Location of Meeting: Services Inc, Joliet IL
Steve discussed the recent ARC conference. At the conference, Greg Fenton gave a presentation on the current committees created to look at enhancing service coordination. At that presentation, parents expressed concern that we not build a system that is too restrictive in its approach to services. Rather than having a proscribed schedule of visits (i.e. monthly) that there is flexibility is the visits. Greg tried to make it clear that the role of service coordination is going to change in regards to the support plan. The support plan will consist of goals and desires that the person has and will be completed by the ISC's.
Lori stated that from a family perspective when her daughter was in school she wasn't aware of service coordination agencies since she wasn't requesting services at that time. Lori's family became involved with service coordination when her daughter was initially put on the PUNS. During the last conversion process, her daughter started receiving adult home based services.
Further discussion is needed in the area of "Do we need to have more of a lifeline process/connection in service coordination?"
Lori brought up the point that the annual waiver redetermination process can be confusing for a family regarding the assessments. There was a discussion of the ICAP assessment tool and its limitations. The ICAP score can also impact the funding level for a person receiving cila services. Lori stated that it would be helpful to have a "fact Sheet" of assessments to give to parents so they are aware of what each assessment is used for and why. The purpose of each step needs to be described in better detail to families so there is transparency throughout the process. Our current process is a deficits based approach rather than a strength based approach.
Mary Lou asked the group "How often would you say with all of the people who are initially eligible, receive waiver services and supports from your agency, how many people are identified as no longer eligible to needing that level of care?" Across the board, each person stated that less than 5% of people are found ineligible. Mary Lou noted that we spend time doing eligibility and redetermining eligibility when the percentage of people who are found ineligible (after initially being determined eligible) is very low. It was noted that many folks are no longer eligible due to not qualifying for Medicaid.
There was discussion regarding other ways that we could "redetermine" eligibility rather than what the State of Illinois is currently using. Active treatment is not a requirement in home and community based services. On the federal level, it is only a requirement for institutions. Federal government requirements: Do they have a need for these supports? Do they have a need for this level of care? The federal requirement is based on the idea of support, not treatment. In the absence of support, how would this person do?
Mary Lou reported that yesterday the Bureau of Community Services, the Bureau of Transitional Services staff, some staff from the Bureau of Quality Management and staff from Money Follows the Person met for a training. The topics discussed were:
The Challenge of Independent Service Coordination:
Rethink the referral process of how it is now? Providers allege that ISC agencies aren't sending referrals their way or are playing favorites. How do we make it work so it is transparent, and works for all of us, including families, providers and service coordination agencies?
We first engaged in a brief review of what exactly additional monitoring visits consist of:
Team discussion that for most families that interact with ISC agencies that receive home based services families are looking for information and resources beyond what the DD system would pay for. The team noted that this illustrates why these positions are not first year positions for QIDP's but for QIDP's who are experienced and have knowledge to convey information. The QIPD's really need to be skilled in how to do active listening with a family so they can reflect back to a family. There also needs to be additional focused staff training and the funding to go with it. Other states have a very defined curriculum of what 1st year QIPD's skills set, 2nd year QIDP skills set, etc. In Illinois, DHS-DDD does not have a separate training specifically for ISC agencies. It was noted that there should be enhanced training for ISC agencies available within the DD division. DHS-DDD is also discussing having internal requirements for training for Community Services staff in the division.
The DHS-DDD needs to find a solution of how to find a consistent population to draw QIPD's.
There needs to be Development training modules that move people from an entry level position QIPD position with no skills to a highly skilled QIDP position. A long term goal would be to develop a curriculum for a college degree.
A small team will meet via Go to Meeting to review the ISSA manual. The team will go through the ISSA guidelines prior to our 5/20/14 meeting to address all of our responsibilities as a service coordination agency. The team will also review Attachment A pages that Apply to ISC agencies. The team will consist of Mary Lou Bourne (Facilitator), Jennifer Gilmore, Lisa Jacino, and Denise Oligney-Estill.
Thought to consider: Do we change to have one manual to reflect all the duties including ISSA, Bogard, PAS, and PUNS/Program 500. Team will consist of Denise, Jennifer, Lisa (Mary Lou will facilitate)
Tuesday May 20th at Service Inc in Joliet from 9am-3pm
2300 Glenwood Avenue, Joliet IL
Minutes Prepared By: Denise Oligney-Estill
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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