Life Choices Steering Committee Meeting Minutes (11-12-14)

Following is a summary of the major items discussed during the meeting:

The objective of the meeting was to receive updates from Life Choices Project work teams, demonstrate how the various team recommendations fit together, share recommendations being worked on for implementation, and receive a preview of the next important steps.

Life Choices Steering Committee Meeting Minutes (11-12-14) (doc)

Agenda Items

  1. Opening Remarks and Overview of Life Choices Progress since February

    1. Feedback on the Project

      Mary Lou Bourne and Greg Fenton welcomed the group and thanked everyone for coming and for their many contibutions to the Life Choices Project Greg noted that the Division has been both humbled and energized by the level of commitment on the part of ISC agencies, service providers, DD staff, self-advocates and family members. Special recognition was extended to familiy members. Mary Lou noted that regardless of whether family members have jobs in this field, their contributions really went above and beyond. Family members present for the meting were given a round of applause.

      Mary Lou then provided an overview of activities and events that transpired since the February 19th meeting, including a summary of the processes that culminated in the formation of work teams, the scheduling of meetings, and group concurrence with team recommendations.

  2. Interactive Updates from Work Teams: Activities and Recommendations

    1. Work Team 1 - Service Coordination Enhancement

      • Team members were acknowledged. The Work Team consisted of many ISC members, a family member, and DDD members. The Team met several times, and yielded good participation for the most part.
      • The three tasks that were assigned to Work Team 1 were:
        • Identify what competencies, knowledge and training might be needed to perform service coordination;
        • Identify changes needed in the structure and business processes that would support the Team's work; and
        • Identify a set of performance measures to use in ascertaining the effectiveness of the Team's work.
      • The work group's tasks were divided once they came up with their list of recommendations. They found some consistency in the themes of their recommendations, and following are their 6 themes:
        • Recommendation to clarify the Work Team's responsibilities;
        • Recommendation to clarify what the ISC role is in monitoring, particularly with provider agencies;
        • Recommendation for data collection and reporting;
        • Recommendations related to improvement in Person-Centered Planning;
        • Recommendation for training expectations; and
        • Recommendation for development of a full array of services in the whole system - not just the ISC role, but how the ISC role fits into the services and processes being offered throughout the State.
      • Discussed slides of the Teams' recommendations (which have been posted on the DHS web site).
  3. Comment/Question and Answer Period (Q & A)

    Following the presentation, there were a number of comments, questions and responses, including the following:

    • Comment: A participant requested to peruse the recommendation handouts and documents, and was informed that all recommendations were available on the DHS web site.
    • Comment: One participant expressed her approval for what the Team had done, and would like providers included in the recommendations related to monitoring.
    • Question: A question was raised regarding the decision to move to 6 (monitoring) visits per year?
    • Answer: The Team didn't determine exactly how many visits would be appropriate, they felt that 6 would be the minimum, as they felt 4 would not be enough. The Team is suggesting a process in which, with State approval, the ISC could conduct more visits if s/he felt there was a need to do that.
  4. Work Team 2 - Intake and Eligibility

    Heather Houser described the purpose of Team 2, which she explained was to develop strategies to help individuals and families better navigate the system. The Team looked at making intake and eligibility two completely separate tasks. They felt that the Intake role should be short, quick and to the point, while the Eligibility role would take a little more time.

    The members of Team 2 who were present were acknowledged. Heather indicated that they had a fairly good-sized Team. For the meetings that were held, they traveled all over and met via conference calls as well. Attendance was pretty good most of the time. Heather noted that the Team did not have a Chairperson; Mary McGlauchlen was the Communicator; and Mary Lou Bourne was the Team's Facilitator.

    Heather spoke about the specific tasks assigned to Team 2, which were:

    • Describe a process for support coordinators to use when describing supports available so that first contact discussion with families can be made as consistently as possible;
    • Describe a new model to identify supports needed requested by family;
    • Steps to carry out the timely identification of DD eligibility, which includes families and advocates;
    • Consistency included in determining eligibility;
    • Training system-wide for everyone, not just ISSAs;
    • Standard criteria set for eligibility;
    • Consider combining work;
    • Create a central database that shares all common general information.

    Discussed slides of the Teams' recommendations (which have been posted on the DHS web site).

    Comment, Question and Answer Period (Q & A)

    • Question: Is the Team recommending that ISC agency staff attend the IEP meetings?
    • Answer: Didn't necessarily recommend that they attend the IEP meetings, although that would be good, (Heather expressed this was her own view) the team definitely felt there needs to be involvement from an ISC agency - at least two years prior to their graduation.
    • Question: Regarding psychological assessment of people who are mild/moderate, a question was raised regarding who would be doing the psychological. Would a clinical psychologist be performing the assessment?
    • Answer: Yes.
    • Question: Do we want HFS to create a streamlined process?
    • Answer: Yes, absolutely, we want to streamline the process for Medicaid eligibility because currently it takes too long to get them on Medicaid and get their services started, and that is unacceptable.
    • Question: Regarding transition planning for students prior to graduation, someone asked whether the recommendation was for planning 2 years prior to exiting the school system?
    • Answer: Yes, whether they're leaving at age 18 or 22. (Note: the transition planning required by Dept. of Ed must start at 14; this reference was the transition to determine if eligibility for adult DD services exists.)
    • Question: Regarding the recommendation regarding a state-wide brochure for the ISC agencies, a participant asked whether it would be appropriate to include in that brochure information about intake and eligibility?
    • Answer: That's a great piece for the alignment, thank you for picking up on that.
    • Comment: You mentioned the Eligibility vs. services that are available to families when meeting with them for the first time, some description of services available is going to be the most valuable thing they walk away with from that meeting.
    • Answer: Our thought was that, during intake and eligibility, when you're talking about the individuals' needs, it's going to fit in somewhere with what they need, we just don't want to basically say "these are the services, which one do you want". This is a recommendation that came from a family member on our Work Team.
  5. General Comments and Concerns

    • Families who are on the PUNS think they are going to get that. They are waiting a long time, instead of advocating and pursuing alternate doors for other options that could possibly meet their needs. One example is of a family that was on the waiting list for 6 years, and then told they were not eligible.
    • Another important piece is the education and training of what services are available. A lot of parents aren't going to be able to articulate what services they need because they don't know what the array of services are. Someone noted that they'd hate to see the ISCs choose what they think fits the family; instead, the family should have the full array and work with the Coordinator.
    • In terms of families, one of the reasons why this is so important to families is because when families come into an ISC agency, they may be the guardian, and they do not need to be bombarded with what services are available. They need to look at the individual that they are representing so that the individual can be included in the process. It is really important in this role that guardians allow the person to participate in the process. Getting to know that individual is the first step.
    • It was noted that there is a book out from the University of Chicago titled Nudge, about behavioral economics, which talks about choice architects - so if you put on your intake, eligibility and service determination hat when reading this book, it makes the case very strongly of why not to put specific services into people's minds at the front end. The book was highly recommended, and reportedly easy to read.
  6. Work Team 3 - PUNS and Medicaid Enrollment

    Jane Nesbitt, Chairperson, described the purpose of Team 3, which she explained was to develop an action plan to respond to feedback received from the PUNS Listening Tours. Tasks completed were:

    1. To convene 4 meetings - 3 in person and 1 on a conference call;
    2. Made 32 recommendations with 100% consensus from all Team members;
    3. Placed Team recommendations into 4 quadrants - and their placements continue to be adjusted (these will be online soon).

    Jane reported that Team 3 consisted of 15 members total. Celia Feinstein was the Team's Facilitator; Jane was the Team's Chairperson; Michelle Tibbs from Western Illinois Service Coordination was the Team's Communicator; DHS Liaison was Reta Hoskin. One family member, who also works for the Family Support Network, was a member, and there was representation from 3 Provider agencies and 9 ISC agencies. The Team's Subject Matter Expert (SME) was Celia Feinstein, and the DHS-DDD Representative was Reta. Many committee members were present for today's meeting and were acknowledged.

    Jane explained the 32 recommendations that were made. The Team's recommendations fell into 6 categories:

    1. 6 recommendations in PUNS Outreach and Education;
    2. 6 recommendations in PUNS Completion;
    3. 6 recommendations in PUNS Updates;
    4. 6 recommendations in PUNS Closing;
    5. 6 recommendations in PUNS Instrument Revision; and
    6. 2 recommendations in PUNS Training.

    Jane discussed the slides of the Teams' Recommendations (which have been posted on the DHS web site).

    Jane reported on the Teams' next steps, which are:

    1. Team is committed to additional and ongoing subcommittee work it will take to ensure recommendations become a reality and contribute to real change;
    2. Team is committed to PUNS being more than a waiting list and a method to enroll individuals onto a waiting list;
    3. Team is committed to making PUNS outreach and education, PUNS completion, PUNS updates, PUNS closings, PUNS instrument revision and PUNS training to be meaningful and with consistent methodology so that it remains important and individuals' needs can't and won't be ignored;
    4. Team believes that the 20,000 individuals identified - and the 20, 30, or 40 thousand more people who have yet to be identified - need more access to the knowledge that the ISC agencies can provide, if given the means. Schools can provide, if given the means. Communities can provide, if given the means - when we all work together.

    Comment/Question and Answer Period (Q & A)

    Following the presentation, there were a number of comments, questions and responses, including the following:

    • Question:  For the annual updates that don't require face-to-face contacts, how are families going to attest that they were offered a face-to-face contact on the actual PUNS when it has been done via telephone?
    • Answer:  We will be sending them copies of what we did over the phone, and they will sign and return them. That doesn't mean we will get 100% compliance. We will at least be able to substantiate the fact that we sent it to them.
    • Question:  Why wasn't just ICF-DD Ligas included in the list of express PUNS?
    • Answer: There are some individuals with Ligas who may be added to the express PUNS.Question: Regarding communication and the process for closing out PUNS - Communication is critical. You're going to send out letters, and you may get xx amount back - I did not hear what the process is to ensure that there is competence in the cultures that you're reaching out to in order to make sure that families understand what PUNS is, what it means. You can have all this stuff written, but if it's not in a language that is clear and family-friendly, you will not get a response back.
    • Answer: Hopefully we did touch on all of those concerns in some form in our recommendations. We know it's hard work and we know that each ISC agency works and deals in different communities with different groups, and we believe that there isn't an ISC agency that isn't out there making a good best effort, and we want that to continue.

    Mary Lou pointed out that the 4th bullet down specifically points out that the ISC agencies need to have outreach that is specifically geared toward an encompassing cultural diversity beyond a certain minority, and that the initial letter sent out includes a statement in multiple languages that indicates if you don't understand this, here's how to get in touch with us to have it in a different language.

    Reta Hoskin acknowledged the special attention be given to closing out PUNS. She noted that DDD was looking into implementing the close out recommendations earlier rather than later. Funding is currently available through the PUNS Integrity Project. Many records on PUNS are more than a year old now. ISC agencies have has been asked to do a lot lately, and have really come through with Ligas, SODC transitions, etc. It is believed that about 46% of the open records on PUNS are out of date. DDD was able to obtain Federal Balancing Incentive Program funding to help obtain resources to bring records up to date for the annual update requirements. Half of the funding is available in FY15, the rest in FY16. Allocation to ISC agencies may be determined on the basis of populations served. Reta added that the recommendations about closure of a PUNS records and the communication issues are really important, and it's important that we focus on them now.

    • Question: How was the timeline (contacting families 60 days prior to the annual update, and sending out letters 45 days prior to the annual update) decided?
    • Answer: Jane would be happy to take suggestions on changing the schedule.
    • Comment: When people get things too far in advance, they get lost on the kitchen table. Your timeframes are way too long. Personally, two weeks is sufficient. When you have 90 days, that's meaningless. It helps families to not see the seriousness in this.
    • Answer:  This was talked about with the Team. The 90 days was the initial notice and it was discussed about reducing it down, but the Team decided on the 90 days due to the face-to-face meetings to be scheduled. Within that time period, especially when the families want a face-to-face meeting, we need time for them to contact you or vice versa; we need time to get the information entered into the system; it's an opportunity for a family to not have to respond right away, etc.

    There are people on the PUNS list who lived at home and have since died, and when there's no response from the family, we call the family and are informed at that time that the individual has died or is in hospice and died a few days later. There comes a point to leave them (family) alone.

    As a family member, we have lives too; we have to have time to make arrangements, make our schedules, etc. The 90 day timeframe gives us an opportunity to make a decision if we want to do it in person, etc. If the individual within that 90 days can respond to you, and it's workable for both of you, then don't have to wait the 90-days.

    • Question: For people who speak a different language, is there an issue with reaching out to them and getting a hold of them?
    • Answer:The respondent stated, "We'll find access to the services; what we're suggesting in the recommendations is that it be mandatory to use the outreach and interpretive service when necessary".
    • Comment: The ability for an individual that the PUNS belongs with them and goes easily from one ISC agency to the next, instead of having to close from this ISC agency and be reopened here, and somehow a better transition for that family to pass on and to continue with the next ISC. We are often the first people that these individuals and families come into contact with, and some of us take it very personally, and be able to transition the person to the next ISC agency, to not have to close out and start all over again.
    • Answer:Realizes that is a concern and part of our conversation, and not sure why it did not end up in one of the recommendations, but absolutely do hear you.

    It's a systems issue too, and we're looking at ways for our computer system to allow the ISC agency that began the PUNS record to enter the information and let us know that their data can be shared. It's not something that's easy for us to do with the limitations, but it is something that we're looking at and realize that it is a very important issue.

  7. Work Team 4 - Individual Profile and Provider Selection

    Wanda described the purpose of Team 4, which was to give more emphasis to the person receiving services and to emphasize the person-centeredness of the service system.

    Tasks assigned were to:

    • Continue efforts to develop a person-centered profile that describes individuals abilities, preferences, goals and support needs;Develop guidelines for assessment and development of the profile;
    • Determine training needed prior to their requirement for service coordinators to develop the profile.

    Throughout all of Team 4's meetings, the word "profile" and "plan" intermixed. The Team doesn't necessarily have a name, so the word "Profile" or "ISP" might be used interchangeably, but mean the same thing.

    Team 4 members who were in attendance were acknowledged. Team 4 consisted of 6 ISCs, 1 very involved parent, 3 DD staff, 1 from IARF, 1 provider and 1 from the Institute. It was a very well-rounded group.

    The main thing that the Team reached consensus on is that there should be one single annual Plan across the state. The reason for this would be to help ensure consistency of services wherever a person may be; by having a standardized form, the appearance of the form becomes more polished, more professional, and has more significance. Currently, there is too much going on, and we need to reduce redundancy. This will be long-term and will take quite a bit of time to get consensus across the whole state with one kind of Plan.

    Discussed Team 4's vision and recommendations.

    Next steps are to:

    • Finalize some sort of format and develop the roll-out process, as this is a huge endeavor;
    • Revise the profile;
    • Develop specific procedure and protocol on provider referrals and selection;
    • Finalize a plan and new process with written procedures;
    • Submit revisions to the Steering Committee for feedback and request for clarification on the Team's recommendations.

    Comments, Question and Answer Period (Q & A)

    Following the presentation, there were a number of comments, questions and responses, including the following:

    • Question:  How will the response plan work?
    • Answer:  The plan is to include everything about the individual….their family, their medications, their past, their dreams, what they envision doing for work, their religious interests, their friendships, family involvement, etc. The provider response would be how we can meet the needs the individual has identified.
    • Question:  Where is the accountability that the Provider will indeed provide the services as written in the profile?
    • Answer:  That's why we wanted the profile to remain a part of the service plan. Accountability is currently with the ISSAs in the quarterly visits. Magic word for the reasons we wanted the response plan is "accountability". Advantage of doing this is potentially a better strategy because maybe one provider will be indicating that they can only do 3 things, but at least the other two things are still on the table and maybe someday another Provider will be able to address the other things.
    • Question:  There is a website out there called the Harrisburg Project, in which you key in a zip code and a number of providers come up. As a family member, I would prefer to have something like that, than to have confidential information about my family member on some bulletin board that could be accessed and compromised.
    • Answer: The Plan would not actually be on the bulletin board, just actually a generic description - for example: 25 year-old, female, ambulatory wants a 4-bed or less CILA, own room, near Chicago. If the individual does not want a specific provider, then providers are able to respond to the ISC, indicating that they may be able to meet some or all of those needs.
    • Q. Anyone thinking that if eligibility is determined up front before people go on the PUNS, a packet will still be needed with the Psychological and all of those results sent at the time when services are going to be initiated?
    • A. Things that drive rates will be needed, (i.e. icap, nursing packet, etc.) Things that determine eligibility will already have been sent forward and done and gone. If there's not a nursing packet included, the assumption is that you're not asking for nursing services. If you're asking for nursing services, you will need to demonstrate where that need came from. The packet is going to be very different as far as how and when it arrives.
  8. General Comments and Concerns

    Regarding Natural Supports and Liability:A participant expressed her satisfaction about the way the Team is looking at the policies. It was noted that this is very important and we need to focus on how we can do this. We know that there are obstacles to nurturing and developing natural supports. Part of the disincentive for providers is concerns of their liability when utilizing more natural supports; they (providers) need some guidance on how to do that and remain in compliance with the State to provide the supervision they are charged with.

  9. Work Team 5 - Service Monitoring and Collaboration for Quality

    Patty Walters described the purpose of Team 5, which was to provide recommendations for establishing better collaboration and creating synergy opportunities between the ISCs and Service Providers that lead to better quality and improved health and safety outcomes. The overall theme through the Team's months together was being clear what we're really speaking to is relationships, whether that's relationships between ISCs and families, providers and families, or ISCs and the providers - ensuring there is a Team process that has representation from all the groups with focus on the individual.

    Tasks assigned were to:

    • Create a new ISC Individual Visit and Interview document. The Team looked at CMS, new language, looked at CQL, and the focus was health, safety and person-centered…these items were emphasized in the documents the Team created;
    • Tool to develop - augmentative communication resources - we all know that there are lots of people who don't have a voice and can't necessarily answer the questions, which again, goes back to the relationships;
    • Determining performance indicators;
    • Team Recommendations.

    Patty O'Brien acknowledged the members of the Team, which included Mary Lou as the Team's Facilitator; Patty Walters was the Team's Chair; Shawna Egan was the Team's Communicator; Joe Turner was the Team's DDD Liaison; as well as Joshelle Williams, Mary Jane Friedrich, Matt Toohey, Steve Zider, Patty O'Brien, Deb Stanley, and Trevelyn Thomas.

    Discussed Team 5's recommendations.

    Next Steps, pending approval from the Steering Committee, are:

    • The Team would like to establish the pilot rollout and timeframe;
    • They would like to identify 6 - 10 ISC agencies, providers, and parents/guardians/individuals to participate in this pilot, so that they can test out the Individual Visit and Interview document and interpreted guidelines;
    • They would also schedule a training to initiate the pilot;
    • Once that time period has ended, the Team would like to evaluate the feedback from the pilot and meet with the Steering Committee to provide revisions and recommendations. Recommendations would then be submitted to the State for final approval;
    • They would like to see a full project implementation hosting multiple mandatory joint trainings for ISCs, providers, how to use the new tools, adopt person-centered planning practices, and understand the need for performance indicators. Parents/guardians would be encouraged to attend. In regards to the joint trainings, they like that Team 4 had a list of what ISCs would be trained in and what providers would be trained in - and ideally everyone would receive the same training so that the consistency occurs across the board. Also when Team 1 referenced training, they indicated making sure that everyone involved in the process (continuing education, updates, revisions) all of that gets communicated and rolled out at the same time across the State.
    • The State will develop a realistic timeframe to phase in project implementation consistent with revised CMS and BQM guidelines, and to ensure all stakeholders can become successful;
    • One component is that providers are all over the place with person-centered planning - some are really progressive, some others need help along the way - the intent would be to give them time following the training to start practicing those before the ISCs start evaluating them on that. This will take some time to see some of this come to fruition, but it's a process.

    Comments, Question and Answer Period (Q & A)

    There were no questions or comments regarding Team 5's presentation.

  10. Work Team 6 - Business Process

    • Team is working as we speak, looking at the various recommendations that the Teams have come up with. Hope to be done early - mid December. May be asking for clarification from the Chairs of the other Teams.
    • Our job is to put a valid, reasonable cost on this whole system and DHS line-by-line/summary format in the hopes that they can say yes - or they can at least take those recommendations as most important and fund those sooner than later.
    • The Members of Team 6 who were present today were acknowledged.

    Mary Lou indicated that all of this, hopefully, will be posted on the web site within the next couple of days.

    Mary Lou led a group discussion on "Areas of Alignment"

    • Data-based computer program statewide.
    • Education and training outreach component.
    • Language used and user-friendly documents that everyone can understand.
    • Training - Not only type of training we're providing, one of the things that came through is that we want everyone to receive the same training. Training to be made available, and ongoing, on the DHS web site for all new staff.
    • Focus on person-centered.
    • Important that we have clarity with our language…what we say is what we mean.
    • We want consistency….consistent forms, services, message, and training through websites, brochures, and talking to people; how we do that, though, is the challenge.
    • Participation of families and process designed for families.

    Mary Lou led a group discussion on "Areas Where Gaps Exist"

    • Find a way to bring the providers of service in so that they really understand what ISC agencies are doing and why they're doing it.
    • Difference between ISC's role and BQM's role - there is some overlap there that doesn't need to be there.
    • Decision about eligibility before being placed on the PUNS list? Is this a potential gap? Believes it will take care of the gap…false sense of hope for a lot of families and the communication will be better with families for those annual updates, if they know that they're working toward services instead of just another letter stating that they're still waiting.
    • When determined eligible for DD services, is there some way to engage them in some minimal case management while they are on the PUNS list? This may be a gap.
    • Potential gap with young children being brought in on the PUNS list. - Celia, the original author of the PUNS list, plans to make recommendations about age and when someone should come on the waiting list and to define the parameters of the waiting list - maybe recommend to add an additional waiting list specific to children, versus everyone in the State waiting.
    • One of the things Team 5 worked on was that they divided the enrollment and services into 3 different phases: 1) Intake into the system; 2) Ongoing service coordination; and 3) Waiver services - 3 distinct phases that could be monitored in and of themselves.

General Comments and Concerns

  • A question was raised regarding federal funding for IT - Can PAS Agencies or providers access this funding? - No; however, it is something that Team 6 is aware of and is talking about.
  • There is a web site called www/, which is part of the federal government. Under the Affordable Care Act, all providers who receive Medicare/Medicaid funds are required to develop electronic health records. Four years ago, the decision was made to "carve out" long-term services from that requirement. The deadline came in January 2014, and have now moved on to what the federal government calls "long-term services and supports". They are now paying attention to how they are building the standards for electronic health records for long term services and supports. DD will not be carved out of that. The idea of a database is compelling and extremely necessary.

 Update from the Steering Committee on activities, team recommendations, and future action steps; Q&A

  • Greg acknowledged the Steering Committee members that were present today.
  • Greg reported that the Steering Committee members were actively involved in the Teams. They have received recommendations from 5 Teams and have asked them to make a presentation, which occurred on 8/27/14 for Teams 1, 2 and 4; and again on 10/22/14 for Teams 3 and 5. As a direct result of the presentations, the Steering Committee gained a better understanding of which recommendations could be accomplished over the short term without a great deal of resources. Teams 1, 2 and 4 recommendations were posted on the DHS website, and the Steering Committee has determined which recommendations should be assigned to internal DD staff to work on, and which ones would be returned to the work teams for additional work.
  • Team 3 and Team 5's recommendations have not been fully vetted through the Steering Committee, but they plan to do so shortly. These are not yet posted - the Committee has yet to determine which will be assigned to internal DD staff and which will be returned to Teams for additional work.
  • The Steering Committee is also looking at how we communicate policy and procedural changes - to ensure we have a good vetting process so that when major changes are announced, they are effectively communicated to all stakeholders.
  • DDD has made changes to the Informational Bulletin process. The document has been updated and timelines have been incorporated in that document.
  • The Committee is also looking at the organizational climate and the organizational culture to see that both are conducive to the recommendations coming out of this project. Looking at structures, systems, jobs, bureaus, and reporting lines. One meeting has already taken place to look at how to restructure in a way to strategically position the Division to support the recommendations coming out of the project. More information will be shared as we move forward.
  • In regards to the comment regarding the new Administration coming in, does that mean we stop everything with Life choices? No, it does not mean that. Greg explained that we recognize that those recommendations requiring fiscal support will need to be vetted through the new Administration. Those short-term recommendations that require no additional resources will continue moving forward. Our goal is to get some recommendations implemented and victories under our belt and then present them to the new administration in order to gain support to proceed with recommendations that are more long-term.
  • Greg recognized and thanked Mary Lou Bourne, for doing an extraordinary job of facilitating the meeting. He also recognized Sheila Romano and Sandy Ryan for standing behind this project and for the support of the DD Council. Additionally, he thanked everyone and their respective staffs for coming today.
  • Greg's final message was that we never forget the people we serve. That is what drives all of the discussions, planning, and movement toward the recommendations. On behalf of the Division, Greg thanked participants for not forgetting about the people we serve.

 Open Discussion/Added Agenda Items

Mary Spriggs shared a conversation that she had earlier in the day with Director Casey in which he stressed the commitment of the Division to this project and recognized all the work that had gone into the Life Choices Project. He noted that a solid foundation has been established for change and for the future.

Next Steps, Review of Action Plan Wrap up, and Adjourn Meeting

  • Next meeting date, time, and location have yet to be determined.
  • Meeting was adjourned at 2:58 p.m.

Summary submitted respectfully by,

Rose Ann Winkel

Gregory A. Fenton