Indicator 2 - Percent of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings.

Helping Families. Supporting Communities. Empowering Individuals.

Overview of the Annual Performance Report Development: See Indicator 1.

Monitoring Priority Effective General Supervision Part C / Effective Transition
Indicator 2

Percent of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings.

(20 U.S.C. 1416(a)(3)(A) and 1442)

Measurement Percent = [(# of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings) divided by the (total # of infants and toddlers with IFSPs)] times 100.

FFY Measurable and Rigorous Target

FFY Measurable and Rigorous Target
FFY09/SFY10 At least 89.5% of all children with IFSPs active on June 30, 2010 will have their services provided predominately in the home or in community settings.

Actual Target Data for FFY09/SFY10

Indicator 2 (# of infants and toddlers with IFSPs who primarily receive early intervention services in the home or community-based settings/total # of infants and toddlers with IFSPs) X 100
FFY09/SFY10 Result (16,960/18,266) X 100 = 92.9%
FFY09/SFY10 Target 89.5%

October 31, 2009, data (92.9%) demonstrates a slight improvement in the proportion of children with IFSP services authorized predominately in natural settings and exceeds the target for FFY09/SFY10 of 89.5%. When a service, which is identified in a child's IFSP, is authorized in the Cornerstone system, a place of service code is designated. When the provider submits a claim for that service, the Early Intervention Central Billing Office (EI CBO) ensures that the place of service code matches the authorization for that service. On a monthly basis, the EI CBO generates a report on services provided predominately in the home or in community settings, which reflects the settings for services that have been processed for payment. The child's IFSP must include a justification when services are authorized in a non-natural setting, along with a plan to transition to a natural setting, when available.

Predominate Setting History

Setting Oct 2007 Oct 2008 Oct 2009
Typically Developing 4.60% 4.2% 5.0%
Home 84.90% 88.1% 87.9%
Provider Location/Other 10.50% 7.8% 7.1%
% Natural Setting 89.50% 92.2% 92.9%
Client Count 17,486 18,535 18,266
Centers & Provider Locations 1,841 1,439 1,306

Cases in Predominately in Natural Settings By CFC & Geographic Regions

CFC # & Area Home Day Care/ Comm. Natural Settings Home Day Care/ Comm. Natural Settings
#1 - ROCKFORD 82.0% 5.4% 87.4% 79.1% 9.39% 88.5%
#2 - Lake County 89.4% 2.0% 91.4% 92.6% 1.91% 94.6%
#3 - FREEPORT 70.9% 7.7% 78.5% 68.9% 10.70% 79.6%
#4 - Kane & Kendall Counties 91.3% 2.5% 93.8% 93.9% 3.05% 96.9%
#5 - Du Page County 94.1% 4.0% 98.0% 97.0% 1.27% 98.3%
#6 - N. Suburbs 86.3% 5.7% 92.0% 86.4% 7.86% 94.3%
#7 - W. Suburbs 89.6% 2.4% 91.9% 90.7% 3.28% 94.0%
#8 - SW Chicago 95.3% 2.2% 97.5% 96.5% 1.38% 97.9%
#9 - Central Chicago 88.9% 3.9% 92.8% 92.0% 3.71% 95.7%
#10 - SE Chicago 89.9% 0.6% 90.5% 92.1% 0.49% 92.6%
#11 - N. Chicago 86.1% 1.9% 88.0% 87.7% 2.21% 89.9%
#12 - S. Suburbs 97.5% 1.4% 98.9% 98.6% 1.08% 99.7%
#13 - MONMOUTH 86.7% 7.4% 94.1% 82.6% 10.92% 93.5%
#14 - PEORIA 33.1% 9.6% 42.7% 25.5% 6.62% 32.2%
#15 - Joliet 89.3% 4.8% 94.1% 88.0% 5.33% 93.4%
#16 - DANVILLE 74.1% 18.5% 92.6% 74.5% 17.60% 92.1%
#17 - QUINCY 85.1% 6.3% 91.4% 82.0% 10.36% 92.3%
#18 - SPRINGFIELD 56.9% 34.0% 90.8% 56.7% 33.52% 90.3%
#19 - DECATUR 87.4% 10.2% 97.6% 87.8% 9.51% 97.3%
#20 - EFFINGHAM 98.7% 1.3% 100.0% 98.5% 0.88% 99.4%
#21 - BELLEVILLE 96.5% 0.8% 97.4% 99.2% 0.33% 99.5%
#22 - CENTRALIA 98.8% 0.0% 98.8% 97.9% 0.88% 98.8%
#23 - NORRIS CITY 100.0% 0.0% 100.0% 100.0% 0.00% 100.0%
#24 - CARBONDALE 93.2% 6.2% 99.4% 92.9% 6.55% 99.4%
#25 - McHenry County 92.4% 4.5% 96.9% 92.6% 3.24% 95.9%
State 88.1% 4.2% 92.2% 88.0% 4.89% 92.9%
Cook County 89.6% 2.8% 92.4% 90.9% 3.21% 94.1%
Collar Counties 91.2% 3.7% 94.9% 92.7% 3.08% 95.7%
Downstate 80.3% 8.3% 88.6% 79.3% 9.14% 88.4%

Discussion of Improvement Activities Completed and Explanation of Progress or Slippage that occurred for FFY09/SFY10):

Progress or Slippage for Indicator 2: Statewide, the proportion of children served predominately in natural settings increased from 92.2% at the end of October 2008 to 92.9% at the end of October 2009. Both Cook County and its collar counties demonstrated an increase in the proportion of children served predominately in natural settings, with 10 out of the 12 CFC offices in these areas showing increases. On the other hand, downstate CFC offices showed a slight decrease (88.6% to 88.4%) when compared to October 2008 data. The data for CFC #14 (Peoria), a CFC office which has faced the greatest challenges to providing services predominately in natural settings, contributes the most to this region's lower number. Among the downstate CFC offices, only two other CFC offices have a proportion of children serviced predominately in natural settings that falls below 90% (CFC offices #1 and #3), both of which showed improvement from the previous year. Overall CFC offices' performance remained fairly constant, with 14 CFC offices making improvements, 7 CFC offices showing modest decreases, one office (CFC #14) with a large decrease, and three offices remaining unchanged.

Situations that impact service delays, including payment delays, also impact the availability of services in natural settings. See Indicator 1 for more details.

Illinois has greatly improved its documentation of findings and correction of noncompliance. In FFY06/SFY07, it expanded the process to utilize its data system. A system of identification and correction of noncompliance was developed, but not fully implemented until FFY07/SFY08, due to delays in sending notification of findings to CFC offices. Findings based on FFY06/SFY07 were sent in February 2008. Findings based on FFY07/SFY08 data were sent on December 2008. Illinois is now on track to provide timely notification and to monitor and document correction of noncompliance. On August 27, 2009, the Bureau sent a single letter to each CFC office that included the CFC office's determination (in accordance with 616(a)(1)(C)(i) and 300.600(a) of IDEA 2004) and the notification of findings of noncompliance, based upon FFY08/SFY09data. On September 10, 2010, the Bureau sent a single letter to CFC offices with determinations and notification of finding based upon FFY09/SFY10 data.

For correction of noncompliance, this APR looks at findings occurred in FFY08/SFY09. For Indicator 2, Illinois uses its data system and a formal system of notification, as described in Indicator 9, to identify findings and document correction of noncompliance. In SFY08/FFY09, 5 findings of noncompliance were identified for Indicator 2, with all findings of noncompliance corrected within one year. In FFY09/SFY10, 2 new findings were identified. A new system of notification of findings and correction of noncompliance is being implemented that will assist the lead agency and the CFC offices in tracking performance and providing adequate notification when a correction has taken place.

Improvement Activities Completed

No new improvement activities were identified in the FFY08/SFY09 APR. Previous improvement activities, such as monthly predominate setting reporting to CFC offices, performance contracting, and identification of findings and development of corrective action plans continue.

Improvement Activity Status/Timeline/Resource
Illinois has made continued improvements to the proportion of children served predominately in natural settings, with the impact of service delays being the greatest challenge to future progress. The IICEI Service Delay Workgroup is currently considering recommendations for strategies to address these issues. (See Indicator 1.)   In FFY09/SFY10 the Service Delay Workgroup, presented to the IICEI recommendations that would support an integrated services approach, which emphasizes collaboration among IFSP team members. CFC offices #1 and #6 are currently piloting this option. The Workgroup has also discussed provider recruitment strategies, including strategies for posting unmet service needs.

Other improvement activities include the following:

  • In order to ensure that all providers are addressing the Principles of Early Intervention and other important policies, rules, regulations and guidelines, effective September 1, 2009, all providers were required to use the guidelines and "Developmental Justification of Need to change Frequency, Intensity or Location" worksheet found in the EI Service Descriptions, Billing Codes and Rates manual. Providers who wish to request an increase or decrease in the frequency or intensity of an authorization or a change in location to an existing authorization submit a written "Developmental Justification of Need to Change Frequency, Intensity or Location" worksheet to the individual child's service coordinator. Upon receipt of a justification that contains all required information found in the worksheet, the service coordinator will convene an IFSP review meeting. These guidelines reiterated the federal requirement that EI services must be provided in a natural environment, unless a written justification exists for providing these services in other settings. If a recommendation is made to change the location to a non-natural environment and the IFSP team agrees with the recommendation, the Natural Environment Worksheet must be completed at the IFSP meeting. A May 21, 2010 memo further clarified the need to complete both the "Developmental Justification of Need to Change Frequency, Intensity or Location" and the Natural Environment Worksheet, under these circumstances.
  • In the systems overview training, which is required to be completed before a credential is awarded, personal safety and self awareness are discussed as part of the first activity in the face-to-face training session. It is also discussed as part of the online service coordinator training. Many optional training opportunities have been offered around the topic of "Providing Services in Natural Environments" by the EI Training Program, as well as by individual CFC offices. In each of these training sessions, "providing services in high risk areas" was discussed. In addition, both state and national resources focused on providing services in natural settings can be accessed on the EI Training Program web site under the "Natural Environments" tab on the resources page.
  • The Program Integrity Project, discussed in the Overview of the Annual Performance Report Development section of Indicator 1, includes a pilot project at CFC #14 (Peoria), a CFC office which has faced the greatest challenges to providing services predominately in natural settings. The pilot project offered additional information based on intensive file reviews. This data supports training and technical assistance strategies to address this problem. Strategies for recruitment have also being implemented. Specific steps taken by CFC #14 during FFY09/SFY10 include the following:
    • held discussions at all LIC, provider meetings and staff meetings;
    • increased provider recruitment efforts to seek out more independent providers who typically provide services in natural settings;
    • held a training session on May 20, 2010 for service coordinators and EI providers outlining the Principles of EI, including delivery of services in natural settings;
    • held meetings with agencies to encourage delivery of service in natural settings; and
    • offered monetary incentives in calendar year 2009 from the grant administrator to one large agency to offset expenses connected with switching some services to natural settings.

Revisions, with Justification, to Proposed Targets / Improvement Activities / Timelines / Resources for FFY10/SFY11): The State Performance Plan (SPP) has been revised to specify, for each indicator, annual targets and improvement activities for each year through FFY2012 (July1, 2012 through June 30, 2013).

Measurable and Rigorous Target

FFY Measurable and Rigorous Target
SFY2011 - (2011-2012)  At least 90% of all children with IFSPs active on June 30, 2012 will have their services provided predominately in the home or in community settings.
SFY2012 - (2012-2013)  At least 90% of all children with IFSPs active on June 30, 2013 will have their services provided predominately in the home or in community settings.

Proposed target values for FFY2011 and FFY2012 reflect a maintenance level when compared to the FFY2010 target value of 90%. Based upon recent years' data, it appears that the program may have reached a plateau in the proportion of children served predominately in natural settings. In addition, the proportion of children served predominately in natural settings may be negatively impacted by circumstances that impact service delays. (See Indicator 1.)

The improvement activities described in the SPP are ongoing efforts. The following are new improvement activities to be implemented through FFY12/SFY13.

New Improvement Activity Timelines & Resources

As part of the CFC 14 pilot project, develop and implement a training plan targeting strategies to increase the proportion of children served predominately in natural settings. Other strategies for FFY10/SFY11 include the following: hold provider recruitment fair, distribute recruitment letters to area licensed professionals; and continue discussions with CFC office staff, EI providers and parents. Strategies will be shared with other CFC offices. The pilot project training and technical assistance plan will be completed and implementation initiated by June 30, 2011. Other listed strategies will be completed by June 30, 2011. Through June 30, 2013, ongoing strategies will be shared with CFC offices through updates at monthly managers' meetings and through additional pilot projects, when applicable.

Resources include the Bureau of Early Intervention, the EI Training Program, EI System Ombudsman, and the EI Monitoring Program.

Continue to track CFC office performance on services provided predominately in the home or in community settings, but discontinue the practice of issuing findings based strictly upon data. Effective with the issuing if findings in the first quarter of FFY11/SFY12.

Resources include the Bureaus of Early Intervention and Performance Support Services.