Indicator #8 - Transition

Transition

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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.

In early 2002, the Illinois Interagency Council on Early Intervention (IICEI) placed particular emphasis on improving the transition process. They have received regular reports on transition performance, similar to the measure used in OSEP's focused monitoring, since that time. The same measure has been included in the program's performance contracting system since its inception. After performance seemed to level out at the end of SFY 04/FFY 03, new steps were introduced based on public input. A new set of termination codes was introduced to help the program better understand why cases were being closed without special education eligibility being determined. Also, a new transition tracking form was introduced to help the program get better feedback from school districts. All of these efforts have helped inform the development of the State Performance Plan and have impacted performance.

For the question of transition steps being in each IFSP, the program increased emphasis on this requirement in training and the IFSP itself now includes language that indicates the family acknowledges that transition steps were part of the process, even with the initial IFSP. The modification to the IFSP demonstrates 100% compliance.

As for documentation of the transfer of child find data to the LEA, we have placed increased emphasis on fine-tuning our data sharing process with the Illinois State Board of Education (ISBE). During FFY 06/SFY 07, ISBE phased in its transfer process. This data sharing process was in place for all of FFY07/SFY08 and ensures that each LEA is informed about every child who is ready to age-out. ISBE also receives a matrix of the number of children enrolled by age cohort for each school district each month and a list of children terminating from EI with information similar to what they receive on the child find lists. The matrix can be used to aid in local planning. The termination lists help ISBE follow-up quickly with school districts on those cases where EI indicates SE eligibility was not determined.

Although there are processes in place to ensure 100% compliance with the development of steps and with the transfer of information to LEAs, the program also requires CFCs to record the date on which these steps took place in our Cornerstone data system. While this is a duplicate check on these requirements the program considers them very important. To emphasize that point we report on the level of Cornerstone documentation in this report. Poor documentation by individual CFCs will be follow-up on and technical assistance will be provided.

The program does not have a means of assuring 100% compliance with transition meetings statewide. If eligibility was determined, even if transition meeting dates were not entered into Cornerstone, it demonstrates that a transition meeting was held. If eligibility was not determined compliance will depend on dates being entered into Cornerstone. During the latter months of FFY 06/FFY 07, the program incorporated recording of transition meetings held into its monthly statewide and CFC level statistical reports. This measure is very strict. It only counts specific events recorded. If SE eligibility was determined but a meeting was not recorded it is not counted. Effective with third quarter of FFY07/SFY08, the proportion of transition meetings held for children exiting the program at age 3 became one of the 10 measures for which incentive funding is granted to the top 12 performing CFCs each quarter. The proportion of children who have SE eligibility determined when they leave the program at age 3 also remains a measure that carries incentive funding.

Incentive funding provides a positive reward to agencies that perform well. There are also negative consequences to doing poorly in the transition process relative to the rest of the state. Local determinations are set based on a scorecard. A CFC receives a point if their average rank for all 10 incentive measures overall puts them in the bottom five of 25, indicating weak performance overall. Two of the 10 measures relate to transition. Reflecting the IICEI's special concern about transition and concern about poor performance and limited improvement relative to other measures, the bottom five CFCs in terms of recording transition meetings are given another negative mark against them. A CFC can receive no more than one point to be determined in substantial compliance. A score of four or more puts them in the lowest group.

Monitoring Priority: Effective General Supervision Part C / Effective Transition

Indicator 8: Percent of all children exiting Part C who received timely transition planning to support the child's transition to preschool and other appropriate community services by their third birthday including:

1. IFSPs with transition steps and services;
2. Notification to LEA, if child potentially eligible for Part B; and
3. Transition conference, if child potentially eligible for Part B.

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

Measurement:

1. Percent = [(# of children exiting Part C who have an IFSP with transition steps and services) divided by the (# of children exiting Part C)] times 100.
2. Percent = [(# of children exiting Part C and potentially eligible for Part B where notification to the LEA occurred) divided by the (# of children exiting Part C who were potentially eligible for Part B)] times 100.
3. Percent = [(# of children exiting Part C and potentially eligible for Part B where the transition conference occurred) divided by the (# of children exiting Part C who were potentially eligible for Part B)] times 100.

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

Measurable and Rigorous Target:

1. 100 percent of children leaving Part C will have transition steps and services in their IFSP.
2. The LEAs will have been notified of 100 percent of the children exiting Part C that are potentially eligibility for Part B.
3. A transition conference will be held for 100 percent of the children who leave the Part C program at age 3 and whose families have consented to participate in a meeting.

Actual Target Data for FFY 07/SFY 08:

1. 100 percent of the children leaving Part C have transition steps and services in their IFSP. (Compliance due to specific IFSP requirements. [(16,805/16,805)*100]=100%
2. 100 percent of the children exiting Part C, LEAs have been notified that the children are potentially eligible for Part B. [(12,546/12546)*100]=100%
3. 97.4% of the children who leave the Part C program at age 3 whose families have consented to participate in a meeting, a transition conference was held. [(8,747/8,976)*100]=97.4%

Actual Target Data for FFY 07/SFY 08:

FFY 07/SFY 08 Transition PerformanceDocumented Within Cornerstone Data System

Indicator 8a.: Transition Steps = 100% Compliance due to specific IFSP requirements

NOTE: Every IFSP signed by a family, including the first one includes language that indicates transition steps were discussed. This documents 100% compliance with this requirement but the program also requires documentation in Cornerstone. That documentation is measured below.

	All Terminations	Transition Steps	% With Steps
State Totals	16,805	11,461	68.2%

Indicator 8b. : Referrals Made LEA = 100% Compliance through data sharing agreement

NOTE: Illinois assures 100% of all children who reach age 3 have been referred to the LEA through an electronic data sharing agreement with Part B/Illinois Board of Education. The data below represents a secondary documentation system within the Cornerstone data system.

	Terminations Past 30 Months	Not SE Eligible	Potentially Eligible	Referrals	% With Referral	Potentially Eligible Excluding Family Delay	Adj. Referrals Documented
State Totals	12,546	2,163	10,383	8,795	84.7%	9,301	94.6%

Indicator 8c. : Transition Meetings Held = 97.4% Compliance

	Terminations Past 30 Months	Not SE Eligible	Potentially Eligible	Referrals	% With Referral	Potentially Eligible Excluding Family Delay	Adj. Referrals Documented
State Totals	12,546	2,163	10,383	8,747	84.2%	8,976	97.4%

Transition Steps - Indicator 8a

All four findings of uncorrected noncompliance noted in the FFY06 Illinois APR were identified and documented through the program's monitoring process. Documentation of correction of noncompliance was made during the subsequent annual monitoring visit in which it was identified that there is evidence that the previous fiscal year corrective action plan has been implemented and continues to address areas of violation.

Each IFSP in Illinois includes language that indicates transition steps have been developed and discussed during the IFSP meeting. Field staff and providers have been trained that this is a required element of the IFSP process. By signing an IFSP the family certifies that this took place. Thus, the state starts with the assumption that this has been done in 100% of cases. However, there are several means of follow-up. The most complete of these is noting that steps have been developed in Cornerstone. Specific steps are to be written into the IFSP and reside in Cornerstone but in a text format that cannot be queried systematically.

During the report year, the number of case closures for which documentation of transition steps could be verified in Cornerstone was 68.2%, slightly improvement from the 66.6% documented in FFY06/SFY07. Both the number of cases with referrals and the number of meetings held improved. However, the high number of cases that close without this secondary form of documentation of the transition is a concern. The program has put a great deal of effort into improving the transition process, both at the state and local levels. The concern is that this lack of documentation may reflect a lack of commitment to the process, particularly early in a case.

Eventually the Cornerstone system will be rewritten to allow us to directly query transition steps but that is several years off. In the meantime the program will study a better way to document that transition steps have been included in plans. In addition to steps to improve compliance and reporting centrally, the program also reviews case records for documentation of transition steps through its monitoring system.

The greatest issues with transition in general, and specifically with documentation of steps in Cornerstone, continues to be in Chicago. Chicago lags far behind the rest of the state. For the reporting year they documented that just 51.8% of cases has transition steps at closing, compared to 68.2% statewide. The best performance is in the Cook suburbs at 80.0%.

FFY 07/SFY 08 Transition Meetings Held by Area
Documented with Cornerstone Data System

CFC # & Name	All Terminations	Eligibility Determined	Steps Documented	Transition Steps	% w/ Transition Steps	Rank
#1 ROCKFORD	525	298	60	358	68.2%	12
#2 LAKE COUNTY	760	414	206	620	81.6%	4
#3 FREEPORT	321	147	52	199	62.0%	18
#4 KANE-KENDALL	875	454	158	612	69.9%	10
#5 DUPAGE COUNTY	1,228	707	227	934	76.1%	5
#6 N SUBURBS	1,355	789	360	1,149	84.8%	3
#7 W SUBURBS	873	510	348	858	98.3%	2
#8 SW CHICAGO	668	226	223	449	67.2%	13
#9 CENTRAL CHICAGO	877	227	221	448	51.1%	24
#10 SE CHICAGO	750	173	78	251	33.5%	25
#11 N CHICAGO	1,724	487	448	935	54.2%	23
#12 S. SUBURBS	1,033	475	128	603	58.4%	20
#13 MACOMB	395	203	53	256	64.8%	16
#14 PEORIA	539	282	249	531	98.5%	1
#15 JOLIET	1,303	649	224	873	67.0%	15
#16 BLOOMINGTON	549	292	76	368	67.0%	14
#17 QUINCY	227	100	34	134	59.0%	19
#18 SPRINGFIELD	301	164	45	209	69.4%	11
#19 DECATUR	346	151	109	260	75.1%	6
#20 EFFINGHAM	435	205	44	249	57.2%	21
#21 BELLEVILLE	605	314	110	424	70.1%	9
#22 CENTRALIA	354	197	29	226	63.8%	17
#23 NORRIS CITY	191	98	38	136	71.2%	7
#24 CARBONDALE	154	60	26	86	55.8%	22
#25 MCHENRY CO.	417	248	45	293	70.3%	8
Statewide	16,805	7,870	3,591	11,461	68.2%
Chicago	4,019	1,113	970	2,083	51.8%
Suburban Cook	3,261	1,774	836	2,610	80.0%
Collar Counties	4,583	2,472	860	3,332	72.7%
Downstate	4,942	2,511	925	3,436	69.5%

Referral to LEA - Indicator 8b

All 13 findings of noncompliance noted in the FFY06 Illinois APR were identified based upon system data. As noted below under Referral to LEA - Indicator 8b, strategies have been implemented statewide that ensures that all children who reach 30 months of age or who start EI services after that ages are made known to the Local Education Agency as a results of full implementation of a data sharing agreement with Part B/Illinois State Board of Education. As a result, all findings of noncompliance regarding this notification have been corrected.

During all of FFY07/SFY08 Illinois utilized the data sharing agreement with Part B/Illinois State Board of Education to assure that every child who reached 30 months of age or who started EI services after that age were made known to the Local Education Agency. Since this data sharing process is universal, it is possible to assure that 100% of children are referred to their LEA for transition. This process actually starts as soon as a child reaches 27 months of age. Early problems that prevented child find information getting to the correct LEA for a small number of children have been eliminated.

In addition, during FFY07/SFY08 the program continued to improve the transition tracking form that goes from the CFC to the LEA at referral and is returned to the CFC when the eligibility determination process is concluded.

Although the Part C/Part B process covers all children, the EI program continues to expect CFCs to fully comply with referral rules and to document their actions in Cornerstone. The greatest focus is on holding and documenting transition meetings, since we do not have a supplemental means of assuring that meetings are held but we can assure that the LEA receives referral information. However, we also expect them to document the development of transition steps and the referral of child find information to the LEA. While these activities are duplicative in documenting performance on this indictor they is still important to document compliance with all state required steps.

The table below shows how well CFCs documented referrals in Cornerstone during FFY07/SFY08. For the year 84.7% of all children who were potentially eligible were referred to their LEA. In the majority of instances where a referral was not documented the family involved did not agree to the referral. If you factor out family issues it was 94.6%. However, the program has provided guidance to Service Coordinators clarifying that even if a family declines to allow a referral to the LEA the CFC must send a transition tracking form to the LEA. The form is to include just the identifying information provide date included through the data sharing agreement and a note that the family has declined the referral. It is then up to the LEA to decide what to do with the information.

It is clear that the rule indicating basic child find information must be sent to all the LEA in all instances must be reinforced. The State Board of Education expects the LEA to assess the eligibility of every child or know the story if they cannot. So, failure of the CFC to forward a transition tracking form to the LEA early is inefficient because the LEA is expected to call the CFC if they do not receive a form. A CFC should send the basic information early if a family does not agree to referral or if they do not give an answer. If the situation changes they can send a more complete transition tracking form later.

Aside from the issue with family delay, the other factor that is common to a large number of cases for which a referral to the LEA is not documented is very late entry into the program. This means the child entered care within three-months of turning three. The program has let Service Coordinators know that when a child presents to EI very close to their third birthday should be encouraged to complete the special education eligibility process instead of taking all the time necessary go through the EI eligibility process. This needs to be reinforced.

FFY 07/SFY 08 Referrals to LEA by Area *

CFC # & Name	Terminations Over 30 Mon.	Not Available or Eligible	Possibly Eligible	Referral Made	% of Referrals Documented	Potentially Eligible Excl. Family Delay	Referral Documented Excl. Family Delay
#1 ROCKFORD	395	52	343	329	95.9%	335	98.2%
#2 LAKE COUNTY	581	92	489	443	90.6%	457	96.9%
#3 FREEPORT	242	53	189	157	83.1%	174	90.2%
#4 KANE-KENDALL	649	76	573	483	84.3%	529	91.3%
#5 DUPAGE COUNTY	943	123	820	761	92.8%	781	97.4%
#6 N. SUBURBS	1,028	136	892	850	95.3%	862	98.6%
#7 W. SUBURBS	689	101	588	525	89.3%	533	98.5%
#8 SW CHICAGO	493	156	337	291	86.4%	292	99.7%
#9 CENTRAL CHICAGO	641	122	519	344	66.3%	399	86.2%
#10 SE CHICAGO	513	134	379	203	53.6%	264	76.9%
#11 N. CHICAGO	1,264	238	1,026	688	67.1%	791	87.0%
#12 S. SUBURBS	760	102	658	506	76.9%	538	94.1%
#13 MACOMB	282	51	231	223	96.5%	226	98.7%
#14 PEORIA	421	83	338	296	87.6%	314	94.3%
#15 JOLIET	952	174	778	680	87.4%	702	96.9%
#16 BLOOMINGTON	407	48	359	314	87.5%	341	92.1%
#17 QUINCY	151	31	120	111	92.5%	113	98.2%
#18 SPRINGFIELD	254	42	212	183	86.3%	192	95.3%
#19 DECATUR	253	41	212	201	94.8%	207	97.1%
#20 EFFINGHAM	312	84	228	210	92.1%	214	98.1%
#21 BELLEVILLE	465	65	400	363	90.8%	377	96.3%
#22 CENTRALIA	266	52	214	205	95.8%	207	99.0%
#23 NORRIS CITY	143	27	116	100	86.2%	113	88.5%
#24 CARBONDALE	114	34	80	70	87.5%	72	97.2%
#25 MCHENRY CO.	328	46	282	259	91.8%	268	96.6%
Statewide	12,546	2,163	10,383	8,795	84.7%	9,301	94.6%
Chicago	2,911	650	2,261	1,526	67.5%	1,746	87.4%
Suburban Cook	2,477	339	2,138	1,881	88.0%	1,933	97.3%
Collar Counties	3,453	511	2,942	2,626	89.3%	2,737	95.9%
Downstate	3,705	663	3,042	2,762	90.8%	2,882	95.8%
Excluding Chicago	9,635	1,513	8,122	7,269	89.5%	7,555	96.2%

* NOTE: The measurement of referrals to LEAs via Cornerstone is a secondary process to reinforce the data sharing agreement process with ISBE and EI program rules on the referral process.

Transition Meetings - Indicator 8c

Two of the seven findings of uncorrected noncompliance noted in the FFY06 Illinois APR were identified and documented through the program's monitoring process. Documentation of correction of noncompliance was made during the subsequent annual monitoring visit in which it was identified that there is evidence that the previous fiscal year Corrective Action Plan has been implemented and continues to address areas of violation.

As with transition steps and referrals to school districts, the EI program takes a more aggressive approach in monitoring performance than is required by federal guidelines in all of its ongoing reporting. For example, the monthly statistical report produced on the statewide and CFC levels measures transition meetings held and does not exclude meetings not held due to family reasons. This measure carries incentive funding for the top performing 12 of 25 CFCs each quarter. For FFY07/SFY08, 84.2% of cases that left the program at 30 months or older had a transition meetings documented. Removing instances where the reason was related to family issues the percentage improves to 97.4% [8,747/(10,383-1,407)*100].

As with the other two transition measures, there is reason to believe actual performance was better, even when family issues are involved, but documentation remains a problem. The program has seen improvement since it made this a performance contracting measure that carries incentive funding. The closer working relationship between school districts and CFCs also is fostering improved performance. This improvement stems from the data sharing process and the associated increased pressure school districts feel from ISBE to perform. This means that both Part C and Part B have systems in place to create incentives and disincentives to follow transition rules. In addition, a statewide transition group organized by the Illinois State Board of Education has been a continuous source of positive momentum.

For the year, only two CFCs were able to document that at least 95% of transition meetings were held when you include family delays. When family delays are removed from the equation three downstate CFCs showed documentation for 100% of potentially eligible children and 20 were over 95%. Of the four larger geographic groupings, only Chicago fell below 95%. They came in at 93.3% and they were the only large area to perform worse than last year. The lowest percentage was CFC 10 (Southeast Chicago) at 79.5%. Chicago has continued to present the most significant problems. All four Chicago area CFCs rank in the bottom five when family delays are included.

Aside from family reasons for meetings not being held, the most common theme for failure to hold a meeting for a potentially eligible child was that they child entered service late, often within three-month or less of turning three.

FFY 07/SFY 08 Transition Meetings Held by Area Documented with Cornerstone Data System

CFC # & Name	Terminations Over 30 Mon.	Not Available or Eligible	Possibly Eligible	Meetings Held	Meetings Not Documented		Excluding Fam. Delay % of Meetings Documented
					Family Reasons	System Reasons
#1 ROCKFORD	395	52	343	324	18	1	99.7%
#2 LAKE COUNTY	581	92	489	448	32	9	98.0%
#3 FREEPORT	242	53	189	157	28	4	97.5%
#4 KANE-KENDALL	649	76	573	486	57	30	94.2%
#5 DUPAGE COUNTY	943	123	820	736	82	2	99.7%
#6 N. SUBURBS	1,028	136	892	846	44	2	99.8%
#7 W. SUBURBS	689	101	588	519	64	5	99.0%
#8 SW CHICAGO	493	156	337	277	59	1	99.6%
#9 CENTRAL CHICAGO	641	122	519	337	134	48	87.5%
#10 SE CHICAGO	513	134	379	198	130	51	79.5%
#11 N. CHICAGO	1,264	238	1,026	681	337	8	98.8%
#12 S. SUBURBS	760	102	658	532	105	21	96.2%
#13 MACOMB	282	51	231	221	8	2	99.1%
#14 PEORIA	421	83	338	294	38	6	98.0%
#15 JOLIET	952	174	778	683	86	9	98.7%
#16 BLOOMINGTON	407	48	359	314	45	-	100.0%
#17 QUINCY	151	31	120	111	8	1	99.1%
#18 SPRINGFIELD	254	42	212	178	24	10	94.7%
#19 DECATUR	253	41	212	200	-	12	94.3%
#20 EFFINGHAM	312	84	228	210	15	3	98.6%
#21 BELLEVILLE	465	65	400	358	42	-	100.0%
#22 CENTRALIA	266	52	214	205	8	1	99.5%
#23 NORRIS CITY	143	27	116	101	14	1	99.0%
#24 CARBONDALE	114	34	80	70	10	-	100.0%
#25 MCHENRY CO.	328	46	282	261	19	2	99.2%
Statewide	12,546	2,163	10,383	8,747	1,407	229	97.4%
Chicago	2,911	650	2,261	1,493	660	108	93.3%
Suburban Cook	2,477	339	2,138	1,897	213	28	98.5%
Collar Counties	3,453	511	2,942	2,614	276	52	98.0%
Downstate	3,705	663	3,042	2,743	258	41	98.5%

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

The Illinois Early Intervention Program demonstrated 100% compliance with 8a (transition steps) and 8b (referral to the LEA). However, the state continues to utilize secondary measures through Cornerstone to promote the importance of transition and to promote a local response that goes beyond compliance.

The documentation of both transition steps and referrals to LEAs improved slightly in the report year. However, in concert with the Illinois State Board of Education, the program put a great deal of effort went into improving the transition process. So, we are disappointed there was not more improvement.

The improvement in percent of children exiting Part C and potentially eligible for Part B that had a transition conference was more encouraging, with an improvement from 96.1% to 97.4%, when factoring out family caused problems. When family issues are left in the calculation performance improved even more, from 81.8% to 84.2%. Although, that still means a large percentage of families are either declining a referral to special education or are otherwise not participating enough to complete the eligibility determination process. Hopefully, the improved cooperative relationships between Part C and Part B will help us continue to reduce both system and family issues that prevent special education eligibility from being determined by age three.

Progress can be attributed to several factors. The statewide transition system, including a data sharing agreement between the ISBE and DHS, is fully implemented. Home address coding and other data issues have been resolved, resulting in child find information being forwarded on 100% of children reaching 30 month of age. That process also helps decrease the number of instances where transition meetings are not held.

• Additional modifications of the transition tracking form have resulted in better communication about the transition process and documentation of its outcomes.
• STARnet and the Early Intervention Training Program staff continued to provide statewide training to both Part C and Part B regarding the transition of children from early intervention services into early childhood special education services.
• ISBE and EI Bureau staff continue to work cooperatively to address issues relative to transition. ISBE continues to facilitate a statewide transition workgroup that is co-chaired by EI staff.
• A family transition workbook, "When I'm 3, where will I be?" became available in January 2008. This family transition workbook is a product of the Illinois Birth-5 Transition Guidance Committee in collaboration with the Illinois State Board of Education (ISBE) and the Illinois Department of Human Services (DHS). Parent liaisons and service coordinators from Child and Family Connections (CFC) offices, parent representatives, school district personnel and many others contributed to this workbook. The workbook is given to families in the Early Intervention Program as a resource and planner for their transition from Early Intervention into school district and community programs.
• As a direct result of a recommendation from the Illinois Autism Task Force, the Illinois Department of Human Services hired a Transition Coordinator to help facilitate the transition from Early Intervention to Early Childhood services and from Special Education services to adult services. The Transition Coordinator established a number of important linkages between service providers, the Early Intervention CFC offices, and representatives from school districts across the state.
• Upon the recommendation of the IICEI Transition Workgroup, the CFC offices have collected data regarding unsuccessful transitions for family reasons from families who transitioned from the system during the time period October 1, 2008 - December 31, 2008. The data will indicate the reasons why a family chose not to participate in the transition to Part B services.
• Materials related to transition on the NECTAC website were reviewed with the IDHS Transition Coordinator to determine activities the state needed to undertake to ensure compliance.
• Staff participated in several webcasts related to transition to facilitate technical assistance.
• Other larger states transition procedures were reviewed to obtain technical assistance.

Revisions, with Justification, to Proposed Targets / Improvement Activities / Timelines / Resources for FFY07-10/SFY 08-11

Although it is not considered an improvement activity, the program will reinforce that it considers any instance where a potentially eligible child's SE eligibility is not determined to be a negative outcome, even if it is for family reasons, and that we will treat them as such in performance contracting.

• No new improvement activities are proposed at this time.