Agency Schedule Detail

Authorization Number : 50760116

Agency Series No. : 80-IL-011

Status : Active

Agency Web Link :

Agency : OOD

Confidential Description : Records may include confidential personal information of the consumer.

Division : OODVRHB

Vital Description :

Section : OODVRHBILOB

Record Title : Independent Living Participant Case File

Revision : 1

Record Description : The Independent Living Older Blind Program (ILOB) serves individuals who are 55 years or older and who have a significant visual impairment with the goal to maintain their independence in a non-institutional setting. Record may include: Assessment; initial interview; case notes; Consent to Obtain and Release Information Form; Examinations/Referrals; Restoration; training; Individual Living Plan (ILP); Referral to Facility; Appointment Letter; Functional Limitations Worksheet; surveys; Certificate of Eligibility; authorization and billings; vendor invoices; documentation of SD/MSD; Application for Services; reviews; and supporting documentation.

Retention Period	Retention Justification	Media Code	Method of Disposal
Case files are maintained in an active or closed status. Active case files are retained until the status changes to closed. Closed case files are maintained for ten (10) federal fiscal years after date of closure or as required for auditing purposes and then destroyed. A Certificate of Disposal is required when destroying these records.	Records are retained for reference in case the participant returns for future services.	Electronic	Delete
Case files are maintained in an active or closed status. Active case files are retained until the status changes to closed. Closed case files are maintained for ten (10) federal fiscal years after date of closure or as required for auditing purposes and then destroyed. A Certificate of Disposal is required when destroying these records.	Records are retained for reference in case the participant returns for future services.	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Michelle Korting	Records Officer	10/21/2022 10:44:47 AM
Approved	Terri Dittmar	Record Administrator	10/28/2022 7:44:52 AM
Approved	Martin Meeks	State Auditor	10/31/2022 8:59:50 AM
Approved	Fred Previts	State Archivist	11/9/2022 1:58:15 PM

Notes

Date	Reason	User