Team 3: PUNS and HCBS Enrollment Meeting Minutes (6-10-14)

Tuesday, June 10, 2014, 10am - 1 pm

IL Planning Council on DD
830 S. Spring St.
Springfield, IL 62705

Members Attending

  • Reta Hoskin, DHS
  • Celia Feinstein, CFA, Inc.
  • Betty Jackson, Envision Unlimited
  • Michelle Tibbs, WISC
  • Special Guest: Tony Records, Ligas Court Monitor
  • Terrry Cremer, Association for Individual Development
  • Jane Nesbit, DDSME
  • Alisha O'Boyle, Day One Network
  • Leslie Hart, Day One Network
  • Carolyn Racki, PACT
  • Mary Kaye Speidel, SICCS

Members Not Attending

  • Janine Gudac, DHS
  • Theresa Positano, Options & Advocacy
  • LeAnndra McGlauchlen, CISA
  • Cindy Sullivan, Options & Advocacy

For Team 3 Celia Feinstein is the facilitator, Jane Nesbit is the chairperson, and Michelle Tibbs is the communicator.


Team members introduced themselves. The list of team members' names and email addresses are available on DHS's website under the Life Choices Project.

Opening Remarks-Celia Feinstein

Celia Feinstein gave opening remarks. Once it was determined the PUNS instrument and process needed to be evaluated and updated, Celia completed the PUNS listening tours. "The PUNS listening tour: report and recommendations for action" was recently released and is available on the IL Planning Council on Developmental Disabilities web site. We will spend this meeting becoming familiar with responsibilities of our group, giving feedback to the PUNS report, and determining suggestions for immediate and long-range implementation. We will set an agenda for how our team will proceed.

Opening Remarks-Reta Hoskin

Reta Hoskin gave opening remarks. It had been decided for Team 3 to wait to meet until the PUNS listening tour report was released. The meeting schedule will be discussed today. Senior management within DHS meets twice a month to review how the Life Choice Project is progressing. Kevin Casey is invested in making changes in the case management system and strengthening it.

  • The State received federal approval for participation in the balancing incentive program (BIP) to receive an enhanced Medicaid match as long as certain requirements are met. The initiative covers multiple divisions within DHS and other Departments and it is expected to provide 90 million dollars. One of the requirements is to have a conflict free case management system in place, which Illinois does through ISCs; however, there are issues that need to be reviewed. One of the areas DHS is looking at is ISPs being developed by providers rather than ISCs, which may pose a conflict of interest. Although it is permitted, there has to be certain safeguards in place. Another requirement is to have a common access point for services (no wrong door). The State is looking for a tool that all entities could use for entry into services. The State issued an RFP for vendors to apply to develop a Universal Assessment Tool (UAT) for the state. With this, there would be an automated system where the information would already be available should someone access the system multiple places. Discussions are still underway.

    There is a stakeholder committee working with the State on the BIP issues. DHS submitted a funding proposal of how they would spend the match. Some of the funding will go toward the UAT. Some of the money will be used for the Ligas expansion once that funding is exhausted since they were able to show the general assembly that the State had funded this initiative previously and would again in all likelihood. DHS plans to fund 4, four person 24-hour stabilization homes for waiver participants who are in a struggle to maintain current residential placement due to extreme behaviors (two upstate, and 2 downstate). The intention would be to have SST involved and if the team agreed that a temporary out of home placement may be beneficial, apply for temporary placement not to exceed 60 days. This is meant to be a short-term stabilization benefiting individual and provider. DHS expects to serve approximately 90 individuals/year through this service.

    An amendment to the adult waiver was submitted to the federal government in April to cover this service. DHS is developing RFPs for providers to operate these homes. One restriction will be the provider must have a CILA license or be able to get one soon. DHS may be requiring a higher QIDP ratio, behavioral therapist on staff, more access to nursing. There is also an Employment First Initiative to review SEP. DHS is bringing in a vendor to work with 200 waiver participants for job opportunities. Approximately 30 million dollars of the BIP funds will be allocated for these initiatives.

  • 1115 waiver if approved will bring major changes to the state. It was submitted last Wednesday. Governor's Office of Health Innovation and Transformation (GOHIT) is establishing workgroups to work on implementation, service definitions, long term care supports, technology, etc. This would combine all 9 of the state's waivers. DD has 3 waivers: 1-adults, 2-children's home-based, 3-children's residential. DD waivers currently serve 20,000. The state is hoping to receive additional federal matching funds.

Group Composition

Group Composition: A concern was expressed that there are no family members on this team. If anyone knows a family member who may be interested in serving, please contact Jane Nesbit with the person's contact information. The possibility was mentioned of including one of the new family advocates on this work team.

Recommendations for Future Team 3 Work

The following recommendations were mentioned as areas for the team to work on:

  1. PUNS outreach - within our communities and within our schools; comprehensive & detailed relationships with local school districts;
  2. Eligibility before PUNS - develop list of documents to assemble prior to adding person to PUNS; If eligibility is still questionable, complete level II PAS so appeal rights will kick in and takes the pressure off of PAS (although data reflects that +/-1% of selections have had eligibility issues)
  3. Training & ongoing support for ISCs; Use the PUNS Listening Tour Report & Recommendations to revise and update the PUNS Tool and Manual, build more consistency and a more prescriptive process to improve the integrity of the waiting list, designate staff at DHS to contact regarding PUNS, improve the process of facilitating existing support systems and services, choice, and realistic expectations regarding length of time one might anticipate to wait;
  4. Annual updates
  5. ROCS - reports, transparency, transferring between ISC agencies, etc.

Unless the record has been updated within the last 3 years, people aren't selected from PUNS.

Future Agenda Items

In preparation of the next meeting, please review the updated Ligas implementation plan, the PUNS manual, the PUNS tool, the PUNS update process, any existing policies/procedures/rules about how to incorporate PUNS into ISC's work. Be thinking about whether the PUNS selection detail needs to be copied from the Ligas implementation plan into another user friendly document such as an information bulletin for providers and on the website for families;

Next meeting

Next meeting will be one of the following dates to be determined: 7/8/14, 7/28/14, or 7/31/14 in Pontiac or Lincoln. Michelle Tibbs will send out a meeting notice with the date, time, and location.

Minutes written and prepared by Michelle Tibbs