May 1, 2000

SPECIAL NOTE: Copyright 2000. The Monday Report is produced each week as a benefit to the agencies that are members of the Child Care Association. Please protect this membership benefit - DO NOT copy and distribute this report to agencies/staff that are not members of CCA. Thank you for your cooperation.

DCFS presented a procedural plan for helping agencies calculate the steps and costs necessary to reach the projected ratios. The initial FY'01 contract will be based on the adjustments reached via these calculations using FY '98 and FY '99 performance statistics. The first step is to revise the total caseload. An agency will fall into one of four categories: 1) Agency exceeded performance target both years; 2) Agency met performance target both years; 3) Agency fell short on year 1 but exceeded target in year 2; and 4) Agency met target year 1 and exceeded target year 2. The difference each year between actual permanencies and the 24% permanency goal are calculated against the starting caseload. This calculation yields an "earned reduction." The new caseload size is then set on any earned reduction. The earned reduction is calculated against the statewide average earned ratio of 20.23% to figure "ratio points. "The final contract adjustment is based on the ratio points. Number of BARCS will be recalculated as well as the number of cases per paid BARC that will be lost for those agencies that just met the target both years or fell short one year while exceeding another year.

This description highlights a procedure that is complex. DCFS laid out a series of charts that show the calculations according to a sample set of caseload scenarios. DCFS and CCA will work on further sample sheets as well as a work sheet for agencies in order to help agencies calculate their own caseload levels and ratio adjustments. The Cook Performance Based work group of May 3 will be used to obtain feedback on how to make such worksheets usable for the agencies. We should have some type of product to offer agencies within 2 weeks.

As the system recalibrates, those agencies that just met the target both years, or that fell short one year will lose cases per BARC as the system readjusts. The committee discussed the pros and cons of transferring cases or holding off on further intake until agencies were at the required caseload ratio numbers. This issue will be discussed in more detail at the Cook Performance Based meeting on May 3 and recommendations made back to the overall work group at the next meeting. Additionally, agencies that exceeded the target any year and elected the Cash Bonus will see a buydown at a rate of 3:l. For every 3 cases above the permanency mark upon which the cash option was paid, the agency's paid caseload for next year will be reduced by one case.

Cook Traditional Foster Care was discussed. DCFS staff presented their concern that due to budget constraints, they will not be able to offer any significant reduction in caseload ratio without closure of some agency programs. This would allow redistribution of cases. They asked the group for a recommendation on where such a cutoff line should be drawn. This is a complex issue due to the fact that the system as a whole in Cook has not yet met the 24% target. After much discussion the private agencies did not reach a consensus on whether to recommend a cutoff line or where to place it. The agencies confirmed their strong recommendation that caseload reductions are needed in Traditional care as well as in HMR. However, they did not reach consensus that it was their job to recommend cuts of programs or state a cutoff line. This issue will be discussed in more detail at the next meeting.

Downstate programs were discussed. The downstate system has been performing at a consistently high rate of permanency performance. DCFS staff stated a concern about agencies that home offices in one city yet have smaller site programs away from the home office. They categorized these smaller site programs as often lacking quality, and attributed this to "drive-by supervision." They stated their intent to begin individual discussions with agencies to look at possible reductions or closures of programs in smaller sites. Private agency representatives took issue with the categorization of these programs as lacking in quality when they were demonstrating high permanency rates. We need assurance that they are talking with each agency about the same set of indicators that are indicative of quality work. Additionally, many agencies must supplement the smaller site programs with private funds just to keep the program viable or to respond to the competition with caseload sizes at other entities, including DCFS, and to concerns of the court.

DCFS staff stated that due to budget constraints there was little opportunity to readjust caseload ratio size for downstate. Once again, DCFS staff asked the group to recommend the reduction of those Cook agencies that are not performing in Traditional Foster Care to redistribute funds towards downstate caseload ratio reductions. The group did not reach any consensus on this issue.

This committee will meet again the week of May 8 to continue discussion of Downstate programs and Cook Traditional. The Cook performance contracting work group due to meet for its regular meeting this week will work with DCFS staff on clarifying procedures for the Cook HMR adjustments. Once these procedures are set, CCAI will assure our agencies get the worksheets and will provide a technical assistance session for agencies. (MB)

The entire schedule has not been confirmed. However, this week the Governor will be at the following locations: May 1--Carbondale City Hall--6:00-8:30 PM; May 2--Collinsville Gateway Convention Center-12:00-2:00 PM; May 2--Charleston, Eastern Illinois University--5:00-7:00 PM;May 3--Bloomington, Illinois State University--1:45-3:34 PM; May 4--Rockford--(time and place not yet confirmed). He will be doing these meetings in many locations around the state over the next several weeks. As we get the details we will be passing these on to the membership. (RHM)

ASSOCIATION TO MEET WITH DHS TO DISCUSS IN-STATE RESIDENTIAL EFFORT RELATIVE TO INDIVIDUAL CARE GRANTS
The Association will be meeting early next week with the Office of Mental Health of the Dept. of Human Services to discuss a joint effort between the Department and in-state residential facilities to: 1) bring back to Illinois children who are currently placed out of state under Individual Care Grants; 2) develop processes for the increased utilization of in-state facilities to prevent children from being referred to out-of-state facilities. There will be a number of issues that will need to be addressed in this process including working to address the specific needs of voluntary placed children and their parents as well as the increased acuity of care that will be needed to deal with this specific population of children. We have a number of agencies which currently serve ICG populations so we are very confident that we will be able to mount a successful joint effort in this regard. As the details unfold, we will be letting agencies know and begin a process of working with agencies to increase their service to this population. (RHM)

UPDATE ON LATEST ISSUES WITH THE JUVENILE DIVISION OF THE DEPT. OF CORRECTIONS
Over the past several weeks concerns have been raised about the latest efforts being made by the Dept. of Corrections to transition juvenile placements out of private residential facilities back to their homes and communities. The primary concern has been that the facilities serving these youngsters were once again given very short timeframes to terminate these placements--in some instances, less than a week. A major concern was that a number of these youngsters are currently enrolled in school and they would lose credit for all the work they have done if their placements are terminated before the end of the school year. We have had a number of discussions with DOC relative to these concerns and a number of our residential programs also did an excellent job of advocating for children currently in their programs. As a result DOC has decided to let those youngsters currently enrolled in school finish out their school year before they are returned home. However, they have taken the position (by and large) that youngsters enrolled in equivalency or GED programs can, in fact, finish these programs just as successful at home and they are proceeding with moving these youngsters. DOC continues to assert that the motivation for accelerating the discharge dates for these youngsters is to be able to move new referrals into our residential programs. They are concerned because they have many youngsters in need of these step-down placements and they feel the need to create vacancies for them by expediting the return home of children currently in care. We have asked for a meeting with the leadership of the Program Services Unit of DOC (the unit which has been making the decisions to move these youngsters) in order to try to establish a more consistent and up-front process to involve facilities more effectively in making these decisions. We also want to discuss with them the need to let facilities know that there, in fact, are referrals in the wings to help to fill in the vacancies which are currently being created. We have reminded them of the critical need for advanced planning and affirmation of continuing need. We will keep our residential programs apprised of the outcomes of those meetings. (RHM)

ASSOCIATION CONTINUES IT EFFORTS TO DEVELOP SELF-INSURED HEALTH CARE PLAN FOR INTERESTED MEMBER AGENCIES
Earlier this year the Association began an effort to look at the possibility of sponsoring a self-insured health care plan for its member agencies. We conducted a survey and asked for information from interested agencies. We had a good response and in working with the firm that has been providing consultation to us on this effort, Better Business, Inc., we have determined that there is a sufficient level of interest for us to consider taking the next step in this process. We will be presenting the findings of the study to the CCA Board of Directors at their May meeting. Following that meeting we will be making decisions relative to our next steps. (RHM)

Residential Summit Steering Committee:
DCFS Residential Care Vision
The private sector members of the Steering Committee met with Tom Finnegan of DCFS to review work Tom and Department have been developing in regard to the DCFS Residential Care Vision requested by providers. The outline presented consists of an estimated DCFS residential population of 2,580 of the total 33,353 DCFS wards. Tom reported that DCFS now licenses approximately 3,800 Institution/Group Home beds statewide. This means that for next year DCFS will contract for about 68% of the states licensed capacity. The Department intends completing several steps to assist in the placement of DCFS youth in I/HG programs. Profiling of DCFS wards in I/GH placement will be completed with final numbers developed for the following categories: (DD), (SED), (DD-MI), (MI) and (SACY). The next step will be to update Institution and Group Home program plans to incorporate four aspects: Primary Treatment, Model Specific, Time Limited, and Outcomes Based. The Medicaid work-group is working on a draft outline for the updated program plans. DCFS reported working closely with other state code departments and is encouraging them to follow a similar process to present their I/GH needs to providers. Tom indicated DCFS is also working closely with the CCA Chapin Hall project in the collection of I/GH data. While this vision is a work-in-process, DCFS is clearly indicating they wish to better define the clients and match them with program specific placements. (D.D. Fischer)

MAY 8 EDUCATION MEETING IN SPRINGFIELD
This meeting will be held from 10:00 � 3:00 and will cover numerous topics in education. ISBE representatives Gordon Riffel and Dennis Williams will be present in the morning to discuss special education certification, teacher professional development requirements and alternative assessment for children in nonpublic schools. In addition, we will discuss the changes in the surrogate parent program, legislative and budgetary summaries, compliance problems, and the status of the IPCRB rule changes. This meeting will provide the most current education information from DCFS and ISBE. Call the CCA office for more information. (BRH)

CCA/DCFS Partnership in Quality
Quality Assurance Committee
The joint public and private committee on Quality Assurance met last week in Chicago with counterparts on-line from the Florida to continue discussions on Quality Improvement and Quality Assurance. The group received a briefing from Michael Sumski on the Quality Improvement System developed by and for DCFS. The system is in the third year of planning and implementation with two additional years allowed for full implementation. DCFS has implemented a classic QA/QI approach at the field level and is now concentrating on central office functions. Quality Councils begin at the field level of DCFS and extend all the way to a statewide Quality Council. One important feature of the system is "peer review", by this DCFS means the use of staff to review case files of other DCFS staff. The process is complete with a formal review tool and the Department has indicated this internal process has been very beneficial to those participating. Private agency members of the group indicated some of their organizations have also instituted this form of internal "peer review" and structure the review process to help meet accreditation and Medicaid regulations.

The group has agreed to design and complete a survey of the private sector in regard to their level of QA/QI implementation. This survey will help define the private sector need for QA/QI assistance and training.

Finally, the group worked on defining indicators of quality for both a public and private child welfare organization. This project is coordinated by Fotena Zirps of Florida, the individual associated with the CCA efforts on QA/QI as well as the architect of the DCFS system of Quality Improvement. The committee is working on the following indicators of quality; National Accreditation, Quality Improvement System, Ratios of Staff to Clients, Risk Management, Outcomes Measurement, Customer Satisfaction, Staff Qualifications, Financial Stability, and Training Programs. Following the design of the indicators a field test is planned. (D.D. Fischer)

CERAP TRAINING-DOWNSTATE AND COOK
DCFS has scheduled a number of CERAP training sessions. Sessions downstate have been scheduled as follows: Northern Region on 5/10, 6/7 and 7/19 (location to be announced based on registrations;) Central Region on 5/15, 5/16, 6/14 and 7/19 (location to be announced based on registrations;) and Southern Region on 6/21, 8/23, and 11/29(State Police/IDOT Building, Collinsville). There is a limit of l5 persons for the 6/2l Southern region.

Cook County sessions will take place at the Illinois Institute of Technology Research Institute, 10 West 35th Street, Chicago. Dates are May 5, May 12, June 6, June 15, June 16, July 10, July 17 and July 21. Additional training dates for August through December will be posted in mid-summer.

Registration forms must be submitted in advance. A copy of the form can be obtained by contacting Karen Evans-Thomas at 312-328-2828 or by calling the general Training and Development Services number at 312-328-2970. As a reminder, CERAP certification is required by Senate Bill 1357 and will be one of the requirements of the Direct Employee Services License.

TRAIN THE TRAINERS OPPORTUNITY RE: SUBSTANCE AFFECTED FAMILIES
There are still slots available for the remaining SAF training dates. DCFS will be sponsoring a series of 2 day training sessions, geared for trainers or supervisors on Substance Affected Families and DCFS policy guide 99.13. Private agencies are invited to send two supervisors or managers to the training. There is no charge for the training but each agency is responsible for travel expenses. Day one is from 9:30 a.m. to 5:00 p.m.and day two is from 8:30 a.m.- 4:00 p.m. All will be held at the DCFS IITRI Training Center, 10 W. 35th Street, Chicago. The sessions are open to any private child welfare agency program. The dates are: May 8 & 9; May 15 and 16; and May 17 and 18. For a registration form contact: Northern Illinois University at 800-637-1396. (MB)

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