October 2, 2014 - Illinois Interagency Council on Early Intervention

Audience

Open to the general public.

Time

10:00 am to 1:00 pm

Locations

Illinois Primary Healthcare
500 South Ninth Street - 2nd Floor
Springfield, Illinois

Agenda

  1. Introduction of Council Members
  2. Approval of 7/10/2014 Draft Meeting Report
  3. SSIP Update
  4. Approval of Annual Performance Report Indicator Target Values
  5. Service Delivery Approaches Workgroup
  6. Parent Reimbursement Workgroup
  7. Telehealth Update
  8. Letter of Support for Preschool DevelopmentGrants - Expansion Grant
  9. Approval of Council Meeting Dates/Locations:
    1. Thursday, January 8, 2015 (video conference)
    2. Thursday, April 2, 2015 (north location)
    3. Thursday, July 9, 2015 (video conference)
    4. Thursday, October 1, 2015 (Springfield location)
  10. Adjournment

Meeting Report

Present

  • Karen Berman, IL Early Learning Council Designee
  • Bob Cammarata, ICG Health Care Services
  • Gerri Clark, Division of Specialized Care for Children (DSCC)
  • Brenda Devito, CFC #6 Manager
  • Ann Freiburg, Division of Family and Community Services
  • Margaret Harkness, IL Council on Developmental Disabilities
  • Beatrice Nichols, IICEI Chairperson, Head Start
  • Pam Reising-Rechner, IL State Board of Education (ISBE)
  • Kathy Schrock, Easter Seals DuPage and Fox Valley
  • Therese Wehman, Elmhurst College
  • Susan Tromley, IL Department of Children and Family Services
  • Amy Zimmerman, Health & Disabilities Advocates

Absent

  • J. Diane Adams-Alsberry, CALM, Inc.
  • Representative from DHS, Bureau of Child Care and Development
  • Julie Doetsch, IL Dept of Healthcare and Family Services
  • Ginger Mullin, IL Department of Public Health
  • Mary Petersen, Department of Insurance
  • Deanna Pratscher, parent, Thornton
  • Connie Sims, DHS, Division of Developmental Disabilities
  • Constance Williams, PhD, DHS/Division of Mental Health

Contents of Council Packet

  • Agenda
  • Draft Council Report - July 10, 2014 Meeting
  • Early Intervention Program Caseload Summary Report
  • Draft Child & Family Outcomes Targets
  • Outcomes Targets and Performance
  • Draft Reimbursement Voucher Policy as of April 3, 2014
  • Draft Reimbursement Voucher Policy as of September 19, 2014
  • Fact Sheets - Preschool Development Grants & Expansion Grants
  • Draft Letter of Support for Preschool Development Grants Expansion Grants
  • Children's Services Subcommittee Work Plan
  • CMCS Informational Bulletin - Medicaid Coverage of Services to Children with Autism

Call to Order

 The Illinois Interagency Council on Early Intervention (IICEI) convened at 10:02 a.m. 

Introduction of Council Members

Council members introduced themselves. Pam Reising-Rechner introduced Vicki Hodges, the homeless liaison at ISBE. Questions regarding issues for homeless families can be directed to Ms. Hodges. 

 Approval of April 3, 2014 Meeting Report

The April 3, 2014 meeting report was approved as written.

State Systemic Improvement Plan (SSIP) Update

The discussion of the SSIP began with a video of the process that has been completed so far. This video reviewed the quantitative data analysis, the identification of the state identified measurable result (SIMR), the selection of pilot sites in Race to the Top Innovation Zones (IZs), and instructions to focus groups that will be part of qualitative analysis in the selected pilot areas. In each pilot area, three focus groups will be held, one for CFC staff, one for EI providers, and one for IZ Committee members. All three focus groups have been held in two of the selected pilot areas, with just one remaining to be held in the third area. Input form the focus groups will be used to identify root causes and develop individualized strategies. Family input will also be gathered.

It was suggested that the breakdown of caseloads in the IZs by service coordinator be compared to service coordinator caseloads across the state. The importance of looking at the ethnic backgrounds of families when identifying root causes was recommended. The selected pilot areas include one with a significant Hispanic population. How child outcome scores are determined was explained. Articulating the overlap between the focus of the SSIP and IZs was recommended. Issues for referral and retention were discussed. The need for alignment across birth to five and a way to link EI data to kindergarten readiness assessments were suggested. The importance of effective transition was identified.

Approval of Annual Performance Report (APR) Indicator Target Values

Chelsea Guillen presented the suggested target values for the APR Indicators 3 and 4 that include child and family outcomes. The Child and Family Outcomes Workgroup looked at historical data and projected targets. Changes to the family outcomes process were identified and the establishment of new baseline data was explained. The summary statements for child outcomes were explained. Target values for child and family outcomes were approved.

Tahney Fletcher provided data about Indicators 5 and 6 that represent participation rates for children under the age of one and children under the age of 3. The group discussed strategies to set targets, first deciding on what number was appropriate to use for the first target value and then on how the expected increase per year would be determined.

It was suggested that more needs to be done to get additional children under the age of one into the program and that a workgroup could be formed. Other supports that families with children under the age of one utilize were discussed. Ongoing efforts to increase the under one participation were described. SSIP pilot strategies will likely include targeted messages to the primary care community. New efforts to allow Medicaid enrolled physicians to make referrals through the Cornerstone system were described. Families' confusion about being able to participate in more than one program was identified.

Tahney Fletcher also provided data about Indicator 2 that represents services provided in the natural environment. Council members recommended keeping the target value at 90 percent across the six-year time period. It was recognized that the State's performance exceeds the target value, but concerns were raised that increasing the target may make it harder for families to access services. It was suggested that the Department look at ways to review data provided in the justifications written when services are not provided in natural environments. 

 Service Delivery Approaches (SDA) Workgroup

Therese Wehman and Chelsea Guillen provided an update on the SDA Workgroup. The membership of the group and the value of the process to engage the professional organizations and others in formulating these recommendations has resulted in mutual respect and understanding of other's perspectives and opinions. The group has completed the final recommendations for the Intake process and will be moving through the other functions of the system. Recommendations will include background information with some key statements and steps on how the recommendations will be implemented. The group continues to meet monthly. Hopefully, recommendations will be ready for the Council to review at its April meeting. 

 Parent Reimbursement Workgroup

 Brenda Devito reviewed the reimbursement policy drafted by the workgroup. Changes from the original document provided by the Department were described.

  • To make it fair for all families, the policy was expanded to include a voucher policy for families that don't have funds to pay for services up front.
  • Families will be required to submit income and insurance information.
  • The language about services in natural environments was softened so that services will be provided in the natural environment, whenever possible. If a child has been waiting for a service, the policy would allow him/her to still receive a service even if it is not provided in the setting identified in the IFSP.
  • CFC offices would be asked to share a list of potential providers in their service area.
  • Rather than being subject to files being monitored by the EI Monitoring Program, requirements were softened to require documentation of the child's progress.
  • Both services provided in the natural environment and services provided in a non-natural environment would be reimbursed at the State rate.
  • Families, if assessed a family fee, will incur costs for services subject to fees.
  • The non-EI provider can be paid at the State rate for IFSP development time for teaming purposes, including attending IFSP team meetings.
  • Language about switching child to an EI provider when one becomes available was softened to allow the service coordinator to facilitate a transfer. If families elect to continue services with non-EI providers, they will no longer be eligible for reimbursement. It was recommended that this transfer begin when and EI provider is "identified" rather than "available."

The workgroup was commended for its efforts. It was clarified that polices about family fees and use of insurance would apply. The wording in step #6 was updated to read, "Services or out-of-pocket expenses will be paid or reimbursed at the State rate with proper documentation of the expense." Families would have the option to participate in the reimbursement/voucher process or not and may still file a complaint. The policy was approved by the Council as revised. It was clarified that the Council was looking for data on what service delays look like by discipline in general geographic areas, taking out parent delays.

Ann Freiburg shared information about efforts to include the entire IFSP in Cornerstone. The Bureau is forming a workgroup with CFC staff to work on this project. The project is broader than documenting service delays in Cornerstone and will take additional time to complete. A description of virtual Cornerstone was provided. This system will provide Cornerstone access using laptops with Internet capability. The remote access screens look different, but the information collected is the same. This is the feature that will allow referrals to be sent by physicians to CFC offices via Cornerstone.

 Letter of Support for Preschool Development Grants - Expansion Grant

The Early Learning Council has requested a letter of support from the Council for the submission of a preschool development grant. Karen Berman explained that the goal of the grant is to expand services to full-day preschool for 4 year olds. The mission and the targeted populations were identified, which include the most vulnerable children and families. Local school districts would actively partner with CFC offices and LICs in the community. It was requested that the list of school districts involved be provided so that CFC offices can be informed. It was suggested that the expansion of the at-risk definition might identify additional children that would benefit from EI services and could be used as momentum to get more funding for EI. The benefits of EI's existing infrastructure, the need for additional funding, and concerns regarding provider shortages were expressed. Beatrice Nichols requested approval to move forward with the letter of support. The Council approved the submission of the letter.

 Medicaid Coverage of Services to Children with Autism

Amy Zimmerman talked about Medicaid coverage of services to children with autism and asked the group to think about how this impacts EI. A copy of the full document provided in the Council packet can be found at http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf. Children with autism are receiving EI services, with no specific modality, such as ABA, identified. Services are based upon the principles of EI (i.e., supports in the context of the family) and the outcomes identified for the child in his/her IFSP. It was recommended that families be informed about all available services, including those options available to the family outside of EI system. The Bureau will be involved in follow-up discussion with HFS.

 Approval of Council Meeting Dates/Locations

Ann Freiburg requested the approval of the following Council meeting dates and locations. The Council provided its approval.

  • Thursday, January 8, 2015 (video conference)
  • Thursday, April 2, 2015 (north location)
  • Thursday, July 9, 2015 (video conference)
  • Thursday, October 1, 2015 (Springfield location)

Adjournment

 The meeting adjourned at 1:00 p.m.

Contact Information

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

email: jennifer.grissom@illinois.gov