suspected abuse, neglect, or exploitation to the appropriate investigatory agency directly is required regardless of the circumstances. 

Table 2: Reporting Process for Allegations of Abuse, Neglect, or Exploitation

1.12.2: Reporting in a Facility

Incidents that involve customers residing in a facility should be reported to the authority responsible for the facility. 

To report allegations of abuse, neglect, or exploitation, the individual who has cause to believe that abuse, neglect, or exploitation has occurred:

1. immediately contacts law enforcement if the incident is a threat to health or safety; and
2. notifies their manager, supervisor, or the appropriate contract manager of the allegation.

The supervisor, manager, or appropriate contract manager:

1. consults with TWC Human Resources for next steps; 
2. consults with TWC OGC, as appropriate; and 
3. fills out Form RSM-4740, Security Incident Report, on the same day or no later than 48 hours of the date the allegation was made, and forwards it by email to: 
   • incidentreports.rsm@twc.texas.gov; and 
   • the supervisor, manager, or appropriate contract manager’s chain of management.

1.13: Responding to Subpoenas for Customer Records

TWC releases customer information to a federal or state court, an administrative hearing officer, or a judge when presented with a subpoena, an order, or a summons. Valid subpoenas are binding upon TWC, with or without the customer's consent.

If the OSS receives a subpoena, court order, or other summons, they immediately contact OGC directly and notify their immediate supervisor. Release of information under a subpoena, court order, or summons is centrally coordinated through OGC. Subpoenas are centrally tracked through the TWC's Office of General Counsel Open Records. Release of records is prohibited unless expressly approved by OGC, including, but not limited to, the following circumstances:

• A customer, customer’s representative, or lawyer requests that a TWC employee verbally discuss a subpoena with a lawyer.
  • A lawyer, judge, magistrate, or court clerk calls or writes TWC concerning a subpoena.
    • A TWC employee is served with a subpoena that requires them to appear: 
    • in court;
    • before an administrative proceeding; or 
    • for an oral deposition.

The OIB staff member sends a copy of the subpoena via email to open.records@twc.texas.gov or via fax to (512) 463-2990. Responses to subpoenas, court orders, or summons are centrally coordinated through the OGC Open Records department. Release of records is prohibited unless expressly approved by OGC. The OIB staff member should contact OGC via email at open.records@twc.texas.gov or call the VR Records Coordinator at (512) 936-6355 for instructions pertaining to the above circumstances. The OSS sends any requests to answer written questions that accompany a subpoena to OGC and awaits instructions for processing.

1.14: Voter Registration

On February 21, 2018, under the National Voter Registration Act of 1993 and Chapter 20 of the Texas Election Code, the TWC VR Division was designated by the Secretary of State to provide voter registration services through its VR and OIB programs. The TWC VR Division must ensure that TWC customers are afforded the right to receive assistance with voter registration.

Note: From September 1, 2016, to May 11, 2018, policy did not require TWC VR staff to offer voter registration services to OIB customers.

OIB staff is prohibited from:

• influencing a customer’s political preference or party registration;
• displaying political preference or party affiliation;
• making any statement or taking any action to discourage a customer from registering to vote; and
• documenting in RHW case management notes or case files the customer’s response or reaction to being given the opportunity to register to vote.

OIB staff may email questions on policies and procedures related to TWC voter registration services to the VRSM support mailbox at vrsm.support@twc.texas.gov, and review Form VR1680INST, Instructions for the Opportunity to Register to Vote.

OIB staff must inform OIB customers that they may contact the Texas Secretary of State Elections Division at any time to ask questions or file a complaint, and they must provide the contact information below:

Elections Division

Texas Secretary of State

P.O. Box 12060

Austin, Texas 78711-2060

Phone: (800) 252-VOTE (8683)

Email: elections@sos.texas.gov

Website: http://www.votetexas.gov   

1.14.1: Voter Registration Procedures

OIB staff must offer the customer the opportunity to register to vote at the time of application for services or when the customer reports a change of address.

1.14.2: Application for Services

During the application for services, OIB staff must:

• provide an opportunity for voter registration to all customers of voting age; 

In Texas, an individual may register to vote when they are at least 17 years and 10 months old, if they will be 18 years of age on Election Day. 

• help the customer complete the Texas Voter Registration Application if the customer requests assistance;
• mail the completed application for the customer, unless the customer declines assistance and indicates that they wish to submit the application to the voter registrar or take the blank application form, in which case OIB staff must inform the customer that they can submit it to the voter registrar; and
• document that voter registration services were provided to the customer by completing: 
  • the Opportunity to Register to Vote page of the Personal Information page in RHW; or 
  • (if RHW is unavailable) Form VR1680, Opportunity to Register to Vote; and 
• obtain the customer’s signature, unless the customer refuses to sign, in which case the OSS will check the appropriate box.

Note: For additional information about completing this form, refer to Form VR1680INST, Instructions for the Opportunity to Register to Vote.

1.14.3: Declination to Register

For customers who do not want to complete a voter registration application form, OIB staff must check the appropriate box in RHW. If RHW is not available, staff completes Form VR1680, Opportunity to Register to Vote, and obtains the customer’s signature. If the customer refuses to sign, then OIB staff checks the corresponding appropriate box on the form. All VR1680 forms are retained in the customer’s case file.

1.14.4: Change of Address

When a customer reports a change of address in person, OIB staff must:

• provide a Texas Voter Registration Application to the customer if they are of voting age;

Note: In Texas, an individual may register to vote when they are at least 17 years and 10 months old, if they will be 18 years of age on Election Day.  

• help the customer complete the Texas Voter Registration Application if the customer requests assistance;
• mail the completed application for the customer, unless the customer declines assistance and indicates that they wish to submit the completed application to the voter registrar or take the blank application form with them, in which case the OIB staff member must inform the customer that they may submit it to the voter registrar; and
• document that voter registration services were provided to the customer by completing:
• the Opportunity to Register to Vote page on the Personal Information page in RHW; or
• (if RHW is unavailable) Form VR1680, Opportunity to Register to Vote; and 
• obtain the customer’s signature, unless the customer refuses to sign, in which case the OSS will check the appropriate box.

Note: For additional information about completing this form, refer to VR1680INST, Instructions for the Opportunity to Register to Vote.

The OSS is not required to obtain the customer’s signature on Form VR1680 when a customer reports a change of address by phone, email, or other communication. OIB staff must:

• mail a Texas Voter Registration Application and Form VR1681, Texas Voter Registration Application Letter, to customers who are of voting age;
• help the customer complete the Texas Voter Registration Application if the customer requests assistance; and 
• document that voter registration services were provided to the customer by completing the Opportunity to Register to Vote page on the Personal Information page in RHW.

1.14.5: Designation of an Agent

When applying for OIB services or anytime throughout the OIB process, a customer may designate an agent to sign and act on behalf of the customer for voter registration purposes. 

An agent is a designated individual that may act on behalf of a customer for voter registration purposes and is defined in the Texas Election Code Section 13.003 Application by Agent. An applicant may appoint, either orally or in writing an agent to perform one or more of the following acts for the applicant:

• complete and sign a registration application;
• submit an application;
• act on the applicant’s behalf in the process of approving the application, including a challenge of the applicant;
• receive a registration certificate in person; and
• submit a notice or other applicable document for correcting registration information
• To be designated as an agent; the person must:
• Be the customer’s spouse, parent, or child, and
• be a qualified voter of the county or have submitted a registration application and be otherwise eligible to vote.

The agent must be identified and designated on the VR1487 Designation of Applicant or Customer Representative, signed by the agent and the applicant.

Back to Table of Contents

Chapter 2: General Overview of the Older Individuals Who Are Blind Program

2.1: Purpose and Scope of the Older Individuals Who Are Blind Program

The OIB program offers specialized services to individuals ages 55 and older whose independence is threatened because of vision loss. 

The OIB program’s primary purpose is to help individuals remain independent and improve their quality of life. This is accomplished by focusing on helping customers adjust to blindness and develop skills to enable them to live confidently and independently in their homes and communities. 

2.1.1: Who Does the Older Individuals Who Are Blind Program Serve?

OIB helps customers:

• who have a significant visual impairment; 
• whose ability to function independently in the home, their family, or community is substantially limited due to visual impairment; and 
• for whom the delivery of OIB services will substantially improve their ability to function, allow them to continue functioning, or help them progress toward functioning independently in their home, family, or community. 

2.1.2: Older Individuals Who Are Blind Funding and Partnerships

The OIB program is funded through the federal Rehabilitation Services Administration and state matched funds and uses various community resources to maximize customers’ successful outcomes. Some examples of partnerships include the CILs, the Texas State Independent Living Council, VA, the HHSC, and other local community resources.

Together, these programs promote independent living through customer control, peer support, self-help, self-determination, equal access, and individual and systemic advocacy to ensure full integration and inclusion into society.

2.1.3: What Services Are Provided Through the Older Individuals Who Are Blind Program?

Federal law at 34 CFR Part 367.3 defines ILS-OIB as including:

• services to help correct blindness, such as:
  • outreach services;
  • visual screening;
  • surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions; and
  • hospitalization related to these services;
• the provision of eyeglasses and other visual aids;
• the provision of services and equipment to help an older individual who is blind to become more mobile and more self-sufficient; 
• mobility training, braille instruction, and other services and equipment to help an older individual who is blind adjust to blindness;
• guide services, reader services, and transportation; 
• other appropriate services designed to help an older individual who is blind to navigate daily living activities, including support services and rehabilitation teaching services;
• independent living skills training, information and referral services, peer counseling, and individual advocacy training;
• facilitating the transition from nursing homes and other institutions to home and community-based residences with the requisite support and services;
• helping customers who are at risk of entering institutions to remain in the community; and
• other independent living services, including facilitating the transfer to a local CIL.

While federal regulations allow for the above services to be purchased with OIB funds, services are subject to available funding. Currently, OIB does not help with medical services (refer to Chapter 9.1.1 Medical and Clinical Therapeutic Support). OIB services are designed to be responsive to the amount and kind of assistance needed. These services can include providing:

• information about adaptive techniques and resources related to vision loss; 
• referrals to other community resources related to aging, disability, and other individualized concerns; 
• group trainings to encourage self-confidence–building experiences; 
• one-on-one in-home adaptive skills training; and 
• peer support development. 

For additional details about OIB services, refer to Chapter 9: Active Services and Service Delivery.

2.1.4: Customer Informed Choice

“Informed choice” is defined as the means by which a customer chooses their rehabilitation path based on their needs and circumstances and the OIB program’s rules as it relates to all stages of the OIB process.

The principles of informed customer choice require that the customer must be informed about and involved in choosing among alternative:

• intermediate objectives;
• services and the settings in which those services are provided;
• entities providing such services; and
• methods used to provide or procure the services.

The OSS must document clearly when informed choice was provided to the customer and the outcome of the customer’s decision. 

2.1.5: Role of the OIder Individuals Who Are Blind Services Specialist

Independent living services for OIB are provided by the OSS and/or an independent living contractor or CIL for a specific service.

The role of the OSS is to:

• determine the customer’s needs for minimal services and/or eligibility; 
• coordinate services with available resources; 

Note: Available resources will vary in different locations. 

• perform customer assessments; 
• provide or coordinate arrangements for skills training and other active services; 
• use all available comparable services and benefits before spending agency funds; 
• inform each customer of services that require determination of economic need and the necessity of applying comparable benefits before purchasing services; 
• communicate with vendors concerning the OIB program to assist them in understanding the overall goals of the program, the limited funds available, and the need for skills training; 
• support informed choice by advising customers of their rights, responsibilities, and agency expectations surrounding active OIB services; 
• educate customers regarding accessing available services and assist with access as needed; 
• be aware of and develop community resources; 
• help customers by functioning as an advocate as needed;
• enter customers’ required documentation into the caseload management system RHW; and 
• promote attainment and practice of the six core elements of Texas Confidence Builders for OIB. 

2.1.6: Customer's Responsibility

The customer will be encouraged to take the primary responsibility for contacting other agencies. The OSS retains responsibility for monitoring progress and providing support as needed.

The customer’s responsibility is to:

• through informed choice, take an active role in planning their ILP; 
• actively participate in services; and 
• inform the OSS of changes that might affect participation in active services, including comparable benefits, changes in income status, changes in living situation, and changes in health or vision. 

2.1.7: Definitions for Types of Residences for OIB Customers

1. Nursing Home A nursing home is a residential facility that provides 24-hour skilled nursing care, rehabilitation services, and assistance with daily living activities to individuals who require medical supervision due to chronic illness, disability, or recovery from surgery or injury. Nursing homes are licensed and regulated by state health agencies and must comply with federal standards.
2. Independent Living Center An independent living center is a community designed for older adults or individuals with disabilities who do not require ongoing medical care but seek a supportive environment with accessible housing, community resources, and optional services such as housekeeping, meal preparation, and transportation.
3. Assisted Living Center An assisted living center provides housing, personal care assistance, and support services for individuals who need help with daily activities such as bathing, dressing, and medication management but do not require the level of medical care provided by a nursing home. Assisted living facilities promote independence while offering structured support and monitoring.
4. Group Home/Adult Foster Home is a residential facility or in-home setting providing housing, care, and support for individuals needing assistance with daily living, often due to disabilities or mental health conditions.  It offers a structured environment with trained staff to promote independence and well-being.
5. Hospice/Palliative Care is a healthcare service focused on the quality of life for individuals with serious illness or end of life care.

2.1.8: Approval Requirements for Providing Services to Customers in Long-Term and Hospice/Palliative Care Settings 

The guidelines of the OlB program establish standards for the provision of services to residents in long-term care facilities.  These standards ensure the effective allocation of resources and appropriate oversight, with particular attention to nursing home residents, group home residents and hospice/palliative care patients requiring extensive support. 

Customers in independent living and assisted living facilities can access both minimal and services provided with an ILP without requiring manager approval. However, residents in nursing homes, group or adult foster care homes, and hospice or palliative care patients must obtain OIB manager approval before development an ILP with the customer. The OSS must submit an approval request in RHW. If denied, the OSS may still move forward with minimal services to support the customer’s independent living goals.

The OSS must ensure that if the customer has a Power of Attorney or legal guardian that they are fully involved in the OIB case. 

2.2: Older Individuals Who Are Blind Case Flow

2.2.1: Initial Contact

The Initial Contact phase occurs when a customer is referred to the OIB program and staff complete the necessary information on the Initial Contact page in RHW. The purpose of this phase is to provide information and referral services for the OIB program and to identify the customers’ needs and goals in determining whether minimal or substantial services are warranted. OIB staff will offer and set up an application appointment if needed and typically mail out the “Guide to Independent Living for Older Individuals Who Are Blind or Visually Impaired”. The case remains in Initial Contact in RHW until the application is completed and the customers’ signature is entered, or the customer receives all needed minimal services. For more information on Initial Contact, refer to Chapter 3: Initial Contact.

2.2.2: Minimal Services

Minimal Services may be provided once Initial Contact is completed and the individual is in Initial Contact with Case Assignment, Application, or Eligibility phases in RHW.  During these phases, the OSS begins engaging with the customer to address immediate needs while gathering information necessary to determine eligibility for independent living services.

For more information on minimal services, refer to Chapter 4: Minimal Services.

2.2.3: Application and Comprehensive Application Assessment

Once the OSS determines an application is necessary, they will work with the customer to complete the required application information in RHW and obtain information necessary to determine eligibility, unless it is decided that minimal services will meet the need of the customer. An application is not complete until the customer has signed (or had their representative sign) Form VR5054, Signature Form for OIB Program Applicants. For more information on the application, refer to Chapter 5: Application.

During the Application phase, the OSS also completes the Comprehensive Application Assessment Forms (electronically), or Form VR2955 Comprehensive Application Assessment (paper version), to obtain necessary information from the customer to determine service eligibility. Once there is documentation that the customer is eligible, the OSS can plan for services. The comprehensive application assessment and services can be amended after eligibility if it is determined that information has changed and will need to be updated. 

2.2.4: Eligibility

Eligibility determination occurs after documentation is obtained determining that the customer has a visual impairment that is a substantial limitation to living independently and has met all other eligibility criteria outlined below. “Eligibility” identifies OIB program applicants who have a significant visual disability and who can benefit from independent living services. 

The eligibility criteria for OIB services are as follows:

• Criterion 1—The individual is 55 years of age or older.
• Criterion 2—The individual has a visual impairment that is a substantial limitation to living independently.
• Criterion 3—The delivery of OIB services will improve the customer’s ability to function, continue functioning, or move toward functioning independently.

Note: The applicant must meet all three criteria to be eligible for the OIB program. For more information on eligibility, refer to Chapter 7: Eligibility.

2.2.5: Active Services

A customer moves into Active Services when they have completed an ILP signed plan or Form VR5054 Signature Form for OIB Program Applicants, and services have been initiated. Active services are provided to develop or improve the independent living skills necessary for the customer to increase their independence in their living and community environment. During this phase, the OSS initiates agreed-upon services and follows up as necessary to ensure the customer is making progress with their independent living goals. For more information on active services, refer to Chapter 9: Active Services and Service Delivery.

2.2.6: Closure

Once a customer completes all the agreed-upon services in the ILP, and the customer’s independence has increased with the provision of OIB services, the OSS will move forward with a successful closure. If a customer is no longer participating in services or is ineligible, a case can be closed as unsuccessful at any time. For more information on closure, refer to Chapter 10: Closure.

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Chapter 3: Initial Contact

3.1: Definitions of Referral and Initial Contact

3.1.1: Referral

A “referral” occurs when either an individual or an individual’s family member or friend, health care professional, a CIL, or other community organization provides the following basic demographic information to OIB program staff: 

• Name
• Phone number
• Address
• Date of birth
• Visual disability
• Referral source
• SSN, if available

A temporary SSN can be created in RHW when the permanent SSN is not available. Before creating a temporary SSN, staff must:

• request that the customer provides the SSN by the time the OIB application is signed;
• review the appropriate alternative identity verification documentation as set out below in VRSM Part A, Chapter 3.2: Citizenship and Authorized Identification;
• ensure that the case file contains a copy of alternative identity verification documentation (if no SSN has been provided); and
• if the SSN is provided later, update RHW with the correct SSN.

If necessary, the temporary SSN may be used at closure. 

3.1.2: Initial Contact

An initial contact occurs when all information in the Initial Contact screen in RHW is completed and the population indicator for ILS-OIB is selected. Cases should be assigned to an OSS immediately upon entering the initial contact. 

3.2: Appropriate Referrals for the Older Individuals Who Are Blind Program

Pursuant to 34 CFR Part 367.5, “An older individual with blindness refers to an individual aged 55 or older whose severe visual impairment makes securing competitive employment extraordinarily difficult but for whom independent living goals are feasible.”

Therefore, in accordance with federal regulations, an appropriate customer for the OIB program is an individual who is 55 years of age or older and has a severe visual impairment. If a customer is under the age of 55 or does not meet requirements for a significant visual impairment, they should be referred to their local CIL for services. 

Note: Customers who are interested in employment should be referred to the VR program.

3.2.1: Referrals to a Texas Workforce Commission Vocational Rehabilitation Services Office or Older Individuals Who Are Blind Helpline 

When a customer contacts a TWC VR Services office by phone, email, or in person, or if a referral is made through the OIB Helpline, office staff will:

• gather the necessary information from the customer (refer to Chapter 3.3 Gathering Information during the Initial Contact);
• refer the customer to the appropriate OSS in their area if the customer meets the age and disability criteria for services;
• make a referral to the CIL for other independent living services as needed; and

direct the customer to the appropriate CIL if the customer does not meet the basic eligibility criteria for OIB Services.

3.3: Gathering Information during the Initial Contact

When gathering information from a referral during an Initial Contact, the OIB staff completes the following in RHW: 

• Initial Contact page
• Referral Source page
• Contact tab under the Case Management page 

Note: List at least one alternate contact for the customer to be reached if the customer is unable to be located. The OSS must verify that a signed release form is on file at the time of application, allowing communication with the listed contact throughout the life of the case.

3.3.1: Initial Contact Procedures

During Initial Contact, the OSS:

• develops an understanding of the customer’s needs and explains the purpose of the OIB program to the customer;
• provides information and referral services, which may include:
  • Guide to Independent Living for Older Individuals Who Are Blind or Visually Impaired;
  • other types of information and referral services based on the individual’s stated need; and
• works with the customer to determine if the customer’s needs will be met with minimal services, or if the customer will move forward with an application.

To explain the purpose of the OIB program and to develop an understanding of an individual’s needs, the OIB staff member should communicate with the individual in a way that best accommodates their limitations and in their preferred mode of communication.

3.4: Timeframe for Scheduling First Visit or Application

The OSS must respond to customers in the Initial Contact phase in a timely manner. The customer should be contacted as soon as possible, but no later than 30 business days after case assignment in RHW, to determine the customer’s needs and to schedule the first visit and/or application. 

3.5: Case Note Requirements for Initial Contact

When the OSS contacts the customer, they will enter a case note to reflect the discussion with the customer during Initial Contact and whether the customer’s needs can be met with minimal services or if the customer will be completing an application. If it is determined that the customer wants to apply for OIB services and will not benefit from only minimal services, the application appointment should be scheduled at the first contact with the customer, if possible. 

Note: If the first contact with the customer is to complete the comprehensive application assessment, there is no need to enter a separate contact case note. However, any contact with the customer in initial contact should be documented in RHW with the appropriate case note title.

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Chapter 4: Minimal Services

A customer who receives minimal services can be defined as a customer who:

• receives OIB services that are not considered substantial;
• receives adaptive devices or goods that cost less than $150 (in total); and/or
• does not require more than two face-to-face visits with an OSS or independent living skills trainer or Vocational Rehabilitation Teacher.

Customers must self-identify that they have significant vision loss affecting their independence to participate in minimal services. If the customer cannot indicate that they have significant vision loss, or share how it is affecting their independence, the OSS asks if the customer wants to move forward with completing an application to determine if they are eligible for services.

Note: If the cost for minimal services slightly exceeds $150, please consult with the OIB manager to decide whether to close the case under minimal services or transition it to the Application phase.

4.1: Minimal Services in Initial Contact

Minimal services can be provided when a customer is in the Initial Contact with Case Assignment phase in RHW. Minimal services during Initial Contact with Case Assignment in RHW can include:

• a copy of the Guide to Independent Living for Older Individuals Who Are Blind or Visually Impaired publication; 
• providing Information and Referral services and/or; 
• making no more than two face-to-face meetings for IL skills training such as marking appliances and equipment and/or;
• providing adaptive devices that cost less than $150.00 (in total) either from bulk supplies or ordering from vendors.

Note: A customer must receive at least one visit of independent living skills training session and/or adaptive devices to be considered a successful closure. Providing only information and referral services and/or the copy of the Independent Living Services for Older Individuals Who Are Blind or Visually Impaired does not constitute providing minimal services. 

A minimal services case in the Initial Contact phase is closed successfully after it is determined that:

• the customer will not require substantial services;
• the customer’s independence has improved; and
• no further services are needed.

Note: An OSS must ensure that the customer has received services needed to improve their independence and document that these services were provided. 

4.2: Minimal Services in Application

If an OSS completes an application with a customer and then determines, along with the customer, that no substantial services are needed to help the customer improve their independence, minimal services provided during the Application phase can include:

• No more than two face-to-face meetings for independent living skills training such as marking appliances and equipment; 
• providing information and referral services; and/or
• providing adaptive devices that cost less than $150 (in total) from either bulk supplies or vendors.

A minimal services case in the Application phase can be closed successfully after:

• the customer will not require substantial services;
• the customer’s independence has improved; with the provision of minimal services, and
• no further services are needed.

Note: If an OIB caseworker determines that a customer requires substantial services, the eligibility determination process can proceed.

4.2.1 Minimal Services at Eligibility

Minimal Services at Eligibility may occur when:

• The customer has completed the application process
• The OSS has completed the eligibility determination
• The customer is found eligible, but both the OSS and the customer determine that substantial services are not needed

A minimal services case in the Eligibility phase may be successfully closed when:

• the customer will not require substantial services;
• the customer’s independence has improved with the provision of minimal services; and
• no further services are needed.

4.3: Case Note Requirements for Minimal Services

For any minimal services case-Initial Contact, Application, or Eligibility, the OSS must document a case note in TWH that includes:

• what services or goods were provided to the customer;
• how the service improved the customer’s independence;
• the reasons why a customer is not requesting or requiring substantial services; and
• whether OIB independent living skills training was provided to the customer.

When Independent living skills training is provided, the OSS must use the OIB IL skills training case-note drop-down and follow the documentation requirements in Chapter 13.3.

Before closing the case, the OSS must notify the customer that their OIB case is being closed and confirm that no additional services are needed. This notification may be delivered in person, by phone, or in writing. It must include the reason for the case closure and be documented in a case note in RHW.

If the customer has complete#13.3d an application for OIB services and the OSS is unable to contact the customer directly for any reason, then written notification must be sent by letter or encrypted email at least 10 business days before closing the case to allow time for the customer to contact the OSS if there are any concerns about closing the case. The OSS copies and pastes the email or letter notification that was sent in a case note with the subject “Attempt to Contact.”

4.3.1: OIB Minimal Services Successful Closure

A case note with the title of “Closure” must be documented in RHW describing how minimal services met all of the customer’s needs and increased their independence. The case note must include information on what goods and/or services were provided and how those services increased the customer’s independence. The OSS must also complete requirements as outlined in Chapter 10.2.2: Minimal Services Closure Requirements. 

4.3.2: Older Individuals Who Are Blind Minimal Services Unsuccessful Closure

A case note with title of “Closure” must be documented in RHW describing the reason for the unsuccessful closure. If the OSS has been unable to contact the customer, case notes in RHW must have at least three documented attempts. The closure case note should also include any goods or services that were provided to the customer. The OSS must also complete requirements as outlined in Chapter 10.8.2: Unsuccessful Closure Case Note Requirements.

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Chapter 5: Application

An OIB application uses the RHW Application window to:

• gather personal information and learn about the individual’s need for services; and
• obtain documentation to determine if the customer is eligible for OIB services. 

All applicants are entitled to participate in an application regardless of economic need or an applicant’s ability to participate financially. For more information regarding customer participation in the cost of services, refer to Chapter 7.7: Customer Participation in the Cost of Services.

Any individual who wants to apply for TWC VR services must be allowed to do so. TWC VR staff may not deny an application to an individual for any reason. 

5.1: Application Definition and Purpose

An “applicant” is an individual who has provided information to an OSS and signed Form VR5054, Signature Form for OIB Program Applicants.

Note: If the customer signs the printed version of Form VR5054, Signature Form for OIB Program Applicants, then the OSS must enter the application into RHW within five business days. The printed and signed Form VR5054 must be maintained in the customer’s paper case file after the data is entered.

The purpose of the application is to gather information to determine an applicant’s:

• risk of increased dependence without services due to vision loss;
• access to support systems;
• need for residential care;
• need for independent living skills training and services; and
• eligibility for OIB services.

If TWC determines that the applicant is eligible for OIB services, the applicant’s personal information in RHW must be kept updated throughout the life of the case, as current economic and disability status is essential for planning and providing services.

5.2: Application Process

During the application meeting, an OIB staff member will explain the following to the customer: 

• The purpose and expected outcomes of the OIB program
• The definition of “informed choice” 
• OIB expectations of the customer
• The roles of the OSS and the customer
• The details of the Can We Talk? brochure (then document in a case note how the brochure was provided)

The OSS must also obtain the required signatures on the application and all other necessary forms, including Form VR5054, Signature Form for OIB Program Applicants.

The application can be completed at the customer’s home, over the phone, or at any location agreed upon by the customer and the OSS, ensuring sufficient privacy to maintain the confidentiality of the customer’s information.

Note: A fast-track option is available in RHW for returning customers to expedite the completion of their application when:

• the date is within a year from when their previous case was closed; and
• the customer has the same disability as in their previously closed case.

An OSS can use the fast-track option to copy some of the customer’s application information from the previous case to the new case. The OSS must verify all information, including any wages and monthly financial details, to ensure accuracy.

Although a customer does not need to be physically present in a VR office to apply for services, they must be in Texas to apply for OIB services. The customer or their representative can participate by phone or complete the application at the customer’s home or another agreed-upon location.

When scheduling an appointment to complete an application for services, the OSS determines the customer’s: 

• language preference; and/or
• need for: 
  • a translator;
  • sign-language interpreter services;
  • reasonable accommodations; and/or
  • other support services to facilitate the application and eligibility process.

5.2.1: PIN Usage

A customer’s PIN is used to sign documents in their electronic case file. The following OIB program documents are available for electronic signature in RHW and may be signed using a PIN or by original signature: 

• Form VR5054, Signature Form for OIB Program Applicants
• Form VR5155, Independent Living Plan
• Form VR5156, Independent Living Plan Amendment

5.2.2: Electronic Signature

The customer enters a PIN that only they know. The customer does not share the PIN with the OSS. 

5.2.3: Original Signature

In the OIB program, most customers sign a hard copy of the following forms: 

• Form VR5054, Signature Form for OIB Program Applicants
• Form VR5155, Independent Living Plan
• Form VR5156, Independent Living Plan Amendment

If a hard-copy signature is obtained instead of a PIN signature, then the hard copy of the signed document must be filed in the customer’s paper and electronic case files.

5.2.4: Pseudo PIN

RHW automatically assigns the last four digits of a customer’s SSN as a pseudo (temporary) PIN when the initial contact is created.

The customer sets a new four-digit PIN:

• before completing the application for services; and
• at any time that the PIN is reset throughout the life of the case.

The customer enters a PIN as a signature of authorization on the application and on all other electronic RHW documents that require a signature of authorization (for example, the application, ILP, and any ILP amendment).

When the customer is setting their PIN, the OSS encourages the customer to use a number that is easy to remember and is not the last four digits of the customer’s SSN. (RHW uses the last four digits to create the pseudo PIN.) The customer should make a personal note of the PIN and keep it where it can be found easily.

The OSS must not record the PIN or any type of prompts or hints that could inadvertently compromise the confidentiality of the PIN in the customer’s case record.

5.2.5: Guardian Signature or Power of Attorney

The signature of a guardian is required when a customer is assigned a legal guardian.

When required, the guardian sets a PIN in RHW. When a guardian sets the PIN, an OSS encourages the guardian to use a number that is easy to remember and is not the last four digits of the customer’s SSN or the first four digits of the customer’s case ID. Note: RHW uses the first four digits of the customer’s case ID to create the parent or guardian pseudo PIN. The parent or guardian should make a personal note of the PIN and keep it where it can be found easily.

The OSS must not record the PIN or any type of prompts or hints that could inadvertently compromise the confidentiality of the PIN in the customer’s case record. 

When required, an OSS asks a guardian to:

• enter the PIN in the designated field on a RHW document; or
• sign on the designated signature line on the paper version of the form.

5.2.6: Representative’s Signature

A customer or their legal guardian may designate an individual to serve as the customer representative in all or part of the rehabilitation process. The representative may be authorized to sign documents, speak on the customer’s behalf, or serve in other capacities indicated on Form VR1487, Designation of Applicant or Customer Representative. In some cases, a representative can help facilitate communication and help the rehabilitation process move forward to a successful outcome.

When required, the representative sets a PIN in RHW. When the representative is setting the PIN, the OSS encourages the representative to use a number that is easy to remember and is not the last four digits of the customer’s SSN or the last four digits of the customer’s case ID. Note: RHW uses the last four digits of the customer’s case ID to create the representative pseudo PIN. The representative should make a personal note of the PIN and keep it where it can be found easily.

The OSS must not record the PIN or any type of prompts or hints that could inadvertently compromise the confidentiality of the PIN in the customer’s case record. 

When required, an OSS asks the representative to:

• enter the PIN in the designated PIN field on the RHW document; or
• sign on the signature line on the paper version of the form.

5.2.7: When Older Individuals Who Are Blind Staff Members May Enter a PIN on Behalf of a Customer

A PIN is the equivalent of a legal signature. An OSS must not enter it in RHW without the direct consent and involvement of the customer.

The only circumstances under which OSS members may enter a pseudo PIN in RHW on behalf of the customer are as follows:

• The customer completed a paper application when RHW was not available.
• The customer is not present when the PIN needs to be entered but did agree to let the OSS enter a pseudo PIN on the customer’s behalf.
• The customer cannot physically enter a PIN.

The OSS documents the use of the pseudo PIN, and the reason for using it, in a case note.

5.2.8: Electronic Signature Procedures When Customers Cannot Enter a PIN or Sign Physical or Electronic Forms

When signatures are required, OIB staff must work with customers to obtain their signatures, using encryption when required, by:

• obtaining handwritten signatures;
• obtaining digital signatures using an approved software option; or
• sending a copy of the document to the customer when the customer has the equipment necessary to print, sign, and return an electronic copy of the signed form (such as a photo or scanned copy).

Note: Examples of approved software to collect digital signatures include Adobe Acrobat and DocuSign (when it is an option for a TWC VR form). Approved software, including Adobe and DocuSign, can be used on smart devices (such as tablets and phones).

It is essential to discuss with the customer their ability to sign forms, whether with handwritten signatures or electronically. Given that many OIB customers may be unable to see the forms provided due to vision loss, OIB staff can obtain an email from the customer indicating their agreement to use an electronic signature when they are unable to sign by any other means.

When obtaining an email from the applicant or customer indicating agreement for their signature, staff must document that the applicant or customer has reviewed and authorized the OSS to sign Form VR5054 on their behalf. The OSS will copy and paste the email into the RHW case note, including the customer’s statement of agreement. When the form is printed, this email should be attached to the form, such as when eye reports are requested from a doctor’s office.

5.3 Steps for Completing the Older Individuals Who Are Blind Application

The following steps must be completed by the OSS during the application process:

1. Complete the application page in RHW, including the following windows:
   • Personal Information
   • Insurance Policy
   • Veteran Information
   • Monthly Financial Information
   • Social Security Income Benefits
   • Information Request (unless the eye report has already been received)
   • Signed VR5054, Signature Form for OIB Program Applicants 
2. Complete the OIB Comprehensive Application Assessment using Microsoft Forms and enter case notes.
3. Obtain any available copies of customer’s SSN, state-issued ID (if SSN was not provided), and financial information (if it is readily available from the customer). 
4. Complete case actions for next steps to determine eligibility or minimal services needs. If records need to be requested to determine eligibility, or if an eye exam or vision test needs to be set up, the OSS sends an action to the responsible OIB staff within five days of the application being completed. 

Note: Although information gathered at application will indicate the customer’s participation in the cost of services (by completing the monthly financial information page), it is the responsibility of the OSS and OIB staff to ensure that information gathered at application is updated throughout the life of the case relating to the customer’s income and disability information.

OIB staff must ensure that all information in the application is accurate. If information is missing, it must be obtained as soon as possible. However, missing information should not delay the application completion or eligibility determination for OIB services. Customers are required to provide information that is complete and accurate to the best of their abilities. However, if customers cannot provide financial documentation, or do not have the ability to provide the information, the OSS documents why the information is not in the case file and moves forward with the case without the documents. The customer must still provide either their SSN or other forms of ID listed below to OIB staff before the case can be moved into eligibility status. 

5.3.1: Identification Verification Documents

To receive OIB services, an applicant must be present in Texas. If an applicant has not provided their SSN during application, the applicant must provide another form of ID before they are eligible for OIB services. 

Acceptable Documents

DHS maintains lists of documents a customer can use to verify their identity. The DHS Form I-9 Acceptable Documents webpage provides examples of the various documents:

• List A – Documents that Establish Both Identity and Employment Authorization: 
• List B – Documents that Establish Identity 
• List C – Documents that Establish Employment Authorization

5.3.2: Allowable Purchases During Application

Limited purchases may be authorized after completion of the application to support the assessment of the customer’s eligibility for services (this period is referred to as the “Application” phase).

Allowable purchases for assessments during Application phase include:

• an eye examination; 
• a low-vision examination (to determine eligibility only if information is not present or able to be obtained from a general eye examination); and
• physician reports.

Note: Diagnostic tests will be purchased only when studies that are needed for the eligibility determination are not readily available from other sources, or when available information is incomplete or inadequate. Assessments needed for eligibility should be scheduled as soon as possible after the application is completed. 

5.4: Time Frames for Scheduling the Application

If an OSS cannot meet with the customer to complete the application for services at the time of the initial contact, the customer is scheduled for an appointment for the earliest possible date. The application appointment date should be no later than 30 days after the date of initial contact, or after a good faith effort is made to meet this requirement. A good faith effort is defined as three or more attempts to contact the customer or contact listed in RHW. All attempts must be documented in RHW using the case note topic “Attempted to Contact.”

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Chapter 6: Comprehensive Application Assessment

The comprehensive application assessment enables the OSS to gather necessary information for the ILP and expedite services. It is typically scheduled alongside the application for services and can be conducted over the phone, in person, or at an agreed-upon location. If more than minimal services are needed, a comprehensive application assessment case note is completed and entered in RHW after the application. If not completed at the time of application, it should be done within two weeks of signing.

The OSS conducts the comprehensive application assessment and gathers essential information to determine eligibility and the nature and scope of needed services. This assessment is used to create the ILP, including planned services. However, updates may be necessary if the customer’s eye condition changes significantly or if evaluations indicate the need for additional or different services.

Note: If additional assessments are needed after a customer has been determined eligible for services, the comprehensive application assessment may be amended to include additional information to complete the ILP. Please refer to Chapter 9.3 Vision Services for more information about diagnostic evaluations and assessments available after eligibility. 

6.1: Comprehensive Application Assessment

The OSS completes the comprehensive application assessment with the customer using Form VR2955, Comprehensive Application Assessment for Independent Living Program.

The OIB comprehensive application assessment addresses the following core skills using the following Big Six core areas of the Texas Confidence Builders training philosophy:

• Adjustment to Blindness
• Independent Living Skills
• Travel Skills
• Communication Skills
• Support Systems
• Quality of Life

Information gathered from the comprehensive application assessment should follow the Texas Confidence Builders philosophy and be used as a primary tool to develop the ILP if the customer is eligible for services. 

6.1.1: Texas Confidence Builders Philosophy

Texas Confidence Builders is a training philosophy used by TWC VR for OIB customers to develop the skills and confidence they need to continue living independently in their community. It focuses on three principal areas to help customers feel empowered and develop confidence in themselves: learning, thinking positively, and building skills. This philosophy supports the following foundational skills for improving the ability to function independently in the community and at home.

Adjustment to Blindness—Customers learn to understand and accept that it is respectable to be blind and build realistic self-confidence based on personal competency and high expectations and ensures that people who are blind or visually impaired enjoy the same opportunities as other Texans to pursue independence.

Independent Living Skills—Customers gain the confidence to manage dozens of day-to-day tasks, such as independently preparing a meal, cleaning their home, doing laundry, preparing a budget, and taking care of personal finances. Through Texas Confidence Builders, customers learn to be self-sufficient in managing their own medications, accessing health-related services, and dealing with doctors and other professionals. Customers also learn various methods for organizing information such as meetings, appointments, addresses, music collections, recipes, tools, and a variety of nonvisual ways to organize and access information. These skills help customers become more confident, self-reliant, and gain a sense of control of their lives, all of which is vitally important to people who want to be independent, make their own choices, and lead their own lives.

Travel Skills—Customers meet this challenge head-on by learning a variety of travel techniques, including confidently using a white travel cane in a variety of settings. Based on their individual abilities, customers learn how to navigate city sidewalks, cross busy intersections, ride various modes of transportation, maneuver through a bustling airport, take a quiet walk on a country road, or stroll independently in their homes and communities. The goal is to help customers develop a sense of confidence in their ability to travel independently at their own discretion.

Communication Skills—Customers learn how to communicate through the medium that is suited for them based on their needs and interests. 

Support Systems—Customers learn information about other agencies and resources that can help them reach their goals. Customers also learn the importance of social activities and hobbies to maintain a work-life balance.

Quality of Life—Customers explore recreational activities and hobbies based on their interests and abilities. They also learn about services available to help them reach their individualized independent living goals. 

6.2: Case Note Requirements for the Comprehensive Application Assessment

The OSS will complete Form VR2955, Comprehensive Application Assessment electronically and enter a case note in RHW titled “OIB Comprehensive Application Assessment.” The OSS can copy and paste the report in RHW or complete the case note requirements listed below as long as each area of the report is completed. 

The following must be completed in the case note if the OSS chooses not to copy and paste the form in RHW:

• All information provided in the application portion of the document
• An overview of each of the Big Six areas and in which areas the customer needs assistance and services
• The “Summary of Recommendations and Justification for Equipment” and “Next Steps for the Case” copied from the form

6.3: Amending the Comprehensive Application Assessment After Eligibility

If, after diagnostics are completed, or the customer’s eye condition or other extenuating circumstances change, the assessment portion of the comprehensive application assessment may need to be updated. Staff members should carefully review each section of the assessment before the ILP is written and document any updates in a case note titled “Comprehensive Application Assessment” with the “Add to Topic” titled as “Amendment.” The following is required to include in the case note:

• Summary of changes on the form
• Any additional diagnostics that were provided after the initial comprehensive assessment (if applicable)
• Why the changes are needed to help the customer increase their independence and address their vision loss.

Note: During the Eligibility and Plan Development phase, it might be necessary to update the IL Services page in RHW to include new information from the comprehensive application assessment, ensuring all independent living services that will be added to the customer’s ILP match the IL services page and information completed in the comprehensive application assessment. OIB staff members should ensure that the IL services page is updated throughout the life of the case as needed. 

6.4: Secondary Disabilities 

A “secondary disability” is a disability or health condition that may or may not be associated with the customer’s visual condition but may still have a bearing on an individual’s independence. 

During the comprehensive application assessment, the OSS should determine if secondary disabilities will affect the customer’s ability to participate in OIB services. If the customer requires services to address a secondary disability to participate in OIB services related to vision loss, the OSS should determine if there are any comparable benefits available and refer the customer to a CIL when appropriate. 

The OIB manager must review and approve the purchase of any goods or services related to a secondary disability. However, if a customer requires a good or service, and the primary reason for the need is due to vision loss, an approval is not needed. 

For further guidance on services related to secondary disabilities, please refer to Chapter 9.11: Services for Secondary Disabilities. 

Chapter 7: Eligibility

OIB program applicants who are eligible for OIB services are those who: 

• are not being served with minimal services; 
• have applied for OIB services; and 
• meet federal eligibility criteria guidelines. 

7.1: Eligibility Requirements for Older Individuals Who Are Blind Services

Eligibility should only be determined by an OSS or OIB staff. The OSS uses three eligibility criteria to determine whether an applicant is eligible for OIB.  

7.1.1: Legal References for Eligibility

• 34 CFR § 367.5(9) Independent Living Services for Older Individuals who are Blind
• Texas Administrative Code Title 40 §853.5 - Eligibility

7.1.2: Eligibility Criteria for OIB Services 

The eligibility criteria for OIB services are as follows:

• Criterion 1—The individual is 55 years of age or older.
• Criterion 2—The individual has a visual impairment that is a substantial limitation to living independently.
• Criterion 3—The delivery of OIB services will improve the customer’s ability to function, continue functioning, or move toward functioning independently.

Note: The applicant must meet all three criteria to be eligible for the OIB program.

7.1.3: Eligibility Criterion 1—Age

Individuals must be 55 years of age or older at the time of referral. If they are younger than age 55, they are not eligible for OIB services and should be referred to a CIL for provision of independent living services.

7.1.4: Eligibility Criterion 2—Visual Impairment

An eye exam can be used to document a visual impairment and should be obtained when determining eligibility or throughout the life of the case. The OSS must ensure the Disability Information page in RHW is updated correctly before case closure and if there are questions regarding the eye condition. If the customer has not had an eye exam in the last year and cannot afford one, the OSS should provide customer-informed choice in selecting an eye doctor to perform an eye examination. Comparable benefits must be used first before the purchase of an eye exam if they are available. Eligibility can be determined by the following methods:

• An eye report indicating—
• Blindness - visual acuity with best correction of 20/200 or less in the better eye; a visual field of 20 degrees or less; or a combination of both. 
  • Low Vision- visual acuity with best correction of 20/70 or less in the better eye; a visual field of 30 degrees or less in the better eye; or a combination of both.
  • Significant Visual Impairment - A disease or condition of the eye that does not meet the definitions of Blind or Low Vision but does create a significant impediment to independent living and cannot be corrected with glasses or contact lenses.
• An observable visual disability (The OSS observes that a customer has eye prostheses or has had eyes removed.)
• Social Security Disability records indicating vision loss and eligibility for benefits (The customer has provided documentation that they are receiving social security disability benefits for vision loss or blindness.) 
• Past records indicating the customer has previously been a customer of VR or OIB services, and records are available indicating eligibility based on at least one criterion listed above.

If it is known that the customer has a progressive eye condition, but does not meet the criteria above, they may still be determined eligible for services if there is documentation from an ophthalmologist or low-vision doctor that the customer’s condition is progressive and will worsen within the next six months. The customer must also meet the other eligibility criteria. 

Under 40 TAC §853.1 and §853.5(a), OIB staff is required to use the visual acuity that meets the following criteria to determine eligibility:

• Reflects the best corrected distance
• Is obtained with simple refraction (glasses or contact lenses) rather than low-vision aids
• Is measured by the Snellen eye chart or converted to the distance Snellen eye chart equivalent by an ophthalmologist or optometrist

If it is determined that the individual does not have a visual impairment that affects independent living, the individual is not eligible for OIB services and should be referred to a CIL for provision of independent living services.

7.1.5: Eligibility Criterion 3—Independent Living Services Are Required to Increase Independence

The OSS evaluating an applicant’s potential for independent living considers how services will:

• decrease limitations to independent living; and 
• provide greater opportunity for independent living. 

To determine eligibility for Criterion 3, the OSS must consider how the applicant’s vision loss limits daily activities. A visual impairment affects everyone differently. Some critical questions include the following:

• How does low vision or blindness affect the applicant’s independence? 
• How long have they had vision loss, and how are they adjusting to their vision loss? 
• What daily living tasks are difficult or impossible for the applicant to accomplish because of low vision or blindness? 
• Are there other disabilities or limitations that affect the applicant’s independence? 
• Will OIB services and supports likely increase the applicant’s independence? 
• Does the applicant have difficulty remembering information?
• If the applicant has difficulty remembering, is their ability to learn new skills significantly impaired? 

To establish eligibility under Criterion 3, the comprehensive application assessment must indicate that an applicant needs services and that services will improve their ability to function, continue functioning, or move toward functioning independently.

Although the initial evaluation is critical for the eligibility decision, evaluating an applicant’s ability to benefit from OIB continues throughout the life of the case and, depending on the nature and severity of the disability, may vary greatly from one individual to another. Services that may be provided to help determine eligibility can include:

• a preliminary screening using the Guide to Independent Living for Older Individuals Who Are Blind or Visually Impaired process; 
• a comprehensive application assessment to determine the potential scope of services; and 
• continued observations by the OSS and other service vendors (such as in-house service providers, independent living contract service vendors, and CILs). 

7.2: Certifying Eligibility 

To certify an applicant as eligible for OIB services, the OSS reads and electronically signs the following eligibility statement, which is included in the drop-down menu for eligibility selection in RHW:

“I certify that this individual is eligible for independent living services based on:

• the presence of a significant physical, mental, or sensory disability that interferes with their ability to become or remain independent in the home, family, and/or community and the presence of a severe disability; and 
  • IL services are required to enable the individual to be independent, maintain independence, or move toward independence in the family, home, and/or community.”

The OSS does not have to print the eligibility statement unless the customer requests a copy or it is needed by another agency (if the customer signs Form VR1517-2, Authorization for Release of Confidential Customer Records and Information, requesting a release of confidential information).

7.3: Closing a Case as Ineligible 

If the OSS determines that the applicant does not meet one or more of the above criteria, then the applicant is not eligible for OIB services. The OSS then consults with local CIL staff to determine whether the CIL can provide independent living services or refers the customer to other appropriate services if there are other unmet needs such as housing, utility, or health care assistance. The OSS must complete an eligibility case note in RHW and include in the “Add to Topic” section: Ineligible. The case note must explain which criteria the customer does not meet, and why they do not meet them, and what referrals were provided to the customer.

To certify an applicant as ineligible, the OSS:

• discusses the decision with the applicant and refers them to appropriate resources;
• refers the customer to the CAP and provides the Can We Talk? brochure to the customer either in person or via mail; 
• completes an eligibility case note in RHW and includes in the “Add to Topic” section: Ineligible; 

Note: The case note must explain which criteria the customer does not meet and what referrals were provided to the customer;

• discusses with the customer that they can reapply for services at any time and discusses information that is needed to meet eligibility requirements; and
• completes the Closure After Application page in RHW indicating that the customer is ineligible.

7.4: Timeframe for Determining Eligibility and Writing an Independent Living Plan

Eligibility should be determined as soon as possible, or within 60 days of the application being signed, except for unforeseen circumstances or if customer is receiving minimal services during application. If an eligibility determination is delayed, the reason must be stated in a case note. Only exceptional and unforeseen circumstances beyond TWC’s control should prevent the decision from being made as soon as possible or within 60 days of the application being signed. For example, the customer cannot attend a required examination or evaluation at the scheduled time and had to delay this important activity due to an unforeseen, temporary medical condition.

7.5: Case Note Requirements for Eligibility

The OSS must document in RHW how the customer meets each criterion. A case note titled “Eligibility” must be used, detailing how each criterion is met as outlined below.

Criterion 1: Individuals must be 55 years of age or older at the time of referral. Indicate the customer’s age at the time of eligibility.

Criterion 2: Documentation must indicate that the customer has a visual impairment meeting the criteria listed in Chapter 8.1.4. The case note must include the customer’s eye condition, visual acuities or visual fields, the name of the eye doctor, and how the information was obtained. 

If the visual disability that substantially limits independent living is not documented in a medical report, additional documentation is required. This may include information obtained from a Social Security disability award letter indicating blindness or from observation when a customer has eye prostheses or no eyes. The documentation must explain why an eye report cannot be obtained or is not needed, such as in cases where the customer is completely blind and eligible based on observation, and to require a customer to participate in an eye examination which would be unnecessary and potentially distressing. 

For customers who are eligible due to a progressive eye condition, the case note must include all the above information and indicate that the condition is progressive, even if the customer does not currently have a significant visual impairment or legal blindness.

Criterion 3: Documentation must include the customer’s needs and goals for OIB services, their ability to participate in services, and the OSS’s decision about whether independent living services will improve the customer’s ability to live independently.

7.6: Referrals to Other Programs or Services 

If it is determined that an applicant is ineligible for independent living services, referral to other programs or services may be appropriate. Referral to other programs could occur at any point in the case, such as after:

• the application assessment; or 
  • services are planned or initiated if the applicant’s situation changes.

7.6.1: Referral to Centers for Independent Living

When a disability other than vision represents the most significant factor restricting independent living, or when an applicant does not meet the criteria for the OIB program, the applicant will be referred to the appropriate CIL for provision of independent living services.

The OIB program and CILs may simultaneously serve the customer if:

• the customer meets the criteria for the OIB program; and
• the combination of vision loss and other disabilities creates a restriction on the customer’s independent living. 

The OIB program and CILs may offer services to address different disabilities. However, the OIB program and CIL staff should collaborate closely through consulting and sharing resource information to address the customer’s independent living needs.

Refer to the Centers for Independent Living web page for more information. 

7.6.2: Referral to the Vocational Rehabilitation Program

Customers who do not meet eligibility criteria for the OIB program or who wish to seek employment may be referred to the VR program at the same location or the nearest VR field office if the customer expresses interest in employment. 

7.6.3: Referrals to Other Community Programs 

If a customer has additional needs that cannot be addressed through OIB services, the customer should be referred to other community programs that may be able to help people with specific needs (for example, Meals on Wheels programs, senior activity centers, and Lighthouse for the Blind organizations). The OSS should help the customer gain access to these programs when they are available.

7.7: Customer Participation in the Cost of Services

7.7.1: Legal Authority

• 34 CFR § 367.67(a) May an individual’s ability to pay be considered in determining his or her participation in the costs of OIB services?
• TAC Subchapter C. Customer Financial Participation 853.21

7.7.2: Purpose

The purpose of customer participation in the cost of services is to:

• encourage customer commitment to an independent living goal; 
  • create a cooperative relationship between the customer and TWC; and 
    • maximize OIB funding. 

Per 34 CFR §367.67(a)(1), states are neither required to charge nor prohibited from charging customers for the cost of independent living services under the OIB program. If a state charges customers or allows service vendors to charge for the cost of independent living services provided under the OIB program, the state is neither required to nor prohibited from considering the individual customer’s ability to pay in determining how much the customer must contribute to the cost of services.

However, if a state chooses to charge or allow service vendors to charge for the cost of independent living services provided under the OIB program, 34 CFR §367.67(b) requires the state to maintain policies that meet certain criteria. The guidelines in the following sections are designed to document those policies.

7.7.3: Guidelines for Customer Participation in the Cost of Services

A customer’s eligibility for OIB services does not depend on the customer’s income or liquid assets. However, if the customer’s net income or liquid assets exceed BLR, the customer must participate in the cost of services. An OIB manager may grant an exception if the customer’s participation would prevent the customer from receiving a necessary service to achieve their independence as a result of services being provided. 

Customer participation in the cost of services is based on the economic resources of all members of the customer’s family who have a legal obligation to support the customer. The family’s resources are evaluated in terms of the maximum allowable amount of economic resources as calculated in RHW.

Consistent with federal law and TAC Subchapter C. Customer Financial Participation 853.21, TWC requires the participation of individual customers in the cost of services provided under the OIB program. Therefore, the OSS must:

• ask all customers, regardless of their economic resources, about their ability to pay for OIB services;
  • ensure that documentation is provided in the file of the customer’s financial need; 
    • explain the method for determining the amount charged for the OIB services and how the financial need test will be applied;
    • discuss with each customer the costs of specific services and determine the financial responsibility of each party; and
    • ensure that customers who have been determined eligible for Social Security benefits under Titles II and XVI of the SSA, relating to Supplemental Security Income and Social Security Disability Insurance, shall not be charged any cost to receive OIB services under the OIB program. 

Note: This includes customers who are receiving Title II benefits related to Social Security retirement who meet the requirements to obtain old-age and survivors insurance benefit payments (for more information, please refer to SSA.gov).

If a customer is a dependent, then the economic resources of the family or guardian are used to determine participation in the cost of services. 

Comparable services and benefits must be used before spending OIB funds. Comparable services must be adequate in terms of timeliness, location, scope, and the willingness of the applicant or customer to participate.

7.7.4: Monthly Income and Allowable Additions for BLR

For purposes of calculating BLR, the following must be included in the RHW Monthly Financial Screen and Social Security Screens if applicable:

• Net wages and net income for the customer, customer’s spouse (if applicable), and legal guardian (if the customer is claimed as a dependent for purposes of Federal income taxes); 
• all Social Security benefits; income such as public support payments, 
• VA income benefits, unemployment compensation income, 
• Workers' Compensation income, 
• private disability insurance, or annuities; 
• child support payments received by the customer,
• liquid assets such as cash, plus assets that are easily converted to case for the customer, the customer’s spouse (if applicable) and legal guardian (if the customer is claimed as a dependent for purposes of federal income taxes).

Allowable additions to monthly income:

• Monthly home mortgage or rental payments;
• Prescribed diet and medicines used by the customer;
• Debts imposed by court order;
• Medical costs.

Dollar amounts should be entered in RHW on the Monthly Financial Information page, which is under Application.

7.7.5: When to Determine and Apply Economic Resources

A determination of customer economic resources is:

• made after determination of eligibility; and 
  • applied before service planning.

7.7.6: Reevaluation of Economic Resources

Economic resources must be reevaluated:

• at least annually; or
• when there is reason to believe that the family’s economic status has changed. 

Examples of economic status change may include:

• an increase or decrease in income,
• unexpected medical expenses
• unanticipated disability-related expenses;
• a change in family size;
• catastrophic loss, such as fine, flood, or tornado;
• short-term financial hardship, such as a major repair to the customer’s home or personally owned vehicle; or
• other extenuating circumstances for which the customer makes a request and provides supporting documentation. 

7.7.7: Services Subject to Customer Participation in Cost

Per 34 CFR §367.67(b)(1), TWC has determined that customers whose economic resources exceed the maximum allowable economic resources must participate in the cost of the following services:

• Maintenance (excluding maintenance for diagnostic services)
• Transportation (excluding transportation for diagnostic services) 
• Adaptive aids and OIB supplies over $50

7.7.8: Services Not Subject to Customer Participation in Cost

Customers do not have to contribute economically to the following goods and services:

• Diagnostics and evaluation services completed during application and comprehensive assessment (including maintenance and transportation) to determine eligibility and ILP development
  • Counseling, guidance, and referral services provided by TWC staff
    • OSS services, including contracted OIB skills training
    • O&M training
    • Low-vision evaluations
    • Adaptive aids and OIB supplies under $50 
    • Interpreter services
    • Services paid for or reimbursed by a source other than TWC
    • Training in the management of secondary disabilities or related health conditions (for example, diabetes education, deafblind services, or independent living skills training, which can be provided by contracted or in-house service vendors)

7.7.9: Calculating Customer Participation in Cost

RHW calculates each customer’s participation automatically based on:

• 300 percent of the current applicable HHS Poverty Guidelines, as determined by family size; and 
  • the information that is entered into the system about the individual’s income, family status, and economic need. 

Refer to the HHS Poverty Guidelines under the authority of 42 USC §9902(2).

RHW uses net monthly income and family size in relation to the poverty guidelines for the current fiscal year to determine the amount that a customer must contribute to the cost of services. This is a monthly amount that is applied only during months that a service or good that requires customer payment is provided.

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Chapter 8: Independent Living Plan, Independent Living Plan Amendment, and Joint Annual Review 

8.1: Content of the Independent Living Plan

The ILP must contain:

• a description of the independent living goal;
• a discussion of the use of comparable services and benefits;
• a list of any needed intermediate objectives or steps;
• the criteria for evaluating progress;
• a description of specific services needed to reach the ILP goal, including: 
  • start dates;
  • end dates;
  • specific vendors and/or location of services;
  • plan service category; and
  • whether the service is arranged, provided, or purchased;
• a list of the specific responsibilities of the customer, OIB, and other entities;
• an explanation of the customer’s participation in the cost of services; and
• the frequency of contact that was agreed upon.

When appropriate, the ILP also includes:

• an explanation of the criteria used to determine customer participation in service costs; and
• additional information requested by the customer or considered vital by the OSS.

The service dates for the ILP must encompass the date that services are initiated to the expected date that services will be completed.

8.1.1: Independent Living Goals

In addition to the goal of living as independently as possible, individual independent living goals (objectives) are unique to each customer. They represent the range of life achievements made possible through independent living services.

Independent living goals are determined through the assessment process beginning at application and agreed upon by both the OSS and the customer. Independent living goals relate directly to addressing the customer’s functional needs and what the customer wants to achieve to have independent relationships with their home, family, and/or community.

Independent living goals are significant life objectives that:

• enable the customer to remain or become more independent in the home, family, and/or community; and 
• are made possible through OIB services. 

8.1.2: Intermediate Objectives

Intermediate objectives describe the accomplishments a customer hopes to reach in a significant area and are related to each service. The OSS can select from the appropriate drop-down menu in RHW but should also add objectives (goals) that are specific to the customer’s goals for independent living. Objectives most applicable to OIB customers are the acquisition of:

• confidence and the use of independent living skills; 
• diabetes self-management skills; 
• travel skills; 
• technology skills and equipment; and 
• skills with low-vision aids to improve functional vision.

8.1.3: Progress Review Criteria

Progress review criteria are procedures or schedules used to evaluate a customer’s progress and can be selected from the drop-down menu in RHW. Progress review criteria should also be customized and added to this section when appropriate.

Examples of progress review criteria are as follows:

• Demonstrates new learning and applies to daily or work routines;
• Disability—Confirmation of medical improvement
• Disability—Confirmation of psychological improvement
• Disability—Confirmation of support group attendance
• Training—Reports of satisfactory progress

8.1.4: Planned Services

“Planned services” describe the services required to accomplish intermediate objectives. The service description should be broad and include all components of the service, such as evaluation, training, and equipment. For example, “O&M evaluation, training, and equipment as recommended and as funds are available.”

OIB services are initially addressed during the comprehensive application assessment based on:

• the applicant’s perception of needs and difficulties; and 
• the OSS’s observations and communications.

Since some of the aids and services might not be known at the time the plan is signed, the OSS may choose to write generic headings (for example, independent living training and aids, low-vision services, information and referral services, deafblind services, adaptive aids, and skills training). Later, the specific services and aids are noted in a service justification case note indicating which services and aids will be provided. 

Through informed customer choice, the OSS and customer agree upon needed services that will be included on the ILP. All goods and services agreed upon during the comprehensive application assessment should be included on the ILP. If a service is no longer needed or was not included on the original comprehensive application assessment, an amendment to the comprehensive application assessment should be completed to reflect the changes so that the services on the ILP and comprehensive application assessment match. For more information, refer to Chapter 6.3 Amending the Comprehensive Application Assessment. 

For a list of OIB services that are defined in 34 CFR §367.3, refer to Chapter 2.1.3: What Services Are Provided Through the Older Individuals Who Are Blind Program?

8.1.5: Service Dates

For each planned service on the ILP, the OSS estimates the length of time that the service will require, including the following:

• Start date—The OSS enters the projected start date. This date is the best projection of when services will begin or when goods are ordered. If the actual dates vary within an expected range for delivery of the service or good, no amendment is needed. 
• End date—The OSS enters the projected end date. This date is the best projection of when services will be completed or when goods are expected to be delivered to the customer. Allow enough time for services to be reasonably completed. If the actual dates vary within an expected range for delivery of the service or good, no amendment is needed. 

The estimated completion date of all ILP services must be documented on the ILP with the estimated month, date, and year. If the service date ends and services are still needed, an ILP amendment must be completed. Please see Chapter 9.4 – Independent Living Plan Amendment for more information. 

8.1.6: Service Vendors

For each planned service, identify the service vendor who will provide the service in RHW, using the vendor’s title or organization, including in-house service vendors. If the OSS is unsure of who the vendor will be, list a generic heading, such as “O&M instructor.” Once the vendor’s name is known, the OSS will enter a service justification case note indicating who the vendor is and documenting that the customer was provided informed choice and has agreed upon the service with the listed vendor. 

If a service vendor needs to be changed, staff will also enter a service justification case note regarding the reason for the service vendor change, the service vendor listed on the ILP, and the name of the new service vendor for which the service authorization will be issued. 

8.1.7: Service Delivery Methods

The following service payment delivery methods are available:

• Arranged (for example, Meals on Wheels, arranged by the OSS)
• Provided (for example, OIB independent living skills training provided by the OSS)
• Purchased (for example, diabetes education purchased from a certified diabetes instructor)

8.1.8: Planning of Frequency of Customer Contact

“Frequency of customer contact” is defined as the rate at which interaction with the customer or representative through face-to-face communication, phone calls, written correspondence, or email occurs. All communication with customers must be confidential and secure. When TWC VR staff initiates contact with the customer or representative with no response, this is documented as “attempted contact.”

The frequency of customer contact depends on the needs and preferences of the customer. The OSS discusses and plans the amount and type of contact needed (face to face, phone or email.) and documents the agreement on the ILP so that:

• both the customer and the OIB Service Specialists know their responsibilities; and 
• the customer is contacted at a rate that meets their needs (there is a maximum amount of time that should be scheduled between contacts).

Frequency of contact can change as needed throughout the life of the case based on the customer’s needs. Each customer contact should be entered in RHW. The OSS must use case notes to document:

• customer contact;
• unsuccessful attempts at customer contact; and 
• all changes to the schedule of customer contact. 

8.1.9: Older Individuals Who Are Blind Program Responsibilities

OIB responsibilities involve tasks that OIB staff performs to help the customer achieve intermediate objectives and independent living goals. Examples include:

• encouraging and facilitating confidence building; 
• monitoring progress; and 
• providing the necessary information to allow for informed choices. 

8.1.10: Customer Responsibilities

Customer responsibilities are the tasks that the customer must complete to achieve intermediate objectives and independent living goals. The OSS selects customer responsibilities from the drop-down menu in RHW and may also customize responsibilities in RHW that correspond to the achievement of each objective.

Customer responsibilities could include:

• keeping all appointments;
• participating in training;
• practicing skills between training sessions; and
• contacting staff if changes occur with the customer’s disability, medical or health status, address, interest, living arrangements, phone number, and/or income. 

8.1.11: Customer Contribution

The OSS indicates the type of goods or services the customer has agreed to pay for or provide. 

Examples of customer’s contributions are:

• transportation; 
• a portion of the cost of a low-vision device;
• a portion of the cost of assistive technology; and
• glasses.

For more information, refer to Chapter 7.7 Customer Participation in the Cost of Services.

8.1.12: Role of the Older Individuals Who Are Blind Service Specialist in Plan Development

The OSS might find it necessary to help the customer by: 

• identifying comparable services and benefits; 
• contacting (or helping the customer contact) comparable providers of services and benefits; 
• preparing the customer for referral to another agency or program; 
• providing appropriate applications, letters, and so on to community resources;
• staffing the case with a CIL case worker, if appropriate;
• arranging appointments, if necessary; and 
• following up on and documenting the results. 

Note: Each OSS is expected to establish and maintain good working relationships with community agencies, state agencies, and charitable organizations by developing an understanding of their goals and the nature of their services. 

8.2: Time Frame to Complete the Independent Living Plan

The ILP must be completed as soon as possible, but no later than 90 days after the customer has been determined eligible for OIB services.

8.2.1: Extension of Time for the Independent Living Plan 

If the OSS and customer cannot complete the ILP within 90 days after the date that eligibility is determined, the OSS must do the following:

• Inform the eligible individual of the reasons that the development of the ILP will require additional time to complete and when the ILP is expected to be completed.
• Obtain agreement from the customer that the extension of time for completing the ILP is necessary.
• Give the reasons that an extension of time is required.
• Complete the Extension of Time page in RHW, including the date to which the ILP completion is extended.

If the eligible individual does not agree to an extension of time, the OSS must document the individual’s decision in a case note and explain that OIB services cannot be provided without an ILP. If the eligible individual and OSS cannot come to an agreement regarding the contents of the ILP within 90 days, the OSS must document the status of the pending ILP and consult with the OIB manager on how to proceed with the case. The OSS then informs the eligible individual of the right to appeal the decision and provides the Can We Talk? brochure. OIB staff must document the date and method the information was provided to the eligible individual in RHW.

If the OSS cannot make contact with the eligible individual to obtain agreement with the extension of time for ILP development by the 90th day, the OSS must document a good-faith effort and may close the case, as appropriate. Additionally, the OSS must follow the closure and notification policies and procedures.

Extensions are limited to 30 days at a time. The OSS must create a new extension of time in agreement with the customer every 30 days. This ensures that extensions are being used only when appropriate and necessary and reassessed regularly so the ILP is developed as soon as possible and within the extended time frame.

8.3: Using the Comprehensive Application Assessment to Complete the Independent Living Plan

All services and goods, including services arranged through comparable benefits that are listed on the ILP, must have been identified and discussed on the comprehensive application assessment. If necessary goods or services are identified by the OSS and customer after the completion of the comprehensive application assessment, an amendment case note should be included to discuss the addition or changes in services before the ILP is completed. Refer to Chapter 6.3: Amending the Comprehensive Application Assessment After Eligibility for more information. 

8.3.1: Comparable Benefits 

OIB must not expend funds on comparable goods and services unless the OSS and the customer have made maximum efforts to secure assistance from other sources to pay for the service.

Information about available comparable benefits and services must be included on the customer’s ILP. This includes any comparable services and benefits that the customer has or has agreed to seek. The OSS must clearly describe the customer’s responsibility to apply for and maintain eligibility for comparable benefits, such as benefits from the VA. 

8.4: Independent Living Plan Amendment

If there are substantive changes in the OIB services to be provided, the ILP is amended as necessary by the customer or, as appropriate, the customer's representative, in collaboration with the OSS. 

The amendment must be completed before the dates of services on the ILP or current ILP amendment have expired.

When completing an ILP amendment, review and update what is reviewed as part of the JAR. For more information, refer to Chapter 8.5: Joint Annual Review.

8.4.1: Content of the Independent Living Plan Amendment

The ILP amendment is a standalone document that captures the goals and services that the customer will need to continue to progress toward their independent living goal. All policies and procedures for completing the original ILP apply to the completion of the ILP amendment. Refer to Chapter 8.1: Content of the Independent Living Plan for more information.

All services that remain in effect at the time that the ILP is amended must be included in the ILP amendment. The start date of services on the ILP amendment should reflect the date that the services first started if they were included in the original ILP or a previous ILP amendment. New services that are added to the ILP amendment cannot have a start date prior to the date of the current ILP amendment.

Before services can continue, the ILP amendment must be signed by both the OSS and the customer or their representative, either in RHW or on a printed version of Form VR5156, Independent Living Plan Amendment, unless a VR5054, Signature Form for OIB Program Applicants, has been completed and is on file. For more information on Form VR5054, refer to Chapter 8.6: Independent Living Plan Waiver.

If RHW is unavailable, the OSS may use Form VR5156, Independent Living Plan Amendment. The information from Form VR5156 should be promptly entered into RHW, and the signed paper copy should be maintained in the customer’s case folder. Upon completion of the ILP amendment in RHW, a copy of the document should be printed and provided to the customer. However, if the customer signed Form VR5054, Signature Form for OIB Program Applicants, at the time of application, a copy of the ILP amendment does not need to be signed or provided to the customer unless requested.

8.4.2: Independent Living Plan Amendment Documentation

When completing an ILP amendment, the OSS reviews and updates the JAR as needed (refer to Chapter 8.5: Joint Annual Review). Additionally, the OSS documents in RHW the justification for any changes to the goals, services, vendors, or other content that will be included in the ILP amendment and the justification for any additional services that are needed to achieve the independent living goal (including documentation of best value for purchased goods and services).

Note: When services are deleted because of funding restrictions or because they are no longer needed or appropriate, the OSS documents these changes in a case note. The OSS decides when it is necessary to provide a clarification of complex service delivery in writing.

8.4.3: Case Note Documentation Requirements for the Independent Living Plan Amendment

When changes are made to the ILP amendment, the OSS must enter a case note topic of “IPE/ILP amendment” in RHW to indicate any changes to the goals, services, vendors, or dates of services along with any other pertinent information. Additionally, the case note should indicate which services and why those services are continuing on the ILP. 

8.5: Joint Annual Review 

If an ILP amendment is not completed within 12 months, then the OSS must conduct a JAR with the customer or with the customer’s representative to review the ILP and the customer’s progress toward the ILP objectives. If an ILP amendment is completed within 12 months, then a JAR is not required. Completing either a JAR or an ILP amendment restarts the clock in RHW for the next required annual review as one year from the date of either activity.

When completing a JAR, the OSS meets with the customer and, as appropriate, the customer’s representative to:

• review the details in the current ILP or ILP amendment;
• determine if there is a need to complete an ILP amendment;
• review and update all information captured in RHW under the following menus: 
  • Initial Contact
  • Monthly Financial Information
  • Insurance Policy
  • Plan
• review and update release forms; and
• document the JAR in a case note.

8.5.1: Joint Annual Review Documentation

The JAR case note must include a specific review of all required elements of the ILP, including a review of the progress made toward reaching the customer’s independent living goal. This includes the following:

• Intermediate objectives
• Progress (including training progress, if applicable)
• Planned services and goods (including vendors and service dates)
• Comparable benefits
• Customer participation in cost of services
• Roles and responsibilities

If the JAR does not result in substantial changes in the OIB services to be provided or the vendors of the OIB services, then an amendment is not required. Include a statement in the JAR case note to confirm that both the customer and OSS agree that no changes are needed.

If the JAR results in substantial changes in the OIB services to be provided or the vendors of the OIB services, then an ILP amendment is required.

If the JAR results in a need for new diagnostics to determine whether new services are needed, an ILP amendment is not necessary. A service justification case note must be written in RHW explaining the necessity for the new diagnostics. Once the results have been received and reviewed by the OSS and customer, if new services are required and agreed upon, an ILP amendment will be necessary to cover those services.

If the JAR results in a need for only new ancillary or supportive services to support services that already exist on the ILP or current ILP amendment, an ILP amendment is not required. Instead, a service justification case note can be used to document the need and authorization for these services. The start and end dates for the ancillary or supportive service must not go past the end date for the associated service on the ILP. 

8.6: Independent Living Plan Waiver

The customer may choose to waive the original ILP and any ILP amendments by signing Form VR5054, Signature Form for OIB Program Applicants. Form VR5054 then becomes a part of the electronic case record. 

When the customer waives the written plan, it is important to understand that:

• the customer is not waiving their rights; and
• the OSS remains responsible for discussing all aspects of the ILP with the customer, including the terms and conditions stated on the ILP, as well as all amendments to the plan.

The OSS continues to:

• document all planned services on the ILP (but without providing a copy to the customer); and 
• maintain the waiver in the customer’s electronic case file. 

8.7: Service Justification

If a non-substantial service or good (such as transportation, maintenance, or an item that costs less than $50) is needed for a customer to participate in OIB services, or if there is a change in a vendor, a service justification case note can be used to document purchasing services not listed on the ILP. 

The following documentation is required in the service justification case note: 

• Specific service or good to be purchased
• Justification for service or good to be purchased
• Begin and end dates of service
• Availability and use of comparable benefits
• Application of customer’s participation in cost of service (if any)
• How the customer exercised informed choice
• Best-value purchasing decision
• Any additional notes about the purchase of a good or service

Back to Table of Contents

Chapter 9: Active Services and Service Delivery

9.1: Service Description

A customer in the Active Services phase is a customer who has a completed ILP (signed plan or waiver) and is moving forward with service delivery. “Service delivery” is the coordination of goods and services to OIB customers. The following are two common types of services to consider when providing goods and services: 

• In-House Services—Services that are provided in-house by creating a service record in RHW as follows:
• Deafblind Services 
• Diabetes Education
• Orientation & Mobility
• VR Teacher Services
  • Contracted Services—Contracted Services are active services that are authorized by the OSS and provided by a specific contracted vendor. TWC has contracted vendors that vary by region and help with services for the OIB program, including the following: 
• Assistive Technology and Training
• Independent Living Skills
• Diabetes Education
• Orientation & Mobility
• Senior Keys to Independent Program
• Adaptive Aids

9.1.1: Medical and Clinical Therapeutic Support Services

Therapeutic medical treatment is a service to correct, modify, or substantially stabilize a slowly progressing physical impairment that constitutes a barrier to independence. If a customer needs medical treatment for an eye condition, the OSS must refer them to the most appropriate resource. OIB does not pay for medical treatment. 

Rehabilitative therapy support services such as low-vision evaluations, counseling by a licensed provider on adjustment to blindness issues, or low-vision occupational therapy are considered medical services and should follow purchasing policies outlined in the VRSM Part C, Chapter 5.2.c: Medical Services with Special Requirements.

9.1.2: Supportive Goods and Services

“Supportive goods and services” refers to necessary items and services that support the independence of the OIB customer. These goods and services are either listed in the customer’s ILP or documented in a service justification case note. 

For more information on supportive services, refer to Chapter 9.10 Supportive Services.

9.2: Older Individuals Who Are Blind Independent Living Skills Training 

9.2.1: Service Description

“Independent living skills training” is training in techniques that enable a customer to perform daily living skills in alternative ways. Training can be provided directly by the OSS or purchased by a contracted independent living skills vendor. 

 Independent living skills are divided into the following categories:

• Personal management—including grooming, eating, health, safety, clothing identification and coordination, and the use of medications
• Home management—including sewing, cleaning of clothing, housekeeping, meal preparation and kitchen safety skills, planning for grocery shopping, and minor home maintenance
• Communication—including telling time and time management, using the telephone, money management, writing, organization, and using adaptive devices
• Information access and technology—including training on the use of magnifiers, CCTVs, and other devices for low-vision, as well as adaptations of computers and other types of technology

• Information and Referral—services that help the customer identify and use alternative resources, such as Meals on Wheels and the Texas State Library, to meet their individual needs

  Note: Information and referral services can be provided at any point in the independent living process.

Refer to Vocational Rehabilitation Vocational Rehabilitation Standards for Providers Manual (VR-SFP) Chapter 10: Independent Living Services for Older Individuals Who Are Blind for more information on requirements regarding independent living skills training.

9.2.2: Independent Living Skills Training Provided by Older Individuals Who Are Blind Service Specialists

The OSS can provide independent living skills training directly to the customer and should clearly document in a case note a summary of the training.

The OSS’s responsibility includes coordinating services, considering options, and providing comprehensive support while managing available resources.

The OSS’s goal is to provide comprehensive support while managing resources by:

• ensuring that essential services are provided to individuals with visual impairments;
• coordinating services and providing training related to adaptive skills, independent living, and other disability areas;
• providing services that include assistance with daily living tasks, basic mobility training, and access to assistive technology; and
• considering options, including outside services, budget constraints, and community resources. 

9.2.3 Independent Living Skills Training Provided by a Vocational Rehabilitation Teacher

Vocational Rehabilitation Teacher Services (VRT) support Independent Living (IL) skill development for individuals who are blind or visually impaired. These services focus on building practical, everyday skills that promote safety, confidence, and independence in the home and community. VRT services should be considered when the VRT has capacity to serve OIB customers. The OSS should work with the VRT and the Program Support Specialist to determine if the VRT is able to serve OIB customers. For a detailed description and steps for referring to the VRT, please refer to Part C, Chapter 6.7-Vocational Rehabilitation Teacher (VRT)Services.

OSS Responsibilities when referring to a VRT:

• Identify customers for IL skills training
• Create a SR requesting VRT services;
• Provide VRT with training recommendations or the Comprehensive Application Assessment; 
• Exchange frequent and regular communication during the provision of VRT Services.

Note: The OSS and VRT shall collaborate in determining applicable timelines and in establishing the use and source of adaptive aids to support Independent Living Training.

9.2.4: Contracted Independent Living Skills Training

Based on a customer’s ILP, the OSS authorizes which independent living services are to be provided through a contracted vendor. The ILP should include clear documentation of service coordination. Contracted vendors can offer independent services when addressing specific goals in the ILP. For more information on referrals and payment processing, refer to VR-SFP Chapter 10: Independent Living Services for Older Individuals Who Are Blind.

Note: CCRC does not serve customers participating in the OIB program. To receive services from the CCRC, a customer must be receiving VR services. There is more information about this procedure in the VRSM.

9.3: Vision Services 

Before approving the purchase of vision services, the OSS must first assess the necessity of such services. All comparable benefits must be exhausted prior to using OIB funds for vision services.

Vision services may encompass referrals along with the coordination of eye care needs in alignment with the customer’s independent living goals. In cases where diagnostic services are unavailable, vision services may also include assistance in obtaining medical eye information to determine eligibility for specific independent living services.

9.3.1: When to Obtain Vision Services

Vision services are purchased only when: 

• diagnostic services are unavailable and eligibility needs to be determined;
• to obtain more information about the customer’s vision loss and specific needs;
• specific recommendations for low vision devices or items is needed.

9.3.2: Older Individuals Who Are Blind Service Specialist Role in Providing Vision Services

The OSS may help with coordination and case management of the following:

• Referrals to community organizations for eye restoration treatment
• Low-vision examinations
• Demonstration of low-vision aids 
• Provision and training of low-vision aids 
• Non-optical devices and methods

Note: Medical treatments are not purchased in the OIB program.

9.3.3: Purchase of Low-Vision Evaluations or Devices

Before referring a customer for a low-vision evaluation or purchasing devices, the OSS must assess the customer’s needs and the availability of comparable benefits. If appropriate, comparable benefits should be used for full or partial payment. When non-optical devices (such as improved lighting, contrast, or writing guides) can meet the customer’s goals, these alternatives should be prioritized before considering any purchase of low-vision services.

Not all customers wish to use low-vision devices. The OSS must discuss options with the customer to determine their interest in pursuing evaluations or devices. For example, some customers may be content with their current situation or may have financial resources above economic guidelines but are unwilling to participate.

9.3.4: Customer Eligibility for Low-Vision Services

Many customers may not benefit from low-vision evaluations or devices, particularly those who:

• have vision worse than 20/400;
• have a field restriction of 10 percent or less;
• have not completed restoration services;
• have unrealistic expectations (such as achieving 20/20 vision, driving a car, or receiving specific glasses);
• lack transportation for evaluations or follow-ups; or
• do not have the health or stamina to participate fully in the evaluation and follow-up.

If the customer has a quickly progressing eye condition (a condition in which vision worsens within six months) or has a visual acuity or field restriction at or worse than listed above, OIB manager approval is required for customers to attend a low-vision evaluation. 

Low-vision recommendations from a low-vision specialist should be carefully evaluated to ensure they provide the best value and are necessary for enhancing the customer’s independence. Items that can be obtained through a contracted vendor must be purchased from the contracted vendor. 

Only items unavailable through a contracted vendor can be purchased from a low-vision doctor’s office. The OSS should discuss the recommendations with the customer, explaining the concept of best value and the customer’s potential contribution to the cost of services when possible.

9.3.5: Guidelines for Purchasing Low-Vision Devices

The guidelines for non-spectacle mounted items are as follows:

• They must be purchased from contracted vendors or catalogs only.
  • If bioptics are prescribed, OIB manager approval is required.
  • If recommendations include codes not listed in RHW, state office consultant review is required after OIB manager approval. 

The guidelines for CCTVs are as follows: 

• CCTVs are limited to customers with thoroughly assessed and documented needs (the OSS uses Tech Start screener to determine if CCTV or other devices are appropriate for a customer).
• Documentation on the comprehensive application assessment must indicate that CCTV is necessary for the customer to achieve independence and how CCTV will increase their independence.
• CCTVs must be purchased through contracted vendors unless a recommended device or comparable device is unavailable but is available through a vendor such as a low-vision doctor’s office.

The guidelines for magnifiers and similar items are as follows: 

• The OSS uses the best-value purchasing approach.
• The OSS demonstrates magnifiers to customers to help them determine their own magnification needs.
• The OSS creates the purchasing justification case notes, which must include the following details:
  • Tasks made easier by the magnifier
    • Devices demonstrated
    • Chosen magnification and readable font size
    • Customer’s contribution toward the purchase (if applicable)
    • How the device will increase or maintain independence

The guidelines for transitions glasses lenses are as follows: 

• Transitions lenses may only be approved if the prescription explicitly specifies they are needed. 
• The prescription is documented in a case note.
• The prescription ensures that the tinting is medically necessary. 

9.4: Deafblind Services 

Deafblind services empower individuals to gain confidence and independence in communication and information access. These services facilitate integration, enhance independent living skills, and promote community engagement. 

Customers are referred to deafblind services when:

• hearing loss is medically documented; 
• hearing loss is suspected; or 
• the customer is functioning as a person who is deafblind.

Note: When an OSS suspects a customer may have hearing loss, or if the customer already has documented hearing loss, the OSS must refer the customer to a deafblind specialist before scheduling audiological or hearing-aid evaluations. 

The deafblind specialist assesses the combined vision and hearing loss, advises the customer on sharing relevant information with their audiologist, and suggests questions to ask about hearing-aid features and considerations. This ensures the customer receives appropriate guidance. (For more information on deafblind services, please refer to VRSM Part C, Chapter 6.3: Deafblind Services.)

9.4.1: Procedures for Hearing Aids 

If the OSS suspects or becomes aware that a customer has hearing loss that could impact their participation in the OIB program, hearing aids may be appropriate. However, before exploring hearing aid purchases, the OSS must ensure that all comparable benefits have been exhausted and that there is clear documentation of the customer’s referral to their local CIL for the purchase of hearing aids as a comparable benefit. 

CILs receive funds to purchase medically necessary equipment such as hearing aids. Hearing aids are considered a secondary disability purchase and require OIB manager approval before being listed on the ILP or purchased.

When hearing loss is suspected, the OSS should assess whether the customer has recently undergone a hearing examination and work to obtain relevant records. Once It has been identified that the customer has hearing loss, the OSS must refer to the Procedures for Purchasing Hearing Aids Desk Reference.

Note: For more information regarding purchasing hearing aids, please refer to VRSM Part C, Chapter 5.2.f: Hearing Aids.

9.5: Diabetes Management

The OIB program ensures that blind or visually impaired customers have customized diabetes self-management education services. The services are provided by an in-house diabetes education program specialist or contracted diabetes education vendor that specializes in providing techniques, trainings, and adaptations that are unique to both the customer’s diabetes and their vision loss.

Customers are referred when they:

• have not received formal diabetes education from an accredited or recognized diabetes program;
• are not meeting treatment goals; and/or
• are transitioning in life or care, such as changing health care vendors.

Note: Customers must be offered informed choice of available contracted diabetes education vendors or the diabetes program specialist. If diabetes services are unavailable through these means, the customer is advised of community diabetes programs available and the potential limitations of these programs to provide specialized diabetes education for people who are blind or visually impaired. This discussion is documented in a case note in RHW. 

9.5.1: Consideration for Family Involvement

During the training period, the OSS evaluates whether family members or caregivers will be present. Their involvement can reinforce skills training and enhance the effectiveness of diabetes management services.

For contracted Diabetes Education services: refer to VR-SFP Chapter 7: Diabetes Education Services.

For In-House Diabetes Education services: see VRSM Part C Chapter 6.4.a: Diabetes Self-Management Education BVI-Provided Services.

9.6 Orientation and Mobility Services 

Orientation and Mobility (O&M services help OIB customers become confident and independent travelers. These services teach skills for safe travel indoors and outdoors, aiding integration into the community and surrounding environments. To ensure that OIB customers can access customized and accessible services to meet their needs, OIB provides in-house services and/or contracted services.

The OSS refers O&M services to a customer if they:

• feel unsafe traveling in the home;
• intend to travel independently outside the home as a regular part of their daily routine;
• are physically and mentally able to benefit from O&M training; or 
• have identified specific goals for O&M training.

For Contracted Orientation and Mobility Services:  For information regarding contracted O&M services, see VR-SFP Manual Chapter 5: Orientation and Mobility.

For In-House Orientation and Mobility Services:  For information regarding In-House O&M services, see VRSM Part C Chapter 6.5 Orientation and Mobility (O&M) Services. 

9.7 Assistive Technology

Assistive technology for blind or visually impaired includes tools and devices designed to help individuals with vision loss access information and independently perform daily tasks. Technologies range from screen readers, braille displays, speech recognition software, and video magnification. These tools empower individuals who are blind or visually impaired to navigate the digital world, communicate effectively, and enhance their overall quality of life. The OSS must ensure that customers who are blind or visually impaired can access the assistive technologies and services they need.

9.7.1: Assistive Aids and Technology

When funds are available, assistive technologies and adaptive aids may be purchased for customers after evaluating their needs. The TECH-START assessment includes questions about the customer’s visual acuity and stability, previous computer use, and ownership. The assessment also considers how the technology will support the customer’s independence goals, their experience with free adaptive software, and their ability to use other software like Microsoft Word or Excel. Additionally, the customer’s capacity to learn new information and the necessity of accessible software demonstrations are evaluated. The assessment also includes discussions about cost participation and training. The TECH-START should be used as a tool to assist the OSS with determining what assistive technology best meets the needs of the customer, however, it is not a requirement for all customers to be assessed. If a customer is a previous or current assistive technology user they may not need to be assessed and the OSS and customer can determine the best technology for their needs. 

Assistive technology must be purchased from a contracted vendor and be an approved item listed on the VR Assistive Technology unit’s Evaluation Products List. Form VR2014, Rehabilitation Equipment Receipt and Agreement, must be signed by the customer to show that they understand the purpose and conditions under which assistive equipment is being issued. The OSS must have a case note documenting any assessment as well as a justification case note with specific information related to any items or services purchased.

9.7.2: Assistive Technology Training and Purchasing

Assistive technology training is important for customers to be able to properly use their assistive devices and software. If the OSS determines that assistive technology training is needed based on the customer’s skill level and experience, the OSS may purchase a baseline assessment and training from an approved evaluator-contracted service vendor. For more information on all contractor responsibilities, service descriptions, and costs, please refer to VR-SFP Chapter 9: Assistive Technology Services for Customers with Visual Impairments. 

9.7.3: Assistive Technology Manager Approvals

The purchase of certain high-tech assistive technology devices that require higher levels of dexterity and cognitive functioning, such as Envision glasses, requires prior approval from the OIB manager. This measure is in place to help with the following:

• Evaluate Necessity—Confirm that the requested device is essential for the customer’s daily living activities and significantly enhances their independence.
• Budget Management—Ensure that the OIB program’s budget is allocated effectively to benefit the maximum number of eligible customers.
• Most Effective Outcome—Customer will be successful using the device to increase their independence, and the device is the best value and option for their individual needs. 

Note: Any assistive Technology Purchases exceeding $2,500.00 will need manager approval. Please reference the Appendix A: Table of Approvals.

9.8: Bulk Supplies 

Rehabilitation supplies are known as “bulk supplies,” or “consumable supplies.” They are defined as high-use, low-cost supplies. The OSS uses bulk supplies when working with customers to provide training and increase independence and when purchasing items for a customer would result in a delay of services. Staff should ensure bulk supplies provided to a customer are documented in RHW case notes. 

9.9: General Group Skills Trainings

General group skills trainings for OIB are designed to enhance essential independent living skills within a collective environment. Participants learn skills including, but not limited to, the following:

• Home management
• Meal preparation
• Personal care
• Mobility training
• Assistive technology
• Adjustment to blindness
• Recreational and leisure

Note: Group skills trainings often require multiple types of purchases, and the OSS must follow all applicable procurement and purchasing requirements along with any other requirements listed in the Older Individuals Who Are Blind Policy and Procedure, VR-SFP (see chapters depending on services), or the VRSM Part D, Chapter 3: Purchasing Goods and Services.  

9.10: Supportive Services 

Supportive services help customers in participating in or being evaluated for OIB service eligibility. Support services consist of the following two types:

• Maintenance 
• Transportation

These services should only be provided to customers who need support services to participate in OIB activities. 

9.10.1: Maintenance 

Maintenance payments are funds paid directly to the customer to help with expenses associated with an OIB service in which the customer could not otherwise participate in the activity. 

The OSS must clearly document the need for maintenance services in the case record. These services must be necessary and reasonable under the customer’s circumstances at the time a decision is made.

Decision-making factors include, but are not limited to, the following:

• Individual rehabilitation needs consistent with the customer’s informed choice
• Market rates
• Availability of cost-effective alternatives
• All other established policies and procedures, including policies and procedures for customer participation in the cost of services, also known as BLR

For more information on requirements for maintenance payments to customers, please refer to VRSM Part C, Chapter 16.2: Maintenance Services.

9.10.2: Transportation 

“Transportation services” are defined as financial support that can be paid directly to the customer in order for the customer to pay for a ride share (such as Uber or Lyft) or a third party who will provide the transportation. Transportation services may not be used to pay for any normal living expenses. Regardless of the reason for transportation services, they must be provided by the most economical and effective carrier that meets the customer’s disability-related needs. The need for transportation services must be clearly documented in the customer’s ILP or in service justification case notes if services are needed to help a customer in participating in activities related to eligibility determination, such as eye medical appointments or low-vision evaluations. 

For more information on requirements for transportation, please refer to VRSM Part C, Chapter 16.4: Transportation Services.

9.11: Services for Secondary Disabilities

The OIB program is committed to providing high-quality services to older adults who are blind and visually impaired through specialized support and community resources. TWC recognizes the unique challenges faced by this population and the impact of secondary disabilities. 

9.11.1: Secondary Disabilities

A secondary disability is a health condition not directly related to visual impairment but affects an individual’s independence. Examples include:

• hearing impairment or deafness;
• dementia;
• impaired cardiac or circulatory function;
• mental illness;
• developmental disabilities;
• orthopedic impairment or conditions that affect mobility; and/or
• any other disability that affects a customer’s independence that is not vision-related.

9.11.2: Secondary Disability Impacting Blindness

A secondary disability impacting blindness is an additional health condition that either arises from or affects the primary condition of blindness. The OSS can determine the needs and provide training for the customer since the secondary disability impacts the customer’s vision. 

Note: It is essential to obtain the appropriate OIB manager approvals when addressing a secondary disability that impacts an individual’s primary condition of vision loss. This ensures that all necessary resources and supports are provided effectively and in compliance with organizational policies. Any purchased service related to secondary disabilities requires OIB manager approval. 

9.11.3: When to Refer to Community Resources

To ensure individuals with secondary disabilities not related to blindness receive appropriate support and resources, TWC will refer them to relevant community organizations and resources as appropriate. A referral should be considered if the secondary disability significantly impacts the individual’s daily life. Community resources include, but are not limited to, the following:

• CILs
• Area Agency on Aging
• HHS
• Local area resources

Back to Table of Contents

Chapter 10: Closure

The OIB program offers a comprehensive range of closure categories for customer services. This chapter provides an in-depth description of each closure category and the specific criteria associated with each type.

10.1: Types of Closures

Types of closures are as follows:

• Minimal Services Successful Closure
• Planned Services Successful Closure
• Unsuccessful Closure Before Plan Initiated
• Unsuccessful Closure After Plan Initiated
• Closure Before Application 
• Closure After Application

10.1.1: Unable to Locate Customers Before Unsuccessful Closures 

For cases closed unsuccessfully at any point during the case due to the OSS being unable to locate the customer, the OSS must provide sufficient documentation of at least three attempts to establish contact with the customer. Examples of attempts include calling the customer’s phone number or an alternate phone number, sending an email, or using the customer’s listed contact. The OSS must also mail the customer a letter at least 10 days before closure notifying them that their case will be closed if there is no response.

10.2: Minimal Services Successful Closure

10.2.1: Criteria for Minimal Services Successful Closure

A case can be closed successfully under OIB minimal services if it meets the following criteria:

• Limited independent living services provided—no more than a few visits based on the customer’s needs and may include some limited purchases of adaptive aids
• Information and referral services and minimal adaptive aids provided—the customer received relevant information such as the Guide to Independent Living for Older Individuals Who Are Blind or Visually Impaired and some adaptive aids or minimal training necessary to meet the goals of the customer.
• The customer does not need further services from OIB—with the provision of minimal services, the customer has achieved a greater level of independence in their home and community.

10.2.2: Minimal Services Closure Requirements

Before closing a case successfully in minimal services, the OSS must:

• review the case to ensure: 
  • the criteria for minimal services is met;
  • the customer’s goals and needs were addressed; 
  • the customer’s independence increased as a result of services; and 
  • no other services are needed;
• ensure all service records for in-house services have been completed (if applicable);
• notify the customer of the case closure and provide any additional resources or referrals as needed;
• provide the Can We Talk? brochure if an application was taken;
• update the IL Services page; and
• complete all necessary documentation in RHW to reflect the closure status. 

10.3: Successful Closure After Plan Initiated

10.3.1: Criteria for Successful Closure After Plan Initiated

Services are considered successfully completed if both of the following criteria are met:

• The customer’s independent living goals, as outlined in the ILP, have been achieved, and no further services are required.
• The customer is living in the least restrictive environment and at the highest level of independence, as agreed upon by both the OSS and the customer.

10.3.2: Closing in Special Circumstances

The decision to close a customer’s case as successful is the joint responsibility of the customer and the OSS.

In some cases, an OSS may close a case if the customer chooses to live in an environment the OSS deems less than suitable only if the customer has increased some level of their independence. For example, a customer might desire to live in a situation that, in the view of the OSS, is not compatible with the customer’s physical capacities or their mental abilities, and/or does not appear to be suitable for a reasonable period of time. However, good counseling requires that the OSS recognizes the customer’s right to make such choices. The OSS is obligated to provide the customer with:

• assistance in understanding their situation as it relates to independent living;
• information to make informed decisions;
• encouragement to pursue a more suitable objective, consistent with the developed ILP; and
• documentation of the assistance provided in the closure letter.

10.3.3: Customer Notification

The OSS and customer must agree to successful case closure (unless the customer is unable to be located or contacted with at least three attempts to contact), and the OSS must: 

• inform the customer of the closure; 
• provide the customer with the Can We Talk? brochure; and 
• send a closure letter. 

This letter is available for printing after the Successful Closure page in RHW is completed. 

10.3.4: Procedures for Successful Closure After Independent Living Plan Development

The procedures for successful closure after ILP development are as follows.

1. Discuss closure with the customer, including the following steps:

• The OSS discusses the case closure with the customer.
• Both the OSS and the customer agree that all requested services have been addressed and no further services are needed. 

2. Verify Records:

• The OSS checks all relevant service records to ensure that:
• service records for in-house vendors are completed;
• all open service records are canceled or closed;
• all SAs for goods and services are received, paid, or canceled;
• all supporting documents for SAs are received;
• the customer’s ILP is reviewed and updated to reflect all planned services; and
• all case notes are current and accurate and reflect the OIB case history.

Note: Goods and services received before an invoice can be paid for after case closure.

3. Review IL Services page in RHW.

The OSS ensures that each service on the IL Services page is marked accordingly.

4. Document successful closure and complete closure case note, including the following steps:

• The OSS documents the successful closure in a case note following case note requirements outlined in Chapter 10.8.1. 
• The OSS completes the Successful Closure page in RHW.

5. Send closure letter and Can We Talk? brochure, as follows: 

• The OSS sends a closure letter to the customer informing the customer when the case is closed. 
• The letter includes information on the customer’s right of appeal and the CAP. 
• The Can We Talk? brochure should be included with the letter. 

10.4: Unsuccessful Closure Before Plan Initiated

A case is closed as “Unsuccessful Closure Before Plan Initiated” if the customer was determined eligible for OIB services, but an ILP cannot be developed for any reason. 

10.4.1: Procedures for Unsuccessful Closure Before Plan Initiated

The procedures for an unsuccessful closure before an ILP is initiated are as follows:

1. Discuss closure with the customer when possible, including the following:

• The OSS discusses the case closure with the customer when possible. When this is not possible, the OSS creates a case note documenting why the case is being closed and attempts to contact the customer. 
• The OSS informs the customer they may reapply for services at any time if they wish. 

2. Verify Records:

• The OSS checks all relevant service records to ensure:
  • service records for in-house vendors are completed;
  • all open service records are canceled or closed;
  • all SAs for goods and services are received, paid, or canceled;
  • all supporting documents for SAs are received; and
  • all case notes are current and accurate and reflect the OIB case history.

Note: Goods and Services received before an invoice can be paid after case closure.

3. Review IL Services page in RHW.

• The OSS ensures that each service on the IL Services page is marked accordingly.

4. Document unsuccessful closure and complete closure case note, including the following steps:

• The OSS documents the unsuccessful closure in a case note following the case note requirements outlined in Chapter 10.8.2. 
• The OSS completes the Unsuccessful Closure page in RHW.

5. Send closure letter and Can We Talk? brochure, as follows: 

• The OSS sends a closure letter to the customer informing the customer when the case is closed. 

  Note: The OSS does not send a letter due to death of a customer or if the customer is unable to be located by their address. 

• The letter includes information on the customer’s right of appeal and the CAP. 
• The Can We Talk? brochure should be included with the letter. 

10.5: Unsuccessful Closure After Plan Initiated

A case is closed as “Unsuccessful Closure After Plan Initiated” if OIB services listed on the ILP are unable to be completed for any reason. 

10.5.1: Criteria for Unsuccessful Closure Before or After Plan Initiated

“Unsuccessful Closure After Plan Initiated” may be appropriate when the goals developed and planned by the OSS and the customer cannot be fully achieved. Various circumstances may prevent the attainment of the independent living goal. After considering all pertinent facts, the OSS may discontinue services and close the case as Unsuccessful Closure After Plan Initiated.

10.5.2: Decision Not to Follow Through 

Customers might decide not to follow through with a program of services that is being developed or has been implemented. Before closing the case, the OSS must:

• ensure the customer understands the purpose of the program and the services available;
• inform the customer that they may reapply for OIB services later; and
• document in case notes the reasons the customer decided not to proceed.

10.5.3: Referrals to Other Agencies or Texas Workforce Commission Programs 

When a customer can be appropriately referred to another agency or TWC program, the referral involves more than merely advising the customer to apply to the other agency or program. The OSS provides referral assistance by:

• discussing the possible referral with the customer and obtaining a signed release of information;
• transmitting pertinent data to the other agency or program;
• providing additional help as required to best meet the customer’s needs;
• notifying the customer in writing of the actions taken; and
• documenting the referral in case notes.

10.5.4: Procedure for Closing a Case as Unsuccessful Closure After Plan Initiated

The procedures for an unsuccessful closure after ILP development are as follows:

1. Discuss closure with the customer when possible, including the following:

• The OSS discusses the case closure with the customer when possible. When this is not possible, the OSS creates a case note documenting why the case is being closed and attempts to contact the customer. 
• The OSS informs the customer they may reapply for services at any time if they wish. 

2.  Verify Records

• The OSS checks all relevant service records to ensure:
• service records for in-house vendors are completed;
• all open service records are canceled or closed;
• all SAs for goods and services are received, paid, or canceled;
• all supporting documents for SAs are received; and
• all case notes are current and accurate and reflect the OIB case history.

Note: Goods and services received before an invoice can be paid for after case closure.

3. Review IL Services page in RHW.

• The OSS ensures that each service on the IL Services page is marked accordingly.

4. Document unsuccessful closure and complete closure case note, including the following steps:

• The OSS documents the unsuccessful closure in a case note following the case note requirements outlined in Chapter 10.8.2. 
• The OSS completes the Unsuccessful Closure After Plan Initiated page in RHW.

5. Send Closure Letter and Can We Talk? brochure, as follows: 

• The OSS sends a closure letter to the customer informing the customer when the case is closed. 

Note: The OSS does not send a letter due to death of a customer or if the customer is unable to be located by their address.  

• The letter includes information on the customer’s right of appeal and the CAP. 
• The Can We Talk? brochure should be included with the letter. 

10.6: Closure After Application

A case is closed after application if the customer has applied for OIB services but has not been determined eligible for services. A case may be closed after application for the following reasons: 

• The OSS could not locate the applicant.
• The customer is ineligible for OIB services.
• The applicant moved out of state.
• The applicant is deceased.
• The applicant has been institutionalized.
• The applicant is no longer interested in services. 

10.6.1: Ineligibility Criteria

If a customer is determined ineligible for OIB services because they do not meet eligibility requirements, refer to Chapter 7.3: Closing a Case as Ineligible. 

10.6.2: Procedure for Closure After Application

The OSS takes the following steps when closing a case after application unsuccessfully due to ineligibility or other reasons:

1. Complete Closure After Application Page—The OSS completes the Closure After Application page in RHW.

2. Send closure letter—The OSS prints and sends the closure letter from RHW to the customer or their representative, informing the customer of their right to appeal, and includes the Can We Talk? brochure with the letter. 

   Note: The OSS does not send a letter due to death of a customer or if the customer is unable to be located by their address. 

3. Review IL Services page in RHW—The OSS ensures that each service on the IL Services page is marked accordingly.
4. Document closure—The OSS records the closure in a case note including the reason the case is being closed.

10.7: Closure Before Application

A case is closed before application when an Initial Contact has been entered but an application has not been completed for the customer. 

10.7.1: Procedures for Closing a Case Before Application 

The OSS takes the following steps when closing a case before application unsuccessfully due to ineligibility or other reasons:

1. Complete Closure Before Application page—The OSS completes the Closure Before Application page in RHW.
2. Review IL Services page in RHW—The OSS ensures that each service on the IL Services page is marked accordingly (if applicable).
3. Complete closure case note in RHW—If the case is closed before application, there is no drop-down menu to record the closure reason in RHW. Therefore, the reason for closure should be documented in a case note.

10.8 Closure Case Note Requirements

All closed cases must include a case note detailing the reason for closure. 

10.8.1: Successful Closure Case Note Requirements

If a case is closed successfully in minimal services, or successfully after plan initiated, a case note titled “Closure” must contain the following:

• The reason for case closure
  • How goods and/or services helped the customer in meeting their independent living goals (if applicable)
  • How the Guide to Independent Living for Older Individuals Who Are Blind or Visually Impaired helped the customer in meeting their independent living goals (if applicable)
  • How minimal services met the need (if applicable)
  • What goods, services, and/or equipment were provided to the customer throughout the life of the case
  • What training was provided in the use of goods and/or equipment 
  • How goods, services, and/or equipment provided by OIB helped the customer in increasing their independence
  • All referrals to other programs, agencies, or resources to help the customer in maintaining their independence after case closure

10.8.2: Unsuccessful Closure Case Note Requirements 

If a case is closed unsuccessfully before or after application, or before or after plan initiated, a case note titled “Closure” must contain the following:

• The reason for case closure
• What goods, services, and/or equipment were provided to the customer throughout the life of the case
• All referrals to other programs, agencies, or resources to help the customer in maintaining their independence after case closure

10.9: When to Open a New Case for Additional Services

A new case should be opened if:

• extensive services may be needed;
• the customer experiences a significant change in their visual disability;
• the customer was made ineligible but has new information that can be used to determine eligibility for services; and/or
• the previous case has been closed for more than one year.

Note: If a new case is opened, the new case file can include copies of information from the customer’s previous case file.

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Chapter 11: Case Management Requirements

The recording of individual customer services must adhere to both federal and state regulations and be consistent with OIB program policies.

For the purposes of audits, examinations, and compliance reviews, federal law mandates that the designated state agency—the sole state agency authorized to provide rehabilitation services to individuals who are blind and to administer the OIB grant—must grant the Secretary and the Comptroller General, or any of their duly authorized representatives, access to the following:

• Records maintained under this part—All records maintained as per the relevant regulations
• Pertinent books, documents, papers, and records—Any additional documentation that is relevant to the financial assistance received
• Individual case records or consumer service records—Comprehensive records of individuals served, including names, addresses, photographs, and evaluation records

This requirement is stipulated under 34 CFR §367.70.

Note: The purpose of this section is to establish standards and formats for an OSS to record customer services in the caseload management system RHW. These formats ensure that the minimum information required by the OIB program is documented while allowing workers the flexibility to include additional relevant information as needed.

11.1: Case Notes

Case notes are only recorded in RHW and must meet all state and federal program requirements. Any OIB or VR staff that interacts with a customer, family member or vendor is able to enter a case note in RHW in the customer case file. 

11.1.1: Purpose

OIB staff members must use case notes to compile information resulting from interactions with the customer, the customer’s family or representative, referral sources, service vendors, and others. Case notes should establish a sound record of effectiveness and efficiency by:

• conveying compliance with federal and state laws regarding:
  • the use of funds; and
  • the decisions and timeliness in service delivery;
• documenting the OSS’s decision making and application of the OIB process;
• documenting the customer exercising informed choice;
• providing a clear and concise explanation of the customer’s progression through the OIB process;
• explaining any causes for delay, planned interventions, and the result of interventions; and
• documenting how OIB services were seamlessly provided to the customer during any absences of the OSS assigned to the case.

System-generated case notes include letters created in RHW. These case notes are automatically entered into RHW and cannot be modified.

11.1.2: What to Include

Significant events or developments related to the customer must be documented. These include, but are not limited to, the following:

• OSS actions (assessments, training notes, vendor notes)
• Rationale for services
• Explanations for extended phases
• Receipt of medical information and evaluations
• Loss of contact and efforts to reconnect
• Significant changes in the customer’s situation (such as disability, family, and/or financial circumstances)
• Changes in or efforts to secure comparable services and benefits

Note: RHW provides a drop-down menu of suitable topics for OIB staff to select when documenting relevant events or developments in a customer’s case. OIB staff members can also add additional information if necessary.

11.1.3: What Not to Include

Please avoid including the following in case notes:

• References to the customer’s HIV status
• Duplicative information from other forms or reports, unless significant to the case note
• Information not pertinent to the customer’s disability
• TWC internal issues, policies, or systems unrelated to the case

11.1.4: Method of Recording 

Case notes should be completed promptly, ideally within one week of an event. They must be objective, concise, and relevant, providing a clear understanding of the customer’s needs and the OSS’s actions. Each case note should address all required elements regarding who, what, where, when, why, and, if appropriate, how.

11.1.5: Summarizing Multiple Contacts and Referring to Documentation

The OSS may use a single case note to summarize information or actions taken over several contacts, preferably within a one-week period. Each contact or action date must be included in the case note body. Additionally, letters or other documents essential to understanding the customer’s needs, including the original ILP and any subsequent amendments, may be referenced or copied and pasted in a case note.

11.2: Case File Organization

OIB case files are managed electronically in a Teams virtual case file. OIB case files must be organized in the same way to ensure uniformity. OIB staff members are responsible for the following:

• Management of the caseload
• Location of paper case files
• Case correction activities

11.2.1: Case File Heading

Each case file should have the same naming convention: Last Name, First Name Case ID (for example, Smith, John 1981234).

Note: Each case file should be a channel in the unit’s Teams site.

11.2.2: Standard Subfolder Structure for Vocational Rehabilitation Older Individuals Who Are Blind Folders

Each case file must contain the following: 

• General correspondence, including—
• emails that need to be saved; and 
• Internal and external correspondence that needs to be saved.
• Application and releases, including—
• application documents;
• insurance documents;
• documents signed by the customer digitally or by ink;
• ILPs and amendments (if a paper ILP was used); and
• ILP waivers.
• Records and reports, including—
• assessments;
• medical records;
• other records; and
• agency forms.
• Identification documentation
• Purchasing records, including—
• SAs (purchase orders);
• vendor invoices;
• quotes and bid documentation;
• maintenance or transportation logs; and
• rehabilitation equipment, items, receipts, and agreements.
• External collaboration with contractors (vendors), including emails or other documentation from contractors or vendors regarding the case
• Previous case and pre-standardized virtual file documents, including—
• documentation from a previous Texas VR and/or OIB case; and/or
• virtual documentation for this case obtained before the standardized virtual file process was implemented.

11.2.3: Date Stamping

Records and reports received from other sources, such as training records, must be reviewed by the OSS before they are filed in a customer’s case file. The OSS must enter applicable documentation in RHW that they have reviewed the report before payment. Each document must be date stamped before including in the electronic case file. 

Content that is not relevant to a customer’s OIB case should not be maintained in the customer’s case record. When content is received that is not relevant to the customer’s OIB case, OIB staff members should dispose of this information.

11.3: Maintaining Closed Case Files

OIB must maintain the full case record for a total of seven years after closure.

For more information regarding requirements on maintaining and processing closed case files, refer to VRSM Part E, Chapter 3.1: Case Record and Documentation.

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Chapter 12: Required Case Note Documentation

12.1: Comprehensive Application Assessment Case Note

An OSS conducts an interview with each applicant and documents significant observations using the OIB Application/Comprehensive Assessment form. Additionally, the OSS records any training or services provided during the application and/or comprehensive application assessment visit.

Note: Refer to Chapter 5.2 Application Process for all requirements for the comprehensive application assessment. 

12.2: Eligibility Case Note

Refer to Chapter 7.5 Case Note Requirements for Eligibility for more information on information to include in the eligibility case note. The OIB Eligibility Case Note template may be used to ensure all criteria is met for the eligibility case note.

12.3: OlB IL Skills Training Case Note

All training sessions with the customer completed by the OSS must be documented in a case note. Each training case note should include the following:

• The specific skills training provided
• The customer’s response to the training, including the degree to which the customer acquired the skills and whether additional training is needed
• Assignments given and the customer’s retention and application of previous training
• How the customer is incorporating the skills into everyday activities
• The next steps or training planned for the subsequent appointment

Note: The OSS Independent Living Skills Training Case Note template can be used to ensure that all requirements for the case note are met. 

12.4: Joint Annual Review Case Note

The OSS must conduct a JAR with the customer or their representative at least once every 12 months, or more frequently if necessary. This review assesses the ILP and the customer’s progress toward its objectives. Refer to Chapter 8.5.1 Joint Annual Review Documentation for more information about completing a JAR. 

The JAR case note should include the following:

• The method of completion (via phone or in-person)
• The ILP planned services reviewed and their status
• Any new services needed
• Amendments to the ILP
• The estimated time to complete independent living services

12.5: Service Justification Case Note

Refer to Chapter 8.7 Service Justification for case note requirements for the service justification case note. 

12.6: Purchasing Case Note

A purchasing case note is used to provide information regarding services purchased. It can be used by any OIB staff member and may include information regarding a specific SA. The SA number should be included when applicable in the case note. 

12.7: Closure Case Notes

Refer to the applicable subchapter under Chapter 10: Closure for information on requirements for closure case notes. 

Chapter 13: Technical Requirements 

13.1: Phase Adjustment

Phase adjustment reactivates a case from closure to active services. This function can be applied to any closure with a plan, whether successful or unsuccessful, and includes the removal of closure information. Phase adjustment must be approved by the OIB manager and can only be completed within a program year quarter. 

Phase adjustment should be used when a customer objects to case closure following an update or if the case was closed in error.

13.2: Case Transfer Requirements 

Cases are transferred for various reasons, and the customer must agree to the transfer. A request for case transfer can be made verbally or in writing by the customer. Before transferring case records, the OSS must take the following steps:

1. Obtain the customer’s consent for the transfer.
2. Notify the receiving OSS.
3. Complete a joint review with the receiving OSS of current work and ongoing services.
4. Review and/or update the ILP, JAR, or ILP amendment.
5. Close or update all service records.
6. Pay and/or close all SAs.
7. Review the electronic case files to ensure all records are complete and accurate.
8. Contact the OIB manager to complete and approve the case transfer.

Note: Vendors must be notified when SAs are closed without payment. The receiving unit will issue a new SA for ongoing services, if applicable. For more information, refer to the VRSM Part E, Chapter 3.2: Opening, Transferring, and Phase Adjusting Case Records.

13.3: Case Review Information

Case reviews offer an OSS essential guidance in delivering services to customers by:

• identifying policy compliance and noncompliance;
• addressing judgment and decision-making; and
• providing suggestions for improved processing, use of community resources, and caseload management.

For more information on requirements and processes for completing OIB case reviews, please refer to the OIB Case Review Guide.

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Chapter 14: Purchasing

The procurement requirements for goods and services for TWC independent living services OIB customers align with the processes and procedures established for VR customers. OIB staff members must adhere to the policies and procedures outlined in the VRSM Part D Chapter 3: Purchasing Goods and Services. Additional requirements for purchasing specific goods and services, such as approvals, consultations, or specific documentation, are detailed in other chapters of this manual.

14.1: Purchasing Decisions

OIB staff members should exhaust all comparable benefits and determine the needs of the customers accordingly.

14.1.1: Informed Customer Choice 

Informed choice empowers older individuals who are blind or visually impaired to make informed and confident decisions regarding the services they receive.

14.1.2: Best Value 

OIB best value purchasing is the acquiring of the most cost-effective services that meet the needs of older individuals who are blind or visually impaired. This process, also known as determining the acquisition cost, ensures that all factors influencing the total cost and value to both the customer and the OIB program are considered. This approach guarantees that the services provided are both affordable and of high quality, meeting the specific needs of the individuals served.

14.1.3: Purchasing Policies 

OIB uses purchasing policies outlined in the VRSM unless otherwise stated in the OIB Manual. For information on all purchasing policies, please refer to VRSM Part D Chapter 3: Purchasing Goods and Services.

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Appendix A: Table of Approvals

Caseload Management 

Support Services 

Assistive and Rehab Technology

 Out-of-State Services or Payment Rates 

Psychological Services 

Note: Questions about required consultations and approvals can be submitted to the OIB program managers.

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Review 

The OIB program management, or its designee, is responsible for reviewing this policy and these procedures and will update the Document History log if necessary. 

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Acronym Reference List

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The OIB program management, or its designee, is responsible for reviewing this policy and these procedures and will update the Document History log if necessary. 

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