The problem resolution protocol is based on five foundational principles. These principles include:
ISSAs are to ensure an initial response to complaints or otherwise identified problems within two business days. Time frames to resolve the identified issues involved are outlined below. Independent Service Coordination agencies (ISC) are also to ensure that services continue while resolution of the issues is pending. See four steps listed below:
Issues or concerns, identified during the course of any ISC contact with individuals, guardians, family members, community providers, or other advocates, will initially be addressed with the person responsible for oversight of daily program implementation (agency QSP, house lead, ISC worker, etc.). The ISC and the agency staff will develop an action plan, acceptable to both, for addressing the issues or concerns. (If there is a medical or safety need, then appropriate, prompt action is required of the ISC. Likewise, problems that require reporting to OIG or some other regulatory body must first be handled per those requirements, and then, if appropriate, submitted to the dispute prevention/problem resolution process. If the identified issues or concerns are perceived to be significantly serious, then the ISSA will immediately utilize Step 2 or Step 3.) If no action plan is developed after 30 days, the issue shall be moved to Step 2.
If seriousness warrants, the matter is not resolved per the action plan, or if the parties fail to create a mutually acceptable action plan, the ISSA and/or the agency staff will immediately contact his/her supervisor to inform the supervisor of the unresolved issue or concern. Additional efforts at resolving the issue or concern will be promptly undertaken using the following guidelines:
Both the ISSA and the agency program level staff person must provide a written statement of the problem, as each sees it, and their recommended solution. These written statements will be shared with the other party prior to any additional problem solving discussions.
Continuing problem solving discussions will include all four participants (ISC and supervisor, agency program level staff person and agency program director).
Copies of resolution plans will be forwarded to the agency Executive Director and the ISC Executive Director.
If no action plan is reached within 14 days, the issue shall move to Step 3.
If the matter remains unresolved, then the Executive Director of the ISC agency and the Executive Director of the agency will be brought into the problem-solving discussions (discussions will now have six participants). If resolution can not be reached within 7 days, the issue shall move to Step 4.
If the matter is not resolved under Steps 1 through 3, the ISC Executive Director will contact the Division's Bureau of Quality Management within 2 business days following completion of Step 3 via submission of Referral to DHS Division of Developmental Disabilities for Monitoring and/or Technical Assistance form included in the Appendix. The Bureau will collect all available information regarding those involved and will work with the parties to bring about a final resolution to the problem. In the event the parties are unable to reach agreement, then the Department will issue a final and binding decision.
The time frames specified above are to be considered maximum time frames. If it becomes clear, for example, on day five that resolution cannot be reached under Step 1, then the parties should proceed immediately to Step 2. Individuals served may contact the Division directly at any time during the process if they so choose.
Documentation of the conflict resolution process will be maintained in the individual's ISC record. The ISC agency will document in the individual's ISC record that it has provided the individual and guardian with information regarding the progress of the conflict resolution process. The content of that information will be included in the documentation.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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