January 11, 2024 - Agenda and Meeting Report

Audience

Open to the general public.

Time

9:30 am to 1:30 pm

Location

Due to the current pandemic, this meeting will be held via Zoom teleconferencing. To participate, please utilize the link below provided by Illinois Early Intervention Training to register for the meeting.

IICEI Registration: Thursday, January 11, 2024

Once you register, you will be provided with an immediate confirmation, that will indicate Zoom participation information will be forthcoming. You will receive an email with specific access instructions and your unique Zoom link closer to the meeting date.

Agenda

  • Call to order
  • Introduction of Council Members: Brenda Devito
  • Approval of October 12, 2023 Draft Meeting Report: Brenda Devito
  • Message from a Parent
  • Department of Early Childhood Agency Update: Ann Whalen, Transition Director
  • Cross State Research
  • Illinois EI cost model: Afton Partners
  • Workforce Workgroup Update
  • Public Act 102-0926 - Substantiated Abuse Neglect Eligibility: Pfeffer Eisen
  • ARPA Incentive Payments: Benny Delgado
  • APR Report: Chelsea Guillen
  • Bureau Updates
    • Bureau Staff
    • Family Fees
  • Council Membership
  • Public Comment Period
  • Adjournment of Meeting: Brenda Devito

Attendees

IICEI Members In Attendance
Amy Santos, Personnel Preparation Representative Yes
Amy Zimmerman, Advocate Representative Yes
Angel Williams, Illinois Department of Child and Family Services/Erikson DCFS Welfare Project Yes
Benny Delgado, IDHS, Chief, Bureau of Early Intervention Yes
Brenda Devito, Clearbrook, Chairperson Yes
Christine Doyle Morrison, Provider Representative Yes
Chuck Farr, Child & Family Connections (CFC) 13 Program Manager, Rural Representative Yes
Dee Dee Lowery, CFC 1 Program Manager, Urban Representative Yes
Donna Emmons, Illinois Head Start Representative Yes
Esther Beard, Advocate Representative Yes
Ginger Mullin, IL Dept. of Public Health Yes
Jennifer Gentile, IL Dept. of Human Services, Division of Developmental Disabilities Yes
Kate Ulmer, ISBE, McKinney-Vento, Homeless Representative Yes
Kristy Doan, IL State Board of Education Yes
Lisa Betz, Child and Adolescent Services Div of Mental Health Yes
Lynnette DeGraffenreid, Provider Representative Yes
Margaret Harkness, IL Council on Developmental Disabilities Yes
Matthew Pickett, IL Dept. of Insurance Yes
Meghan Burke, Parent Representative No
Michael Garner-Jones, IL Dept. of Human Services, Bureau of Subsidy Mgmt. (Child Care) Yes
Nisha Sanghvi, Provider Representative Yes
Rosie Perez, Parent Representative No
Shelly Roat, IL Division of Specialized Care for Children (DSCC) Yes

Council Packet Contents

  • Agenda
  • Draft Council Meeting Report - October 12, 2023

Minutes

1) Call to Order

Brenda Devito, Illinois Interagency Council on Early Intervention Chairperson, called the meeting to order at 9:33 am

2) Introductions of Council Members

Members introduced themselves and stated their agency/role on the Council.

3) Approval of the Draft Council Meeting Report - October 12, 2023

Motion made to approve the minutes by Christi with the correction of the spelling of her name. Lynette seconded. Motion passed.

4) Message from the Parent -Benny Delgado

A video recording from a service coordinator working in the system for 4 years when she gave birth to twins 3 months before the beginning of the pandemic. She returned to work one week prior to the shutdown. Due to her experience as a service coordinator, she recognized the symptoms of speech delay in her twins and self-referred when her babies were 16 months old. She found that being served by a CFC other than the one she worked in to be very different. The processes for eligibility were different between the two CFCs and although she knows the rules and regulations for early intervention, she found that she was not prepared for what it was like to experience early intervention as a parent. The amount of self-advocacy she had to incur for her children's services was alarming.

This parent emphasized the need for the State Agency to focus on ways to make it easier for service coordinators to communicate with families to ensure they have the information and the documentation needed for their children and families. She shared her concern that many, likely most, families are not well informed in early intervention and do not have the advocacy skills to make understand what is happening or what is available for them. The turnover in service coordinators creates another level of challenge for families to connect and to benefit from this system. The process needs to be more transparent across time so that there is more consistency for parents and families.

Feedback from Council Members reiterated the significance of open and consistent communication. Efforts to strengthen family engagement remain a priority. It is hopeful that the new data system will better address these issues.

Benny shared that broadening the Bureau staff to work more directly with regional entities and other efforts with Cross State Research, etc. will also help to address related issues.

Benny has been making the time to work across the State in the field with providers in their home visits. He took the time to recognize the works of Shelly Herboth, DT and Mary Probst, PT. Their service and commitment to families as early intervention service providers continues to reflect excellence in service delivery aligned with the mission and principles of Illinois early intervention. Brenda extends applause to the many providers in the system also committed to excellence and doing amazing work in their service to families.

5) Department of Early Childhood Agency Update: Ann Whalen, Transition Director

Ann prefaced her presentation with a reminder of the Governor's long-standing commitment to Early Childhood and Care and of his mission to making access to equitable, high quality, affordable ECEC in Illinois the best in the nation. Information on the structural, program, and workforce changes that have and are contributing to the progress in early childhood in Illinois was shared.

The challenges of transitioning to a unified state agency are complex and cross several systems within Illinois. To continue to advance equity and access in ECEC a better structure is needed. This transition brings ISBE, IDHS, and DCFS together under this unified agency including the planning and building of critical infrastructure to serve families with young children.

A multi-year timeline for this to happen was presented with the New Agency anticipated to be fully operation in FY27.

To ensure and maintain diverse representation during this transitional phase, a Transition Advisory Committee (TAC) has been established to identify and seek stakeholder input with emphasis on understanding families' goals and needs. IICEI has been identified as one of several stakeholders whose expertise and engagement will factor into this transition.

Ann also shared opportunities for those interested in the work TAC to connect and opened the floor for comments and/or further discussion. Questions/comments/discussion included:

  • Will EC Special Ed be included with ISBE and how will Chicago Public Schools be represented?
  • From a legislative perspective, are any holds in the processes impacting early intervention direct services and providers anticipated before the New Agency is fully operational in FY27?
  • Can we expect existing programs to be restructured under other agencies?
  • It was recommended that a representative of the Department of Early Childhood be a permanent part of the IICEI quarterly meeting agendas and other efforts made to remain connected and part of this transition.

6) Cross State Research: Ted Burke

Ted presented an overview of the findings of Cross State Research project that began in the Spring of 2023 and formally introduced to IICEI in the Summer of 2023. The purpose of this project was to inform Illinois on how other states are addressing early intervention workforce systems, both EI service coordinators and providers with a focus on ensuring equitable access for all eligible families. And to identify strategies and practices that have improved recruitment, retention, access, and quality.

Regarding service coordinators this project focused on compensation, funding mechanisms, and employment models.

For providers the focus included employment models, compensation rates, differential compensation, benefits provided, supervision, professional development, transportation costs, cancelled appointments, collaborations.

A brief overview of findings include:

  • Illinois Families -
    • High service delays
    • Illinois is meeting only 1 of 3 targeted family outcome measures.
    • Families with excellent and consistent service coordination from the beginning of their early intervention journeys generally reported positive experiences.
    • Poor communication from both service providers and service coordinators resulted in families reporting unsatisfactory early intervention experiences.
  • Illinois Service Coordinators -
    • High rate of job turnover
    • High caseloads
    • Many inconsistencies between CFCs with how policies and procedures are being implemented, how service coordinators are being paid and receiving benefits.
    • Equity issues are prevalent in rural and urban areas.
    • General lack of understanding as to the role of a service coordinator
    • On the positive side, there is a wide variety of supports offered through EITP and State initiatives to strengthen the service coordinator and CFC experience.
  • Illinois Providers -
    • Financial and compensation issues are the biggest challenges identified.
    • Entering the EI System can be challenging for new providers.
    • Inconsistencies in communication and procedures from the State and CFC offices about State policies and procedures.
    • Lagging use of technology
    • Insurance billing is complex, often time consuming and costly.
    • Equity and access disparities particularly in under-resourced communities
  • National Landscape -
    • All States are experiencing workforce shortages.
    • Funding for early intervention varies considerably by state.
    • Models of service coordination vary significantly by state.
    • Many states are paying providers significantly higher rates than Illinois.

A brief overview of recommendations include:

  • Workforce Stabilization (More immediate, short-term strategies) -
    • Implementing one or more additional rounds of incentive bonuses
    • Provide differentiated rates to providers working in specific areas of the state.
    • Provide mileage reimbursement to providers working in specific areas of the state.
    • Compensate providers for missed appointments.
  • Workforce Strengthening and Stabilization Recommendations (More long-term permanent strategies) -
    • Increase rates for providers and service coordinators and provide cost of living adjustment annually.
    • Develop pilot apprenticeship programs for service coordinators and developmental therapists in targeted CFCs and regions of the state.
    • Implement functional, secure, accessible data systems.
    • Implement billing of private insurance by State/CBO for all insurance claims
    • Develop a new provider mentor program.
  • Workforce Infrastructure Support Recommendations (Sustaining permanent system support to be implemented at any point in the process) -
    • Hire a marketing firm to conduct a public awareness campaign focused on recruitment.
    • Implement efficiency strategies to support new providers entering early intervention.
    • Expand regional support of CFCs.
    • Develop an IL Comprehensive Systems of Personnel Development.
  • Potential Next Steps -
    • Develop a detailed implementation plan.
    • There are many initiatives in process in Illinois and across many states. Continue to stay connected to them and benefit from their best practices.
    • Consider opportunities to pilot initiatives on a small scale.

A brief discussion about the potential of working with Illinois' Department of Insurance to move toward the implementation of billing private insurance by the State/CBO followed. Other reactions to this report revolved around steps to move forward with intentionality and purpose.

7) Illinois EI Cost model: Afton Partners present: Abby McCartney and Marissa Ortiz

An update on Focus Group information and Data Analysis of this project was presented by Abby and Marissa.

The project goals and principles as presented in October 2023 were reviewed.

The information gathering phase of the project is nearing the end. Steps of this part of the project included data collection/analysis, focus groups, and provider survey.

A diverse range of participants representing all 25 CFCs in Provider focus groups were held over 9 sessions. Findings from the information gathered and feedback from providers were highlighted and include -

  • 90% of providers believe that current compensation rates are too low compared to similar roles in different settings.
  • Lack of travel reimbursement, pay for cancellations, and lack of benefits are a major concern.
  • On the positive side, EI professionals are passionate for their work and appreciate the flexibility in their schedules.
  • Independent providers report a heavy burden of administrative tasks i.e., billing insurance, contacting CBO, dealing with inadequate technologies.
  • Service Coordinators are significantly overworked and underpaid, impacting both families and providers and resulting in high rates of turnover.
  • Interpreters, translators, and bilingual providers take on extra work without extra pay.
  • Former EI professionals cited various reasons for leaving the field including:
    • Low compensation
    • Inconsistent pay is a recurring challenge resulting from maintaining a desired caseload and high cancellation rates.
    • Expiring credentials and the process to renew is complicated and unclear.
    • Lack of benefits

Data Analysis Highlights Included -

  • Shortage of service coordinators with those in the system carrying above average caseloads.
  • There are service delays across the whole state, however, children in downstate Illinois experience a disproportionate share of service delays.
  • Service delays disproportionately affect children of color.
  • Families in ZIP Code areas with the highest rates of poverty are twice as likely to receive services virtually.

Next Steps Include -

  • Family Focus Groups
  • Provider Surveys on Cost
  • Provider Time Use Survey

8) Workforce Workgroup Update - Chelsea Guillen/Christi Morrison, Co-Chairs

Christi reported that 4 meetings have been held. The workgroup has also met with AFTON and will be meeting with Ted Burke to examine the findings of the Cross State Project. The group will work to synthesize and collaborate with the work being done in the various projects and how the work of these projects aligns with the charges of the Workforce Workgroup.

9) Public Act 102-0926 - Substantiated Abuse/Neglect Auto Eligibility; Pfeffer Eisin, Benny Delgado

Benny provided a brief update on the progress of EI compliance with this legislation including the collaborative work with Erikson, the progress of the Bureau of EI, and the implementation of next steps.

Pfeffer, Director of Erikson/DCFS Early Childhood Project, provided a brief history of the program in existence since 1998. She reported on the progress her program has made in the collaboration with EI towards full implementation of auto eligibility of all children in care since this legislation became law. Included in Pfeffer's report -

  • DCFS and Early Intervention share a commitment to family centered service planning that reflects:
    • Service Load - there is a crisis families need support with a variety of issues.
    • Family Voice - what do families think is important to them?
    • Engagement - family engagement that goes beyond referral process.
    • Systemic Barriers - a lot of work provided at the ground level that goes unseen and/or unacknowledged.
    • Acknowledgement of Past Systemic Oppression and Overreach - 60-70% of child welfare children are black and brown.
  • During the first 3 quarters of FY23, Erikson DCFS EC Project individualized contacts to case managers on behalf of children as follows:
    • 820 referrals to Early Intervention
    • 1607 unique instances to CFC's - all CFCs have been responsive and cooperative.
    • 239 referrals to Home Visiting
    • 352 referrals to Early Head Start/Head Start
    • 208 referrals to Child Parent Psychotherapy
    • 59 referrals to Nurturing Parenting Program

 Amy Z commented on the importance of being pro-active in auto eligibility by being deliberate in offering services before developmental delays are assessed.

10) ARPA Incentive Payments: Benny Delgado

Benny gave an update on provider incentive payments. Approximately 4,951 payments will be made in smaller chunks to process through the Comptroller's office more efficiently. All is moving forward, and a Provider Information Notice will posted later in the day.

11) APR Report: Chelsea Guillen

Chelsea reported that, as in the past, a high-level overview will be presented today. The detailed draft report will be issued to Council Members before it is issued to OSEP. The data reflected in this report is FFY22/SFY23.

A brief overview of the Indicators reported to OSEP was presented by Chelsea.

Indicator 1 - Timely provision of services - Compliance indicator must be 100%. Target not met.

Indicator 2 - Services in Natural Environments - Results indicator - Target 95.5%. Target exceeded.

Indicator 3A - Child Outcomes/Positive Social-Emotional Skills - Results Indicator - Targets not met.

Indicator 3B - Child Outcomes/Acquisition & Use of Knowledge/Skills - Results Indicator - Similar pattern as in 3A, targets not met.

Indicator 3C - Child Outcomes/Use of Appropriate Behaviors to Meet Needs - Results Indicator - Follows the pattern of 3A and 3B, targets not met.

Chelsea pointed out that given Illinois' mandate to serve children who have experienced substantiated abuse and neglect, Illinois is now considered an At-Risk State.

Child Outcomes for Illinois's At-Risk population will now be reported in a new category.

Motion made by Nisha to accept the additional At-Risk reporting category and the targets reflected in this report. Seconded by Dee Dee . Motion passed.

Indicator 4 - Family Involvement/Family Outcomes Survey - Results Indicator - 4 A target met, 4 B & C targets not met.

Indicator 5 - Child Find/Participation Rates (Birth to One) - Results indicator - Target has been met.

Indicator 6 - Child Find (Birth to Three) - Results Indicator - Target has been met.

Indicator 7 - 45-Day Timeline - Compliance Indicator must be 100% - Slight slippage of 1%.

Indicator 8 - EC Transition - Results Indicators - Targets have not been met, but data does indicate improvement.

Indicator 9 - Resolution Sessions - Not applicable.

Indicator 10 - Mediation - Zero mediations held. No data to report.

Indicators 11 - SSIP -Results Indicator - Pilot sites reflected in this indicator are up from 3 to 8. Target has been met.

12) Bureau Updates: Katie Jacobs

a. Bureau Staff - It was reported that of the 5 vacant positions 2 have been filled, 1 has been posted and closed with interviews scheduled, 1 is posted and closed, and 1 position posted. 6 new positions have been created. 3 are in the approval process and 3 are being drafted. A new organizational chart is anticipated soon.

Benny welcomed the newest staff member, Ellen Johnson, CFC Specialist to the Southern Region. A new Fiscal Manager is to begin on February 1st.

b. Family Fees

A new fee schedule is in process with waiver eligibility expanded. Reinstatement is yet to be figured out, but a phased in approach is the goal. More details to come.

Esther recommends that letters to the governor and legislative leaders to increase funding for early intervention.

Amy Z made a motion that a letter to the governor and legislative leaders from the Bureau to consider increasing funding for early intervention be sent. Esther seconded and will take the lead on its implementation. Motion passed.

13) Council Membership - Benny

Amy Z will be retiring from the Council, this is her last meeting. Brenda also announced that this is her last meeting as Chair. New members to be seated soon.

14) Public Comment Period -

No requests for public comment.

15) Adjournment - Chair calls for a motion to adjourn.

A motion to adjourn was made by Amy Z and seconded by Angel. Motion carried. Meeting adjourned at 1:06 pm

Contact Information

Katie Jacobs

IDHS - Bureau of Early Intervention

823 East Monroe Street

Springfield, IL 62701

Ph: 217/299-7158

Email: Katie.Jacobs@Illinois.gov

If you are in need of special accommodations, please email or call Katie Jacobs.