Ligas Data Report as of 6-30-12 (pdf)
August 15, 2012
Paragraph 33 of the Ligas Consent Decree: …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors' Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants progress toward achieving compliance…
This is the second Ligas Data Report. Per the Ligas Consent Decree, the Division of Developmental Disabilities (DDD) will produce reports of data and information regarding implementation of the provisions of the Ligas Consent Decree every six months. The due dates for these reports will typically be February 15th and August 15th of each year. Unless otherwise specified in the body of this report, the data collected represents a time frame of June 15, 2011 through June 30, 2012.
Class Member List
The DDD is maintaining a centralized, master class list as described in the Ligas Implementation Plan. Individual records are categorized into three separate areas: individuals living at home in the community, individuals living in an ICF/DD who were admitted after June 15, 2011, and individuals living in an ICF/DD who were there on June 15, 2011 (the date of the Court's approval of the consent decree). Written statements documenting a desire to be a part of the class are obtained for each individual in the latter category. Individuals are added to or removed from the class list as appropriate. The table below provides a summary of the class list as of July 26, 2012.
Summary of Class Member List
| Category |
FY12 |
FY13 |
FY14 |
FY15 |
FY16 |
FY17 |
Cumulative
Total toDate |
| Living at Home |
10887 |
|
|
|
|
|
|
| ICF/DD after 6/15/11 |
8 |
|
|
|
|
|
|
| ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) Total |
671 |
|
|
|
|
|
|
| DD PAS 10 |
13 |
|
|
|
|
|
|
| DHS 1243/1238 |
181 |
|
|
|
|
|
|
| EFE Form |
456 |
|
|
|
|
|
|
| OSG Request |
8 |
|
|
|
|
|
|
| Other Guardian Request |
13 |
|
|
|
|
|
|
| # At End of Fiscal Year |
11566 |
|
|
|
|
|
|
Individuals were added to or removed from the Class Member List as follows during FY12:
Summary of Individuals Added
| Additions |
Number |
| Individuals in ICFs/DD on 6/15/11 |
448 |
| Individuals in Community Settings |
9 |
| Total Additions |
457 |
Summary of Individuals Removed
| Removals |
Number |
| Individual Moved Out of State |
31 |
| Determined Clinically Ineligible |
6 |
| Determined Financially Ineligible |
3 |
| Withdrew-Reason Not Given |
27 |
| Individual Deceased |
24 |
| Objector |
1 |
| Other |
8 |
| Incorrect SSN (Duplicate Record) |
21 |
| Ineligible Setting |
24 |
| Unable to Locate Individual |
44 |
| Submitted in Error |
3 |
| Total Removals |
192 |
Services for Class Members in ICFs/DD
The DDD informed PAS/ISC agencies of the confirmed class members residing in ICFs/DD as of June 15, 2011, and instructed the agencies to complete eligibility determinations and facilitate the choice and selection process. PAS/ISC agencies are now reporting to the DDD on a monthly basis progress made in assisting the individuals with their options. The DDD continues to inform the PAS/ISC agencies of new class members as they are identified.
Summary of Services for Class Members in ICFs/DD
| Target Dates from Consent Decree |
12/30/13 |
12/30/15 |
6/30/17 |
Cumulative
Total to Date |
| # of Class Members With Waiver Capacity Award Letters |
115 |
|
|
|
| *Total Class Members Who Have Moved to Waiver Services (per billing data) |
97 |
|
|
|
| Subtotal Who Received CILA Services |
95 |
|
|
|
| Subtotal Who Received HBS Services |
2 |
|
|
|
| Subtotal Who Received CLF Services |
0 |
|
|
|
Please note that the above data includes individuals who are moving due to ICF/DD downsizing and closure agreements.
Services for Class Members from the Waiting List
Two selections have been completed from the PUNS database (the Division's waiting list) since the approval of the Consent Decree using the criteria specified in the Ligas Implementation Plan. The Class Members selected have been notified and the PAS/ISC agencies have been instructed to complete eligibility determinations and facilitate the choice and provider selection process. A set of tables is maintained that provides summary information regarding the results of the selections. These tables are available on the Division's website at https://www.dhs.state.il.us/page.aspx?item=41142.
| Ligas Benchmarks |
1,000 6/30/13 |
500 6/30/14 |
500 6/30/15 |
500 6/30/16 |
500 6/30/17 |
Cumulative Total to Date |
| # of Class Members Selected From The Waiting List (PUNS) |
1426 |
|
|
|
|
|
| Total Class Members With Waiver Capacity Award Letters |
117 |
|
|
|
|
|
| Total Class Members Who Have Received Waiver Services (per billing data) |
54 |
|
|
|
|
|
| * Subtotal Who Received CILA Services |
4 |
|
|
|
|
|
| * Subtotal Who Received HBS Services |
50 |
|
|
|
|
|
ICFs/DD Resident Outreach
A Request for Proposals (RFP) was drafted and shared with the RFP development and review team for comment. Comments have been received and incorporated into the draft. The draft is now being finalized with the State's procurement staff. Until such time as a contractor is selected and in place, there will not be any data to report under this section.
| # of Adults in ICFs/DD |
|
|
|
|
|
|
|
| # of Adults in ICFs/DD |
FY12 |
FY13 |
FY14 |
FY15 |
FY16 |
FY17 |
Cumulative Total to Date |
| # of Individuals who Excluded Themselves from the Class by Having Objected to the Decree Prior to its Approval or by Submitting a Written Request to be Excluded Prior to Compilation of the Initial Class List |
|
|
|
|
|
|
|
| Total Class Members (2a) |
|
|
|
|
|
|
|
| Total Potential Class Members |
|
|
|
|
|
|
|
| # with Initial Phone Contact |
|
|
|
|
|
|
|
| # Choosing Not to Meet w/Outreach Contractor |
|
|
|
|
|
|
|
| # Choosing not to Meet but Want Info Sent |
|
|
|
|
|
|
|
| Total # Choosing to Meet w/Outreach Contractor |
|
|
|
|
|
|
|
| # Persons Completed Written Request for Community Services Through Outreach |
|
|
|
|
|
|
|
| # Undecided |
|
|
|
|
|
|
|
| #Pending |
|
|
|
|
|
|
|
| #Choosing ICF/DD |
|
|
|
|
|
|
|
Transition Service Plans
With input from the PAS/ISC agencies, new draft forms and procedures have been developed for the Transition Service Plans. These draft forms and procedures will be piloted beginning in September of 2012. Two PAS/ISC agencies have been selected for the pilot and will participate in a planning meeting with Division staff and the Monitor on August 23, 2012. In the meantime, there is not any data to report under this section. Per the Ligas Implementation Plan, PAS/ISC agencies are following the processes described in the DD PAS manual to assist individuals in obtaining needed services.
Summary of Transition Service Plans
| Category |
FY12 |
FY13 |
FY14 |
FY15 |
FY16 |
FY17 |
Cumulative
Total to Date |
| # with Services Implemented Prior to Transition Plan Completion |
|
|
|
|
|
|
|
| # with Transition Service Plan Completed |
|
|
|
|
|
|
|
| # with Transition Service Plan Under Development |
|
|
|
|
|
|
|
| Total to Date |
|
|
|
|
|
|
|
Crisis Services
The DDD continues to process service requests for individuals in crisis situations. With the assistance of the Monitor and input from the Plaintiffs, the DDD has developed an action plan to improve the timeliness of processing requests and ensuring service provision. Below is summary data regarding the requests processed during this reporting period.
Summary of Crisis Services
| Category |
FY12 |
FY13 |
FY14 |
FY15 |
FY16 |
FY17 |
Cumulative
Total to Date |
| Total # of Crisis Requests Received |
343 |
|
|
|
|
|
|
| Total # of Class Members Approved |
290 |
|
|
|
|
|
|
| # of Class Members Approved for CILA |
205 |
|
|
|
|
|
|
| # of Class Members Approved for HBS |
85 |
|
|
|
|
|
|
| Total # of Class Members Who Received Services |
247 |
|
|
|
|
|
|
| # of Class Members Who Received CILA Services |
173 |
|
|
|
|
|
|
| # of Class Members Who Received HBS Services |
74 |
|
|
|
|
|
|
| Total # of Class Members Denied Crisis Approvals |
53 |
|
|
|
|
|
|
Voluntary ICFs/DD Closure/Downsizing Agreements
The DDD continues to work with ICF/DD providers that wish to downsize or close their facilities on a voluntary basis. The information below summarizes the agreements underway during this reporting period. Please take note of the following issues involving the data in the table below:
- Included in the FY12 numbers are persons who were part of closure/downsizing agreements that were in process at the time of the approval of the Consent Decree on June 15, 2011. Therefore some individuals may have moved prior to that date and were not included in the Class as they already had community-based services prior to the approval of the Consent Decree.
- It is a rare occurrence, but it is possible that some individuals who are part of closure/downsizing agreements are determined to be ineligible for the Adult Developmental Disabilities Medicaid Waiver. In such instances, the individuals are funded in community-based services with only State funding and are not eligible for membership in the Ligas Class.
- In comparing this data with that in the section entitled "Services for Class Members in ICFs/DD", note that the data source for whether an individual has moved is different between the two sections. This section uses self-reported information from the ICF/DD providers regarding the status of their closure/downsizing agreements; the section entitled "Services for Class Members in ICFs/DD" uses billing data. Typically, there is a greater lag time in the billing data.
| Category |
FY12 |
FY13 |
FY14 |
FY15 |
FY16 |
FY17 |
Cumulative
Total to Date |
| # of Agreements Initiatied |
9 |
|
|
|
|
|
|
| Total # Licensed Capacity |
144 |
|
|
|
|
|
|
| Total # of People to Move |
125 |
|
|
|
|
|
|
| * Moved to CILAs |
74 |
|
|
|
|
|
|
| * Move to HBS |
0 |
|
|
|
|
|
|
| * Transferred to Other ICFs/DD |
3 |
|
|
|
|
|
|
| * Move to Other Settings |
0 |
|
|
|
|
|
|
| * No Selection Yet Made |
48 |
|
|
|
|
|
|
Eligibility Appeals
The DDD continues to process appeals of eligibility. With the assistance of the Monitor and input from the Plaintiffs, the DDD and Department of Healthcare and Family Services has developed an action plan to improve the timeliness of processing appeals. Below is summary data regarding the appeals processed during this reporting period.
Summary of Eligibility Appeals
| Category |
FY12 |
FY13 |
FY14 |
FY15 |
FY16 |
FY17 |
Cumulative
Total toDate |
| Total Class Members Submitting Appeals |
57 |
|
|
|
|
|
|
| Subtotal Appeals Upheld |
9 |
|
|
|
|
|
|
| Subtotal Appeals Denied |
29 |
|
|
|
|
|
|
| Subtotal Appeals Pending |
17 |
|
|
|
|
|
|
| Subtotal Appeals Withdrawn |
2 |
|
|
|
|
|
|
Budget for Ligas
The Governor's introduced budget for FY13 included $38.9 million in increased funding to the Division of Developmental Disabilities for items related to Ligas Consent Decree implementation. This $38.9 million includes:
Budget Category
Description of Expense |
FY13 Proposed
Amount |
Comments |
| Contractual Agreements |
| RFP ICF/DD Outreach |
$200,000 |
|
| Eligibility Determinations |
$450,000 |
|
| Increased PUNS Enrollment Processing |
$16,000 |
|
| Transition Service Plans Development |
$160,000 |
|
| New ISSA Services |
$679,000 |
|
| Person-Centered PlanningTraining |
$200,000 |
|
| Transition Service Plan Reviews & Consult |
$110,000 |
|
| Family Liaison |
$90,000 |
|
| Total Contractual |
| DDD Additional Staffing |
|
|
| Strategic Planning - Ligas Compliance Coordinator |
$108,277 |
|
| Data Support |
$93,408 |
|
| Quality Management - clinical reviews |
$653,856 |
|
| Transition Services - facilitate and monitor |
$373,632 |
|
| Appeals |
$79,004 |
|
| Rate Setting |
$93,408 |
|
| Medicaid Waiver - post payment reviews |
$280,224 |
|
| Total Staffing |
$1,681,809 |
|
| Direct Services |
| PUNS Selection |
$26,401,140 |
1,000 additional individuals; 300 annualized from FY12 ad 700 phased in during FY13; 1/2 CILA and 1/2 HBS; average annual cost for CILA $49,429, plus $2,500 one-time start up; average cost for HBS $25,740 |
| ICF/DD Transitions |
$8,873,310 |
400 individuals; 200 annualized from FY12 and 200 phased in during FY13; average annual cost for CILA $49,429, plus $2,500 one-time start-up |
| Total Direct Services |
$35,274,450 |
|
| Total Estimated Budget |
$38,861,259 |
|
The new funding for Ligas Consent Decree Implementation remains in the final budget passed by the General Assembly and signed by the Governor; however, the appropriation line containing this funding was reduced overall by 4%. At this point in time, the Division believes it can proceed with implementation as planned, managing the 4% reduction through a slower than anticipated phase-in of the direct services.
Spending for the ICF/DD program remains constant. In FY11 ICF/DD spending totaled $392.8 million, with 6,427 being served at the end of that fiscal year. Spending for FY12 is estimated to be $388.0 million, with a projected 6,350 being served at the end of the fiscal year. The FY13 introduced budget included $390.0 million for an estimated 6,300 individuals in ICFs/DD. As noted above, the appropriation line containing this funding, however, was reduced overall by 4%.
Spending for the Waiver program in FY12 is estimated to be $652.2 million. 18,710 individuals were served in FY11; 20,000 are projected to be served by the end of FY12; and 20,500 are estimated to be served in FY13.
Implementation Plan Updates and Amendments
There have not been any amendments or updates to the Implementation Plan since its submission to the Court on December 15, 2011. The DDD continues to consider possible changes to the PUNS selection process.
