MONDAY REPORT

March 4, 2002

SPECIAL NOTE:  Copyright 2002. The Monday Report is produced each week as a benefit to the member agencies 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.

Table of Contents

CHILD WELFARE.. 2

FOSTER CARE INFRASTRUCTURE REPORT. 2

UPDATE ON SPECIALIZED AND PERFORMANCE BASED PROGRAMS.. 2

SPECIALIZED FOSTER CARE.. 2

COOK PERFORMANCE CONTRACTING DIRECTIONS.. 2

DOWNSTATE PERFORMANCE CONTRACTING ISSUES.. 3

HMR LICENSING REQUIREMENTS.. 3

ADOLESCENTS.. 3

FEDERAL OUTCOMES.. 3

EDUCATIONAL OUTCOMES.. 4

FEDERAL PREPARATORY REVIEWS.. 4

ITS/PLACEMENT STABILIZATION.. 4

COOK PERFORMANCE BASED WORK GROUP REPORT. 4

�        ERC/DCP Issues. 4

�      APT Issues. 4

�        FY02 Mid-year Reconciliation Timeline. 5

�        HMR Licensing- Independence Facilitation Grants. 5

�        Agency Closure. 5

�        AODA Reconciliation  5

�        Infrastructure Meeting Update. 6

�        Court Performance  6

�      Next Meeting. 6

DOWNSTATE PERFORMANCE CONTRACT MEETING.. 6

PRESIDENT BUSH�S WELFARE REFORM AGENDA.. 6

MENTAL HEALTH.. 6

OFFICE OF MENTAL HEALTH BUDGET BRIEFING.. 6

COMMUNITY HEALTH AND PREVENTION.. 7

GENERAL.. 8

CWAC MEDICAID WORKGROUP.. 8

�        Suspension, Termination and Appeal Procedures  8

�      Post Payment Reviews. 9

�        Additional FY01 Billing Runs for Comp Programs  9

�        Certification of Campus-Based Programs  9

�      Roy Miller�s October 30^th Letter to Providers  9

�      45 Day Pre and Post Billing for FFS Contracts  10

�        Level of Care  10

MEMBERS IN THE NEWS.. 10

SOCIAL HISTORIAN SPEAKS TO LCFS STAFF.. 10

HELPFUL WEBSITES FOR PUBLIC POLICY AND ADVOCACY. 10

UPCOMING EVENTS.. 11

Calendar: 11

FOSTER CARE INFRASTRUCTURE REPORT

UPDATE ON SPECIALIZED AND PERFORMANCE BASED PROGRAMS

The Foster Care Infrastructure Committee met in Joliet on February 28. Highlights included:

SPECIALIZED FOSTER CARE

COOK PERFORMANCE CONTRACTING DIRECTIONS

These issues will all be discussed in more detail at the next meeting.

DOWNSTATE PERFORMANCE CONTRACTING ISSUES

HMR LICENSING REQUIREMENTS

DCFS intends to add contract language to all HMR contracts related to licensure of relative placements. The state stands to lose up to $50 million as DHHS enforces its current regulations on levels of reimbursement for unlicensed placements. Currently, 2200 homes remain unlicensed. With recent initiatives, 1500 of these homes had an intensive discussion on licensing in recent months, yet only 100 actually submitted a licensing application. The group discussed how to add language about reasonable efforts to obtain licensure for a home.

ADOLESCENTS

The current double credit for permanency for adolescents is causing contract problems. (Agencies may have hit the 33% mark but have more remaining kids in placement.) DCFS proposed that since the double credit has not significantly increased permanencies for adolescents, it should be eliminated. This issue will be revisited as the group reviews the 33% permanency requirement in HMR.

FEDERAL OUTCOMES

DCFS proposes leaving contract language the same in these areas on the next contract.

EDUCATIONAL OUTCOMES

DCFS will implement contractual language specifying educational outcomes required. A small group will work with DCFS staff to draft this language for consideration of the group.

FEDERAL PREPARATORY REVIEWS

DCFS will add language requiring all agencies to participate in the preparatory reviews for the federal audit and to implement the regular internal case audits. DCFS agreed to gather more information from downstate areas on the ability of agencies to obtain court dates and reports for certain cases that customarily have not been regularly reviewed by the court.

ITS/PLACEMENT STABILIZATION

DCFS is still looking internally at the future use of these programs. The group suggested a further review of how to assure ITS was uniformly available in all areas of the state was needed.

The Infrastructure group will meet again in April to follow up on the pending contract issues, Downstate rotation/intake issues and Cook HMR issues. (MB)

COOK PERFORMANCE BASED WORK GROUP REPORT

The PBC Work Group met on Wednesday, February 27th at LSSI 10 West 35^th Street.  Discussion focused on:

�        ERC/DCP Issues

DCFS discussed the Cook South Supervisors meeting held on 02/22. Discussion focused on concerns Intake Staff have in terms of obtaining vouchers, medical cards, etc. Some of the supervisors from South reported that workers would ask for vouchers and then never come to pick up the voucher. Bob Trine from Cook North reported that nearly 40% of the vouchers he issues never get used.  Mary Ellen and Kara have been working together to receive invites to the supervisor meetings held at Cook North and Cook Central as well.

�        APT Issues

Treva discussed the letter that went out to agencies to invite them to the 3^rd Administrative Case Review/Agency Performance/Private Agency Informational Session on March 7, 2002 from 9:30 to 12:00 at the DCFS office located at 15115 S. Dixie Highway in Harvey. Topics of discussion will include:

o       Overview of Purchase of Service/Agency Performance team

o       Emergency Residential Center (ERC)

o       Court

o       Case Consolidation

o       Purchase of Service/Agency Performance Initiatives i.e. AODA, ILO, Foster Care, HMR II

***Registration begins promptly at 9:00am

�        FY02 Mid-year Reconciliation Timeline

Reconciliation materials were mailed to agencies the week of February 18th. Additions/Deletions are due back by the close of business day on Wednesday, March 6^th. Materials should be mailed to:

                                    IDCFS

                                    Office of the Executive Deputy Director

                                    Attn: Kara Teeple

                                    100 West Randolph 6-100

                                    Chicago, IL 60601

Stability case lists were also included in the materials. Positive Outcomes for adolescents a big change in this process. Please look closely at your neutral lists to ensure accurateness of data. If a child steps up to Specialized or Treatment level (FHT) but remains with the same provider, this is considered a Neutral Outcome. Please look at the Negative Outcome list to ensure that the step-ups with the same provider are deleted from this list and added to the Neutral Outcome list.

AFCARS data is not updated so please look closely at the cases that are out of compliance. Paper AFCARS copies or printouts of the CM-46 and CM-47 screens may be sent in to verify compliance. We apologize for this inconvenience.

�        HMR Licensing- Independence Facilitation Grants

A letter went out to HMR Permanency Coordinators on 2/21/02 that included the listing of all children currently with unlicensed caregivers who may be eligible for an Independence Facilitation Grant. This is a one-time only grant made possible by funding provided under the Federal Foster Care Independence Act. Children must be between the ages of 14 and 18. Youth in this range that are adopted or enter a subsidized guardianship before June 30, 2002 will be eligible. The Independence Facilitation Grant consists of six monthly payments to the child of $500 each upon the child�s emancipation, or, if the child does not emancipate by age 20 1/2, DCFS will commence payments at age 20 �.  Please contact June Dorn at (312)814-6858 if you should have any questions.

�        Agency Closure

Discussion was held on distribution of cases transferred as a result of an agency closure.  Cases were distributed based on referral needs and geography. Agencies picked up the family and child files on Tuesday, January 19^th. APT will now be contacting agencies to pick-up the licensing files. APT is working to locate any missing case volumes or materials.

�        AODA Reconciliation

The majority of agencies Statewide submitted the AODA Reconciliation materials by the deadline of 01/31/02. The information will be forwarded to our AODA internal unit to follow-up on cases in which parents need AODA services and are currently not in treatment. The next AODA Reconciliation period will occur in July.

�        Infrastructure Meeting Update

Marcia reported that the group is meeting again on 02/28/02. Discussion has focused on Specialized Foster Care and whether to move towards standardized program plans. Performance discussion to occur in future meetings.

�        Court Performance

Much discussion focused on adoptions and length of time in getting to screening and the variation in what is approved for the subsidy rates. Anne Barclay of CHASI is heading up a court committee and the group met after the workgroup meeting to go over concerns. The �Watch List� Protocol was distributed which details the course of action when POS and DCFS agencies receive negative court reports and no show reports.

�        Next Meeting

The next meeting will be held on March 27th^th, 2002 from 9:30 � 12:00 at LSSI,

10 West 35^th Street (IIT Building) on the 15^th Floor.  There is parking across the street and the Green El Line also is conveniently located across from the building. Contact Marcia Weflen of LSSI at (847) 635-4623 if you should have any questions or if you would like to add items to the agenda. (Our thanks to Kara Teeple of DCFS for sharing meeting minutes with us. MB)

DOWNSTATE PERFORMANCE CONTRACT MEETING

The Downstate Performance Contract meeting with DCFS is scheduled for 1:00 p.m. on March 13^th at 628 E. Adams in Springfield.  Tricia Fox, Catholic Social Service in Peoria is taking Marge Berglind�s place as Private Agency Co-chair. Tricia would like to meet with any interested private agencies at 11:00 a.m. at the CCAI office, 300 E. Monroe, to set the private agency agenda for future downstate meetings and prioritize issues for discussion. (MB)

PRESIDENT BUSH�S WELFARE REFORM AGENDA

The following is the Internet link to information about the President's welfare reform agenda that was announced on 2/26/2002:

http://www.whitehouse.gov/infocus/welfarereform/ (MB)

OFFICE OF MENTAL HEALTH BUDGET BRIEFING

The Office of Mental Health within DHS held statewide budget briefings through their regional networks statewide on Tuesday, Feb. 26, 2002.   It was reported that the overall shortfall for the state for FY02 was $750,000,000.  As was reported previously, the DHS reduction for FY02 was $111,800,000.  This included hiring restrictions, travel restrictions and furlough days by state employees.  For FY 03 DHS had to take an additional reduction of $66,484,300.  For the Office of Mental Health, the FY02 total budget was $615,443,500 split between community ($318,852,100) and State Hospitals ($278,615,400).  For FY 03 the total budget was $595,093,600 with $325,197,500 for community services and $249,693,400 for State Hospitals.  The Office of Mental Health had to cut $20 million for FY03.  In looking at the $20 million reduction needed the Office of Mental Health set as a priority to preserve community service and restructure the state operated facilities.  

State hospitals will see approximately a $30 million reduction from FY02.  Elgin will be downsizing, which will result in a $12.1 million decrease.  Zeller will be closing, resulting in a $15.4 million reduction from FY02.  Targeted layoffs with the state hospitals will also result in a reduction of $3 million.  $16,141,000 of these reductions will be reinvested in the community for those regions.   Adding back in the pay increases for AFSCME results in $28 million reduction for state hospitals.

If the $20 million in FY03 cuts would have been applied across the board, all service providers would have received approximately 6.27% reduction.  Priorities used in determining the cuts included:

Following shows briefly $20 million in cuts that were made to the Office of Mental Health.

1.) $3,000,000                Family Assistance Program/Home Based Services   

2.) $4,893,000                Targeted (See above)

3.) $12,000,000              Across the Board Cuts to all adult programs for 5.547%

Some adult service programs may not see reductions if they are in the regions where Zeller and Elgin are located.  There was additional discussion about agencies looking to cut those program areas where fewer non-eligible clients may be receiving services.  Eligible populations re defined as: 1.) most seriously ill; 2.) Medicaid; 3.) Coming from restricted setting.  (JMS)

COMMUNITY HEALTH AND PREVENTION

Within the FY02 and FY03 budgets for Community Health and Prevention, the Teen REACH program received a reduction both in FY02 and FY03.  The amount in FY02 was unobligated funds that had not been allocated to current agencies so the FY02 reduction would not impact current programming.  The FY03 reduction of almost $1 million represents a 9% reduction in services.  DHS is in the process of a competitive RFP process for FY03, which could result in less funding to programs if the proposed budget amount remains.  There are currently 84 providers that receive Teen REACH.  Ten of those providers just received funding through a competitive RFP process during 2001 so have a three-year commitment for funding.   All other programs will be involved in the RFP process.  The average amount of funding to a program is $200,000; however, applications will be acceptable above that amount if they can be defended.

Project Success basically received 9 months funding for 12 months in FY02.  All programs had received an initial 3-month continuation at the beginning of the year due to the confusion of the funding for the program in the legislative budget process.  An RFP process was issued for continued funding for the remainder of the year.  In order to expedite the amendment process, 3-month funding obligations were done for the remaining 9 months.  Although agencies had a 9 month contract following the RFP process 9 months of funding had not been obligated; therefore, with the problems in the FY02 budget the last quarter of the Project Success program had remained unobligated and was identified as part of the DHS cuts.  For FY03 Project Success was eliminated from the budget.  When asked if this was based on program results or outcomes, it was indicated that many programs had begun to build on what is already in the community and some through 21^st Century funding in order to continue those collaboration efforts.   (JMS)

CWAC MEDICAID WORKGROUP

A follow up to the previous Medicaid Committee report, which included discussions around SACWIS and HIPAA, includes the following additional agenda items: suspension, termination and appeal procedures; post payment reviews; additional billing runs for FY01; certification of campus-based programs; letter from Roy Miller; 45 day pre and post billing; and levels of care.  The next meeting of the Medicaid group will be Thursday, April 11, 2002 from 10 to Noon at St. Joseph�s Carondelet in Chicago.

�        Suspension, Termination and Appeal Procedures

At the last Medicaid workgroup meeting there was discussion related to the suspension, termination and appeal procedures.  DCFS had been working with DHS to propose an amendment to Part 132 so that appeals linked with DCFS Medicaid issues will be submitted to DCFS.  Part 132 currently states that all appeals under Part 132 must be submitted to DHS.  When CWAC Medicaid Advisory Workgroup members met on October 24^th to discuss suspension, termination, and appeals, it was thought that DPA would be in charge of all Medicaid appeals and hearings.  It now appears that DCFS will need to establish a process for these appeals and hearings when DCFS takes action under Part 132.  In looking at the related time frames, it was agreed that for Tier 3 findings the 30-day warning would be dropped so they would have 60 working days versus 90 days to correct the problems or would be terminated from Medicaid.  Tier 3 findings relate to the most serious level of problems with 50% of billings unable to be validated.

Issues that continue to need to be addressed: maintaining client safety and well-being during the suspension period; releasing Medicaid claims that may still be vulnerable; developing and implementing a DCFS process for Medicaid and appeals and hearings; ensuring that there is a clear delineation between Medicaid issues/procedures and Non-Medicaid issues/procedures; notifying applicable people/offices/agencies regarding Tier 3 findings and other serious concerns; ensuring that providers are aware of who will be notified about what issues.

�        Post Payment Reviews

Under the most recent proposed framework, the scope of post-payment reviews is tied to the most objective and quantifiable Medicaid requirements.  There was discussion about the use of extrapolation and making Comp service providers with Tier 3 billing problems to revert to fee for service billing.   The workgroup concluded that neither extrapolation nor reverting to fee for service billing would solve the problem with bad billing.  Instead, providers that have Tier 3 findings should be suspended and then if necessary terminated from Medicaid.  In addition, DCFS needs to establish a system for transitioning clients from poorly performing programs to programs that meet expectations.

�        Additional FY01 Billing Runs for Comp Programs

DCFS intends to have an additional FY01 billing-processing cycle in February to see which Medicaid billings currently in the system can be claimed.  The focus will be on Comp services providers who have already been paid for services, but there were insufficient accepted billings to justify those payments.  Comp providers already receive a 5% grace in billing shortfall/errors.  This should cover instances of 906 problems that the provider was unable to resolve through ordinary means as well as other difficulties that arise.  For FY02, the 5% grace should also cover days that the provider does not bill because no service was provided.  So far, the preliminary data indicates that the number of Comp providers below the 95% accepted billing threshold is lower than in previous years.  Some of these providers may reach the 95% accepted billing threshold after the February billing run.  Providers who are still below the 95% after further contacts have been made to make corrections will be liable for repayment to DCFS.

�        Certification of Campus-Based Programs

Some providers have campus-based programs with only one address/building on the Medicaid certificate.  Other providers have campus-based programs with all of the individual buildings/cottages listed on the Medicaid certificate.  In checking with DHS, each individual building/cottage on the campus must be certified and must appear as a separate entry on the Medicaid certificate.  The Infant Parent Institute will be checking the records and then working with providers to get the expected entries on the Medicaid certificates.  For certain providers the documentation for getting the individual buildings/cottages on the Medicaid certificate is already on file and only needs a corrected Medicaid certificate.  For other providers, documentation will need to be collected to certify or re-certify the individual buildings/cottages on the campus.  This ties to the appropriate enrollment numbers by DPA for billing.  There are concerns that a DPA or HCFA audit could question billings submitted under the wrong DPA enrollment number.

�        Roy Miller�s October 30^th Letter to Providers

The expectation is that providers will bill only when a Medicaid service has been provided.  For Comp providers this means that there must be a link between program and billing so that the billing staff knows which days should not be billed through MBS.  However, the expectation is that Comp providers will provide at least one Medicaid services for each client per day � even when the client is away from the placement.

�        45 Day Pre and Post Billing for FFS Contracts

Some providers are finding that the 45-day period for pre and post FFS billing is not sufficient to meet expectations for service delivery.  For example it typically takes much longer than 45 days to receive approval for Independent Living.  Also if a child is moving from residential to foster care, it often takes longer than 45 days to address all of the transition issues.  The 45-day pre and post is not established in Part 132.  The parameters for pre and post Medicaid billing are found in DCFS memo, so DCFS will be evaluating those parameters.

Providers are also reporting problems with rejected billings after clients have been discharged.  When providers have rejected billings that cannot be resolved through ordinary steps they should forward information to Stephanie Hanko at DCFS. 

�        Level of Care

A copy of a letter was distributed that will be mailed to all Medicaid foster care providers.  The letter instructs Medicaid foster care providers to indicate on the front of Levels of Care form that an admission to Medicaid program is being requested.  The goal is to facilitate quick processing of these Levels of Care.  (JMS)

MEMBERS IN THE NEWS

SOCIAL HISTORIAN SPEAKS TO LCFS STAFF

Lutheran Child and Family Services kicked off National Professional Social Work Month by inviting Rima Schultz to give a presentation on "Jane Addams: Social Work Pioneer."

Ms. Schultz, a senior research associate at the Center for Research on Women and Gender at the University of Illinois at Chicago, provided LCFS employees with a glimpse into Jane Addams' world, which was one of limited social supports, and which was addressing the issues of industrialism and labor laws. Addams, the founder of Hull House on Chicago's West Side, was a "founding mother" of the social work movement in the late 1880s.

Schultz, the editor of Women Building Chicago: 1790-1990 (Indiana University Press) was able to draw from her store of knowledge as she described how Addams' work affected the jobs that each LCFS employee does today. For example, an LCFS data analyst learned that, long before the computer era, Jane Addams started gathering statistics on the population she served in order to allocate resources more efficiently.

LCFS provides services to children, families and communities at more than 30 sites throughout Illinois.  (LLL) 

(To submit your agency�s news for The Monday Report, send to Linda Lenzini, Director, Marketing and Public Relations, at the Child Care Association. MSWord e-mail attachments for information and JPG�s for pictures are preferred.)

HELPFUL WEBSITES FOR PUBLIC POLICY AND ADVOCACY

Building Blocks for Youth at http://www.buildingblocks.org offers a number of resources for a fair and effective youth justice system. Among these resources is a downloadable PDF document, �Public Opinion on Youth, Crime and Race: A Guide for Advocates.� The guidebook, authored by Mark Soler, President of the Youth Law Center, dashes some common misconceptions about juvenile crime and provides recommendations about messaging for advocates. . To obtain a complete list of helpful websites for advocacy, contact Linda Lenzini, Director, Marketing and Communications, at [email protected] )

Calendar:

March 5 - �Discipline of Students with Special Needs in Illinois,� Bev Johns, Gary Kerr,

                 Springfield IL, register by phone:715-833-3959

March 8-9 � 2002 Spring Foster and Adoptive Parent Conference��Every Child is a Success

                     Story.�  Crowne Plaza Hotel, Springfield.

March 12 � CWAC SACWIS Advisory Committee

March 20 � CCAI�s Board Meeting and Leadership Dinner, The Hyatt Lodge, Oak Brook

March 21 � CCAI�s Spring Membership Meeting, Hamburger University Conference Center,

                   Oak Brook

May 3 - Learning Disabilities Association of Illinois Spring Workshop, featuring Reed Martin,

             Special Education Attorney, Holiday Inn, Naperville, (708) 430-7532

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