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INSTRUCTIONS for VERIFYING CIL SERVICE AREA (yellow form)

If we do not hear from you by May 7, 2004, we will assume that the enclosed information is accurate for each county listed: [1] Your CIL is responsible for the 4 Core IL Services, and [2] that in each of the counties you are responsible for, the disability population is served (not underserved or unserved)

[1] Fill in CIL Name and Main Office Location

[2] County List: If necessary, correct the list of Counties where your CIL is responsible for providing all 4 Core IL Services . These are counties for which your CIL receives State, Federal, or other funds to provide the 4 Core IL services, or which your CIL Board includes in your 4 Core IL service area responsibility. Cross out or add counties as needed.

[3] Responsibility: Circle YES or NO for each county your CIL is responsible for.

[4] Capacity:  If you circled a YES for the county, select and check only one box: Served    Underserved    Unserved

If you circled a NO for the county, DO NOT check a capacity box.

For consistency in determining “Served, Underserved, Unserved” please use the guidelines on the reverse side of this page. We took them from the appendix of Michigan’s approved 2002-2004 State Plan for Independent Living. Michigan’s criteria may not quite match that of your State or Center, but we need consistent criteria in order to aggregate the national data. Michigan’s guidelines recognize a difference between service responsibility and service capacity, include detailed descriptive guidelines, and were approved by RSA.


INSTRUCTIONS for VERIFICATION of CIL OFFICE LOCATIONS (Purple form)  Make sure your zip codes are correct – we map office locations from the zip code.

[5] Verify/correct your Main Office contact information.

[6] Add each CIL satellite office location: Zip Code, Town, State. Include all locations where you have a physical presence away from your main Center – satellites, branch offices, outreach offices, etc. This information will be used to update the enclosed map which now shows 301 satellite locations.

[7] Verify your main office location on the map. If your CIL is not in a traditional main office-satellite relationship, we may have designated the wrong location as the “main center” location. If so, please let us know so we can correct the map

[8] Return your CIL’s yellow and purple forms in the enclosed postage paid envelope before May 7, 2004.

Or mail to: Alexandra Enders, RRTC Rural, 52 Corbin Hall, Univ of Montana, Missoula, MT 59812 or FAX to: 406.243.2349

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