Indicator #7 - IFSPs Initiated within 45 Days of Referral

IFSPs Initiated within 45 Days of Referral

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Part C State Annual Performance Report (APR) for FFY 07/SFY 08

Overview of the Annual Performance Report Development:

The Illinois APR documents performance data on State targets for each Child and Family Connections (CFC) office and documents CFC and state progress or slippage toward measurable and rigorous targets. The Illinois Early Intervention (EI) Program makes the Illinois APR and State Performance Plan (SPP) available on its web site and through links from the other EI web sites (the Illinois Early Intervention Training Program; Provider Connections, the Early Intervention credentialing office; and the Early Childhood Intervention Clearinghouse). The APR and SPP documents are also available to the public at each of the 25 CFC offices.

The APR is part an ongoing process of performance measurement and strategic planning for the Illinois Early Intervention Program. For a number of years, Illinois has been reporting performance data to key stakeholders including the Illinois Interagency Council on Early Intervention (IICEI), the Child and Family Connections (CFC) offices, and the general public through various reporting mechanisms. Work groups of the IICEI have been formed to address specific indicators (Service Delay Work Group and Transition Work Group) and overall operation issues (Finance Work Group). These work groups have helped analyze data and suggest improvement strategies.

Since January 2002, Illinois has taken an aggressive approach to the measurement and reporting of the timeliness of eligibility determination, particularly compliance with the 45-day rule. Since that time, performance has been reported monthly on the proportion of intake over 45 days, the proportion over 75 days, the proportion of new IFSPs initiated within 45 days, and the average number of days between referral and initial IFSP date. Although few cases go past 75 days, each month we continue to report it because we find most of these cases are data entry or system errors. Generally, most of the necessary work has been completed but some step was missed. This is an extra check to make sure cases do not slip through the cracks.

Several of these measures are part of the program's performance contracting system for which service coordination agencies can earn incentive funding or for which they can be penalized if they fail to meet minimum standards. Performance has periodically been posted on the program website and is reported regularly to the IICEI.

This ongoing reporting process forms the basis for most APR report development. In addition, the program now has a reporting element that requires the assignment of the reason a case took more than 45 days to start an IFSP: CFC, family or provider. That later addition has been used to factor out instances where it took more than 45 days to initiate an IFSP due to family reasons. However, the programs ongoing reporting does not make that distinction because experience has demonstrated that such an exception takes the pressure off and delays for any reason are detrimental to children. Therefore, some of the analysis that follows also shows performance including delays for family reasons.

Monitoring Priority: Effective General Supervision Part C / Child Find

Indicator 7: Percent of eligible infants and toddlers with IFSPs for whom an evaluation and assessment and an initial IFSP meeting were conducted within Part C's 45-day timeline.

(20 U.S.C. 1416(a)(3)(B) and 1442)

Measurement:

Percent = [(# of eligible infants and toddlers with IFSPs for whom an evaluation and assessment and an initial IFSP meeting was conducted within Part C's 45-day timeline) divided by the (# of eligible infants and toddlers evaluated and assessed)] times 100. Account for untimely evaluations.

FFY: 2007 (7/1/07-6/30/08)

Measurable and Rigorous Target: All new IFSPs will be initiated within 45 days of referral.

Actual Target Data for FFY 07/SFY 08: On June 30, 2008, 99.43% of IFSP were initiated within 45 days of referral.(16,881/16,982) *100=99.43%

Actual Target Data for FFY 07/SFY 08:

Measure	FFY 06/SFY07 Actual	FFY 06/SFY07 Goal	FFY 07/SFY08 Actual	FFY 07/SFY08 Goal
Plans Initiated within 45 Days	99.03%	100.00%	99.43%	100.00%

NOTE: Illinois utilizes its Cornerstone data system to measure every the time in intake of every child. All of the tables utilized in this indicator reflect 100% of all cases going through the intake process. However, for purposes of identifying non-compliance, and informing service coordination agencies of non-compliance in writing, we utilize performance for the month of April. Also, in the tables below, the first table showing the distribution of reasons for going past 45 days excludes reenrollments. The history tables that follow include reenrollments. That is why the percent within 45 days is slightly higher in the history tables.

During FFY 07/SFY 08 Illinois continued to reduce the number of instances where it took more than 45 days to initiate an IFSP. For the year 349 of 17,234 new initial IFSPs took more than 45 days, compared to 555 in the previous year. Of that total 252 were delayed due to family reasons and 97 were for system reasons. A total of 97.95% of cases were started within 45 days overall (16,881/17,234). Removing delays for family reasons, 99.43% of new IFSPS were initiated within 45 days (16,881/16,982).

Federal rules allow states to remove family delays from the calculation of service delay performance. So, we report performance for the year based on a federal definition, which excludes cases delayed for family reasons. However, Illinois includes delays for family reasons as part of a state definition. Analysis is included for each definition on both the statewide and local levels.

For the year all of the three larger geographic groupings (Cook, collar counties and downstate) completed more than 95% of cases within 45 days, even by the state definition. Downstate continued to experience more problems than the other two areas. Only four CFCs completed less than 95% of initial IFSPs within 45 days, with 92.68% being the lowest for the year. Excluding family delays, every CFC finished more than 95% of cases within 45 days. The 96.12% for the Bloomington/Danville/Champaign area was the lowest. Eight CFCs completed FFY07/SFY08 with no case going over 45 days for a system reason.

With such small numbers, most delays were created by unusual situations in the individual case or short-term problems for an individual Service Coordinator or provider. Another contributing factor can be problems identifying enough providers. For instance, the Freeport and Kane (CFC 3) & Kendall county (CFC 4) areas each has experienced significant problems identifying enough providers. Similarly, CFC staff vacancies can create problems. That has been a problem for CFC 21 (Metro. East St. Louis) CFC 4 is in a rapidly growing suburban area and CFC 3 has problems in more rural areas that create coordination challenges.

FFY 07/SFY 08 IFSPs Initiated* Within 45 Days Reasons for Delay

CFC # & Name	Total *	Not Delayed	CFC Delay	Family Delay	Provider Delay	On Time	On Time Less Family Delay
#1 ROCKFORD	594	589	1	4	-	99.16%	99.83%
#2 LAKE COUNTY	820	815	3	1	1	99.39%	99.51%
#3 FREEPORT	297	285	2	6	4	95.96%	97.94%
#4 KANE-KENDALL	850	798	4	38	10	93.88%	98.28%
#5 DUPAGE COUNTY	1,186	1,180	2	3	-	99.49%	99.83%
#6 N. SUBURBS	1,487	1,476	4	3	2	99.26%	99.60%
#7 W. SUBURBS	888	884	1	2	1	99.55%	99.77%
#8 SW CHICAGO	712	710	-	2	-	99.72%	100.00%
#9 CENTRAL CHICAGO	882	882	-	-	-	100.00%	100.00%
#10 SE CHICAGO	666	664	1	1	-	99.70%	99.85%
#11 N. CHICAGO	1,941	1,859	5	71	6	95.78%	99.41%
#12 S. SUBURBS	1,000	999	-	1	-	99.90%	100.00%
#13 MACOMB	363	357	-	4	1	98.35%	99.72%
#14 PEORIA	571	533	-	32	6	93.35%	98.89%
#15 JOLIET	1,340	1,318	8	9	5	98.36%	99.02%
#16 BLOOMINGTON	615	570	9	22	14	92.68%	96.12%
#17 QUINCY	217	216	-	1	-	99.54%	100.00%
#18 SPRINGFIELD	304	296	2	6	-	97.37%	99.33%
#19 DECATUR	312	312	-	-	-	100.00%	100.00%
#20 EFFINGHAM	394	394	-	-	-	100.00%	100.00%
#21 BELLEVILLE	624	586	1	36	1	93.91%	99.66%
#22 CENTRALIA	355	353	-	2	-	99.44%	100.00%
#23 NORRIS CITY	201	197	1	3	-	98.01%	99.49%
#24 CARBONDALE	156	155	-	1	-	99.36%	100.00%
#25 MCHENRY CO.	459	453	1	4	1	98.69%	99.56%
Statewide	17,234	16,881	45	252	52	97.95%	99.43%
% of Total	100.0%	97.95%	0.26%	1.46%	0.30%
Cook County (6-12)	7,576	7,474	11	80	9	98.65%	99.73%
Collar (2, 4, 5, 15, 25)	4,655	4,564	18	55	17	98.05%	99.24%
Downstate (All Others)	5,003	4,843	16	117	26	96.80%	99.14%

* Table does not include reenrollments. Except for average days to initial IFSP, all other tables includereenrollments. Most reenrollments take only a few days and almost never more than 45 days.

The sharp improvement in 45-day rule compliance can be traced back to the introduction of regular monthly reporting initiated in January 2002 and the related introduction of performance contracting effective July 1, 2002. This was reinforced by the insistence of the program that it would not consider delays for family reason any differently than other delays. In addition, once the ongoing number of cases over 45 days fell below 100 the program introduced periodic reports of cases that appeared to be over 45 days. This allowed agencies to further refine their processes and to learn about cases that appeared over 45 days due to data errors.

Illinois Early Intervention Program Monthly 45-Day Compliance

Description of Illinois Early Intervention Program Monthly 45-Day Compliance

Immediately after regular monthly reporting was introduced and the outline of performance contracting was introduced, the percentage of IFSPs initiated within 45 days began to improve. Only 31.3% of IFSPs started within the mandated timeframe in SFY 02 and three CFCs completed less than 20% of IFSPs on time. There was a dramatic improvement in SFY 03 but more than 20% of IFSPs still took more than 45 days. In SFY 04, the program initiated more than 90% of IFSPs within 45 days for the first time. That was also the first year in which individual CFCs completed 100% of IFSPs within 45 days. In FFY 07/SFY 08 only three CFCs completed less than 99% of initial IFSPs within 45 days, excluding family delays.

IFSPs Completed Within 45 Days
By CFC & Region, Not Excluding Family Delays

CFC # & Name	SFY02	SFY03	SFY04	SFY05	SFY06	SFY07	SFY08	Rank
#1 ROCKFORD	34.5%	74.7%	89.5%	95.7%	98.0%	98.5%	98.7%	17
#2 LAKE COUNTY	11.9%	72.1%	91.7%	97.7%	99.1%	99.2%	99.6%	9
#3 FREEPORT	30.0%	65.9%	85.0%	90.4%	93.5%	95.0%	96.4%	20
#4 KANE-KENDALL	20.1%	71.7%	85.1%	93.5%	91.2%	92.4%	94.3%	25
#5 DUPAGE COUNTY	33.2%	87.5%	97.2%	99.2%	99.1%	99.6%	99.6%	11
#6 N. SUBURBS	17.0%	88.6%	96.2%	97.4%	97.6%	99.1%	99.6%	10
#7 W. SUBURBS	41.4%	68.1%	94.4%	97.7%	99.3%	99.4%	99.9%	5
#8 SW CHICAGO	44.5%	98.7%	100.0%	100.0%	100.0%	99.9%	99.9%	6
#9 CENTRAL CHICAGO	42.1%	93.0%	100.0%	99.7%	99.9%	99.7%	99.8%	8
#10 SE CHICAGO	30.0%	93.5%	98.3%	98.4%	99.1%	100.0%	99.9%	7
#11 N. CHICAGO	34.3%	81.2%	90.7%	92.5%	91.3%	91.2%	96.4%	21
#12 S. SUBURBS	28.2%	73.7%	89.0%	98.2%	99.8%	99.9%	100.0%	1
#13 MACOMB	32.3%	83.0%	89.6%	92.0%	96.3%	98.7%	99.2%	13
#14 PEORIA	26.6%	69.9%	77.7%	90.1%	93.9%	94.6%	94.6%	22
#15 JOLIET	35.9%	70.2%	76.1%	92.7%	93.4%	98.5%	99.0%	14
#16 BLOOMINGTON	19.3%	70.5%	76.4%	76.6%	92.9%	92.7%	94.5%	23
#17 QUINCY	31.0%	63.4%	90.8%	93.8%	98.4%	100.0%	100.0%	1
#18 SPRINGFIELD	37.3%	77.1%	89.7%	93.2%	95.8%	97.8%	97.8%	19
#19 DECATUR	44.3%	93.9%	100.0%	100.0%	100.0%	100.0%	100.0%	1
#20 EFFINGHAM	38.1%	90.9%	95.6%	98.0%	97.3%	93.5%	100.0%	1
#21 BELLEVILLE	33.6%	69.1%	88.6%	91.1%	93.1%	91.7%	94.4%	24
#22 CENTRALIA	25.8%	79.3%	93.4%	95.7%	96.7%	99.2%	99.2%	12
#23 NORRIS CITY	31.1%	79.6%	86.4%	87.0%	94.1%	99.0%	98.7%	18
#24 CARBONDALE	35.0%	70.7%	96.3%	90.4%	97.5%	98.6%	98.8%	15
#25 MCHENRY CO.	40.7%	82.0%	92.1%	94.9%	97.5%	99.5%	98.8%	16
Total	31.3%	79.4%	90.9%	95.0%	96.4%	97.2%	98.3%
Super Regions
Cook - 6, 7, 8, 9, 10, 11 & 12	33.0%	84.3%	94.6%	97.0%	97.3%	97.6%	98.9%
Collar - 2, 25, 4, 5, 15	28.2%	76.2%	88.1%	95.7%	95.9%	97.9%	98.4%
Balance of the State	31.9%	75.7%	88.2%	91.3%	95.6%	96.2%	97.3%

The average time it takes to move children from referral to IFSP is not a federal measure. However, the 45-day principle is based, at least in part, on the same principles that guide Early Intervention in general. The sooner you get to a child the better. If 45 days is good then fewer than 45 days would be better. The program also views it as a measure of customer service. The sooner a family can get an answer the better. Including the average time to IFSP as a performance contracting incentive measure reinforces the importance of the 45-day rule and assures that the process does not uniformly complete eligibility determinations in 40-45 days when they can be finished sooner.

In SFY 02, when reporting and performance contracting were introduced, all 25 CFCs averaged more than 45 days to process IFSPs. The best performer was CFC 19 (Decatur) in 48.94 days. The high was CFC 6 (Northern Cook County) at 87.36 days. The statewide average was 65.3 days. It would have been worse but reforms were introduced in the middle of the year and they had an immediate positive impact. The next year, with performance contracting in place, only one CFC averaged more than 45 days and the statewide average fell to 35.88 days. The average has continued to fall and was 27.21 days for FFY 07/SFY 08, as each individual CFC has found ways to fine-tune their systems to improve the eligibility determination process.

Average Time (Days) in Intake By CFC & Region

CFC # & Name	SFY02	SFY03	SFY04	SFY05	SFY06	SFY07	SFY08	Rank
#1 ROCKFORD	65.52	39.27	35.51	32.46	29.59	26.61	27.96	10
#2 LAKE COUNTY	87.30	47.16	33.69	30.82	32.15	30.17	27.47	9
#3 FREEPORT	64.70	43.53	35.71	32.47	32.15	31.90	29.71	14
#4 KANE-KENDALL	78.03	37.66	38.41	32.83	34.96	34.59	34.04	25
#5 DUPAGE COUNTY	76.30	33.32	33.90	33.48	34.45	33.53	33.39	23
#6 N. SUBURBS	87.36	38.41	34.40	30.29	31.38	29.14	29.48	12
#7 W. SUBURBS	53.53	37.84	30.90	26.53	27.99	25.67	24.48	6
#8 SW CHICAGO	57.45	28.44	21.11	18.00	17.61	16.89	17.27	2
#9 CENTRAL CHICAGO	59.10	28.11	25.66	26.04	24.17	21.98	21.65	4
#10 SE CHICAGO	79.74	20.14	20.65	16.33	16.56	17.12	15.29	1
#11 N. CHICAGO	56.78	35.12	31.60	29.91	31.22	31.40	29.89	17
#12 S. SUBURBS	62.94	35.51	32.15	24.14	21.98	20.95	22.92	5
#13 MACOMB	55.23	35.83	35.91	33.58	29.23	28.53	29.20	11
#14 PEORIA	64.56	44.03	39.91	34.14	30.76	29.45	29.74	15
#15 JOLIET	59.46	39.45	39.81	31.34	33.36	22.68	20.84	3
#16 BLOOMINGTON	64.22	41.69	38.76	37.34	29.34	31.95	29.98	18
#17 QUINCY	55.04	40.80	34.25	32.74	31.14	29.46	29.83	16
#18 SPRINGFIELD	58.41	40.76	38.70	34.45	31.26	30.22	31.05	20
#19 DECATUR	48.94	30.23	30.00	28.21	29.12	26.65	24.91	7
#20 EFFINGHAM	57.51	35.11	32.73	33.04	33.84	33.80	31.19	21
#21 BELLEVILLE	52.94	41.70	38.01	36.62	36.21	35.67	32.30	22
#22 CENTRALIA	59.87	37.23	32.45	28.72	26.83	24.72	26.56	8
#23 NORRIS CITY	51.82	38.32	36.91	36.21	33.48	29.68	30.70	19
#24 CARBONDALE	57.43	41.58	35.08	34.82	33.24	32.66	33.73	24
#25 MCHENRY CO.	57.13	39.13	33.63	30.39	30.19	28.86	29.51	13
Statewide	65.3	35.88	33.07	29.78	29.54	27.70	27.21

Discussion of Improvement Activities Completed and Explanation of Progress or Slippage that occurred for FFY 07/SFY 08:

During FFY 07/SFY 08 Illinois' EI program continued its aggressive approach of treating all instances where it takes more than 45 days to initiate an IFSP the same, even if for family reasons. This creates a heightened sense of the importance of getting families answers on eligibility as quickly as possible in all situations and the need to find ways around problems. Even where there are family issues CFCs are encouraged to help families overcome their problems. There also is a protection from closing cases just to avoid going over 45 days due to problems because there also is a performance contracting element based on which CFCs do the best job of limiting terminations from intake due to family reasons. This framework has created a continuous quality improvement environment that encourages all CFCs to find new ways to make the eligibility determination process work better for all families.

Revisions, with Justification, to Proposed Targets / Improvement Activities / Timelines / Resources for FFY 2007-2010/SFY 2008-2011

No changes in targets, improvement activities or timelines are proposed through the remainder of the SPP period.