Team 3: PUNS and HCBS Enrollment (7-31-14)

Members Attending

Members Not Attending

• Janine Gudac, DHS 
• Leslie Hart, Day One Network
• Carolyn Racki, PACT

Meeting Minutes

Celia Feinstein asked if everyone had a chance to review the 6/9/14 meeting minutes, had any questions or comments, and whether everyone felt they received enough information. The consensus was the meetings were very detailed and helpful. No one had any questions or other comments.

1. Opening Remarks and Agenda -Jane Nesbitt

   • Jane Nesbit welcomed and thanked everyone for participating in the meeting.  Jane Nesbit offered the following agenda for today's meeting:
     1. PUNS Tool rewrite - Celia w/team input & PUNS Manual re-write - Celia w/team input & ISC Training Schedule - ISC Agency's coordinate and host
     2. PUNS Eligibility - this "may be" prescriptive and outlined (and addressed/discussed as a part of Team 2) - Reta, Celia w/team input, So…1 & 2 may need to be worked on together
     3. PUNS Outreach - ISC Agencies have been asked to provide an FY15 Outreach Plan - full team Input
     4. PUNS Initial Enrollment & Annual Updates - recommended methodology - full team input
     5. PUNS & ROCS - full team input
     6. The consensus was to work on the PUNS tool re-write and manual at the 7/31/14 meeting to determine recommendations. Everyone was asked to review the PUNS tool and manual and bring suggestions to the 7/31/14 meeting.
     7. PUNS eligibility may be addressed in Team 2 discussions with waiver eligibility.
     8. Initial PUNS enrollment was discussed. For people who are having a crisis funding packet submitted, ICF/DD downsizing, and SODC downsizing, the existing requirement to complete PUNS (then close PUNS once placed) creates excess work for ISC agencies and families. DHS needs to be able to track people needing services and receiving services. One idea discussed was to have an "express" for specific situations like those mentioned above so DHS still had a way of tracking the information. This will be discussed at the next meeting to decide if a recommendation will be made.
   • Annual updates are important. Celia expressed what she discovered during listening tours is they aren't working now. Almost no one is doing them face to face. Families expressed to her they want to do them face to face. People have to travel long distances, PAS is not getting paid for annual updates, and families are being pushed to contact PAS to update. Initially the letter sent out by DHS told families to contact DHS. At one point in time the letter was changed to say contact the local PAS agency. In Celia's report she recommended annual updates be face-to-face for emergencies and for change in category. We need to obtain quality information and also be respectful of the agency's time. DHS found during PUNS selection that people have moved out of state, out of the area, have died, and are still on PUNS. The legislature is questioning the validity of data. There is variation throughout the state of how PUNS updates and closings occur.
   • Team 3 will discuss at the next meeting whether to make a recommendation to DHS to revise the language in the annual update letter to be simple, straight-forward language, (giving specific suggestions) and change the timeframe for the letter to be mailed. Initially the purpose of the DHS letter was to serve as a reminder to families that the ISC agency would be updating the PUNS with them soon.
   • Team 3 also needs to establish procedures for PUNS updates such as possibly having the ISC agency send a letter to individuals letting them know it's time for annual update, when letter will be sent, contents of letter, offering the opportunity for a face to face meeting, reminding family to bring any information that affects their status on PUNS. The PUNS tool could have a disclaimer on the form for the individual/guardian to sign saying a face-to-face meeting was offered, but they chose to complete the PUNS by telephone, mail, email, or fax. Families don't always understand how their situation impacts PUNS. It was expressed by some team members that requiring all annual updates face to face set up the system for failure and frustration for families, PAS, and DHS. Some families prefer not to meet face to face due to time with work, family, or other commitments. We need to allow for individual/guardian choice and flexibility. Another comment was expressed that it is reasonable to expect to meet once a year face to face because of the importance of what we are talking about.
   • Celia Feinstein also suggested DHS take a stance on how many calls, letters, and certified letters are sent to individuals before PAS closes a person in PUNS. Families and agencies expressed frustration with the inconsistency throughout the state.
   • Team 3 needs to make prescriptive recommendations to DHS.
   • The issue of not being able to locate a person to update PUNS was discussed. DHS does not do automatic closures. People who are selected from PUNS may not be able to be located due to not having an annual update or due to not informing PAS they moved. Mail is sometimes returned undeliverable, marked by post office as unable to forward. It's very frustrating trying to locate families who need annual updates or have been selected from PUNS and are unable to be located. Team 3 may establish procedures for letting family know importance of contacting PAS with changes in situation, address changes, and importance of individual/guardian participating in annual update and implement procedures throughout the state for consistency. Procedures may include a follow up letter to the individual/guardian after completing initial PUNS.
   • Reta Hoskin will share a draft document with Team 3 that a couple DHS staff worked on of criteria PAS could use before closing a person to PUNS.
   • Should length of time on the PUNS list be a criteria for PUNS selection? This will be discussed at the next meeting.
   • There are approximately 3,091 new enrollments to PUNS per year.
   • Stephanie Leach is due back 8/15/14 and Reta Hoskin will invite her to join Team 3.
   • An outreach plan will be developed using the DHS memo that went out to ISC/PAS executive directors on 7/1/14. There needs to be a strong relationship between the local school districts and the local PAS agencies. Cultural issues and special populations including autism need to be included in the outreach plan. We may want to make a recommendation that Team 2 address eligibility specific to autism.
   • ROCS- The lack of capacity, lack of compatibility with other data systems, lack of ability to manipulate data, and lack of ROCS being compatible with new computers were issues raised during listening tours. To maintain proper data and share it with legislature, state, providers, ISCS agencies, and families we need to move forward in technology.
   • It would be helpful for ISC agencies to be able to generate their own reports with specific information and manipulate the information within agency to create what is needed. Information such as how many people are new to PUNS, updates, categories, ability to give families numbers and give families hope.
   • Reta Hoskin stated there will be a rewrite of the ROCS system. Contractors are currently collecting information at DHS to determine the scope of project and what will be involved. Reta will be setting up a small group of stakeholders to put a workgroup together. Team 3 was invited to bring names to the next meeting of anyone within their agency who is familiar with ROCS and would be good on the ROCS committee.
   • Team 3 could make a recommendation that DHS rewrite the ROCS system to include changing technology capabilities.

Future Agenda Items

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

1. PUNS Tool re-write - Celia w/team input & PUNS Manual re-write - Celia w/team input & ISC Training Schedule - ISC Agency's coordinate and host
2. PUNS Outreach - ISC Agencies have been asked to provide an FY15 Outreach Plan - full team Input
3. PUNS Initial Enrollment & Annual Updates - recommended methodology - full team input (Discussion about "express PUNS")
4. Closing PUNS
5. ROCS (determine recommendation, bring potential names to Reta for ROCS workgroup)

Summary of Action Items

Team Members are asked to review PUNS manual and PUNS tool in preparation of next meeting. Team members are asked to review these meeting minutes as we move to make recommendations toward discussed items.

Next meeting

7/31/14 10am-1pm IARF, 206 S. Sixth Street, Springfield, IL 62701 (Parking is available at the Hilton and there is underground parking on 6th Street)

Minutes written and prepared by Michelle Tibbs