Ligas Compliance Data Report of 2-15-13

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 third 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 for FY 2013 represents a time frame of July 1, 2012 through December 31, 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 January 15, 2013.

FY12* FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Living at Home 10694 10439
ICF/DD after 6/15/11 21 21
ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) Total 668 770
DD PAS 10 12 10
DHS 1243/1238 186 334
EFE Form 448 403
OSG Request 8 8
Other Guardian Request 14 15
# At End of Fiscal Year 11383 11236

*The numbers for FY12 were incorrect in the last Ligas Data Report issued in August of 2012. In developing this current report, it was discovered that the Division's reporting mechanism for some of the data in this section was counting the number of electronic records as opposed to the number of individuals. The FY12 numbers are corrected here.

Individuals were added to or removed from the Class Member List as follows during FY13:

Additions Number
Individuals in ICFs/DD on 6/15/11 171
Individuals in ICFs/DD after 6/15/11 8
Individuals in Community Settings 20
Total Additions 199
Removals Number
Individual Moved Out of State 23
Determined Clinically Ineligible 12
Determined Financially Ineligible 6
Withdrew-Reason Not Given 88
Individual Deceased 20
Objector 1
Other 5
Incorrect SSN (Duplicate Record) 10
Ineligible Setting 23
Unable to Locate Individual 108
Stay in ICF/DD 50
Total Removals 346

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.

Target Dates from Consent Decree:  12/30/13 12/30/15 6/30/17 Cumulative Total to Date

12/30/13 12/30/15 6/30/17 Cumulative
Total to Date
# of Class Members with waiver capacity award Letters 216
*Total Class members who have moved to
waiver services (per billing data)
157
Subtotal who received CILA services 151
Subtotal who received HBS services 4
Subtotal who received CLF services 2

NOTE:  The data above includes individuals who are moving due to ICF/DD downsizing and closure agreements.

Services for Class Members from the Waiting List

Three 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 web site 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) 3112
Total Class Members with waiver capacity award letters 514
Total Class Members who have received waiver services (as reported by the PAS agencies and providers) 328
Total Class Members who have received waiver services (per billing data) 268
*Subtotal who received CILA services 28
*Subtotal who received HBS services 240

ICFs/DD Resident Outreach

With input from the Monitor, Class Counsel, and Intervenors, the DDD issued a Request for Proposals (RFP) to secure the services of a contractor or multiple contractors to contact all Potential Class Members residing in ICFs/DD; however, the DDD did not receive any bids in response to the RFP. After consultation with the State's procurement staff to ensure all regulations are appropriately followed, the DDD is now in discussions with a potential vendor. 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 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

The DDD is finalizing the development of its process for completion of a Transition Service Plan for each class member seeking services in a Community-Based Setting. An initial version of a standardized format and accompanying instructions was developed with input from the Monitor, Plaintiffs Counsel, PAS/ISC agencies, and other advocates throughout the system. Two PAS/ISC agencies are piloting the draft process and materials with Class Members and providers in their areas. These two PAS/ISC agencies participated in a planning/training meeting with the Monitor and DDD staff on August 23, 2012 in order to begin the pilot.

As the Implementation Plan is being revised, 41 Transition Service Plans have been developed and submitted for review by the DDD and Monitor. Monthly conference calls have been held among the two PAS/ISC agencies, Monitor, and DDD staff throughout the pilot. The standardized format and accompanying instructions are now undergoing final revisions, based on the experience of the pilot, for Statewide implementation.

Training for all PAS/ISC agencies is scheduled for April 16, 2013. Local training sessions for small groups of PAS/ISC agencies will be held throughout the rest of April and May. A webinar session will also be made available. These training opportunities are being conducted by DDD staff and the Monitor. The DDD will begin reporting data in this section after the statewide implementation targeted for July 1, 2013. In the meantime, 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.

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. Below is summary data regarding the requests processed during this reporting period.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Total # of Crisis Requests received 343 153 496
Total # of Class Members approved 290 136 426
# of Class Members approved for CILA 205 92 297
# of Class Members approved for HBS 85 44 129
Total # of Class Members who
received services
247 132 379
# of Class Members who received
CILA services
173 89 262
# of Class Members who received
HBS services
74 43 117
Total # of Class Members denied
crisis approvals
53 17 70

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.
FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Total # of crisis requests received 343 153 496
Total # of Class Members approved 290 136 426
# of Class Members approved for CILA 205 92 297
# of Class Members approved for HBS 85 44 129
Total # of Class Members who
received services
247 132 379
# of Class Members who received
CILA services
173 89 262
# of Class Members who received
HBS services
74 43 117
Total # of Class Members denied
crisis approvals
53 17 70

Eligibility Appeals

The DDD continues to process appeals of eligibility. Below is summary data regarding the appeals processed during this reporting period.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Total Class Members
submitting appeals
57 25 82
Subtotal appeals upheld 9 11 20
Subtotal appeals denied 29 8 37
Subtotal appeals pending 17 4 21
Subtotal appeals withdrawn 2 2 4

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 Determination
$450,000
  • Increased PUNS Enrollment Processing
$16,000
  • Transition Service Plans Development
$160,000
  • New ISSA Services
$679,000
  • Person-Centered Planning Training
$200,000
  • Transition Service Plan Reviews & Consult
$110,000
  • Family Liaison
$90,000
Total Contractual $1,905,000
DDD Additional Staffing
  • Strategic Planning - Ligas Compliance Coordinator
$108,277
  • Data Support
$93,408
  • Quality Management - Clinical Reviews
$653,856
  • Transition Services - Facilitate & 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 and 700 phased in during FY13; one-half CILA and one-half 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 is implementing the consent decree 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.

The Governor's Budget Address for FY14 is scheduled for March 6, 2013. The DDD will provide information from the Governor's Proposed Budget, as it relates to Ligas funding, to the Monitor, Plaintiffs, and Intervenors as the information is available.

Implementation Plan Updates and Amendments

The first annual update of the Ligas Implementation Plan has been completed with input from the Monitor, Plaintiffs and Intervenors.