July 10, 2014 - Quality Care Board Meeting

Audience

Open to the Public

Date

Thursday, July 10, 2014

Time

2:00 pm

Location

Teleconference

Phone #: 888-494-4032 Access Code: 1469835118

Minutes

Present: Susan Keegan, Chairperson; Thane Dykstra; Untress Quinn; Ginny Conlee; Neil Posner; Inspector General Michael McCotter; Deputy Inspector General Robert Furniss; and Chris Milbrandt

1. Update regarding the new fiscal year, especially with regard to gaining additional staff

IG McCotter stated we will not be getting any of the new staff that we requested. We have made changes by realigning some of the bureaus. The bureau chief position in southern Illinois is vacant. In the meantime, the Bureau Chief of Central Investigations, Bill Diggins, is overseeing that bureau in addition to his own. We have also temporarily assigned Jim Nesler as Acting Bureau Chief for southern Illinois.

2. UPDATE - Governor's Budget Address - Impact on OIG

This agenda item coincides with #1. We are expecting retirements of investigative staff this year. Our caseload and number of hotline calls have risen. We had a fiscal year total of 4,438 calls in Rule 50 and Rule 51 cases. In FY14, we received over 3,500 in Rule 50 cases alone.

Question: Can you revise your investigative protocol? Three out of the four investigators we hired are doing a good job. We need help in the northern bureaus. We are looking at changing our protocols and finding ways to work more efficiently. We are also looking at the agencies doing some of the investigations for us. Is there a way we can deflect the minor cases back to the agencies - involving something that a staff member shouldn't have said. Cases that don't rise to the level of mental abuse. There were 660 of these types of cases last year.

Realignment - Our Cook and Metro Bureaus have the highest volume of cases. The Northern Bureau investigators have begun typing up the cases that have been completed by the two bureaus. We have redrawn the boundaries. The investigators are taking on a significant amount of Cook County. Since the Northern Bureau's numbers are manageable, the investigators have been very helpful.

The workload has gone up. According to the hotline, this is a record year for receiving non-reportable calls. Something else that will affect us is the financial exploitation bill. We will be getting more of those cases and they will be registry reportable.

Question: Aren't those police matters? Some of these the police won't take. People can be placed on the Health Care Worker Registry.

Question: Do your investigators do their own clinical work? Yes.

Question: Is there some way they can dictate to a steno pool? We only have four clerical staff and five investigative bureaus. I don't think they can do that. We have equipped the investigators with laptops. IG McCotter indicated that we are going to have to try to hire temporary people. He has asked the investigative staff to concentrate on the backlog. He has been hearing rumors that certain people want to retire.

IG McCotter will check on the applications that you can speak into and it will type for you. It would free up investigators' time if they didn't have to type up their reports.

Chairperson Keegan asked if there is anything that we, as a Board, can do. IG McCotter responded that at this point in time, he didn't think so because of the budget. Chairperson Keegan stated that at least we could make a record that we don't have enough investigators and the ones you have are spread thin. IG McCotter stated that everyone's hands are tied.

Chairperson Keegan stated that we make record of that additional staff were not given to OIG because of budget constraints. IG McCotter will forward the information to Susan that he sent to Secretary Saddler when OIG requested the additional staff. Chairperson Keegan also requested information on our current situation, growth in reporting over the last couple of years, how the volume is increasing, etc. Ginny motioned that record be made. Thane seconded the motion. Chairperson Keegan called a motion asking for approval to send a letter. A letter will be drafted and we will get input on it. All in favor. Motion carried.

3. Review of redacted cases

DIG Furniss stated that we have done this in the past. We used to do them by categories: Physical abuse, neglect, death, egregious neglect. If there is a certain category of cases, let us know. Chairperson Keegan stated we just want a sampling.

How far in advance of the meeting do you want these? How about a couple of weeks? OK. They will be sent out on a quarterly basis.

4. Annual Report - Status report and preliminary trends for past fiscal year (even though it is not finalized)

IG McCotter stated that the Annual Report is not to be completed until the end of the calendar year. The report doesn't come out until the end of the calendar year. Chairperson Keegan wants to make sure our January meeting is after it is sent out. IG McCotter stated we can send you a copy of what we send to the printer.

5. UPDATE - Review any revisions to the investigative directives for the OIG, per the April 2014 meeting minutes

Question: Have we had any revisions to the investigative directives? No. There may be a distribution within the next couple of weeks. When Lois gets a distribution out we will send them to you at that time.

6. UPDATE - Review any revisions to policy and protocols for investigations of alleged abuse and neglect per the Quality Care Board statutory mandate.

Chairperson Keegan stated for us to send the distribution to the Board at the time they are sent out.

7. UPDATE - Schedule a Board participation or observation of a training activity per the Quality Care Board statutory oversight.

Everyone on the Board needs to observe a training activity. We are getting a current training schedule out to you for the rest of the year. Deb DiLello is over training.

8. UPDATE - Schedule Board participation in a facility inspection per the April meeting discussion.

Chairperson Keegan wants information, for the record, why it is not possible for them to attend a facility inspection. The Board feels it is not allowing them to fulfill their oversight function. IG McCotter stated that he will give them the site the information is located.

9. UPDATE - Review current policies concerning methods for improving the intergovernmental relationships between the OIG and other State and federal offices.

Illinois State Police Agreement and Department of Public Health Agreement - Chairperson Keegan stated she noticed that all of the ISP notices go to Michelle. She was wondering if IG McCotter should also get notices so we have them right away. IG McCotter stated we already get them.

Question: Are these agreements working? Yes. I think there were some tweaks made. It works well. When ISP takes a case, they delay the completion of our case until they complete their case. The last audit didn't reveal any problems.

In terms of Public Health issues, the issue was that they have their own statutory deadlines for conducting and completing investigations. There was concern how it would be regarding cross purposes. They recognize we have a job to do. It hasn't been a problem. If something comes up, we lay low. Public Health has seven days to finish their investigation.

DIG Furniss stated that we did come up with a new way of instructing our investigative staff. If we develop credible evidence of physical or sexual abuse, the investigator will inform the bureau chief and the bureau chief will inform the facility so they can remove the staff from the count.

Question: Why don't we tell them what to do? We don't get involved in disciplinary matters. We don't have the authority. We can't tell them to discipline or fire anyone.

Chairperson Keegan stated that we have to be direct and tell them you have to follow your procedures that are in effect. Most facilities aren't going to ask us what are we going to do now. They know exactly what they are supposed to do.

10. Approval of April 10, 2014 meeting minutes

Motion to approve the minutes - Neil

Motion seconded - Thane

All in favor

Minutes approved

11. Miscellaneous issues/questions

Next Quality Care Board meeting was changed from November 13, 2014 to

October 23, 2014 at 2:00 p.m. by teleconference.

Chairperson Keegan reviewed what was decided during the meeting:

Mike was going to send the QCB the letter with respect to staffing and fill in some of the budget numbers and number of cases that have been going up
Redacted cases a couple of weeks prior to our meetings
Send the Board new directives as we amend them
Revisions to policies and protocols as they are amended
Someone is going to send the legal case and an opinion
If the two interagency agreements are updated, give the Board copies