April 4, 2013 - Illinois Interagency Council on Early Intervention

Audience

Open to the general public.

Time

10:00 am to 1:00 pm

Location

United Cerebral Palsy of Greater Chicago - Infinitec Southwest
7550 West 183rd Street
Tinley Park, Illinois

Agenda

  1. Call to Order
  2. Introduction of Council Members
  3. Approval of January 10, 2013- Draft Meeting Report
  4. Compliance with Part C Regulations
  5. Update on Impact of Part C Regulations on Use of Public and Private Insurance
  6. Bureau Staff Changes
  7. IFSP to Services Update (I2S)
  8. Provider Recruitment Tool
  9. Service Delivery Approach Workgroup
  10. Telehealth/Teletherapy Follow-up Discussion
  11. Adjournment

Meeting Report

Present

  • J. Diane Adams-Alsberry, CALM, Inc.
  • Bob Cammarata, ICG Health Care Services
  • Gerri Clark, Division of Specialized Care for Children
  • Margaret Harkness, IL Council on Developmental Disabilities
  • Beatrice Nichols, IICEI Chairperson, Head Start
  • Deanna Pratscher, parent, Thornton
  • Pam Reising-Rechner, IL State Board of Education
  • Dorelia Rivera Martinez, parent, Elmwood
  • Gina Ruther, DHS, Bureau of Child Care and Development
  • Kathy Schrock, Easter Seals DuPage and Fox Valley
  • Amy Tarr, Division of Family and Community Services
  • Therese Wehman, Elmhurst College
  • Robin York , IL Department of Children and Family Services

Absent

  • Julie Doetsch, IL Dept of Healthcare and Family Services
  • Matthew Grey, IL Department of Public Health
  • Mary Petersen, Department of Insurance
  • Connie Sims, DHS, Division of Developmental Disabilities
  • Constance Williams, PhD, DHS/Division of Mental Health

Contents of Council Packet

  • Agenda
  • Draft Meeting Report - January 10, 2013
  • Lead Agency - Case Summary Report

Call to Order

The Illinois Interagency Council on Early Intervention (IICEI) convened at 10:05 a.m.

Introduction of Council Members

Council members introduced themselves.

Approval of January 10, 2013 Meeting Report

The January 10, 2013 Meeting Report was approved as written.

Compliance with Part C Regulations

 Amy Tarr provided an update on efforts to comply with new Part C regulations.

  • Senate Bill 2217, which includes the required consents to use public and private insurance and other changes to come into compliance with federal regulation, has passed the Senate Human Services Committee. Representative Jacobson will sponsor the bill in the House.
  • Federal regulation allows states to use private insurance without parental consent if specific assurances are in State statute. The Department is taking steps to see if it can get a sponsor for a bill with that language.
  • Changes to the administrative code should be filed with JCAR within the next month or two.

Update on the Impact of Part C Regulations on Use of Private and Public Insurance

  • An update was provided on the impact of the required consent to use private insurance (estimated $5.1 million loss) and share personally identifiable information with the Department of Healthcare and Family Services for billing purposes (estimated $100,000 loss).
  • The Governor's budget includes $80.6 million for Early Intervention, a $7.7 million increase to offset the loss of funds due to new private insurance use policies and an increased caseload.
  • The Early Intervention grant application is due on April 22. The 5% sequestration has resulted in an $800,000 decrease for Illinois' SFY14 grant amount.

Bureau Staff Changes

Bureau staff updates include Blake Whitson leaving the Bureau, the promotion of Ann Freiburg to the position vacated by Jennifer Kepner's retirement, and the addition of Alecia Butler, an administrative assistant.

IFSP to Services Update (I2S)

The new I2S workgroup includes southern Illinois CFC offices, Bureau staff and Chelsea Guillen. The I2S workgroup is meeting to address strategies for timely services. Each participating CFC office is identifying strategies. The Service Delivery Approaches Workgroup will be kept informed of this work.

Provider Recruitment Tool

Ann Freiburg presented information about a new effort to assist CFC offices in provider recruitment ,using maps of Illinois with service needs indicated for the four main disciplines. The need is identified by Zip code and coded by the number of children waiting for services. The maps will be posted on the Provider Connections website and updated quarterly. Issues around providing services in natural environments, including safety concerns, were discussed. Targeted provider recruitment at universities within communities with service needs and within Latino communities was suggested.

Service Delivery Approaches Workgroup Report 

 Therese Wehman and Chelsea Guillen provided the Council an update of the work of the Service Delivery Approaches Workgroup. The group is now looking at different types of service delivery models and the infrastructure needed to support them. The floor was open for discussion for council and audience members to provide input to the process. The following is a brief summary of the issues that were shared.

  • Completing IFSPs right after doing evaluations is overwhelming for parents. The IFSP should be held after the family has reports in writing.
  • There are concerns with cultural diverse families in the IFSP process and that we are not capturing the needs and the goals that are important to families. We need to train providers to be more culturally sensitive and to communicate better with families.
  • Parents need a better understanding of what Early Intervention is. The current intake process does not include enough time to support this need.
  • It was recognized that the parent is the first, most important teacher of the child. Respect for the family, time to build relationships, and cultural competence are needed.
  • Isolation of providers needs to be addressed. Communication options were discussed.
  • Monitoring should be looking at the quality of work and relationships with families.
  • Recognize that EI should enhance the family's capacity. When more providers go into a family's home, parent feel less empowered.
  • The fee-for-service system impacts decisions regarding frequency and duration in ways that are not always best for families.
  • In order to be the best therapists, you have to treat (i.e., provide direct services) not just do evaluations.
  • Families communicate about being overwhelmed by the number of therapists coming into their homes by not showing up or not opening the door.
  • Family training should be provided so that families will say what they need.

Telehealth/Teletherapy Follow-up Discussion

Kathy Schrock provided an update on information about telepractice. Thirty-three responses to a survey that was sent to Part C coordinators were discussed. Ten of the responders use telepractice for select EI services. For three states, it is an established model of service, four states are piloting it, and three states provide this delivery model temporarily or inconsistently. It is most frequently used with speech/language therapy, with other services cited.

The survey provides some information about which states are using this technology in EI and under what conditions. Factors considered when determining this service model, technology used, confidentiality strategies, funding, and barriers were identified. The motivation seems to be to address unmet needs in rural areas.

Council members provided feedback regarding survey results. Research was requested on the use of this technology and its effectiveness for the 0 - 3 population. It was clarified that in Illinois, Medicaid only reimburses for telepractice when the physician is involved in the providing the service. Other funding sources for consideration include use of insurance and grant funding.

The group was asked to request more information from the three states that have used the model, including confidentiality documents and what is needed to implement a pilot. Information about the technology (Skype) was requested and whether families know that it is not secure. Other topics of discussion included: the family's technology capability, use in unsafe neighborhoods, use where there are only a few therapists that speak a language, and use as part of a mixed delivery model, with some sessions in person an others on Skype. If the group is looking to approach the insurance industry, it was suggested that work start with a grant and evidence is collected to show that the technology can be implemented with good outcomes.

Adjournment

The meeting adjourned at 12:02 pm.

If you are interested in more information regarding this council, please contact:

Contact Information

Jenni Grissom
IDHS - Bureau of Early Intervention
823 East Monroe
Springfield, IL 62701
Ph: 217/524-1596

email: jennifer.grissom@illinois.gov