June 15, 2018 Redeploy Illinois Oversight Board Meeting

Audience

Redeploy Illinois Oversight Board Members and Staff. The public is welcome to attend.

Date/Time

June 15, 2018
9:30am to 11:30am

Location

This meeting will be conducted via video conference with Chicago & Springfield Locations as follows:

Chicago: 401 Clinton Building, 7th Floor Executive video conference room
Springfield: Harris Building, 3rd Floor Executive video conference room

Agenda

Call to order/Roll call
Approval of minutes for May 18th RIOB meeting
Approval of minutes for May 24th Executive Staff meeting
DHS Updates - Funding
FY18 Fiscal update
1. Year End projections
2. Site payment timeliness
3. Redeploy expenditures and commitments/number served
4. ICOY/Focused update
Data Work Group update/discussion/decisions
1. Outcomes
2. DMC
3. Redeploy Guidebook
Program/Policy discussions/decisions
1. Eligibility
  1. Misdemeanor level offenses
  2. Assessed commitment risk level
  3. Overcharging youth
  4. Pre-adjudicated youth
2. Detention diversion
3. OYAS/YASI
4. Redeploy Focus
5. Program expansion
6. Mental Health
7. Medicaid
All Sites recommendations discussion/site response/decisions
FY19 unobligated funds discussion/decisions
Meeting Dates
Adjourn

MEETING MINUTES

Call to order
The meeting was called to order at 11:01 am.
Roll call
Karrie Rueter, George Timberlake, Anne Studzinski, Peter Parry, Tracy Senica, Paula Wolff, Betsy Clarke, Mary Ann Dyar, Pam Rodriguez, Rich Adkins, Rick Velasquez, Janet Ahern.
Staff and Guests: Kristen Marshall, Erica Hughes, John Payne, Steve Sawyer, Quinn Rallins and Olivia Wilks.
Approval of minutes
The Board discussed the minutes from the May 18, 2018 Board meeting.|
Motion: Paula Wolff motioned to approve the minutes from the May 18, 2018 RIOB meeting. Rick Velasquez seconded the motion.
Decision: The Board approved the minutes from the May 18, 2018 RIOB meeting.
The Executive Committee discussed the minutes from the May 24, 2018 Executive Committee meeting.
Motion: Anne Studzinski motioned to approve the minutes from the May 24, 2018 Executive Committee meeting. Janet Ahern seconded the motion.
Decision: The Executive Committee approved the minutes from the May 24, 2018 Executive Staff meeting.
DHS Funding Updates
Fiscal Updates
1. Year End Projections
2. Site payment timeliness
  Karrie reported providers indicated they were being paid within days of submitting their expenditure reports.
3. Redeploy expenditures and commitments/number served
  Karrie Rueter reported the projected lapse amount for FY18 was approximately $2.7 million. There is $5.73 million appropriated to the Redeploy Program in FY19, and the RIOB has allocated $3.1 million of it. The slight decrease in obligations from last year is due to the loss of the Redeploy Program in Peoria County. Providers are progressively spending more over the course of the year as they are rebuilding. One Board member asked how Redeploy spending compares to other programs. Karrie indicated that in addition to the budget impasse, they were also impacted by the changes in eligibility. Redeploy lost more providers than other programs.
  RIOB members briefly discusses the possibility of charging counties for committing Redeploy eligible youth to IDJJ, but ultimately decided that outreach about the Redeploy Program, as well as the Redeploy Focused Program, would be more effective.
4. ICOY/Focused update
  ICOY indicated that no counties applied for the Redeploy Focused grant money this quarter.
Data Work Group updates
1. Outcomes
  One RIOB/Data Work Group member suggested the need to develop outcome measures program-wide to demonstrate effectiveness. The Data Work Group will begin by using looking at the current reports generated by eCornerstone. Karrie Rueter agreed to provide information on eCornerstone and its reporting capabilities to the Data Work Group. The first target of analysis will be the change in risk and protective factors for Program youth. It was also suggested the RIOB determine how long we measure outcomes post-discharge.
  Two RIOB members suggested the addition of a researcher to the Data Work Group to help with developing ways to measure outcomes and success, especially post-Program participation. The RIOB discussed the impact of research on Program youth, noting that research indicates less system involvement results in better outcomes.
  One RIOB member recommended a standing order from judges indicating probation can share data with Redeploy staff. It was suggested Steve Sawyer draft this order. It was also recommended that IDJJ find a way to indicate past Redeploy participation in their data.
  Motion: Anne Studzinski moved to give the Data Work Group the permission to actively explore outcomes, evaluation, and the ability to make funding recommendations to the full Board if needed to complete the work of the committee. Paula Wolff seconded this motion.
  Decision: The Board approved this motion unanimously.
2. DMC
  An RIOB/Data Work Group member stated that the Data Work Group will identify missing data around DMC and how to best assist at the local level. Sites indicated their first DMC steps include training to do consciousness raising.
3. Redeploy Guidebook
  Karrie Rueter provided a one-page synopsis of the Redeploy Guidebook, suggesting significant changes are needed. It will go to the Data Work Group for additional edits.
Program/Policy
1. Eligibility
  1. Misdemeanor level offenses
    The RIOB discussed developing a clearer referral process to CCBYS because they are a starting point with law enforcement to work with providers to divert youth. The Board indicated it would be useful to convene Redeploy, MHJJ, CCBYS, and Juvenile Justice Councils (including the Juvenile Justice Commission) and discuss collaboration and working with youth together. The 1-2-year goal would be to create a planning grant for sites to coordinate the use of these programs together. One Board member indicated the need for public defenders during those discussions.
    Motion: Anne Studzinski moved that the RIOB fund competitive planning grants that include a combination of Redeploy sites, CCBYS, Juvenile Justice Councils (including the Juvenile Justice Commission), public defender representation, MHJJ, and SASS sites. If these stakeholders cannot participate in the planning grant, the county or circuit must indicate why.
    Amendment: Karrie Rueter offered an amendment that in deterring grantees, the RIOB would prioritize current sites, followed by previous Redeploy sites, followed by eligible sites, etc.
    George Timberlake seconded the motion, including the amendment.
    Discussion: The RIOB indicated they will develop a committee to assist with the conceptual framework of this planning grant.
    Decision: The Board approved this motion unanimously.
    DHS staff reported that if the RIOB agrees with providers serving misdemeanor offenders the additional cost would be minimal because most sites built this population into their FY19 budgets. An RIOB member asked how to ensure sites will not start sending their highest risk youth to DJJ, and Karrie stated that the sites will provide detailed information on committed youth monthly to monitor impact.
    An analysis of the statute by Judge Sawyer found many references to detention, indicating that youth eligible for commitment to detention would also be an appropriate target population for Redeploy. Statutorily, sites can serve misdemeanors because they are a part of the detention population.
  2. Risk level
    Peter concurred that misdemeanor youth could be served under the current statute and changes are not needed to accommodate this population. One RIOB member stated that he learned during site visits that some of the highest risk youth are charged with misdemeanors, and providers indicate they cannot serve these youth until they commit a felony. Another RIOB member state the planning grant can be used to collaborate efforts around detention.
  3. Overcharging youth
    One Board member indicated that he learned during a site visit from a judge that they would overcharge youth to get Redeploy services. RIOB members stated they might support serving Class X Forcible Felony offenders, clarifying that these youth would become part of the 25% reduction population. A statute revision would be required.
  4. Pre-adjudicated youth
    Karrie indicated a need to educate CCBYS providers, as some sites were unaware they could serve pre-adjudicated youth. A suggestion was made to edit the current policy to include the OYAS and the YASI as acceptable referring instruments and adding misdemeanor offenders to the Redeploy eligible population. A full YASI would still be required for any youth enrolled into the Redeploy Program for full services.
2. OYAS/YASI
  The RIOB discussed the two instruments, noting that the OYAS does not address mental health and trauma. The RIOB suggested either tool can be used to refer youth to the Redeploy Program, but a full YASI would be required upon acceptance into the program.
  Karrie suggested the sites write applications to request permission to serve misdemeanor youth by illustrating they are in good standing, or meeting program goals and objectives. Staff would review applications and provide recommendations to the RIOB, who would then decide whether or not to approve the application.
  Motion: Pam Rodriquez moved to accept the pre-adjudication policy edits that included using the OYAS as a possible referring instrument in addition to or instead of the YASI assessment as well as adding misdemeanors to the Pre-Adjudication Policy per the Board. The Board clarified that this change was not to include the Focused population.
  Rick Velasquez seconded the motion.
  Decision: The Board approved this motion unanimously.
  One RIOB member asked if this would require more tracking of detention data, and George Timberlake asked for recommendations to improve JMIS in order to do so.
3. Detention diversion
  Betsy Clarke suggested the next Planning Grant, or the Collaborative Community Planning Grant, be used to educate local stakeholders about detention and diversion. Rich Adkins added that probation is redoing supervision and detention standards, which will lead to discussions of opportunities for diversion. He also stated JDAI money is no longer available. The RIOB suggested the Redeploy Program work on the premise that admissions to detention must decrease.
4. Redeploy Focused
  The Focused Committee comprised of Anne, Janet, and Peter indicated they would develop materials explaining what the program materials and would share that with Rich. Rich would then take that information to his field staff and the committee would meet with the field staff to get feedback on how to effectively disseminate this information. Rich indicated he would like a clear one-page document for the field staff. Anne suggested that the Focused program could use the guidebook and eligibility data to create the one-page document. The Board determined that for counties with 0 commitments, the focused program could still be offered services for up to three kids. The Board discussed the State bar could do a CLE on Redeploy Focused and Peter suggested staff could present at the Public Defender meeting in October.
  Motion: Janet Ahern moved to establish a committee to develop a one-page document highlighting the Redeploy Focused program.
  Discussion: The RIOB highlighted that the Focus Program would be available to any county that commits fewer than 10 youth on average, including 0 They could serve up to three youth per year. Pam Rodriguez seconded the motion.
  Decision: The Board approved this motion unanimously.
5. Program Expansion
  DHS staff reported only 7 current eligible sites, most of which also have detention centers: Cook, Champaign, Sangamon, Lake, Rock Island, Vermilion, and Kane Counties. Paula suggested that there should be a specific strategy for the county Boards, judges, probation, public defenders, etc. Paula suggested that there should be a phone call to address this issue starting with Board members who attended site visits and then there should be a broader conversation about who has relationship with who.
6. Mental Health
  Quinn reported that MHJJ will continue to work with their current 20 providers. MHJJ currently gives funding to providers to be more proactive with detention centers and provide incentives to engage aftercare specialists. Heidi discussed DJJ and aftercare services for youth with mental health issues, usually referring them to community service-providers.
7. Medicaid
  Janet summarized managed care for the Board, indicating that it began in January 2018 and that there are 6 programs around the state. It is regional, which means there is no choice of provider- it is based on where people live. Janet indicated that ultimately more preventative services will be available and will likely decrease emergency room usage. Janet reported that the 1115 waiver requires to expand mental health services and has existed since 2015. This will allow for integrated health including more expansive substance use care for opioid addiction and resources to keep youth out of mental health institutions. Janet reported that DCFS may have an advisory group on managed care and how it rolls out in Illinois. Janet highlighted that there are 10 pilots to link behavioral and physical health services, but each require Medicaid reimbursable licenses.
  Rick indicated that there are some challenges for providers new to Medicaid including adopting an electronic health records system and understanding payment differentials. Rick also pointed out that the 1115 waiver focuses on the adult population. Pam reported that Medicaid is an entitlement so if there is something medically necessary there is no financial cap, however managed care limits how much of a service someone ca access. So even if a clinician or judge advocates for extended services, it only will be provided if approved by managed care. One challenge reported was when clients move from one MCO to another MCO. The former MCO cannot share their information. Another reported challenge was that even if a child is Medicaid eligible, one cannot assume their family is also eligible.
  The Board suggested that Redeploy funds could be used for ancillary services that are not covered, which requires the Board to determine what is covered by the 1115 waiver. The Board discussed the fact that flex dollars are important under the managed care model, so there will need to be efforts to braid funding. Rich mentioned that Nebraska is a good model for this work. The Board discussed putting together a memo for the sites to explain the direction of managed care and assurance that Redeploy will support these changes.
  Janet clarified that former wards are Medicaid eligible until 26 as long as the ACA remains intact. Rick discussed mobile crisis response for mental health situations as something that will begin immediately, which is what SASS was doing. There will be tiers of crisis. The Board discussed how to address issues of service waitlists, Rick indicated many sites are moving towards telepsychiatry. Janet indicated one benefit to this system is there are care coordinators are supposed to link youth to appropriate services.
  The Board indicated that managed care and Medicaid does not actively engage with aftercare. Quinn indicated that he is working on a project working to enroll youth in Medicaid coming out of DJJ because currently once youth leave DJJ they may be eligible for Medicaid, but still need to re enroll. The Board suggested that there should be a process for youth on probation or parole to ensure they are enrolled.
  The Board discussed the need to explore whether sites are paying for Medicaid eligible services, whether Redeploy youth are Medicaid eligible, and generally what their Medicaid familiarity is. Karrie reported that she has created a survey or series of questions to determine how many Redeploy youth are Medicaid eligible, to find out if/how sites know this information and how they are currently braiding funding.
  Motion: Rick Velasquez moved to inform and survey our current providers regarding Medicaid practices and the use of Medicaid. Peter Parry seconded the motion.
  Decision: There was no discussion and the Board approved this motion unanimously.
All Sites
After discussing the changes in policy that stemmed from recommendations at the June All Sites meeting, Anne directed staff to provide a response letter to the sites articulating the RIOB's decisions.
Motion: Anne moved that staff provide a response letter to each site with the RIOB's decisions around their All-Site meeting recommendations. Paula seconded the motion.
Decision: There was no discussion and the Board approved this motion unanimously.
FY19 Unobligated funds
One RIOB member asked whether funding can help with expungements. Another RIOB member stated that CGLA provides mentoring and training on the expungement process. It was also suggested a public defender help educate stakeholders around expungement.
Motion: Pam Rodriguez moved that Redeploy develop a multipronged strategy to increase access to expungement for Redeploy youth to be funded by unobligated Redeploy resources if necessary. Betsy seconded the motion.
Decision: There was no discussion and the Board approved this motion unanimously.
George Timberlake put forth a resolution to encourage DHS to prioritize Redeploy for CYEP excess funding. Pam Rodriguez seconded this resolution. The Board approved this resolution unanimously.
Meeting Dates
1. Executive Staff meeting: Friday, July 20th, 2018
2. Full Board Meeting Friday, August 17th, 2018
3. September All Sites meeting
4. October RIOB full Board/Planning meeting
Adjourn
Motion: Paula Wolff motioned to adjourn the meeting. Tracy Senica seconded the motion.
Decision: There was no discussion and the meeting was adjourned at 11:32 am.