Ligas Data Report as of 6-30-15 (docx)

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 seventh 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 for FY 2015 represents a time frame of July 1, 2014 through June 30, 2015.

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 July1, 2015.

FY12 FY13 FY14 FY15 FY16 FY17
1 Living at Home 10,691 10,309 15,083 16,660
2 ICF/DD after 6/15/11 27 41 131 221
3 ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) 695 919 1,079 1,393
3a DD PAS 10 12 9 9 10
3b DHS 1243/1238 229 520 700 1055
3c EFE Form 432 363 331 290
3d OSG Request 7 6 5 4
3e Other Guardian Request 15 21 34 34
4 # At End of Fiscal Year 11,413 11,269 16,293 18,274

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

Additions in FY13 Additions in FY14 Additions in FY15
Individuals in ICFs/DD on 6/15/11 351 243 329
Individuals in ICF/DDs after 6/15/11 16 94 70
Individuals in Community Settings 47 5,029 2,186
Total Additions 414 5,366 2,585
Removals Removals in FY13 Removals in FY14 Removals in FY15
Individual Moved Out of State 35 15 13
Determined Clinically Ineligible 18 21 8
Determined Financially Ineligible 11 6 3
Withdrew-Reason Not Given 153 124 98
Individual Deceased 35 13 450
Objector 1 1 0
Other 6 3 0
Incorrect SSN (Duplicate Record) 17 0 6
Ineligible Setting 26 54 13
Unable to Locate Individual 167 74 54
Stay in ICFDD 89 31 47
Submitted in Error 0 0 1
Total Removals 558 342 693

Note: Prior Fiscal Year numbers may change from previous reports due to updates made in class member types and effective dates. The total number of removals and additions will not reconcile to the net increase or decrease in class members due to some individuals changing class status from year to year.

Note: The relatively large increase in the number of removals reported as deaths during FY15 is due to an enhancement to the DDD's database which now enables the DDD to regularly and automatically identify individuals who have become deceased. This enhancement has captured reports of deaths not previously identified in the prior fiscal years.

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.

Target Dates from Consent Decree: 12/31/13 12/31/15 6/30/17 Cumulative Total to Date
1 # of Class Members With Waiver Capacity Award Letters 612 591 1203
2 Total Class Members Who Have Moved to Waiver Services (per billing data) 595 547 1142
2a Subtotal Who Received CILA Services 580 545 1125
2b Subtotal Who Received HBS Services 12 2 14
2c Subtotal Who Received CLF Services 3 0 3

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

  • The 12/31/13 Benchmark is 1/3 (297) of the known ICF/DD Class Members as of 6/15/13 (889).
  • The 12/31/15 Benchmark is 2/3 (932) of the known ICF/DD Class Members as of 6/15/15 (1399).
  • The 06/30/17 Benchmark is all of the known ICF/DD Class Members as of 6/15/17.

Services for Class Members from the Waiting List

Four 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 Total
1 # of Class Members Selected From The Waiting List (PUNS). 4310
2 # of Class Members in ICF/DDs after 6/15/11 who were part of a downsizing 82
3 Total Class Members With Waiver Capacity Award Letters 2443
4 Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers) 2410
5 Total Class Members Who Have Received Waiver Services (per billing data) 2379
5a
  • Subtotal Who Received CILA Services (per billing data)
517
5b
  • Subtotal Who Received HBS Services (per billing data)
1860
5c
  • Subtotal Who Received CLF Services (per billing data)
2

ICFs/DD Resident Outreach

With input from the Monitor, Class Counsel, and Intervenors, the DDD issued a Request for Proposals (RFP) to secure the services of a contractor or multiple contractors to contact all Potential Class Members residing in ICFs/DD; however, the DDD did not receive any bids in response to the RFP. After consultation with the State's procurement staff to ensure all regulations are appropriately followed, the DDD entered into discussions with a potential vendor. The vendor, The Council on Quality and Leadership (CQL), is now under contract with the DDD, and planning and development activity is underway. CQL has assigned/hired a Project Director and Project Manager. The vendor has also hired individuals to conduct the initial phone contact and face-to-face interviews. With input from the Monitor, Class Counsel, and Intervenors, the vendor has developed an overall process description, a set of frequently asked questions with responses, a phone script for initial contacts, and meeting presentation materials. Geographic areas for the phase in of initial contact were selected. These areas are Madison and St. Clair Counties in the southern part of the State and the South and Southwest Suburbs of Cook County in the northern part of the State. CQL conducted training for the interviewers in September, with participation by DDD staff and the Monitor. An additional training session was held in January of 2014 for interviewers who were hired after the initial session. CQL has now initiated or completed outreach activity in all areas of the State. CQL's work will continue through January 31, 2016.

FY12 FY13 FY14 FY15 FY16 FY17
1 Total Potential Class Members pending contact 2620 590
2 # with Initial Phone Contact 546 1272
3 # Choosing Not to Meet w/Outreach Contractor 393 941
4 # Choosing not to Meet at this time, but Want Future Contact 29 32
5 Total # Choosing to Meet w/Outreach Contractor 124 299
5a # Persons Completed Written Request for Community Services Through Outreach 32 83
5b # Undecided 18 36
5c # Pending 13 46
5d # Choosing ICF/DD 61 134

Transition Service Plans

An initial version of a standardized format and accompanying instructions was developed with input from the Monitor, Plaintiffs Counsel, PAS/ISC agencies, and other advocates throughout the system. Two PAS/ISC agencies piloted the draft process and materials with Class Members and providers in their areas. These two PAS/ISC agencies participated in a planning/training meeting with the Monitor and DDD staff on August 23, 2012 in order to begin the pilot. DDD staff and the Monitor reviewed the Transition Service Plans that were developed as the pilot was underway. Monthly conference calls were held among the two PAS/ISC agencies, Monitor, and DDD staff throughout the pilot. The standardized format and accompanying instructions were modified, based on the experience of the pilot, for Statewide implementation.

Training for all PAS/ISC agencies was held on April 16, 2013. This statewide training session was then followed with local training sessions for small groups of PAS/ISC agencies throughout the remainder of April and May. The training opportunities were conducted by DDD staff and the Monitor. Statewide implementation occurred on July 1, 2013: as of that date, Transition Service Plans are required for all individuals who move. A modified version of the Transition Service Plan has been provided for the PAS/ISC agencies for use with individuals who moved prior to statewide implementation of the Transition Service Plan format.

Total Plans Completed
1 # with Transition Service Plan Completed 1446
2 # of Modified Transition Plans Completed 435
3 Total to Date 1881

Crisis Services

The DDD continues to process service requests for individuals in crisis situations. Below is summary data regarding the requests processed.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
1 Total # of Crisis Requests Received 343 298 424 486 1,551
2 Total # of Class Members Approved 290 274 397 461 1,422
2a # of Class Members Approved for CILA 205 162 217 282 867
2b # of Class Members Approved for HBS 85 112 180 178 555
3 Total # of Class Members Who Received Services 288 269 397 460 1,414
3a # of Class Members Who Received CILA Services 203 159 217 282 861
3b # of Class Members Who Received HBS Services 85 110 180 178 553
4 Total # of Class Members Denied Crisis Approvals 53 24 27 25 129

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 since the Consent Decree was approved. 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.
FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
1 # of Agreements Initiated 9 16 22 13 60
2 Total # Licensed Capacity 144 486 340 238 1208
3 Total # of People to Move 117 406 278 201 1002
3a * Moved to CILAs 113 380 252 123 868
3b * Moved to HBS 0 0 0 0 0
3c * Transferred to Other ICFs/DD 4 3 8 3 18
3d * Other 0 23 7 6 36
3e * Move Pending 0 0 11 69 80

Eligibility Appeals

The DDD continues to process appeals of eligibility. Below is summary data regarding the appeals processed since the Consent Decree was approved.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
1 Total Class Members Submitting Appeals
(Rows 2,3,4,5 = Row 1)
57 40 50 204
1a Crisis Appeals N/A 16 17 23 56
1b Eligibility Appeals N/A 41 23 27 91
2 Subtotal Appeals Upheld 9 22 6 18 55
3 Subtotal Appeals Denied 29 18 15 27 89
4 Subtotal Appeals Pending 17 11 13 2 43
5 Subtotal Appeals Withdrawn 2 6 6 3 17

Ligas Spending / Budget Plan (updated 8/1/2015 )

PUNS Placements $16,063,150 $49,069,580 $71,443,415 $78,718,807
CILA (includes Residential, Day Program and ISSA) $3,289,717 $11,717,483 $21,630,595 $24,704,132
Home Based Support Services (includes ISSA) $12,773,433 $37,352,097 $49,812,820 $54,014,675
Transitions from ICF/DD's $400,293 $5,309,754 $23,847,582 $25,359,116
CILA (includes Residential, Day Program and ISSA) $12,255,100 $33,092,256 $56,342,017 $70,813,031
Home Based Support Services (includes ISSA) $169,285 $319,033 $398,605 $410,897
Net ICF/DD change -$12,024,092 -$28,101,535 -$32,893,040 -$45,864,812
Staffing and Contract Costs $4,941,829 $8,181,134 $9,240,931 $10,096,274
Court Monitor $182,367 $175,788 $189,300 $188,250
Personal Services (DD Division staff) $1,241,559 $1,504,825 $1,601,574 $1,629,774
HBSS Fiscal Intermediary Costs $440,250 $1,266,450 $1,770,700 $1,896,600
PAS /ISC for Assessments & Transition Service Plans $2,902,653 $4,166,571 $4,130,033 $4,130,033
PUNS Integrity Project $307,364 $1,771,368
Outreach Contract (Council on Quality /Leadership) $175,000 $700,000 $721,000 $180,250
Other Consulting $0 $367,500 $520,960 $300,000
Total $21,405,272 $62,560,468 $104,531,928 $114,174,198

Additional Budget Related Information

ICFDD Services Cost

Overall spending for the ICFDD service system is described below:

ICFDD Services Cost FY12 FY13 FY14 FY15 FY16
Projected
Change Over
4 Years
ICFDD Spending (millions) $ 384.4 $ 372.4 $ 356.3 $ 351.5 $ 338.5
Change from Prior Year (millions) $ (12.0) $ (16.1) $ (4.8) $ (13.0) $ (45.9)
Average Persons 6,292 6,156 5,715 5,203 5,082
Change in persons from prior year (136) (441) (512) (121) (1,210)

Adult Waiver Services Cost

Adult waiver "accepted claims" is described below:

Adult Waiver Services FY12 FY13 FY14 FY15 FY16
Projected
Change Over
4 Years
Adult Waiver Claims (millions) $ 551.8 $ 595.2 $ 658.2 $ 704.3 $ 726.0
Change from Prior Year (millions) $ 43.4 $ 63.0 $ 46.1 $ 21.7 $ 174.2
Unduplicated Persons (entire year) 17,566 18,621 19,508 20,874 21,500
Change in persons from prior year 1,055 887 1,366 626 3,934

DD CILA Waiver Services Cost

As a subset of Adult Waiver Services, spending for CILA, including day program and ISSA services is described below:

DD CILA Waiver services
Adult Waiver Claims (millions) $ 462.1 $ 498.9 $ 546.9 $ 583.7 $ 600.9
Change from Prior Year (millions) $ 36.8 $ 48.0 $ 36.8 $ 17.2 $ 138.8
Unduplicated Persons (entire year) 9,709 10,149 10,650 11,392 11,700
Change in persons from prior year 440 501 742 308 1,991

Source:  Billing System - Client Type C

Implementation Plan Updates and Amendments

The original Implementation Plan was completed and filed with the Court with input from the Monitor, Plaintiffs, and Intervenors. Subsequent annual updates are completed each year. The original Implementation Plan and the subsequent update are posted on the DHS website at: http://www.dhs.state.il.us/page.aspx?item=69861 .