Team 3: PUNS and HCBS Enrollment (9-11-14)

 Members Attending 

  • Terry Cremer, Association for Individual Development
  • Celia Feinstein, CFA, Inc., Facilitator
  • LeAnndra Keltner, CISA
  • David Ogunbode, CSO
  • Leslie Hart, Day One Network
  • Alisha O'Boyle, Day One Network
  • Jane Nesbit, DDSME, Chairperson
  • Reta Hoskin, DHS
  • Teresa Positano, Options & Advocacy
  • Carolyn Racki, PACT
  • Missy Kichline, Parent
  • Mary Kaye Speidel, SICCS
  • Michelle Tibbs, WISC, Communicator

Members Not Attending

  • Betty Jackson, Envision Unlimited 
  • Cindy Sullivan, Options & Advocacy 


  1. PUNS Updates
  2. PUNS instrument
  3. PUNS Manual
  4. Outreach Plan
  5. Additional resources

Celia Feinstein received a letter from Mary Lou Bourne, DHS, requesting recommendations and consensus by each team member no later than one week prior to the executive staff meeting scheduled on 10/22/14, 1-5 p.m. in Springfield. Team 3 and Team 5 have been invited to present recommendations. All team members are invited to attend. Celia explained the quadrants created by DHS.

  1. PUNS One Time Funding

    Reta discussed the funding received by the Illinois Planning Council on Developmental Disabilities to complete Ligas outreach in ICF/DDs. The Council has a small amount of funding that may be allocated for outreach to Ligas class members living at home, by creating educational materials. DHS is considering allocating one time funding to ISC agencies (based on funding through the balancing initiative) to address the backlog of overdue PUNS updates. DHS may consider allocating the funding based on the percentage of people on PUNS within each ISC agency for whom updates have been done. A suggestion was made to provide 50% of the funding initially and then provide the remaining 50% once the ISC agencies have eliminated the backlog of PUNS updates as an incentive to complete the updates. The suggestion was that 50% be allocated when 50% of the updates are completed and the remaining 50% be allocated when 95% of the updates have been completed.

July 31, 2014 Meeting Minutes

  • The meeting minutes were reviewed and each recommendation from the 7/31/14 meeting minutes was discussed to obtain consensus from the team. All recommendations will be stated below.
  • David Ogunbode shared a sample letter with the team that CSO sends the family once selected from PUNS or when a person needs emergency funding explaining they need to apply for Medicaid immediately and the benefits of doing so. This will be reviewed during the revision of the PUNS manual.


  • Encourage people to apply for Medicaid during transition planning.
  • Encourage people to apply for SSI once they turn 18.
  • ISC agencies host informational sessions inviting Family Community Resource Centers (DHFS), Adult Protective Services (DOA), Division of Rehabilitation Services (DRS), Department of Child & Family Services (DCFS), and school districts. DHS central office send a letter to all of the local offices explaining they will be contacted by the local ISC agencies to participate in informational meetings to improve the service system.
  • Revise the PUNS tool to contain a statement with a check box for the individual/guardian to sign stating a face-to-face meeting was offered, but they chose to complete the PUNS by telephone, mail, email, or fax.
  • Revise the PUNS tool to contain a statement stating whether the individual participated in the PUNS meeting.
  • DHS DD division should revise the language in the annual update letter to be simple, straightforward language.
    • DHS should make the letter available in foreign languages (Spanish, Polish, Asian, languages based on the population #s in the state of Illinois, etc.)
    • Add a checkbox with a sentence stated in a specific foreign language near the bottom of the letter stating if you need interpreter services or the letter in a different language, mark it and mail it to your ISC agency.
    • State the number of people selected from PUNS the previous year to show PUNS matters.
    • Include a statement in the letter "if your address or phone number changes, please notify your ISC agency".
  • DHS should improve the process by which ISC agencies obtain the 90 day letters, and provide training of how the Mobius reports are accessed.
  • DHS should provide ongoing ROCS training for everyone using ROCS.
  • Include a statement on all forms/letters related to PUNS (not only the annual update letter), "if your address or phone number changes, please let us know."
  • Require all initial PUNS be completed face-to-face.
  • ISC take initiative to contact families for annual PUNS updates.
  • Require all annual updates for those in emergency category and for a requested change from critical to emergency category be completed face-to-face with the individual present. If ISC starts an update by phone then determines a change to emergency category, the PUNS MUST be completed in a face-to-face meeting. For those individuals with a PUNS remaining in planning for need or critical categories, the PUNS update may be done by phone, mail, fax, or email as long as the opportunity for a face-to-face meeting was offered to the family.
  • Offer each individual and guardian the opportunity for face-to-face meeting to update PUNS and offer alternative locations.
  • Revise the PUNS tool to contain a checkbox for "Express PUNS" for people who do not need to be selected from PUNS to request funding such as having a crisis funding packet submitted, ICF/DD downsizing, SODC downsizing, DCFS wards aging out, and Bogard class members. Abbreviated information to be completed and guidelines will be included in the PUNS manual revision.
  • Require all PUNS to be signed by individual and/or guardian except for Express PUNS. (Exception-closing PUNS due to being unable to locate guardian.)
  • Closing PUNS:
    • DHS continue sending PUNS update letter 90 days prior to due date.
    • ISC complete1st phone call/text 60 days prior to PUNS update due date.
    • ISC complete 2nd phone call/text 1-2 weeks following 1st phone call, varying day and time of call.
    • ISC complete1st letter/email 45 days prior to PUNS update due date stating record will be closed if no response within 30 days
    • ISC complete 2nd letter/email after 2 weeks of previous letter stating case will be closed if you don't respond in 30 days.
    • After 2 weeks of 2nd letter, ISC will close the PUNS.
  • Develop a standardized script for the phone calls and letters within the revised PUNS manual.
  • Give ISC agencies access to Medi System.
  • Within the revised PUNS manual include specific information of who is eligible for PUNS and who is required to be present to complete the PUNS tool. A person 12+ should be encouraged to participate in the meeting. Reschedule PUNS meeting if necessary to accommodate attendance.
  • DHS should update the consent form to include electronic communication and remove the witness signature line.

Reta would like to send a letter to all the ISC agencies as soon as possible explaining how ISC agencies can access the PUNS information on DHS's website and how to access Mobius reports. Jane Nesbit, David Ogunbode, & Michelle Tibbs will work together to create instructions and send them to Reta.

Employees of ISC agencies not receiving the group emails sent to executive directors and program managers may contact Pam Baker at (217) 782-3075 to request to be added to the "PAS plus" list. Anyone is welcome to sign up on the DHS website for informational notices.

PUNS Tool Revision

Below are the major areas Team 3 suggests changing.

  • Create "Express PUNS" - this will also result in a change in the emergency and crisis categories
  • Align the categories with PAS criteria
  • Develop a different grid around the services so the urgency of each identified need within a category is distinguished
  • Review service definitions to assure consistent with PUNS (example "regular work"/sheltered workshop, supported living arrangements)


  • The letter from Robert Griffith was reviewed and discussed.
  • The suggestions from the ARC of Illinois were reviewed and discussed.
    • #1 and #2 will be addressed through Team 2.
    • #3 and #4 will be addressed through the PUNS manual revisions.
    • #5-#9 Celia will discuss with Reta.
    • #10 will be addressed in the outreach plan.

Outreach plan

  • A "PUNS Night" alternative was discussed. The definition of a PUNS Night was not the same for the ISC Agencies in attendance. Some ISC Agencies indicated that PUNS Nights work well for them. Other ISC Agencies felt there was not ample time, ability to offer privacy, and or confidentially to complete a PUNS. In some areas the experience has been that people make appointments and do not show up. Our Team 3 discussion recommended that when ISC Agencies schedule PUNS Nights, the ISC Agencies assure individual privacy to protect confidentiality. An outreach activity and an alternative to PUNS Nights would/could also be "PUNS Informational Evenings" where basic identifying & demographic information is collected and exchanged and the actual completion of the PUNS is scheduled for another time. The "PUNS Informational Evening" option is also an opportunity for ISC Agencies to explain PUNS, answer general questions regarding eligibility, discuss the waiting list, the selection process, and the services available after selection
  • Transition fairs are informational only and a great forum for distributing brochures and business cards asking people to contact the ISC agency to schedule a PUNS meeting.
  • Team 2 will be establishing eligibility criteria.

Future Work

  • PUNS tool revision
  • PUNS manual revision
  • Outreach Plan-use 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 ISC agencies. Cultural issues and special populations including autism need to be included in the outreach plan.

Summary of Action Items

Recommendations placed into quadrants will be emailed to each Team 3 member within the next week for approval. Celia would like a subcommittee of Team 3 to work on the PUNS tool revisions, the PUNS manual revisions, and the outreach plan. Each team member will be asked to express if interested in assisting with any of these areas.

Next Meeting

No Team 3 meeting scheduled for 10/22/14,  1-5 p.m., DHS Life Choice Project Meeting, location to be announced

Minutes written and prepared by Michelle Tibbs