October 4, 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 July 12, 2018 Draft Meeting Report
  • Early Intervention Provider Connections
  • Lead Poisoning Workgroup
  • Telehealth Workgroup 
  • Council Membership Status Kathy Schrock
  • Ongoing Updates
    • State Systemic Improvement Plan
    • Annual Performance Report
    • Federal 618 Compliance
    • Federal Compliance for Determinations
    • IMPACT
    • Service Delivery Approaches (SDA) Workgroup Recommendations
    • Cornerstone
    • Digital Signatures
    • Budget
    • Bureau Staff
  • Service Delays Data
  • DRAFT 2019 Council Dates
  • Adjournment of Meeting

Council Report

Present

Meghan Burke, Parent

Bob Cammarata, ICG Health Care Services

Benny Delgado, Leaps and Bounds Family Services, Inc.

Ann Freiburg, IDHS, Bureau of Early Intervention

Margaret Harkness, IL Council on Developmental Disabilities

Vicki Hodges, ISBE, McKinney-Vento

Dee Dee Lowery, CFC 1 Program Manager

Ginger Mullin, IL Dept. of Public Health

Kathy Schrock, Easter Seals DuPage & Fox Valley

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

Rita Wahl, CFC 20 Program Manager

Amy Zimmerman, Legal Council for Health Justice

Absent

J. Diane Adams-Alsberry, CALM, Inc.

Karen Berman, Ounce of Prevention Fund

Teresa Bertolozzi, Parent

Kelly Cunningham, IL Dept. of Healthcare & Family Services

Kristy Doan, IL State Board of Education

Melissa Ehmann, Parent

Donna Emmons, Head start

Heather Lalor, Parent

Lori Orr, Governor's Office of Early Childhood Development

Rosie Perez, Parent

Lynette Strode, IL Assistive Technology Program

Becca Trevino, Parent

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

Karen Woods, IL Dept. of Insurance

Council Packet

  • Agenda
  • Draft Council Meeting Report - July 12, 2018 Meeting
  • Council Membership
  • Early Intervention Program Caseload Summary Report
  • Draft 2019 Council Meeting Dates

Call to Order

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

Introduction of Council Members

N/A

Approval of July 12, 2018 Draft Meeting Report

Kathy moved to approve the report. Page 4 edit suggested by Bob. He would recommend deleting the third sentence about the method of telehealth. Minutes approved with the recommended correction.

Early Intervention Provider Connections

Rob Derry presented information about Provider Connections' (PC) activities. Provider Connections has been at Western Illinois University since 1997. Their service to the field has evolved over the years. Rob described the focus of each staff member's work. They also have one student (Quentin Thurman) employee who helps with filing.

During FY'18, processed close to 3800 credentialing applications. Issued 1326 new credentials. While people also go inactive each month, there has been a shift to gaining more than losing now. Have worked more recently on cleaning up provider database by inactivating credentials for those who have not billed for any service in a 12 month period. Started this process in October of 2017 and continue engaging in cleanup on a quarterly basis. They receive a list from CBO for those who have not been billing. Cleanup includes removing their association with entities for whom they are no longer providing services. Credential is only inactivated when they have no active payees remaining. Work closely with CFCs on this process as well so that provider shortages don't worsen.

They have lots of visitors to their website (215,639 hits in FY18). They have distributed over 12000 electronic newsletters to active providers and other system stakeholders. Also currently working on an online credential application process.

Rob then provided a tour of their website, highlighting some of the search options available. Amy Zimmerman asked about how the information for which CFCs the provider will serve is collected. Rob indicated that the provider, him/herself, indicates this on new and renewing applications. There could be more direction provided around this when the electronic application becomes available. Benny offered some suggestions for enhancing provider profiles, similar to what is collected on the IDTA website. Rob said that this could be helpful with descriptors clarifying that information is self-reported.

Bob Cammarata commended Rob on the efficiency of their staff and website. He also asked if PC was the "official" website for provider information when changes are made. Ann clarified that all of the administrative websites are now updated consistently, but that the provider payee agreement requires that all providers monitor the PC website for news and information. Kathy asked about the provider information available by CFC. Rob shared that they can break down provider information by CFC, but it won't show if they are currently accepting referrals/serving children. Benny asked if Rob has a sense of provider longevity. While this is not something he monitors, he knows that there are many folks who have been enrolled longer than 5 years and that the number of credentials being inactivated each month is declining.

Lead Poisoning Eligibility Workgroup Update

Amy Zimmerman provided an update on recent activities. Trainings at pilot CFCs have been conducted. Amy thanked the many partners that have supported the work. Primary implementation challenge has been around provider engagement from the medical community. Lots of materials have been developed for families to help them understand the project. Child Find has provided the folders for the information that medical providers can share with families. They have recently engaged the Public Health Departments most closely affiliated with the pilot CFCs as Illinois legislation now recognizes CDC recommendation for the level of concern. Nurse visits are now required when children have Blood Lead Levels (BLL) of 5 and above. Benny discussed the messages and some of the resources that are being shared with providers during training so that they understand how to support families in this project. Amy reminded everyone that the pilot aims to reduce the impact of lead exposure on children's development so that families feel more informed and fewer services may be needed in the future.

Telehealth Workgroup

Bob reported that the workgroup has not met since the last Council meeting. Workgroup feels that this approach is a way to get needed services to families. Bob reported on efforts in Illinois where telehealth is occurring. Ann shared that she recently received some more information on telehealth at a cross-state learning collaborative meeting. Practice acts are being reviewed to see if this method of practice can be supported. Kathy shared that both national and state resources are being utilized. Bob reminded people that a PowerPoint to use for training was previewed at the last Council meeting. Although a few slides needed updating, Bob is wondering about a plan for sharing this information more broadly. Ralph said that it appears the HFS workgroup on telehealth is currently inactive but connections with that workgroup have been made. Amy encouraged Ann to engage those in charge of the workgroup to make sure Healthcare and Family Services (HFS) knows EI is interested in exploring this option for service delivery. Ann shared that she already has a plan for connecting to the work. The workgroup recognizes that they still need to address Megan's concern about how information will be shared with families. Megan said that she has a student who has begun exploring the literature for telehealth use in EI. She is willing to share that information with the workgroup. Kathy asked about next steps to keep the momentum. Ann will see if she can update the PowerPoint and be back in touch with Kathy about next steps.

Council Membership Status

We have two provider openings now and three more providers that should be exiting. Kathy, Diane, and Bob should all be leaving soon. Kathy stressed the importance of getting new participants and asked Council members and attendees to think about who they could encourage to get involved. Benny shared concern that provider members should be representative of the overall provider pool and still working with families utilizing the EI philosophy. Bob was recently in attendance at a meeting with other providers who he approached about serving on the Council. DeeDee suggested bringing this issue up at the next Managers' meeting to see if managers have ideas for potential candidates as well.

Amy asked questions about the vetting process once an application is submitted and if there is information that the Council could prepare to share with potential applicants to encourage their participation. Ann clarified that the Governor's office is responsible for appointments; Bureau has not been asked to provide feedback on candidates. Jenni will reach out to Governor's office to see if additional information could be provided to help with Governor's selection of candidates. Margie shared some insights about how board appointments have worked for the Illinois Council on Developmental Disabilities.

A new personnel preparation representative is also needed. Kathy asked if additional members/perspectives need to be considered. Early Learning Council representation needs to be clarified. Will revisit consideration of home visiting representation when Karen Berman can be present and available to provide input. Kathy asked Council members to think about the criteria they might use to determine when additional representation is needed for their work. There may be value in making sure that all the systems that can potentially serve EI children and families are represented.

Ongoing Updates

Ann provided summaries that were included in the Council materials.

  1. State Systemic Improvement Plan- Ramping up work on second coherent improvement strategy. Recently discussed potential for statewide expansion of activities.
  2. Annual Performance Report- Summary document provides details.
  3. Federal 618 Compliance- Need to provide numbers in EI by exit reason and race, ethnicity and gender; also report on dispute resolution and child count settings.
  4. Federal Compliance for Determinations- Federal government provides states with annual determinations based on compliance data and other factors that reflect a state's "risk" to the Department. OSEP has encouraged us to more proactively address our longstanding noncompliance. Our state contact has visited and held calls with us to provide support. Ann reminded Council members of our standard for "correcting" noncompliance. Our standard is far more rigorous than other states. We are being encouraged to examine our standard and our practices for correcting noncompliance. Have recently convened a workgroup to advise Bureau on proposed changes to this process. Amy asked where Council members can find information from OSEP about this. Ann shared that this is available via OSEP's response in our APR. Amy asked that any changes be brought back to the Council for their education and feedback. Amy asked for updates at each Council meeting from any Bureau workgroups.
  5. Illinois Medicaid Program Advanced Cloud Technology (IMPACT): Nothing new to report. Planning to hold another meeting before end of October to continue discussions around ongoing issues. Bob shared that the automatic updates for professional licenses now appear to be working.
  6. Service Delivery Approaches (SDA) Workgroup Recommendations: Ann provided a thorough update to the Council in their packet. Several of the items were able to be incorporated through the recent NOFO process for CFCs. Some changes to performance contracting and counting of intake cases were made. Staffing penalty for this year was waived since CFCs will need time to hire staff. Kathy asked about the additional costs associated with the intake calculation. Ann said that it is not necessarily a greater cost to the system as other items, e.g. fewer incentives, LIC/SEC funding, have been changed. There is potentially $2 million more available to be accessed by CFCs. Funding will be more responsive to CFC caseload changes. Amy asked Dee Dee for more explanation of how this change was impacting her CFC. Amy asked Ann to highlight some of the changes made in October that are reflected in the document shared with Council members. Changes that were made in NOSA are specifically reflected in the update. Many of the items have also been accomplished through SSIP work. Amy asked if the procedure manual will be available for comment. Ann stated that this is only done when the Rule changes.  Ann talked about updated policy and procedure and the ability to understand whether changes are being implemented, e.g. if the family was given the option to have the IFSP and eval on separate dates. Benny asked about efforts to ensure actual implementation of policy and procedure. Monitoring has an active role in this process. Gary shared examples of how they examine this across the state. Is there any data to share that shows the implementation of changes and their impact? This is not readily available as there are many variables that influence implementation, e.g. family preferences. Current focus is on documentation since this is the primary source of information for what is occurring. Parent input could be utilized to provide a fuller picture of practice. Gary reminded people that parent surveys are a part of the current monitoring process and could potentially be enhanced. He will share current survey with Council members for their feedback. Council members are encouraged to review the update and prepare for more discussion at the next meeting.
  7. Cornerstone: Ann has a meeting on Friday. Still trying to determine whether EI can produce their own RFP to get the system we need. She has a good sense of what is needed from the system, but she is concerned about the delays to the process.
  8. Digital Signatures: DHS, as an agency, is exploring this more. Ann will provide updates as they become available.
  9. Budget: Same GRF as last year. Slight increase in our federal funding.
  10. Bureau Staff: Heather is currently on leave. Accountant has left her position. Nick has been helping in this area while position is vacant.
  11. Statistics: Provider payments are current through 9/19/18.

Fiscal Workgroup

Kathy explained that this group would be looking at program funding and expenses. This workgroup could provide advice for future needs and directions to explore. One concern is that rates for providers and CFCs have not changed for many years. Benny, Karen, Bob, and Amy have volunteered to participate on the workgroup. Chelsea agreed to participate/support as well. Ann has reached out to HFS contact for additional information about rates. Legislator participation could be useful as well. Jenni to find folder of prior group to review past participants.

Service Delays Update

Ann reviewed the maps Council members received. Amy asked for clarification on how Bureau received information. It is still provided manually on a monthly basis by CFC Managers. Council members offered some suggestions for improving the maps, e.g. clearer legend (ranges have overlapping numbers), total number waiting, length of time waiting. Current status is important information for providers to have, especially in terms of recruitment.

SSIP Messaging workgroup did produce a new brochure for primary referral sources. Council members are encouraged to share widely to assist with child find efforts. Amy announced that she will leave copies of the Quick Resource Guide that supports public understanding of why developmental screening is important for people to review. Standardized referral and fax back forms have recently been updated. Amy also asked that the parent reimbursement policy have the word "voucher" added and offered her support with implementation. She also thinks that families will need information about this in order to utilize this process.

Vicki shared that her liaisons encounter some difficulties making EI referrals. Ann helped her find the link that they will need for appropriate referrals.

2019 Council Date Approval

Ann asked for verification that the proposed dates will work. Kathy asked for motion of approval and Bob so motioned. Ginger seconded. Motion passed.

Adjournment

Amy motioned to adjourn the meeting and Bob seconded. The meeting adjourned at 1:04 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