Audience
Open to the general public.
Time
10:00 am to 1:00 pm
Location
Double Tree Hotel
5000 West 127th Street
Alsip, Illinois
Agenda
- Call to Order
- Introduction of Council Member
- Approval of October 2015 Draft Meeting Report
- State Boards & Commissions Ethics Requirement for Councils regarding Non-Illinois.gov Email Addresses
- Bureau Update
- APR/SSIP Update
- Updates to CFC Procedure Manual &EI Service Descriptions, Billing Codes & Rates
- Provider Handbook
- Ongoing Updates
- Service Delivery Approaches (SDA) Workgroup
- Cornerstone Updates
- Parent Reimbursement Recommendation
- Website Postings
- 240 Hour Provider Training Requirement Discussion
- IMPACT Update
- Council Appointments
- Adjournment
Meeting Report
Present
J. Diane Adams-Alsberry, CALM, Inc.
Karen Berman, Ounce of Prevention Fund
Bob Cammarata, ICG Health Care Services
Yvonne Clearwater, IL Dept. of Insurance
Brenda DeVito, CFC 6 Program Manager
Ann Freiburg, Part C Coordinator, DHS, Bureau of Early Intervention
Vicki Hodges, ISBE, McKinney-Vento
Kelley Washington, IL Early Learning Council
Beatrice Nichols, IICEI Chairperson & Head Start
Kathy Schrock, Easter Seals DuPage & Fox Valley
Therese Wehman, Elmhurst College
Amy Zimmerman, Health & Disabilities Advocates
Absent
Gerri Clark, Division of Specialized Care for Children
Margaret Harkness, IL Council on Developmental Disabilities
Roselyn Harris, DHS, Bureau of Child Care & Development
Ginger Mullin, IL Dept. of Public Health
Deanna Pratscher, parent, Thornton
Pam Reising-Rechner, IL State Board of Education
Sylvia Riperton-Lewis, IL Dept. of Healthcare & Family Services
Kathy Ward, DHS, Division of Developmental Disabilities
Angel Williams, IL Dept. of Child and Family Services
Constance Williams, Ph.D., DHS, Division of Mental Health
Call to Order
The Illinois Interagency Council on Early Intervention (IICEI) convened at 10:10am.
Introduction of Council Members
Bea Nichols asked Council Members to introduce themselves.
Approval of October 1, 2015 Draft Meeting Report
Kathy made a motion to approve the meeting report; Brenda seconded. Motion was approved.
New Ethics Requirement
Ann received an email from DHS about a movement related to boards and commissions for securely sharing information. Need to either communicate through Illinois.gov email system or use SharePoint where information can be shared and accessed. Ann has asked if it is still permissible to use regular email to alert Council members to the presence of information in the Illinois.gov or Sharepoint systems so members would know to log in. DHS said that it would be permissible, but also asked that this kind of communication be limited. Ann asked if Council members had a preference for how this is handled. Kathy said that the easiest path should be explored/utilized. Her preference would be email so that it isn't a two-step process. Ann will share information with Council members about how to obtain an Illinois.gov email address. State agency personnel may not need an Illinois.gov email address as other state agency emails are secure already. Kelly asked about how people would gain access to Sharepoint. Would it be any easier to set up accounts this way? Ann has had mixed experience with Sharepoint, but she can explore this if it is everyone's preference. Therese reiterated the importance of receiving a notice through private email if things were sent to the Illinois.gov email address. The members seem to prefer the email mechanism. Ann will discover the instructions on obtaining and using an Illinois.gov e-mail account and share with members
Bureau Update
Ann has submitted requests for open positions to be filled. She has not yet received any updates on progress. She is hoping that the Data Manager position will be filled soon. Kathy Schrock asked about the state budget. She has been hearing rumors that the budget may not be settled until November. Ann has been able to pay our various entities through the court decree related to Medicaid. The only payments that she cannot currently make are family fee reimbursements. Although this is not a large number of families, Ann recognizes the importance of getting this money back to the families who are waiting for it. Amy clarified that family fees really don't relate to the standing court decree, but there could be a precedent from other programs. Ann will try to check with other programs to see if this exists. Brenda asked how many open positions are within the Bureau. Ann said that the Chief, Data Manager, and Public Service Administrator positions are currently all open.
Annual Performance Report (APR)/State Systemic Improvement Plan (SSIP) Update
Claudia Fabian reported that the APR is due February 1st. They are in the midst of their work on it and will be sharing the document with Council members soon. Working towards consistency across all data. She shared some of the preliminary results for some of the indicators. Compliance indicators results are: 1-97.92%, 7-99.9%, 8A-92.54%, 8B- 100%, and 8C is still being addressed. Results indicators 2-88.13%, 3&4 still being addressed, 5-1.54%, 6-4.5%. We have an opportunity to request an extension if necessary. Karen asked about the metric for Indicator 1 related to timely services. Ann shared that Illinois defines timely as within 30 days of IFSP development, but delays for family reasons are not reported to OSEP. Amy asked if all of a child's services need to be delivered to be in compliance. Ann believes that the child must receive all the services on their IFSP in the manner recommended to be in compliance, but she will verify that OSEP focuses on the intensity/frequency and not just the service. Karen asked for a clarification about the natural environments calculation. Ann verified that nothing has changed with our calculations. Karen thought that there was a letter stating that if a justification existed for services outside the natural environment that it wouldn't be considered as out of compliance. Ann is not familiar with that language. Amy and Karen will share that information with Ann. Amy asked about what we need to report when we don't meet targets. Ann shared that we have the ability to produce a narrative that includes possible improvement strategies for addressing shortfalls. This part has not been prepared yet so they do not have anything to share with Council members right now. Ann reiterated that they will be sharing the product with Council members as soon as it is prepared. Kathy asked if there were any particular areas where the Bureau would like feedback. Ann said that overall, as well as specific feedback, are both welcome. Bea asked about continuing difficulties with the system required for submission. Claudia said that the difficulties have been reduced, but that the pre-population of existing data was delayed. Ann shared that states were allowed to provide feedback after last year's submission. Some, but not all, of this feedback has been incorporated.
SSIP is now in Phase 2. Product is due April 1st. We have expanded the group working on the SSIP to include additional system stakeholders, including 7 parents. Theory of action has been driving additional plan development. Focus is on infrastructure development to support the implementation of evidence-based practices. Three primary areas were identified for improvement- messaging, training/technical assistance, and policy/procedures. Working to improve the SiMR in our three pilot areas- Williamson County, Aurora, and Greater East St. Louis. National TA provider met with us last week to consider the evaluation component of our plan. She also suggested narrowing our focus to make it more reasonable. We now have two focus areas: child outcomes measurement and family engagement. We are working on evaluation questions, performance indicators, and options for measurement. Will be continuing our work on the second area tomorrow. Council members will receive a copy of the draft to review prior to submission. Ann expressed her appreciation for all the time spent and feedback provided by the workgroup. Claudia reminded everyone that we have the opportunity to start small and refine the plan as needed. Amy asked what Indicator 11 is and if it is the same for all states. Ann clarified that states had an opportunity to choose from the three child outcomes, but that Indicator 11 is our State Systemic Improvement Plan. Amy asked how messaging, training, and policy relate to improving child outcomes. Ann reminded Council members that the data analysis in Phase 1 helped us identify areas needing improvement. The three areas grew from these. The full plan will identify how the three areas can support improved child performance. Bob applauded the Bureau's efforts to include families and Innovation Zones. He wanted to know what a leadership team at a CFC would look like. Claudia said that the team will likely vary across the selected CFCs but may include current CFC resources like the CFC Manager, SECs, Pediatric Consultants, etc. in addition to Training Program members and other EI Partners. Brenda expressed concern about adding additional responsibilities without new resources. Ann reiterated that OSEP's focus is on the leveraging of existing resources, helping people work more efficiently, and engaging community partners. Kathy asked if leadership teams are implementation or ongoing teams. Claudia clarified that the leadership teams will be ongoing and supportive of the implementation of the plan. Kathy is unclear how community partners will be engaged for EI system improvement efforts. Claudia says that individual partners may or may not be involved with a given CFC, but that many of these partners are engaged already through the Innovation Zones' efforts. Bob shared the structural changes that he has witnessed in the Innovation Zones that have improved communication between the various systems/partners involved. Karen asked about how Council members and other stakeholders can get more information about these plans to ensure alignment between this plan and other state systems work. She would like to see people who serve in multiple capacities sharing across the systems so that everyone can benefit from what we are learning. Brenda described the importance of measuring child outcomes appropriately and the application of some of our processes to other systems. Amy asked about the possibility of checking on parental stress at system entry, during the process, and at transition.
Updates to CFC Procedure Manual & EI Service Descriptions, Billing Codes & Rates- Provider Handbook
Procedure Manual was updated and released on November 1st. Webinars for CFCs occurred prior to implementation. CFCs were very engaged in the revision process. Provider Handbook is also being updated. Workgroup has many providers on it. Eventually the handbook will be reviewed on a yearly basis. Amy asked if the SDA Workgroup's recommendations are being considered as this is revised. Therese asked that the Council receive this draft for review prior to release. Karen asked if the timeline for this revision would allow Council members to provide meaningful feedback to the Bureau. Claudia said that the goal for implementation of the Handbook would be no later than the new fiscal year. Family Guide also being reviewed and updated. Being reviewed by family focus groups. Amy asked to see a draft before it is released. Claudia can send to Council members after receiving the family feedback.
Ongoing Updates
Service Delivery Approaches (SDA) Workgroup Recommendations
Ann has been reviewing the recommendations frequently. Within the 18 recommendations, Ann was able to identify a number of items that were feasible, easily accomplished, and aligned nicely with SSIP efforts. The recommendation about families getting good and consistent information is doable. The caseload and data system recommendations may need to be addressed at a later time. There are discussions even at higher levels about the importance of systems that improve data collection and utilization. This will just not be a quick change. Karen shared that the new data system may be an item that other systems have a vested interest in and that this might be a way to access funding for the data system.
- Recommendation 3 will be addressed through SSIP.
- Recommendation 4 will require more discussion/planning given the changes in developmental screening being conducted outside early intervention. Several Council members talked about things, such as children with medical diagnoses, prior screenings, funding, cost-savings, and SC responsibilities that would need to be considered as part of this discussion.
- Recommendation 5 requires further discussion.
- Recommendation 6 is being addressed partially through new policy/procedures, the report format, and targeted SSIP activities.
- Recommendation 7 is partially being addressed through SSIP activities.
- Recommendation 8 highlights enhanced role of Monitoring. There are changes being implemented within the Monitoring Program both in regard to process and tools as well as SSIP activities that may help us get closer to achieving this.
- Recommendation 9 would require more discussion and effort for Bureau to implement.
- Recommendation 10 requires changes to RFPs. Ann believes that the performance contracting needs to be reviewed and could benefit from a focus on desired behaviors as well as compliance. Team recommendations would require additional stakeholder input for Bureau's consideration. Recommendation about team communication has some easily implementable aspects and is partially addressed through some SSIP activities, but needs more discussion and planning. IFSP recommendation is being addressed.
- Recommendation 14 is being partially addressed through revisions to CFC procedure manual and provider handbook.
- Recommendation 15 is being addressed through SSIP activities.
- Recommendation 16 needs some revisiting and she plans to work with CFC managers on this. Some efforts have been undertaken, but it doesn't seem that they moved us far enough along. Multiple people acknowledged that this needs to be a comprehensive approach with multiple partners in regard to both recruitment as well as retention.
Some of these recommendations have only been addressed at a high level at this time. Transition recommendations are supported by policy and procedure revisions in the new Procedure Manual. Many efforts have been undertaken in this regard, but there is still room for growth. In regard to the proposed timeline, Ann would prefer to take a different approach. She would propose that the Bureau take on those recommendations that can be easily implemented and work on others as workloads, legislative changes, and budget issues allow.
Cornerstone
Bureau has submitted request for putting child outcomes edits and service delay tracking into Cornerstone. Administration of Cornerstone has been moved into CMS. No longer have an outside contract for this. Ann does not know how promptly requests will be addressed given the staffing limitations. Karen wants verification that the submitted requests include tracking of children who are homeless and those who are involved with DCFS since there are federal reporting requirements related to this. Ann shared that this could be addressed through better utilization of current case closure codes, through submitted requests, and through additional cross-system work that is currently underway. Karen asked about referral tracking and results of evaluations. She described the power of this data and how it could potentially inform systems work. Amy asked if the Council could review what information has been requested for addition so that they could see what may still be necessary but missing. Ann stressed that we are awaiting feedback from Cornerstone about options for incorporating the requested changes. Amy shared some other ideas for how referral information could be collected to make it more useful.
Parent Reimbursements
Ann has not had an opportunity to look at these recommendations yet.
Website Postings
Ann wanted to address questions about what has been posted on EI websites. Bureau has not typically posted work products from workgroups, so she would like Council members' feedback on their ideas and concerns. Karen feels that once products are approved that there should be a way to share the information. She understands concerns related to people's expectations, so there may need to be explanatory/ introductory paragraphs that are added to the documents. Other Council members agreed that it is important to share information that has been approved. Therese feels that the SDA workgroup's final report should be released only in its entirety but that it may also be important to link or denote when recommendations are actually implemented. Brenda expressed concern about how to note the recommendation status of the items as people may be cutting/pasting pieces of the report or taking items out of their context. Karen shared the process for other councils' recommendations being posted and the benefit of starting a practice of posting recommendations to get the field accustomed to that. Ann also noted that they are working to get the website for EI updated.
Discussion on 240-Hour Provider Training
Ann asked to be reminded about what needed discussing. Bob shared that this item is related to part-time providers' participation in the system. The 240 hours is prohibitive to providers who work in other systems. Bob feels that this needs to be examined given our continuing service delays. Rob shared that if providers are close when their 18 month period is up, it is more likely that they will be granted an extension. Extensions are less likely to be granted when the extended time period would still not necessarily allow them to meet the requirements. Brenda and Therese discussed the need to have our providers prepared and committed to working in the early intervention system whose requirements are quite different from other possible service settings. Ann felt that it could be helpful to make this requirement clearer on the front end as people enter the system.
IMPACT
DHS continues to engage in discussions with IMPACT to troubleshoot ongoing difficulties related to provider enrollment. Illinois needed to make a shift to bring the state into compliance with the Affordable Care Act. This change is not specific to early intervention, so we are trying to make the system work based on our provider and payee types. Issues continue to be identified and solutions are explored. There are discussions about how to shift back to our former processes in order to get new people into the system. The old process allowed us to see more about the providers' status. This shift to old processes would, however, limit temporarily our ability to claim Medicaid reimbursement for certain providers. Kathy asked if the Bureau could benefit from legislative support on this issue. Ann will check on the viability of this option for obtaining a solution. Enrollment processes have been extended per a posting on the IMPACT website. At this time, even if an agency is in and approved in the system, their individual providers cannot go in and associate themselves with their agency. Amy asked about the reduced Medicaid payments reported on the caseload summary report. Ann said that the amounts are down because of some changes at HFS in under processing of claims. Ann feels that the decrease is somewhat related to catching up on the part of HFS and our inability to make payments early in this fiscal year as we can only claim payments once we have actually made payments.
Council Appointments
The Bureau has submitted a list of people that they think will be ready for attendance at the April meeting. These additions bring us to nearly a full Council. We still need one more parent representative. Send interested parents to Claudia. Karen asked if this includes representatives that have been suggested for addition to the Council. There may still be room to add people, but the Council is capped at 30 members. Bea Nichols is stepping away from her Council responsibilities. Kathy Schrock will be assuming the role of Chairperson. Kathy expressed her excitement to be stepping into this role.
Adjournment
The meeting adjourned at 1:15pm. Therese made a motion to adjourn, Bob seconded.
Contact Information
Jenni Grissom
IDHS - Bureau of Early Intervention
823 East Monroe
Springfield, IL 62701
Ph: 217/524-1596
email: jennifer.grissom@illinois.gov
