Held via video conference - Springfield/Chicago

Present

  • Bob Cammarata, ICG Health Care Services
  • Gerri Clark, Division of Specialized Care for Children
  • Deborah Saunders, IL Dept of Healthcare and Family Services
  • Janet Gully, DHS, Bureau of Early Intervention
  • Beatrice Nichols, IICEI Chairperson, Head Start
  • Deanna Pratscher, parent, Thonton
  • Kay Henderson, IL State Board of Education
  • Sandy Ryan, IL Council on Developmental Disabilities
  • Kathy Schrock, Easter Seals DuPage and Fox Valley
  • Gail Tanner, IL Department of Public Health
  • Therese Wehman, Elmhurst College
  • Robin York, IL Department of Children and Family Services

Absent/Excused

  • Joan Adams-Alsberry, provider
  • Diane Blythe, parent, Crystal Lake
  • Dorelia Rivera Martinez, Melrose Park
  • David Rubovits, PhD, Jewish Child and Family Services
  • Connie Sims, DHS, Division of Developmental Disabilities
  • Mary Petersen, DFPR, Division of Insurance
  • Constance Williams, PhD, DHS/Division of Mental Health

Contents of Council Packet

  • Agenda
  • Lead Agency Report - October 7, 2010
  • Draft Report from July 15, 2010
  • Ombudsman Report
  • Update of Early Intervention Taskforce
  • CFC Adverse Pregnancy Outcomes Report System (APORS) Survey

Call to Order

The Illinois Interagency Council on Early Intervention convened at 10:00 a.m.

Introduction of Council Members

Council members introduced themselves.

Approval of July 15, 2010 Meeting Report

The July 15, 2010 Meeting Report was approved as written.

IICEI Workgroup Reports

Finance Work Group

Kathy Schrock provided a report on the Finance Work Group. The group has met two times since the last Council meeting. The group has discussed payment delays, which have extended to 10 weeks. It has also discussed the 10% cuts to CFC offices and admin contracts. The group would like information on how these cuts have affected the ability of the system to provide services, with specifics on cuts made and efficiencies identified. Several examples were provided. Janet Gully explained that several CFC office Support Services Plans are still being finalized and the CFC budgets that were submitted to the Department's Office of Contract Administration have not been shared with the Bureau. As soon as information is available, it will be shared with the Council.
In response to a question about late payment charges resulting from the Prompt Payment Act, Ms. Gully explained that interest owed to providers as a result of late payments will come out of the EI Revolving Fund.

The work group discussed insurance billing issues for developmental therapists, which arose as a result of a correspondence to providers from Blue Cross/Blue Shield (BC/BS). Concerns about this process were discussed, including issues regarding the list of codes made available by BC/BS for this billing, the need for a code that appropriately reflects developmental therapy (DT) services, and subsequent problems among providers regarding these issues. Kathy Schrock spoke with the president of the DT association and will follow-up with her about board action regarding exploration of the use of appropriate billing codes. The unsuccessful outcome of a pilot for billing DT services was reported. Janet Gully will inquire about insurance use in other states, but available information will be limited, as most other states are just now accessing insurance payments for the EI services. The Early Intervention Central Billing Office (CBO) and the DT association will be asked if there are DTs that have been successfully billing insurance, and, if so, what codes have they used.


Finally, the work group continues to monitor how the CBO's insurance billing unit is doing. It is being used consistently and has demonstrated a savings to the system. Bob Cammarata recognized that the success rate of the unit is comparable to other entities that bill insurance. In addition, family fees are being reduced as fewer state funds are being expended for services.

Service Delay Work Group

Bob Cammarata reported on the work of the Service Delay Work Group. The group has met three times since the last Council meeting. The group is working with Provider Connections on an online method to identify areas where there are provider vacancies/needs. The group has also done additional work on the Integrated Services Approach Guidelines. A revised draft was distributed. Council members will be sent an electronic copy of the draft document, along with a letter of comments. Members are to send comments to the draft document to Bob Cammarata by October 15. It was clarified that the integrated services approach is an option, not the only approach for Early Intervention services. CFCs #1 and #6 are currently piloting this option. Mr. Cammarata commented on several changes to the professional association membership of the work group.

Ombudsman Report

Chelsea Guillen, the Early Intervention ombudsman, provided an overview of her activities including visiting CFC offices, providing resources to people in the field, reviewing data, identifying areas for clarification or training, and learning about what is going on nationally with goals to improve program practices and communication between system entities. A written summary of the CFC office visits was provided. Specific information about the outcomes of ombudsman activities was requested. Reaching out to other stakeholders (i.e., providers and families) and collecting and analyzing existing data were discussed. Ms. Guillen will look into participation on Council work groups.

Lead Agency Report

Janet Gully shared the plans for the OSEP verification visit, which is scheduled for November 3 - 5. In September and October, the Bureau has been spending time preparing for this visit, including biweekly calls with OSEP. The emphasis of the visit will be noncompliance and the correction of non-compliance as well as fiscal and data. Ms. Gully explained OSEP's definition of noncompliance, including performance on indicators that require 100 percent compliance. Correction of non-compliance, down to the child-level, is required within 12 months. Issues for states regarding this correction were discussed. Six CFCs have been selected for specific review. Information on all aspects of the program have been gathered and submitted to OSEP. The agenda for the visit is in a preliminary stage. No input from the Council during the visit has been requested. 
Ms. Gully explained to Council members that the posted balance for the EI Revolving Fund on the Comptroller's web site does not accurately reflect what is available in the DHS system for the program to spend.


Ms. Gully shared information about activities with other state agencies.
The Council received a copy of an IL Department of Public Health survey of CFC managers regarding the Adverse Pregnancy Outcomes Reporting System (APORS). The Bureau facilitates the transmission of referrals from APORS to the CFC offices. Survey information will be used to identify ways to improve this process. 


In order to bring the state into compliance with CAPTA, the Department of Children and Family Services (DCFS) is implementing a process to screen children that reside in intact families. Staffs are being hired to screen these children and refer them to EI, when appropriate. Intact families will not be required by DCFS to follow-up on these referrals. The impact on the number of children in the EI system is not currently known. CFC office staff will be trained when the process is ready to roll out. 


CFC offices will be trained on a DCFS resource database that will help service coordinators identify services and resources that are available in a family's community. The database currently holds information on 1,300 agencies and 2,700 programs.
Deborah Saunders provided an overview of several efforts the Department of Healthcare and Family Services is collaborating with the Early Intervention Program, including facilitating the electronic transfer of referral information to and from the Cornerstone system, targeting NICUs and medical homes. Medical home performance improvement efforts have targeted developmental screening and HFS is working on this information can be shared with EI.


It was noted that the percent of families with insurance has dropped. Ms. Gully also reported that the enhanced FMAP (12% higher reimbursement) has been extended from 12/31/10 to 6/30/11.

EI Taskforce Report

Janet Gully reviewed each recommendation from the EI Taskforce report. Although the priorities that the Council has identified remain the priorities for the recommendations, the Bureau is proceeding with the initial steps for the implementation of recommendations within existing resources.

Recommendation 1-

Web-based system: The Bureau has met with the Illinois Primary Health Care Association (IPHCA, the vendor for the EI-Central Billing Office and Cornerstone support,) to determine if modifications could be made to the current system to make it more responsive to users. A consultant is working with IPHCA on this issue. The Council will be updated on what improvements can be made within current resources.

Recommendation 3 -

Recruitment and retention of qualified staff: The Bureau and its contractors are coordinating their efforts to work with professional associations that support the EI Program. Work with the associations is focused on coordinating provider recruitment and on education and information sharing regarding appropriate practices for services to infants and toddlers in the EI Program. A provider recruitment video developed and distributed by the national Center to Improve Recruitment and Retention of Qualified Personnel for Children with Disabilities, will be made available to CFC offices and Council members. The Bureau will be looking for other federal resources.

Recommendation 6-

Assistive Technology: The Bureau is convening an AT Work Group. Membership on the group was described. The AT Work Group will review the AT service and make recommendations regarding changes to the AT service request, approval, and provision processes. If you are interested in participating on this group, please let Ms. Gully know.

Recommendation 8 -

Improving the consistency of monitoring: Discussions with the EI Monitoring Program have been held to post more materials to ensure that consistent information is available to everyone being monitored.

Recommendation 9 -

Transition issues with the Chicago Public Schools: CFCs 8, 9, 10, 11 are working directly with CPS on this issue. The Bureau has spoken with ISBE regarding several issues.

Recommendation 10 -

Exploring new funding and maximize cost efficiencies. No new funding has been identified, but the Bureau has worked with CFC managers to identify cost efficiencies. Some of these efficiencies deal with recommendations for the CBO and Cornerstone systems. Challenges to changing the Cornerstone system were discussed.
Currently there are no resources to address the following recommendations. Options that are being discussed include using federal technical assistance staff paid for by the Office of Special Education Programs (OSEP) such as staff from the North Central Regional Resource Center (NCRRC) and from the National Early Childhood Technical Assistance Center (NECTAC) regarding their availability to assist with research and data collection. Another option is to contract for a graduate research student to conduct this research. An advisory panel would still be convened, but research and support of this panel is needed. The Council will have a role in the further consideration of recommendations, once resources are available for that work. It was recognized that it is important to identify through research what other states are doing, as long as it is balanced with what is important in the state. Input from providers across the state is needed. It was suggested that the Bureau use the Council as a resource as much as possible. The lack of feedback on posted documents was discussed, along with the need for those who comment on documents to see how their feedback is used.

Recommendation 2 -

Review of service delivery model

Recommendation 4 -

Child Find: Review of referral policies/procedures, documents

Recommendation 5 -

Review of initial and annual eligibility criteria and determination process

Recommendation 7 -

Qualitative monitoring

Adjournment

The meeting adjourned at 11:42 a.m., with the following reminders. Additional responses to the OSEP Council survey are needed by October 13; Kathy Schrock will follow-up with the IL DT Association; and comments to the Integrated Services Approach Guidelines should be sent to Bob Cammarata by October 15.