April 6, 2017 - 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
  • Council Members Introductions
  • Approval of January 12, 2017 Draft Meeting Report
  • Illinois Leadership Education in Neurodevelopmental & Related Disabilities Program (IL LEND)
  • Early Hearing Detection and Intervention (EDHI)/Joint Committee on Infant Hearing (JCHI) Workgroup
  • Part C Application
  • Update on Annual Performance Report (APR) & State Systemic Improvement Plan (SSIP)
  • Update on Lead Poisoning Eligibility Workgroup
  • Ongoing Updates
    • IMPACT
    • Service Delivery Approaches (SDA) Workgroup Recommendations
    • Cornerstone
    • Parent Reimbursements
    • Budget Update
    • Bureau Update
  • Tele-Practice
  • Adjournment

Meeting Report

Present

  • Bob Cammarata, ICG Health Care Services
  • Benny Delgado, Leaps and Bounds Family Services, Inc.
  • Brenda DeVito, CFC 6 Program Manager
  • Kristy Doan, IL State Board of Education
  • Ann Freiburg, Part C Coordinator, IDHS, Bureau of Early Intervention
  • Margaret Harkness, IL Council on Developmental Disabilities
  • Vicki Hodges, ISBE, McKinney-Vento
  • Ginger Mullin, IL Dept. of Public Health
  • Rosalina Perez, Parent
  • Kathy Schrock, Easter Seals DuPage & Fox Valley
  • Ralph Schubert, Division of Specialized Care for Children (DSCC)
  • Lynette Strode, IL Assistive Technology Program
  • Rita Wahl, CFC 20 Program Manager
  • Karen Woods, IL Department of Insurance

Absent

  • J. Diane Adams-Alsberry, CALM, Inc.
  • Karen Berman, Ounce of Prevention Fund
  • Teresa Bertolozzi, Parent
  • Roselyn Harris, DHS, Bureau of Child Care & Development
  • Patricia Hooper, Parent
  • Brandy O'Connor, Parent
  • Deanna Pratscher, Parent
  • Sylvia Riperton-Lewis, IL Dept. of Healthcare & Family Services
  • Kathy Ward, IDHS, Division of Developmental Disabilities
  • Therese Wehman, Elmhurst College Angel Williams, IL Dept. of Child and Family Services
  • Constance Williams, Ph.D., IDHS, Division of Mental Health
  • Amy Zimmerman, Legal Council for Health Justice

Council Packet

  • Agenda
  • Draft Council Meeting Report - January 12, 2017 Meeting
  • Early Hearing Detection and Intervention (EDHI)/Joint Committee on Infant Hearing (JCHI) Workgroup Chart
  • Early Intervention Program Caseload Summary Report

1) Call to Order

Kathy Schrock called the meeting to order at 10:02 am

2) Council Member Introductions

Kathy asked Council members to introduce themselves and share their affiliation. Kathy announced that Brenda has been promoted at Clearbrook and will be leaving the Council. This means that a new CFC representative for the Council needs to be identified.

3) Approval of January 12, 2017 Draft Meeting Report

Lynette motioned for approval; Bob seconded. Motion carried.

4) Illinois Leadership Education in Neurodevelopmental & Related Disabilities Program (IL LEND) 

Presentation cancelled due to representative's conflict with attending today.

5) Early Hearing Detection and Intervention (EDHI)/Joint Committee on Infant Hearing (JCHI) Workgroup

Advisory council for EDHI has been dissolved, however, she recently met in Pontiac with stakeholders to see how the goals discussed at the last meeting can still be advanced. At the meeting, steps, timelines, measurement, and responsible parties were identified related to these goals. Ginger also reported that they have submitted their funding application and they should find out about that by July 1st. The other part of their funding is uncertain at this time unless a reauthorization and appropriation occurs. Their program is not a funded mandate. It is purely grant lead.

6) Inclusion Summit

Margie handed out copies of the Inclusion Summit report to Council members. They had good cross-sector representation at the Summit, approximately 80 attendees. Results of the summit included a shared definition of inclusion, possible ways to address challenges around identified themes, and opportunities for collaboration. The report contains details about each of these. Possible immediate actions, e.g. sharing of research, developing cross-sector professional development, and identifying supports, are also identified within the report. She wants to share the report with the various groups that can support inclusive efforts and to begin identifying responsible parties. Kathy asked if assignments had already been given but Margie shared that this will be a next step. Kathy asked if Margie had an idea of what early intervention's role would be. Margie said that training is one likely component and that coordination and support are likely to be the other. Kristy shared that EI's adoption of the vision statement is also likely to be important. Benny noted that early intervention's collaboration with other programs/services that support our children is also important.

Margie noted that bringing people together allowed them to see opportunities for coordination and to identify areas where values/purposes overlap. Brenda shared that it is often confusing for families to identify the roles of the various individuals visiting their homes, e.g. home visitation and early intervention. Ginger shared that she has encountered this as well in her program. Families often don't realize the differences between the various programs and how their supports/services might be different. Ann added that this was an issue addressed through some of the RTT work.

7) Part C Application

Ann reported that she is getting ready to submit our application. Draft has been posted and no comments have been received. Since 2012 we have been requesting conditional approval, but the last point needing resolution is the data sharing agreement with ISBE. As soon as this is completed and signatures are obtained, we can seek full approval. Application is due April 20th. Having full approval can help us with the federal differentiated monitoring approach as conditional approval is viewed as a risk factor.

8) Update on Annual Performance Report (APR)

The APR was submitted timely in February 2017. Ann thanked everyone for their comments and collaboration to produce the report. She expects to get OSEP's feedback soon.

9) State Systemic Improvement Plan (SSIP)

Claudia reminded everyone that we have just completed year 1 of the Implementation Phase. We have started our work in 3 pilot areas addressing two coherent improvement strategies- one around child outcomes and one around family engagement. We have a large stakeholders group that has provided input and helped develop the plan. A subgroup of this larger group was created to oversee the evaluation components. This evaluation group has then divided into other groups (and invited other participants to join) to address the work- these groups are Performance Support, Professional Development/Technical Assistance, Leadership Teams, and Messaging. Highlights of our progress include the creation of leadership teams, capacity-building with leadership team members, development of a procedure for the child outcomes summary (COS) process, development of family materials about COS, creation of PD evaluation rubric, revision of the EI brochure, production of a messaging rubric for evaluating PA materials to ensure that they are consistent, formulation of a plan for data collection, development of communication plan, and refinement of the evaluation plan. Lessons learned include: we were too ambitious in regard to our timelines; time invested in Leadership Teams (LT) is critically important; there is great benefit in having locals drive system change; and teams are unique with differing skills and resources. She is confident that our plan is good and heading in the right direction.

Kathy feels that this plan is extraordinary. She can tell that passion and commitment are driving the process. At this point, the thought of scale up can be overwhelming so we need to focus on current work to keep it moving. Kathy affirmed that the focus on outcomes is very important and reflects the current way of the world. Bob asked if Council members can get electronic copies of the submitted plan. Claudia will make sure this happens. Bob also asked about existing training opportunities for the field related to child outcomes. Claudia and Chelsea highlighted the availability of the DaSy modules and ongoing child outcomes training through EITP. Bob will be encouraging providers he knows to update themselves on the materials now available. Brenda shared that there are some opportunities for variability/individualization within the proposed process. Benny shared that he thinks of this approach to completing child outcomes as a refinement of our processes rather than a change. Providers want to do the best job they can and this information will allow people to do that.

Benny asked about the providers selected for the leadership teams given the range of interest and engagement of providers in a given area. Leadership team members are largely those who Implementation Science would call the "early adopters"- the providers who have traditionally been interested and engaged in system issues. Nicole Hise shared her experiences with team members and providers in her area. Benny expressed the importance of reaching others through their experiences in the system. Terri Kampwerth also shared how they are bringing providers together soon to make sure that everyone has the same resources available for use. Sandi Hix described her experiences with the leadership team at CFC#4. Even those who have historically been supportive of EI principles and practices are continuing to learn as they complete training and refine the child outcomes process. They will soon be inviting their next group of providers to receive some of the same training they have received. Ginger shared how impressed she is with how the different groups are spreading the word to others.

10) Update on Lead Poisoning Eligibility Workgroup

First group has decided that the lead blood level for eligibility will be 5 µg/dL for Illinois. There have been a couple of calls for the second workgroup. This group's discussion has focused on what services would be provided for eligible children. IDTA hosted a Facebook Live event to share information and gather some feedback from providers. This group of children may look differently than many others we serve as their delays often become more pronounced as they get older. The group is also considering what we know about other diagnoses that exhibit similar challenges and from low incidence disability guidance that has been developed. Many times, there are other environmental risk factors influencing the child's development. Kathy says that we are still learning about what we should be considering for children if they are not currently exhibiting delays in development. Brenda shared that there is a lot of confusion about what intervention would be addressing. Benny shared that while this area is different, what we will probably be working to do is promoting consistent, responsive interactions with the child's caregivers. This is what we know lays a positive foundation for future learning. Kathy shared that the frequency of intervention may look different for this group of children and may look like periodic check-ups.

Bob says that one thing of critical importance is retaining the information about the child's lead exposure as this can help people better understand the child's development later. Discussions in the workgroup mirrored to some degree the supports available through the EDHI work in that they are preparing families for what they can expect in the child's future. Ginger shared that the diagnosis is important to document and share with those who may serve the child in the future. She shared that the landmark research about the importance of intervening in regard to hearing loss by six months occurred twenty years before there was guidance about recommended interventions. Ginger said that there are particular challenges to keeping children in the system when families cannot see the impact of the diagnosis. She also shared that when they began their longitudinal tracking related to hearing loss, they had university support to set up systems for data collection. This may be something that the workgroup should consider as they move forward. Kristy mentioned that the transition planning conference is probably going to be critically important in helping families and school staff prepare for these children's needs. Benny pointed out that helping families understand the potential future impact of the exposure is really important. Rosie talked about the importance of coordination with the healthcare community. An audience member shared that having a medical binder can be important for sharing information as children move through different systems. Ginger shared that notification of a positive result to the appropriate service system needs to be considered. Putting together some guidelines for intervention will also be important to ensure that quality/consistency is ensured. Ann reminded everyone that the Governor's Children's Cabinet is also addressing lead issues so we will be involved, on some level, as these initiatives move forward.

11) Ongoing Updates

  1. Illinois Medicaid Program Advanced Cloud Technology (IMPACT):
    Bureau received notice that effective 2/28/17 providers who were not revalidated were to be removed from the system. We have since learned that IMPACT is only removing them if they have not revalidated since the last HFS validation (which occurs on five year cycles). Bureau and Provider Connections are still working to get everyone moving on this process. We think that there are only a few hundred providers who have not recently validated or revalidated. Rob Derry explained the process for revalidating in the legacy system. Of those few hundred, many do not have any current authorizations. There are quite a few providers who, however, have information that does not match in EI and IMPACT. Those with mismatching information will hopefully be corrected during their credential renewal. Brenda reminded everyone of the importance of letting any of those with current authorizations know what may be coming and working with CFCs to do outreach to any of those being impacted. Ann acknowledged her request and shared that despite meeting monthly, they continue to learn new things about IMPACT.
  2. Service Delivery Approaches (SDA) Workgroup Recommendations:
    No new information to share right now.
  3. Cornerstone:
    Moving forward on child outcomes updates; will be proposing some changes based on IFSP workgroup recommendations.
  4. Parent Reimbursements:
    No new information to share right now.
  5. Budget Update:
    No information shared with Ann yet. Bob shared that the pattern of current payments to providers are right before the 90 day timeline would be reached and the interest penalty applied. Ann mentioned that the provider payment for 1/18/17, the January CFC payments, and the January administrative partners' payments have recently been made. Benny shared provider concerns about the lack of movement on the budget and asked if a letter for the Council would be forthcoming. Kathy shared that there was too much concern from the state agencies involved to move forward with a letter from the Council. Benny said that this is important to know so that others who are comfortable can take up the issue with their legislators.
  6. Bureau Update:
    We have a new person on staff in Ann's old position- Heather Hofferkamp. She came to us from HFS and foster care training. Nick Marsters has accepted the contracts/grants position that Tahney vacated. We now have a fiscal opening. The data manager position was posted. The administrative assistant 2 position is now vacant. The administrative assistant 1 position will also be vacated soon as Shante is moving to another office.

12) Old Business

Bob asked for an update on electronic signatures and DOIT. In regard to DOIT, Bureau has a person assigned to review our information but no new information has been received. Ann has reached out to DHS contact who says that DHS is not likely to accept electronic signatures but that digital signatures may be an option. Ann will follow up again.

Benny wanted to acknowledge the CFCs that supported the IDTA reflective practice groups. He gave a gift to Brenda and Ann will take Peter's gift to him.

13) Tele-Practice - Kathy Schrock

A vendor in St. Louis invited Ann to see how they were utilizing tele-practice. They are currently using this method of service provision for their parent engagement personnel. They utilize a secure site for this communication. They are willing to share what they have done and what they have learned with the Bureau. Kathy gave an update on some information she received from Colorado. They recently passed legislation to get insurance to approve all EI services for delivery through tele-health. They call them "live video visits" to help families better understand what happens. Their experiences have helped to dispel some of the myths about tele-health. It is clear how this approach emphasizes the coaching aspect of intervention. They are also finding greater parent engagement and reduced travel costs. Challenges that remain are provider buy in and technology connectivity issues. Utah State offers a provider training for tele-therapy online.

Kathy asked if a group should be formed again to examine this issue as a potential strategy for addressing unmet service needs. Bob thinks we should to stay current and to help us address service delays. Benny feels that there is value in exploring options and setting expectations. Brenda also thinks it's worth learning more about how and why it works. Rosie supported this exploration as a family member as well. Margie asked what it would take to make it happen, but Ann isn't sure. Kathy is asking for the creation of a workgroup to begin exploring. Bob and Benny volunteered to participate; Dee Dee is willing to participate and other CFCs' participation will be solicited. There are also EI providers who are already doing it that may be willing to participate. Ginger can share some information she has with Ann. Kristy mentioned that she also has a recorded version of recent webinar for 619 coordinators about tele-therapy. Kathy asked Bob to lead the workgroup and he agreed.

14) Adjournment

Next meeting is July 13, 2017 at Moraine Valley Community College in Palos Hills, Illinois. Karen motioned for adjournment and Bob seconded. The meeting adjourned at 12:33 pm.

Contact Information

Jenni Grissom
IDHS - Bureau of Early Intervention
823 East Monroe
Springfield, IL 62701
Ph: 217/524-1596

email: jennifer.grissom@illinois.gov