ISL is characterized by creativity, flexibility, responsiveness and diversity. ISL enables people with disabilities to be fully integrated in communities. ISL services provide

individualized supports, delivered in a personalized manner, to individuals who live in homes of their choice. Individuals receiving ISL supports may choose with whom and where they live, and the type of community activities in which they wish to be involved.

CI assists and/or teaches participation in community activities. These activities and/or skills are needed to be a participating member of a community,

CI expectations are for individuals to interact with the broader community on a regular basis, including community activities that enable individuals to engage directly, throughout the day, with people who are not paid to provide them with services. In addition, community activities are organized for the benefit of the individuals to foster relationships with the broader community.

ISD focuses on complex skill acquisition/development, to assist the individual in achieving maximum independence in home and community-based settings. This includes but is not limited to cooking, laundry, shopping, budgeting, paying bills, and accessing public transportation. The service assists the participant to acquire life skills necessary for independent living. ISD differs from the PA service in that a personal assistant may directly perform activities or may support the individual to perform ADLS and IADLS as part of the service. This service is an outcome based service, clearly identified in the Individual Support Plan (ISP). The service is utilized for the development of a clearly identified skill or skill set.

PA services include assistance with any activity of Activities of Daily Living (ADL) or Instrumental Activities of Daily Living (IADL) . Assistance for ADLs includes bathing, toileting, transfer and ambulation, skin care, grooming, dressing, extension of therapies and exercise, care of adaptive equipment, meal preparation, feeding, and incidental household cleaning and laundry. IADLs include shopping, banking, budgeting, using public transportation, social interaction, recreation, and leisure activities. Assistance with IADLs includes accompaniment, cueing and minor problem-solving necessary to achieve increased independence, productivity and inclusion in the community. The personal assistant may directly perform some activities and support the individual in learning how to perform others.

DH services focuses on skill acquisition/development, retention/maintenance to assist the individual in achieving maximum self-sufficiency. DH services assists the individual to acquire, improve and retain the self-help, socialization and adaptive skills necessary to reside successfully in the community. Fundamental skills are a foundation for further learning, such as etiquette in a public setting, recognition of money, proper clothing attire for the time and setting, answering phone, etc. Examples of DH services include, but are not limited to, utilizing etiquette skills at a restaurant, checking out a book at a library, mailing a letter, exchanging money for purchases, etc. This does not only occur in the facility, but on a regular basis in the community to use in a real life situations. DH services differ from the PA services in that a PA may directly perform activities or may support the individual to learn how to perform ADL’s and Instrumental Activities of Daily Living (IADL’s) as part of the service.