The Institute on Public Policy for People with Disabilities

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The Disability Services Advisory Committee (DSAC) is comprised of community agency, statewide association, state operated facility and individual representatives advocating for their constituents in the Illinois DD system. 

1.     DRAFT RECOMMENDATIONS OF THE DSAC DD COMMITTEE, December 14, 2007

Person-Centered Planning

  1. The State should strengthen opportunities for individuals in community settings by the addition of the Individual Service Option in a new Adult Developmental Disabilities Home & Community Based Waiver.
  1. Individualized budgeting should be developed so person-centered services can be supplied to individuals, including those who may have exceptional behavioral or medical needs, in the setting of an individual’s informed choice.
  1. Re-shape developmental training as a "service definition," making it more person-directed. Developmental training should continue as individual programming that is a collection of individually chosen services that can be provided in the setting of the person's choice, which may or may not be a traditional developmental training setting.
  1. The State must focus on infrastructure improvements that will maximize opportunities for people to choose living arrangements, supports and services that maximize their independence and their involvement in community living by implementing several initiatives, including: enacting crisis prevention and intervention programs and other supports necessary for true community involvement, developing of the capacity of the local service network to respond appropriately to the needs and desires of individuals and taking action through leadership to change policies so that new capacity development is in concert with expressed need according to the PUNS database. This recommendation would require new funding, including expansion of the State's Medicaid waiver program, to develop crisis management teams, enhance existing provider capacity and development of new provider capacity.

Quality Assurance

  1. The State should provide funding so that all individuals receiving services through the Division of Developmental Disabilities can have access to Individual Service and Support Advocacy (ISSA) services. Currently this support is only available to individuals enrolled in the Waiver.
  1. Review and analyze the State’s quality assurance or management capacity to develop a cohesive statewide quality assurance policy; enhance the overall developmental disability service system to be responsive to the people it supports and the State and federal government which funds those supports.
  1. Quality Assurance must be clearly defined, have measurable standards that are uniformly applied across all service settings and be financially supported by the Governor's office and the legislature.
  1. Provide funding of $8 million to the Division of Developmental Disabilities to implement a statewide, person-centered Information Technology Management System to track services, supports, individuals’ satisfaction with services and individual goals.
  1. Provide funding to the Division of Developmental Disabilities to implement an electronic health record system.

CODB/Reimbursement

  1. The State should provide the Division of Developmental Disabilities with a five percent Cost of Doing Business (CODB) FY2009 budget increase ($57.5 million) for community providers.
  1. The Department of Human Services must work in unison with the General Assembly, consumers, community partners, and trade associations to develop and fund uniform reimbursement methodologies and payment rates that reflect the cost of providing services and supports – including fair wages and benefits; recognize individual needs and levels of functioning; consider geographic differentials; allow for required staffing ratios, and pay for unfunded mandates. This methodology would include consistent accountability standards and would require that all human service providers submit cost reports to the State which are consistent across the entire service delivery system. Once developed, the quality of services and supports must be maintained by a statute that requires yearly trend factors be built into the rates and reimbursements.

Workforce

  1. The State should include sufficient funding in the FY 2009 Division of Developmental Disabilities budget for a $1.50 per hour market adjustment for entry level direct care staff up to and including Qualified Mental Retardation Professionals (QMRP’s) and Qualified Mental Health Professionals (QMHP’s) in his FY09 budget for the Department of Human Services to reflect increases in the minimum wage. The Governor proposed, and the General Assembly passed, increases to Illinois’ minimum wage over four years (2007 – 2010) from $5.75 to $8.25. Additionally, Congress passed and the President signed legislation that would increase the federal minimum wage over three years (2007 – 2009) from $5.85 to $7.25. While necessary to provide a living wage, the increases should not and cannot negatively impact the ability to attract and retain qualified direct support personnel.
  1. Provide $4.5 million in funding to the Division of Development disabilities to provide mandated training for direct care workers in CILAs. The Division currently pays for these trainings with dollars budgeted for other programs. In addition, the Division will recognize and provide funding for training modified for the State of Illinois offered through the College of Direct Support, which includes training for both Direct Support Professionals and Supervisors and
  1. Provide $4.6 million in funding to support the nursing recommendations of the CILA Nurses Work Group.

PUNS

  1. A system and procedure should be established whereby all people listed in the emergency category in the Division of Developmental Disabilities Prioritization of Urgency of Need for Service Survey (PUNS) lists be provided needed services immediately, but not longer than 30 days, that people listed in the critical category needing certain supports and services be provided services within 90 days and that those listed in the planning category be provided services according to an agreed upon plan. This recommendation is related to the PUNS information developed by the Division of Developmental Disabilities but could also apply to PUNS information being developed by the Division of Mental Health and Division of Rehabilitation Services. $74 million in funding would be required to provide services to all people listed in the emergency category and an additional $200 million would be required to provide service to all people listed in the critical category.
  1. All individuals receiving services from the Division of Developmental Disabilities, regardless of setting, should have the opportunity and choice to enroll and indicate their needs in the Prioritization of Urgency of Need for Service Survey (PUNS).
  1. Broaden awareness of the PUNS systems for school personnel, people with developmental disabilities and family members. Awareness for the latter groups should be focused beyond general awareness to include how an assessment is conducted, by whom, and who should be involved in the process. In addition, develop capacity for and a deeper analysis of the PUNS data to assist in the State’s development of supports, budgeting, and planning efforts.
  1. Individuals should automatically be registered on the PUNS in the school system. In addition, accompanying transition planning would standardize both eligibility determination and documentation.

 

Other

  1. The Division of Developmental Disabilities should reinvest 100 percent of the funding it receives from the hospital tax money into the developmental disabilities service system to provide services to individuals with developmental disabilities who are not currently served by the State and to develop new supports and services, including new CILA, new adult home-based services, new enrollment in the home- and community-based children’s waiver and the statewide crises project. 
  1. The Division of Developmental Disabilities should continue to be a part of the hospital tax program if the program is continued beyond FY 2008.
  1. Currently, Illinois has a policy of "unconditional" discharge from State Operated Developmental Centers (SODCs) for individuals who attempt community placement, which does not guarantee as safety net that individuals may need on a temporary or long term basis. The State should change this policy so that individuals have the choice to return to the SODC from which he or she was discharged if a community placement fails.
  1. The State should immediately release the crisis intervention RFP and undertake an evaluation of the initiative’s implementation.
  1. Revise State policies to disallow development of new large congregate care facilities.

In addition to the above recommendations, the Developmental Disability Subgroup supports the sufficient funding of SODCs so that individuals who choose to remain in SODCs are provided with quality services in a safe environment.