May 11, 2017 - Quality Care Board

QUALITY CARE BOARD MEETING

May 11, 2017 @ 2:00 P.M.

TELECONFERENCE

Phone #: 1-888-494-4032

Access Code: 1469835118

RECORDED

Present

Michael McCotter, Inspector General; William Diggins, Deputy Inspector General; Susan Keegan, Chairperson; Thane Dykstra, Untress Quinn, Amy Tarr, Mark Kraus, Louise Branick and Presenter: Jayma Bernhard Page from Division of Developmental Disabilities, Bureau of Quality Management

Called to Order

Meeting was called to order at 2:05 p.m. with attendance taken. Although the quorum for this meeting was not met the meeting will proceed.

The two additional agenda items that Thane Dykstra requested for the meeting today will be incorporated into section IV. Legislative Update and section V. Training respectively in the agenda are as follows: ? Update on proposed legislation relevant to OIG. ? Update on OIG's review of the curriculum used by community agencies to train staff on Rule 50.

Approval of Minutes

 February 9, 2017 minutes were provisional approved with no corrections needed. Motional to approve the minutes - Thane Dykstra Motion Seconded - Untress Quinn All in Favor, none opposed, minutes provisional approved due to this meeting not having a quorum and will be finalized at the next Quality Care Board Meeting.

Inspector General's Report

Inspector General McCotter reported OIG's stats stating that the assigned OIG cases year to date are up; with a total of 1500 cases thus far which is an increase of 18.7% from last year assigned cases. The total cases that have been completed year to date are down 13.6%. OIG at this time is doing quite well on completing cases and getting them through. New investigators are adapting well and completing their cases in an efficient manner. Personnel issues: Interviews have been conducted for the Bureau Chief position in the Cook area and she has formerly accepted the position and plan to have her on start by the either June 1st or 16th, 2017. Interviews have been conducted for the Bureau Chief's position for the south bureau and the chosen candidate decided not to accept the position. Within a couple of weeks he rescinded that decision and inquired if the position was still available. IG McCotter decided that his indecisiveness was not what was needed at OIG and decided to move forward. So the position is still open and Eric Mosley will continue to work in the capacity of the Bureau Chief. Position will be posted at a later date. Mark Kraus was offered and accepted the position of Bureau Chief in OIG's Bureau of Compliance and Evaluation effective April 16, 2017. Lois McCarthy OIG's Policy and Legislative person retired last year. She was brought back on contract until the position could be filled. During that time we were able to acquire Amy Tarr (May 2017). She brings has a wealth of experience to the job and in policy and legislation. Lois has been working with Amy bring her up to speed on the Legislative and policy end for OIG. A few personnel issues with some investigators that are ongoing and will have some resolution by the next meeting. They haven't really adapted well to being an investigator and have been retrained; teamed up with other investigators and it still just haven't worked out. The plan is to rehire more investigators in the future.

Legislative Update

Amy Tarr provided an update on the House and Senate Bills (see attached).

SB1400: This amends the Health Care Worker Background Check Act. It provides certain "employers" can't retain individuals for direct care positions who have findings on the health care worker registry for physical, sexual abuse or financial exploitation.. This is effective immediately. This act does not have to do with OIG employees it has to do with agency employees that are placed on the registry so they can't work in the health care field. It just expands the number of employers that can't hire them. This registry is run by Public Health, and it ensuring the accuracy of the registry.

HB0742, SB1750 and SB1751 are not OIG's bills and came out in the December joint house and senate hearing the Secretary and IG attended. These bills are due to the situation where community mental health and developmental services agencies lost their license, so they tried to obstruct OIG's investigations by not honoring the subpoenas stating that they are no longer licensed through the state and don't have to cooperate.

HB 3515, House Amendment 1 - There are two previsions under this bill that would impact OIG. The first part eliminates the statutory exemption of Brian's law and the second part makes all FOIAs and investigative reports available to the public including CILA addresses. If this passes there would be two inconsistent laws on the books. This bill contradicts the DHS Act which prohibits the release of unsubstantiated and unfounded reports and also contradicts the Illinois MH/DD Disability Confidentiality Act. OIG works with DHS Legislation and testify in committee hearings when requested.

Presentation 

Division of Developmental Disabilities Bureau of Quality Management Jayma Bernhard Page Jayma Bernhard Page, Bureau Chief for the Division of Developmental Disabilities Bureau of Quality Management gave a presentation of the overview on the role that the bureau has with regards to OIG's activities with the presentation being attached to the minutes. The position of QIDP means Qualified Intellectual Disability Professional. The QIDPs have served as case managers and the position requires a bachelor's degree in human services with a year of direct service experience to qualify for the title.

Training

Several internal trainings have been formulated for the investigators with so many new staff with no investigative background or direct experience with individuals with disabilities and mental illness. Extensive PowerPoint trainings will Quality Care Board May 11, 2017 Page Three be given which will provide them with more detailed trainings regarding the rules and regulations when conducting their investigations. One of the PowerPoints trainings is Rule 116, which allows for direct care staff to administer medication in CILAs without a nurse being present. This training is based on the training that the Division of Developmental Disabilities, bureau of Quality Management uses when training the agency nurses. The Falls and Head Traumas training was developed by OIG's Clinical Coordinators and discusses falls and head injuries, what can occur to an individual and what to look for when falls or head injures happen and the measures that have been put into place. Two more online training will be made available to OIG staff later this year. The first one is Rule 115 normally known as the CILA Rule and is relative to how a CILA is licensed and operated with the requirements for the agency and staff in providing to the individuals they serve. Rule 119 will be the second one and is known as the DT Rule which covers developmental training sites where individuals may go for job skills or other daily activities and will cover the rules and regulations for those sites. Amy Tarr will develop training for staff on testifying at depositions, criminal and administrative hearings. The newer staff does not have the training or experience on testifying and this will training will prepare them on this. OIG is working on posting, within a year, some of the trainings on the website but do want it thought that by posting these trainings that they are the definitive source on those topics.

OIG no longer conducts in-person Rule 50 training because the community no longer handles primary investigative work and due to the retirement of OIG training personnel. OIG has gone to an online Rule 50 training for OIG staff and agencies are required to train there staff every other year. OIG will ensure that the agency trainings are consistent with what Rule 50 is and that it meets OIG's training needs. Some of the issues that are being noticed with the agency trainings are as follows: 

  • Using the incorrect definition in there trainings 
  • Misinterpreting the four hour reporting requirement
  • Not fully understanding and misinterpreting when an allegation is reported
  • Getting the documentation ready under 50.30f of Rule 50
  • Not understanding removal of staff when there is credible evidence
  • Inconsistent reporting between program sites within the same agency
  • What the definition of employee means

OIG will complete an analysis of the agencies training and once completed it will be shared with the Secretary and the board and then work on ideas to improve the agency trainings on Rule 50.

Review of Recent Investigative Reports 

Discuss Any Flagged Reports Review of Recent Investigative Reports was tabled for discussion until the next meeting due to Neil Posner's absence.

Board Member Appointments

Status of Appointments There is no update regarding the appointments of the quality care board members. Chairperson Susan Keegan will continue to contact the Secretary's office and will provide updates on what is found out on the appointments for this board. Susan Keegan requested that someone e-mail her the direct contact information for Secretary Dimas.

Outstanding Issues

No outstanding issues to report. Outstanding FOIA Requests All FOIAs up to date at this point have been standard with no issues. No further contact from the Tribune since there last article was published.

Adjournment

Chairperson Keegan - asked for a motion to adjourn Motion to adjourn - Thane Dykstra Motion Seconded - Untress Quinn Meeting adjourned at 3:10 p.m.

Next meeting is scheduled on September 14, 2017 at 2:00 p.m. and at that time next year's meeting schedule will be set.