ICG Rule 135 Revision Workgroup Meeting Minutes - 11/21/2013


 

ICG Rule 135 Revision Workgroup Meeting Minutes - 11/21/2013

Present: Ray Connor/Co-chair, Judy Griffeth/Co-chair, Roberta Allen, Kimberly Jenkins, Christina Kuczora, Jean Meister, Margo Roethlisberger, Rita Thorpe, Lisa Betz

Participating by phone: Dr. Dennis Beedle, Michelle Carmichael, Hannah Chapman, Candina Crane, Katie Donahue, Jamie Germain, Robin Green, Kathy Henke, Patrick Knepler, Colette Lueck, Dr. Renee Mehlinger, Dr. Cynthia Mester, Chris Norton, Debbi Smith, Dee Ann Ryan

Discussion:

The meeting began with roll call and introductions. Roberta Allen volunteered to take meeting minutes.

Patrick Knepler & Dennis Beedle provided an overview of the administrative rule making process as well as the original statute the ICG funding is governed by.

Participants began discussing each section of the rule, with the following recommendations:

  • Section 135.5 Purpose
    Participants discussed needing to use language reflective of SOC values and to clarify role/goal of the program. Ray Connor and Jean Meister will develop suggested language for this area.
  • Section 135.10 Definitions
    Participants agreed to adjust the definitions throughout the review process, based on recommendations from other sections.
  • Section 135.15 Incorporation by Reference
    This is reported to be standard language in the Rule which does not require adjustment.
     
     
    Section 135.20 Eligibility criteria
    • a) Participants questioned need to further define residency requirements. If any addition is necessary (though this may better fit in the application section), suggestion would be to include language as defined in the Public Aid Code.

    • b) Participants discussed using functional criteria. Currently Data & Outcomes workgroup is discussing possible instruments that assess functional abilities. Current language does specify that youth must have "severely impaired reality testing" AND may include the other symptoms listed. Questions included whether the symptoms listed as evaluated as having equal weight? Where do youth who fall on the autism spectrum fall? (Will they be served through the DD system instead?) Participants also recommended including "trauma informed criteria". Need to further discuss, including possibly leaving the language unchanged, but addressing the interpretation/practice implications.
    • c) Participants recommended a functional tool/language be added here too, once developed. Recommendations: Await review of Data/Outcomes workgroup consideration of a functional criteria tool.
       
    • d) Participants discussed interpretation of this section to refer to the state code agencies, not an adult guardian assigned through probate court. Recommended changes: The child must not be under the guardianship of another State agency which could assume financial and legal responsibility for the youth, (e.g., DCFS or DJJ).
    • e) Participants discussed questions about students enrolled in parochial or other private schools and homeschooling, as well as students who are not identified as special education eligible at the time of application for ICG. Questions raised included: Are only youth who have an IEP eligible to apply for ICG? It seems clinically inappropriate to require a student disrupt his/her educational setting to enroll in public school district, solely to be eligible to apply for ICG, particularly given the uncertainty of being approved as well as the required response time for ICG application as well as placement location time, should the family pursue RTC upon receipt of the ICG. Are these requirements solely financial, to ensure tuition costs are covered if ICG is approved and used for residential? Further consideration is needed in this area.
       
      f) No changes in this section, though changes may be recommended in application section (135.40).
       
  • Section 135.30 Parent/guardian responsibilities
    • a. Participants discussed need to improve language to be more family-driven, using SOC values. Recommendation: Need to define "must participate", including role of parent as youth becomes own legal guardian at 18.

    • b. Participants discussed this section is relevant only to RTC placement; recommendation to clarify. Participants also questioned role of adoption subsidy, which is not listed in rule. Need to further explore that. Recommended changes: When a youth is placed in residential care, all public sources of financial support available to or for the child, including but not limited to Social Security benefits (SSA) and supplemental security income (SSI) (42 USC 1381), must be applied to the costs of residential care, to the extent provided by law. Does this include adoption subsidy?
       
    • c. Participants discussed this section is relevant only to RTC placement; recommendation to clarify. Participants also discussed the 94R waiver, which excludes family income after the 90th day in residential placement, for application for Medicaid eligibility. Recommended changes: Upon placement in residential care, if the child is not already receiving benefits from SSA, the parent/guardian will authorize the residential placement staff to initiate an application for SSI immediately after placement (or on the 90th day, depending on family income levels). If the child is receiving benefits from SSA upon admission into residential care, the parent/guardian will authorize the residential placement staff to initiate an application on behalf of the residential agency to become payee for SSA benefits. 
       
    • d. Participants discussed that this section, along with subparts b and e, refer to financial matters/income levels. What is the need for this language if this funding stream is not a means-based system?
    • e. See notes in subsection d.

    • f. No changes recommended.


    • g. No changes recommended. From a practice view, where/when/how is this info transmitted? 
    •  
  • Section 135.40 Application process

    1. Participants briefly reviewed this section & identified minor revisions to be made. Ray Connor will make suggested revisions for review at the next meeting.
    2. Participants agreed to meet again in two weeks, on Thursday December 5, 2013 from 1-3 at the ICG Program Office/Annex. Co-chairs Ray Connor and Judy Griffeth will provide draft revisions of recommendations from this meeting and we will continue discussion of the Rule at the next meeting.
       

Notes submitted by:

  • Judy Griffeth, LCSW
  • Placement Director/Allendale