Ligas Data Report as of 6-30-2018 (issued 8-15-2018)

Ligas Data Report as of 6-30-2018

August 15, 2018

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 fourteenth 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 2018 represents a time frame of July 1, 2017 through June 30, 2018.

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.

# Class Member FY12 FY13 FY14 FY15 FY16 FY17 FY18
1 Living at Home 10,691 10,309 15,083 16,660 13,428 14,115 14,689
2 ICF/DD after 6/15/11 27 41 131 221 195 219 234
3 ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) 695 919 1,079 1,393 1,479 1,499 1,374
3a DD PAS 10 12 9 9 10 10 9 9
3b DHS 1243/1238 229 520 700 1055 1174 993 962
3c EFE Form 432 363 331 290 262 178 175
3d OSG Request 7 6 5 4 1 299 209
3e Other Guardian Request 15 21 34 34 32 20 19
4 # At End of Fiscal Year 11,413 11,269 16,293 18,274 15,102 15,833 16,297

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

Additions Additions in FY13 Additions in FY14 Additions in FY15 Additions in FY16 Additions in FY17 Additions in FY18
Individuals in ICFs/DD on 6/15/11 351 243 329 120 349 3
Individuals in ICF/DDs after 6/15/11 16 94 70 34 36 34
Individuals in Community Settings 47 5,029 2,186 2,250 2041 1693
Total Additions 414 5,366 2,585 2,404 2426 1730
Removals Removals in FY13 Removals in FY14 Removals in FY15 Removals in FY16 Removals in FY17 Removals in FY18
Individual Moved Out of State 35 15 13 311 74 83
Determined Clinically Ineligible 18 21 8 56 23 29
Determined Financially Ineligible 11 6 3 34 2 2
Withdrew-Reason Not Given 153 124 98 443 121 109
Individual Deceased 35 13 450 89 54 63
Objector 1 1 0 0 0 0
Other 6 3 0 3,237 939 713
Incorrect SSN (Duplicate Record) 17 0 6 36 13 7
Ineligible Setting 26 54 13 7 0 1
Unable to Locate Individual 167 74 54 1,257 224 271
Stay in ICFDD 89 31 47 52 20 93
Submitted in Error 0 0 1 13 0 0
Move to ICFDD 0 0 0 57 56 35
Total Removals 558 342 693 5,592 1526 1406

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.

Note: The reported increase in the number of removals during FY16 is due to an enhancement to the DDD's database which now enables updates to regularly and automatically identify individuals who have been closed on the PUNS waiting list. This enhancement has captured closures not previously identified in the prior fiscal years. The PUNS Integrity Project and the continued automated sweeps of PUNS are both factors in the reported reductions.

Services for Class Members in ICFs/DD

The DDD informed 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. ISC agencies report to the DDD on a monthly basis progress made in assisting the individuals with their options.

# Target Dates from Consent Decree: 12/31/13 12/31/15 12/31/17 12/31/18 Cumulative Total to Date
1 # of Class Members With Waiver Capacity Award Letters 610 685 137 10 1442
2 *Total Class Members Who Have Moved to Waiver Services (per billing data) 598 682 149 8 1437
2a Subtotal Who Received CILA Services 583 676 143 8 1410
2b Subtotal Who Received HBS Services 12 6 6 0 24
2c Subtotal Who Received CLF Services 3 0 0 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 (923) 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

Seven 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 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 PUNS Selection Data & Ligas PUNS Selection Data.

# Ligas Benchmarks Total
1 # of Class Members Selected From The Waiting List (PUNS). 5924
2 # of Class Members in ICF/DDs after 6/15/11 who were part of a downsizing 121
3 Total Class Members With Waiver Capacity Award Letters 3622
4 Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers) 3590
5 Total Class Members Who Have Received Waiver Services (per billing data) 3563
5a *Subtotal Who Received CILA Services(per billing data) 851
5b *Subtotal Who Received HBS Services(per billing data) 2707
5c *Subtotal Who Received CLF Services(per billing data) 5

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 and completed outreach activity in all areas of the State. CQL's contract ended on January 31, 2016.

# Action FY12 FY13 FY14 FY15 FY16 FY17
1 Total Potential Class Members pending contact 2620 590 0
2 # with Initial Phone Contact 546 1272 1625
3 # Choosing Not to Meet w/Outreach Contractor 393 941 1281
4 # Choosing not to Meet at this time, but Want Future Contact 29 32 0
5 Total # Choosing to Meet w/Outreach Contractor 124 299 341
5a # Persons Completed Written Request for Community Services Through Outreach 32 83 127
5b # Undecided 18 36 30
5c # Pending 13 46 0
5d # Choosing ICF/DD 61 134 184

Transition Service Plans

An initial version of a standardized format and accompanying instructions was developed with input from the Monitor, Plaintiffs Counsel, ISC agencies, and other advocates throughout the system. Two ISC agencies piloted the draft process and materials with Class Members and providers in their areas. These two 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 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 ISC agencies was held on April 16, 2013. This statewide training session was then followed with local training sessions for small groups of 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 ISC agencies for use with individuals who moved prior to statewide implementation of the Transition Service Plan format.

# Action Total Plans Completed
1 # with Transition Service Plan Completed 1915
2 # of Modified Transition Plans Completed 434
3 Total to Date 2349

(Note: Effective January 1, 2018, Ligas Class Members were required to complete the Transition Plan process through the completion of the Discovery Tool, Personal Plan, and Implementation Strategy.)

Crisis Services

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

# Action FY12 FY13 FY14 FY15 FY16 FY17 FY18 Cumulative Total to Date
1 Total # of Crisis Requests Received 343 298 424 486 504 467 373 2,895
2 Total # of Class Members Approved 290 274 397 461 482 447 339 2,690
2a # of Class Members Approved for CILA 205 162 217 283 312 263 265 1,707
2b # of Class Members Approved for HBS 85 112 180 178 170 184 74 983
3 Total # of Class Members Who Received Services 288 269 397 460 479 447 337 2,677
3a # of Class Members Who Received CILA Services 203 159 217 282 310 263 263 1,697
3b # of Class Members Who Received HBS Services 85 110 180 178 169 184 74 980
4 Total # of Class Members Denied Crisis Approvals 53 24 27 25 22 20 34 205

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.
# Action FY12 FY13 FY14 FY15 FY16 FY17 FY18 Cumulative Total to Date
1 # of Agreements Initiated 9 16 22 13 2 0 3 65
2 Total # Licensed Capacity 144 486 340 238 32 0 48 1288
3 Total # of People to Move 117 406 278 202 24 0 32 1059
3a *Moved to CILAs 113 381 266 191 22 0 31 1004
3b *Moved to HBS 0 0 0 0 0 0 0 0
3c *Transferred to Other ICFs/DD 4 3 8 4 0 0 0 19
3d *Other 0 22 4 7 2 0 1 36
3e *Move Pending 0 0 0 0 0 0 0 0

Note: Numbers and outcomes are recorded in the Fiscal Year in which the agreement was initiated.

Eligibility Appeals

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

# Action FY12 FY13 FY14 FY15 FY16 FY17 FY18 Cumulative Total to Date
1

Total Class Members Submitting Appeals

(Rows 2,3,4,5 = Row 1)

 57 57 40 50 49 44 57 354
1a Crisis Appeals N/A 16 17 23 23 12 34 125
1b Eligibility Appeals N/A 41 23 27 26 32 23 172
2 Subtotal Appeals Upheld 9 22 6 18 19 9 13 96
3 Subtotal Appeals Denied 29 18 15 27 19 28 39 175
4 Subtotal Appeals Pending 0/Returned 6 17 11 13 2 6 6 2 57
5 Subtotal Appeals Withdrawn 2 6 6 3 5 1 3 26

Division of Developmental Disabilities - Ligas Estimated Cost

Projection updated August 2018

FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY 19 Est
PUNS Placements $16,150,533 $49,250,644 $69,943,708 $80,514,365 $93,382,207 $111,557,781 $131,791,876
CILA (includes Residential, Day and ISSA) $3,350,904 $11,930,742 $21,908,832 $28,448,960 $32,961,342 $39,676,667 $46,178,537
Home Based Support Services (includes ISSA) $12,799,629 $37,319,902 $48,034,876 $52,065,405 $60,420,865 $71,881,114 $85,613,339
Transitions from ICF/DD's
$12,448,318
$33,481,751
$57,030,058
$73,798,698
$79,628,341
$88,579,504
$92,077,553
CILA (includes Residential, Day and ISSA) $12,231,062 $33,083,789 $56,541,429 $73,187,640 $78,886,167 $87,694,939 $91,149,997
Home Based Support Services (includes ISSA) $217,256 $397,962 $488,629 $611,058 $742,174 $884,565 $927,556
Net ICF/DD Change -$11,873,366 -$27,210,233 -$50,207,670 -$56,372,906 -$63,168,888 -$55,865,055 -$45,404,506
Staffing and Contract Costs
$329,550
$ 2,039,176
$ 5,465,264
$ 7,144,893
$ 8,214,838
$ 6,259,166
$ 6,629,066
$6,629,066
Court Monitor $ 142,618 $ 182,367 $ 175,788 $ 189,300 $ 207,544 $ 213,250 $ 213,250 $213,250
Personal Services $ 186,932 $ 1,239,834 $ 1,504,825 $ 1,601,574 $ 1,629,774 $ 1,629,774 $ 1,629,774 $1,629,774
HBSS Fiscal Intermediary Costs $ 441,975 $ 1,269,150 $ 1,624,400 $ 1,743,900 $ 2,005,100 $ 2,375,000 $2,375,000
Independent Service Coordination (ISC) $ 514,336 $ 497,048 $ 497,048 $ 497,048 $ 497,048 $497,048
Pre-Admission Screening $ 933,665 $ 1,683,247 $ 1,663,994 $ 1,663,994 $ 1,663,994 $1,663,994
BIP Services on PUNS database $ 307,364 $ 1,771,368 $0
Outreach $ 175,000 $ 700,000 $ 721,000 $ 180,250 $0
Family Advocacy Initiative $ 266,700 $ 400,000 $ 400,000 $ 250,000 $ 250,000 $250,000
Transition Service Planning $ 100,800 $ 120,960 $ 120,960 $0
Total $329,550 $18,764,661 $60,987,426 $83,910,989 $106,154,995 $116,100,826 $150,901,296 $185,093,989

Notes:

FY18 rates have been adjusted for the DSP 75 cent per hour increase (effective 8/1/2017)

FY19 rates have been adjusted for the DSP 50 cent per hour increase (effective 7/1/2018)

HFS has recently changed the DD LTC (i.e. ICFDD) payment and reporting to a web-based system. This has temporarily interrupted DHS

access to traditional production reports. Therefore, the ICFDD liability is subject to further adjustments at a later date.

Additional Budget Related Information

ICFDD Service System Cost

Overall spending for the ICFDD system is described below:

FY12 FY13 FY14 FY15 FY16 FY17 Est FY18 FY19 Est.
Cost in Millions $382.8 $370.9 $355.6 $332.6 $326.4 $319.6 $326.9 $337.4
Change from Prior Year $-11.9 $-15.3 $-23.0 $-6.2 $-6.8 $7.3 $10.5
Average Persons 6,244 6,136 5,702 5,184 4,984 4,833 4,764 4,764
Change from Prior Year -108 -434 -518 -200 -151 -69 0
Change from FY12 $-11.9 $-27.2 $-50.2 $56.4 $-63.2 $-55.9 $-4504

Source: Est. Liability per HFS Reports. DHS Budget Office.

Adult Waiver Services

Adult Waiver "Accepted Claims" is described below:

FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 Est.
Adult Waiver Claims (millions) $553.3 $595.3 $658.3 $710.6 $748.6 $762.8 $780.3 $803.8
Change from Prior Year $42.0 $63.0 $52.3 $38.0 $14.2 $17.5 $23.4
Unduplicated Persons 17,607 18,621 19,509 20,512 20,797 21,205 21,805 22,405
Change from Prior Year 1,014 888 1,003 285 408 600 600

Source: Accepted Claims Reports (Mobius)

DD CILA Waiver Services

A subset of Adult Waiver services, spending for CILA services, including residential, day and ISSA is described below:

FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 Est.
DD CILA Services Billings (millions) $462.1 $498.9 $546.9 $593.5 $619.8 $624.2 $651.8 $684.4
Change from Prior Year $36.8 $48.0 $46.6 $26.3 $4.4 $27.6 $32.6
Authorized CILA Persons 9,515 10,038 10,441 11,243 11,410 11,430 11,389 11,489
Change from Prior Year 523 403 802 167 20 -41 100

Source: Billing System & Authorized Client Report

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 updates are posted on the DHS website at: Ligas Implementation Plan and Plan Updates.