Deaf & Hard of Hearing Services (DHHS)
DHHS contracts with local community agencies throughout the state to provide case management via the Increasing Independence Program (IIP). Case managers provide community support services to individuals who are deaf or hard of hearing to ensure improved independence.
Forms for the Increasing Independence Program
- Social Services Block Grant (SSBG) Application and Services Registration - SF 49452 (K2/09-09)DHHS0033
Enables DHHS staff to keep statistics on the number of people we serve along with other information such as age, gender, sex and so forth.
- Social Services Block Grant - SF 48203/DHHS0002
Enables DHHS to ascertain that the interpreting and case management services are within the specified federal guidelines. Statistics are compiled from this form on who was being served, number of hours, etc. The quality of interpreting and case management services can be measured using this information.
- INtake Questionnaire – SF 55538 (3/14)
This is a tool for overall evaluation and determine current independent functioning levels in order to develop a goal setting.
- Block Grant Plan of Action – SF 54038 (9-09) / DHHS0022
This is a tool to create the strategy to work with a consumer to achieve the enhanced independent goals.
- Block Daily Log - SF 54037
This is a progress note to track a consumer's progress on their set goals to become independent.