October 6, 2016 - Illinois Interagency Council on Early Intervention

Audience

Open to the general public.

Time

10:00 am to 1:00 pm

Location

Illinois Primary Healthcare Association
500 South Ninth Street - 2nd Floor
Springfield, Illinois

Agenda

  • Call to Order
  • Introduction of Council Members
  • Approval of July 14, 2016 Draft Meeting Report
  • Lead Poisoning Eligibility
  • Ongoing Updates
  •  IMPACT
    •  Service Delivery Approaches (SDA) Workgroup Recommendations
    •  Cornerstone 
    •  Parent Reimbursements
    •  Budget Update
    •  Bureau Update
    •  Electronic/Digital Signatures
  • Service Delays Data
  • 2017 Council Dates
  • Adjournment of Meeting

Meeting Report

Present

Karen Berman, Ounce of Prevention Fund

Teresa Bertolozzi, Parent

Bob Cammarata, ICG Health Care Services

Benny Delgado, Leaps and Bounds Family Services, Inc.

Brenda DeVito, CFC 6 Program Manager

Ann Freiburg, Part C Coordinator, DHS, Bureau of Early Intervention

Paulette Dove, IL Department of Insurance

Margaret Harkness, IL Council on Developmental Disabilities

Vicki Hodges, ISBE, McKinney-Vento

Ginger Mullin, IL Dept. of Public Health

Kristin Doan, IL State Board of Education

Kathy Schrock, Easter Seals DuPage & Fox Valley

Ralph Schubert, Division of Specialized Care for Children

Lynette Strode, Illinois Assistive Technology Program

Rita Wahl, CFC 20 Program Manager

Kathy Ward, DHS, Division of Developmental Disabilities

Therese Wehman, Elmhurst College

Amy Zimmerman, Legal Council for Health Justice

Absent

J. Diane Adams-Alsberry, CALM, Inc.

Roselyn Harris, DHS, Bureau of Child Care & Development

Patricia Hooper, Parent

Brandy O'Connor, Parent

Rosalina Perez, Parent

Deanna Pratscher, Parent

Sylvia Riperton-Lewis, IL Dept. of Healthcare & Family Services

Angel Williams, IL Dept. of Child and Family Services

Constance Williams, Ph.D., DHS, Division of Mental Health

Council Packet

  • Agenda
  • Draft Council Meeting Report - July 14, 2016 Meeting
  • Fact Sheet on Child Lead Poisoning
  • Analysis of Service Delay
  • Early Intervention Program Caseload Summary Report
  • Draft 2017 Council Meeting Dates

Call to Order

 The Illinois Interagency Council on Early Intervention (IICEI) convened at 10:07 am.

Council Member Introductions

Kathy asked all members to introduce themselves.

 New Council Member Appointment

Ralph Schubert representing the Division of Specialized Care for Children introduced himself during the regular introductions as replacement of Gerri Clark, who retired earlier in the year. 

 Approval of July 2016 Draft Meeting Report

Lynette made a motion to approve the meeting report; Bob seconded. Motion was approved.

 Interagency Coordinating Council (ICC)

Brenda shared information about a webinar she attended for ICC members. Four states (Utah, Colorado, Nebraska, and Massachusetts) shared how they orient new members (2 from Part C; 2 from Part B). They do a meeting to get new members acquainted with Council. Provide handbooks, describe charge, and discuss how meetings are run. Part B did summer meeting and Part C did their meeting in the fall. Also, had a discussion about mission and principles, schedules, and how to do voting. Most are just starting mentorship opportunities for their new members. Most Council positions have 3-year terms. Some had standing committees to address ongoing issues, like membership, fiscal issues, program planning, personnel preparation, and specialty services (low incidence/service gaps). Information was not provided about pros and cons of standing committees versus ad hoc workgroups. All stressed reminding participants of the advisory nature of the work.

Kathy opened a conversation about the potential of having some standing committees that meet on a quarterly basis. This might have advantages for personnel who work on system issues as they would have a group that they could go to for input. Kathy reminded people that there used to be a standing financial committee that produced some useful recommendations. Bob feels that issue-oriented workgroups have been productive; one exception might be an executive group to guide Council's work. Therese feels that purposeful, time-limited groups tend to be more productive. It can be harder to generate enthusiasm for longstanding groups. Brenda said that with a larger Council, like what we have now, it could be more productive to have smaller groups for discussion/work that they bring back to the larger membership. Ginger asked what guidance our by-laws/rules provides about standing committees versus workgroups as maybe this should guide the decision. Benny asked if there are any current issues requiring a smaller group's attention at this time, but none were identified. Answering questions about annual goals for the larger Council might drive decision making about committees. Kathy suggested sending out some prompts for members to respond to for annual goal-setting. Margaret reminded everyone that state agency representatives are bound by open meeting act requirements. Until a decision is made, Kathy shared that Council members are available to assist with issues/input as needed.

Lead Poisoning Eligibility

Anita Weinberg from Loyola has been working on lead poisoning prevention in Chicago and across Illinois. Primary focus has always been on prevention since consequences cannot be reversed. Amy referred people to the information in their Council packet. Strong evidence base exists between lead poisoning and behavior/school performance. Amy feels that it is the perfect time for EI to think about how we support children who have been lead poisoned given the recent media attention from Flint, MI. Amy and Anita have researched how other states are handling EI eligibility for children who have been lead poisoned. A total of 21 states provide automatic eligibility for lead poisoning; 15 more have eligibility related to "toxic substances". The Governor's children's cabinet is making lead poisoning prevention a priority; and it is a priority in the city of Chicago for next five years as well. Conditions on our EI eligibility list are set by Illinois.

Amy is asking for two workgroups to address the issue as different cutoffs have different consequences in terms of numbers of children needing to be served (first group to think about defining eligibility as related to lead level). Have begun reaching out to potential workgroup members for this group and their work would be time-limited and based on their knowledge and surveys of other states. Second group would be thinking about what plans for these children might look like. Amy made a motion for the Council to be involved in two workgroups regarding lead poisoning- one to define eligibility and another to consider service needs. Discussion began by Bob talking about his work in Cicero in regard to lead poisoning. Kathy asked about other states' eligibility and its relation to service decisions. Ann talked about its similarity to other automatic eligibility conditions in that the service plan would be based on the individual child's needs. Anita shared that providing services/supports before exhibiting delays is critical to the children's future success. Ginger asked about timeframes for when delays are likely to occur relative to exposure. Many children get tested for lead around one year of age and often "symptoms" do not show up until the behavioral and academic challenges become greater. Brenda asked about our field's preparation for supporting young children exposed to lead that do not demonstrate delays. Benny suggested that the second workgroup work on guidance for those who would be working with these children. Teresa added if this guidance could include what areas need to be targeted/monitored for children who are not yet demonstrating delays. Ginger feels that the hearing loss approach can be useful to this work. Teresa asked about continuity of this approach as children transition out of EI as not supporting them beyond EI age could still have serious consequences on their later experiences. Karen talked about other discussions that are occurring that might assist with this continuity. Brenda asked about studies that show what happens if they get EI, but then have a gap in services, in terms of their ultimate outcomes. Amy feels that this is a current gap in the literature. A unified, longitudinal data system could help answer many of these questions. Ginger asked about the need for not only a developmental response but also a medical response. The medical response is primarily only necessary for children with higher lead levels. Public health is involved once a child is identified as lead poisoned to help eliminate sources from the environment. Motion was approved. Members were encouraged to contact Amy with their interest in working on this topic after the meeting.

 Ongoing Updates

  1. Illinois Medicaid Program Advanced Cloud Technology (IMPACT): IMPACT is the provider enrollment system at HFS developed to meet requirements of the Affordable Care Act (ACA). We needed Phase 1 providers enrolled by 9/30/16. Ann is still working to resolve issues to get everyone in and make sure that no one gets "kicked out". She does not yet have an answer about future reimbursements for providers who were not enrolled by 9/24/16. Currently working on CFC enrollment for targeted case management claims. About 900 providers are enrolled and correctly indicated as EI providers (3000 was the estimated number expected to enroll) so far. Bureau and Provider Connections working through providers who have enrolled but may not be properly affiliated with EI or their payees (this impacts about 300-400 people right now). Rob and Council members discussed some of the challenges encountered. Bureau continuing to work with IMPACT staff to resolve issues, but it is currently unclear how this will ultimately impact HFS reimbursement. Ann reminded everyone that only certain categories of providers needed to enroll in IMPACT during Phase 1. Modifications to enrollments can be made under certain set of parameters- some changes can be made by the individuals but others require IMPACT's assistance. A manual is being developed. Benny reiterated offer to help Provider Connections put together a video of how to enroll. Current information estimates that approximately 1700 of the phase 1 providers have not even entered the IMPACT system, so they are still trying to develop a plan for how to approach this pool of providers. Bob reminded everyone that providers often don't notify PC when they leave the system- this notification often does not occur until credential renewal, so our numbers and affiliations could have some inaccuracies.
  2. Service Delivery Approaches (SDA) Workgroup Recommendations: Ann provided Council members with a format for consideration for receiving updates on the recommendations and accompanying steps. For the copy that Council members received, the lightest gray indicates items that are being worked on; medium gray indicates items that have steps in place and may have been achieved; dark gray indicates items that need more consideration to begin work. Part of prioritizing activities is related to identifying and allocating resources. Amy asked if there were things that the Bureau needs assistance with to move forward. Ann said that there is a group that can help with most of these. Karen asked about 1D and 1F, items related to CFC funding of SCs. Document indicates that achieving this would require changes in CFC contracts, so is contract being amended? Ann explained that many of the things need piloting to work out procedures before contract can be changed. CFC #5 is piloting screening during intake to identify procedures and necessary supports. Bob requested ongoing updates on the screening work. Ann will add this to her ongoing updates. Ann asked for feedback on the format's utility after the group has had time to review. Therese asked that Council members receive the information at least a week in advance so that they have time to review.
  3. Cornerstone: Some updates have been made, for example, corrected tool list and child outcomes edits. Data has been received and submitted the data for the 618 reporting. Ann has started working on the data for the APR as we need a bigger template for the child outcomes data. Hoping to have APR information to share with the Council prior to the January 2017 meeting. WIC recently announced that they will no longer be using Cornerstone. The Department of Innovation and Technology (DoIT) is working with other programs that use Cornerstone to see what changes are necessary. Ann has begun discussion and is sharing the scope of our work needs. Council members offered their assistance with helping others understand the current challenges and needs. Karen asked about how they can support Bureau's efforts to get these changes made. Perhaps creating a master list with requested changes including why needed could be shared with Council members. This list could be used to prioritize the work and determine feasibility. Therese reminded everyone that there are really two issues with a data system, one related to bringing Cornerstone up to date and another related to identifying a system that would really address system needs. Developing the list could, however, support both discussions.
  4. Parent Reimbursements: Ann reported that after many discussions, this doesn't seem like a path that the Bureau will pursue. Her preference continues to be getting quality providers in the system. She has concerns with having multiple payment options and the potential challenges with enrollment now that we have IMPACT. Amy reminded everyone of the positives of the policy, for example, potential provider pipeline, vouchers for families and the potential of complaints when services are not available through EI. Ann is not certain the plan is really viable, especially in the areas where providers are so limited. If the providers exist, it seems that they would enroll in the system. Amy asked to have another conversation about it. Brenda reminded everyone of the current provisional process for bringing in providers. Karen reiterated her feelings that current efforts are not sufficient to address the shortages and her concerns that this issue differentially impacts families across the state and across income brackets. Ann agreed to have a call with Karen and Amy to explore the policy again. Brenda will send Ann the list of the workgroup participants. Paulette asked about how complaints are handled, so Ann provided an overview of the process. Paulette described how they use their complaint data to see if the process they use, despite noted differences, could be useful to the Bureau.
  5. Budget Update: Nick is still working on CFC contracts to bring them into alignment with GATA requirements. Amy clarified that EI has been added to the court order requiring Medicaid payments. Stop gap budget expires 12/31/16, so it is unclear what happens as of 1/1/17. No new information about meetings or progress on budget.
  6. Bureau Update: Tahney Fletcher left the Bureau for the Division of Developmental Disabilities; Tahney has requested to return to Early Intervention as of Monday. At least 3 vacancies exist. Ann has been able to upgrade the data manager position to reflect the Bureau's needs. She has also received permission to submit a request, but no word on posting. Ann also announced that she has accepted the Bureau Chief position.

 Service Delay Data

Ann reviewed the service delay information for Fiscal Year 2016 with Council members. Information is provided by percentages rather than actual number of children to protect confidentiality. Delays are grouped by region and represent the various reasons provided for the service delays. Bob asked for additional information about how the percentages were calculated. Amy expressed concern with the quality of the information provided to the Bureau. Brenda shared that while it is a tedious process to report the data, she feels that they have a sound process for tracking/reporting. Ann suggested resurrecting the I2S workgroup in the northern area. Council members described the importance of understanding unique needs of a given area. Ginger suggested conversations with an area that seems to be struggling based on the reporting. Dee Dee Lowery, Program Manager, CFC 1 shared information about the challenges in her area, what services children need and how she tracks reporting. It is rare that a child would be getting no service; they may just not be getting all of their services.

Council members felt that digging deeper into an area's issues could be really helpful and possibly assist with generating solutions. Kathy asked for ideas for next steps. Bob suggested drilling deeper in a single CFC to understand its unique issues. Therese said that solutions will likely need to be generated from those living in the area since they have a better sense of what has been tried and what might work. Amy asked if the length of the delay is captured in the reporting and Ann shared that it is. Ann will reach out to the Safety Workgroup CFC to see if minutes and survey results can be shared with Council members to better understand the challenges in the Chicagoland area.

 Approval of 2017 Council Dates

Proposed dates included in packet. Benny motioned to approve the dates; Bob seconded. Motion carried.

 Adjournment

The meeting adjourned at 1:23 pm. Bob made a motion to adjourn; Brenda 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