January 9th, 2025 - 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 via Zoom teleconferencing, please utilize the link below provided by Illinois Early Intervention Training to register for the meeting.

IICEI Registration: Thursday, January 9th, 2025

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
  • Approval of October 10th, 2024 Minutes
  • Message from Parent
  • Advocacy Update
  • Workforce Workgroup Update
  • Fiscal Responsibilities of Council Presentation
  • Annual Performance Report
  • Telehealth Workgroup
  • Cost Modeling Report
  • Bureau Updates
    • DMS 2.0
    • DEC Secretary Announcement
    • Bureau Staff Update
  • Public Comment Period
  • Adjournment of Meeting

Attendees

IICEI Members In Attendance
Alison Liddle, Provider Representative/Chairperson Yes
Aasma Tariq, Parent Representative Yes
Anastasios "Taso" Michalopulos, Provider Representative Yes
Angel Williams, Illinois Department of Child and Family Services Yes
Angelia Lee, Head Start/Early Head Start Representative 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
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
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
Gary Arnold in attendance for Margaret Harkness, IL Council on Developmental Disabilities Yes
Matthew Pickett, IL Dept. of Insurance Yes
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 - October 10th, 2024
  • Workforce Workgroup Update
  • Cost Model Report
  • 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 9:30

2) Introductions of Council Members

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

Benny expressed gratitude for the support of Donna Emmons and years of service on IICEI. Donna's seat is now filled by Angelia Lee.

3) Approval of the Draft Council Meeting Report - October 10, 2024

Brittni made a motion to approve the minutes. Kate seconded. Motion passed. Minutes approved as distributed.

4) Message from the Parent

This parent shared that she has 2 sons, a 4 year old who had received speech and physical therapy services through early intervention and a 2 year old with significant needs, currently receiving 6 services through early intervention. Her youngest son is currently at a developmental level ranging from 5 - 9 months old. He has less than a year before aging out of early intervention. Her school district is part of a special ed Coop and her local school program does not have the resources to support him. This parent is advocating for homebound services through the school district; however, the supports needed will not be provided. Any consideration for extended early intervention services in any capacity beyond the age of 3 for her son would be a huge help to her family.

Benny opened the discussion by reflecting on the critical role of the transition process and asked the council to consider any opportunities that early intervention services can be further utilized to support families. Comments included:

  • Acknowledged that there is a need for many families to receive extended services and the value in exploring further opportunities for early intervention to expand services. However, the questions of whether early intervention has the resources to do so when current needs are not being met due to provider shortages.
  • Are there existing agencies to meet this need? ISBE or Advocacy services?
  • The need for family advocacy was expressed.
  • The Early Intervention System and the School System are different, each with a different focus. Further outreach to ISBE was suggested to strengthen partnerships between the two systems and to better address the needs of families when transitioning from one system to another.

5) Advocacy Update: Zareen Kamal

Updates on the Babies Can't Wait campaign to increase funding included:

  • 9 Rallies and press conferences were held and well attended. Media coverage was provided for events.
  • A Change.org petition was shared during the rallies.
  • A survey by the Grassroots Alliance showed that 20% of the providers indicated that they would remain in EI if no improvement were made within the coming year.
  • Continued collective advocacy leading up to the Governor's Budget address is crucial. Over 40 organizations have signed on to support the call for an increased budget to EI.
  • An online action campaign encouraging all to send letters to legislators is in the works.
  • Early Childhood Advocacy Day in Springfield is scheduled for March 4th.
  • Keesha shared updates on her involvement in a new advocacy group to further raise awareness through several social media outlets of the need for further early intervention supports to families. Keesha stated that she is also recording the Council meeting to share through social media.

Benny also shared that EITP records the Council meetings and provides the recordings to posted to the DHS website.

Workforce Workgroup Update: Carol Muhammad and Chelsea Guillen

Carol began her update acknowledging the commitment of the workgroup members and the efforts to address the charges before them. The group continues to meet on the 2nd Tuesday of the month. Updates included:

  • Using feedback from a recent survey of those providers recently completing the required System Training for credentialing, the Workgroup's recent focus has been on mentorship and supports to new providers in the credentialing processes.
  • The November meeting focused on the challenges experienced by providers with system entry/the credentialing process and then getting referrals once credentialed. Survey responses reflected the challenges of lengthy timelines of the credentialing process and confusion of the guidelines/process of obtaining a credential. Challenges also express were those of insurance and billing concerns.
  • The December meeting was a year-in-review wrap up addressing any issues that might have been overlooked in previous meetings and the needs of provider retention.
  • Working with Afton Group has been beneficial
  • Further rationale and insights into the survey used to help define the focus of this workgroup were also shared.

Comments: Benny expressed his appreciation for the leadership and commitment of the members of this workgroup.

6) CIFR: Fiscal Responsibilities of Council Presentation

Meg Nelson and Sarah Walters

The Center for IDEA Fiscal Reporting (CIFR) presented a brief overview of its mission and recent support provided to the IL Bureau of Early Intervention. CIFR is a technical assistance center that helps guide states to improve the quality and use of the IDEA Part C and Part B fiscal data to advise and assist in making financial programmatic decisions and meeting IDEA fiscal requirements.

Identify Fund Sources.

Fiscal responsibilities of the Council are to advise the Lead Agency in making financial and programmatic decisions that include identifying available resources, provide feedback and guidance on the grant budget, the use of grant funds to support Council activities. Each state is different in how they finance on early intervention. Some available revenue sources are State funds, Local funds, Insurance/Medicaid, Federal funds and programs.

The Council also prepares and provides broad stakeholder feedback, fiscal guidance for funding surplus/shortfall or movement of funds between line items, and the impact of extraneous factors, such as public emergencies/natural disasters, on funding.

The use of federal funds for early intervention services are prescriptive and to be the payer of last resort.

Subject to the approval of the Governor, funds may be used to:

  • Conduct hearings/forums
  • Reimburse council members for expenses to attend council meetings and perform duties. This also includes childcare for parent members.
  • Paid compensation to unemployed members or who forfeit wages from other employment to perform official Council business.
  • Hiring services of professional/ technical/clerical support to carry out Council functions.

CIFR has been working with Benny and the Bureau of IL Early Intervention to advise and lay foundational groundwork in the development of a fiscal sub-committee workgroup; provide resources/information on how other states use fiscal workgroups and determine the next steps in the implementation of the charge of a Fiscal Workgroup.

Discussion followed on what, if anything, can be done to address issues with Medicaid and increase Medicaid reimbursement rates? Benny is working to further partnerships and understanding of how Medicaid contributes to EI funding. Benny meets regularly with Medicaid counterparts to address current access and iniquities because of Medicaid funding policies/practices.

7) Annual Performance Report (APR): Chelsea Guillen

FFY23/SFY24 APR overview

Data reflected in this report cover children that exited EI from July 1, 2023 - June 30, 2024

  •  Indicator 1 (Compliance Indicator - requires 100% compliance) does not meet 100% but in improving
  •  Indicator 2 (Results Indicator - 96% Compliance) small drop but compliance met
  •  Indicator 3 (Child Outcomes - data separated between the 3 Child Outcomes) overall indicators continue to trend downward
  •  Indicator 4 (Family Involvement - data reflects Family Outcome Survey responses) slight slippage
  •  Indicator 5 (Child Find) - exceeded target
  •  Indicator 6 (Child Find) - exceeded target
  •  Indicator 7 (45-Day Timeline - Compliance Indicator) did not meet 100% compliance
  •  Indicator 8 (Transition - 3 Part Compliance Indicator) did not meet 100% compliance
  •  Indicator 9 (Resolution Sessions) Illinois does not currently meet the minimum required to report
  •  Indicator 10 (Mediation) Illinois does not currently meet the minimum required to report
  •  Indicator 11 (SSIP) - exceeded target
  •  Indicator 12 (New indicator - currently optional) no data to be reported

 A comprehensive report will be issued to the Council mid-January before submitted to OSEP

8) Telehealth Workgroup: Alison Liddle

Benny presented highlights of the charge of this Workgroup and asked Council Members to consider chairing the workgroup.

The mission of the workgroup is to advise on the continued long-term use of LVV focused on 5 key elements of the charge.

  • The use of LVV for Intake, Evaluations, Assessments, and IFSP Meetings
    • Review existing guidance on the use of LVV
    • Develop recommendations for the use of LVV by CFC offices in IFSP meeting ensuring that families are supported and engaged in the process
  • Decision-Making Process for LVV Utilization in the IFSP
    • Provide guidance on the decision-making process for including LVV as a service delivery option
    • Develop strategies to support teams in the facilitation of meaningful and supportive conversations with families about LVV ensuring that it is one of several options offered
    • Review the current IFSP template and recommend updates to ensure clear documentation of team decisions to use LVV, in-person, or hybrid service delivery.
  • Resources for Families and Providers
    • Review existing resources related to the use of LVV and assess their relevance and effectiveness in current permanent implementation context.
    • Identify gaps or additional resources needed to better support families and providers in understanding LVV, its implementation, and making informed decisions
    • Recommend strategies for the dissemination and utilization of resources at key points in the EI service delivery process
  • Professional Development and Training
    • Review existing training materials created for LVV implementation to determine if updates are needed
    • Identify existing workforce needs to inform future learning opportunities for providers
  • Alignment with Practice Acts for Licensed Professionals
    • Review all relevant practice acts for licensed therapists regarding the use of telehealth.
    • Identify conditions specifying when telehealth can be utilized and the required documentation to ensure compliance with these practice acts
    • Provide recommendations to ensure EI policies/procedures for LVV align with requirements of licensed professionals' practice acts

9) Cost Modeling Report: Afton Partners

Leslie Schwartz and Abby McCarty were brought back and reported on the results of this Project that began October 2023 that began with information gathering through data collection, focus group, and surveys. Context/History of this report was briefly reviewed highlighting the specific goals of the project to understand the full cost of the EI System and to develop recommendations for a payment structure that will meet the needs.

Current State of Illinois EI based on information gathered in the early stages of this project

  • Illinois served 10.2% of children under the age of 3, ranking 12th out of all states 2022-23.
    • However, this may not reflect all children who need EI services. Some estimates indicate that 13-20% of children under the age of 3 could benefit from EI. It was also noted that Illinois recently expanded eligibility to include children in care of the state and those who have experienced abuse or neglect creating a larger population of eligible children who could benefit from services.
  • Massachusetts currently leads all states in the percentage of children served at 20.2% in 2022-23.
  • The current EI System does not meet the needs of many EI Practitioners and families.
    • Payment structure for providers is far too low
    • Families struggle to access services in a timely manner - Intake delays reached a 5-year high in 2023
    • Active providers declined by over 6% while Active cases increased 5%
    • Of the Provider reimbursement rates compared across 11 states in this study, Illinois ranks 10th

Key Takeaways: Input from EI families and practitioners informed payment reform recommendations:

  • Rates should provide competitive compensation that accounts for all of providers' time.
  • Compensation should reflect the challenges of serving underserved areas.
  • CFC funding should reflect modeled costs, including reduced Service Coordinator caseloads.

Payment Reform Draft Recommendations

  • Make progress towards aligning base pay and grants to modeled costs
    • Align Base pay to market rates and ensure rates cover the full amount of time to provide services and account for cancellations.
    • Modify CFC grants to reflect modeled costs and set minimum service coordinator salaries.
    • Partner across agencies to maximize federal revenues and Medicaid reimbursements.
  • Consider layering additional incentives to reach under-served and multilingual communities.
  • Pilot other structural changes that need further exploration.

This Cost Modeling study concluded the following:

  • On average, the modeled cost of delivering EI services is 95% higher than current direct service rates.
  • The difference between current spending on direct services and projected spending on rates that reflect the modeled cost is estimated to be approximately $150M (This $150M considers a projected 5% increase in services provided as more children and families are eligible to access services.)
  • For CFCs, the average cost of operation at salary levels that reflect staff's education and experience is estimated to be $3M for an average CFC, compared to the current average grant size of $2.3M
  • The estimated cost to increase grant sizes to this level is approximately $18M statewide.

Reaching Underserved Communities Recommendations

  • Consider higher rates for services in underserved areas.
  • Consider higher rates or additional compensation for multilingual providers.

Piloting Structural Changes to Consider

  • "Grow Your Own" program
  • Salaried Employment Options
  • Mentoring & Coaching
  • Provider Benefits Pool

Ann Whalen, IDEC, expressed the significance of this report and its consideration as the new IDEC Agency comes together. This report will be shared with the IDEC Transition Advisory Committee.

Comments and questions included

  • It was asked if the cost model included any support for awareness activities.
    • A valid question, but no. The focus of this project was the workforce.
  • There was much appreciation for the work of this project and raising the level of awareness to the status of service delivery in Illinois Early Intervention.

A motion was made to draft a letter to the governor and was made by Keesha. Second by Zareen. No further discussion.

Motion passed. The advocates on the council will draft the letter for review.

Bureau Updates: Benny Delgado

  • A link to the Illinois Register and the document proposal to the administrative rule regarding family fees was provided.
  • DMS 2.0 the date has been extended to 2027 or 2028.
  • Therese Ramos has been named to the new position of the DEC Secretary.
  • Charlotte McAneney resigned leaving a vacancy that the Bureau hopes to fill as soon as possible.

10) Public Comment Period

Ericka Reffett expressed the need to bridge the gap between NICU and home babies.

Talibah Moore requested updates on Modified Service Deliveries in Pilot areas. Lesley Schwartz responded indicating that further information will be available in the coming weeks.

Delreen Schmidt-Lenz expressed gratitude for the information shared in the meeting and all the good work being done to benefit children and families.

Keesha expressed her thank you, again, to Afton Partners and all for raising awareness to families.

Request was made through chat for an update on the new Data System. Benny reported work continues with the development and finalization of the sign-on processes and CBO functions.

11) Adjournment

 Carol motioned to adjourn. Chuck seconded. Motion passed. Meeting adjourned at 1:00 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.