Open to the general public.
10:00 am to 1:00 pm
Moraine Valley Community College
9000 College Parkway, Building M
Palos Hills, Illinois
- Call to Order
- Introduction of Council Members
- Approval of April 4, 2019 Draft Meeting Report
- Lead Poisoning Eligibility Workgroup Update
- Early Intervention/Home Visiting Convening Update
- Tele-Practice Workgroup Update
- Council Fiscal Workgroup
- Access to Services Report Out
- Ongoing Updates
- Digital Signatures
- Service Delivery Approaches (SDA) Workgroup Recommendations
- Service Delay Reporting Updates
- Adjournment of Meeting
Karen Berman, Ounce of Prevention Fund, Advocate Representative
Meghan Burke, Parent Representative
Bob Cammarata, ICG Health Care Services, Provider Representative
Kisha Davis, IDHS - Child Care
Benny Delgado, Leaps and Bounds Family Services, Inc., Provider Representative
Ann Freiburg, IDHS, Bureau of Early Intervention
Margaret Harkness, IL Council on Developmental Disabilities
Vicki Hodges, ISBE, McKinney-Vento
Dee Dee Lowery, CFC 1 Program Manager
Ginger Mullin, IL Dept. of Public Health
Lori Orr, Governor's Office of Early Childhood Development
Rosie Perez, Parent Representative
Kathy Schrock, Easter Seals DuPage & Fox Valley
Ralph Schubert, Division of Specialized Care for Children (DSCC)
Therese Wehman, Elmhurst College
Angel Williams, IL Dept. of Child and Family Services
Amy Zimmerman, Legal Council for Health Justice, Advocate Representative
J. Diane Adams-Alsberry, CALM, Inc., Provider Representative
Michelle Baldock, IL Dept. of Insurance
Teresa Bertolozzi, Parent Representative
Fran Collins, IDHS, Division of Developmental Disabilities
Kelly Cunningham, IL Dept. of Healthcare & Family Services
Kristy Doan, IL State Board of Education
Melissa Ehmann, Parent Representative
Donna Emmons, Head Start Representative
Lynette Strode, IL Assistive Technology Program, Provider Representative
Becca Trevino, Parent Representative
Rita Wahl, CFC 20 Program Manager
Constance Williams, Ph.D., IDHS, Division of Mental Health
- Draft Council Meeting Report - April 4, 2019
- Service Delay Maps
- Early Intervention Program Caseload Summary Report
1) Call to Order
Kathy called the meeting to order at 10:05am.
2) Introduction of Council Members
Council Members introduced themselves and their agencies/roles on the Council. Kathy brought up the recent announcement of the rate increase and wanted to thank all those involved in that work.
3) Approval of April 4, 2019 Draft Meeting Report
Therese moved to approve the report. Bob seconded; meeting report approved. No changes were recommended for this report.
4) Lead Poisoning Workgroup Update
Amy Zimmerman distributed handouts regarding auto eligibility for lead exposed children. Amy was excited to mention that legislation was passed during session to include Lead exposure as an auto-eligible EI condition. Amy was thankful to everyone who assisted in making this happen. By SFY2021, rules will need to be place for implementation. During the pilot completed by CFC 1, 7, & 9, referrals for children with lead exposure had a good number of referrals, but there were low numbers in in terms of families taking advantage of EI services. While 27 families are receiving services, only 12 are in the pilot. Erikson Institute is performing a review for quality of services with families of children exposed to lead.
Amy also worked with Illinois Department of Public Health (IDPH) and the majority of referrals to the pilot are coming from IDPH. Amy stated a service guidelines document is under development and will be shared with providers. Additionally, a survey regarding Lead Exposure will go to council workgroup; Benny Delgado also agreed to send to Illinois Developmental Therapy Association members. Amy also would like to develop a short video for providers of what EI services to children with lead exposure could look like.
Those interested in completing survey may contact Amy Z. directly. Amy is also working on creating a survey with or for IDPH and Medical Providers. Handouts from Amy showed preliminary maps for the pilot CFC areas for children with blood levels of 5 or higher. Amy researching the feedback from the pilot CFCs and the challenges faced with engaging families not interested in EI services. Amy stated there is still a lot to do as a council. Kathy thought it was good to see what families have to say about why they did not take advantage.
5) Early Intervention/Home Visiting Convening Update
Karen Berman asked if we posted shared items (by council members) which EITP confirmed had been shared. Ounce of Prevention completed a survey on dual services with EI Providers and home visitors, while the Bureau of EI completed a survey with CFC Program managers and Service coordinators. Trying to implement systemic changes to referrals to/from each program. Karen believed it was important to not only complete a survey, but to also provide feedback on survey results. A summary was developed and disseminated to CFC Managers, posted in the Quarter 4 EITP newsletter and are on the EITP website. A subcommittee, which includes Chelsea Guillen and Lori Orr, has been formed to meet in the next few weeks to address challenges and possible changes to training.
According to survey results, EI Providers and Home Visiting staff do not have access to information on preservice. EI Training and Ounce are working together to help build cross training to determine the benefit and what information is most critical to each of the programs. Additional information to be shared at next Council meeting. Evaluations are being completed to determine the benefit and what info is the most critical. Hoping for more progress info at next meeting.
Auto referral for post-partum conditions to EI not well known. The Governor's office is looking to post more information about risk factors that are impacting children and make Home Visiting families with young children auto eligible for EI, looking for ways to help families become more comfortable with these eligibility criteria. Karen notes that some changes needed are on the IFSP to add places for more information about supports a family has and prioritize children who are ineligible to be referred to HV, for future contact with family by other providers/home visiting. Looking for meaningful contact with all families not those just in EI. Kathy notes that children who do not meet criteria for eligibility might still need intervention and could be reevaluated in 6 months. Benny notes that his program has reached out to home visiting and they attended a team meeting for shared information/reflection. Providers are sharing resources with families/other providers. This helps support transition goals for families. IDTA is working to measure how families feel supported and if they were provided with resources for future issues. Benny shared a story about working with a family where child had feeding issues, didn't qualify for EI due to these issues, but family history/issues might change that, and additional resources can help address this issue through collaboration.
Ann recommended creating a resource map to have available for EI staff so that when a family mentions a need, staff will have access to all services that are available. We feel this work may be underway from GOECD. Once a Service Coordinator hears a buzz word that lets them know a family might need other resources, they will have easy access to all resources available in that area.
Karen notes that CFCs are aware of Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and already have easy access. MIECHV is working to make services available across the state.
Bob Cammarata noted that EITP included survey result in their last newsletter and that he has had feedback from providers. Providers shared that the only way they are made aware that a family is involved with Home Visiting is if the family chooses to share. Angel Williams asked about ineligible children in the process of transitioning being considered for other services. No referrals have been made at this time. Amy noted that EI should work to engage families with auto-eligible conditions in the easiest way possible, without scaring people away with requests for documentation. Dee Dee Lowery stated that they do not require documentation for families who say have a medical condition, for example, Bi-polar disorder. Amy asked that modifications to the referral form be considered that explains this better. Vicki Hodges noted that in the Southern Region, there was very little awareness of the homeless program and asked if there is information about homeless programs available with the home visiting information. Karen noted that there was not. Karen would welcome the opportunity to serve children who are homeless and noted that we need more data to track this and then determine how to get the word out to families.
Recommendation to look at service delivery models and take into consideration that families are very mobile, and this is a challenge to provide service delivery when families move. Discussion about monitoring visit resulting in a ding for moving from one area to another. Ann requested additional information to follow up.
Vicki noted that in transition, not a lot of school districts take birth to three children into consideration and there needs to be an emphasis on helping all the children in the home.
Nakisha Hobbs introduced herself, shared her job responsibilities and how she is over Early Childhood programs noted, specifically EI and MIECHV. She shared that there could also be connections with the Childcare Assistance Programs (CCAP) and other programs to be sure that families are being offered as many resources as possible as the result of one visit. Kathy noted that the Council would benefit from more information on all the resources/ needs. Vicki shared that the cross training being done has resulted in more families being serviced overall. Ann mentioned that Vicki provided a presentation on the Homeless program and asked if Vicki could provide that same presentation to the Council. Vicki agreed. Mention of other programs to be shared as well. Karen recommended the council review the Child and Family Connections Procedure Manual and Illinois Early Intervention Provider Handbook prior to the next council meeting for additional comments on potential language to support collaboration among programs.
6) Tele-Practice Workgroup Update
Bob stated that there were action steps a few months ago regarding training. A face-to-face with CFC 10 (staff and providers) was completed thanks to Carol Muhammad, CFC Program Manager. Benny also provided a presentation to CFC 20 and provided the PowerPoint of the presentation to CFCs 21 & 23.
Bob had a general feeling that providers were aware of Telehealth. The practice is universally accepted by council. Action steps were provided by Ann on things to be considered prior to implementation. Amy and Julie, law student intern, have an internal document prepared. Bob said nothing is preventing the EI Program from using Telehealth as a method of service delivery. Amy stated that many changes need to be made prior to implementing a pilot and requested to implement a pilot prior to making any changes to legislation. Bob said legally we can proceed, but there was still questions regarding liability insurance. Benny mentioned he spoke with an insurance agent and that policies do not necessarily cover Telehealth; additional coverage may be needed. A question was asked on what if a family or provider were to go out of state, can they still provide services? Bob said that there is still some discussions that need to be done. Bob stated that some providers are covered to perform Teletherapy under their current insurance plans, it just depends on the company. A recommendation was made to speak with Michelle Baldock, the council's insurance representative about this insurance. Kathy said that if a family went to Indiana, the provider would have to be licensed in Indiana. Confidentiality was something else discussed, as far as what documents would have to be developed/signed? Another question was what platform would be used to ensure privacy. Bob said there are already electronic programs in the field that are HIPAA/FERPA compliant. Bob said that some of the programs, charge $20 a month for unlimited use. Amy stated that there are some disciplines that are allowed to do Telehealth therapy per their licensure acts. Pilot may need to be done that are already able to provide services via licensure. Bob stated it would be a good decision to have a discussion. He also thinks we need to move forward with a pilot. Bob asked how we are reporting these discussions. We may need to provide a summarized document, like the guidelines provided by Ann. Bob suggested having a discussion about a summary document prior to next Telehealth meeting. Discussion documentation received from meeting with providers and families, (Meghan Burke). Nine focus groups and how they responded when polled about Telehealth. Once completed, information on results will be shared.
7) Council Fiscal Workgroup
Karen stated she wanted to ensure we are serving all children as required by federal law which included requesting and receiving new funds. Little behind from where they would be but will be sending a request for data to the Bureau of EI for the new data system. Currently working on a graphic with workgroup for presenting at to next council meeting in October 2019.
Karen stated that while EI Providers received a pay increase, how can we better serve CFCs and Service Coordinators regarding caseloads/ salaries; wants to bolster teaming. There was a desire that providers have coaching/reflective supervision and be paid to do this. Request that the next meeting's agenda include a Preschool grant presentation. Finance commission to be convened by Governor's Office and what a fully-funded Early Childhood system would require. Karen stated that there needed to be some thought about if we wanted to serve more children in Illinois and what that would look like. Example as how to reach more families through at-risk categories and service delays. Bob asked questions on what the composition would include. He assumes we are being represented by our Human Service representative? Bob asked what the council would need to do to ensure EI has a place at the Finance Commission's table. Benny stated we as a council should be more persistent in becoming involved. Benny also recommended we address racial disparities. Benny mentioned he had a conversation with a state representative, and they stated that although the EI Program is great, in her district, which is a predominately African-American community, there were no EI Providers nor any willing to come to her district. Nakisha spoke that she is a part of the Early Learning Council (ELC). IDHS is in process of trying to turn things around to gain more communication of Stakeholders. Governor's website has ELC meetings dates/times listed. Lori Orr also shared she is on the ELC and said that there are many things that should be embedded. Therese Wehman asked if the ELC could provide a quarterly update of strategies being done. Nakisha mentioned that the Finance Committee is not a part of the ELC. She went on to say that she would work with Ann to get her updates to share with ELC also.
Kathy said that, in general, she struggles with information sharing and it is overwhelmed; next steps are sometimes lost. Kathy asked if there is any value of council members sharing focus points ahead of time with the council. Ginger said that a committee she sits on has to send out a narrative, so it can be reviewed ahead of time, three weeks in advance, that has a character limit. Amy said she likes the idea of having key points to talk about. Benny recommended that we set one meeting to be extended so we can have all the discussions and get some work done on action steps. Kathy asked if members could have their key (three, no more than four) points, three-weeks ahead of council packet distribution. Then include those points and resolutions on the agenda. Karen asked if Kathy was asking us to be more intentional about discussions? Kathy said that if you are a standing item on the agenda that it is assumed that any information will be shared. Ann said we could send a save-the-date notification, one-month ahead of time to ask if there are any items members would like have on the agenda.
8) Access to Services Report
Carol Muhammad and Kay Komie presenting from CFC 10. Main focus was to see why they were seeing more service delays in some of CFC 10 service areas. Service Coordinators working to get a bottom up approach and how to manage and improve these service delays. Ann came to them several years ago asking if the Bureau would support meeting to discuss concerns and strategies. Others were invited and opened up the meeting so we could look at this more globally, which they agreed and called the workgroup "improving access to underserved early intervention services in underserved communities". The workgroup met quarterly. Carol feels this has had a great impact. One of the most significant challenges was safety for families, providers and Service coordinators. Homelessness and lack of dependable transportation were others. Transportation is a rather underutilized and not a resource available across the geographic area of the CFC/State. There are also many families that have issues with allowing a provider into their home.
A survey was conducted with the help of Chelsea Guillen, to see if safety was truly a concern. They learned that the most significant issue was where the family resided. Nearly 80% of providers said they are serving families outside of the home, but still in a natural environment. Workgroup reached out to the community in search of family-friendly environments. The CFC also experienced Service Coordinator and provider turnover due to not interested in going to certain communities. LIC Coordinator suggested not using the term "safe haven" but rather "community connection". Another strategy specific to CFC 10, was being able to speak to the leader of LaRabida who headed up writing two grants to support these activities, including a small grant from "Lyft" which provided transportation to 25 families a week, in natural environments. Also includes publication addressed to child care to describe EI and the safety they can be assured of when working with EI Providers. CFC 10 also developed communication methods on how to use their voice in volatile situations. EITP focused the annual CFC Conferences on self-care and the lessons learned include sharing your story. Solid resources were also shared with families to ensure they are more involved.
Amy asked if they had to complete a relationship, aka, MOU, with Lyft? She also asked how scheduling was being done? Carol said that there was a developed MOU tool a few years back and they used that to add child care or community centers. Grants also allowed for the ability to sponsor rental space, toys, etc. Carol is hoping to continue these relationships when funding is no longer available.
Margaret Harkness said she used to provide home visiting services and asked how does the HV program determine if a home is inappropriate, for instance, DCFS involvement. Kay said that some families say upfront, you cannot come in my home. Providers will say I cannot come to your area but there is a community center nearby where the family, child and provider can meet. Some families do request services in the home, so alternatives could be something like providers co-treating. As far as DCFS, Service Coordinators and Providers know they are mandated reporters. We also think about other resources, i.e. Social Work, etc. Carol said that they really look at it on a case-by-case basis.
9) Ongoing Updates
In 2020, an additional $7 million was awarded to the EI Program to continue services to Illinois families and additional $5 million awarded to cover pay increase. Ann is working with HFS finalize the rate schedule. The increase should not affect provider billing as providers they should be billing the usual and customary rate. Karen asked if Service Coordinators would be eligible for rate increase and does this go to the CFC as compensation. Ann answered yes. Karen asked the Service Coordinators would get raises. Ann answered that the targeted case management fee and caseload calculations would be revised. However, this is ultimately the decision of the CFC and fiscal agent. Karen asked if the CFCs would be sent a memo directing CFCs to give raises. Ann expressed that each CFC makes a budget and is unsure IDHS can send such a directive. Ann shared that the number of new Service Coordinator requests have sky-rocketed, so contractors are understanding the new performance contracting. Lori asked if a survey could be sent to CFCs regarding how increases and funds will be utilized and what the barriers are for higher salaries to Service Coordinators. Lori asked if provider agencies will absorb increase or if providers will really see that increase. Nakisha noted that they could discuss a possible notice of intent regarding increase and then follow up with a survey to determine if the intent was followed. Benny noted that agencies payees could be provided with the same notice. Benny asked a few agencies and they noted that the providers would be getting the increase. Karen asked Bob if his agency intended on passing on the increase. Bob noted that at this time, he is unable to address questions about how his agency will disperse the increase, as they have not had time to process the information and determine the fiscal impact or how the providers will benefit from the increase. Benny notes that the providers within his agency has been updated and his income has lessened as providers were given a raise. Amy asked if the contract will change based on the rate increase. Ann notes that the base rate information in the contracts will be updated. Ann notes that information on the intent can be shared, but it is the fiscal agent who makes the final decision.
b) Illinois Medicaid Program Advanced Cloud Technology (IMPACT):
Due to an update on Assistive Technology guidelines, this will affect agencies and their ability to enroll as Durable Medical Equipment provider.
Ann has made contact with the IDHS liaison for an RFP for the new data system. The RFP has been forwarded and Ann is awaiting feedback.
Nick Marsters has left his position with the Bureau but assisted with all contracts until complete. The Bureau currently has three open positions at this time.
e) Digital Signatures:
No updates to report. Two IDHS forms for internal use have been added, but unable to obtain further information. Digital signatures will affect Periodic Financial Report signatures.
f) Service Delivery Approaches (SDA) Workgroup Recommendations:
No updates to report at this time.
10) Service Delay Reporting Update
Karen requested a meeting prior to the next meeting of the council in October to discuss Service Delays. Ann referred to service delay maps and shared data information outlined on maps. Ann agreed. Karen asked how many children are waiting for each service in each area and the break down should be by race. Angel noted CFC 11 has the highest rate of services through DCFS. Ginger noted that by breaking down the numbers into that many categories could pose a confidentiality issue. Ann notes that she would look at numbers and see if we need to do this with percentages if needed. Amy noted that the reporting can alter the statistics as well. Ann notes that the information reported also goes to OSEP and that family exceptions are not noted. A meeting will be planned to be held in August. Members who would like to be included on this workgroup are: Kathy, Amy, Karen, and Ginger, and Angel.
11) Other Items
Bob asked about status of Council Membership appointments. Bob shared he was informed by individuals that he had recommended, that the Governor's office has sent verification of receipt of application notifications. Jenni Grissom has reached out to the Governor's office regularly to check in on new appointments. Those appointments are still underway.
Amy asked about procedure manual release. Ann notes that the time frame has passed but they are will be released soon.
Benny motioned to adjourn the meeting and Bob seconded. The meeting adjourned at 1:18 pm.
IDHS - Bureau of Early Intervention
823 East Monroe
Springfield, IL 62701
If you are need of special accommodations, please email or call Jenni Grissom.