Open to the general public.
April 7, 2011
10:00 am to 1:00 pm
Via Video Conference at the following sites:
- Hay Edwards School, 400 West Lawrence Street, Carl Suter Room, Springfield, Illinois
- 401 South Clinton, Think Tank Video Conf. Room - 7th Floor, Chicago, Illinois
- Call to Order
- Introduction of Council Members
- Approval of January 20, 2011 Draft Meeting Report
- IICEI Workgroup Reports
- Finance Workgroup Report
- Service Delay Workgroup Report
- Service Delivery Approach Workgroup
- Report from Joint Meeting of Early Learning Council Members
- Early Intervention Taskforce Report
- Lead Agency Report
Attendance - Present
- Bob Cammarata, ICG Health Care Services
- Gerri Clark, Division of Specialized Care for Children
- Janet Gully, DHS, Bureau of Early Intervention
- Sheila McCurley for Gail Tanner, IL Department of Public Health
- Beatrice Nichols, IICEI Chairperson, Head Start
- Pam Reising-Rechner for Kay Henderson, IL State Board of Education
- Sandy Ryan, IL Council on Developmental Disabilities
- Deborah Saunders, IL Dept of Healthcare and Family Services
- Kathy Schrock, Easter Seals DuPage and Fox Valley
- Connie Sims, DHS, Division of Developmental Disabilities
- Therese Wehman, Elmhurst College
- Robin York , IL Department of Children and Family Services
- Joan Adams-Alsberry, CALM, Inc.
- Diane Blythe, parent, Crystal Lake
- Mary Petersen, Department of Insurance
- Deanna Pratscher, parent, Thornton
- Dorelia Rivera Martinez, parent, Elmwood
- David Rubovits, Ph.D., Jewish Child and Family Services
- Gina Ruther, DHS, Bureau of Child Care and Development
- Constance Williams, Ph.D., DHS/Division of Mental Health
Contents of Council Packet:
- Lead Agency Report - January 20, 2011
- Draft Meeting Report - October 7, 2010
- 2010 Annual Performance Report Summary
- 2010 Annual Performance Report
- 2011 IICEI Meeting Dates
Call to Order
The Illinois Interagency Council on Early Intervention convened at 10:02 a.m.
Introduction of Council Members
Council members introduced themselves.
Approval of October 7, 2010 Meeting Report
The October 7, 2010 Meeting Report was approved as written.
IICEI Work Group Reports
Finance Work Group
The Finance Workgroup met three times since the last meeting of the IICEI. As of today the Administrative contracts are paid through November 2010, and provider payments are paid up through the 11/18/10 voucher.
Tom Hwang from the CBO has been visiting CFC offices to obtain input from both providers and CFC staff to determine how to make the CFC processes and billing process more efficient.
States are looking for opportunities and other ways to capture revenue for their EI Programs. Illinois is ahead of other states in this area. Based upon research by Chelsea Guillen, it appears that Illinois is the only state offering a free insurance billing service to its providers. Providers can access this service through the EI CBO Insurance Billing Unit.
EI Bureau staff has been working with DHS and HFS Fiscal to capture Interpreter/Translator match dollars via the Medicaid Administrative claiming process. This initiative is due to a new Rule let by the Centers for Medicare and Medicaid (CMS) dated July 1, 2010. HFS has agreed that EI can begin to claim for these services at 75% match for dates of service beginning February 4, 2009 forward. Bureau staff has been working with the CBO to get reports generated to allow DHS Fiscal to submit and support the claim.
A sub-group of the Finance Workgroup created and distributed a survey via survey monkey to the Administrative contracts Fiscal Agents in hopes of determining the impact of the 10% budget cuts that may not be determined via the EI data. Results of the survey will be discussed at the next Finance Workgroup meeting.
The Governor's office called a meeting with several EI providers on December 29, 2010 to discuss the state's budget situation and the impact of payment delays on providers. The Bureau of EI did not call this meeting. The Governor's office invited Janet Gully to attend along with others from DHS including Secretary Michelle Saddler, Grace Hong Duffin and Grace Hou. Kathy Schrock attended as the Chair of the EI Finance Workgroup and Lora McCurdy attended on behalf of IARF. Janet and Kathy spoke to the impact of payment delays on EI providers. The Governor's representative provided a very clear message about the state's budget situation. The EI providers requested that EI payments be put in an expedited status. The Governor's representative explained the priority for payments as defined in law and stated that the law would have to be changed to include EI providers in order for expedited payments to occur. The providers understood the complications of expedited status. The providers were told that DHS overall will be underfunded by more than $200 million dollars for this fiscal year and it was stressed that this is a state fiscal issue, not just an EI issue.
A second meeting occurred via phone conference with the same providers as a follow up to the December 29, 2010 meeting. The state income tax increase was discussed at this meeting. The impact of the tax increase is unknown until next fiscal year. Senate Bill 336 would have allowed the state to pay the backlog of payments owed and put providers on a 30-day payment cycle. SB336 did not pass.
If EI could identify more efficiencies to reduce the EI budget, it still would not affect payment delays. The delays are related to the states fiscal condition, not EI. Efficiencies will only insure that we are providing good and adequate services to our children.
A recommendation was made that the Finance Workgroup reviews the recommendations from the EI Task Force. The Workgroup will do this at their next meeting.
Service Delay Work Group
The FY08 APR indicator #1 identified that 3.5% of EI children were not receiving services within 30 days of the IFSP. The Council identified four areas of concern. The Workgroup was established and the first meeting scheduled in February 2008. The purpose was to review the areas of concern and propose solutions. The group is a very diverse and passionate group. The composition of the Workgroup included representatives assigned by the PT, OT, DT and ST Associations as well as providers, CFC Managers, IICEI members and others. Initially, recruitment and retention of providers was the targeted area of concern. The group looked at the part of the state with the highest service delays, which was CFC #1 in Rockford. The EI Training Program held a training session in Rockford to look at service delivery approaches nationwide and the specific needs of Illinois. Based upon the Rockford training, the Workgroup developed the Integrated Services Approach (ISA) for consideration. The Workgroup reported the results of the training and the information received to the Council at a meeting nine months ago. As part of the development of the ISA, the breakthrough occurred for the Workgroup when it started to look at approaching services for one child and focused on how the IFSP service team could better organize to provide services to this child/family. After looking at multiple examples, the Workgroup came up with the "Integrated Service Approach" with the purpose of the approach being how the IFSP team can better organize to function as a team to provide a more efficient service delivery method to children/families. There was agreement among the members of Workgroup that this would be a way that all disciplines could work together and better serve children/families. The approach is in complete compliance with Rule 500, the practice acts, and the National PT, OT and ST Association's guidance to their members on service delivery methods per Part C of IDEA.
The Workgroup has met three times since the last meeting of the IICEI. New members of the Workgroup have voiced concerns with the approach. It appears the objectors feel that the approach would be a violation of IDEA, Rule 500, and practice acts and they had concerns regarding the service guidelines. Even though other members of the Workgroup clearly stated that all issues had already been researched and discussed to determine if the approach would violate any of the above. Predominately, the function of the Developmental Therapist as Special Instructors was again questioned leading to a disturbing meeting. The Workgroup had to take a step back and begin again.
The Workgroup thought that if productive discussions could occur at the child-level again, the new members would understand and the group could once again begin to move forward. However, that was not the case. Now the Workgroup is repeating all discussion previously agreed to prior to the involvement of new members. The problem continues to be the role of the DT. Part C of IDEA and Rule 500 defines the role of special instruction, which is the role of the DT. However, the new members of the group have a problem with the name and scope of the DT. Names should not be more important than the role and function of the DT as special instructor. The Workgroup verbalized its frustrations and wanted to move on. They are trying to provide alternatives to normal service provision in the areas that are lacking providers. The "Integrated Service Approach" would be an optional approach. It is one approach not the approach
The Workgroup has now been working on the approach for two years. It is obvious that we need to do something differently. This is now a system agenda where we need to talk about moving providers to a different level of service provision. It is time to stop the discussions and make the changes required to move forward. Some disciplines function very well from this approach now. Most have not been working from this perspective since entering Early Intervention. Providers need to talk and team in order to provide the best services possible to children/families. Providers need to work together. In April 2010, the Council recommended that EI move forward to pilot the approach. CFC #1 implemented the approach as a pilot shortly thereafter. CFC #6 has also joined the pilot.
Janet recommended that a new Workgroup be formed that will be chaired by Chelsea Guillen, EI System Ombudsman, and co-chaired by Therese Wehman, the Personnel Preparation representative of the IICEI, to develop a strategic plan to implement the "Integrated Service Approach." The work completed by the Service Delay Workgroup will be used by the new Workgroup to create a long-term strategic plan to determine how to move forward to implement the approach. The strategic plan will look at what needs to be done such as do we need to make policy changes, etc. It is now time to make changes and move forward to determine how to implement this approach statewide. We need to learn what CFC #1has been doing and how the approach has been working. DeeDee Lowery from CFC #1 will be asked to speak at the next Council meeting about how the approach has been working in her area. Other CFC's have requested to join the pilot project.
The Service Delay Workgroup will now move forward to focus on other issues that impact service delivery. This Workgroup includes a large number of members with diverse opinions. Movement needs to occur to ensure that EI services are based upon best practice and what is best for children and families. The Workgroup is working with Provider Connections to place vacancies on the website where a provider could go to provide services. This will be the discussion at the next Workgroup meeting.
At the last Council meeting, members ask that Chelsea Guillen come and speak about her work as EI System Ombudsman. Chelsea has been contacting and visiting the CFC offices to identify issues and problems. Bureau staff has been working on recommendations that providers and CFC offices have made to Chelsea. We are also looking at types of technical assistance that EI can provide immediately. She is participating on various workgroups as well. She has also been investigating the roll of special instruction in other states. Illinois is not the only state that uses DTs. Most states are using a model that mirrors the "Integrated Service Approach" such as the Primary Service Provider Approach or Consultative Model. It has taken most states about 7 to 10 years to implement the approaches.
Chelsea is also working with the Program Integrity Project at CFC 14, and one big problem is natural environment. CFC 14 will receive training in a different way to enable staff to work with the natural environment problem. The EI trainers will train CFC staff to become trainers and resources to help alleviate the problem.
Another project is to look at what other states are doing to evaluate components of their systems. Finances are a big concern for all states.
She is also trying to gather information from other stakeholders. For example, she is talking to CFC offices and reviewing family outcome data and looking at issues and strategies to increase the under one participation rate.
Lead Agency Report
OSEP completed their verification visit with Illinois. They looked at the general supervision system that includes monitoring, training, and other components. Blake Whitson worked with them to show them the Cornerstone system. Illinois will get a final letter in that outlines the results of the visit and Janet will share that letter with the Council.
An AT Workgroup has been meeting and hopes to have recommendations to present to the Council at the April meeting.
Services are paid through the November 17, 2010 voucher. The state is paying as quickly as possible based upon funds received.
Procurement handout - Each Council member has a Procurement handout in their packet. This information applies to Council members because they are members of a Board or Commission. If council members receive questions about procurement, they are required to go on the procurement website and enter both the question and the answer. This includes communication about future contracts, RFPs, etc. Members must report every question and answer. DHS legal staff are working on a training to make the new procurement requirements clearly known. If EI Bureau Staff receive questions, the questions and answers will also be posted on the website, which is a public website. If you are unsure if you need to report the question and answer Janet can take the question to the DHS Ethics officer for review and determination. This law also applies to state agency staff. The law went into effect in January 2011. Send your questions to Janet and she will take them to the DHS Ethics Officer. The Ethics Officer would rather questions come through Janet because she is Ethics officer for the entire DHS and all of their Boards/Commissions. Council members have an ethical responsibility in concerns to this law.
DHS has received a list of additional questions that are unable to be answered at this point. Once the information is available, Janet will share them with the Council. The purpose of this discussion is not to discourage questions. Everyone has a right to ask questions. The purpose is to let you know about the new law, your responsibility under the new law, and that the questions you receive and the answers you give will now be public. There is a FAQ document on the website identified in the Procurement handout. Go to the website in your handout and it will take you to the FAQ's.
APR - A Workgroup of the Council was brought together in December to review the APR. Janet discussed the content of the APR and stated that it will be posted on the EI website and there will be a 30-day public comment period.
A recommendation to form a Workgroup to implement the "Integrated Services Approach" with Chelsea Guillen as Chair and Therese Wehman as Co-Chair occurred. The recommendation to form the Workgroup was approved by the Council.
The meeting adjourned at 11:52 a.m.