April 5, 2018 - 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 January 11, 2018 Draft Meeting Report
• Lead Poisoning Eligibility Workgroup Update
• Early Intervention Monitoring Program
• Early Intervention/Home Visiting Convening Update
• Annual Performance Report/State Systemic Improvement Plan (SSIP) Update
• Local Interagency Council Roles
• Ongoing Updates
  • IMPACT
  • Service Delivery Approaches (SDA) Workgroup Recommendations
  • Cornerstone
  • Parent Reimbursements
  • Budget Update

• Digital Signatures
• Tele-Practice Workgroup Update
• Council Fiscal Workgroup
• Service Delay Reporting Updates
• Adjournment of Meeting

Council Report

Present

Karen Berman, Ounce of Prevention Fund

Meghan Burke, Parent

Bob Cammarata, ICG Health Care Services

Benny Delgado, Leaps and Bounds Family Services, Inc.

Dee Dee Lowery, CFC 1 Program Manager

Donna Emmons, Headstart

Kristy Doan, IL State Board of Education

Ann Freiburg, IDHS, Bureau of Early Intervention

Margaret Harkness, IL Council on Developmental Disabilities

Melissa Ehmann, Parent

Vicki Hodges, ISBE, McKinney-Vento

Ginger Mullin, IL Dept. of Public Health

Lori Orr, Governor's Office of Early Childhood Development

Rosie Perez, Parent

Kathy Schrock, Easter Seals DuPage & Fox Valley

Lynette Strode, IL Assistive Technology Program

Rita Wahl, CFC 20 Program Manager

Therese Wehman, Elmhurst College

Angel Williams, IL Dept. of Child and Family Services

Karen Woods, IL Dept. of Insurance

Amy Zimmerman, Legal Council for Health Justice

Absent

J. Diane Adams-Alsberry, CALM, Inc.

Teresa Bertolozzi, Parent

Kelly Cunningham, IL Dept. of Healthcare & Family Services

Roselyn Harris, DHS, Bureau of Child Care & Development

Heather Lalor, Parent

Ralph Schubert, Division of Specialized Care for Children (DSCC)

Becca Trevino, Parent

Kathy Ward, IDHS, Division of Developmental Disabilities

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

Council Packet

• Agenda
• Draft Council Report from January 11, 2018
• Recommendations to Improve Collaboration & Coordination across Home Visiting and Early Intervention in Illinois
• Tele-Therapy Benefits and Challenges PowerPoint document
• Early Intervention Program Caseload Summary Report

1) Call to Order

Kathy Schrock called the meeting to order at 10:00 am.

2) Introduction of Council Members

Kathy welcomed new Council Members and then asked others to introduce themselves. Bob reminded Council members and meeting attendees that the Week of the Young Child begins April 16, 2018.

3) Approval of January 11, 2018 Draft Meeting Report

Bob moved to approve the report. Lynette seconded. Minutes approved.

4) Lead Poisoning Eligibility Workgroup Update

Amy Zimmerman gave an update on the development of work in the pilot sites. Funding for this project was provided through the Illinois Council on Developmental Disabilities. Ann was able to obtain OSEP approval for piloting lead eligibility. An additional application has been submitted to fund the evaluation component of the project. The workgroup is interested in learning what is different for children when we start EI for these children before delays appear. Erikson submitted the evaluation application to determine the impact of the work. This will allow a closer look at the children's performance over time. Amy shared that people in other states have in interest in what we learn as well. A piece of the pilot involves having providers use the DAYC-2; EITP has scheduled trainings on this tool for the providers in the pilot areas. A winter webinar about this project was conducted earlier this year. Amy thinks approximately 100 people attended. It has been re-recorded and is now posted on the EITP website. They will also be discussing this project at the Northern CFC Conference on May 4th. Bob mentioned that he received the Illinois Department of Public Health lead poisoning report earlier this week. Numbers of children appear to be pretty stable. New numbers confirm that pilot sites are still appropriate targets for our efforts. DeeDee mentioned that, on the CFC side, they are starting to pull together teams to support the identified children.

5) Early Intervention Monitoring Program

Gary Reed shared information with Council members about the role of Monitoring in the EI system. He began by introducing himself and sharing information about his background. The program's role is to ensure that system participants are adhering to program policy. He feels that Monitoring gets to see all aspects of the EI system. Their role within the system is evolving. Original focus was on compliance. Now there is more of a focus on supporting improved performance through technical assistance and resource sharing. Want to do more with following up on corrective action plans and developing strategies for addressing issues/concerns. They visit every CFC each year for a Monitoring visit. Also monitor performance of providers, approximately 1200 per year. Examining these files gives a good sense of what practice looks like in the field. Feel like they have an opportunity to really improve the quality of the system. Help make connections for people so that they understand how errors/lack of compliance impact quality. Vander Weele Group is the fiscal agent. Gary then opened it up for questions/comments.

Bob shared that their most recent Monitoring visit had a different feel in that monitors were really focused on helping providers do their work better. He also recently attended the follow-up meeting for CFC#9's monitoring visit. Attending allowed the providers to understand what the CFC is being held accountable for and how they might be helpful moving forward. He encourages other CFCs to take a similar approach. Gary felt that the approach was useful in building relationships and making connections between each other's actions. Therese asked about the concerns that they most frequently see and how the Council might help in addressing them. Gary shared that the most frequently missed CFC opportunity relates to six-month meetings that don't occur or don't occur in a timely fashion. Biggest issue for providers is appropriate and consistent documentation. Kathy talked about the importance of the shift from compliance to other issues of quality. Identifying strengths and opportunities for growth provide a direction for improving the system. She asked about the background of the monitors. Gary shared that they enter the program with a variety of experiences so training and preparation of the monitors is critical. Our system is a difficult system to understand and lots of support is necessary in order to prepare them to help others. Gary is looking forward to working in the future with the data manager so that we have other sources of information to use for system improvement. Benny commended Gary on his willingness to make the shift in the program's focus and asked about positive trends being identified. Biggest area of improvement has been documentation. People are getting better at "telling the story of their work". Also see real improvements in the execution of exit meetings as children prepare to leave the program.

Heather shared that a piece of her job is researching the appeals from Monitoring's findings. She has been able to see a real shift in the documentation and support being provided by Monitoring. The follow up over time has really changed. Melissa asked about how they get family input on the system. Gary talked about their focused monitoring process and how that differs slightly. They have a dedicated person to collect family input in order to understand the entirety of their EI experience. His ultimate vision for Monitoring is to be able to comprehensively understand the system through a picture they capture for each child. He feels that it is critical to understand how all the pieces influence and impact each other- less focus on silos and more focus on connections. Gary is happy to come back and share more information about the data collected and trends identified. Bob asked for additional information on the background of staff when he makes that presentation.

6) Early Intervention/Home Visiting Convening Update

Karen Berman reminded people of the materials that were included in their packet. She then reminded people of the impetus for the convening and the entities involved. Primary influence was the release of the federal statement on Part C and Home Visiting (HV). Convening was intended to help people understand the recommendations, think about where IL is in regard to these recommendations, and then identify areas to focus on in order to further our progress. Hoping to keep focus tight in order to really make progress. Karen expressed the importance of having leadership involved as these plans develop. This effort has benefitted from this support and from the support of the training entities for these programs. Karen would like Council members to really understand the report and the actions being undertaken. She reviewed some of the initial information. Although some states have the same advisory body for both EI and HV, in Illinois, we want to support shared representation on the various Councils and Task Forces that guide the state's work. Hoping that these recommendations can help us better understand the needs of communities and the children who live there. Better coordination across systems will be beneficial as will understanding what is in place and what is missing. Group feels that a statewide system for HV intake could be beneficial. Want to improve mapping of HV programs. Have already experienced success with getting EI ineligibility added as a priority for Prevention Initiative programs. Working on getting a universal touch on newborns in certain parts of the state. Coordinated intake and referral could benefit from more guidance and support. Although there was not time to review all the information within the report, Karen asked that people read through the information and let her know if there are items that are of concern and/or interest.

Focus shifted to reviewing the first phase of implementation. Want to get input from those in the fields about what barriers/challenges exist to coordination across the programs. Need help with developing survey/questions and then thinking about dissemination of findings. Members were informed to let Lori know if they are interested in assisting with this work. Second area is around better statewide coordination of intake and referral. After survey information is collected, a small group of leaders from the programs will need to be convened to address identified challenges. Information sharing across programs is critical to making better referrals and making sure children and families get the services they need. Ginger pointed out the importance of sharing data in order to track what is happening. Lori asked if a subgroup of the IICEI could be convened to address the recommendations. Dee Dee asked what investigating had been done into places in the state where this coordination is working. Karen shared that those involved in the group weren't aware of places that it was going well but would be interested in knowing if there were models/approaches that could be replicated. Several audience members shared their experiences with coordinating within their area and across CFCs. Kathy wondered if a CFC workgroup might be a better initial first step to inform what the Council workgroup could help address. Amy asked about the potential of having groups running on parallel tracks so that activities don't get delayed. Next steps include getting more information from CFCs/LICs about what is currently happening and getting volunteers for the Council subgroup. Lori emphasized the importance of actually hearing from SCs when we collect EI input. Bob, Therese, Donna, and Benny volunteered (DeeDee will take lead). Meghan has a master's student who she is willing to contact about supporting the work as well.

7) Annual Performance Report (APR)/State Systemic Improvement Plan (SSIP) Update

APR and SSIP reports have both been submitted in a timely fashion. OSEP comments for us should be ready soon. Ann thanked everyone who made comments and provided feedback. Although we still need to begin the second improvement strategy, Ann is beginning to contemplate how we will coordinate the ramping up of the SSIP. Amy asked about the Council receiving OSEP's feedback in case there are things that members can help with. Ann agreed to share this when available. Local Interagency Councils have an important role in supporting the SSIP work and may be a group to consult as we begin to plan for scale up.

8) Ongoing Updates, Ann Freiburg

a) Illinois Medicaid Program Advanced Cloud Technology (IMPACT):

Managed to submit TCM claims for SFY17 and SFY18 to date; we have gotten our federal match for late January and most of February claims -$3.7 million (which is about $1.4 million larger than usual); IMPACT has warned Ann that this may not continue until it gets enrollment all figured out on their side; no news about additional Phases of implementation; Bureau just now has identified a consistent contact within IMPACT group; also still working on solutions for enrolling our AT providers

b) Service Delivery Approaches (SDA) Workgroup Recommendations:

Ann has postponed updating until RFPs for the CFCs have been posted as some recommendations are reflected there; Karen asked if the SDA recommendations could be posted on the EI website and on the OECD website for the ELC to see as well; report is final, but Ann wants to include some introductory information as well.

c) Cornerstone:

Ineligibility code with HV referral has been added in most recent release; DeeDee asked for updated clarification about which codes to use for which programs; Ann indicated that this is being worked on now. PA42 which includes screen for Medicaid eligibility is being reconnected for CFC use but is being tested right now. Bureau has also started getting a 'bad address' report providing us a way to clean up our database; Ann will share these with CFCs soon. Still unclear as to what system will be replacing Cornerstone in 2020. Meetings are ongoing. We are still on list for requested updates to Cornerstone, but the timeline of these updates is uncertain. Amy requested that the requested changes be shared with Council members.

d) Parent Reimbursements:

Final language is ready; it will be included in the updated CFC Procedure Manual when it is released. Karen asked what messaging will need to accompany the implementation of the new policy and offered to help with that. Ann responded that all releases come with a summary/announcement.

e) Budget:

State budget includes a $3Million increase which will be used to address the changes in the new RFPs. The federal Part C budget was also increased, but we are not sure how that will trickle down to states. Due to the increase, a portion of the federal budget has to be set aside for expanding Part C to kindergarten. It is a small amount of money for the state and would likely not support the infrastructure changes required to accommodate the change. Benny raised the issue of potentially extending service for kids who have difficulty transitioning timely into ECSE because of the timing of their birthdays. Karen shared that Representative Evans is the IL representative sponsoring the IL legislation (HB5347) for extending Part C age eligibility. Karen asked if we can determine how many kids would be impacted if the timing of transition changed to the school year following their third birthday. Meghan and Rosie shared their experiences with their own children and feel that many families would appreciate options for when they transition.

Ann provided updates on EI Administrative RFPs. Monitoring was in a renewal year. CBO was awarded to CQuest again. Clearinghouse RFP period closed on March 29, 2018. Credentialing RFP period closes April 17, 2018. EITP RFP period closes on April 26, 2018. Bureau has completed their work on the CFC RFPs. These have not posted yet, but they are anticipating that this will occur any day now.

f) Bureau:

Susan Lyons will be a new administrative assistant starting with the Bureau on April 16, 2018. The EI data manager posting came down yesterday. Bureau will also be getting a summer intern who can hopefully help with payee agreements.

Ann asked if the CFC Managers on the Council think other Managers would mind if the Bureau shared the CFC Manager's Meeting Notes with Council members. Dee Dee and Rita don't think others would mind and Bob shared that he would appreciate reading through them as they often share timely updates. Karen asked about how LIC Coordinators coordinate their activities to address community challenges/issues. Ann shared that there is not a formalized mechanism for this within the current system structure. Current LIC calls are more topical than strategy-sharing, but topics are based on feedback from LIC Coordinators and their expressed challenges. LIC annual report is shared with Council members each year. An audience member asked why there isn't LIC representation on the IICEI as those are the folks who mimic the Council structure at the local level. Although it isn't a formal role on the IICEI, one of the current CFC managers serves as her area's LIC Coordinator as well. Ann reminded people that they can contact Council members throughout the year so that stakeholders have a voice. Ann said that LIC coordination could be discussed on an upcoming Managers' call. Karen and Lori also suggested thinking about more active recruiting of LIC Coordinators into Early Learning Council, Community Systems Development Subcommittee work.

g) Digital Signatures:

Ann shared DHS guidelines with Council members. Kathy offered to have her IT people speak with DHS folks to get more clarity on what is missing in current guidelines as it pertains to EI. Bob will send Ann information about what they feel is still needed in order to move this forward. Kathy asked about the possibility of scheduling a meeting that brings relevant parties together. Ann will try to work on that.

9) Tele-Practice Workgroup Update

Heather Hofferkamp reviewed highlights from the PowerPoint available to Council members. The workgroup has strong representation from providers in the field. Kathy and Benny put the presentation together to educate the provider community. There are a number of states utilizing tele-practice in a variety of ways. Next steps for the workgroup were shared. Kathy has recently identified a legislative person who can help with this work who has experience with tele-therapy legislation.

Contact Information

Jenni Grissom
IDHS - Bureau of Early Intervention
823 East Monroe
Springfield, IL 62701
Ph: 217/524-1596
email: jennifer.grissom@illinois.gov

If you are need of special accommodations, please email or call Jenni Grissom.