PUNS and HCBS Enrollment (2-24-16)

02/24/16 1:30pm Phone conference

Team 3 Members participating 

  • Terry Cremer, Association for Individual Development
  • LeAnndra Keltner, CISA
  • David Ogunbode, CSO
  • Leslie Hart, Day One PACT
  • Carolyn Racki, Day One PACT 
  • Jane Nesbit, DDSME
  • Reta Hoskin, DHS 
  • Teresa Positano, Options & Advocacy
  • Cindy Sullivan, Options & Advocacy 
  • Missy Kichline, Parent
  • Mary Kaye Speidel, SICCS
  • Michelle Tibbs, WISC

DHS staff participating (in addition to Reta Hoskin who is listed on Team 3)

Dara German - Andrea Medley

For Team 3 Celia Feinstein is the facilitator, Jane Nesbit is the chairperson, and Michelle Tibbs is the communicator.

Jane Nesbit welcomed and thanked everyone for participating in the meeting and contributing to the changes to improve the PUNS process.

Reta Hoskin - opening comments

DHS has implemented the first round of changes to the PUNS to be effective 3/1/16. Many of the recommendations were a direct result of the work completed by Team 3. The PUNS tool posted to the DHS website contains some errors (page numbering and the Case Registration pages) and DHS is working to post the corrected PUNS tool to the DHS website. DHS would like Team 3 to discuss and recommend different category labels to alleviate confusion and frustration for everyone. Express PUNS is something previously recommended that could be discussed further. PUNS Outreach and educational opportunities about enrolling in PUNS are high on DHS's priority list. ISC agencies have the cards of information developed under an investment from the Illinois Council on Developmental Disabilities to distribute.

Questions/comments submitted to Team 3 for discussion/clarity

  • The ISC is to schedule a face-to-face meeting for anyone who is not able to understand on the phone.
  • "Express PUNS" option was a previous recommendation from Team 3. Discussion occurred about why DHS requires a PUNS to be completed for people who would not need to be selected from PUNS for services due to having targeted funding. (Example: crisis cases, Ligas, SODC, DCFS).
    • DHS will consider internally if they are able to develop a mechanism for tracking similar information without having the individuals enrolled on PUNS.
    • If another tracking mechanism is not an option, Team 3 will recommend adding to page 1 of the PUNS tool "Expedited" as a reason for the PUNS for these situations.
    • If "Expedited" is added to the PUNS tool, Team 3 will recommend individual/guardian signature not be required for thee opening or closing PUNS.
    • DHS-DDD will check with MIS to discuss the possibility of developing a way for ROCS to recognize once "Expedited" is marked and page 1 is processed, display the next screen containing a list of each targeted funding group with a checkbox next to each. Once that screen has been processed, the PUNS would be complete and the main menu would display. (no other screens would need completed so they would not be displayed).
    • DHS would want to revise the crisis funding packet requirements to remove PUNS printscreen from the list.
  • DHS will be selecting 700 names from PUNS in March, 2016 in order to increase the likelihood of at least 500 individuals entering into services to be in compliance with the Ligas Consent Decree requirement.
  • DHS has made a commitment to the Ligas plaintiff to select from PUNS 50% needing CILA and 50% needing home-based support services. If the PUNS has HBS and CILA both marked, the individual would be able to choose which one he/she needed at the time of the selection. If a person selects HBS, he/she has the right to remain on PUNS if he/she wants CILA within 5 years.
  • Team 2 made a recommendation to DHS to have PAS completed at the time of PUNS enrollment. Discussion will occur next week at the ISC Executive Directors' meeting with DHS. If the end result following that meeting is to move forward with the recommendation, Team 3 will volunteer to revise the section of the PUNS manual to list what constitutes initial assessment for PUNS enrollment (OBRA1, specific assessments/documentation).
  • Team 3 was originally asked to discuss eligibility in terms of Medicaid eligibility discussion with individual/guardian at initial PUNS enrollment meeting.
  • DHS-DDD will discuss with MIS the ability to add a drop down menu next to "Transfer" on page 1 of the PUNS to list all the ISC agencies. The ISC agency would click "transfer" then select the ISC agency transferred to. The receiving ISC agency would not enter the PUNS into their ROCS system until completing the annual update or if PUNS needed updated earlier. The initial PUNS enrollment date would not be lost since the PUNS was transferred and not closed.
  • PUNS may contain needs in more than one category.

PUNS Tool Revisions

  • Page 1
    • "Effective Date (as defined in PUNS Manual)" replaced previous statement concerning the date as requested at the 2/2/16 meeting of DHS, ISC agencies, and Team 3.
    • Add "Expedited" under Reason for PUNS section below "New".
    • All the reasons currently listed were discussed and left as they were.
    • "Unable to locate" is used when an individual/guardian does not respond to contact attempts by phone or mail. "Incorrect Social Security Number" is used when a Social Security Number can't be changed in ROCS.
  • Page 2 - Email address lines will be added for ISC, individual, guardian.
  • Page 3-4 - Client Case Registration Information - not discussed at this time
  • Page 5-8 Categories
    • Team 3 would appreciate suggestions for categories to remove "Emergency" and "Critical" labels. Discussion including Changing the categories to "1, 2, 3" but those would still need to be defined. Another possibility is combing the "emergency" and "critical" categories to "Needs services within one year" and changing the planning category to "Needs Services in 1-5 years". "Expedited" would cover those needing services in less time.
    • Emergency Need out-of-home section- delete #4
    • Critical Need section - delete #12, 13, 15, 19. Combine #14, 16, 18 and revise it to state Person is losing eligibility for children's services and needs adult services.
    • Planning for Need section - delete #4, 5, 6. Combine #9, 10, 11, 12 and revise it to state Person is losing eligibility for children's services and needs adult services.
  • Page 9-10 Discussion occurred about deleting residential supports for settings that would not be able to be selected from PUNS, however those need to be listed to be check marked once placed into services.
  • Page 11 Supports Needed.
    • Replace the Individual Supports Box with "Home-based Support Services".
    • Delete the Transportation section.
    • Leave the Vocational Section.
    • Under Residential Supports, delete the two current items and list Family CILA, Host Home CILA, Intermittent CILA, and 24-Hour CILA

Future agenda

  • Revise the PUNS Manual
  • Review sample letters
    • DHS letter to individuals/guardians regarding update due
    • Letter enrollment to PUNS (optional or recommend requirement)
    • 1st letter
    • 2nd letter
  • Outreach Plan-use the DHS memo that went out to ISC/PAS executive directors on 7/1/14. There needs to be a strong relationship between the local school districts and the local ISC agencies. Cultural issues and special populations including autism need to be included in the outreach plan.

Next meeting

3/24/16 1:30pm - same call in# and passcode#)

Minutes written and prepared by Michelle Tibbs