The Illinois Annual Performance Report (APR) documents performance data on State targets for each Child and Family Connections (CFC) office as well as 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 online at: www.dhs.state.il.us and through links from the other EI websites (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. The APR was presented to the Illinois Interagency Council on Early Intervention (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 changes to the SPP.
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 called 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. Currently, options for a web-based system with additional functionality are being explored. A new monthly service delay reporting system was piloted in FFY10/SFY11 and rolled out statewide in August 2011. This system allows CFC offices to identify new children for whom services are delayed, including the reason for delay; reporting on unresolved cases; and making any data corrections.
Since January 2002, the program has also utilized a standardized monthly reporting system on a series of performance measures. Since the beginning of SFY03 (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 local determinations. Local determinations are made in the first quarter of the fiscal year (July-September), when 12-month data from the previous fiscal year becomes available. Other reports to CFC offices include caseload summaries and 45 days intake. 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. In FFY10/SFY11, quarterly "mini APRs", including CFC-specific data on Indicators 1, 7, and 8C, were also provided to CFC offices.
Illinois has fully implemented a system of identification and correction of findings of noncompliance in accordance with OSEP Timely Correction Memo 09-02. Information from data systems and file reviews and the EI monitoring, dispute resolution, complaints and hearings and "other" processes are used to identify noncompliance for both CFC offices and Early Intervention service providers. The CFC office/EI provider is notified in writing of the finding and its correction. Correction of findings involves several steps. Development and implementation of corrective action plans ensure that the policy, procedure, or practice that led to the noncompliance has been corrected. Child-specific/individual instance correction is documented through the use of data systems and file reviews. When required, implementation of the specific statutory/regulatory requirements by CFC offices is documented using data based on 100 percent compliance over three consecutive months or through a file review in which all files demonstrate compliance.
During FFY10/SFY11, two workgroups of the IICEI wrapped up their work and one new workgroup was formed. The Finance workgroup reviewed 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 developed Integrated Services Approach Guidelines and monitored the activity of a pilot project. The workgroup also discussed provider recruitment strategies, including strategies for posting unmet service needs.
The Service Delivery Approaches workgroup began meeting in May 2011. The charge of the Service Delivery workgroup is:
- To examine/investigate approaches to Early Intervention service delivery that facilitate teaming and communication;
- To develop and present recommendations for adopting a service delivery approach for early intervention services in Illinois; and
- To design specific steps needed to implement the recommended service delivery approach for early intervention services in Illinois that includes a timeline for a phased in implementation.
The Bureau convened an Outcomes workgroup to review outcome strategies and 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.
In addition, the Bureau has convened several ad hoc workgroups to address specific issues with input from CFC offices and EI providers. An Assistive Technology (AT) workgroup has reviewed the AT request, approval and provision processes in Illinois' EI Program and is developing recommendations to streamline these processes. In addition, an IFSP workgroup has been reviewing the content and format of the IFSP to make sure that it complies with federal requirements and provides families and providers relevant and understandable information.
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. The EI Taskforce report can be found on the DHS Website.
All EI Taskforce recommendations have been considered and work is moving forward to address several recommendations.
- Options are being explored on the design and implementation of a web-based data management system, which is recommendation #1 in the report.
- Review of the service delivery model, as requested in recommendation #2, is the work of the Service Delivery Approaches workgroup.
- The recruitment, development and retention of highly qualified and culturally and linguistically competent personnel (recommendation #3) are being addressed through efforts of the Bureau and its contractors, in coordination with the professional associations that support EI. Work is focused on coordinating provider recruitment and on education and information sharing regarding appropriate practice for services to infants and toddlers in the EI program.
- Review of the current Assistive Technology service in order to identify current inefficiencies in the AT system, the incorporation of recommended practices, and the realization of cost savings (recommendation #6) is being considered by the AT workgroup.
- The EI Monitoring Program and the Bureau have been working on recommendation #8, the enhancement of the monitoring system, through plans to roll out Program Integrity Pilot project strategies statewide based on an every-three-year cycle beginning in FFY11/SFY12.
- Several CFC offices have been working with the Chicago Public Schools as requested in recommendation #9.
- Finally, the Bureau continues to explore new funding and maximize cost efficiencies. In FFY10/SFY11, EI has started to receive Medicaid payments from new efforts to bill for interpreter/translator services.
The Program Integrity Project was designed to accomplish statewide program equality; fidelity to program principles and state and federal laws; and long-term program stability continue. Work on several pilot projects continued and 2 new pilot projects were added in FFY10/SFY11.
- In FFY09/SFY10, a system ombudsman position was added to the Illinois EI Training Program. The system ombudsman supports the Department's Program Integrity Project. 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, identified areas for clarification or training, and researched what is going on nationally, with the goals to improve program practices and communication between system entities.
- During the FFY10/SFY11, the Bureau, the system ombudsman, the EI Training Program, the EI Monitoring Program and selected CFC offices participated in three Program Integrity pilots. The pilot projects involve in-depth file reviews, data analysis, identification of system challenges, and customized training and technical assistance planning and implementation. The pilot projects focused on three areas of concern: 1) provision of services in natural environments (Indicator 2), 2) under age 1 participation rate (Indicator 5), and 3) transition (Indicator 8). Piloted strategies are then evaluated. Lesson learned through these pilots are shared with all CFC managers at monthly CFC manager's meetings and strategies are incorporated into system training and technical assistance approaches. A new focused monitoring process will expand the Program Integrity process statewide, with focused monitoring visits in a minimum of eight CFC offices in FFY11/SFY12. Each CFC office will received a focused monitoring visit every three years or more frequently, if needed.