ISSA Monitoring Visits

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.22.011

Purpose:

This Information Bulletin informs Division of Developmental Disabilities (DDD) stakeholders of changes to Independent Service Coordination (ISC) agency Independent Service Support Advocacy (ISSA) monitoring visits.

Background:

In 2018, the Illinois Department of Human Services (IDHS), Division of Developmental Disabilities (DDD) reduced the number of Independent Service Support Advocacy (ISSA) face-to-face visits from 4 per year to 2 per year for individuals receiving services through the Adults with Developmental Disabilities waiver. Effective July 1, 2022, ISSA face-to-face visits will return to 4 visits per year for all Home and Community Based Services (HCBS) waivers operated by DDD.

Process:

As the case management entity, the ISC agency is responsible for developing the Personal Plan, monitoring the implementation of the Personal Plan as well as the health, welfare and safety of the individual receiving DD services.

Quarters

The quarters are based on the State Fiscal Year and defined as follows:

  • Q1: July 1 through September 30
  • Q2: October 1 through December 31
  • Q3: January 1 through March 31
  • Q4: April 1 through June 30

Minimum required visits

  • The ISC agency will conduct a minimum of four face-to-face ISSA visits per year (one per quarter) to each person in a DDD Waiver program and will consist of the following:
    • At least one face-to-face visit must be conducted to complete the Discovery Process/Personal Plan. This visit will count as the face-to-face visit for that quarter. The ISC can conduct additional visits to complete the Plan if necessary.
    • Three additional face-to-face monitoring visits are to be spaced throughout the following 3 quarters. The ISC Monitoring Visit Notes will serve as documentation for these visits.
  • If the ISC met with the individual multiple times to complete the Discovery/Personal Plan, then the ISC should identify and record one of the face-to-face dates that they are using to calculate future monitoring visits occurring in the following 3 quarters.
  • Prior to conducting the required monitoring visits, the ISC should contact the individual (as appropriate), guardian, family member or friend (if allowed by the individual) to formally schedule the visit if occurring in the family home or other pre-determined location (as opposed to a drop-in visit at a day program).
    • Inquire if there are issues or concerns, or information that needs to be collected prior to the forthcoming visit.
  • The ISC must consider and plan for the amount of time needed to make contact with the guardian prior to a visit and begin the process as early as necessary. At a minimum, the ISC's effort to contact the guardian, family member and/or friend should consist of at least the following efforts:
    • One telephone call
    • One written communication (text, e-mail, or letter)

Location of Monitoring visits

  • Residence: A minimum of two face-to-face monitoring visits must be conducted at the individual's residence to assess the individual's satisfaction with the outcomes and services as well as to monitor their health, safety, and welfare. The monitoring visits should occur in the person's home/residence; this includes licensed settings (i.e., CILAs, CLFs, child group homes) as well as non-licensed settings (individual's own or family homes).
  • Day Program (as applicable): If the individual attends a day program, one face-to-face monitoring visit must be conducted at the site (Community Day Service, Enhanced Residential Habilitation formerly known as At-Home Day/37U, Adult Day Service, or other day service setting) to assess the individual's satisfaction with the outcomes and services as well as to monitor their health, safety, and welfare. The ISC should also consider visiting privately funded sites if the individual spends a considerable portion of their time each week at this setting. The ISC also has the ability to do the visit at the individual's school as appropriate and warranted.
    Additional notes:
    • A visit to an individual's competitive integrated employment or small group employment site is not required.
  • No Day Program: If the individual does not attend a day program, the 3rd face-to-face monitoring visit should occur in the location of the individual's choosing.

Additional Monitoring visits

Separate from the minimum required monitoring visits and the visit(s) for the Discovery Process/Personal Plan, the ISC should conduct additional monitoring visits (face-to-face) any time there are significant issues or emergencies with the person receiving waiver services.

  • The number of additional monitoring visits should be conducted based on the person's needs.
  • Additional monitoring visits can occur in the person's residence or in other locations. The location (i.e., day program site, hospital, home) should be based on the situation or reason for monitoring.
  • In most cases, the ISC should conduct Additional Monitoring visits within 30 calendar days of becoming aware of an issue.
  • The exact timing of the visit should be based on the urgency of the situation and the potential risks to the person receiving services.

The following are a list of circumstances which may require at least one additional face-to-face visit:

  • Police involvement [with or without court action]
  • IDHS Office of the Inspector General investigative findings of egregious neglect, abuse, and/or exploitation
  • Status after a hospitalization
  • Significant life changes/transitions
  • Significant behavioral issues/concerns that could change the individual's Personal Plan or Implementation Strategy
  • Significant medical issues/concerns
  • Death of family or close supports that have a potential to adversely affect the individual's services and/or supports
  • Changes in level of care needs within the waiver
  • Guardian's interests are in conflict with the person's desires that adversely affect the person's services and/or supports
  • Unresolved individual/guardian issues and concerns that adversely affect the individual's services and/or supports
  • Situations which create concerns related to health, well-being, and service provision
  • Danger of losing current placement
  • Involvement of Service and Support Teams (SST) or Short-term Stabilization Homes (SSH).

Effective Date:

This information Bulletin is effective 07/01/2022