August 19, 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.

CHILD WELFARE.. 1

CHILD WELFARE ADVISORY COMMITTEE (CWAC) REPORT. 1

DCFS Budget Status. 2

Overview: SED Subcommittee Restructuring.. 2

Subcommittee Membership.. 4

FAMILY CENTERED SERVICES FACT SHEET. 4

Foundation And Enhanced Child Welfare Training Waiver Programs. 5

Work Simplification.. 5

Runaways. 5

Finance and Administration.. 5

CWAC FINANCE AND ADMINISTRATION REPORT. 5

Audit Concerns for Federal Recovery. 5

Contracts. 6

Rate Methodology. 6

Family Habilitation Plan.. 6

Bedhold Policy. 6

Excess Revenue.. 7

Audit Confirmation Letters. 7

Multi-region Contracts. 7

Intact Family Services. 7

Cash Assistance.. 7

Penalties for HMR Unlicensed Homes. 7

System of Care Software.. 8

HIPAA.. 8

DCFS FOUNDATION AND ENHANCED TRAINING SCHEDULE.. 8

NORTHERN.. 8

FAMILY CENTERED SERVICES REGIONAL REVIEWS.. 8

GENERAL.. 8

CCAI SCHEDULES HIPAA SEMINAR � SAVE THE DATE- SEPTEMBER 17. 8

CHILDREN�S HOME ASSOCIATION HAS A SUCCESSFUL CQI PROGRAM FEST. 9

UPCOMING EVENTS.. 10

WRAPAROUND SERVICE PLANNING & DELIVERY: 10

PRINCIPLES, STRENGTHS AND USES FOR CHILD WELFARE STAFF IN ILLINOIS.. 10

FALL MEMBERSHIP MEETING - SAVE THE DATE and MAKE YOUR RESERVATION.. 10

IADDA TO HOST CONFERENCE ON �ADVANCING THE CONVERSATION: IMPROVING SUBSTANCE ABUSE PREVENTION AND TREATMENT� 10

FIRST NONPROFIT ANNOUNCES FREE SEMINARS.. 10

Calendar.. 11

CHILD WELFARE ADVISORY COMMITTEE (CWAC) REPORT

CWAC met in Chicago on August 15. Key issues addressed were:

DCFS Budget Status

Director McDonald reported that during final budget decisions for the FY�03 state budget, DCFS was cut first at $25 million and later at an additional $67.5 million. Planned layoffs to balance the budget are delayed while the union takes the layoff to arbitration. This will further impact the DCFS budget the longer the layoffs are delayed. He stressed these further cuts will come from DCFS operations and will not impact contract and grant lines. Essential to DCFS managing their budget is the continued success of various initiatives including step-down and permanencies in unlicensed homes. Intake of new cases is staying stable. There appears to be no increase in abuse/neglect, including the impact of TANF cuts. With the flat intake and continued discharge of children from the system due to aging out and achieving permanencies, DCFS expects continued shrinkage of the caseload. Ultimate projection is to be at 15,000. The FY�04 budget planning process is beginning. It is anticipated there will be a flat budget projected with no additional funding for DCFS.

Overview: SED Subcommittee Restructuring

Director McDonald stressed that it is critical from a service and budget standpoint for DCFS to continue its efforts to reduce the level of residential care use while increasing the treatment focus and service outcomes. He is proposing some type of PPO (Preferred Provider Network) in which the system better matches a child�s needs with programs that can respond. Length of stay would be managed and special populations identified. Adaptation of models proven to work with various populations, such as MST, need to be employed. If these efforts are successful, the opportunity presents itself for better deployment of resources to support those agencies best able to respond to child needs and department expectations. Principles of this system will evolve. The sooner the parameters of the PPO are defined and length of stay in residential is controlled, the sooner the resources can be redeployed. There is urgency in getting this PPO underway. Although initial discussions are open to all, eventually DCFS will make decisions on further contracts with residential agencies as the PPO principles are developed.

To manage the various elements of the PPO discussion, to reflect the need for review of the System of Care, and to work with DCFS on pursuing an additional IV-E waiver for residential, the SED Committee is being restructured. Three main Subcommittees will manage the discussions in these areas:

PPO: Develop and implement an integrated and coordinated provider network

through which children with serious emotional disorders receive appropriate and cost- effective residential services as demonstrated by improved clinical outcomes, shortened length of stays, and transitions to stable and less restrictive living arrangements. To develop this network, the work group will focus on improving the current infrastructure and increasing the competency of residential resources through training, program plan development, and other initiatives.

Title IV-E Waiver:  Through development of a IV-E waiver, pilot an evidence-based treatment model that focuses on residential care deflection and reduced length of stay. The primary goal is to make a case for IV-E investments in clinical interventions targeted for the SED population. This subcommittee will also develop and advise the Department on potential opportunities for system reinvestment in children's mental health programming.

System of Care (SOC):  Provide ongoing feedback on the redesign of ITS and community-based service delivery targeting placement stability in foster care. This subcommittee will be made up of both SOC providers and foster care providers, and will guide the work of the existing SOC workgroups.

Existing Work Groups and Proposed Relationship With New Subcommittees:

Training Work Group:  The work group created a fairly detailed curriculum outline and implementation plan. The question of training delivery has not been resolved and a variety of options are being considered.

Position in the SED Subcommittee Structure:  Reconvene a training implementation work group that reports to the PPO committee.  The work group should focus on minimizing costs associated with the training rollout.

As long as an adequate number of agencies volunteer to host the trainings in all regions and that both agencies and the Department supply trainers, most costs typically associated with training could be avoided.

Outcomes Work Group: 

1. The work group reviewed the data from the "Time I Administration" at its last meeting. Continued monitoring of the system by the work group is recommended.
2. Jennifer O'Brien provides periodic training to clinicians on how to administer the CFARS and manage the module/web site. All indications are that the training is effective.

Position in the SED Subcommittee Structure:

Position the work group as it currently functions under the PPO subcommittee

Joint Planning Work Group:

1. The original purposes of the work group were to identify utilization trends and provide the private sector with information needed for decision-making. There is still a need for work in this area.
2. Additional areas that would be appropriate for the work group to address include: Matching residential youth ready for step down with agencies that provide Specialized Foster Care.
3. ILO issues and residential care cooperation

Position in the SED Subcommittee Structure:

Reports to the PPO subcommittee 

Care Management and Community Linkages Work Group Status:

For a variety of reasons, the work group has not been active for several months.

Position in the SED Subcommittee Structure:

Because the work group's original objectives fall under the scope of other committees, workgroups and/or support groups, it will be discontinued.

Additional Support Groups:

1. Four existing work groups, that focus on issues which impact residential care but are not under the SED Subcommittee's umbrella, should continue in their existing capacities as well as function to support the work of the PPO Committee. The existing work groups include:
2. ILO Work Group;
3. Specialized Foster Care Work Group (composed of representatives of the Infrastructure Committee);
4. Medicaid Work Group; and
5. Children with Sexual Behavior Problems (CSBP) Work Group. These work groups should periodically make reports to inform the PPO Subcommittee of current projects and issues, and directly work with the Utilization Trends Work Group to address system issues that limit integration and coordination among different levels of care.

Subcommittee Membership

Currently, CCAI and DCFS have compiled a list of volunteers interested in participating in each of .the Subcommittees and recommendations from the Department, CCA and CBHA. Membership is still open although once the work groups start, then new members will not be allowed. Agency executives and program managers are being encouraged to serve.

Initial Subcommittee Meetings are scheduled as follows:

PPO Subcommittee

Tuesday, August 27, 2002 10:00 a.m. to 12:00 p.m.

100 West Randolph Ave, 6th Floor, Room 215

SED IV-E Waiver Subcommittee

Tuesday, August 27, 2002 1 :00 p.m. to 2:00 p.m.

100 West Randolph Ave, 6th Floor, Room 215

SOC Subcommittee         

Tuesday, August 27,2002 2:30 p.m. to 5:00 p.m.

100 West Randolph Ave, 6th Floor, Room 215

FAMILY CENTERED SERVICES FACT SHEET

Foundation And Enhanced Child Welfare Training Waiver Programs

DCFS staff reported the following information pertaining to training:

Foundation training is now two weeks in length and is offered twice per month in Cook

County and once per month in Northern, Central and Southern Regions. Focus groups will be convened, in the fall of this year, under Mary Ochman-Ahmed to obtain feedback about the utility of the revised curriculum. Mary may be reached at 217- 785-5689.

Enhanced Training begins on Monday August 19,2001 and follows the Foundation Training that began on August 5,2002. Agencies assigned to the first tier of training include Central Baptist, Lifelink, Shelter Incorporated, Little City Foundation, Guardian Angel Home, SOS Children's Center and Easter Seal Jayne Shover Center. The waiver team is conducting agency entry meetings in order to become acquainted and establish guidelines for the collaboration. Agencies to be included in the next tier of training will be notified sometime in late fall for inclusion in the January group. The experimental supervisors from the newly included agencies will attend a three day Training of Trainers before the training begins. Agency entry meetings will follow. Other agencies, per our sampling plan, will be included in subsequent years, through year four of the project.

If there are questions please contract Jennifer Bradburn at 312/328-2797.

Work Simplification

DCFS staff have begun to identify how to streamline the extent of forms and to reduce the number of forms. DCFS has identified 473 different forms. The work group recently reviewed the proposed 5 page SOC referral form and has reduced it to one page.

Runaways

DCFS has reviewed its current population and found 700 children listed as runaway in the system. More than 240 are in Cook. Renard Jackson�s unit will be contacting all agencies to ask for aggressive efforts to find these kids, and make determinations about the safety of their current living arrangement. Some cases can be safely closed from the system following the proper assessment.

Finance and Administration

See full report elsewhere in this Monday Report. (MB)

CWAC FINANCE AND ADMINISTRATION REPORT

CWAC FAS met in Chicago on August 14. The following issues were addressed:

Audit Concerns for Federal Recovery 

DCFS consultants from Maximus have been working on how to assure DCFS is in compliance with federal audits in the future and can obtain full federal recovery of funds. The role of private providers with DCFS under GASB 34 (Government Accounting Standards Board) suggests new standards that will impact rate methodology in the future including movement from fund accounting to entity-wide focus and adopting a more corporate focus. Key areas of impact are: 1) the reporting of Infrastructure costs of providers, including fixed assets and equipment. Is the infrastructure cost being properly reported on balance sheets and cost reports? 2) The variance in depreciation requirements of the rate methodology system and principles of accelerated depreciation; 3) capitalization thresholds and consistent application across providers and 4) reporting requirements.

Maximus is working with DCFS finance staff to assure they will pass future compliance tests. Maximus consultant staff as well as DCFS field audits staff may visit various private agencies to clarify and gather data. A sub-committee of FAS will work with DCFS on reviewing the current depreciation schedule in effect since l988.

Copies of the outline of the GASB34 issues prepared by Maximus, as well as copies of the 1988 DCFS Depreciation Memo can be obtained by calling the CCAI Springfield office.

Contracts

Some contracts were submitted late. Priority treatment was given to getting substitute care contracts with current funding on line quickly. As more are getting to the Controller�s office there is a payment impact. Legal staff signatures are needed on contracts over $250,000 and there is some delay on a few programs. Agencies that have not yet received a contract, especially substitute care, should contact Resa Early in Springfield contracts to determine if there is any problem with their contract.

Rate Methodology

DCFS is still gathering FY�02 data on high-end care use in order to refine future projections. Initial projections suggest DCFS is on track for implementing some form of rate methodology. The current formula, however, will severely impact several agencies that will lose a significant portion of rate. The impacts on those agencies and on the overall high-end system must be looked at before there is agreement to proceed. If the rate methodology formula is changed in any way, DCFS will need to do an emergency rule. A work group of FAS will work with DCFS on this in the next few weeks to determine recommendations.

Family Habilitation Plan

The program plan has been revised for the service formerly known as Homemaker. The Family Habilitation/Parent Support & Mentoring program is completed and has been mailed to providers with a rate of $19.67, The Supervision and Transportation (rate of $18.27)  and Transportation Only (rate of $12.94) programs will have a combined program plan and is in the process of DCFS internal review.

The FAS group expressed concern that there is a gap in the overall funding of this service. Although the Homemaker Work Group agreed to decreased utilization in exchange for a different rate if the program was changed, the current contracts do not reflect previous contract levels. DCFS staff expressed that it was not the intent of DCFS to reduce this budget line. There is still development of the budget plan in certain regions since the previous Homemaker funds were redeployed to foster care and family preservation lines. CCAI will continue to track this issue with DCFS staff.

Bedhold Policy

Agencies have raised a number of concerns about the policy. There is a common perception that agencies will lose funds as a result of this change. This is not the intent. Providers can get paid but will need to follow increased reporting requirements. Lack of response from DCFS staff pertaining to the staffings should not stop a bedhold since the policy specifically details what agencies can do when DCFS does not respond. The FAS group agreed it is too early to know if the policy is workable or under what circumstances a program would lose funds. DCFS contracts staff will develop a Q & A sheet to go to all agencies to clarify these issues.

Excess Revenue

DCFS will submit the proposed rule change reflecting the discussions of the FAS group over the past year. Seven percent can be maintained in cost-based programs similar to the model allowed for for-profits. The new rule will be in effect for FY�02 cost reports. When this rule is ready to go to JCAR, CCAI will forward a copy to all agencies for comment.

Audit Confirmation Letters

DCFS should have these out to agencies for use with audits by September 20. On sub-recipient reporting, DCFS proposes reporting by contract and dollars and not by service codes as in the past. This will be sent to any agency providing case management. Any agency needing a report of all funds paid by DCFS for their audit should contact Roy Miller for this letter. Since there is still lack of agreement between DCFS and DHS about responsibility for reporting Title XX funds to the feds, agencies should again expect a separate letter from DHS on Title XX amounts. This may come later in the year again.

Multi-region Contracts

DCFS would like to move to contracts with each region. The �buy-in� across regions to one agency contract causes problems when all regions are not yet ready to make purchase estimates. Agencies involved in statewide contracts that cross-regions should provide comment to CCAI ([email protected]) on their thoughts on this and the potential impact/advantages/barriers.

Intact Family Services

Nancy Ronquillo of CHASI will serve as a link between FAS for Intact Contract Issues and the newly revised In Home Service Committee to assure program contract issues are addressed.

Cash Assistance

Cash assistance was removed from Family First contracts as of July 1. There were significant audit problems in tracking the amounts allowed per client per year. DCFS maintains that most cash assistance can be obtained through NORMAN funds or Chafee funds. A work group of FAS will review circumstances in which NORMAN is not applicable for cash assistance needs and try to identify procedures. Workers or supervisors in Family First contracts that have feedback on this issue can contact CCAI ([email protected]) to identify such circumstances. If any agency made cash assistance disbursements at the beginning of July before learning of the contract change, they should contact Roy Miller for resolution of the payment.

Penalties for HMR Unlicensed Homes

As developed in the Infrastructure group, penalties will be applied to agencies that have not followed the protocol for seeking and reporting licensing efforts for HMR unlicensed homes. There are a number of cases in which agencies have failed to file the Notice of Intent or failed to follow through on a complete licensing application upon intent. The penalty will be $25 for every child in an unlicensed home. The initial penalties for July were waived by DCFS. They will begin to levy the penalty in August. Amounts under $250 will not be subject to appeal unless the agency can prove the DCFS information is erroneous. 

There are still 645 unlicensed homes with no documentation filed. The total penalty across the system will be $28000 per month at this time. We encourage agencies to check on the status of all unlicensed homes and collect information from foster care staff about why the homes continue to be undocumented.

System of Care Software

The pilot for testing the billing software is underway at several agencies. DCFS hopes to deliver and train on this software to all SOC entities by the end of August. DCFS clarified that any excess revenue from these programs will be subject to recovery by DCFS since there are no �like� programs in agencies.

HIPAA

DCFS cautioned agencies to prepare for HIPAA compliance. DCFS is trying to become exempt since they serve as parent for dependent children. This does not mean that providers will be exempt. (See notice of HIPAA training elsewhere in this Monday Report and watch the mail for CCAI training on HIPAA.) (MB)

DCFS FOUNDATION AND ENHANCED TRAINING SCHEDULE

COOK           

FOUNDATION CLASS with ENHANCED FOLLOWING            

FOUNDATION                                             ENHANCED

8/05/02 --8/19/02                                               8/19/02 -9/16/02

9/9/02 -9/23/02                                               9/23/02- 10/21/02

11/12/02- 11/26/02                                             10/29/02 -11/27/02

12/02/02- 12/16/02                                             No class scheduled

NORTHERN            

8/18/02 -9/03/02

9/23/02 -10/07/02

10/28/02- 11/13/02

12/02/02- 12/16/02

*Northern Region workers attending the Enhanced Training will travel to Cook. (MB)

FAMILY CENTERED SERVICES REGIONAL REVIEWS

Regional reviews of the Family Centered Services applications from each of the LANs throughout the state was completed the week of August 12, 2002.  Applications that were submitted for review had been recommended by the LAN partnership committee.  Review of the applications consisted of recommendations to approve, approve with changes or deny the application.  Applications that were submitted needed to serve the target population of children and families at risk of entering DCFS.  The Division of Child Protection should refer 50% of the clients.  The other may be referred from the community schools and DCFS child welfare.  This is a deflection service.  Open DCFS cases should not be referred.  Cases referred to FCS programs should be a deflection alternative to any active DCFS or POS casework involvement.

The next step in the review process for the applications will be a review by central office during the week of August 20^th with a targeted starting date for those approved of Sept. 1, 2002.  Additional information needed for any application or any application received after the August 9^th deadline would have a later starting date.  (JMS)

CCAI SCHEDULES HIPAA SEMINAR � SAVE THE DATE- SEPTEMBER 17

CCAI has scheduled a seminar for September 17, 2002 to conduct a brief overview on �what is HIPAA�.  HIPAA represents the Health Insurance Portability and Accountability Act.  It was designed to implement standards related to electronic transfers of health information, the security of that information and how privacy of the information is protected.  It is not as easy to say that all services funded through Medicaid are impacted or all non-Medicaid services will not be impacted.  The Child Welfare League of America is still working on the clarification of these regulations and who will be considered a covered entity or business associate for purposes of addressing the requirements of this Act.  At this time it is difficult to state the exact impact it will have on child welfare agencies, but due to its ambiguity with the child welfare system and that the first deadline that is approaching is October 15, 2002, we felt is was essential to inform everyone about the purposes of this act.  CCAI is also recommending that all agencies file this extension for compliance with the code sets that is due October 15, 2002 in order to receive an additional year to implement the requirements if it is determined that your agency is covered by the act.  Filing the extension does not mean that you become a covered entity, but provides coverage in the event that HIPAA applies to you.   It may not be possible to address all your questions at this time, but this seminar will at least provide some basic information about the act and explain what it is designed to do.  The speaker for the session will be Deanna Mool, Partner with Sorling, Northrup, Hanna, Cullen and Cochran, Ltd. In Springfield, Illinois.  Deanna Mool is also serving as the consultant with the Governor�s Office on the implementation for HIPAA in Illinois. 

Copies of the registration form should be received by your agency shortly and will also be posted on the CCAI web site (www.cca-il.org).  The session will be on Sept. 17, 2002 from 10 to 2 at the Holiday Inn Select in Naperville.  The cost for members will be $65 and for non-members $75.  A small block of rooms is being held at the rate of $80.  Call the hotel directly to make a reservation.  If you have any initial questions about HIPAA, please direct them to Jan Schoening.  We can also include those as part of the agenda for the seminar.  Any questions about registration for the seminar should be directed to Sandy Armstrong.  (JMS)    

CHILDREN�S HOME ASSOCIATION HAS A SUCCESSFUL CQI PROGRAM FEST

Children�s Home concluded it�s second year of Continuous Quality Improvement (CQI) on June 30, 2002.  CQI is a management model of shared decision making that recognizes and uses the expertise and experience of staff to continually assess and improve the quality of services.  It is a model that promotes staff empowerment, creativity and responsibility.  Children�s Home believes that those who are closest to the services and work are the best people to make changes for improvement.  Thirty-one teams, that included all full-time employees, were formed.  These teams chose projects to work on for the entire fiscal year.  Listed below were some objectives of the teams:

On August 13, 2002, a Quality Fest was held to recognize and celebrate the accomplishments of staff.  Each team presented their projects to the panel of judges and awards were given out based on the quality and effectiveness of the project.  Pictures of the Quality Fest will be posted this week on the CCAI website.  (RJS)

WRAPAROUND SERVICE PLANNING & DELIVERY:

PRINCIPLES, STRENGTHS AND USES FOR CHILD WELFARE STAFF IN ILLINOIS

This one day session is targeted for supervisors and managers of foster care providers and will provide participants with a basic understanding of assumption & values associated with WRAParound planning as well as techniques for applying WRAParound in their service settings. The workshop will cover techniques for strength discovery including development of functional strengths which can be used in creating interventions.  A significant portion of the workshop will focus on needs including analyzing behavior to understand unmet need, crafting needs statements and applying creative options to meet underlying needs.

Check our training website for more details and registration information.

FALL MEMBERSHIP MEETING - SAVE THE DATE and MAKE YOUR RESERVATION

The Child Care Association of Illinois� Fall Membership Meeting will be held on October 23 & 24, 2002 at Starved Rock Lodge and Conference Center, Highway 178 & 71, Utica, Illinois.  Rooms are being held at Starved Rock for the nights of October 22 and 23.  If you would like to make your reservation you can call 800.868.7625 or 815.667.4211.  Rooms range in price from $85.00 to $105.00.  Please be sure and tell them you are attending the Child Care Association meeting.

Many of you have attended association meetings at Starved Rock in the past.  We have not been to Starved Rock in two years so we are happy to be going back there this year.  We have heard from many of you how much you enjoy Starved Rock and visiting this picturesque area of our state, especially in the fall.  If you would like to visit Starved Rock�s website go to www.starvedrocklodge.com.  Make your reservation and plan to attend October 22-23. (SKA)

IADDA TO HOST CONFERENCE ON �ADVANCING THE CONVERSATION: IMPROVING SUBSTANCE ABUSE PREVENTION AND TREATMENT�

The Illinois Alcoholism and Drug Dependence Association is holding its� Great Lakes Regional Conference on September 22-25 at the Radisson Hotel Lincolnwood, Lincolnwood, Illinois.  The conference will bring together prevention and treatment clinicians, administrators, researchers, policymakers, and allied service providers in order to improve practices and collaborations in substance abuse prevention, treatment, recovery and mental health throughout the Midwest region.  For registration information, please contact IADDA at 217/528-7335 or visit www.iadda.org.  (SKA)

FIRST NONPROFIT ANNOUNCES FREE SEMINARS

On September 12, and again on November 21, First Nonprofit Mutual Insurance Company will host a seminar on �Unemployment Taxes: An Untapped Treasure�.  Participants will learn how to: 1) reduce unemployment costs by 40-60% a year; 2) the benefits of being in an unemployment program vs. the state pool; 3) how to prepare for unemployment hearings; and 4) plus a lot of HR tips on hiring/firing techniques.  Time for both days is 2:00-3:30 p.m. at First Nonprofit, 111 North Canal Street, Main Level Conference Room, Chicago.  To register, please call Linda Kirk at 800/526-4352, Ext. 7874.

A seminar will also be held on September 19 from Noon-4:00 p.m. at First Nonprofit on �Sexual Harassment Prevention with Illinois Dept. of Human Rights�.  This workshop focuses on maintaining a workplace free from sexual harassment by informing employees alike of their legal and ethical responsibilities, and by building awareness of the emotional and occupational cost of harassment incidents.  To register, please call 800/526-4352, Ext. 1531.  (SKA)

Calendar

Aug. 22            CWAC SACWIS Advisory Workgroup � Springfield

Sept. 17            HIPAA SEMINAR, 10:00 a.m. � 2:00 p.m., Holiday Inn Select, Naperville, IL

Sept. 23            Retooling with WRAParound Services, Springfield

Sept. 24            Retooling with WRAParound Services, Chicago