CCA: Monday Report 04-01-02

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.

The Workforce Summit sponsored by the Child Care Association of Illinois, Uhlich Childrenï¿½s Home, Childrenï¿½s Home Association of Illinois and Childrenï¿½s Home and Aid Society of Illinois provided a unique opportunity for 39 participants to exchange ideas and develop future strategies.

The summit opened with greetings sent by Congressman Fortney Pete Stark, chief sponsor of the Child Protection Services Improvement Act. Statement by Representative Pete Stark to the Child Welfare Workforce Summit in Chicago, Illinois:

ï¿½I regret that I'm unable to join you today at the Child Welfare Workforce Summit. I applaud the Child Care Association of Illinois, Children' s Home and Aid Society of Illinois and Uhlich Children's Home for sponsoring this event and I appreciate the opportunity to send this greeting.

Thank you to all the groups present for your work on this important issue of improving the quality of Illinois' child welfare workforce. Child welfare workers perform a critical service to our most vulnerable children. These children need the committed, trained help of our best child welfare workers. All too often, however, we lose child welfare workers because their caseloads are too high and they don't earn enough money to pay their bills. Replacements for these positions are hard to find and many candidates are not qualified to do the job. This situation puts the safety and well being of our most vulnerable children at risk.

Last year, I introduced the Child Protection Services Improvement Act, which I believe would help alleviate some of these problems. My bill provides education loan forgiveness for child welfare workers that have worked for an agency for at least two years. In addition, the bill provides states with $500 million in matching grants over five years to improve the quality of their child welfare workers. States can use these matching grants:

ï¿½ attract and retain qualified candidates and coordinate services with other agencies

These dollars can also go to private welfare agencies at the states' discretion.

This issue needs to be addressed now to help the 568,000 children in our foster care system who have suffered from abuse and neglect. A joint survey by the Child Welfare League of America, the American Public Human Services Association and the Alliance for Children and Families reported that child welfare agencies are facing a workforce crisis. The study found the average staff turnover rate for child welfare caseworkers is 19.9% in public agencies and 40% in private agencies. The study also found that child welfare workers left the field because their caseloads were too high and their salaries were too low. Nearly half of the welfare agencies report difficulty in finding and retaining qualified candidates for these positions.

I wish you all the very best as you wrestle with these difficult issues. Thank you once again for the opportunity to address this summit. I look forward to continuing to work with you to improve the lives of our nation' s children.ï¿½

Keynote speaker, Dr. Andrew Reitz of the Walker Trieschman Center of CWLA provided a national perspective on the workforce crisis in child welfare and identified 3 key areas for enhancing the field: increasing salaries, improving training and career options and improving public perception.

A panel of human resource and program experts including Muriel Barnes, Center for Childrenï¿½s Services; Marjory Kostoglanis, Uhlich Childrenï¿½s Home; and Jennifer Streitmatter, Childrenï¿½s Home Association of Illinois shared the challenges associated with recruitment and retention of staff from agency perspectives.

A panel of legislative experts shared their perspectives on how to promote awareness of the workforce crisis for federal and state legislators. Panelists included Ra Joy, District Director for Congresswoman Jan Schakowsky; Sal Serna, Labor Issues for Congressman Luis Gutierrez and Pat Horne, Legislative Director for State Representative Tom Dart. All panelists stressed the need for continuous contact with legislators, and continuous provision of information in concise ways on the problem. It is important to obtain numerous sponsors in both parties in both houses to successfully pass legislation. If more legislators are aware of the problem prior to being asked to co-sponsor a bill, it becomes easier to attain interest. It is important for local agencies to keep in contact with the press, including op-ed pieces and stories about impacts of agencies in communities or impact of legislation. These stories if printed can then be forwarded to the state rep/senator or senator/congressman to highlight the issue and highlight the concern of the press on the issue. The panelists also encouraged agencies to ask elected officials and their staff aides to serve on boards of directors or advisory boards of agencies. This provides first hand knowledge and experience about the problem for elected officials.

The day concluded with a discussion of how agencies can follow up on the key issues identified in the summit, including preparing op-ed pieces for local papers.

We encourage any member agency with programs, offices, staff or clients in the areas served by Representative Dart, Congressman Gutierrez or Congresswoman Schakowsky to write a letter of thanks for assisting us in this summit.

v We urge all member agencies to contact their Congressman and ask them to co-sponsor the Child Protection Services Improvement Act (HR 1371). We also urge you to contact Senators Durbin and Fitzgerald and ask them to consider sponsoring companion legislation in the Senate. You will notice that the legislation specifically mentions private agencies as key participants in any benefits. As you contact elected officials, it will be helpful to present the specific work force challenges faced by your particular agency. If any agency needs assistance in preparing such information, they can contact Linda Lenzini in the Springfield CCA office.

Please forward a copy of any press coverage you receive as a result of your efforts or any correspondence to federal officials. CCAI will be following up with our Congressmen and Senators and would like to be able to reference this material.

Additionally, watch CCAI correspondence for information relating to state legislation pertaining to the workforce issue. We are still working with Representative Dart to attempt to obtain state legislation that would provide Illinois state loan forgiveness for child welfare workers.

CCAI distributed a Press Release on the event to all major media outlets. A copy of the release can be obtained by contacting the CCAI Springfield office or visiting our web site. (MB)

Following the completion of the 2002 Olympic Winter Games in Salt Lake City, Gateway will donate up to 4,500 computers.

Grant consideration is limited to eligible organizations recognized by the Internal Revenue Service as a nonprofit entity, with priority given to schools and community centers whose programs help enhance access to technology for traditionally underserved communities.

These systems were supplied to the Salt Lake Organizing Committee for use during the 2002 Olympic Winter Games to track official event results, statistics and standings for athletes, coaches, spectators, officials, and the media. Any organization interested in being considered must complete an online application; faxed or written applications will not be accepted.

The application will be posted on Gateway's web site from April 2 to July 31, 2002. For additional information, or to fill out a form for notification about Gateway's Olympics PC Donation Program when it becomes available in April, please access the following website: http://www.gateway.com/olympics/donations.shtml.

The Downstate Performance Based Work Group met in Springfield on March 13. Topics covered were:

(See Monday Report of March 4 for a complete summary. ) Issues pertaining specifically to Downstate programs were summarized by Trish Fox:

A. DCFS is requesting after hours response from all Downstate POS agencies for referrals. POS agencies believe the current practice of POS agencies determining their after hours availability is sufficient given that it appears to be working and since there is no funding available to support the costs of requiring everyone to have this capability.

B. DCFS wants to combine both Relative and Regular referrals in the Downstate rotation, thereby eliminating Relative foster care as exclusive to POS agencies

C. POS agencies want to see a case-by-case (rather than assigned days/weeks) referral system in place FIRST, a rotation system that better rewards agencies with better permanency performance in operation, and be assured equal access to resources beyond the scope of the contract before a combined rotation is put in place.

1. Review permanency requirements for Spec/Treatment and determine if they continue to be realistic

A specific question regarding the interpretation of the current contract, which allows a POS agency to request assistance from DCFS if more than ï¿½50% of the casesï¿½ are involved in therapy, was raised. Further clarification is needed on whether the 50% mark represents the number of foster care cases vs. the number of individuals receiving therapy (i.e., one foster child, two biological parents may all be receiving therapy) or 50% of the family cases. If an individual is receiving more than one type of therapy service, is this counted as ï¿½1ï¿½ or the number of therapies attended?

A. DCFS is committed to a ï¿½pureï¿½ child-by-child rotation for initial placement opportunities in the rotation system. If an agency refuses this initial opportunity, agencies with higher permanencies will be rewarded with more opportunities for initial referrals. DCFS is working on the technological system to put this in place, and it will be functional in May.

B. Referral Rotation Reports will be provided on a Quarterly basis in order to review where referrals are going, etc. DCFS will be reviewing the ï¿½reward systemï¿½ to determine it is working. DCFS plans to give preference to agencies performing at a higher rate.

A. Reports have been sent out, and DCFS is requesting a fairly quick turnaround time.

B. Specific questions regarding Stability Data were asked; if any agency has a question, they can call Laura at 217-785-2492. Specifically, moves made to meet the mandate for one worker-one family will not be counted. A question regarding moves made to consolidate sibs was thought not to be counted, but this will be further clarified.

C. DCFSï¿½s goal is to have the Reconciliation information ready for the April 11 Infrastructure Meeting.

Jeff Burhman of DCFS reported that a mailing List (Jeff Burhman) a letter was sent to each private agency that has attended training to request the names to whom the report needs to be sent. This letter was sent to 36 Executive Directors, and 18 had been returned by this date. Follow-up calls will be made by DCFS to those agencies that had not responded to the letter.

DCFS staff reported that HMR licensing is a challenge to DCFS and the State of Illinois based on the Federal governmentï¿½s decision not to provide dollars for unlicensed relative foster homes. There are two solutions: 1) increase the number of homes that become licensed, and 2) encourage permanency for those children in the unlicensed relative homes.

The results of the initiative to have relative homes become licensed are not encouraging. Fewer than expected are interested in pursuing licensure, and the follow through is even less. Of the 3600 POS HMR homes, over 1900 of those homes are still unaccounted for in any type of form response to DCFS. There was also discussion regarding strengthening the criteria to place children with relatives so that homes would more likely meet licensing standards. This was challenged as to how this fit with the philosophy of best interests of children being placed with relatives; it was acknowledged that this was somewhat conflictual.

A number of Central Region providers sometimes experience a 2-3 week delay in getting new medications and changes in dosage of psychotropic medications approved. This then resulted in a discussion during which agencies identified incidents where wards were hospitalized and placements disrupted due to the delay in medication approvals. Additionally, some psychiatrists are no longer willing to see wards due to this process. Three specific concerns will be explored by DCFS: 1) the process which is cumbersome due to the number of individuals in the ï¿½chainï¿½; 2) the delay in response to medication requests; 3) the denial of approval of prescribed medications. It is requested that if the DCFS psychiatrist is refusing to approve the medication/dosage, that they discuss this physician-to-physician so that a possible agreement can be reached.

DCFS is requesting recommendations for contract changes/clarifications. To be included at this time:

Counseling issues including what is the 50% counseling requirement? (See above discussion)

Volunteers from POS agencies will work with DCFS to develop points for discussion that will be taken to the Infrastructure Committee regarding these issues.

Two particular populations have been targeted by DCFS for the Permanency Initiative; 1) children under 3 y/o, and 2) wards 18+y/o in unlicensed relative foster homes.

It is anticipated that the Chaffee grant of $3000 to wards 14-18 who achieve permanency will be extended from the current end date of June 30, 2002 to October 31, 2002, to encourage permanency for this age group.

At the private agency pre-meeting, concerns regarding DCP issues were addressed. Specific concerns regarding downstate DCP should be e-mailed to Tricia Fox at [email protected] prior to April 24. At the pre-meeting on that date, the group will define these concerns and decide the best way to work with DCFS towards resolution.

The next two scheduled DCFS/POS Downstate Meetings are scheduled on April 24 and June 19, from 1-3pm at 628 E. Adams, Springfield. POS agencies are encouraged to attend the pre-meeting prioritization conference on both dates at 11:00 at the CCA Office, 300 E. Monroe, 2^nd Floor, Springfield. (Our thanks to Lynn Mercurio of Chaddock and Tricia Fox of Catholic Social Services in Peoria for this summary report.) (MB)

A blustery first day of Spring found over 110 attendees at the Membership Meeting at Hamburger University on the McDonaldï¿½s Campus in Oakbrook. Those attending included Executive Directors, executive-level administrative personnel, and program personnel.

The kickoff Leadership Dinner on the evening of March 20 featured a presentation by Jerry Stermer, President and CEO of Voices for Illinois Children. Now in its sixth year, Voices for Children has vigorously strived to create inclusive collaborations and sound strategies for advocating for children and families in Illinois. An easy-to-understand theme, ï¿½Every Child Counts,ï¿½ has created the umbrella under which Voices and its supporters advocate for early education, prevention strategies, and other family and community initiatives that benefit children. A $2.5 million grant for paid media from the McCormick Tribune Foundation and the issuing of Illinois Kids Count 2002, a study underwritten by the Casey Foundation, have collectively placed Voices for Children in the public eye. Stermer urged CCA to join Voices for Children to support alternative budgeting messages to the legislature and to emphasize that the current budget is both unacceptable and unnecessary.

CCA President and CEO Margaret Berglind also unveiled the CCA Strategic Plan for FY2002-2005 and reviewed pending legislation that impacts CCA member agencies. Presentations on the FY2003 budget and the 2001 Outcome Measures report were done by Shaun Lane, policy analyst for CCA, and DD Fischer, consultant to CCA.

Concurrent afternoon sessions included a panel presentation on residential issues and an overview of a recent Chapin Hall study; a presentation on current developments in specialized and performance-based programs and a review of future trends and utilization patterns; and a review of new directions for the Child Care Associationï¿½s Outcomes Project.

Current Funding at 75%: Current funding payments will again be reduced to 75% levels for May and June. This will allow full reconciliation of the caseload and payment. Agencies should be alerted to this change in payment now in order to plan for May and June. DCFS is also concerned about the continuation of the current funding model given problems experienced recently in the closure of a large agency. DCFS feels there are still a number of agencies that use current funding for operations expenses and are not restricting the funds for foster parent payments. Members of the group will work with DCFS on crafting potential guidance language to issue to agencies.

Lapse in Current Funding: There are still a number of agencies that face imminent lapse of their current funding due to failure to submit cost reports and/or audits. We encourage all executive directors to check with their finance staff to assure their agency has submitted all required reports in a timely basis.

Grants will soon be available from the Weyerhaeuser Family Foundation. This foundation is a source of funding for certain types of proposed programs. For more information and application information for the foundationï¿½s 2002 Childrenï¿½s Initiative, go to www.wfamilyfoundation.org and click on "Guidelines - Childrenï¿½s Initiative." (mb)

The Department of Human Services issued an emergency rule in the March 1, 2002 Illinois Register with a 45 comment period that sets out the process and the reasons a TANF case may receive an exception to the 60-month lifetime limit on the receipt of TANF cash assistance. The client will be notified and must file a written request for an exception. The rulemaking also sets out the process and timing for making a written request and provides for periodic review of the decision.

1.) The client has an application for Supplemental Security Income pending at the Social Security Administration and the Department determines the client is probably eligible for SSI. If the client is in the appeal stage of the SSI application, there must be legal or advocacy representation, unless the client can show legal representation is unavailable.

2.) The Department determines that the client has a medical barrier, which prevents the client from obtaining or retaining employment of at least 30 hours per week.

3.) The client is in an approved education and training program, which will be completed in six (6) months or less after the clientï¿½s 60^th month.

4.) The client is in an intensive service program to help overcome a barrier to work, including but not limited to programs under mental health, substance abuse, vocational rehabilitation, domestic violence, homeless services and involvement with DCFS. An exception to the 60-month limited will be granted for this reason only if the clientï¿½s involvement in the program precludes the ability to obtain or retain employment of at least 30 hours per week.

5.) The client has a severely disabled child approved for a waiver under the Home and Community Based Care Program.

6.) The client is the only adult in the assistance unit and is the primary caregiver for a child under age 18 with a physical or mental health problem(s), or is the primary caregiver for his or her spouse who has a physical or mental health problem(s) and the demands of care giving do not allow the caregiver to obtain or retain employment that would satisfy section 112.1(b).

All requests and comments should be submitted to Susan Weir, Bureau Chief, Bureau of Administrative Rules and Procedures, Department of Human Services, 100 South Grand Avenue East, 3^rd Floor Harris Bldg., Springfield, Illinois 62762 (217) 785-9772. The emergency amendment was effective Feb. 19, 2002 and remains in effect for a maximum of 150 days. (JMS)

CCAI included information in one of the Feb. Monday Reports explaining briefly what HIPAA stands for and what is included in those sections of the act that will begin to be implemented this year. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. To date the issue has been raised by the CWAC Medicaid Advisory Workgroup and how it would impact DCFS providers. To briefly review the issues again, Title II of the Act includes a section, Administrative Simplification, requiring 1.) Improved efficiency in healthcare delivery by standardizing electronic data interchange, and 2.) Protection of confidentiality and security of health care data through setting and enforcing standards. More specifically, HIPAA calls for: 1.) Standardization of electronic patient health, administrative and financial data; 2.) Unique health identifiers for individuals, employers, health plans and health care providers; 3.) Security standards protecting the confidentiality and integrity of ï¿½individually identifiable health information,ï¿½ past, present and future. The extent of the impact of this act within DCFS is still being reviewed. Generally stated the act impacts all health care providers, health plans, employers, public health authorities, life insurers, clearinghouses, billing agencies, information systems vendors, service organizations, and universities. Compliance deadlines require that the transaction codes part of the act must be in place by October 2002. The privacy piece of the act is required to be implemented by April 2003. The security standard of the rule mandates safeguards for physical storage and maintenance, transmission and access to individual health information. (JMS)

CCAI has worked with the Community Behavioral Healthcare Association to include DCFS as part of a state agency panel on HIPAA during CBHAï¿½s two day Spring Conference and Legislative Forum on April 29-30, 2002 in Springfield, Illinois. The purpose of the panel will be for each state agency to present the status of HIPAA implementation and how it will impact their provider systems. Randy Van Lisky of the Governorï¿½s Office has been invited to provide an overview of how the Governorï¿½s Office will direct the executive code departments in preparing for HIPAA. Stephanie Hanko and Bob Laurent will represent DCFS on the panel. Stephanie Hanko serves as the co-chair of the CWAC Medicaid Advisory Workgroup. Other agencies that will have representatives on the panel will be Dept. of Human Services, Dept. of Public Aid and Dept. of Public Health.

A flyer about the CBHA conference with further detail on the HIPAA session was mailed to all member agencies last week. CCAI members can attend the meeting for the CBHA member rate. Even though DCFS is still in the process of reviewing these regulations to determine the extent that they impact their providers, this meeting in conjunction with CBHA offered an opportunity to ask questions of the state agencies and how it impacts their provider systems. CCAI will be pursuing additional sessions for its members as further review of the regulations take place. We would encourage members to take advantage of this opportunity to get information from the state agencies perspectives at this time. The HIPAA panel is on Tuesday, April 30, 2002 from 10 to Noon. If you did not get a copy of the brochure and are interested in attending contact the CCAI office. (JMS)

Last week it was announced by HHS Secretary Tommy Thompson that changes are being proposed to the medical privacy rules of the Health Insurance Portability and Accountability Act (HIPAA). The Standards for Privacy of Individually Identifiable Health Information took effect April 14, 2001. As required by HIPPA, the Privacy Rule covers health plans, health care clearinghouses, and those health care providers who conduct certain financial and administrative transactions electronically. Most covered entities must comply with the rule by April 14, 2003. Small health plans have until April 14, 2004 to comply with the rule. The Privacy Rule creates national standards to protect individualsï¿½ personal health information and gives patients increased access to their medical records. To ensure that the provisions of the final rule provide strong privacy protection without hindering access to health care, DHHS is proposing modifications to the Privacy Rule. The proposed modifications are being made in the following areas: consent and notice; minimum necessary and oral communications; business associates; marketing; parents and minors; uses and disclosures for research purposes; request for comments on an alternative approach to de-identification; uses and disclosures for which authorization are required; and other identified provisions.

Lutheran Child and Family Services was honored at the Illinois State Capitol on March 21^st with the Prevent Child Abuse Month 2002 Program Excellence Award.

The award, for the Mothers Outreach to Mothers (MOMS), a program in Fayette and Effingham counties, provides education, support and guidance for mothers of newborns in Fayette and Effingham counties.

"MOMS is designed to prevent child abuse and neglect by addressing things like social isolation, youth, stress and the need for enhanced child rearing techniques," says Mavis Gehant, LCFS counseling supervisor and director of the MOMS program.

The program works by training volunteer "mentor" mothers who spend one hour a week with at-risk young mothers referred to the program by the county health departments. The mentors, themselves all experience mothers and grandmothers, serve as role models, showing mothers how to play, interact and take care of their babies. The mentors also listen to the new mothers' concerns and link them to resource groups and other available community services.

Metropolitan Family Services also won an award for its Parents Plus Partners program in Palos Hills.

CCAI will sponsor two workshops for The Children and Family Research Center, School of Social Work, University of Illinois, on April 4^th in Springfield and April 8^th in Chicago.

The Children and Family Research Center (the Center) was established in 1996 with an emphasis on outcomes, linking outcomes to practice, and evaluating services that directly apply to DCFS policy and practice. Each year, the Center seeks research projects that support the Centerï¿½s goals and objectives through the Developmental Grant Program. Private child welfare agencies are encouraged to submit proposals for consideration. The Center has developed a one-day workshop in which potential grantees can learn Developmental Grant priorities and receive technical assistance on development of research projects and Developmental Grant proposal completion.

Workshop topics include: current Center priorities, organizing a proposal, developing a budget, collaborating with a research consultant, and preparing for submission to the Department of Children and Family Services Internal Review Board.

This workshop is designed for individuals involved with project development including program managers, quality assurance experts, and program development individuals. It would not be useful to send direct practice-level workers, as they would not have the appropriate knowledge and skill for this workshop.

The most successful proposals are likely to be for exploratory research or pilot projects; research reviews that include pertinent analysis of topics as they relate to or inform child welfare practice, policy, or programming, or projects that are an outgrowth of an existing research program or an extension of research experience.

If you would like to register for the Springfield or Chicago workshop please call the CCAI office at 217.528.4409.

April 2 ï¿½ Integrating Program and Finance, Prevention First, Inc., Springfield, 9:00-4:00

April 12 ï¿½ Integrating Program and Finance, Catholic Charities of Chicago, St.

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

June 5-6 ï¿½ CCAIï¿½s Annual Membership Meeting, Crowne Plaza, Springfield