Independent Living Skills Training (ILST)

Independent Living Skills Training Services (ILST) are individually designed to improve or maintain the ability of the waiver participant to live as independently as possible in the community. ILST assists in recovering skills that have decreased as a result of onset of disability. Also, ILST will primarily be targeted to those individuals with progressive illnesses to maintain essential skills. ILST may be provided in the waiver participant’s home or in community settings typically used by the general public. This service will primarily be provided on an individual basis; only in the unique situation where the waiver participant will receive greater benefit from other than a 1:1 situation, will a group method of providing service be approved.

What are the ILST provider responsibility?
It is the responsibility of the ILST provider to conduct a comprehensive functional assessment of the waiver participant, identifying the participant’s strengths and weaknesses in performing ADL and IADL related to his/her established goals. The Provider will use the results of the assessment to develop an ILST Detailed Plan. The Detailed Plan will identify milestones to be met during the six (6) month period. The assessment must also include a determination of the participant’s best manner of learning new skills and responses to various interventions. This comprehensive and functional assessment must be conducted at least annually from the date of the last assessment.

What are the services ILST provides?
ILST services may include assessment, training, and supervision of an individual with self-care, medication management, task completion, communication skills, interpersonal skills, socialization, sensory/motor skills, mobility, community transportation skills, reduction/elimination of maladaptive behaviors, problem solving skills, money management, pre-vocational skills, and skills to maintain a household.

What services are not provided by ILST?
ILS training provided in licensed settings that are not the person’s home.

Overnight supervision

Services that duplicate other Minnesota state plan or waiver services.

What should the Outcome of ILST Look Like?
ILST must be provided in the environment and situation that will result in the greatest positive outcome for the waiver participant. It is expected that this service will be provided in the waiver participant’s environment; for example, in the participant’s kitchen as opposed to a provider’s kitchen. This expectation is based on the difficulty many participants experience with transferring or generalizing knowledge and skills from one situation to another.

For example, design the methods, materials and settings used to provide ILST to meet the following outcomes:
1. Increase the person’s independence by teaching skills so the person can perform tasks and activities with decreased dependence on caregivers.
2. Increase the person’s opportunities to interact with people without disabilities who are not paid caregivers.
3. Provide daily schedules, routines, environments, and interactions similar to those of people without disabilities of the same chronological age.
4. Provide skill training in an environment where the person will use the skill.
5. Support the person’s development of decision-making skills and informed choices in all aspects of daily living, including selection of service providers, goals and methods, location and decor of residence, roommates, daily routines, leisure activities and personal possessions.

It is expected that ILST providers will train the waiver participant’s informal/natural supports, paid staff, and waiver providers to provide the type and level of supports that allows the waiver participant to act and become as independent as possible in ADLs and IADLs. This service may continue only when the waiver participant has reasonable goals. It is used for training purposes and not ongoing long-term care supports. Reasons to provide or continue this service must be clearly stated in the Support Plan within the context of clearly defined and reasonable goals.

What are Qualifications of ILST Provider?
The qualification of ILST provider is governed by 2020 MN Statutes Chapter 245D Home and Community-Based Services Standards.

Subdivision 1. Staffing requirements.
The license holder must provide the level of direct service support staff supervision, assistance, and training necessary:
(1) to ensure the health, safety, and protection of rights of each person; and
(2) to be able to implement the responsibilities assigned to the license holder in each person’s coordinated service and support plan or identified in the coordinated service and support plan addendum, according to the requirements of this chapter.

Subd. 2.Supervision of staff having direct contact.

Except for a license holder who is the sole direct support staff, the license holder must provide adequate supervision of staff providing direct support to ensure the health, safety, and protection of rights of each person and implementation of the responsibilities assigned to the license holder in each person’s coordinated service and support plan or coordinated service and support plan addendum.

Subd. 3.Staff qualifications.

(a) The license holder must ensure that staff providing direct support, or staff who have responsibilities related to supervising or managing the provision of direct support service, are competent as demonstrated through skills and knowledge training, experience, and education relevant to the primary disability of the person and to meet the person’s needs and additional requirements as written in the coordinated service and support plan or coordinated service and support plan addendum, or when otherwise required by the case manager or the federal waiver plan. The license holder must verify and maintain evidence of staff competency, including documentation of:
(1) education and experience qualifications relevant to the job responsibilities assigned to the staff and to the primary disability of persons served by the program, including a valid degree and transcript, or a current license, registration, or certification, when a degree or licensure, registration, or certification is required by this chapter or in the coordinated service and support plan or coordinated service and support plan addendum;
(2) demonstrated competency in the orientation and training areas required under this chapter, and when applicable, completion of continuing education required to maintain professional licensure, registration, or certification requirements. Competency in these areas is determined by the license holder through knowledge testing or observed skill assessment conducted by the trainer or instructor or by an individual who has been previously deemed competent by the trainer or instructor in the area being assessed; and
(3) except for a license holder who is the sole direct support staff, periodic performance evaluations completed by the license holder of the direct support staff person’s ability to perform the job functions based on direct observation.
(b) Staff under 18 years of age may not perform overnight duties or administer medication.