April 4, 2019 - Illinois Interagency on Early Intervention

Audience

Open to the general public.

Time

10:00 am to 1:00 pm

Location

Illinois Primary Healthcare Association
500 South Ninth Street - 2nd Floor
Springfield, Illinois

Agenda

• Call to Order
• Introduction of Council Members
• Approval of January 10, 2019 Draft Meeting Report
• Early Intervention Central Billing Unit
• Lead Poisoning Eligibility Workgroup Update
• Tele-Practice Workgroup Update
• Council Fiscal Workgroup Update

• Inclusion Re-Convene Update
• Annual Performance Report (APR)/State Systemic Improvement Plan (SSIP) Update
• Ongoing Updates
  • IMPACT
  • Service Delivery Approaches (SDA) Workgroup Recommendations
  • Cornerstone
  • Budget Update
  • Bureau Update
  • Digital Signatures
  • Service Delay Reporting Updates
• Adjournment of Meeting

Meeting Report

Attended

• Karen Berman, Ounce of Prevention Fund, Advocate Representative
• Bob Cammarata, ICG Health Care Services, Provider Representative
• Fran Collins, IDHS, Division of Developmental Disabilities
• Kisha Davis, IDHS - Child Care
• Benny Delgado, Leaps and Bounds Family Services, Inc., Provider Representative
• Kristy Doan, IL State Board of Education
• Ann Freiburg, IDHS, Bureau of Early Intervention
• Margaret Harkness, IL Council on Developmental Disabilities
• Vicki Hodges, ISBE, McKinney-Vento
• Ginger Mullin, IL Dept. of Public Health
• Lori Orr, Governor's Office of Early Childhood Development
• Rita Wahl, CFC 20 Program Manager
• Therese Wehman, Elmhurst College
• Angel Williams, IL Dept. of Child and Family Services
• Michelle Baldock , IL Dept. of Insurance
• Amy Zimmerman, Legal Council for Health Justice, Advocate Representative

Excused

• J. Diane Adams-Alsberry, CALM, Inc., Provider Representative
• Teresa Bertolozzi, Parent Representative
• Meghan Burke, Parent Representative
• Kelly Cunningham, IL Dept. of Healthcare & Family Services
• Melissa Ehmann, Parent Representative
• Donna Emmons, Head Start Representative
• Dee Dee Lowery, CFC 1 Program Manager
• Rosie Perez, Parent Representative
• Kathy Schrock, Easter Seals DuPage & Fox Valley
• Ralph Schubert, Division of Specialized Care for Children (DSCC)
• Lynette Strode, IL Assistive Technology Program, Provider Representative
• Becca Trevino, Parent Representative
• Constance Williams, Ph.D., IDHS, Division of Mental Health

Council Packet

1) Call to Order

Benny Delgado called the meeting to order at 10:06am and welcomed new members.

2) Introduction of Council Members

Council Members introduced themselves and their agencies/roles on the Council.

3) Approval of January 10, 2019 Draft Meeting Report

Bob moved to approve the report. Therese seconded. Minutes approved.

4) Early Intervention Central Billing Office

Arkeitha Monroe presented information on the work completed at the Central Billing Office (CBO). Council and audience members received a handout that summarized the information. Major activities include: coordination of insurance benefits, claims processing, waiver and exemption determination, insurance billing, voucher preparation, family fee collection, mail management, provider refund collection, Medicaid billing, webmail and help desk services, technical assistance, provider enrollment, report generation and website maintenance. She then reviewed items of interest for various stakeholders on the CBO website. There are 24 individuals who work at the CBO. Bob commented that he has appreciated the Partners' presentations as he has learned something new each time. Ann and Arkeitha provided more information about help desk services and ticket resolution. Arkeitha also explained more about their role in family fee invoicing and collection. Ann provided additional detail about how much is collected through fees and that electronic payments for family fees are on the horizon.

Amy asked about provider use of the CBO's insurance billing services. Arkeitha didn't have the current number of providers who are using this service but did share how CBO markets the program to providers. Lori clarified that providers must start with the billing unit prior to their first visit with the child/family. Amy asked about the capacity of the unit. Arkeitha said that there are many variables that impact capacity as not all providers use the unit for all of their billing, not all providers have the same caseload, etc. Bob feels that there is no disincentive to use the free service provided through the CBO for early intervention billing. Benny encouraged everyone to spread the word about the service and to think about other ways to promote its use. Benny also asked Arkeitha to think about how the Council might be able to help the CBO. One idea shared was having CBO representation at the various professional association conferences.

5) Lead Poisoning Workgroup Update

Amy shared that the workgroup will be reconvened in June 2019. An additional CFC (#9) has been added to the lead pilot. Amy shared her gratitude for the trainers who are working with all the pilot sites. A video for parents will be made soon to help families understand child development and their role in the process. Hoping this will set the tone for what EI visits should look like. As part of this work, EITP provided a DAYC-2 training for CFC 9 providers. Have also completed a Reach Out and Read (ROaR) training for those involved in the pilot work. Through ROaR, they are able to provide 10 books for families at approximately $30/family. Experiencing some difficulty getting families to participate in the pilot. Main challenge has been getting appropriate BLL confirmation. The rules for Public Health's work related to lead were adopted shortly after the last Council meeting. Legislation for EI eligibility has also been introduced (SB 155). Ginger said that there may be opportunities to work with public health/family case management to improve lead and hearing evaluations through outreach. She added that many of these programs have, however, experienced funding and staff shortages. Many public health programs may have interns starting this summer. Benny is wondering if there is need for a workgroup of the Council to help with outreach.

6) Telehealth Workgroup Update

Bob says there are four main areas of reporting. Meghan shared at the last meeting that she was putting together a study to learn about parental knowledge of telehealth. A focus group to collect information was recently completed in the CFC#20 area. Rita shared some insights from that meeting. Workgroup is interested in promoting awareness and gathering feedback. Checked on state perspective regarding telehealth, but it has been difficult to get the information from the HFS workgroup. Working to educate provider community is a focus. Two sessions have been prepared to help with this. Secondary purpose of presentations has been to collect feedback. Notes are being taken for future consideration by the workgroup. Ann worked on information needed for decision-making. Workgroup will begin addressing these items during their next meeting. Plan to do more follow up with Missouri and Maine regarding their efforts related to telehealth. Information was shared at the CFC#10 gathering about an internet provider offering free internet service to families eligible for SNAP. Kathy shared some notes about her agency's telehealth experiences with the workgroup.

7) Council Fiscal Workgroup Update

This group was convened to anticipate future financial needs of the program. Advocates asked for $25M for early intervention over the next few years. $7M is proposed in governor's budget for next year. Items discussed within the group included a new data system, a rate increase for providers, enhanced compensation for service coordinators, and reflective supervision for providers and service coordinators. There is current legislation proposed for a rate increase for providers. Karen urged all Council members to think about the top 3 anticipated needs for strengthening the system. Amy shared that across the state, there has been a decline in Medicaid and CHIP use. She has asked Ann to see if a similar decline is being seen in early intervention. Ann is exploring reasons for this change, but Amy suggests that we may need to be thinking proactively about ways to address this if there is a decline. Benny mentioned that many immigrant families are concerned about continued use of Medicaid and other public resources due to public charge changes. Amy and Karen talked about information that has been developed to help families understand their rights. Benny reminded everyone that many of these messages will need a variety of formats, e.g. different languages, videos, etc. to be effective. Lori suggested that the information currently available be shared with early intervention stakeholders. She also suggested that a more formal presentation about PDG be offered at the next Council meeting.

8) Inclusion Reconvene Update

Karen gave some background about the Inclusion Summits and the recent convening of the Early Learning Council's (ELC) Inclusion Subcommittee and the Early Childhood Least Restrictive Environment workgroup. The recent meeting focused on current work of the groups and the opportunities that may be available with current state efforts. An inclusion informational sheet is available via the ISBE website. A group recently worked with Child Care Aware to look at availability of high-quality childcare and potential demand by families whose children have IFSPs/IEPs. Recommendations have been made to IDHS about potential opportunities to explore via the Child Care Development Fund. There may be opportunities for the Council to help with moving much of this work forward. Benny shared that, as a provider, he feels an obligation to work on children's inclusion in their communities right from the start in order to fully embrace the concept of natural environments.

Angel talked about the challenges related to hard and soft expulsions from childcare. Kristy reminded Angel about the benefits of accessing the Pyramid work. Lori added that there are ongoing efforts related to the Pyramid work and the suspension/expulsion legislation that may help with these challenges in the future. People can comment on the ISBE rules for this legislation through 4/8. Karen is happy to share this information with those who are interested. The Act and proposed Rules are available on the GOECD website.

9) Annual Performance Report (APR)/State Systemic Improvement Plan (SSIP) Update

APR was submitted timely on February 1st. Still waiting on the Office of Special Education Program's (OSEP) comments. Part C's clarification period is 4/4-4/18. SSIP was submitted timely on April 1st. There is usually a call with OSEP after they have had time to review. We submit our SSIP report as an attachment via GRADS system. Provided an update as to our progress on our two coherent improvement strategies. The report will be share with stakeholders soon. Ann informed the council that she hoped to reconvene the larger stakeholder group in the next couple of months. It appears that SSIP will continue beyond the initial five-year period, so we will need to talk about scale up soon.

10) Ongoing Updates

1. Illinois Medicaid Program Advanced Cloud Technology (IMPACT):
   There is a glitch related to tax IDs for new enrollees that is currently being addressed. Bureau staff attended a couple of meetings regarding the audit of the IMPACT system.
2. Service Delivery Approaches (SDA) Workgroup Recommendations:
   Update available in the Council packet. Ann apologized for the delay. She missed an update in October 2018 due to the CFC rebids and in January because of the focus on APR.
3. Cornerstone:
   Have received approval to develop a Request for Proposal (RFP) for an EI data system. Department of Innovation and Technology (DoIT) requires that it is a web-based system. Ann has asked for stakeholder input once RFP is more formalized. Karen asked if information can be shared with the ELC's data, research, and evaluation committee to see if the proposed system could meet anticipated needs. Amy asked about a new system's ability to interact with other child-serving systems. Ann says she is planning to include language regarding the system's interactivity and export/import capabilities. Ann hopes to have something to share in July. There are multiples steps in the governance process. Karen asked about our current financial support of Cornerstone. Ann clarified that we don't contribute to the cost of Cornerstone, so she is uncertain what a new data system and its support will cost. Karen asked how Council members can support efforts to obtain the system that we need. Ginger asked about the sun setting of Cornerstone and how it will impact the procurement process. Many factors impact the timing of implementation, so Ann is hesitant to offer a timeline as to when a new system would be operational. Amy suggested that the RFP include options for user-testing. Karen asked about a small group from the Council meeting with Ann and DoIT to review decisions to be made. Ann will check with DoIT regarding options for information sharing.
4. Budget:
   Ann said that it is unclear what the $7M in the proposed budget is intended to address. She drew people's attention to the caseload and Medicaid information in the packet. Ann looked at the 618 data to see if race/ethnicity participation has changed over time. Looking at FY15-FY18, the proportions haven't changed much. Karen asked about racial disparities in service delivery being a topic for future Council discussion. Ann said that it is difficult to fully reflect when contract payments are being made as payments are somewhat dependent on the timing of contractors' submission of reports.
5. Bureau Staff:
   Still working with personnel on Bureau's fiscal position.
6. Digital Signatures:
   IDHS security office has responded. Question is moving along to IDHS legal. There appear to be some options that are available if IDHS legal approves.

11) Service Delay Reporting

No new information to report, but Bureau staff are still working on this. Karen asked if Carol and Kay could be included on the next agenda to discuss the efforts they have undertaken in their area. Amy asked about secondary reimbursement process. Ann directed her to the wording in the Council packet as this is what will be included when the new CFC Procedure Manual is released. Hope this is released by May 1st. Amy asked about inclusion of related forms/messaging items and if these can be shared as well. She also asked about requirements related to CANTS check and IMPACT enrollment and their inclusion in the process. Will this be a barrier to providers participating? Benny doesn't feel that this would be prohibitive as many will already be enrolled. Bob asked that a cover sheet highlighting changes be included with the release of the new manuals, and Jenni stated that this is already in development.

12) Adjournment

Karen motioned to adjourn the meeting and Bob seconded. The meeting adjourned at 1:01 pm.

Contact Information

Jenni Grissom
IDHS - Bureau of Early Intervention
823 East Monroe Street
Springfield, IL 62701

Ph: 217/524-1596

Email: jennifer.grissom@illinois.gov

If you are need of special accommodations, please email or call Jenni Grissom.