Submitted by 

Julie Hocker

Director, Independent Living Administration and

Commissioner of the Administration on Disabilities

Administration for Community Living

U.S. Department of Health and Human Services

Submitted to

Lance Robertson

Administrator and Assistant Secretary for Aging

Administration for Community Living

U.S. Department of Health and Human Services 

80%

9%

Annual Report on 

Centers for 

Independent Living

Funded under Part C of Title VII of the Rehabilitation Act, as amended

www.acl.gov

ACL is an operating division of the U.S. Department of Health and Human Services.

March 20, 2020
Administration for Community Living | Annual Report on Centers for Independent Living Page 2

Background

Independent Living Programs 

The Rehabilitation Act, as amended, (the Act) authorizes funding for two independent living 

grant programs that collectively support independent living services in the United States. Together 

these programs:

Promote a philosophy of independent living including a philosophy of consumer control, peer 

support, self-help, self-determination, equal access, and individual and system advocacy, in order 

to maximize the leadership, empowerment, independence, and productivity of individuals with 

disabilities, and the integration and full inclusion of individuals with disabilities into the mainstream 

of American society.

The first grant program – Independent Living Services (ILS) program – is authorized Under Title VII, 

Chapter I, Part B of the Act. Initially authorized in the Act’s 1978 amendments as “Comprehensive 

Services for Independent Living,” the funding supported demonstration projects that created 11 

centers for independent living. In 2019, appropriations for the ILS program provided $25,378,000 to 

56 states and territories in formula grants to provide, improve, and expand statewide independent 

living services. 

The second grant program – the Centers for Independent Living (CIL) program – was authorized 

under Title VII, Chapter I, Part C in the Act’s 1992 amendments. The 1992 amendments established 

direct funding for discretionary grants to consumer-controlled community-based organizations: 

Centers for Independent Living.

A Center is defined as: 

“A consumer-controlled,1 community-based, cross-disability, nonresidential private nonprofit 

agency for individuals with significant disabilities (regardless of age or income) that—

(A) Is designed and operated within a local community by individuals with disabilities; and

(B) Provides an array of independent living services, including, at a minimum, independent living 

core services.”2

In 2019, appropriations for the CIL program 

provided 

$90,805,000 

to support 

354 grants 

managed by

284 CILs3

The Act’s 1992 amendments also set standards for CILs and created the Statewide Independent 

Living Councils (SILC). For states to be eligible for the ILS or CIL grants, they must develop and 

implement a State Plan for Independent Living (SPIL). The SILC is responsible for the creation, 

review, and monitoring of each SPIL. CIL representation is a requirement of the SILCs and CIL 

program activities must be consistent with the SPIL. 
Administration for Community Living | Annual Report on Centers for Independent Living Page 3

Requirement and Purpose of this Report

The Workforce Innovation and Opportunity Act of 2014 amended the Act to require the Director of 

the Independent Living Administration (ILA) to provide to the Administrator of the Administration for 

Community Living (ACL), and publish publicly, a report4 on the administration and performance of 

the programs during the prior fiscal year.5 The report must address: 

» The extent to which CILs receiving funds under Part C have complied with the standards and 

assurances in section 725 of the Act; 

» The identification of individual CILs in the analysis contained in that information; and

» Results of onsite compliance reviews, identifying individual CILs and other recipients of 

assistance under Part C. 

Standards and Assurances

The Act sets forth standards and assurances for all programs and activities that are planned, 

conducted, administered, and evaluated in a manner consistent with the purposes of Title VII, 

Chapter I, Part C of the Act, and the objective of providing assistance effectively and efficiently. The 

Act requires that a CIL prepare and submit a report to the Administrator at the end of each fiscal 

year that contains information regarding the extent to which the CIL complies with the standards.6

ACL utilizes the CIL Program Performance Report (CIL PPR) to collect the necessary data and 

information from grantees for each award a CIL receives. The review of CIL PPRs by federal staff is 

a critical component to ensuring compliance and providing ongoing monitoring and oversight. 

Generally, these self-reported data reflect that CILs collectively comply with the standards and 

assurances set forth in the Act. The following sections reflect an overview of the standards and 

assurances set forth in the Act as captured in the CIL PPRs. The report concludes with ACL’s 

additional oversight activities, including those to directly address noncompliance. 

Centers for Independent Living Annual 

Performance Reports

Independent Living Philosophy 

As reported in CIL PPR data, CIL services, programs, 

and activities consistently meet and exceed program 

requirements to be consumer led, consumer driven, 

and include peer support. 

Consumer Driven and Consumer Led

Consumers of IL services, who are individuals with disabilities, set goals and receive services to 

increase their independent living and self-advocacy skills. 

Americans with disabilities are also the leaders of the CILs across our nation. Program Year (PY) 

2018 PPR data reflects 70% of board members and 64% of staff were individuals with significant 

disabilities. Of the staff with significant disabilities, 73% were in decision-making roles. This 

percentage is consistent with the requirement that a majority of CIL board members, staff, and 

decision-makers are individuals with disabilities.

Consumer 

driven

Consumer 

led

Peer 

support

Foundation
Administration for Community Living | Annual Report on Centers for Independent Living Page 4

Disability and Diversity

CILs serve individuals with a variety of disabilities across the lifespan including people with mental 

health-related disabilities, visual or hearing impairments, physical disabilities, and intellectual or 

developmental disabilities. Historically, more than half of all consumers receiving services in a given 

year have a physical disability. Approximately 17% of people served by CILs are individuals with 

intellectual and developmental disabilities.7

In PY 2018, the data demonstrate the diversity of individuals being served. These data are 

consistent with data reported in PY 2016 and PY 2017. 

54% 

female

46% 

identifying as a

minority

25–59 years old

44%

60 years old or over

38%

This data is consistent with data reported in PY 2016 and PY 2017. CILs also report on outreach 

to unserved and underserved populations. Identified in the SPIL, unserved and underserved 

populations will vary by state as assessed by community needs. This assessment can, but does not 

always, include minority populations. CILs report 46% of consumers represent minority populations, 

an increase over the national minority population level of 42%.8

Section 21 of the Act contains a 1% IL funding set-aside requirement for conducting outreach to 

traditionally underserved populations. ACL identified the Native American population as underserved 

by the IL program and funded the Independent Living Demonstration (NAILD) project between PY 

2016 to PY 2020 to better serve this population. Five CILs9 received NAILD funding to: 

» Gain an understanding of service needs of Native Americans with disabilities living in Indian 

Country;

» Improve cultural competence in regard to the needs of specific tribal organizations targeted by 

current CIL grantees; and 

» Capture lessons learned and best practices for outreach and service delivery for Native 

Americans with disabilities. 

A final report on outcomes achieved for the NAILD project will be developed by ACL in FY 2021 

after the conclusion of the demonstration project in FY 2020. 

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IL Core Services 

CILs provide services that enable people with disabilities to live in their community of choice with the 

supports they need. At a minimum, every CIL is required to provide the core services outlined in the Act. 

Core Services Include:

Information and referral services

Independent living skills training

Peer counseling

Individual and systems advocacy

Services that facilitate the transition from institutions to community living, diversion 

from institutions to community living, and transition of youth from secondary 

education to post-secondary life

In PY 2018, CILs reported providing more than 834,000 core service activities. The most significant 

growth reflected in annual CIL PPR data was a 31% increase in transition of youth from secondary 

education to post-secondary life. This increase likely reflects the passage of the Workforce 

Innovation and Opportunity Act of 2014 (WIOA) which added transition of youth from secondary 

education to post-secondary life to the core services. 

While preventing institutionalization and transitioning individuals with significant disabilities from 

nursing homes or other institutions into their own homes has always been a focus of CILs, 

WIOA also added transition from institutions to community living and diversion from institutions 

to community living as core services. Since PY 2016, CILs reported a 5% growth in services 

preventing individuals from going into an institution and a 17% growth in services to individuals 

transitioning from an institution to community-based living. Data show, nationwide, 25,000 core 

service goals were achieved in transition and diversion services.

i

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i

Daily Cost for a Shared Room in a Nursing Home

As of October 2019

Medicaid nationwide average 

$247 

Range across the country10

$150-$1,000+

People with disabilities can live successfully in their community of choice when provided the 

supports they need. Community living not only provides the best pathway to independence, but 

also is far less costly. 

Examples provided by CILs in annual PPR data of services that help people successfully live in their 

community of choice include:

» Able South Carolina (Columbia, SC). Recognizing the role of employment as critical to a 

person’s ability to live in the community of their choice, Able South Carolina provides services 

that increase the competitive integrated employment of young people, ages 16 to 30, who have 

developmental disabilities. These services include: (1) empowering educators, providers, and 

families to support systems change that is centered on the premise that everyone, including 
Administration for Community Living | Annual Report on Centers for Independent Living Page 6

individuals with significant disabilities, is capable of full participation in integrated employment, 

and community life; (2) leading a statewide employment coalition of public educators, disability 

networks, and employers; (3) equipping young people with the skills and confidence to succeed; 

and (4) supporting employers who recruit and employ individuals with disabilities in competitive, 

integrated work environments.

» Walton Options for Independent Living (Augusta, GA). Many CILs provide durable medical 

equipment and home modifications to make community living possible. With the average cost 

under $1200, home modifications such as the ramps and grab bars provided by Walton Options 

for Independent Living are representative of durable medical equipment and modifications 

provided by CILs to transition individuals with significant disabilities from nursing facilities and 

other institutions to a community setting. 

» Atlantis Community (Denver, CO). Transportation supports are vital to successful community 

living. Atlantis Community is collaborating with the Regional Transit District (RTD) to educate 

all RTD drivers about the individuals with disabilities, proper disability etiquette, and ADA 

protections and mandates relating to transportation access for individuals with disabilities. 

Because of the partnership between Atlantis Community and the RTD, the number of rider 

issues resulting in barriers to transportation for individuals with disabilities continues to decline 

in the Denver area. 

Grantee Objectives and Other Services

In addition to core services, many CILs provide an array of other independent living services. 

Additional services may include securing housing or shelter, mobility training, personal assistance 

services, or transportation, including training in the use of public transportation. Annual and threeyear program and financial planning objectives are required to manage the diverse services a CIL 

may provide. 

Examples of achievements reported by CILs include: 

» Liberty Resources Inc. (Philadelphia, PA). Many CILs provide services to assist with securing 

affordable, accessible, and integrated housing. Liberty Resources Inc. was able to expand its 

housing services by hiring a housing specialist in May 2017. This staff member assists people 

with disabilities to identify available housing and complete housing applications, and provides 

support during apartment viewings and lease signings. As a result of expanded services, Liberty 

Resources Inc. transitioned 31 individuals into the community and reduced their nursing home 

transition wait list from an average of 100 consumers to 60 consumers.

» Alliance of Disability Advocates (Raleigh, NC). Emergency preparation, response, 

and recovery is an emerging area addressed by CILs nationwide. Alliance of Disability 

Advocates worked alongside federal, state, and local partners to prevent the unnecessary 

institutionalization of people with significant disabilities during and after Hurricane Florence. 

Staff helped facilitate the transition of 54 individuals with disabilities from post-hurricane medical 

shelters to community living.

» Wyoming Services for Independent Living (Lander, WY). The ability to self-identify helpful 

resources encourages self-advocacy. Wyoming Services for Independent Living developed an 

online comprehensive resource guide where individuals can locate services within the CIL’s service 

area (10 western counties in Wyoming). The tool prompts searches by keyword and filters by 

selecting the county, type of service, and age group. The search result produces the name and 

contact information for the organization that provides the service searched by the individual. 
Administration for Community Living | Annual Report on Centers for Independent Living Page 7

Challenges

Progress on program and financial objectives is reflected in the annual PPR through descriptions of 

services, activities, and achievements, as well as challenges encountered throughout the reporting year. 

The two most common challenges reported by CILs in PY 2018:

Finding and utilizing affordable, 

accessible, integrated transportation 

for people with disabilities 

Securing affordable, accessible, 

integrated housing for people 

with disabilities

ACL is collaborating with other federal agencies to address these and other key issues affecting the 

people served by the agency. In 2019, that collaboration identified an opportunity for CILs to leverage 

funding from both ACL and the Federal Transit Administration (FTA) to increase community integration 

for people with disabilities. Specifically, CILs can use ACL funding as a match resource for FTA 

programs. For example, the FTA’s Enhanced Mobility of Seniors and People with Disabilities program 

makes available federal resources to improve mobility for seniors and individuals with disabilities by 

removing barriers to transportation service and expanding transportation mobility options. If a CIL 

receives a grant from the FTA through that program, and also uses funding they receive from ACL to 

fund those services, the ACL grant funding can be counted toward the FTA match requirement.

Resource Development Activities

To support sustainability and expansion of services, the Act requires CILs to conduct resource 

development activities. A CIL must create sources of income in addition to the funding received 

through the CIL program award. Specific resource development activities vary from CIL to CIL.

 Examples of resource development activities reported by CILs include:

» Peninsula Independent Living Center and Southeast Alaska Independent Living 

Centers (AK) participate in the Veteran Directed Care (VDC) program funded by the Veterans 

Administration. The VDC program funds services necessary to support community living for 

veterans with nursing home level of care or higher. Combined, the Peninsula Independent Living 

Center and Southeast Alaska Independent Living Center received $281,736 in PY18 to provide 

VDC services. 

» Ability360 (Phoenix, AZ) contracts with Medicaid and managed care organizations to serve 

individuals across the state by providing home modifications, nursing home reintegration, and 

over 1,800 homecare workers to support independent living in the home and community of the 

individual’s choice.

» Active Re-Entry (Price, UT) has a certified and trained Veteran Service Officer (VSO) on staff 

funded by the Utah Department of Veterans and Military Affairs. The program provides and 

locates long term care supports and services for veterans using a person-centered approach. 

The CIL’s VSO travels the 27,000 square miles of service area to provide services to veterans.

» Spa Area Independent Living Services (Hot Springs National Park, AR) received a grant from 

the Arkansas Development Finance Authority to provide Tenant Based Rental Assistance to 

people with disabilities. The funding is from the Home Investment Partnerships Program (HOME) 

that provides formula grants to states and localities, often in partnership with local nonprofit 

groups, to provide assistance for individuals to acquire housing. 

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Administration for Community Living | Annual Report on Centers for Independent Living Page 8

Oversight Activities

Compliance and Outcome Monitoring Protocol

ACL is committed to ensuring the proper use of federal funds and took significant steps in FY 2019 

to improve oversight and compliance of the CIL program. 

» Alpha One (South Portland, ME) received a Cumberland County Community Development 

Block grant for $50,000 to support the Critical Access program, which funds building ramps for 

consumers’ homes – preventing placement in a more restrictive setting. 

In PY 2018, CIL resource development activities generated approximately $673,384,490 in 

additional funds to supplement Part C awards that fund CILs. 

$256,094

Average Part C 

CIL Award

$673,384,490

CIL Revenue from 

Other Sources

$14.18

Leveraged for 

Every Part C Dollar i

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1. Standard Monitoring is the ongoing annual review of each CIL grantee. Federal staff use a 

standardized approach to assess select program, operational, and fiscal management data. 

This monitoring includes, but is not limited to, the review of the program performance report, 

fiscal documents, and funds drawdown records. For example, program officers review the pace 

at which a CIL is drawing its grant funding. Drawing funds more quickly or more slowly than the 

norm would require additional follow-up. Although there are many legitimate reasons for either 

behavior, both can be indicators of risk.

2. Comprehensive Review is a more thorough review of a CIL’s operations and includes a 

thorough examination of all the components ACL monitors. A team, led by an ACL program 

officer, conducts an onsite or remote review (the latter is also referred to as a desktop review). 

The Comprehensive Review is an interactive process between the review team and the CIL 

and may require additional document collection and review. On an annual basis, ACL conducts 

Standard 

Monitoring 

Comprehensive 

Review

Targeted 

Review

ACL completed development and piloted a robust tool, the Compliance and Outcome Monitoring 

Protocol (COMP). ACL now conducts systematic and consistent reviews of key risk indicators for 

every CIL, every year. 

The COMP includes 

three interwoven 

processes that can 

occur in any order or 

simultaneously: 
Administration for Community Living | Annual Report on Centers for Independent Living Page 9

comprehensive reviews on a subset of CIL grantees. The process to select CIL grantees for a 

comprehensive review involves a combination of (1) risk factors from monitoring by federal staff, 

(2) random selection, (3) federal staff recommendations, (4) geographic area considerations, and 

(4) requests from grantees.

3. Targeted Review employs remote and/or onsite reviews to identify and address concerns, 

including operations and financial management. Targeted Review involves focused monitoring 

of the grantee in specific areas of concern. This type of review is individualized based on the 

issue(s) with the program. For example, complaints that the CIL facility isn’t accessible might 

begin with a request for additional information from the CIL. That information might be sufficient 

to address the issue – perhaps the front door was broken, but it has been fixed. In contrast, if 

the complainant stated that the CIL has fixed the door, but they still cannot navigate the site 

using a wheelchair, and the CIL insists there is a not a problem, a site visit may be needed to 

accurately assess the issue.

One key goal of COMP is to identify developing issues early so that ACL program officers can work 

with grantees to address situations before they become significant. There is no set frequency as to 

when a grantee could receive a compliance review. If concerns persist, grantees could receive more 

than one site visit and/or remote comprehensive review. COMP is designed not only to improve 

compliance but also to drive continuous improvement across the program so that more Americans 

with disabilities are living independently. 

Pilot Remote Reviews

COMP was launched in June 2018 as a pilot 

with six CILs participating in remote reviews. 

The six CILs that participated were:

State CIL

MD Accessible Resources for 

Independence, Inc.

SC ABLE South Carolina

MI Metropolitan Detroit Center for 

Independent Living

TX Panhandle Independent Living Center

CA Dayle McIntosh Center

WA Spokane Center for Independent 

Living 

The pilot remote reviews provided a protocol 

and program officer training exercise, and the 

opportunity for volunteer CILs to strengthen 

their program and fiscal operations. CILs were 

strongly encouraged to work with the training 

and technical assistance provider to resolve 

findings in a timely manner. 

On-site Reviews

At least six on-site reviews will be conducted 

during FY 2020. Three on-site reviews were 

completed in December 2019. The remaining 

three planned reviews for FY 2020 (and any 

additional) will be scheduled prior to March 31, 

2020. In future fiscal years, ACL will initiate the 

site visit plan for each fiscal year no later than 

60 days after the start of the fiscal year. 

Remote and onsite reviews supplement ACL’s 

larger oversight efforts. Another key element of 

oversight is ensuring that grantees know and 

understand grant requirements. As a result 

of oversight activities, ACL identified noncompliance trends and issued FAQs to clarify 

grant requirements on the issues of lobbying 

and conflicts of interest. Additional FAQs 

are planned for the coming year. Grantees 

continue to provide positive feedback about the 

additional information and support they receive 

from federal staff, and ACL looks forward to 

continuing to improve our outreach, oversight, 

and quality improvement efforts.
Administration for Community Living | Annual Report on Centers for Independent Living Page 10

Endnotes

1 A founding principle of CILs is consumer control, which means that each CIL “vests power and authority in individuals 

with disabilities, in terms of the management, staffing, decision making, operation, and provisions of services, of the 

center.”

2 Core services include: Information and referral, independent living skills training, peer counseling, individual and systems 

advocacy, services that facilitate transition for institutions to community-based living, assistance to those at risk of 

entering an institution, and transition of youth to post-secondary life. 

3 Some CILs receive more than one CIL award.

4 The May 2019 reorganization of the Administration for Community Living designated the Commissioner of the 

Administration on Disabilities (AoD) as the Director of the Independent Living Administration. (The Director of ILA 

continues to report directly to the ACL Administrator, as required by statute.) Prior to this realignment, annual reports had 

not been submitted to the Administrator. 

5 CIL programs are funded from September 30 of one year through September 29 of the following year, with appropriations 

for the fiscal year in which the program began. For example, Program Year (PY) 2018 ran from September 30, 2017 

through September 29, 2018 and was funded with FY2017 appropriations. This report refers to program years, which 

correspond to the fiscal year in which the program’s activities took place. 

6 Sec. 725(c)(8) and (13)

7 Data collection does not measure intellectual and developmental disabilities directly or exclusively. For purposes of this 

report, we include individuals reporting cognitive disabilities in the category of I/DD. It is reasonable to conclude data 

reported as “multiple disabilities” and “other” likely represent additional individuals with I/DD.

8 U.S. Census 2018 estimate

9 Western New York Independent Living; Southeast Alaska Independent Living, Inc.; North Country Independent Living in 

Wisconsin; Disability Services & Legal Center; and Superior Alliance for Independent Living

10 American Council on Aging, Nursing Home Costs by State and Region – 2019, https://www.medicaidplanningassistance.

org/nursing-home-costs/