Ligas Data Report as of 6-30-12 (pdf)


August 15, 2012

Paragraph 33 of the Ligas Consent Decree: …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors' Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants progress toward achieving compliance…

This is the second Ligas Data Report. Per the Ligas Consent Decree, the Division of Developmental Disabilities (DDD) will produce reports of data and information regarding implementation of the provisions of the Ligas Consent Decree every six months. The due dates for these reports will typically be February 15th and August 15th of each year. Unless otherwise specified in the body of this report, the data collected represents a time frame of June 15, 2011 through June 30, 2012.

Class Member List

The DDD is maintaining a centralized, master class list as described in the Ligas Implementation Plan. Individual records are categorized into three separate areas: individuals living at home in the community, individuals living in an ICF/DD who were admitted after June 15, 2011, and individuals living in an ICF/DD who were there on June 15, 2011 (the date of the Court's approval of the consent decree). Written statements documenting a desire to be a part of the class are obtained for each individual in the latter category. Individuals are added to or removed from the class list as appropriate. The table below provides a summary of the class list as of July 26, 2012.

Summary of Class Member List

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total toDate
Living at Home 10887
ICF/DD after 6/15/11 8
ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) Total 671
DD PAS 10 13
DHS 1243/1238 181
EFE Form 456
OSG Request 8
Other Guardian Request 13
# At End of Fiscal Year 11566

Individuals were added to or removed from the Class Member List as follows during FY12:

Summary of Individuals Added

Additions Number
Individuals in ICFs/DD on 6/15/11 448
Individuals in Community Settings 9
Total Additions 457

Summary of Individuals Removed

Removals Number
Individual Moved Out of State 31
Determined Clinically Ineligible 6
Determined Financially Ineligible 3
Withdrew-Reason Not Given 27
Individual Deceased 24
Objector 1
Other 8
Incorrect SSN (Duplicate Record) 21
Ineligible Setting 24
Unable to Locate Individual 44
Submitted in Error 3
Total Removals 192

Services for Class Members in ICFs/DD

The DDD informed PAS/ISC agencies of the confirmed class members residing in ICFs/DD as of June 15, 2011, and instructed the agencies to complete eligibility determinations and facilitate the choice and selection process. PAS/ISC agencies are now reporting to the DDD on a monthly basis progress made in assisting the individuals with their options. The DDD continues to inform the PAS/ISC agencies of new class members as they are identified.

Summary of Services for Class Members in ICFs/DD

Target Dates from Consent Decree 12/30/13 12/30/15 6/30/17 Cumulative
Total to Date
# of Class Members With Waiver Capacity Award Letters 115
*Total Class Members Who Have Moved to Waiver Services (per billing data) 97
Subtotal Who Received CILA Services 95
Subtotal Who Received HBS Services 2
Subtotal Who Received CLF Services 0

Please note that the above data includes individuals who are moving due to ICF/DD downsizing and closure agreements.

Services for Class Members from the Waiting List

Two selections have been completed from the PUNS database (the Division's waiting list) since the approval of the Consent Decree using the criteria specified in the Ligas Implementation Plan. The Class Members selected have been notified and the PAS/ISC agencies have been instructed to complete eligibility determinations and facilitate the choice and provider selection process. A set of tables is maintained that provides summary information regarding the results of the selections. These tables are available on the Division's website at http://www.dhs.state.il.us/page.aspx?item=41142.

Ligas Benchmarks 1,000 6/30/13 500 6/30/14 500 6/30/15 500 6/30/16 500 6/30/17 Cumulative Total to Date
# of Class Members Selected From The Waiting List (PUNS) 1426
Total Class Members With Waiver Capacity Award Letters 117
Total Class Members Who Have Received Waiver Services (per billing data) 54
* Subtotal Who Received CILA Services 4
* Subtotal Who Received HBS Services 50

ICFs/DD Resident Outreach

A Request for Proposals (RFP) was drafted and shared with the RFP development and review team for comment. Comments have been received and incorporated into the draft. The draft is now being finalized with the State's procurement staff. Until such time as a contractor is selected and in place, there will not be any data to report under this section.

# of Adults in ICFs/DD
# of Adults in ICFs/DD FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
# of Individuals who Excluded Themselves from the Class by Having Objected to the Decree Prior to its Approval or by Submitting a Written Request to be Excluded Prior to Compilation of the Initial Class List
Total Class Members (2a)
Total Potential Class Members
# with Initial Phone Contact
# Choosing Not to Meet w/Outreach Contractor
# Choosing not to Meet but Want Info Sent
Total # Choosing to Meet w/Outreach Contractor
# Persons Completed Written Request for Community Services Through Outreach
# Undecided
#Pending
#Choosing ICF/DD

Transition Service Plans

With input from the PAS/ISC agencies, new draft forms and procedures have been developed for the Transition Service Plans. These draft forms and procedures will be piloted beginning in September of 2012. Two PAS/ISC agencies have been selected for the pilot and will participate in a planning meeting with Division staff and the Monitor on August 23, 2012. In the meantime, there is not any data to report under this section. Per the Ligas Implementation Plan, PAS/ISC agencies are following the processes described in the DD PAS manual to assist individuals in obtaining needed services.

Summary of Transition Service Plans

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
# with Services Implemented Prior to Transition Plan Completion
# with Transition Service Plan Completed
# with Transition Service Plan Under Development
Total to Date

Crisis Services

The DDD continues to process service requests for individuals in crisis situations. With the assistance of the Monitor and input from the Plaintiffs, the DDD has developed an action plan to improve the timeliness of processing requests and ensuring service provision. Below is summary data regarding the requests processed during this reporting period.

Summary of Crisis Services

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Total # of Crisis Requests Received 343
Total # of Class Members Approved 290
# of Class Members Approved for CILA 205
# of Class Members Approved for HBS 85
Total # of Class Members Who Received Services 247
# of Class Members Who Received CILA Services 173
# of Class Members Who Received HBS Services 74
Total # of Class Members Denied Crisis Approvals 53

Voluntary ICFs/DD Closure/Downsizing Agreements

The DDD continues to work with ICF/DD providers that wish to downsize or close their facilities on a voluntary basis. The information below summarizes the agreements underway during this reporting period. Please take note of the following issues involving the data in the table below:

  • Included in the FY12 numbers are persons who were part of closure/downsizing agreements that were in process at the time of the approval of the Consent Decree on June 15, 2011. Therefore some individuals may have moved prior to that date and were not included in the Class as they already had community-based services prior to the approval of the Consent Decree.
  • It is a rare occurrence, but it is possible that some individuals who are part of closure/downsizing agreements are determined to be ineligible for the Adult Developmental Disabilities Medicaid Waiver. In such instances, the individuals are funded in community-based services with only State funding and are not eligible for membership in the Ligas Class.
  • In comparing this data with that in the section entitled "Services for Class Members in ICFs/DD", note that the data source for whether an individual has moved is different between the two sections. This section uses self-reported information from the ICF/DD providers regarding the status of their closure/downsizing agreements; the section entitled "Services for Class Members in ICFs/DD" uses billing data. Typically, there is a greater lag time in the billing data.
Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
# of Agreements Initiatied 9
Total # Licensed Capacity 144
Total # of People to Move 125
* Moved to CILAs 74
* Move to HBS 0
* Transferred to Other ICFs/DD 3
* Move to Other Settings 0
* No Selection Yet Made 48

Eligibility Appeals

The DDD continues to process appeals of eligibility. With the assistance of the Monitor and input from the Plaintiffs, the DDD and Department of Healthcare and Family Services has developed an action plan to improve the timeliness of processing appeals. Below is summary data regarding the appeals processed during this reporting period.

Summary of Eligibility Appeals

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total toDate
Total Class Members Submitting Appeals 57
Subtotal Appeals Upheld 9
Subtotal Appeals Denied 29
Subtotal Appeals Pending 17
Subtotal Appeals Withdrawn 2

Budget for Ligas

The Governor's introduced budget for FY13 included $38.9 million in increased funding to the Division of Developmental Disabilities for items related to Ligas Consent Decree implementation. This $38.9 million includes:

Budget Category
Description of Expense
FY13 Proposed
Amount
Comments
Contractual Agreements
RFP ICF/DD Outreach $200,000
Eligibility Determinations $450,000
Increased PUNS Enrollment Processing $16,000
Transition Service Plans Development $160,000
New ISSA Services $679,000
Person-Centered PlanningTraining $200,000
Transition Service Plan Reviews & Consult $110,000
Family Liaison $90,000
Total Contractual
DDD Additional Staffing
Strategic Planning - Ligas Compliance Coordinator $108,277
Data Support $93,408
Quality Management - clinical reviews $653,856
Transition Services - facilitate and monitor $373,632
Appeals $79,004
Rate Setting $93,408
Medicaid Waiver - post payment reviews $280,224
Total Staffing $1,681,809
Direct Services
PUNS Selection $26,401,140 1,000 additional individuals; 300 annualized from FY12 ad 700 phased in during FY13; 1/2 CILA and 1/2 HBS; average annual cost for CILA $49,429, plus $2,500 one-time start up; average cost for HBS $25,740
ICF/DD Transitions $8,873,310 400 individuals; 200 annualized from FY12 and 200 phased in during FY13; average annual cost for CILA $49,429, plus $2,500 one-time start-up
Total Direct Services $35,274,450
Total Estimated Budget $38,861,259

The new funding for Ligas Consent Decree Implementation remains in the final budget passed by the General Assembly and signed by the Governor; however, the appropriation line containing this funding was reduced overall by 4%. At this point in time, the Division believes it can proceed with implementation as planned, managing the 4% reduction through a slower than anticipated phase-in of the direct services.

Spending for the ICF/DD program remains constant. In FY11 ICF/DD spending totaled $392.8 million, with 6,427 being served at the end of that fiscal year. Spending for FY12 is estimated to be $388.0 million, with a projected 6,350 being served at the end of the fiscal year. The FY13 introduced budget included $390.0 million for an estimated 6,300 individuals in ICFs/DD. As noted above, the appropriation line containing this funding, however, was reduced overall by 4%.

Spending for the Waiver program in FY12 is estimated to be $652.2 million. 18,710 individuals were served in FY11; 20,000 are projected to be served by the end of FY12; and 20,500 are estimated to be served in FY13.

Implementation Plan Updates and Amendments

There have not been any amendments or updates to the Implementation Plan since its submission to the Court on December 15, 2011. The DDD continues to consider possible changes to the PUNS selection process.