UPDATED - V.4 - ISC Remote Monitoring Activities

UPDATED - V.4 - ISC Remote Monitoring Activities

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.23.010

Purpose:

This Information Bulletin replaces policy/guidance previously given in DD.20.019, DD.21.010 and DD.22.007.

This communication is intended to provide updated guidance on the requirement for Individual Service and Support Advocacy (ISSA) monitoring activities to return to in person.

Background:

Independent Service Coordination (ISC) agencies are required to provide ISSA monitoring activities to individuals with developmental disabilities who are enrolled in a DD Medicaid Waiver program. Monitoring activities are provided to ensure the health, safety and welfare of each individual as well as to facilitate the Person-Centered Planning process. ISSA monitoring activities are categorized as 1) minimum required annual visits, 2) additional monitoring visits, and 3) other ISSA monitoring activities.

ISC agency staff conduct four minimum required visits each fiscal year for Adult and Children's Waiver recipients: one visit to update the Discovery Tool and Personal Plan and the other three to assess the individual's satisfaction with the outcomes and services they are receiving as well as to monitor their wellbeing.

The ISC agency shall perform monitoring activities as required and needed to ensure the health, welfare, safety, satisfaction and continued Waiver eligibility of the individuals. Prior to the Public Health Emergency (PHE) and initial shelter in place order, the above-mentioned visits were required to be face to face.

ISSA monitoring activities are categorized as:

  1. Minimum required annual visits. One of the three monitoring visits may be conducted remotely when the county's COVID-19 New Hospital Admissions Rate is High and the ISC is unable to reschedule the visit and meet required timeframes. Remote monitoring visits may not replace the required visit(s) to update/develop the Discovery Tool and Personal Plan.
  2. Additional monitoring visits. Additional monitoring visits may be required and are separate from the 4 required monitoring visits. The ISC should conduct additional monitoring visits (face-to-face) any time there are significant issues or emergencies with the person receiving waiver services. Additional monitoring visits may be conducted virtually when the county's COVID-19 New Hospital Admissions Rate is High.
  3. Other ISSA monitoring activities. Other ISSA monitoring activities as directed by DHS will be conducted by telephone, face to face discussions or electronic communications with families, guardians (if applicable) or provider agencies. This also includes reviews of records and other documentation- at a frequency and duration as established by DHS.

In March 2020, DDD suspended all ISC in-home visits due to COVID-19 and the shelter in place order. Through the Emergency Preparedness and Response Appendix of the Waivers (Appendix K), DDD was able to allow ISC agencies to provide monitoring, as well as the creation and update of the Discovery and Personal Planning process, remotely. Now that the PHE has officially ended, this Information Bulletin seeks to reduce the remote provision of these activities and define when a remote visit may be authorized.

In-person Visits:

  • Effective November 11, 2023, ISC agencies are required to conduct all ISSA visits in person, unless authorized as defined in this IB.
  • It is expected that ISC agencies continue to monitor the health, safety and welfare of individuals as well as provide timely and updated Personal Plans.
  • The number of ISSA monitoring activities, beyond the 4 required visits, should continue to be conducted based on the individual's needs as described in the ISC Manual.
  • Families, guardians (as applicable), and provider agencies are expected to follow the Health and Safety Precautions listed below and are responsible for supporting the individual to participate in face-to-face visits. Visits should be arranged with sufficient advanced notice with families, guardians (as applicable), and/or provider agency staff to ensure proper support for the individual can be provided.
  • The minimum required visits must be completed in the required time frames and documented as outlined in the ISC Manual.
  • The ISC agency is required to follow up on any incidents reported through the Critical Incident Reporting Analysis System (CIRAS) as outlined in the CIRAS Manual.

Individual/Family/Guardian/ISC Choice:

  • Individual, guardian (if applicable), and family choices should be respected. Some individuals may choose not to meet in person at the date and time the visit is scheduled due to the county's high COVID-19 New Hospital Admissions Rate is High in which case the ISC may be unable to reschedule the visit and meet required timeframes.
  • In the event an ISC staff member does not feel comfortable with a visit due to the conditions in a home, they should discuss with their supervisor. If the supervisor agrees rescheduling the visit is warranted, then this should be documented in the ISC's notes and the visit should be rescheduled as soon as possible. If the visit is unable to be rescheduled timely because the county's COVID-19 New Hospital Admissions Rate is High and the ISC will be unable to meet required timeframes, the ISC will attempt to change the setting of the visit or conduct a remote monitoring visit.
  • If a situation in a specific residential setting indicates a face-to-face visit cannot be safely accommodated at a specific point in time, the provider agency will supply documentation supporting the safety concern to the ISC and will work with the ISC agency and individual to find an alternate location or date/time to conduct the visit or support conducting a remote monitoring visit when the county's COVID-19 New Hospital Admissions Rate is High and the ISC is unable to reschedule the visit and meet required timeframes .

Health and Safety Precautions

* The safest practice when the county's COVID-19 New Hospital Admissions Rate is High, is for customers, family, guardians (as applicable), and visitors to wear well-fitted masks and physically distance.

ISC and provider agencies are able to use software, such as Adobe, to insert a digital or electronic signature on forms required by DDD. A digital signature is authorized to be used when the signer uses a digital certificate issued by a certificate authority with the appropriate public key infrastructure (PKI). There are online sources for obtaining a digital certificate. As a reminder, a document can't be changed once the original signer uses their digital signature to sign the document.

Resources:

The following additional resources may be useful to programs when developing their policies and procedures:

* For general updates on COVID-19, please refer to Illinois Department of Public Health guidance and frequently review the CDC website dedicated to COVID-19.

Effective Date:

10/10/23