Overview of the Annual Performance Report Development

The Illinois Annual Performance Report (APR) documents performance data on State targets for each Child and Family Connections (CFC) office 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/enrollment office; and the Early Intervention Clearinghouse). The APR and SPP documents are also available to the public at each of the 25 CFC offices. A Workgroup of the Illinois Interagency Council on Early Intervention (IICEI) reviewed the APR and met to discuss the indicators, with an emphasis on proposed target values and improvement activities. The APR was presented to the IICEI for review and comment prior to its submission. In addition CFC managers were given the opportunity to review the draft document and provide input. Both CFC managers and the IICEI reviewed the changes to the SPP, which include annual targets and improvement activities for each year through FFY2012/SFY2013 (July 1, 2012 through June 20, 2013).

The APR is part of 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 IICEI, the CFC offices, and the general public through various reporting mechanisms. The IICEI receives a data report at each of its meetings. Reports are also provided to IICEI Workgroups. Illinois utilizes a central client tracking system, Cornerstone. No activity can take place without a case being active in Cornerstone. Both CFC office and Department staff can pull reports to track client data. Over time the Cornerstone system has become antiquated and its functionality is limited. Improvement activities are restricted to those that can be implemented within the capacities of the current system.

Since January 2002, the program has also utilized a standardized monthly reporting system on a series of performance measures. Since the beginning of SFY 03 (July 1, 2002), Illinois has operated a performance contracting system for CFC offices, based on some of the more important measures found in the monthly statistical reports. These performance measures are also used to identify findings of noncompliance with specific indicators and as part of the process to designate determinations. Other reports to CFC offices include caseload summary and 45 days in intake reports and one that monitors data integrity for the service delay database. These reports allow CFC managers to review service coordinator and child-specific data. Monthly, statewide data on the 32 performance measures are posted on the program's website and include comparison data with the previous month, previous fiscal years' averages, and data from the same month in the two previous years.

Illinois has greatly improved its documentation of findings and correction of noncompliance. In FFY06/SFY07, it expanded the process to utilize its data system. A system of identification and correction of noncompliance was developed, but not fully implemented until FFY07/SFY08, due to delays in sending notification of findings to CFC offices. Findings based on FFY06/SFY07 were sent in February 2008. Findings based on FFY07/SFY08 data were sent in December 2008. Illinois is now on track to provide timely notification and to monitor and document correction of noncompliance. On August 27, 2009, the Bureau sent a single letter to each CFC office that included the CFC office's determination (in accordance with 616(a)(1)(C)(i) and 300.600(a) of IDEA 2004) and the notification of findings of noncompliance, based upon FFY08/SFY09data. On September 10, 2010, the Bureau sent a single letter to CFC offices with determinations and notification of findings based upon FFY09/SFY10 data. Illinois has had in place a system to document the correction of each individual case of noncompliance. It has now added "prong 2," ensuring that CFC offices have correctly implemented the specific regulatory requirement, as defined in OSEP Timely Correction Memo 09-02. A new system of notification of findings and correction of noncompliance is being implemented that will assist the lead agency and the CFC offices in tracking performance and providing adequate notification when a correction has taken place.

Workgroups of the IICEI have been formed to address specific indicators (Service Delay Workgroup) and overall operation issues (Finance Workgroup). The IICEI and these Workgroups help analyze data and suggest improvement strategies.

The Finance Workgroup keeps informed on financial issues for Early Intervention and identifies strategies that could help impact them. Workgroup members review the status of payment delays, budget updates, applicable legislation, and operation of the Central Billing Office, including the implementation of a new insurance billing unit.

The Service Delay Workgroup was formed to support improvement activities for Indicator 1. Initial discussions focused on CFC offices #1 and #3, with suggestions based on local dynamics of that area. The Workgroup has developed recommendations that would support an integrated services approach, which emphasizes collaboration among IFSP team members. Representatives from professional associations were added to the Workgroup to involve them in this dialogue. CFC offices #1 and #6 are currently piloting this option. The Workgroup has also discussed provider recruitment strategies, including strategies for posting unmet service needs.

In addition, the Bureau has convened an Outcomes Workgroup to review strategies and outcome data for child and family outcomes (Indicators 3 and 4) and make recommendations regarding improvement activities, timelines and setting target values for child and family outcomes. Membership of the advisory group include several IICEI members, including parent representatives, CFC office managers, Early Intervention providers, including representation across professional disciplines, and research and training staff.

House Joint Resolution (HJR) 50 created the Illinois Part C Early Intervention Taskforce in response to an identified need for a comprehensive and thorough review of the Part C Early Intervention Program. The intent of HJR 50 was for the EI Taskforce to make recommendations and action plans to address issues related to workforce, financing, monitoring and evaluation, service delivery, and transitions. HJR 50 required that the Taskforce issue a report with its recommendations to the Governor and the General Assembly by July 1, 2010. The Taskforce was comprised of a broad-based group of individuals, including parents of infants and toddlers who are or have participated in the Part C EI Program; advocates who focus on early childhood and early intervention; early intervention, educational and healthcare professionals; and state agency personnel working in early childhood, early intervention, mental health and healthcare programs. Each EI Taskforce recommendation has been reviewed and initial steps have been taken for the implementation of recommendations within existing resources. The EI Taskforce report can be found at https://www.dhs.state.il.us/page.aspx?item=50753.

During FFY08/SFY09, the Early Intervention program initiated the Program Integrity Project to accomplish statewide program equality; fidelity to program principles and state and federal laws; and long-term program stability. The project will result in long-term changes to the system that will be beneficial for infants and toddlers enrolled in the Early Intervention Program and their families, while ensuring that Illinois remains a responsible steward of the funding available for these services.

* The EI Bureau has been sharing a range of data analyses with the IICEI, its Finance and Service Delay Workgroups, and CFC office managers. Three pilot projects are underway to identify and test approaches to promote program integrity. The pilots involve the collection and analysis of data. A plan of training and technical assistance is then developed and implemented to ensure that program principles and procedures regarding eligibility determination and service plan development are being appropriately followed. Lessons learned through these pilots are shared with all CFC managers at monthly CFC managers' meetings.

* A study has been completed and recommendations received on October 1, 2009 regarding an optimal service coordination model for the Illinois Early Intervention Program. Existing data were considered, six focus groups were held, time studies were completed, individual interviews with national experts were conducted, and recommendations were made based upon best practice research. These recommendations are currently being considered.

* On February 15, 2010, a system ombudsman position was added to the Illinois EI Training Program. The system ombudsman supports the Department's Program Integrity Project to accomplish statewide program equality, fidelity to program principles and state and federal laws, and long-term program stability. Activities include: data analysis, coordination of focused monitoring activities, development of strategies to promote compliance with program principles and procedures, report writing, and development and implementation of training strategies. The system ombudsman has supported the Program Integrity Project pilots through data analysis; training and support plan development and implementation, and the transfer of strategies from the pilot sites to other CFC areas. In addition, the system ombudsman has visited CFC offices, provided resources to people in the field, reviewed data, identifying areas for clarification or training, and researched what is going on nationally, with the goals to improve program practices and communication between system entities. Strategies for reaching out to other stakeholders (i.e., providers and families) are being explored, including collecting and analyzing existing data.