Are you ready for a national call center to send vaccine questions your way?

All CILs should have received the following from Jennifer Johnson, Deputy Commissioner, Administration on Disabilities and Director, Office of Disability Service Innovations at Administration for Community Living. It provides information about a national call center — and you are part of the local resources that the national hotline will use to send local questions your way. Here is the text of the letter:

SUBJECT: Launch of Disability Vaccine Call Center

Dear colleagues,

In March, we announced a partnership with the Centers for Disease Control and Prevention (CDC) to increase vaccine access for people with disabilities and older adults. I’m happy to share that the national call center established through that partnership is now ready to serve people with disabilities. 

The Disability Information and Access Line (DIAL) can help people with disabilities find vaccine locations in their communities and assist with making appointments. When needed, the DIAL call center will refer individuals to state and/or local programs for additional supportive services. We will be publicly announcing the launch of DIAL in the coming weeks.  The call center is fully accessible.

We need your help to gradually build call volume so that we can fully test the call center’s systems and processes before the public launch. Could you please begin sharing the DIAL contact information with your clients and networks? Sample language you can use is found at the bottom of this email. We ask that, for now as the center gets established, you not post this information on websites or social media or send to broad lists of email subscribers. Rather, please share with clients who may need assistance and organizations in your network who may be a first point of contact for a person with a disability who may need help accessing vaccines. People can reach DIAL using email or by phone:

Email: DIAL@n4a.org

Phone number: 888-677-1199

Last week, DIAL started receiving referrals from the CDC hotline and will continue to raise awareness about the call center. As the number of callers increases, you may see increased referrals to your program. 

In preparation for receiving calls, the DIAL Call Center team has worked closely with an initial core group of disability partners (see below list) who have provided guidance on:

  • Training. Our trainings have covered effective communication; Independent Living philosophy; core services and how they can support the vaccination process; rights of people with disabilities, including during the vaccination process; and determining the most appropriate referrals for people with disabilities based on their stated needs.
  • Position descriptions. We have worked with our partners to ensure that we have developed position descriptions that will increase reach to applicants with disabilities.
  • Promotion. We are exploring how best to promote this resource to reach as many people with disabilities as possible. We will be in touch again after the public launch to ask for your support in this broader effort. 

If you have any questions, please let us know.

Thank you!

Sample DIAL Language for Partners
Because of the elevated risk of serious illness and death due to COVID-19, vaccination is critically important for people with disabilities. However, we know that many face significant barriers to getting vaccinated. The Administration for Community Living (ACL) has launched DIAL, the Disability Information and Access Line, to support the needs of people with disabilities seeking information and access to the COVID-19 vaccine in their communities. DIAL will connect people with disabilities to local resources that can provide information and assistance in obtaining the COVID-19 vaccine. In addition, DIAL can connect callers to information and services that promote independent living, including inquiries related to food, housing, transportation, and a need for advocacy or peer counseling that may arise due to COVID-19.

Email: DIAL@n4a.org Phone number: 888-677-1199

DIAL was launched as a partnership between the n4a and a consortium of organizations serving people with disabilities. These include:

  • Association of Programs for Rural Independent Living (APRIL)
  • Association of University Centers on Disabilities (AUCD)
  • Independent Living Research Utilization (ILRU)
  • National Association of Councils on Developmental Disabilities (NACDD)
  • National Council on Independent Living (NCIL),
  • National Disabilities Rights Network (NDRN), and
  • The Partnership for Inclusive Disaster Strategies.

This partnership combines the disability networks’ extensive knowledge and expertise in meeting the needs of people with disabilities across the U.S. and n4a’s decades of experience in operating a national call center to connect people to information and services. By leveraging these capabilities, ACL was able to launch this critical tool in less than six weeks.

Frequently Asked Questions about spending Federal Dollars

A new FAQ is out for the overall regulations for spending of federal grant funds — Uniform Guidance found in 2 CFR 200 (and mirrors the regs from our HHS funder at 45 CFR 75). You can find the full text here, where over 140 questions are addressed, but let’s look at a few key ones over the next few posts.

Q-8. What is a risk-based framework that is used to alleviate compliance requirements? A risk-based framework is a critical component of a Federal awarding agency’s performance management framework, particularly as it relates to a Federal program. It helps identify risks that may affect advancement toward or the achievement of a project or sub-project’s goals and objectives. In addition, integrating risk management practices can assist Federal managers to determine an appropriate level of resources and time to devote to project oversight to monitor recipient progress and hold them accountable for good performance. A risk-based framework could also help Federal awarding agencies develop risk mitigation strategies emphasizing strong performance, and reprioritizing routine post award monitoring and oversight strategies. (See§200.102(d).)

If you haven’t looked at a process for identifying and responding to risks, you need to. When you identify risk you can monitor and mitigate those risks more easily. I suggest a risk management plan that includes compliance, safety and service provision risks, and may look a little like this.

Risk Management Plan worksheet:

Identified Risk  Current mitigating measuresWhat needs to be doneHow to monitor long term
         Someone is injured on the property Liability insurance
Safety postings around any work/wet surface		 Uneven surfaces repaired. A regular slip/fall inspection.
         Staff member sues for unfair bias. Staff training for all managers addressing bias, rights, justice. Require annual retraining. Designate a point person to discuss
issues as they arise
The chart for a risk management plan, with headings of Identified Risk, Current mitigating measures, What needs to be done and How to monitor long term.

While we usually suggest you “think positive”, for this process you and your leadership need to bring your disaster fantasies to the table. What are all the things that might go wrong and how can you reduce or remove the risk?

IL-NET National Training and Technical Assistance Center for Independent Living

ILRU’s IL-NET National Training and Technical Assistance Center for Independent Living provides timely and responsive technical assistance (TA) to centers for independent living (CILs) statewide independent living councils (SILCs), and (related to Independent Living Programs) designated state entities (DSEs).

  • For general questions about finding resources or trainings or being added to our email lists to receive updates on upcoming training activities, please contact ILRU at ilru@ilru.org or at 713-520-0232.
  • For more specific questions related to the needs of your organization or improving operational excellence, attend Technical Assistance Office Hours with Paula McElwee — Third Thursday of each month from noon to 2:00 p.m. Eastern. For more immediate assistance, contact the IL-NET Associate Director of Technical Assistance, Paula McElwee, at paulamcelwee.ilru@gmail.com or 559-250-3082 (Pacific time).

For Centers for Independent Living (CILs):

  • ILRU offers peer group technical assistance discussions at 3pm Eastern for:
    • Executive Directors – Second Monday of each month
    • Assistant Directors, Program Managers, or Middle Managers – Second Tuesday of each month
    • CIL Financial Managers – scheduled quarterly
  • For one-on-one technical assistance, contact the IL-NET Associate Director, Technical Assistance, Paula McElwee, at paulamcelwee.ilru@gmail.com or 559-250-3082 (Pacific time).

For Statewide Independent Living Councils (SILCs):

  • ILRU offers peer group technical assistance discussions at 3pm Eastern for:
    • SILC staff and members (called SILCSpeak) – First Thursday of each month
    • Designated State Entities (DSEs) – scheduled quarterly
  • For one-on-one technical assistance, contact the IL-NET Technical Assistance Coordinator, Paula McElwee, at paulamcelwee.ilru@gmail.com or 559-250-3082 (Pacific time).

Peer-to-Peer Mentoring

  • Peer mentoring is a specific form of individualized training assistance that matches CIL or SILC peers with peers from other CILs or SILCs to offer focused assistance with management and program issues. Peer mentoring offers an opportunity for CIL or SILC staff to strengthen operations or programs by learning from experienced colleagues. Please fill out this short survey if you are interested in learning more about:
    • Becoming a mentor and working with an organization to grow their programs or learn how to better run their organization.
    • Receiving a mentor to assist with growing a program or improving operations.

Technical assistance provided by the Southwest ADA Center:

What is Intensive Support?

What is Intensive Support and how does a CIL qualify?

The ILNet T/TA Center provides intensive support to individual Centers for Independent living when the CIL is referred from ACL or from the DSE based on compliance concerns. This is a specific area of technical assistance that requires full commitment from the leadership of the CIL to attain compliance and a higher level of quality performance.

ACL’s Office of Independent Living Programs (OILP) is committed to the COMP system (Compliance and Outcome Monitoring Protocol). The DSE (designated state entity) in each state may also conduct sub-recipient monitoring when a CIL receives state or Part B funds. Either of these processes may require corrective action on the part of the Center.  Either OILP or the DSE may refer the CIL to receive intensive support to correct the compliance issues.

It is possible for a CIL to cited by the DSE, but they DSE does not refer them for intensive support. In this case the CIL may request intensive support for completing the Corrections for those citations.

Criteria for Intensive Support services are as follows:

  • Referral from OILP Program Officer or DSE indicating areas of concern or lack of compliance. Services provided include:
    • Develop a Corrective Action Plan to address identified areas of non-compliance including outcomes and target dates
    • If the CIL denies the findings, assist in understanding what is required and how they can appeal.
    • Provide specific resources (typically training, peer support, or one-to-one TA) to assist the center in completing the Corrective Action Plan and returning to compliance.
  • Referral from OILP Program Officer or DSE of new executive directors. Services provided include:
    • Connecting the new executive director with peers in their state or region.
    • Connect the new individual with the national peer to peer support available in Conversations and Peer to Peer Calls and website resources.
    • Assist the individual in assessing their compliance with the COMP requirements.
    • Assist the new executive director in establishing a plan of action to identify weak areas for their CIL and to identify two or more desired outcomes to accomplish with T & TA.
    • Introduce the new director to the Peer Mentoring program if they express a desire for that support.

What is Intensive Support and how does a SILC apply?

 The SILC intensive support is defined as on-going requests for support that cannot be resolved in a call or two. While referrals may still come from the OIP Program Officer, self-referrals are also accepted.

 SILC T/TA support that takes place over more than sixty days and that has a plan of action will be considered intensive support.

Referrals can be made by the Program Officer at ACL, the DSE, the SILC chair or SILC staff. SILC intensive support will only be available to SILCs that are willing to set a plan with measurable outcomes. We will emphasize compliance with regulations in this process.

Process followed to apply for Intensive Support

  • Referrals or requests for intensive support will be in writing, by email to paulamcelwee.ilru@gmail.com , from the Program Officer or from the CIL, SILC, or DSE. Related compliance review or other concerns must be submitted with the request.
    • For new executive directors, the request may be more general until the CIL or SILC and the T/TA Associate Director, can assess the need and establish two or more measurable outcomes that will advance the operational excellence of the CIL or SILC.
  • Once the initial goals are set, the T and TA Associate Director will work with the Consultant Team to assign the CIL or SILC to the most appropriate consultant for the development of a more comprehensive plan with steps to accomplish as they complete the identified outcomes.
  • The Consultant Team will provide monthly reports to the T and TA Associate Director on the progress toward desired outcomes and the identification of additional areas of need that have come to light.
  • While T and TA is always available on demand, this intensive support is specifically outcome driven and will be considered complete when the desired outcomes are met.
  • Once the T and TA is complete, the CIL or SILC will be given an opportunity to evaluate the intensive support provided.
  • ACL will receive a summary report of the results of all intensive support activities.

What has changed?

In any life there are events that change everything. We live in a world that shifts and changes as events impact us. Think about some events that have changed everything, for the foreseeable future. Post the Kennedy assassination motorcades for presidents were different. Following the Challenger disaster new safety was imposed on all space travel. Post 911 air travel changed forever: who could have imagined the TSA? Post Sandyhook schools everywhere strengthened their protections for school children.

And Post-COVID-19? We can almost see that finish line with the release of vaccines. What has changed forever? I have a few thoughts.

  • We will never take handshakes for granted. I am not sure we will return to them at all, but if we do I suspect no one will be judged for failing to extend their hand. Even fist bumps may be suspect, and elbow bumps may be the new protocol.
  • Signatures will not be expected as the only affirmation. Have you noticed that many businesses no longer require your signature at the time you purchase something with a card? And as Centers we know we can now use an electronic signature or have a staff person verify what used to be signed consumer statements. I suspect this is a long-term change, and we will see businesses and other entities much more comfortable with verification methods other than signatures.
  • Working remotely will be part of an individual work schedule, because we’ve learned we can be very effective working from home. We will have new ways to measure performance, other than just time.
  • Employers will be more involved in the health and well-being of staff. As staff have moved through their own challenges, employers have been beside them, adjusting work schedules, understanding when kids are working in the background, granting mental health days, discussing the fears and challenges of the pandemic. I hope this is a permanent change. It has made workplaces more welcoming and flexible.
  • We are better at using technology. A year ago there was talk about Artificial Intelligence displacing people; and about people who can’t adapt to technology being displaced. We are using technology tools better than ever, including people who struggled with the technology a few months ago. I think this is a permanent change — the world needs technology and is using it well.
  • We are better at creating a healthy environment. From cleaning techniques to mental health support, offices are better than they used to be.
  • People are more included, less marginalized. If your center has more than one office, or has board members from more than one county, you have already seen them responding to the new, more equal playing field of having everyone on the call have equal status. When two-thirds of the group is around the table, the ones participating by phone or video are never really equal in their opportunity to discuss things. Now that everyone is on video with an equal opportunity to participate, they are more included.

Share your thoughts — what else has changed that may have long-term impact?

The latest on Program Performance Reports (PPRs, formerly 704 reports) from ACL

Here is correspondence from your funder regarding your annual reporting, which is typically due December 31. Note that the CILs are submitting only CARES Act reporting in GrantSolutions at this time, and this is due no later than 12/31/2020 at 11:59 pm EST. We are not sure exactly when and how the other PPR reports will be submitted, but you are urged to go ahead and complete a copy of the instrument so you are prepared to submit with very short notice once we know how the report will be collected. Here is the “Dear Colleagues” letter from Corinna Stiles that was sent out this morning.

Dear Colleagues,

As a reminder, ACL has discontinued the use of ACLReporting.  Grantees will not be submitting annual PPRs through ACLReporting.  We are currently working to determine the most suitable web-based platform to meet our Program Performance Report (PPR) needs.    ACL does not anticipate having a web-based platform available prior to the current 12/31/20 PPR due date (723 States 1/31/21).  ACL will provide the PPR submission deadline once a new web-based platform is secured.  ACL strongly encourages you to complete the CIL and ILS annual PPR instrument before 12/31/20 (723 States 1/31/21) and keep in your records so that you can easily and TIMELY transfer data when a data submission platform comes online.  We will share more information as it becomes available.  Please note the following:

CILS:

  • CIL CARES Act PPRs are due in GrantSolutions no later than 12/31/20 11:59 pm EST.
  • ACL strongly encourages you to complete the CIL annual PPR instrument before 12/31/20 so that you can easily and TIMELY transfer data when a data submission platform becomes available. 

DSEs/SILCs:

  • ACL strongly encourages you to complete the ILS annual PPR instrument before 12/31/20 so that you can easily and TIMELY transfer data when a data submission platform comes online.

723 States:

  • ACL strongly encourages you to complete the annual PPR instrument before 1/31/21 so that you can easily and TIMELY transfer data when a data submission platform comes online.

Thank you for your patience,

Corinna Stiles

Corinna H. Stiles, PhD, JD, Director | Office of Independent Living Programs

Administration for Community Living  U.S. Department of Health and Human Services

330 C Street, SW. RM 1123 Washington DC 20201 | 202.795.7446 | www.acl.gov

COVID-19 Information and Resources – https://acl.gov/COVID-19

How are your Consumer Files?

I know one of the things some of you are doing with extra staff time is cleaning up your consumer records. You may call these Consumer Service Records or Consumer information Files or choose some other designation, but the bottom line is that you have a record of the services you provide to an eligible individual. Here are a few items for you to keep in mind.

  • Photo description: A tablet computer sits on a white surface. Five notebooks appear to be coming out of the screen.
  1. All records of individuals served are confidential. Whether you keep private identifying information (social security numbers?) or medical information (neither required by IL but sometimes needed for other services), your records and information about those you serve is confidential. You must keep them locked and password protected. Extra tip: Sometimes consumer information isn’t in the paper or computer file. Sometimes it is in an activity list, a birthday calendar or a mailing or email list. Keep these confidential, too.
  2. Your records must document what your annual reports (PPRs) indicate. How do you demonstrate who you serve, their disability (eligibility) and their desire to have an Independent Living Plan (or waive it)? Right now, all across the country, Centers are pulling reports from their consumer data base to use in completing their Program Performance Report. Look at them closely. Do they make sense? Do the staff seem knowledgeable in how to document? Run a cross-check by staff member to pick up any reporting inconsistencies. Make sure that the information in your PPR is an accurate reflection of the services provided. Extra tip: If you find anything that you have to go back and calculate by hand for the PPR you are working on now, train staff in corrections now so the reports for the current year are accurate.
  3. Review the COMP documents for more details. If your center is reviewed by your federal funder, it will be reviewed using the COMP materials provided by the Office of Independent Living Programs. You can find those materials here. Extra tip: One of the documents in the COMP process is a Consumer Information File Checklist that will help you double check all your records.
  4. Follow your own policies. You should have policies and procedures that specify when a file is closed and why, and a policy on how long you retain consumer records. You must demonstrate that you follow your own policies including these. If you destroy inactive records after seven years, for example, you shouldn’t hang on to inactive records that are 30 years old. Extra tip: Set a specific time for data entry. Some centers set a half day a week when they don’t see consumers so that staff are always caught up on data entry. You also want to set time for file review. This is done annually in small organizations, but may be done monthly or quarterly if needed. It is good practice to have staff review each other’s files from time to time, if your confidentiality policy allows that, so that staff can learn from each other’s processes.

A note about HIPPAA: Centers for Independent Living are not medical entities and are not typically bound by HIPPAA. However, you may have a specific funding source that requires this level of confidentiality. Follow the requirements related to that funding. You can institute that level of confidentiality for all of your consumer records if you wish.

Program Income

Three people (Two women taking notes and one man in a suit) sit around a table with a laptop, notebooks, and a graph. One of the women is seated in a wheelchair.

There are very specific rules (in Health and Human Services Uniform Administrative Requirements in 45 CFR 75) about program income, including the costs of generating income and how that income may be used.

First, if your award (or approved budget) allows it, the costs of generating program income can be deducted from total program income in determining the net amount (which may be negative as you are getting underway).

The default for program net income is that it must be deducted from total allowable costs to determine the net amount you can be reimbursed for under your federal award.

However, if your HHS awarding agency approves, program net income can be used to expand your services.  In other words, you can incur additional costs for similar purposes using the program income.

If you continue to receive income after the period of performance of the federal award, by default, you can use that income at the discretion of your agency unless the federal awarding agency specifically states that income, after the period of performance, must be used to reduce the federal share of cost or to expand your program.

John F Heveron, Jr. Principal, Heveron and Company CPAs

Be particular about Consumer Control

Consumer control is the foundation of Independent Living, and permeates the board, staff and management of Centers as well as the Statewide Independent Living Council (SILC). The requirements are clear:

  • More than 50% (51% or more) of the board members of a Center for Independent Living must be individuals with significant disabilities.
  • More than 50% of the management staff of a Center (whether that is a single person in the Executive Director, or a management team) must be individuals with disabilities.
  • More than 50% of the other staff in a Center must be individuals with disabilities.
  • More than 50% (a majority) of the voting members of the Council must be individuals with disabilities NOT employed by any State agency or center for independent living.

These requirements make it clear — Independent Living isn’t about professional staff as much as it is about people with disabilities forming their own responses to what independence looks like in their community. There should be no hesitation if the CIL is able to have 60% or 80% or 100% people with disabilities in these areas, but absolutely individuals with disabilities MUST form a majority in every component of IL in your state. This is about consumer CONTROL! That word is used for a reason — because unless people with disabilities control the work of both CILs and SILCs, we have missed a key requirement of IL.

There is an area that appears to be a sticking point in some states. Not all disabilities are visible, so if you can’t tell if someone has a disability, you need to ask them. This is definitely not a problem with the board and the council, but asking an employee to disclose a disability is a little touchier, and you cannot ask a prospective employee if they have a disability. What to do? I suggest that you are clear in your interview with prospective employees that you are looking for a qualified person with a disability and if they aren’t aware of disability history and philosophy, provide the short version. Then ask, “What is your personal experience with disability? How do you think you will fit in at a consumer controlled organization?”

Sometimes I hear the complaint that members of the board, or the CIL ED, or council members are not “disabled enough” to serve in their role. First, note that only the members of a Center’s board are required to have a “significant disability”. That term “significant” is not used in any of the other requirements. As a person whose disability is usually not noticeable, I am sensitive to this concern. Certainly we want the community to be able to see that we are consumer controlled, and for that to happen we have to have a fair representation of visible disabilities, but that is not a requirement. When someone asks me about whether a disability is “enough”, my response is, does the person consider themselves part of the disability community? Do they interact in the world as a person with a disability in their work, their home, their community? If not, then they may technically meet the requirement but have missed the spirit of the law. We are community when we come together in our disabilities. We are strong because we are many and we represent a cross-section of disabilities, both visible and invisible.

Here is the toughest part of this conversation. You and I don’t get to decide if someone else is “disabled enough” to count. Each person makes their own declaration. We do not, and will not, require medical proof of disability. While this may allow for people claiming a disability to claim some power, I hope our community is strong enough to weather such actions and continually shift the control of the IL Network firmly to individuals with disabilities.

Is it a conflict for the CIL rep to chair the SILC?

I want to say first that it is not a conflict of interest for a CIL staff member to serve in any office on the SILC, including as chair. The regulations only require that the chair be a voting member, which is the case for all CIL staff members. Not only is it NOT a conflict of interest, but the Rehabilitation Act requires a CIL representative for a reason, and that is to assure that the council is acting in a way that shows they understand Independent Living and the role of Centers. Title VII of the Rehabilitation Act requires, in Section 705(b)2(A) among its voting members, at least 1 director of a center for independent living chosen by the directors of centers for independent living and Section 705(b)2(B) “among its voting members, for a State in which 1 or more centers for independent living are run by, or in conjunction with, the governing bodies of American Indian tribes located on Federal or State reservations, at least 1 representative of the directors of such centers.” This is the first required member(s), I think at least in part because of the importance of a CIL voice on the SILC.

Section 705(b)4(A) requires that the Council “be composed of members — (i) who provide statewide representation; (ii) who represent a broad range of individuals with disabilities from diverse backgrounds; (iii) who are knowledgeable about centers for independent living and independent living services; and (iv) a majority of whom are persons who are— (I) individuals with disabilities described in section 7(20)(B); and (II) not employed by any State agency or center for independent living.”

Note two things in this section of the law. First, ALL members appointed are to be knowledgeable about CILs and the IL services from Title VII of the Rehabilitation Act. Second, while members who work for a CIL cannot be counted in calculating the majority, that membership is not limited in any other way.

Also note that a majority of CILs in the state must agree with the SPIL. Again, evidence of the strong role that CILs are expected to play in collaboration with the SILC.

I am not saying there could never be a conflict of interest. If a specific issue came up where one center was favored over another in some way, a CIL representative may need to express the possible conflict and abstain from discussion/voting. Interestingly enough, depending on the bylaws, the chair often does not typically get a vote except to break a tie, so a CIL executive director who serves as chair might actually have less influence rather than more. But unless one CIL has some advantage over all the others, there is not a conflict. The role of the CIL representative is to make sure the voice of the CILs is heard by the council.

Which brings us back around to the question – can a SILC decide to exclude CIL members from serving on the executive committee? I strongly urge against such a policy or such language in your bylaws. The council is a body that includes at least one CIL representative selected by the CILs, and then may have other members from CILs as well. The council is a key focus point for the discussion of independent living in your state, both in the development of the SPIL and in monitoring its implementation. The CILs are critical partners in that function.

That said, I regret to tell you that it is permissible for the SILC to adopt such a policy, but I strongly discourage it.