May 30th, 2024 - Rescheduled April 11th Meeting Agenda and Meeting Report

Audience

Open to the general public.

Time

9:30 am to 1:00 pm

Location

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, May 30th, 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: Alison Liddle
  • Introduction of Council Members: Alison Liddle
  • Approval of January 11, 2024, Draft Meeting Report: Alison Liddle
  • Message from a Parent
  • Workforce Workgroup Update: Carol Muhammad/Chelsea
  • Illinois EI cost model: Abby McCartney/Afton Partners  
  • Public Act 102-0926 - Substantiated Abuse/Neglect Auto Eligibility
  • Dept. of Early Childhood Agency Update: Ann Whalen, Transition Director
  • Modified Service Delivery Update: Kristen Schraml/Shameka Brown
  • Differentiated Monitoring and Support (DMS) 2.0: Chelsea Guillen
  • APR/SSP Clarification Results: Benny Delgado
  • Payment Error Rate Measurement (PERM) Audits: Benny Delgado
  • Bureau Updates: Benny Delgado
    • Bureau staff
    • Proposed Rule Changes/Public Comment Results 
    • ARPA Incentive Payments
    • Data Management System
  • Upcoming Council Meeting Location: Alison Liddle
  • Public Comment Period: Alison Liddle
  • Adjournment of Meeting: Alison Liddle

Attendees

IICEI Members In Attendance
Alison Liddle, Provider Representative/Chairperson Yes
Anastasios "Taso" Michalopulos, Provider Representative Yes
Angel Williams, Illinois Department of Child and Family Services Yes
Benny Delgado, IDHS, Chief, Bureau of Early Intervention Yes
Brittni Monreal, Parent Representative Yes
Carol Muhammad, Child & Family Connections (CFC) 10 Manager, Urban Representative Yes
Chuck Farr, Child & Family Connections (CFC) 13 Program Manager, Rural Representative Yes
Donna Emmons, 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 No
Kate Ulmer, ISBE, McKinney-Vento, Homeless Representative No
Kesha Harris, Parent Representative Yes
Kristy Doan, IL State Board of Education Yes
Lisa Betz, Child and Adolescent Services Div of Mental Health Yes
Lisa Karp, Parent Representative Yes
Lynnette DeGraffenreid, Provider Representative Yes
Margaret Harkness, IL Council on Developmental Disabilities Yes
Matthew Pickett, IL Dept. of Insurance No
Meredith Barnes, Parent Representative No
Michael Garner-Jones, IL Dept. of Human Services, Bureau of Subsidy Mgmt. (Child Care) Yes
Rosa (Amy) Milagros Santos, Personnel Preparation Representative No
Shelly Roat, IL Division of Specialized Care for Children (DSCC) Yes
Zareen Kamal, Advocate Representative Yes
Zee Parton, Provider Representative Yes

Council Packet Contents

  • Agenda
  • Draft Council Meeting Report - January 11, 2024
  • Workforce Workgroup Update
  • Early Intervention Caseload Summary Report

Minutes

1) Call to Order

Alison Liddle, Illinois Interagency Council on Early Intervention Chairperson, called the meeting to order at 9:33. New to this role, Alison took a few minutes to introduce herself and thank former chair, Brenda Davito, for her assistance with Alison's transition into this role. She also acknowledged changes in the Council's membership.

2) Introductions of Council Members

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

Benny takes a moment to thank former Chair and council members whose terms have recently expired. New members were welcomed.

3) Approval of the Draft Council Meeting Report - January 11, 2024

Alison noted an error in the agenda. The Agenda's, "Approval of the Draft Council Meeting Report", should read April 11, 2024 instead of January 11, 2024.

Donna made a motion to approve the minutes. Angel seconded. Motion passed.

4) Message from the Parent

This parent shared several issues of her child's early development and the challenges of finding help from the medical fields to identify with any specificity as to her child's needs. Because of this parent's frame-of-reference of Illinois Early Intervention at the time, parent stayed away from EI and chose the private sector to address and support each of her child's unique needs as best it could. After coming to a point of not much success, one of her child's doctors told her that her daughter and family needed a team that works well together and recommended early intervention. Early Intervention was contacted, and the process moved fast. This parent documented everything, asked questions, shared her thoughts, and advocated for her child. Her daughter received OT, SLP, DT, Dietician/feeding, PT services and quickly began to make progress.

Reflecting on some of her biggest challenges were dealing with her daughter's selective mutism and anxiety in her child. There is so much yet to be known and understood about childhood anxiety. A major challenge this family endured was the transition process. She and her EI Team fought with the school district to get an IEP reflective of her daughter's needs in place. She shared that the struggles she experienced to transition her daughter who was receiving several services through EI to a school district not wanting to continue them do not make sense. Though her family's journey through early intervention was amazing, she urged early intervention to develop stronger transition practices and a stronger stance on transition to pre school. She also encouraged more training on childhood anxiety, selective mutism, and working with children and families who need several services.

Council Chair thanked this parent for sharing her story and early intervention experience, then opened the floor for feedback and/or considerations for action from council members.

Discussion/comments from the council included:

  • The importance of continued training and next level training/supports of childhood anxiety issues utilizing the expertise of Infant/toddler Mental Health Consultants and reflective practice groups.
  • Develop stronger partnerships with ISBE and School Districts in the transition process using the supports of parent liaisons.
  • It was noted that there is a definite system disconnect between Part C & Part B. One of the Council's provider representatives reported that central Illinois school districts, particular those in the CFC 16 region, since COVID, providers are no longer invited. Consider options to increase coordination in the transition process.
  • It was suggested to consider a parent handbook and/or a parent portal for parents allowing them to be a part of and connected to the notetaking process with service coordinators and providers.
  • This parent was a strong advocate for her child. What about parents who do not know how to advocate for their children? There is a need to address and support these families.
  • Public awareness and disconnect between State systems were issues 23 years ago. Still issues today, something needs to change. Consider a stronger marketing campaign to increase public awareness and reach families sooner.
  • Grateful that this family had a positive experience with early intervention, comments shared also included that there is good happening as well.
  • Other key points shared: 1) the need to expand support for infant/toddler mental health and the further utilization of our Infant Early Childhood Mental Health Consultants and 2) the significance of our transition process and the need to better equip families supports to better guide them through the process.
  • To wrap up and continue with our agenda, Benny summarized Bureau considerations. Work needs to continue with:
    • Strengthening collaborations between programs in place promoting smoother transition processes
    • Further define the role of Parent Liaison using them in the transition process
    • Increase opportunities and options for parent communication either through our new data management system or other mechanism.
    • Increase public awareness.
    • Expanding support to ei professionals and referral sources around infant and early childhood mental health.

5) Workforce Workgroup Update: Carol/Chelsea

Chelsea provided a short summary of workgroup activities.

  • Four meetings have been held since the last council meeting.
  • There have been some changes in the workgroup membership: Carol Muhammad now co-chairs with Chelsea.
  • An OT representative has been identified and will be joining the group in June.
  • The Workgroup meets on 2nd Tuesday of month. Meetings open to the public.
  • May discussion focus has been on the work of the Cross State Research regarding building capacity and understanding of the cost modeling.
  • Carol and Chelsea will continue meeting with the Cross State Research Group to discuss their recommendations to take back to the Workforce Workgroup in June.

6) Illinois EI cost model: Abby McCartney/Afton Partners

Abby and colleague Marisa Ortiz presented an update of recent project activities including key takeaways from their engagement work with the field. The goals of this project that began in October 2023 are to, 1) to Understanding the full cost of the Illinois EI System and, 2) Develop recommendations for a payment structure to address current issues.

Activities since January included:

  • Focus groups of approximately 100 families were held in January and February.
  • To different types of surveys were conducted:
    • One a cost and payment reform survey that asked current costs faced as an ei providers as well as prioritize what was wanted in payment reform.
    • The other a time study of close to 200 ei providers tracking their daily time of billable activities and non-billable activities as they related to their billable activities.

Key Takeaways from EI families and Providers:

  • Rates should provide competitive compensation that accounts for all of providers' time.
    • Current rate does not account for real time for providing a service. Total compensation for EI providers is often far below comparable states and roles.
    • Providers spend over half of their day on non-billable activities. Non-billable time includes travel time, documentation, communicating with families. Time-use study shows that on average 36% of providers time is currently billable.
    • Current reimbursement rates do not provide sufficient compensation, nor do they incentivize activities that improve quality.
  • Compensation should reflect the challenges of serving under-served areas.
    • Families in rural areas are disproportionately experiencing delays. Lack of compensation for travel impacts providers' ability to serve these families.
    • Families in Chicago, especially in neighborhoods of lower socio-economic status, are far more likes to receive LVV despite a preference for in-person services.
    • Many families are not able to access services in their home language.
  • CFC funding should reflect true costs, including reduced service coordinator caseloads.
    • CFCs receive insufficient funding to cover the costs of appropriate staffing and caseloads. Grants do not fully cover CFC staffing patterns.
    • Families with over-burdened service coordinators often bear the responsibility of finding their own providers. Current service coordinator caseloads average above the recommended level of 45, leading to burnout and high turnover.
    • Inconsistent CFC practices and incorrect authorizations impact providers' pay.

Payment Reform Draft Recommendations

  • Align base pay and grants to real costs to improve recruitment/retention and to improve the family experience and access to services.
    • Align base pay to market.
    • Pay providers for the true amount of time that it takes to provide services.
    • Account for cancellations.

Reaching Underserved Communities

  • Using service delays and waitlist date to pinpoint persistently underserved areas, consider higher rates that encourage travel and other investments of providers' time to deliver services in these areas.
  • Offering higher rates for multilingual providers.

Pilot Structural Changes:

  • Families value having providers with shared experiences and backgrounds. Consider a "Grow Your Own Program" to recruit providers from within communities by encouraging EI family members to explore careers in EI.
  • Optional salaried employment for new providers
  • Mentoring and coaching opportunities
  • Benefits Pool

Today's presentation is in draft form and does not reflect all the most recent input. Next steps for Afton are to finalize recommendations and sharing them in a report format. Abby encouraged additional comments/feedback from those present at this meeting.

Comments from the Council

  • How does this align with current EI budget? The 6M increase in the overall budget for FY'25 does not sufficiently cover a rate increase.
    • Is there a role for the council to reconcile the needs with the lack of resources to address short-term needs?
    • What can be reasonably addressed this year?

Abby stated that although she does not have answers to those questions today, she recognizes the challenges involved in the implementation of recommendations. Though there remains work to finalize those recommendations, Afton Partners is willing to continue to work with Illinois to strategize and prioritize next steps.

Benny added his gratitude to Afton Partners. Their work has done a great deal to raise awareness and the voices of those who participated in this project. Once the recommendations are finalized, they will be made public on Provider Connections' website along with research and initiatives.

Afton Partners will also continue to work with the Workforce Workgroup moving forward however, the Workforce Workgroup's focus is on the needs of the workforce and not on the fiscal components of this project.

Alison asked if there is a need at this time to make a motion to create a special workgroup to address fiscal needs. Benny responded that more information is needed and asked the council for their position at this time.

After a short dialogue it was decided that the charge of a workgroup be specific and detailed to be effective. More information is needed before moving forward. No motion made.

7) Public Act 102-0926 - Substantiated Abuse/Neglect Auto Eligibility Workgroup: Benny

A brief history of this legislation and the creation of this workgroup was given prior to updates. Since January's IICEI meeting, DCFS has completed a legal review of the legislation. A technical assistance meeting was held with OSEP that offered information on the impact of the legislation and strategies to consider working towards access to the system for children and families in the welfare system to be as smooth as possible. Moving forward the workgroup continues to meet weekly and will report back as new information is available. A few questions were posted to Zoom Chat and addressed.

8) Dept. of Early Childhood Agency Update: Ann Whalen

Ann provided a brief recap of the history of the progress in moving to a new single State Department of Early Childhood Agency.

Phase 1 is complete. Moving into Phase 2, 'Start Up, Redesign, and Prepare to be Fully Operational", begins the authorization and of the New Agency. Senate Bill 1 passed out of the Senate with bipartisan unanimous support, passed out of the House committee with bipartisan unanimous support, and passed out of the House floor with an overwhelming majority of bipartisan support. It is anticipated that the governor will sign the bill within the designated 60-day timeline.

Ann clarified that this legislation authorizes the new agency and lays out the timeline for programs and services to come together under this new agency. IT DOES NOT make any policy changes to current programs and services. Phase 2 is designed to be a 2-year period that will move forward thoughtfully and with detailed intention, centered on equity and family and provider voices, to integrate current programs and services under the one umbrella of this new agency. The goal is to be fully operational by July 2026. FY'25 includes financial resources to do this work.

Further details into the processes of Phase 2 were presented. Ann also shared opportunities for public engagement in this work.

Questions from the council included:

  • Because the School for the Deaf and Visually Impaired are under DHS, are they included in the workgroups and planning stages?
  • Are there additional ways to think about coordinating or engaging in this work?
  • What can we provide to our CFCs and LICs to share information?

 Alison highlighted past meeting minutes in which it was suggested that the Council consider creating a workgroup to help guide this transition. 

9) Modified Service Delivery Update: Kristen Schraml/Shameka Brown

Kristen and Shameka, coordinators of this project, shared a brief history of the 2021 Legislative Black Caucus that led efforts to pass legislation to increase equitable access to EI services to children and families from historically marginalized and underserved populations. The Workforce and Education Equity Act called for DHS to develop a plan for the State to pilot modifications to service delivery and address the complex needs these families may face and reduce service delays.

Three main phases comprise this Pilot Project: Planning, Implementation, and Evaluation. We are currently in the Planning Phase.

The 6 strategies to support the objectives of the Project were briefly reviewed with a greater focus on Strategies 1 & 3.

1st Strategy Focus: Determine CFCs best positioned to be Pilot Sites.

* Criteria considered for CFC pilot sites included: high service delays, included DCFS involvement, Medicaid enrollments, determination codes from 2023 Cornerstone data, demographics based on 2022 Census data, CFC leadership, caseloads, vacancy rates, and prior experience with other projects.

2nd Strategy Focus: Support, promote, and strengthen local leadership.

* The importance of working together to support and promote the strength of local leadership so that pilot sites have the support that is needed and can build upon existing streams and co-create supports that fit the culture and needs of the region.

 3rd Strategy Focus: Support EI professionals' knowledge and skills and build capacity to implement evidence-informed practices through professional development.

  • Principles of Family-Centered care informed and inspired the development of the professional development plan.
    • Partner with families and colleagues from an anti-racist approach.
    • The Family is the unit of service so that babies and young children exist within the context of loving relationships with caregivers.
  • Family identified priorities, services involving individualized care or services to match family's needs, and utilizing a strength-based approach that supports families, their lifestyles, and their circumstances.
  • Both Asynchronous and synchronous learning opportunities will be offered as well as reflective practice groups and resources for ei professionals. The content areas are to include:
    • Trauma informed care
    • Homelessness
    • Anti-racist practices
    • Culturally and linguistically responsive care
    • Domestic violence
    • The child welfare system
  • PD opportunities provided by the EI Training Program incorporate as many evidenced informed professional development practices as possible including:
    • Authentic job embedded opportunities to practices and evaluate experiences using them.
    • Inclusion of different types of practices for engaging and reflection on understanding and mastery of particular practices
    • Coaching, mentoring, or performance feedback during inservice trainings.
    • Ongoing follow-up to reinforce learning.

 4th Strategy Focus: Review/modify, clarify policies procedures funding mechanisms to provide EI with adequate resources to support families.

* Determining what current policies and procedures need to be clarified or expanded upon to ensure they are being implemented as intended.

 5th Strategy Focus: Analyze current credentialing process and requirements for some of the EI workforce with the purpose of promoting awareness about workforce shortages and recruitment needs.

 6th Strategy Focus: Plan, collect, and analyze data and activate the pilot.

Kristen noted that the recommendations from current projects, i.e., Cross State Research, Cost modeling, etc will be used to inform the work of the Modified Service Delivery project as it moves forward.

10) Differentiated Monitor and Support (DMS) 2.0: Chelsea Guillen

OSEP is implementing a new DMS 2.0 review process that will be coming to Illinois in the next 2 years.

Chelsea presented a high-level overview providing information about this visit and the expectations around general supervision within the early intervention system. The goal of DMS 2.0 is to improve outcomes and results for infants, toddlers, children, and youth with disabilities and their families and to ensure compliance with the rules and regulations outlines in IDEA

5 Monitoring Cohorts have been established to schedule the monitor of all states. - Illinois is in Cohort 4 with engagement scheduled between August 2026 and January 2027.

A brief presentation of the 3 Phases of the process, 1) Discovery, 2) Engagement, 3) Close-Out was outlined.

  • The Discovery Phase begins 5 months prior to Phase 2-Engatement and is focused on the review of publicly available documentation and State submitted documentation requested by OSEP. This phase has 4 components and begins 5 months prior to Phase 2
    • Document Request
    • State Overview Call
    • Stakeholder Engagement
    • Local Component
  • Phase 2, The Engagement Phase is one month period that includes
    • OSEP's actual monitoring on-site visits and virtual monitoring calls
    • Issuance of DMS Monitoring Report
  • Phase 3, Close-Out Period. This can occur for up to one year after the report has been issued with the purpose of
    • Review of evidence of correction
    • Provide Technical Assistance so that the State has support to reach compliance.

Chelsea shared that the Discovery Phase is most relevant to council members with OSEP reaching out to stakeholders.

OSEP's rationale is that without effective monitoring lead agencies do not know whether or how infants and toddlers with disabilities and their families are receiving needed Part C services. In addition, effective monitoring of key results areas helps the lead agency examine and understand potential causes for poor performance on outcomes measures. OSEP is phasing in the general supervision indicator to the current key result areas. A brief example of current review practices and resources were shared.

11) APR/SSP Clarification Results: Benny

Regarding Annual Performance Report (APR) submitted earlier this year, minor clarifications/typos have been identified and corrected. Now waiting for determination results.

12) Payment Error Rate Measurement (PERM) Audits: Benny

HFS is conducting Payment Error Report Measurement audits, through EMPOWER AI. The purpose is to report any improper payments, insurance fraud, made in Medicaid and Childrens Health Insurance Program (CHIP). As per our Payee requirements, Providers may or may not be contacted by EMPOWER AI for records.

Back in 2019 it became required that claims to Medicaid include NPI numbers of PT, OT, SLP, Audiology, AT Vendor, referring physician or provider. Since then, outstanding questions regarding this process have been resolved and system changes will be phased in beginning October 2024.

13) Bureau Updates: Benny

  • Bureau Staff - New Bureau Staff includes Cassandra Squires, Contracts and Grants Manager; Lisa Cave, Fiscal Manager; Charlotte McAneney, EI Services Manager; Karen Lewis, Administration Assistant in the Chicago Office; Kelly Spencer through Temp Services currently provide admin support to Benny. An organizational chart to be shared is in the process. Benny also acknowledged the passing of long-time Bureau Staff member, Colleen Cunningham.
  • Proposed rules changes that were open for public comment include: Family Fees; Updates to extended services; Auto eligibility; and Rule 500. 34 comments received, 33 related to Family Fees - It remains uncertain as to when these changes to family fees will take effect.
  • ARPA Incentive Payments - Moving forward with resolving issues in some payments. Approximately 100 payments continue to be stuck in the process. Identifying and resolving tech issues is in place with the end of June targeted for issues to be resolved and payments made.
  • Data Management System - continue to work towards implementation of a BETA process. Code Tables are being finalized. A Project update from the developer is expected soon.

14) Upcoming Council Meeting Location: Alison

July 11th meeting planned to be in person/Hybrid. With changes in council membership, it was asked if members are still open to this option. Some responded that they were. The July IICEI Meeting will be held in a hybrid meeting format. Location to be determined.

15) Public Comment Period

  • Rachel Mika, PT Provider, expressed her thanks for today's presentations and requested that recorded meetings be made available to providers who are not able to be present.
  • Talibah Moore, Community Organizer, shared her past EI experience and is grateful to Springfield CFC for support. She has since moved to Chicago are hears many negative references to EI. She currently has a toddler that was referred for EI services in October 2023. The IFSP was held in March 2024. Her child recently turned 3 and received 1 month of services before aging out of EI. Talibah stated that she is an avid supporter of Illinois EI and will continue to be but is extremely disappointed with her recent early intervention experiences. Not receiving the services that were promised and entitled to her child and family was traumatic. Families should not have to go through those experiences with Illinois Early Intervention.

16) Adjournment

 Angel motioned to adjourn. Lynette seconded. Motion passed. Meeting adjourned at 12:48 pm.

Meeting Recording

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.