Frequently Asked Questions (FAQs)-Life Choices System Transformation
Note: The questions below do not reflect all questions that have been submitted thus far. As more decisions
are made, the Division will update the list below. Always check the date below to ensure that you are reviewing
the most recent FAQs. The most frequent updates will be toward the end of the document.
Last updated January 2018
Frequently Asked Questions, March 2017
1. When will the Person-Centered Planning process training be made available?
Pilot training began for ISC agencies in January 2017. Watch the Scoop for training announcements this spring for additional ISCs, provider agencies and person's served/family members.
2. Will CEU's be offered for the Person Centered Training?
Continuing Education (CE) credits will be offered instead of Continuing Education Units (CEUs). CEUs are usually given through the Illinois State board of Education and other professional regulation organizations for their specific personnel. If DHS approves a training for specific group of individuals, the governing body for those individuals usually allows the CE credits to count toward CEUs. The CEs for the Person Centered Training will be offered for Qualified Intellectual Disability Personnel only.
Delineation of Duties
3. Are the ISC agency's responsible for writing the Individual Service Plan (ISP)?
- Currently, the providers are responsible for developing the ISP. Effective 7/1/17, the ISC is responsible for developing the Discovery Tool and the Personal Plan as the person's annual ISP is due. Each provider will be responsible for developing the Implementation Strategy.
4. Who will be responsible for assisting the clients and families with benefits such as; Medicaid, DHS funding etc.?
- The ISC will continue to be responsible for assisting and directing families with Medicaid and other benefits.
5. Will the ISC QIDP also be completing the behavior programming for the individual and incorporating it within the Personal Plan?
- The ISC will identify the broader behavioral supports the person needs but it will be up to the provider agency to identify and implement the behavioral strategies
6. Who is responsible for monitoring the Plan?
- The Personal Plan will be monitored by the ISCs. The Division's Bureau of Quality Management, through their sampling review process, will also have some monitoring responsibility.
7. Who will train the DSPs on the new ISPs?
- The training will be conducted by provider agencies. Each Provider will be responsible for its part of the implementation of the Personal Plan. The Division of Developmental Disabilities will also offer general/overall training on the Person Centered Planning process and make these available to all.
8. Who would write the Personal Plan and monitor the progress for a person who does not go to DT but uses their funding only for personal support?
- The Personal Plan will be written and monitored by the ISCs. The Division's Bureau of Quality Management, through their sampling review process, will also have some monitoring responsibility. The expectation is that writing and monitoring the plan will no longer be part of Service Facilitation but rather part of the ISCs' responsibilities.
Independent Service Coordination (ISC) Agencies
9. Given the extra responsibilities of the ISC agencies will hours increase to over 25 hours each year per person?
- At this time, there is no plan to increase hours. Discussions between the Division and ISCs will continue on which tasks may no longer be needed, freeing up time to perform the newly required duties.
10. Will the DHS Individual Service Plan (ISP) Checklist still be needed?
- The Approval Checklist was initiated to provide some standardization across the state. With the move to the Personal Plan format as of July 1, 2017, a standard format is being adopted. The checklist will no longer be needed.
11. Will the ISC still be completing ISSA notes, or will ISC's just be monitoring and noting on the ISP?
- The ISCs will still be expected to complete ISSA notes on their visits. After July 1, 2017 there will be a new form. The purpose of the visit will be to monitor the progress toward the desired outcomes identified in the Personal Plan. The ISC is also expected to monitor the health, welfare and safety of persons served.
12. Will there be a statewide ISP/Risk Assessment form provided to the ISCs or are ISCs responsible for their own ISP/Risk Assessment?
- There will no longer be a separate risk assessment tool. The new process includes methods of identifying, documenting, and addressing risks as part of the Discovery Tool and the Personal Plan development by the ISC. Provider agencies will then use that information to identify specific strategies that will be used within the agency to address those risks.
13. How many people do we anticipate an ISC QIDP will have on their caseload?
- The Division is not going to prescribe a minimum or maximum number for a caseload. This decision is made by each ISC agency.
14. What if there is a disagreement between the Provider and the ISC regarding what can be done by the provider or what is in the best interest of the client and put into the ISP?
- The Personal Planning process will focus on outcomes that are identified by the person receiving services in collaboration with their guardian and family. The ISC will document those desired outcomes, assist in identifying the barriers that currently prevent the outcomes, and assist the individual/family to locate and select agencies that are willing and qualified to provide the needed supports. Before agreeing to provide services for a specific individual, the Provider will know the desired outcome of the waiver participant. The Provider can determine whether or not they are willing and able to provide the requested services. In the case that the Provider is not willing and able to provide services, the ISC will assist the waiver participant and his/her family to locate other qualified and willing Providers.
Provider Agencies & Implementation Strategy
15. Will all Plans and strategies be required to meet new regulation on July 1?
- No, as current annual ISPs are due for update after July 1, 2017, the new process would be implemented at that time. It will take one full year for all persons receiving waiver services to have their Person Centered Planning process in place.
16. Will the state continue to fund QIDP services to providers when the ISC is writing the program plan?
- We do not anticipate changing current rates based on the shift of case management from the provider to the ISC agencies.
17. Will there be a need for monthly QIDP progress notes, or will the ISC complete those?
- The Provider will need to document the progress of the outcomes identified in the Personal Plan but the specific method or frequency of that document has not been finalized. ISCs will document progress of the Personal Plan.
18. If the agency's DSPs/PSWs are responsible for collecting data and running the goals, how will they be held responsible for giving that information to the ISC agencies so that the ISCs can make modifications to the goals when needed?
- Provider agency staff should document progress towards outcomes on a monthly basis (minimum) and make documentation available to ISC staff during the ISC visits.
19. What will the expectation be when a small rural provider cannot implement the outcome identified in the Personal Plan due to a lack of community resources?
- The individual and family can decide if the service needs and desired outcomes are greater than their geographic desires. The Division recognizes that there are service gaps in some areas and has dedicated staff to implement capacity building.
20. When can CILA providers expect to see revisions of Rules 115, 116, and 119 to come into compliance with Federal guidelines?
- The Division is working to complete the changes to Rules 115 and 119. Rule 116 is in the final review stages. In addition, training has started for Rule 116.
21. Regarding Service Facilitation, if the Service Facilitator is not doing home visits, how often will ISCs be in the home?
- The Service Facilitator will no longer be required to conduct home visits after a Personal Plan is developed. There continues to be discussion regarding the minimum number of visits that will be required by the ISC agency. The ISC's emphasis will be to assess the implementation of the Personal Plan and will take action as necessary on an individual basis. Home visits can be a part of the assessment process.
Frequently Asked questions, August 2017
Delineation of Duties
1. Is the ISC agency responsible for writing the behavior plan?
- No. The ISC agency is not responsible for developing behavior strategies. The ISC is responsible for identifying the behaviors that need to be addressed through the Discovery and Personal Plan process.
2. Who will be responsible for completing the following assessments?
- Self-Administration of Medication Assessment and the Physical Status Review/Health Risk Screening Tool: This continues to be required by Rule 116. It has been and will remain the responsibility of the RN-Trainer at the provider agency.
- A Psycho-social Assessment: Not needed or required for persons receiving DD funding. Basic background information will be gathered by the ISC as part of the discovery process.
- Specific Level of Functioning Assessment and Physical Health Inventory for individuals with a mental illness: The provider agency should continue to complete the SLOF annually for people with a mental illness as stated in Rule 115.
- Inventory for Client and Agency Planning (ICAP): This is the responsibility of the ISC but may be delegated to provider agencies.
- A vocational assessment: The ISC will identify an appropriate assessor when it is determined that a vocational assessment is needed to identify services and supports related to work goals.
3. Who will be responsible for obtaining the following assessments/screenings?
- A psychological and/or a psychiatric assessment: both must be conducted for individuals with both a mental illness and a developmental disability: the Residential provider, if applicable will responsible for these for individuals who are currently in a DD Waiver. If no residential provider, ISC will ensure need is documented within the Personal Plan and responsible party will be identified.
- Physical Examination: The residential provider, if applicable will be responsible. If no residential provider, ISC will ensure need is documented within the personal plan and responsible party will be identified.
- Dental Examination: The residential provider, if applicable will be responsible. If no residential provider, ISC will ensure need is documented within the Personal Plan and responsible party will be identified.
- A Communication screening in vision, hearing, speech, language and sign language: This screening should occur by a physician as part of physical examination. If ISC, physician, and or team identify the need for a more in depth assessment, appropriate referrals will be initiated and documented within the Personal Plan as a needed support.
- Physical therapy and Occupational Therapy Screening: These screenings should occur by a physician as part of physical examination. If ISC, physician and team identify need for more in depth assessment, appropriate referrals will be initiated and documented within the Personal Plan as needed supports.
4. As we transition to the Person Centered Planning process, if the team agrees to develop an addendum to the current ISP, will the individual/guardian and ISC approval process still apply?
- If the team is developing an addendum to the current ISP, the individual/guardian and ISC must review and sign the Plan.
5. Does the provider agency sign the Personal Plan?
- Provider agencies that have agreed to develop Implementation Strategies and provide support to the person are only required to sign the Provider Signature Page of the Plan.
6. Do Plans still need to be within 365 days?
- Yes. The Personal Plan (developed by the ISC) must be completed no more than 365 days from the last Plan.
7. What should a provider agency do when the individual says they do not want to pursue the outcomes listed in their Personal Plan?
- It is crucial for all stakeholders to understand that the outcomes listed in the personal plan are those expressed by the individual through the discovery process. Service providers who are aware of the need to change the Plan should notify the ISC of the person's need or desire to change their plan.
8. Do outcomes and/or goals have to be written for the active treatment areas: independence in daily living, economic self-sufficiency and community integration?
- No. As the system transitions to Person Centered Planning, DDD Waiver services will no longer include mandated goals in independence in daily living, economic self-sufficiency and community integration. The outcomes identified in the Personal Plan should reflect what is important to and for a person. Supports and services, outlined in the provider's Implementation Strategy, must be based on the person's preferences, desires, and needs.
9. Will providers conduct a 30 day staffing and develop the ISP after someone has entered services?
- No. After the Personal Plan has been developed, provider agencies are no longer required to develop ISPs or to conduct a 30 day staffing.
10. Will the ISC conduct the Discovery process and develop a Personal Plan for people who are funded 100% by the State or for individuals receiving ICF/DD services?
- No. The Discovery and Personal Plan processes are for people who will be or who are enrolled in a DD Waiver.
11. What should the ISC do if the individual and their guardian do not agree on outcomes in the Personal Plan?
- Legally, the decision making authority rests with the guardian. Expectations for guardians include advocating for the wishes of the individual, even when those wishes are different from the guardian's, except in cases where the individual may be harmed. The Division would expect ISCs and providers to work with the guardian and to advocate for the individual. Often, that may include helping the guardian and individual to reach a compromise. If there is ongoing evidence that the guardian is not acting in the best interest of the individual, there are channels to refer issues back to the probate court and solicit a new guardian, when needed.
12. Where do you note on the plan if a provider is unable or unwilling to provide supports to assist a person to achieve a specific desired outcome? Should this be noted on the Plan anywhere?
- In cases where a current provider is unable or unwilling to assist the person to work towards a desired outcome, the ISC should assist the individual to locate other qualified and willing providers. Until appropriate qualified and willing providers are located, the ISC should document the outcome(s) that are currently on hold. It should be recognized that some individuals will have multiple desired outcomes, all of which may not be met by providers in a specific area. In such cases, the ISC should assist the person to prioritize outcomes and select providers that meet the "top" priorities, documenting the future desired outcomes for a time when qualified and willing providers become available.
13. We now know that the Personal Plan has to be completed within 1 year of the past years implementation date. Is this date the PCP meeting date w/individual's and guardian or does the provider have to be involved in this also?
- The Personal Plan must be completed within 365 days of the previous Plan. The Personal Plan is considered complete when the individual/guardian agrees with the identified outcomes and supporting information in the Plan. The individual, guardian (if applicable) and ISC must sign the Personal Plan. The last signature date of these three parties becomes the annual renewal date for the Personal Plan.
Provider Agencies & Implementation Strategies
14. Will providers still write an ISP and hold the annual Interdisciplinary Team meetings?
- No. Effective July 1, 2017, when the Personal Plan has been developed, providers should not develop any new ISPs and Interdisciplinary Team (IDT) meetings are no longer required.
15. Rule 115 Section 230 states that "the CST shall review the service plan as a part of the interdisciplinary process at least annually for individuals with DD and semi-annually for individuals with mental illness and shall note progress or regression which might require plan amendment or modification". Should the provider continue to hold a semi-annual staffing?
- While the provider agency is not required to hold an annual interdisciplinary meeting, the provider agency should continue to hold the semi-annual staffing for individuals with mental illness until they are directed otherwise. The purpose of the semi-annual meeting is to review the strategies to confirm they continue to meet the needs of the individual. The ISC is not required to participate in the semi-annual review meeting.
16. Who will be responsible for ensuring the individuals' medication will be reviewed by an HRC beginning July 1, 2017?
- Provider agencies subject to Rule 115 and/or Rule 119 will continue to ensure a review of all restrictive interventions (including medications) by the Human Rights Committee. While HRC review is not required for those receiving only home-based services, positive behavioral supports should be discussed with the family at least annually by the ISC as part of the Discovery and Personal Plan process.
17. Do outcomes and/or goals have to be written for self-medication training as specified in Rule 116 when developing Implementation Strategies? If a medication participation outcome is not in the Personal Plan, can a provider agency add one to be in compliance?
Answer revised as of January 2018: No. Under the Person Centered Planning process, training in self administration of medication is no longer required unless the person has expressed a desire to learn to independently take their medication and this is identified in their Personal Plan. Rule 116 will be revised at a later date to reflect this guidance.
18. Some provider agencies currently used an electronic system to produce their ISPs as well as conduct other functions at their agency. Will providers be able to continue use of their current system to develop Implementation Strategies?
- Provider agencies can determine their own tool/format, but an Implementation Strategy must at least contain the following:
- Outcomes identified in the Personal Plan
- A description of how supports and services assist the individual to engage in community life and maintain control over personal resources
- Opportunities to seek employment and work in competitive integrated employment if desired
- Functional goals/training areas and methods to measure progress
- Documentation that services and supports are linked to individual strengths, preferences and assessed clinical and support needs
- Risks included in the Personal Plan and any others subsequently identified; strategies that will be used to mitigate risk and identify who is responsible for implementing these strategies
- All services and supports to be provided regardless of provider or funding source, including type, methods if applicable, frequency, duration and staff assigned if applicable
- Justification for any restriction(s) or modifications that limit the person's choice, access or otherwise conflict with HCBS standards
- Basic descriptive, diagnostic, demographic and medical information
- Documentation for any situation where a person lives in a residential setting owned or controlled by a service provider and modifications to the community settings are requested
- Must reflect ongoing review, monitoring and updating if necessary
- Must also be updated to reflect changes in the Personal Plan at least annually and more often if warranted by circumstances, a change in functional status or at the request of the individual.
19. When an individual is using the same provider agency for both CILA and DT services, should there be two separate Implementation Strategies or just one that is created and monitored by the primary residential QIDP?
- The Implementation Strategy describes how the provider agencies will support the person to achieve his/her desires and needs. In the situation above, a provider agency would not have to develop 2 different Strategies. However, if the strategies for CILA and DT are significantly different and the provider determines that separate Implementation Strategy documents would be more "user friendly" for the staff, the use of separate documents is acceptable. Regardless of whether the provider opts to use separate or combined strategies, each the Implementation Strategy document must contain all the necessary components described in the Implementation Strategy Guidelines. It must support the outcomes, desires and needs specified in the Personal Plan. The provider should keep a copy in both locations so that staffs are aware of the supports and services they are to provide.
20. Are there specific timeframes to write the Implementation Strategy and get it out or to the ISC?
- Answer revised as of January 2018: The provider will have 20 days to complete their Implementation Strategy. The 20 days begins with the date of the signature on the Provider Signature Page of the Personal Plan. ISCs are not required to approve Implementation Strategies. A copy of the completed Implementation Strategy must be provided to the individual/guardian and the ISC.
21. Is there a specific timeframe that the ISC agencies have to get a copy of the plan to provider to write the implementation strategies?
22. Who is required to sign the provider agency's Implementation Strategy and will the ISC approve the Strategies?
- The individual/guardian is required to sign a Provider's Implementation Strategy. The ISC will not sign or approve Implementation Strategies.
23. How will DHS ensure that the ISC is conflict free when offering choice and options to individuals with respect to providers?
- From a Federal perspective, ISCs are "conflict free" because they do not provide direct services. From a programmatic perspective, the Division has received concerns about potential bias for or against some providers by ISCs. The Division is training ISCs regarding our expectations and plans to periodically review options presented/choices given through conversations with individuals and their guardians. As with all issues, if you suspect a problem, we encourage the provider and the ISC to resolve it and, when needed, direct your concerns to DDD as noted in the conflict resolution process. The conflict resolution process can be found at this link Conflict Resolution Process.