April 15, 2010 - Illinois Interagency Council on Early Intervention Meeting Report

UCP of Greater Chicago - Infinitec Southwest

7550 W. 183rd Street - Tinley Park, Illinois

  1. Present
  2. Absent/Excused
  3. Contents of Council Packet:
  4. I. Call to Order
  5. II. Introduction of Council Members
  6. III. Approval of October 1, 2009 Meeting Report
  7. IV. IICEI Workgroup Reports
    1. Finance Workgroup
    2. Service Delay Workgroup
  8. V. Early Intervention Taskforce Working Group Reports
    1. Service Delivery and Transition
    2. Workforce
    3. Monitoring/Evaluation
    4. Finance
  9. VI. Service Coordination Evaluation Study
  10. VII. Lead Agency Report
  11. VIII. Adjournment

Present

Bob Cammarata, ICG Health Care Services

Gerri Clark, Division of Specialized Care for Children

Julie Doetsch for Deborah Saunders, IL Dept of Healthcare and Family Services

Janet Gully, DHS, Bureau of Early Intervention

Roselyn Harris for Gina Ruther, DHS, Bureau of Child Care and Development

Kay Henderson, IL State Board of Education

Beatrice, Nichols, IICEI Chairperson, Head Start

Deanna Pratcher, parent, Thonton

Sandy Ryan, IL Council on Developmental Disabilities

Kathy Schrock, Easter Seals DuPage and Fox Valley

Robin York for Andria Goss, IL Department of Children and Family Services

Therese Wehman, Elmhurst College

Absent/Excused

Mary Peterson, DFPR, Division of Insurance

Karrie Potter, parent, Neoga

David Rubovits, PhD, Jewish Child and Family Services

Dorelia Rivera Martinez, Elmwood

Diane Blythe, parent, Crystal Lake

Connie Sims, DHS, Division of Developmental Disabilities

Myrtis Sullivan, DHS, Division of Community Health and Prevention

Joyce Smith, Lessie Bates Davis Neighborhood House

Gail Tanner, IL Department of Public Health

Contents of Council Packet:

  • Agenda
  • Lead Agency Report - April 15, 2010
  • Draft Report from January 14, 2010
  • Service Coordination Evaluation Study
  • CFC Reviews/Recommendations

I. Call to Order

The Illinois Interagency Council on Early Intervention convened at 10:03 a.m.

II. Introduction of Council Members

Council members introduced themselves.

III. Approval of October 1, 2009 Meeting Report

The January 14, 2010 Meeting Report was approved as written. Bob Cammarata recognized that this is the week of the young child.

IV. IICEI Workgroup Reports

Finance Workgroup

Kathy Schrock provided a report on the Finance Workgroup. The group met three times since the last council meeting. Topics of discussion have included, payment delays, the potential of a 10% ($7.6 million) cut in the Early Intervention appropriation, and recommendations from the EI Taskforce.

The Finance Workgroup helps the Bureau look for ways to cut back and be more efficient.

Information from the CBO billing unit was reviewed. Ways to assist providers in submitting insurance payment information are needed, so that the amount of EI services paid by insurance would not have to be extrapolated.

Service Delay Workgroup

Bob Cammarata reported on the work of the Service Delay Workgroup. The work of this group over the last 11/2 years was reviewed, including the development of the Integrated Approach document, which states the following. "The Service Delay Workgroup recommends that the EI Council accept the Workgroup's recommendation to implement an integrated service approach and that this recommendation be forwarded to the IICEI Finance Workgroup for further discussion as well as to the Bureau for the development of an implementation plan." In response to a question, Mr. Cammarata clarified that this recommendation does not exclude the use of other approaches, but supports the selection of this approach depending on the individual child's circumstances so that the child receives quality EI services.

Therese Wehman explained that being able to bill for time (under IFSP development) for consultative communication between team members is needed for the approach to be successful. Dee Dee Lowery, CFC #1 manager, responded to questions and explained how several IFSP have been written and services implemented after families chose the approach as part of a pilot effort. The Bureau has allowed the billing of off-site IFSP development time as part of the pilot. Training is needed for all providers. Service coordinators need to learn how to write detailed/accurate IFSPs that include well-documented strategies.

Kathy Schrock asked for clarification of the Finance Workgroup's role in reviewing the approach and associated costs and projected savings. To accomplish this, the workgroup would need to know training costs, along with parameters on how much consultation would be needed and reductions in services realized. Mr. Cammarata explained the group had not looked at cost. The group discussed service delays issues around the state. Piloting of the approach would help with identifying actual costs.

The importance of the Workgroup's efforts to involve professional organizations in the development of this recommendation was recognized. The Council accepted the recommendation from the Workgroup.

V. Early Intervention Taskforce Working Group Reports

Janet Gully reviewed the charge of the EI Taskforce and explained that, when the report is published it will be made available for public comment. Council member were invited to provide comments at that time. The Department will consider the recommendations as part of an ongoing process, but there are no plans to make immediate changes to the EI system. Recommendations will be discuss with the Council at its July meeting. Workgroup chairs provided the following information.

Service Delivery and Transition

Lynn Liston and Jennifer Barrett-Zitkus explained that the Service Delivery/Transition Workgroup has been basing its work on EI principles. How the Workgroup has functioned was explained. The group has considered federal law and what other states are doing. Work has been divided into child find, referral, evaluation/assessment, IFSP development, services and supports, and transition. Recommendations are being developed using a consensus building process, using a strength-based approach. Issues have been worked through using electronic (WIKI) resources to share comments.

Workforce

Ted Burke shared the process that the Workgroup has used to discuss issues that include:

  • EI rates are insufficient to attract and retain qualified providers
  • There is a lack of culturally and linguistically competent personnel
  • Communication with providers from the lead agency needs to be improved
  • How research-based approaches fit into EI
  • Finding providers in rural areas
  • Attracting college graduates to the system
  • Difficulties for associate-level providers in EI
  • Each CFC does things differently
  • Service coordinator skills and supports
  • Over-reliance on interpreters
  • Clarification of how to use students in EI

Representation on the Workgroup and use of technology were discussed. The group discussed issues identified by the Taskforce, recommendations, desired outcomes/benefits, steps needed to implement recommendations, and existing resources. Resources from national associations and other states have been shared.

Monitoring/Evaluation

Dawn Melchoirre and Karen Yarborough explained that the Workgroup has looked at what is going on in qualitative and quantitative monitoring, with a wide range of folks involved in the Workgroup process. Topics that have been discussed include the Program Integrity Project, the ombudsman function, and monitoring activities currently going on in the state. Discussion of the current monitoring process identified that it focuses on adhering to policies and procedures, not at quality. A web-based data system, similar to those used by other states, would be a key piece in the system.

Finance

Carl LaMell provided the recommendations from the Workgroup, including the following:

  • Reduce incentives to CFCs by 50%
  • Reduce total LIC Coordination costs
  • Reduce funding to CFCs for pediatric consultative, parent liaison, social/emotional consultant services - allowing CFCs to put the dollars where needed, with approval of the Bureau
  • Reduce the rate of pay for language interpreters
  • Reduce current evaluation/assessment costs
  • Implement a web-based data management and claims processing system

Janet Gully thanked Kirsten Hammock for her work facilitating the EI Taskforce and explained that a workgroup of CFC managers are looking at duplications in the pediatric consultative, parent liaison, social/emotional consultant and LIC coordination functions. CFC would submit a plan on how these functions would be implemented. Kay Henderson suggested that CFC offices access local resources.

VI. Service Coordination Evaluation Study

Ted Burke reviewed the Evaluating the Illinois Service Coordination Model report. He explained the methodologies used to complete a study of the Illinois service coordination model, including the use of national and Illinois data and research, surveys, focus groups, time studies, and individual interviews with national models. The evaluation team and the outcomes from each component of the study were reviewed. The report looks at a designated service coordination model to accomplish statewide equality in delivery of services, services delivered in fidelity to EI guiding principles, and long-term fiscal stability for the Illinois EI system.

Each of the following recommendations was reviewed. CFC managers have provided a response to these recommendations, which were attached to the report. These come as recommendations to the Department, but should change and grow as the system changes and should not be reviewed in isolation from the rest of the system.

  1. Consolidate the number of Child and Family Connections Regions from 25 statewide to 5 statewide for consistency and quality control
  2. Develop practice guidelines, support on-going professional development planning, and implement a new Service Coordinator Evaluator role
  3. Centralize Child and Family Connections Consultative and Support Functions
  4. Implement functional, secure, accessible technology systems for the Illinois Early Intervention System
  5. Accountability, Monitoring and Quality Assurance

Council members discussed several of the recommendation with comments that include the following.

  • This is a really a great report and is a good starting point.
  • The feedback from the managers was exceptional.
  • It is difficult to see how reducing the number of CFC offices to 5 would improve consistency. This issue and the alternate recommendation from the CFC managers were discussed.
  • The need to significantly reduce the caseload was identified as a requirement for implementing the proposed service coordinator evaluator role.
  • Savings would not be realized unless a web-based data system is implemented.
  • It was recognized that the program is doing well and that the surveys indicated satisfaction.
  • The time study of the service coordination position is a benefit.
  • A concern was expressed that CFC offices work in the community would be lost with centralization of functions.

VII. Lead Agency Report

Janet Gully comments included the following:

  • A $7.6 mil reduction in the EI state appropriation has been proposed.
  • Nyle Robinson has moved to the position of Bureau Chief for Home Services in the Division of Rehabilitation Services and Blake Whitson has been assigned as the new data manager
  • Chelsea Guillen started the system ombudsman position on February 15, 2010, and has been looking at data and working with the CFC pilot projects for Program Integrity.

VIII. Adjournment

Kathy Schrock shared information about surveys that her agency's providers completed regarding parent participation in Early Intervention. The survey indicated that a vast majority of parents participate in their child's services. The meeting adjourned at 12:21 p.m.