May 15, 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.

The Association will hold its' 36th Annual Meeting and Training Conference on June 1-2 at the Crowne Plaza Hotel in Springfield. William Ryan is our featured speaker on June 1. Mr. Ryan is a Cambridge-based consultant to non-profit organizations and foundations and is a Fellow at the Hauser Center for Non-Profit Organizations at Harvard University. He is currently investigating the effect of performance-based government contracting on non-profits, the growth of for-profit social service providers, and the prospects for creating new forms of non-profit governance. Mr. Ryan will specifically address: 1) Capacity and Mission, and 2) Capacity and the Market.

CCA will once again sponsor a Barbecue at the Springfield Island Bay Yacht Club on the evening of June 1st. This annual event has become a tradition with the membership and allows the opportunity to unwind and socialize with your peers. (Casual dress a must!!!)

The second day (June 2) Board-to-Member Focus Groups will meet in small break-out sessions from 9:15-10:15 a.m.. CCA Board members will be meeting with his/her "link" agencies to dialogue on the mission and ends of the Association and specifically on the needs and concerns of the membership in relation to the Association's agenda and the role of the CCA Board of Directors. After the focus groups, the Annual Business Meeting will start at 10:30 a.m. The two-day meeting will adjourn after lunch and the CCA Board of Directors will meet at 1:00 p.m.

MEETING WITH MELISSA WRIGHT, ASSOCIATE DIRECTOR OF THE DHS OFFICE OF DEVELOPMENT DISABILITIES
Association Director, Ron Moorman, met last Wednesday with Melissa Wright, the Associate Director of the DHS Office of Development Disabilities. The purpose of the meeting was to initiate discussions as to how our member agencies might assist the Department in meeting their needs for services to children who are currently receiving ICGs (Individual Care Grants) for a variety of developmental disabilities from DHS. The Department is very interested in trying to return a number of children that they currently have residentially placed out of state through the ICG process. The Department is interested in both returning children as well as trying to serve the children in need of these services in-state closer to home and community. We have a number of agencies currently providing these services and we indicated that we would be very interested in working with the Department to achieve their goal. We reviewed the process that we used with DCFS to return children from out-of-state placements including the process of profiling children and profiling agencies. Given the critical role that parents play in this process, it is clear that this system would have to be modified to some degree to acknowledge that role. If we were to profile children in the manner we did with Project Return, this will have to be done with full parental knowledge and approval. Melissa was very interested in our ability to profile our agencies--the possibility we discussed was the profiling of agencies providing these services on our CCA web-site which would, in turn, be linked to the DHS Web-site. This would enable parents to be able to review our list of possible resources in a seamless process--they could contact the DHS website which would refer them to the CCA website which, in turn, would be linked to the web-sites of any individual agency for which they would like to have additional information. It is a process that we are going to pursue and put back in front of DHS for consideration. Melissa also agreed to meet with our membership in the near future (at a date to be established) to review with interested agencies DHS' current needs and their process. We will be organizing that as quickly as we can. (RHM)

DHS DEVELOPMENTAL DISABILITY FORUMS
DHS, Office of Developmental Disabilities held a series of forums throughout Illinois during May to review the draft strategic plan for developmental disability services. CCA attended the forum held in Springfield on May 9, 2000. Two are still scheduled to be held in the Chicago area on May 15 and 16, 2000. DHS solicited comments from those in attendance through small workgroups who were asked to list what they liked about the plan, what concerns they had with the plan and what suggestions they had to address those concerns. DHS will be accepting comments on the plan until the end of May 2000. We would encourage members that provide developmental disability services to submit any comments or concerns you have regarding this plan. This plan will be directing future funding priorities for developmental disability services. The CCA Office will also be submitting comments and would appreciate receiving a copy of all comments made by CCA members. One overall issue with the plan is that it fails to address to any extent children's DD services. Written comments should be submitted to Reta Hoskin, Bureau Chief, Office of Developmental Disabilities, Room 416 Stratton Building, Springfield, Illinois 62765 (or by FAX 217-782-0012). (JMS)

PROPOSED RULE FOR MEDICAID COMMUNITY MENTAL HEALTH SERVICES PROGRAM
A copy of the proposed rule changes for the Medicaid Community Mental Health Services (Rule 132) was filed in the Illinois Register dated May 5, 2000. As was reported in the last Monday Report, the major reasons for the rule changes related to post payment reviews and comprehensive mental health services. Copies of the proposed changes will be mailed out to all members this week. Comments may be submitted for 45 days to Susan Weir, Bureau Chief, Bureau of Administrative Rules and Procedures, DHS, 100 South Grand Avenue East, 3rd Floor Harris Building, Springfield, Illinois 62762. Telephone Number: 217-785-9772. (JMS)

Decisions on Downstate Contracts:
Downstate (everything outside of Cook) issues were discussed and decided. Downstate caseload ratios in HMR and Traditional will go to 19:1. The current bonus system will remain. DCFS made a commitment to address concerns about referral patterns. Referrals will be based by program site on some type of rotational system consistent with an agency's size, permanency and stability performance relative to the rest of the system, and ability to respond to language needs of a case. Add-ons remain the first intake priority (DCFS estimates these to be 20% of intake downstate is from add-ons.) Case transfers are estimated to comprise another 10% of the intake for agencies. A key challenge is how to assure agencies receive new cases more quickly in order to set the tone for future stability right away. The Downstate Work Group due to meet on May 18 will discuss these issues and work to formulate recommended guidelines for a rotational referral system. DCFS staff will work on tracking the individual performance by agency site and field office. DCFS again expressed concern about the performance of certain sites in multiple-site agencies but agreed that discussions with agencies and decisions about contract levels or caseloads in those sites should be a DCFS responsibility. They will be getting in touch with the agencies directly.

Decisions on Cook Contracts:
Various Cook issues were discussed and decided. Caseload ratios in Cook Traditional will go to 20.5:1. This is not a recalibration but is a rate calculation dividing the starting caseload by the 20.5 ratio. (done in the same way as when HMR was brought from 25 to 22.5.) Transfers across programs over the last year will be counted the same way as usual during the reconciliation process. Decisions about agencies that are not performing and the level of performance at which such decisions will be made belong to DCFS. The proposed HMR recalibration system to bring HMR caseloads to l8:1 still remains as described in last week's Monday Report. The protocol for transfer or intake hold decisions for agencies in the HMR downsizing mode as described in last week's Monday Report was accepted with one modification. Agencies will be strongly encouraged to keep cases and drop out of intake until they reach their buydown level. If an agency through its business planning processes wants to deviate from this preferred process, the agency will need to seek approval from the department on the mechanism for transferring cases.

Decisions Pertaining to all Contracts: Downstate/Cook HMR and TFC:
DCFS stressed repeatedly throughout the discussions their concern that responding to private sector requests for lowered caseload ratios represents an incredible investment for the state. DCFS will thus demand assurances that the funds being infused into the private agency programs for reduced caseload sizes actually are spent on casework staff in the individual programs for which the funds are targeted. Resources must stay within the program they are intended for. DCFS proposed the wording of contract language that specifies that excess revenue counts within a contract. Excess revenue in one program cannot be used towards another like program. DCFS also proposed that agencies submit detailed staff matrices and budgets to show they are reflecting this expectation in their planning. They continue to cite their concerns about agencies with egregious financial situations in which funds paid by DCFS for the use of caseworkers in a program are spent on other items while caseloads in the agency remain unacceptably high.

After much debate, the group defined the issue as one of expectations with penalties for not meeting expectations. The expectation will be that the investments made in caseload ratio reductions for specific programs are used for that purpose. This will be monitored closely. Agencies that fail to sustain the required caseloads within a normal range of deviation will be subject to department sanctions, which can include financial penalties. A small group out of CWAC Finance and Administration will develop a set of guidelines on this issue and work with DCFS to define what is the "normal range" as well as a reasonable mechanism for monitoring.

DCFS proposed that another element of the reinvestment strategy is promoting the goal to reach One Worker per Family by the end of FY'01. There were a number of issues raised by the private agencies as to why this may not be a feasible goal in all cases. The issue was finally redefined as a goal to establish one worker/or team within a geographic area and agency per family. Agencies will need to work diligently to assure accountability for family work and case coordination when a case remains split across agency programs. This goal and agencies moving toward this goal as well as systemic issues will be monitored via the 2 performance based work groups with a specific status discussion at mid-year.

Language in all contracts that indicates DCFS' acceptance of instability and disruption (i.e. non-permanencies) will be removed from the contracts. Federal studies due out soon criticize DCFS for high instability rates. Having such language appears to be promoting this. Private agency members concurred with the overall view. From a practical standpoint the issue of a non-permanency measure is no longer valid in Cook since agencies are only going to have permanencies replaced in intake anyway. Downstate is also not practically affected since they are on a per diem basis. Downstate agencies have already started discussion of definitions of stability. The main issue of concern from the private agencies relates to referral replacement of neutral outcomes that go to ILA. DCFS expressed willingness to further discuss some recognition for agencies that are able to secure true independence for older children in care. This will be discussed in future meetings.

Post-permanency support funds will be added to all contracts. Agencies will be asked to provide post-adoption and post-guardianship support for the families, which have gone to permanency. Such support may be in the form of support groups, or referrals to community services. The goal is to intervene in fragile permanency situations early in order to avoid disruption later. The total funds available for this statewide are $750,000 so the contracts for each agency will be small and based on size. The range will go from $4000 to $60,000. Agencies with very small caseloads will be expected to cluster efforts with other agencies in their area in order to maximize effectiveness of the contract. Although the program language for this is not yet final and the work group expected additional questions as a result, the group voiced support for this contract addition and its goal of supporting permanencies.

The Infrastructure Work Group will meet via teleconference in 2 weeks to confirm all changes. DCFS will work to change language on all contracts so these can be reviewed quickly by the group and contracts can be processed. The 2 performance work groups and Finance and Administration sub-group will work on the assignments noted and provide reports back to the overall group. If all goes well, agencies should expect to see new contracts out by the end of May, with a brief turnaround time. All contracts should then be on-line by early July in order to assure no lapse in payment.

Although the system changes are still not at the ideal goals of 15:1 for all programs, and there are still concerns about DCFS' philosophy on excess revenue, we feel substantial progress has been made with DCFS in establishing a better set of programs/contracts for FY'01. We established as fair a system as possible within existing resources for caseload size and assignment, recognition of performance, and planful recalibration given the current child welfare conditions of massive system shrinkage. The addition of post-adoption/guardianship support responds to concerns raised repeatedly by our agencies. There is still much to be worked on over the next year. We can also predict that DCFS will face increased legislative scrutiny of its budget next year, so pressures are upon us to demonstrate how lowered caseloads make a difference. There is also a significant pressure for agencies to reduce turnover levels and secure competent staff. However, we feel we should claim victory for the contract changes made for FY'01. Thanks to CCA members of the Infrastructure Work Group for their hard work on these efforts: Arlene Happach, Tricia Fox, Erwin McEwen, George Thibeault, McGregor Jones and Sharon Bourne, Olivia Delguidice, Marty Sinnott and Greg Kurth, Elizabeth Richmond, Joe Loftus, Bill Gillis and Frances Pace Barnes.

NOSAC STATES TO MEET WITH JIM WHITTAKER
A number of the NOSAC (National Association of State Association for Children) states will be meeting this week with Jim Whittaker, nationally known expert on residential treatment services. Jim is one of the premier leaders in the field of residential services--we have had Jim out to Illinois several times over the years and are looking to have him conduct a workshop for us sometime in the near future. We will be spending Friday with Jim in an examination of the current state of residential services, the new realities facing the field of residential care, changes and modifications that may need to be made, and how we might develop some collective processes to address these issues. It should be a helpful and productive day. (RHM)

CWLA MIDWEST PUBLIC POLICY COMMITTEE
The CWLA Midwest Public Policy Committee met in Chicago on May 4 and 5, 2000. The agenda included a report from each state on relevant issues that are impacting service delivery for children's services in their state. A report was also provided from Karabelle Pizzigati from the Washington Policy Office for CWLA on the status of legislation in Washington. Reports were also given from the Welfare Reform committee and the State Rules committee. Karabelle reported on the introduction of the Child Protection and Alcohol and Drug Partnership Act. (Further details about this bill are in the following article.) It was also reported that the Juvenile Justice legislation was not going anywhere in the absence of a compromise on the gun issues. CWLA will continue to monitor this piece of legislation.

There is a strong indication that there is bi-partisan support for the Title IV-E training issue and there are efforts to locate the dollars to fund it. There are some vehicles in place where the legislative change could be made to allow equal access to the training dollars for private agencies. All states were encouraged to contact Senators and Representatives and highlight the training equity and note that there is both public and private support to say it is important to move forward with this. Senator De Wine from Ohio has introduced a bill to improve access to resources for Court Services. This could be expanded to include the Title IV-E training funding for private agencies. Points of support for arguing the issue include: 1.) It will help meet the goals of AFSA; 2.) It will provide a quality workforce and quality services; and 3.) It will assist in meeting the obligations of being held accountable for service delivery and fiscal requirements.

With regards to the Restraint and Seclusion legislation, there appears to be more opportunity to change the language in S. 976 which passed the Senate last fall. The legislation still needs to be considered in the House. Conversations are continuing on what is appropriate practice without requiring a physician sign off. The restraint and seclusion language is part of the SAMSHA reauthorization which will eventually move forward. If SAMSHA legislation did not pass this year then there would be need for a whole new bill. It was also reported that the HCFA rules on restraint and seclusion will also be out soon. Other legislation on restraint and seclusion are off the table.

A program instruction on the Independent Living Legislation has been issued. State agencies must apply for the funding by June 30, 2000 and will probably use a shortened version since plans have already been submitted for independent living services. Most states will receive an increase in funding. As was reported previously Illinois will be receiving $8,527,488.

Northwestern University made a presentation on the welfare reform project that they are conducting. They will be holding focus groups with child welfare workers and conducting interviews. They will be working with the Welfare Reform committee of the Public Policy Committee. The goal is to review the impact of welfare reform on child welfare. (JMS)

CHILD PROTECTION AND ALCOHOL AND DRUG PARTNERSHIP ACT (S.2435)
CWLA reported at the Public Policy Committee Meeting that the Child Protection/Alcohol and Drug Partnership Act of 2000 was introduced and would create a grant program to promote joint activities among Federal, State and local public child welfare and alcohol and drug abuse prevention and treatment agencies to improve child safety, stability, and permanence for children in families with drug and alcohol problems, as well as promote recovery from drug and alcohol problems. Child welfare agencies estimate that only a third of the 67% of the parents who need drug or alcohol prevention and treatment services actually get help today. This bill builds on the foundation of the Adoption and Safe Families Act of 1997 which requires States to focus on a child need for safety, health and permanence. The bill creates new funding for alcohol and drug treatment and other activities that will serve the special needs of these families to either provide treatment for parents with alcohol and drug abuse problems so that a child can safely return to their family or to promote timely decisions and fulfill the requirement of the 1997 Adoption Act to provide services prior to adoption.

S. 2435 offers $1.9 billion over five years to state child welfare and AOD agencies that agree together to take steps to develop and increase treatment services, establish appropriate screening and assessment tools, or improve strategies to engage and retain parents in treatment. The activities must be directed to families with AOD problems who come to the attention of the child welfare system. Agencies also can use funds to increase capacity to meet these families needs in a timely way by jointly cross-training child welfare and AOD staff, improving data to track progress in these families, and to promote evaluation. S. 2435 holds states accountable for demonstrating the progress they make with these funds. (JMS)

FEDERAL GRANTS
Funding is available from the Administration for Children and Families within DHHS for Adoption Opportunities and Abandoned Infants Assistance. Areas covered from these funds are: 1.) Adoption: Grants to create a network of parent support groups for foster parents, adoptive parents of children with developmental disabilities or special needs and relatives caring for kin in foster care. 2.) Abandoned Infants Demonstration Projects: Grants to set up comprehensive service demonstration projects. 3.) "New start" comprehensive services demonstration projects for abandoned infants. 4.) Family Support Services for grandparents and other relatives caring for children and substance-abusing and HIV-positive women. Deadline for submission is June 12th. For applications call (800) 351-2293 (refer to Program Announcement No. ACF/ACYF/CB FY 2000-01) or online at http://www.acf.dhhs.gov/programs/cb. (JMS)

1999 TRANSFER OF TANF FUNDS TO TITLE XX
It was reported by the American Public Human Service Association in This Week in Washington that States transferred an average of 6%, or $1.028 billion of their $16.7 billion TANF block grant into the Social Services Block Grant (SSBG) in 1999. In FY 2001, states will not be able to transfer more than 4.25% of their TANF funds into SSBG due to the restriction enacted as part of the 1998 Transportation Equity Act. During FY 1999 transfers made by states ranged from the maximum of 10% to some states that did not transfer TANF funds. As a result of this new restriction, 34 states will be required to change their future transfer policies regarding SSBG. (JMS)

FREE TECHNOLOGY TRAINING
I was recently invited to check out a new training facility in Peoria called New Horizons. They are using a "try us first" approach in showing off their state of the art training center. I was really impressed and have now considered using them for my own private network certification. They are offering a coupon good for any 1-day class in their brochure. For executives, it would be a great way to learn Outlook or PowerPoint. For your staff, I though it would be a great free way to learn the basics, intermediate, or advance use of Word 97. The first class is completely free with no obligations for further classes. I want to re-emphasize how clean and advanced the training facility is at the Peoria site. I went recently for a one day HTML class and the instructor was very helpful and thoroughly professional. Again, this is a free way to learn something useful and they also get the recognition they rightly deserve as a premier mid-state training institution. Call Randy Webb at 309-692-1400 to see if you can take a class or if there is a New Horizons near your area.

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