New COLBERT v. PRITZKER CONSENT DECREE 07-4737 FY 2020 … · 2019. 8. 7. · COLBERT v. PRITZKER...

COLBERT v. PRITZKER CONSENT DECREE 07-4737

FY 2020 IMPLEMENTATION PLAN

Fiscal Year 2020 (July 1, 2019 – June 30, 2020)

June 28, 2019

Case: 1:07-cv-04737 Document #: 359 Filed: 06/28/19 of 45 PageID #:3112

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Table of Contents Section I: Introduction and Overview of Consent Decree Page 3 Section II: Outreach Page 4 Section III: Evaluation Page 9 Section IV: Service Planning Page 14 Section V: Transition Activities Page 18 Section VI: Community-Based Services and Housing Capacity Development Page 30 Section VII: Administration Page 39 Section VIII: Implementation Planning Page 44

Case: 1:07-cv-04737 Document #: 359 Filed: 06/28/19 Page 2 of 45 PageID #:3113

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Section I: Introduction and Overview of the Colbert Consent Decree In the Colbert Consent Decree, the State of Illinois agreed to provide the necessary supports and services to enable consenting Class Members (Medicaid-eligible individuals with disabilities residing in Cook County Nursing Facilities) to live in the most integrated Community settings appropriate to their needs, if the services and supports were “cost-neutral,” i.e., no more expensive in the aggregate than the costs of having all transitioned Class Members continue to reside in Nursing Facilities. To measure the cost-neutrality, the Parties agreed at a certain point in time to gather data that would reflect the total costs of maintaining Colbert Class Members in Community-Based Settings relative to the total costs of having those same individuals reside in Nursing Facilities. The costs data was analyzed by a consulting firm. At that time, the results demonstrated it was significantly less expensive to have Class Members live in the Community with appropriate supports than to live in Nursing Facilities. The results were used to develop a Cost Neutral Plan in 2016 (Cost Neutral Plan), which has been used to guide the State in future community reintegration efforts and compliance with the Consent Decree. The Cost Neutral Plan was updated April 5, 2018 (Updated Cost Neutral Plan). Defendants may engage the same consulting firm to do a third analysis of the cost of serving Class Members in Community-Based Settings, using the prior methodology as applied to all of the transitions that have occurred. There is a continuum of distinct yet overlapping processes used to transition safely and appropriately Class Members to a Community-Based Settings, including but not limited to: Outreach, Education, and Marketing; Assessments/Evaluations; Development of Service Plans of Care; Transition of Class Members; Housing; and Community-Based Services. Defendants, with input from the Court Monitor, Counsel for Class Plaintiffs and providers, continue to re-examine and refine the procedures used throughout the entire continuum to ensure the transition process: Respects all individuals, their choice, and their need to be treated with dignity; Is safe, effective and efficient and designed to maximize the number of Class Members

desiring to transition; Reflects best practices of other successful transition and care coordination programs; Promotes the integration of supports across the continuum of care; Appropriately identifies eligible Class Members to enhance the prospect of transition; and Uses the data collected to track outcomes and improve the transition process. Although not specific to the Colbert Decree alone, the State is also embarking on significant changes to the manner in which both the Williams and Colbert Decrees are managed as well as the relevant systems as a whole as set forth below. Defendants are aware of their failure to reach the Court-ordered numbers of transitions and have agreed to take all reasonable steps necessary and appropriate and to spend the Colbert budget to achieve or exceed the Court-ordered numbers of transitions and to comply with the additional requirements of the Consent Decree and Cost Neutral Plan.


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New Commitments for FY2020 As part of a renewed commitment to working with the Parties and Court Monitor (Monitor) to enact lasting programmatic and systems changes required by the Colbert and Williams Decrees, Defendants have identified and agreed to 10 commitments related to the Colbert and Williams Decrees: 1. Move Colbert to DHS1 2. Expedite Expansion of the Front Door Diversion Program in Williams 3. Prioritize Resolution of Medicaid Eligibility, Spend-down, and Redetermination Issues 4. Expand Services to Assist Class Members with SSI/SSDI Applications and Appeals 5. Identify and Address Transition Obstacles (“Pipeline Analysis”) 6. Work with Providers to Implement Multi-Year Growth Plan to Expand Capacity 7. Increase Agency Implementation Staff 8. Review Targeted Medicaid Provider Reimbursement Rates and Consider Adjustments (led

by HFS2) 9. Conduct PASRR3 Review and Revision 10. Integrate Efforts with Leadership from Governor’s Office Six of these commitments fall under Colbert Consent Decree planning and operations (1, 4, 5, 6, 7 and 10). One commitment (2) falls solely under the Williams Consent Decree. The other three commitments (3, 8, and 9) Medicaid eligibility and redetermination issues, HFS service payment/reimbursement rate review and adjustments, and PASRR redesign4 -- reflect larger system transformation efforts and greatly impact Class Members specifically. Addressing system-wide-related issues entail activities that reach beyond the Consent Decrees but will greatly affect and impact Class Members. For the sake of this Implementation Plan (IP), activities discussed below are only in these areas that are Consent Decree-specific. Section II. Outreach (Domain O) Outreach under the Colbert Consent Decree is performed by community service providers with experience serving older adults and persons with disabilities. This will remain consistent during the transfer of the oversight of the Consent Decree to DHS in FY20. This initial phase of the Colbert transition process is educational and informational in nature and introduces Class Members to the possibilities of residing in Community-Based Settings and identifies all of the relevant services and supports available to ensure safe and successful transitions of all Class Members Evaluated as eligible for transition. Outreach staff are trained (and if necessary retrained) to engage and educate Class Members and Nursing Facility personnel regarding Colbert processes and the services and supports available. Specific referral goals are included in each provider’s contract. In order to better ensure the quality and accuracy of the educational and informational aspects of Colbert Outreach in the past, the Defendants will provide supplemental training to Outreach personnel and monitor quality and accuracy. Reports on these matters will be provided on at least a quarterly basis to the Monitor and the Parties.

1 Illinois Department of Human Services (DHS) 2 Illinois Department of Healthcare and Family Services (HFS) 3 Preadmission Screening and Resident Review (PASRR) 4 Certain PASRR redesign elements do, however, fall under Williams Consent Decree requirements.


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Outreach Contact Requirements and Tracking While Colbert Outreach numerical performance exceeded expectations for Fiscal Year 2019 (FY19), enhancements in the area of service delivery will occur in FY20. Each Outreach contact requires an in-person contact with each Class Member at their Nursing Facility residence. The Colbert Tracking System (CTS) is used to track each in-person contact for every Colbert Class Member. There could be circumstances where Outreach attempts were made, and information was left for the Class Member if they were not available during the initial Outreach attempt. Follow up telephone calls from or to Class Members to reschedule the unsuccessful visits are required to occur. These telephone calls are noted in comments in the CTS system, but are not counted in the CTS system as successful outreach contacts. First, the expectations of the quality, accuracy and frequency of Outreach contacts will be documented and communicated to the Outreach providers. For Fiscal Year 2020 (FY20), specific contact intervals will be established, and Outreach providers will be required to document compliance with the number and frequency of unduplicated Class Member contacts, including Class Members who refused to sign a consent/participation during the Evaluation process or who have been re-approached after initial contact (See Task O-1, below). This data will also be included in the Colbert semi-annual compliance reports. Second, Outreach providers will receive regular additional training and educational materials to ensure they are able to identify and be able to discuss the complete array of services and supports available to Class Members (See Task O-4, below). Outreach personnel will continue to receive training that strengthens their ability to engage Class Members with communication issues through the use of Augmentative Communication Resources. Third, quality indicators will be established and communicated to assist the Outreach providers to identify successes and shortcomings (See Task O-2, below). The Colbert Team will develop the reporting system and review the tracking of Outreach contacts monthly for monitoring of Quality Assurance. This includes data on the number of Class Members who consent to Outreach, refuse to engage, and who ultimately accept Outreach services after an initial refusal. In addition to the Outreach process stated above for Class Members and in response to prior recommendations from the former Monitor and the former Consultant (the current Monitor), the Defendants instituted specific Nursing Facility assignments in FY19 for additional targeted Outreach. This assignment provides consistency for Class Members as it affords the opportunity to build rapport between the Class Members and Outreach providers and will continue. This approach made a significant impact on the Colbert program’s ability to exceed its Outreach requirement during FY 19, and it will be continued in FY20. Currently, there are approximately 18,500 Class Members residing in Nursing Facilities in Cook County. Based on the current status of 20 full-time employees conducting Outreach services through our community provider pool, each full time Outreach staff is expected to provide a quality and accurate Outreach contact to at least 925 Class Members during FY20, to inform each of his/her rights under the Consent Decree and to provide complete and accurate information on the types of services, supports, and housing that can support Class Members to transition and live


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successfully in the Community. Strategy 1: Increased Reporting and Tracking of Outreach Contacts and Outcomes and

Provision of Enhanced Training on Supports and Services Task Task

Description Prior OoC/PC Finding5

Agency/Key Staff

Begin Date

Required Completion Date6

Outputs/Outcomes7

O-1 Create written process re: frequency of Outreach

1, 3 Colbert Lead

7/1/19 8/1/19 Greater consistency and performance of Outreach: ensure 90% of Class Members receive Outreach annually, at a minimum

O-2 Develop and communicate outreach-related quality indicators

1, 3 UIC-CON8 Colbert Lead

Pre-FY20

8/31/19 Improved tracking of outreach performance and ability to promptly remediate challenges

O-3 Develop & implement new centralized system to track & monitor Outreach contacts and outcomes of each individual Class Member; continue to use existing systems until new system is active

1, 3 Colbert Lead, DoIT9

IDoA10 HFS DHS

Pre- FY20

6/30/20 Increase continuity and efficiency of Outreach efforts through expanded tracking and analytic capacity by reporting monthly by agency percent of referred class members contacted and percent contacted who agreed to be assessed

O-4 Develop and complete implementation of additional training for Outreach staff regarding complexities of Colbert Class Members, housing options,

1, 3 UIC-CON Colbert Lead

7/1/19 Develop by 8/31/19 Complete training by 10/31/19

Increase referrals overall during FY20 by 10%, including through enhanced education of Outreach staff by conducting initial, face-to-face training of Outreach staff with quarterly updates and training materials (Power Points, handouts) uploaded to

5 Indicates whether the task is related to a previous out-of-compliance or partial compliance assessment rating by the Monitor and refers to the numbered findings in Figure 3 of “Court Monitor Compliance Assessment Report to the Court, Compliance Period: January 1, 2018 – June 30, 2018.” 6 The Defendants will have a tracking document that will clearly identify whether compliance was or was not achieved for each item. This will be provided with the documents for the Large Parties Meetings. 7 After completion of the task, it is anticipated outputs/outcomes may begin during the performance period of FY20 8 University of Illinois College of Nursing (UIC-CON) 9 Illinois Department of Innovation and Technology (DoIT) 10 Illinois Department on Aging (IDoA)


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and available Waiver and State Plan services

website

O-5 Meet with DRS to identify outreach-related best practices (esp. for those with physical disabilities) and opportunities for cross-pollination with DRS outreach programs, including application of Independent Living philosophy & approaches

1, 3 Colbert Lead DRS11

7/1/19 8/1/19 Increased implementation of outreach best practices; additional outreach resources

Peer Mentors During FY19, the use of Peer Mentors in Outreach services was successful. Defendants will continue to utilize this program during the Outreach phase and will explore expanding the Peer Mentor program to include the Service Planning phase of the Continuum. Strategy 2: Expansion of Peer Mentor Program

Task Task Description

Prior OoC/PC Finding

Agency/ Key Staff

Begin Date

Required Completion Date

Outputs/ Outcomes

O-6 Expand Peer Mentor Program

-- Colbert Lead

7/1/19 8/1/19 Begin tracking number of engagements from Peer Mentors to create a baseline

Enhanced Marketing Defendants will also develop and implement a more robust marketing plan. Strategy 3: Strengthen Marketing Efforts



Agency/ Key Staff

Begin Date


Outputs/ Outcomes

O-7 Strengthen marketing campaign, by internal and/or

1, 3 Colbert Lead DHS

Pre- FY20

9/30/19 As identified in the Anticipated Number of Referrals table below, increased referrals in

11 Illinois Department of Human Services, Division of Rehabilitation Services (DRS)


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external means, including, but not limited to using CMS and retaining outside individual(s) or vendor(s)

FY20, including through a targeted Outreach approach

O-8 Update written and electronic Class Member materials to promote transition services and reflect shift in administration to DHS

1, 3 Colbert Lead

Pre-FY20

9/30/2019 Increase awareness of services and administration to be tracked by surveying what information caused Class Members to seek to transition

Collaboration with IDPH The Colbert team and IDPH will regularly meet to address potential violations of the State of Illinois Administrative Code provisions that govern Long Term Care Facilities. These violations directly impact Class Members’ safety, service provision, and their ability to be discharged. The Colbert Team and IDPH will work together to facilitate a mandated reporter training, identify, address and mitigate potential violations. These meetings also include discussions and education regarding administrative rules addressing discharge planning for Nursing Facility residents and discussions regarding strategies and plans to address any identified issues and problems. IDPH, HFS and the Colbert Team will make regular presentations to Nursing Facility administrators and their personnel to reaffirm Consent Decree requirements. The presentations include performance data and engaging the administrators and personnel in discussions regarding how their efforts can make a positive impact on transitions. In addition, the Colbert Team will increase its presence in the Nursing Facilities to work directly with facility personnel to identify and address concerns as they arise. These concerns may include discussion of Service Plans for Class Members who are not ready to transition but who need skill development or other changes. Strategy 4: Enhance Collaboration with IDPH



Agency/ Key Staff

Begin Date


Outputs/ Outcomes

O-9 Twice per year, IDPH12- will facilitate HFS/DHS-led workshops with Nursing Facility administrators and staff, social

1, 3, 32 Colbert Lead DHS HFS IDPH

Pre-FY20

9/1/2019 4/30/2020

Identify baseline and increase referrals by 10% from nursing facilities during FY20, which will assist in reaching the number identified in the Anticipated Number of Referrals table below

12 Illinois Department of Public Health (IDPH)


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workers, peer mentors, ombudsmen, etc. responsible for interacting with Class Members

O-10 Convene monthly meetings with IDPH to identify other regulatory impediments or opportunities to improve Consent Decree compliance and plans to address

55 Colbert Lead IDPH

7/1/19 Ongoing Stronger IDPH role and regulatory environment to support Consent Decree strategy, planning, and operations

O-11 Identify ways to track and report on instances and findings regarding retaliation

5 Colbert Lead IDPH

9/1/19 10/1/19 Comply with Consent Decree requirement

The following chart identifies the past performance and anticipated results for FY20. In estimating results for FY20, Defendants have considered recent past performance, the impact of the transfer of the oversight of the Consent Decree, the processes in place and the implementation of the strategies identified above.

Performance Period Actual Number of Referrals Required Number of Referrals

7/1/17-12/31/17 2,171 - 1/1/18-6/30/18 1,811 - 7/1/18-12/31/18 2,580 - 1/1/19-6/30/19 - 2,242 7/1/19-12/31/19 - 2,466 1/1/20-6/30/20 - 2,713

Section III. Evaluation (Domain E) Per the Colbert Consent Decree, the Evaluation process occurs after a Class Member expresses her/his interest in being considered for the Colbert transition process and is designed to determine whether a Class Member is an appropriate candidate to transition and live safely in the Community. The Evaluation requirements include: a numeric benchmark for the number of Class Members to be evaluated in the compliance period; annual re-evaluations for all Class Members who do not meet distinct exclusionary criteria; and time parameters for evaluations and re-evaluations. The distinct exclusionary criteria include Class Members who decline to receive an Evaluation, have been determined by a medical doctor to have a condition such as severe dementia or other clinically significant and progressive cognitive disorders and are unlikely to improve. Requirements also


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include: the establishment of specific protocols regarding requests for Evaluation after refusals to transition and/or Class Member disputes with Evaluation findings; and the adequate exploration and attempted remediation of Class Member transitioning choice out of Nursing Facilities. After a Class Member has expressed interest in exploring transition, the Class Member, in conjunction with her/his guardian (if applicable) is informed by the Evaluator about the Colbert Transition process, their rights, and any applicable appeals processes, via the Colbert Informed Consent document. Evaluators (Qualified Professionals) The Colbert Team continues to work to improve the Evaluation process and to identify elements necessary for a transition determination as early in the process as possible. As part of that process, Class Members who have not yet transitioned, but who remain on the transition activity schedule for a full year, must receive timely Evaluation updates. Improvements to the tracking system will assist in that endeavor. Additionally, there has been some confusion about what a qualified professional is. Therefore, the definition of a 'Qualified Professional' will be reaffirmed, in accordance with the definition set forth in the Colbert Consent Decree. Defendants will collaborate with the Monitor and Parties if clarification beyond the Consent Decree definition of “Qualified Professional” is necessary. Improving accountability by Evaluator agencies will be implemented to address the quality requirements, including consistency as well as a continuous flow of Class Member referrals for transition. Strategy 1. Strengthen Standardization, Data Collection, and Quality Assurance of

Evaluation Process Task Task

Description Prior OoC/PC Finding

Agency/ Key Staff

Begin Date


Outputs/ Outcomes

E-1 Reaffirm the definition of “Qualified Professional” in accordance with the Colbert Consent Decree

___ Colbert Lead UIC-CON

7/1/19 8/1/19 95% reporting from providers on credentials of qualified professionals; 95% compliance with requirements

E-2 Enhance provider training and clearly outline compliance standards

7, 8, 10 Colbert Lead UIC-CON

7/1/19 10/3119 Improved performance on required completions of evaluations as identified in the Anticipated Number of Evaluations Table below

E-3 Develop and implement guideline matrix and tracking tool, including clear metrics for

7, 8, 9, 10 Colbert Lead UIC-CON

7/1/19 11/30/19 Utilize the tracking tool to enhance performance and assure compliance with evaluation goals as identified in the Anticipated Number of


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provider performance

Evaluations Table below Improved timeliness of receipt of completed evaluations by 30%

E-4 Develop centralized & automated tracking system to track and create reports that identify Class Members who have requested reevaluations (after declining to move) or are due for reevaluations

11, 12, 13 Colbert Lead DoIT

7/1/19 9/30/19 (go-live date)

Improved timeliness of re-evaluations in FY20 by 30%, when compared to FY19 timeliness rates

E-5 Utilize data reports during consults with evaluation providers

11, 12, 13 Colbert Lead

Pre-FY20

Ongoing Submit monthly report to agencies identifying completion of annual re-evaluation of non-transitioned class members including percentage meeting quality standard

E-6 Partner with DRS to train evaluators about the unique needs, services, and special considerations to support evaluation among those with physical disabilities

7, 11 Colbert Lead

Pre-FY20

8/31/19 Evaluators are more adept at identifying and addressing needs of Class Members with physical disabilities

E-7 Confirm that Class Members not referred to PSH13 or other housing options meet at least one of the Consent Decree exclusionary criteria

21 Colbert Lead

Pre-FY20

Ongoing Ensure compliance with Consent Decree

13 Permanent Supportive Housing (PSH)


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Evaluation Process The Evaluation process includes in-person meetings with the Class Member, his or her family/guardian (where appropriate) and current staff, Class Member record reviews, and assessments to identify and meet the needs of Class Members. As recommended by the former Monitor and former Consultant (now Monitor), the Defendants developed an abbreviated evaluation tool and completed a limited implementation and testing. The abbreviated tool increased efficiency, reduced lag times, and has been favorably received. Defendants have widely expanded the use of the abbreviated tool. The abbreviated tool includes the use of the Four Quadrant Clinical Integration Model (which was also recommended by the prior and current Monitors). Each Class Member who is evaluated is assigned to one of the four behavioral/physical health quadrants during this phase. The quadrants are used to assist in service planning for members. Strategy 2. Implement Brief Assessment Approach and Test New Care Navigator Model



Agency/ Key Staff

Begin Date


Outputs/ Outcomes

E-8 Streamline evaluation process & documentation requirements

5, 6, 10 Colbert Lead UIC-CON

Pre- FY20

7/1/19 Reduced length of time between Outreach contact and completed assessment, (80% compliance with required 30-day timeframe); Implement condensed assessment and compare required completion time of updated assessment to time required for previous assessment formats

E-9 Plan and test a Care Navigator System of Transition Service Provision; study results and expand if results support

10 Colbert Lead UIC-CON HFS

6/1/19 10/31/19 (test) 3/31/20 (expansion, if study supports)

Improve continuity of care by designating one care navigator from Outreach through transition into the community (See also Transition domain, below)

Additional identification of data points and tracking is needed to assess needs and trends pertaining to re-evaluations, housing and support services. Strategy 3. Strengthen Ability to Collect Usable Needs/Preferences/Barriers Data through

Evaluation Process Task Task


Agency/ Key Staff

Begin Date


Outputs/Outcomes

E-10 Update assessment tool

11,14 Colbert Lead

7/1/19 (begin

9/30/19 (complete

Enhance reporting on housing preferences through


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to ensure complete documentation & expanded reasons for Class Member preference while respecting choice of care options

IHDA14 update) update) enhanced reporting of information specific to individualized housing preferences resulting in exploration of additional housing options for Class Members in FY20

E-11 Develop specialized training content (tip sheets and webinars) on how Evaluators can “appropriately address” reasons for opposition to evaluation or transition (using most common reasons for opposing transition)

13 Colbert Lead

8/1/19 11/1/19 Decrease Evaluator declines in FY20 by 10% to 785

E-12 Provide additional training to Evaluation Agencies and Nursing Facility staff to strengthen Class Members knowledge of right to appeal

10 Colbert Lead

8/1/19 11/1/19 Raise Class Member awareness of appeal rights

Outputs and Outcomes: Anticipated Overall Number of Completed Evaluations The following chart identifies the past performance and anticipated results for FY20. In estimating results for FY20, Defendants have considered recent past performance, the impact of the transfer of the oversight of the Consent Decree, the processes in place, and the implementation of the strategies identified above.

Performance Period

Actual Number of Completed Evaluations

Required Number of Completed Evaluations

7/1/17-12/31/17 1,619 - 1/1/18-6/30/18 2,555 -

14 Illinois Housing Development Association (IHDA)


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7/1/18-12/31/18 2,504 - 1/1/19-6/30/19 - 2,516 7/1/19-12/31/19 - 2,591 1/1/20-6/30/20 - 2,670

Section IV. Service Planning (Domain SP) Service Planning is the process by which providers work with Class Members to develop a person-centered Service Plan that contains the vision, preferences, community support, service needs, and goals of the Class Member to attain (and maintain) successful transition to the community. Section VI. (B)(5) of the Consent Decree requires that Service Plans “shall focus on the Class Members personal vision, preferences, strengths and needs in home, community and work environments.” Service Plans are required for both Class Members who are recommended for transition — focused on the services and supports that will facilitate transition from the Nursing Facility to the Community — and for those who are not recommended for transition — centered on the goals and services necessary to prepare them for community transition at a later time. Service Plans must be completed within 45 days of the Evaluation, regardless of the recommendation. For Class Members recommended for transition, Qualified Professionals (e.g., Community Mental Health Centers, care navigator agencies) develop the Service Plan, in conjunction with the Class member and/or his or her legal representative, if any, which must be updated at least every 180 days to reflect any changes in the needs and preferences of the Class Member. For Class Members not recommended for transition, the Evaluator develops the Service Plan. The State will take reasonable steps necessary to implement procedures to ensure the accuracy of Evaluations and Service Plans through monitoring and other appropriate measures. Effective January 1, 2019, the Service Plan form was updated and aligned to comply with the Consent Decree and FY19 IP requirements, as a result of the IDoA and IDHS “Synergies” Multi-Year Growth Planning workgroup. UIC-CON reviews a sample of Service Plans for quality assurance and compliance with the Consent Decree. The State will continue working with UIC-CON to ensure the accuracy of Evaluations and to take any necessary corrective actions. A copy of the report will be provided to the Monitor and Plaintiffs’ Counsel on at least a quarterly basis. Timely Service Plan Development/Monitoring While significant improvements have been made, deficiencies remain in the timely completion of the Service Plans. Defendants will take all reasonable steps and actions necessary to ensure completions occur in the required time frames. Defendants believe an enhancement to the Tracking System and a case management system will better assist in identification of deficiencies and implementation of remediation plans for untimely or incomplete Service Plans. Defendants will analyze the feasibility of expanding the Peer Mentors program to allow for Peer Mentor involvement and support of Class Members with mental illness and Class Members with physical disabilities throughout the Service Planning process. Defendants will also increase the number of Certified Recovery Support Specialists (CRSS) used during Service Planning and Transition. These resources are being added to help Defendants work with Class Members to minimize and, in some cases, remove barriers that delay transitions.


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Service Planning actively continues post-transition, with updates completed at least twice within the first year (365 days). Post-transition updates will include in-person visits with the Class Member in the Class Member’s living environment. Strategy 1: Strengthen Service Plan Development and Monitoring



Agency/ Key Staff

Begin Date


Output/ Outcomes

SP-1 Develop upload feature to the Colbert Tracking System; identify other System improvements to assure compliance requirements for Service Plan elements (including specific requirements for non-PSH placement), completion, and submission dates

15, 16, 17, 18, 20, 67

DoIT UIC-CON Colbert Lead

Pre- FY20

Develop upload feature by 11/30/19 Identify additional improvements by 12/31/19

Increase number of completed Service Plans received within 3 months of evaluation by 50%

SP-2 Determine feasibility of utilizing an existing or new data management system, including CRM, system/ software/ applications to fully assess performance outcomes

17 Colbert Lead DoIT

Pre- FY20

9/30/19 Identification, development of specifications, and implementation of new system

SP-3 Review and expand current Quality Assurance processes to include routine reporting, provider-specific, in-person consultation, and periodic refresher training

21, 22, 23, 28

Colbert Lead UIC-CON

Pre- FY20

9/30/19 Transfer quality reviews to Service Plans completed at the time of transition when agency submission improves. Complete monthly data review between UIC-CON and Colbert Lead to identify trends and additional areas requiring review

SP-4 Determine and document feasibility of using

18, 22 Colbert Lead

Pre- FY20

9/30/19 Better identification of person-centered goals of care through peer-led


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Peer Mentors during Service Planning process

model

SP-5 If feasible, develop and implement program with Peer Mentors during Service Planning process. Note: Such a program may need to go through a competitive Notice of Funding Opportunity process

22 Colbert Lead

10/1/19 3/31/20 Better identification of person-centered goals of care through peer-led model

SP-6 Provide specialized training to Service Planning staff on types of representatives that may be available to support Class Members during Service Planning process

15 Colbert Lead

7/1/19 10/30/19 Increased comfort, engagement, and empowerment during service planning process

SP-7 Create and implement process for those who are transitioned into non-PSH settings to receive Service Plan update to prepare them for later transition to PSH

21 Colbert Lead

7/1/19 12/31/19 75% of Class Members in non-PSH settings receive an updated Service Plan

SP-8 Implement process to utilize data from Service Plans in the development of Community Based Housing opportunities

17, 18, 19, 20

Colbert Lead

7/1/19 10/31/19 Improve capacity development by incorporating Class Member needs and preferences

SP-9 Create and publicize an opportunity for

Colbert Lead

11/1/19 Ongoing Establish baseline and achieve 40% increase in Class Member visits to


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Class Members to visit and observe Community-Based settings

community housing and services. Comply with Consent Decree requirement; promote Class Member familiarity and comfort with community housing and service settings

Service Plan/IM+CANS Review With respect to the newly required IM+CANS tool, IDoA has reviewed the tool and determined there are a number of disparities and gaps between the information gathered using IM+CANS and the requirements of the Service Plan under the Colbert Consent Decree. DHS, and as applicable, IDoA, will continue to work to with HFS to review and synthesize these systems to the extent possible. In the alternative, the Colbert team may need to explore whether a modification of Consent Decree requirements for Service Planning is in order to streamline the process in light of use of the IM+CANS tool. Strategy 2: Review of Service Plan Decree Requirements/IM+CANS



Agency/ Key Staff

Begin Date


Outputs/ Outcomes

SP-10 Identify and utilize addenda to IM+CANS, if possible, to accurately reflect Class Member needs

16, 19 Colbert Lead UIC-CON HFS

Pre- FY20

9/30/19 Improved identification of co-morbidities and compliance as a result of CMHCs current use of IM+CANS

Independent Physician Verification of Dementia Diagnoses The Decree also requires independent physician verification for those Class Members who have been determined unable to transition due to a diagnosis of dementia. Defendants will engage a Medical Evaluator to assess and confirm or dispute dementia diagnoses of Colbert Class Members. Strategy 3: Engage Independent Medical Evaluator to Confirm or Refute Dementia

Diagnosis Task Task


Agency/ Key Staff

Begin Date


Outputs/ Outcomes

SP-11 Complete personnel process to identify Medical Evaluator candidates

6 IDoA 7/1/19 7/31/19 Complete posting and identification of Medical Evaluator candidates

SP-12 Engage a Medical Evaluator

20, 21, 28,

Colbert Lead

7/1/19 9/30/19* Utilize non-Nursing Facility-affiliated physician in compliance


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with Consent Decree * Timing is subject to hiring process and availability of qualified applicant.

FY20 Service Plan Targets The following chart identifies the past performance and anticipated results for FY20. In estimating results for FY20, Defendants have considered recent past performance, the impact of the transfer of oversight of the Consent Decree, the processes in place, the need to comply with Court Orders, and the implementation of the strategies identified above.

Performance Period Actual Number of Service Plans Completed Required Number of Service Plans Completed

7/1/17-12/31/17 -15 - 1/1/18-6/30/18 217 - 7/1/18-12/31/18 593 - 1/1/19-6/30/19 - 682 7/1/19-12/31/19 - 784 1/1/20-6/30/20 - 787

Section V. Transition Activities (Domain T) The transition of Class Members who are interested and deemed appropriate for safe Community transition is the central intent of the Consent Decree and Cost Neutral Plans, and broader Olmstead related decrees, emphasizing the rights of individuals to live in the least restrictive setting possible. Within the Transition domain for the Colbert Consent Decree, there are nine distinct requirements. These include requirements to create a transition activity schedule for Class Members deemed appropriate for transition; to transition Class Members on a timely basis; to protect Class Members from retaliation from Nursing Facility staff and others during the transition process; and to transition Class Members to PSH in buildings where 25% or fewer of the residents have a known disability, unless they meet specific exclusionary criteria to be placed in other housing types. Pipeline Analysis In order to better understand and address impediments to transition, a full Colbert Transition pipeline analysis was initiated during the second half of FY19. This process is expected to provide insight regarding the reasons for the current slow rate of transitions. Through this analysis, information will be identified as to the barriers for transition for Class Members currently in a number of transition statuses, including various holds, Complexities Affecting Seamless Transitions (CAST), and those currently and actively matriculating towards transition into the community. This analysis will also provide information on the Community-Based service arrays and housing options both currently available and otherwise needed to support Colbert Class Members in the pipeline. Some of the pipeline issues identified as impediments to transition thus far are as follows:

Insufficient/no income Medical issues

15 Tracking of the number of Service Plans completed began in 2018.


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Behavioral issues Declined transition services Insufficient/lack of Documentation

Based on the initial analysis, some interventions have been identified, but continued information on this population will be vital to transitioning Class Members. The following interventions have been identified and are proposed for FY20 to address the following impediments:

Lack of Funding/Income and lack of documentation will be addressed through the SOAR (SSI/SSDI Outreach, Access and Recovery) process;

Medical/Behavioral Issues will be addressed through continued examination of medical and substance-use related services; and

Declined transition services will be addressed through the re-evaluation process. Provider Accountability and Transition Monitoring Improvements with provider performance and timeliness were initiated in FY19. Corrective Action Planning via a formal process occurs where issues are identified. The Transition Achievement Plan (TAP) process engages management level and pertinent provider agency personnel in a direct dialog via an in-person meeting with Colbert Administrators regarding performance concerns and requires submission of a written plan of action from the provider. This process will continue to be improved. As recommended by the Monitor, improvements to the tracking system are needed. The Colbert program uses data regarding referrals to Evaluations and housing locator assignments to improve compliance and implement performance improvement processes with providers with significant performance concerns. Referrals to Evaluation and housing locator assignment reports are used to identify Class Members who have been waiting for either an Evaluation or to be assigned to a housing locator after 15 days in effort to comply with the 30-day Evaluation requirement and to ensure housing locator engagement is also timely. Defendants recognize that the prior reports used were 30-day reports and negatively impacted compliance. A review of efforts determined that the reports should be run prior to 30 days and offer service providers the opportunity to address timeliness to meet compliance reports. Defendants will assess the feasibility of implementing a Care Navigator System to provide more up-to date and accessible information regarding Class Members for providers and Class Members. Providers are now required to submit full Pipeline Reports on at least a quarterly basis, using a Pipeline Reporting Tool to ensure data is uniformly submitted and contains all relevant and required information. The information includes housing and geographic area of preference for Class Members. The Colbert Program will on-board Technical Support and Transition Development Specialists to monitor the information provided and collaborate with providers on potential solutions to identify and remediate roadblocks. The Colbert Data Analyst is responsible for ensuring data input by provider agencies into the Colbert Tracking System and other reporting is up to date and accurate. The technical Support and Transition Development Specialist will also work with the Colbert Data Analysts and providers to mitigate data inconsistencies.


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Strategy 1: Identify and Address Pipeline Impediments to Transition Task Task


Agency/ Key Staff

Begin Date


Outputs/ Outcomes

T-1 Implement immediate review of the ~150 Class Members who were recommended for transition through March 2019, but who have not been transitioned. Identify barriers and implement remediation

27, 43 Colbert Lead UIC-CON

Pre-FY20

9/30/19 Report that identifies needed systems/process level solutions to address pipeline issues to present at Large Parties Meeting; updated Service Plans with remedies for bottlenecks and new transition dates for affected Class Members

T-2 Implement review of 1,000+ Class Members historically recommended for transition but not currently engaged with a provider, analyze and remedy barriers and bottlenecks


9/30/19 Provide status update by 10/15/19 Remedy bottlenecks by 1/15/20

Report that identifies needed systems/process level solutions to address pipeline issues to present at Large Parties Meeting; updated Service Plans with remedies for bottlenecks and new transition dates for affected Class Members

T-3 Draft and distribute letter to Nursing Facilities regarding access to Colbert Class Members and pertinent records

32 Colbert Lead IDPH

Pre-FY20

8/1/19 Develop and implement system to monitor feedback from assessment and transition agencies regarding barriers to records; Track and mitigate the number of reports of Nursing Facility interference with class member and records access

T-4 Conduct aggregate analysis of Class Member choices to identify trends and

11,14 Colbert Lead UIC-CON

7/1/19 10/1/19 Creation and implementation of specified action plan for remediating significant barriers to transition identified


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barriers & to develop strategies to address

through the pipeline analysis

T-5 Develop centralized monitoring tool specific to tracking & understanding provider contracts during this pre-transition phase

27 Colbert Lead UIC-CON

7/1/19 12/31/19 Report frequency of pre-transition contact by agency as identified through Evaluation, Service Plan and/or tracking method

T-6 Research and analyze the feasibility of utilizing a Care Navigator System of Transition Service Provision


6/1/19 10/30/19 Improve continuity of care by designating one care navigator from Outreach through transition into the community

T-7 Develop and implement the System if supported by research


6/1/19 10/31/19 (test) 3/31/20 (expansion, if study supports)

Improve continuity of care by designating one care navigator from Outreach through transition into the community

T-8 Complete review and documentation of “pipeline” analysis

26, 27, 28

Colbert Lead UIC-CON HFS

Pre- FY20

At least monthly after 8/1/19

Identify barriers and bottlenecks including no/low income, document gathering, etc., and implement remediation

T-9 Identify and take steps to remove barriers and bottlenecks found in pipeline analysis

26, 27, 28

Colbert Lead UIC-CON

8/1/19 9/30/19 and ongoing

Begin tracking and measuring the amount of time Class Members are on hold during FY 20. Decrease time Class Members are on hold during FY 20

T-10 Update Pipeline Reporting Tool for provider reporting

26, 28, 30

Colbert Lead Colbert Data Analyst

FY19 8/1/19 Ensure accurate and complete reporting of pending Class Member transition status for tracking

T-11 Identify staff for pipeline analysis

26, 28, 30

Colbert Lead

7/1/19 8/1/19 Dedicated staff member for tracking


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pipeline data T-12 Quarterly

Analysis of impediments and potential interventions

26, 28, 30

Colbert Lead Colbert Data Analyst Technical Support and Transition Specialists

7/1/19; 10/1/19; 1/1/20; 4/1/20

9/1/19; 12/1/19; 3/1/20; 6/1/20

Identification and analysis of pipeline impediments; potential remedies

Medicaid Eligibility/Redeterminations (Commitment No. 3) The State recognizes there are significant challenges in the eligibility and re-determination process for Medicaid applicant and recipients. While this is an issue much larger than Williams or Colbert and impacts other litigation as well, the State is actively working on implementing strategies to reduce the overall backlog of applications, on streamlining the process, and on engaging in other activities intended to afford relief to those awaiting a decision, a process has been developed to ensure that Colbert Class Members are not adversely affected while the overall system is being addressed. To address concerns with Medicaid spend-downs required of certain Class Members, Defendants will identify potential funding sources for Class Members with unmet spend-down. Defendants will ensure such Class Members are able to both transition and remain in the Community through its spend-down efforts. In addition, a written policy will be developed and distributed to all DHS Local Offices on the proper protocol for handling Class Member spend-downs, and a Local Office staff person has been identified as a point-person for providers to contact if an issue arises. While the larger Medicaid application and redetermination issues are addressed, Colbert provider agencies have a designated contact person at DHS/Colbert to contact directly for any Class Member eligibility/redetermination issues. This individual will raise any concerns with one of three specified DHS Local Offices, whose staff have the ability to review the Class Member Medicaid status and remedy any impediments subject to program requirements and limitations. Second, DHS is collecting information on all Colbert Class Member applications to identify and expedite processing. Finally, with respect to re-determinations, Colbert CMHCs assist (and bill for casework services for) Class Members in submitting re-determination paperwork. For those Class Members currently in Nursing Facilities, the administrators have been provided the DHS/Colbert contact information to address individual issues. Information will be collected on Colbert redeterminations and spend-downs for analysis once the application data is completed. Strategy 2: Develop Proactive and Responsive Measures to Address Medicaid

Redetermination Among Class Members Task Task

Description Prior OOC/PC Finding

Agency/ Key Staff

Begin Date


Outputs/ Outcome

T-13 Creation and distribution of Informational

-- Colbert Lead

7/1/19 9/1/19 Enhanced understanding and handling of spend-


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Bulletin regarding spend-down grant

down grants

T-14 Creation and distribution of spend-down Guidance to Local Offices

-- Colbert Lead

7/1/19 9/1/19 N/A

T-15 Identification of staff to expedite Colbert Class Member issues

-- Colbert Lead

7/1/19 Ongoing Ability to quickly address and resolve individual CM Medicaid issues

T-16 Updates to Parties/Monitor on Colbert application/ redetermination data

-- Colbert Lead

7/1/19 Ongoing monthly after 7/1/19

N/A

Initiation of SSI/SSDI Outreach Access & Recovery (SOAR) Services (Commitment No. 4) The Defendants have identified and are taking necessary actions to remove Class Member barriers to safe and successful transitions, including lack of sufficient income/lack of SSD/SSDI. SOAR services have been initiated to assist Class Members SSD/SSDI applications. DMH is exploring the feasibility of (and, if feasible, will implement) a referral program in which Class Members evaluated as appropriate for transition will have access to DHS-funded legal services to appeal the denial of SSI/SSDI. For any Class Member applications that have been unsuccessful through SOAR but for whom SOAR trained staff continue to disagree with the denial of benefits, a request will be made to DMH for a final appeal to be handled through an attorney or other referral if such a program is determined to be feasible. There will be funding for a total of nine SOAR staff for Colbert provider agencies, totaling approximately $720,000 for FY20. The current proposed staff breakdown is as follows:

Thresholds 2 staff Trilogy 2 staff LSSI 1 staff Aetna 1 staff IlliniCare 1 staff Featherfist 1 staff Access Living 1 staff

These efforts are intended to reduce the number of Class Members on income-related CAST and other holds. If a provider does not receive SOAR staff funding, the Class Members will be referred to a provider with SOAR staff funding for that assistance. The intent is that every Class Member will have access to SOAR staff for assistance. SOAR outcomes will be closely monitored to determine the effectiveness of this approach and to identify baselines and future outcome measures related to submitted and successful SSI/SSDI applications and appeal.


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The Colbert program will participate in the DHS/DRS SOAR Learning Collaborative to ensure best practices are identified and used for SOAR services to Colbert Class Members. The goal of this Collaborative will be to identify strategies and methods to improve both first time application approvals and success on appeal. Ultimately, the goal for Colbert SOAR staff will be consistent with the Williams SOAR staff. For the first year, the goal is that the SOAR staff achieve at least 50% approval on submitted applications (in comparison with the national average of 65%), and 30% of appeals (vs. the national average of 42%) during FY20, and approach or exceed national averages in subsequent years. Strategy 3: Establish SOAR Staffing


Prior OOC/PC Finding

Agency/ Key Staff

Begin Date


Outputs/ Outcome

T-17 Determination of SOAR staffing for Colbert Providers

-- Colbert Lead IDoA DHS-DMH Contracts

FY19 7/1/19 Preparation for contract revisions to include SOAR staff

T-18 Inclusion of SOAR staff funding in FY20 Contracts

-- Colbert Lead IDoA IDHS-DMH Contracts

FY19 7/1/19* Funding for SOAR staff to further ability of Class Member to obtain necessary income for transition and tenure in community

T-19 Exploration of Feasibility of funded Attorney Referral Process

-- DHS/DMH Deputy Director of Systems Rebalancing Colbert Lead DHS/DMH Contracts

FY19 9/1/19 Explore possibility of provision of legal services to Class Members in certain SSDI/SSI appeals

T-20 If feasible, establish funded Attorney Referral Process

-- DHS/DMH Deputy Director of Systems Rebalancing Colbert Lead DHS/DMH Contracts

9/1/19 1/1/20* Provision of legal services for Class Members with likelihood of successful appeal of SSDI/SSI application denial

* Subject to procurement/grantmaking requirements.


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Seating/Mobility and Accessibility Needs of Class Members Defendants will continue to use the University of Illinois at Chicago Assistive Technology Unit (UIC-ATU) to assess Class Members’ Activities of Daily Living, Augmentative and Adaptive equipment, seating/mobility and accessibility needs and to provide resources to ensure safe and successful transitions in partnership with waiver services when necessary. UIC-ATU services and spending will be tracked and reported monthly at Large Parties Meetings. Flexible Funding for Providers To allow provider agencies additional flexibility in the use of funding to further Class Member transitions, in FY20, Colbert provider agencies will have a flexible funding source included in their contracts (total of $300,000 for all providers). The funding will be prorated for each agency, in proportion to their transition required targets for FY20. The funding itself will not be tied to a particular Class Member or an individual transition. The funding must be used on an approved expense, such as: Temporary housing assistance for those Class Members whose SSI/SSDI funding has been

approved but is not yet in place; Landlord mitigation funds; Temporary income supplements for Class Members with approved SSI/SSDI funding; Costs for additional pre-transition needs (i.e. personal items, etc.); and/or Transportation. Use for expenses other than those specified will require prior approval from DMH. Flexible funding expenditures will be reported monthly to DMH for tracking and monitoring. Subject to legal requirements and restrictions, Defendants will also work with providers to add flexible funding, by amendment, to their 7/1/19-12/31/19 agreements with IDoA. Strategy 4: Flexible Funding


Prior OOC/PC Compliance Finding

Agency/ Key Staff

Begin Date


Outputs/ Outcome

T-21 Draft and Release NOFO16 for Flexible Funding*

-- Colbert Lead DHS/DMH Deputy Director of Systems Rebalancing DHS/DMH Contracts

FY19 9/1/19 Solicit providers for flexible funding

T-22 Inclusion of Flexible Funding in Provider Agencies contracts

-- Colbert Lead DHS/DMH Deputy Director of Systems Rebalancing

12/1/19 1/1/20* Enhance ability of Colbert providers to conduct additional

16 Notice of Funding Opportunity


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DHS/DMH Contracts

transition-related activities

T-23 Monthly review of Provider Agencies reporting on Flexible Funding utilization

-- Colbert Lead DHS/DMH Data Analyst

1/1/20* Ongoing Monthly

Ensure Flexible Funding is used in furtherance of transition; analyze effect on transition rates

* Subject to procurement/grantmaking requirements

Staff Bonus/Retention Funds To assist in retaining and recruiting staff, Colbert provider agencies will be provided with Staff Bonus and Retention funds. These funds (a total of $450,000 for all providers) may be used either to pay performance-based bonuses to existing staff, for outside recruitment, or for use as sign-on bonuses for open positions. The funds will be provided directly to the provider agencies. As a part of this initiative, providers will be required to report on how the funding was used (by title/position) and staffing data as follows for the six-months prior to the additional funding and six-months post funding: 1. Time for Positions to be Filled (by title); and 2. Staff Retention/Turnover Data (by title). The current estimates for hiring and retention funds are signing bonuses of up to $1,500 for each open position (depending on the nature of position and difficulty filling position) and up to $500 for annual performance-based bonuses for exemplary staff. This will be consistent with the approach taken under the Williams Consent Decree. Strategy 5: Provider Staff Retention/Bonus Funding



Agency/ Key Staff

Begin Date


Outputs/ Outcome

T-24 Provide Provider Agencies with bonus/retention funding for defined positions

-- Colbert Lead DHS/DMH Contracts

9/1/19 Ongoing through FY20*

Reduction of staffing issues for agencies, including turnover rates, and quicker vacancy filling; potential expansion of services; improved transition rates

T-25 Analyze impact of funding

-- Colbert Lead DHS/DMH

1/30/20 Ongoing Determine effect of funding on


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Data Analyst staff retention, expansion of services and transitions

* Timing is subject to procurement/grantmaking requirements.

MCO Engagement, Incentive Payment Program and Contractual Obligations The role of Medicaid Managed Care Organizations (MCO) in Illinois to effectuate diversions has not fully been realized. To support MCO involvement in diversion efforts, the DHS/DMH will partner with HFS to engage in regular discussions with MCOs and Colbert provider agencies; review MCO contractual obligations pertaining to prior authorization to long-term care and other procedural safeguards against inappropriate Nursing Facility admissions; and to implement an incentive payment program for MCOs. HFS-contracted MCO contracts will be amended as part of the HFS certification for rates to CMS. HFS can identify Colbert and Williams Class Members by MCO who currently reside in an institutional setting, either a SMHRF or Nursing Facility. HFS proposes to pay MCOs a separate incentive over and above their current capitation rate for each institutionalized Class Member they move to the community and maintain for three years. The incentive will pay a significant portion of the total cost for moving the Class Member to the community and lesser amounts for the next two years. It will also be tiered so that a Class Member moved during state Fiscal Year 2020, beginning July 1, 2020, will have a higher payment than those moved in subsequent state Fiscal Years. Finally, if a Class Member is determined to have sufficient medical needs that have primacy over any behavioral needs and is determined inappropriate for transition to the community, HFS proposes that a small incentive payment be provided to the MCO in exchange for robust monitoring and documentation of this determination. The incentive will be large enough to share with their providers and medical team who are critical to the determination. Strategy 6: MCO Engagement, including Incentive Payment Program and MCO

Contractual Obligations Task Task


Agency/ Key Staff

Begin Date


Outputs/ Outcome

T-26 Implementation of Incentive Payment Program

41, 64 HFS FY19 10/1/19 Increased number of appropriate diversions and decrease LTC/SMHRF admissions while increasing community placement and tenure

T-27 Review and Address MCO Contracts

41, 64 HFS 8/1/19 11/1/19 Revised contract language, if needed; appropriate systems rebalancing

T-28 Convene DHS, HFS, MCOs and Williams and Colbert providers

41, 64 HFS, DMH

7/1/19 Ongoing Enhanced communication and coordination; address/remove


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transition barriers

Preadmission Screening and Resident Review (PASRR) Reform The PASRR process may be used to identify those individuals who are appropriate for Community-Based Services, to support development of an initial service plan that outlines needed Community-Based Services and housing, and to identify and refer individuals who would otherwise become Colbert Class Members to appropriate Community-Based Services. However, in practice, PASRR agents do not complete the initial service plan, as the assigned Community Mental Health Center is better suited to identify the services and supports needed for Class Members approved for transition. The Mental Health PASRR system is being updated to take a more robust approach to identifying individuals with behavioral health needs and placing them appropriately. The redesign is expected to be complete before October 1, 2019 with complete implementation expected by April 1, 2020. The PASRR system redesign will ensure identification, assessment, and appropriate placement with specific recommendations on services/supports for all individual Nursing Facility applicants with PASRR-qualified MH, DD, or related conditions. MH PASRR redesign will focus strongly on increasing diversion and more rapid community reintegration from facility placements. It will also include the following: 1. Improvements to the Level I process and tools to ensure identification of all individuals with

PASRR-qualifying conditions and appropriate utilization and tracking of exceptions to immediate Level II completion;

2. Exploration of potential criteria to distinguish appropriate referrals for NF, SMHRF, and more intensive levels of care;

3. Creation of a structure and process for addressing the most complex presentations and clinical needs;

4. Inclusion of an option for short, time-limited admission approval; 5. Update of Resident Review requirements, process, criteria, and determinations; 6. Enhancement of the relationship between PASRR and MCOs to increase collaborative efforts

on diversion and community reintegration, including MCO access to PASRR assessment results; and

7. Improvements to PASRR individual assessment reports, including report content and real-time access.

Strategy 7: PASRR Redesign Task Task

Description Prior OOC/PC Compliance Finding

Agency/ Key Staff

Begin Date

Completion Date

Outputs/ Outcome

T-29 Complete development of redesign

1 HFS

FY19 10/1/19

T-30 Implementation of redesign

1 HFS Other Defendant Agencies

7/1/19 4/1/20 ◊


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T-31 Conversion to new system for assessment input and reporting that includes real-time capabilities

1 HFS

1/1/20 10/1/20 ◊

T-32 Addition of 3 new staff to address PASRR redesign and on-going requirements

1 DHS 7/1/19 Post by 12/1/19, fill by 3/30/20*

Three new DMH PASRR staff in place

◊ Subject to Federal Approval * Timing is contingent on hiring process and availability of qualified candidates

Employment Defendants will ensure that the development of all Service Plans include a focus on the Class Member’s personal vision, preferences, strengths and needs in work environments and other meaningful day activities. All Class Members who express any interest in employment will be referred to DRS for employment support and resources. The Defendants will work with the DRS and continue to offer and improve upon referrals for competitive or supportive employment opportunities as choices for Class Members during FY20. DRS has developed a referral process that prioritizes Colbert Class Members. DRS and DMH/IPS (Individual Placement and Support) services and spending will be monitored and reported on at Large Parties Meetings. In addition, DMH and the DRS have been partners in implementing IPS in Illinois since 2005. Both Divisions work together to ensure IPS teams receive the resources and technical assistance needed to provide IPS services to individuals. DRS and DMH meet quarterly to discuss, brainstorm and problem solve IPS issues, including those involving Williams Class Members and will also include Colbert Class Members. Efforts are ongoing to expand IPS to other CMHCs and increasing the scalability of IPS in Illinois. During FY20, to increase the number of Williams and Colbert Class Members with mental illnesses enrolled in IPS and obtaining employment, and to increase the number of Colbert Class Members with physical disabilities obtaining employment, DMH/DRS will develop proactive plans with all providers to do the following: 1. Clinical staff should use the IPS (or other appropriate) Employment Center’s “Considering

a Job” Employment questionnaire during Class Member Service Plan development to engage Class Members and encourage enrollment in IPS (or other appropriate services);

2. Hire additional IPS Employment Specialist Staff and/or encouraging CMHCs to partner on IPS (or other appropriate) services;

3. Refer Williams and Colbert Class Members to another CMHC or to DRS if the affiliated CMHC does not offer IPS services; and

4. Full Service Williams and Colbert Provider CMHCs ACT Vocational Specialists should utilize the 8 Key Principles of IPS (or other appropriate) Supported Employment that Guide Implementation.


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Data on all Class Member employment-related activities and services, including use of DRS, IPS, inclusion of IPS information in Service Plan development and employment data will be included in the Semi-Annual Compliance Reports. Strategy 8: Employment support


Prior OOC/PC Compliance Finding

Agency/ Key Staff

Begin Date


Outputs/ Outcome

T-33 Review and establish benchmarks for supported employment and supported education engagement and outcomes

17, 23 Colbert Lead DRS DMH

7/1/19 10/1/19 Increased engagement and improved outcomes re: supported employment and education

Outputs and Outcomes: Transitions Defendants will appropriately use appropriated funds in order to meet or exceed the 450 number of transitions established by the Updated Cost Neutral Plan for July 1, 2019 through December 31, 2019. (It is notable that during that time, Defendants will also be transitioning Colbert from IDoA to DHS and, for the first time, issuing competitive solicitations for many of the provider and government-entity grants that support Colbert services.) The following chart identifies the past performance and the court-ordered numbers, reflected in the Updated Cost Neutral Plan.

Performance Period Court Ordered Number

of Transitions Actual Number of

Transitions Anticipated Number

of Transitions

7/1/17-12/31/17 300 197 N/A

1/1/18-6/30/18 300 181 N/A

7/1/18-12/31/18 400 162 N/A

1/1/19-6/30/19 450 - 180

7/1/19-12/31/19 450 - 450

1/1/20-6/30/20 TBD N/A TBD* *Discussions to begin no later than 10/1/19, to be completed on or before 10/15/19, and a proposed transition number will be based on data available on or before 10/15/19. Counsel for Plaintiffs reserve the right to file a motion with the Court if they do not agree with the proposed number by Defendants. In addition, as the transition number will be largely impacted by the NOFO process for Colbert providers which will not be completed by October 15, 2019, Defendants reserve the right to seek adjustment of the October transition number upon completion of the NOFO process.

Section VI. Community-Based Services and Housing Capacity Development (Domain C) A key success factor for Colbert is having a sufficient quantity (and quality) of Community-Based housing and services. There are three requirements in this domain: (i) incorporating and responding to the consultant’s recommendations; (ii) developing sufficient Community-Based Service and housing capacity to support timely transition for appropriate Class Members; and (iii)


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ensuring that Community-Based services address needs specified in Class Members’ Service Plans. Housing Capacity and Development Defendants acknowledge the need for the expansion of housing capacity and will continue to expand our partnership with IHDA. Work to identify and mitigate gaps will continue during FY20 via use of geo-mapping and analyzing current use and activity of the Statewide Referral Network (SRN) and Section 811 waiting list system. Defendants will use information to expand service array neighborhoods identified and expand partnerships with developers and landlords in identified areas to expand housing options available to Class Members. In addition, Defendants will provide waiting list data at each Large Parties Meeting. Defendants are committed to: engaging housing organizations and property owners, including those with experience in serving residents with challenging conditions; expanding transition opportunities for Class Members who are subject to “holds” due to financial reasons; identifying and addressing bottlenecks and barriers; and expanding Class Member access to Permanent Supportive Housing, Supervised Residential Settings, other community-integrated, less-restrictive dwellings and Clustered Model housing options that meet the needs and preferences of Class Members. Strategy 1: Identify Opportunities for and Expand Housing Capacity



Agency/ Key Staff

Begin Date


Outputs/ Outcome

C-1 Complete Geo-Mapping to identify gaps in housing and service needs

36, 37, 40, 41, 42

Colbert Lead IHDA Colbert Data Analyst

Pre- FY 20

9/30/19 Class Member communities of preference will be identified to allow for strategic expansion of housing options and service array

C-2 IHDA report on wait list, analysis of SRN, etc., engagement of IHDA property owners (when applicable), etc. to Colbert

36, 37, 40, 41, 42

IHDA Colbert Lead Colbert Housing Liaison

7/1/19 10/30/19 Utilize all housing options available to offer as choices to Class Members to increase transitions during FY 20

C-3 Convene housing workgroup/ taskforce

40, 41, 42

IHDA, DHS 7/1/19 Ongoing Housing development plan; access to types and quantity of housing needed by Class Members

C-4 Provide leadership to support local housing authorities to apply for HUD for Mainstream

40, 41, 42

IHDA 7/1/19 HUD application deadline

Increased dedicated housing resources for Class Members


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Voucher Program, if eligible (dedicated housing resources for SMI)

C-5 Track and report on granted waivers to landlords

40, 41, 42

IHDA 7/1/19 Ongoing Decreased number of lost units by 25% from baseline

C-6 Develop procedure for and report up-to-date SRN/811 waiting list data/information to track housing need

40, 41, 42

IHDA Statewide Housing Coordinator

7/1/19 Ongoing Accurate and close to real-time data on housing need

Illinois Housing Development Authority (IHDA) Housing Activities The IHDA has two primary ways housing can be made available to Class Members: (i) through investing in buildings and (ii) through providing rental assistance. Bricks and Sticks/Investing in Buildings IHDA provides lending products and equity allocations to developers to build and rehabilitate affordable rental housing throughout Illinois. Within the annual Low-Income Housing Tax Credit awards, IHDA rewards points to developers to set aside a minimum 10% of apartment units in each development for individuals/families referred to the SRN waitlist, an incentive spelled out in the Qualified Allocation Plan. Not all persons on the SRN waitlist are Class Members, but Class Members are given preference for all of those units through the Pre-Screening, Assessment Intake Referral (PAIR) module. This is a valuable source of PSH, but it takes some time to place the units in service, typically two years to develop the property and have individuals move in. IHDA also plans to hold a specific annual funding round to promote the new construction and rehabilitation of new PSH units. These buildings have 25 units or less and are scattered throughout Illinois in areas of Class Members’ geographic preference. In these rounds, 125 PSH units are typically created each year. However, it must be noted that as no more than 25% of the units in any building can be for Class Members, the units dedicated to Class Members in a typical funding round will be approximately 31 units. Rental Assistance IHDA continues to increase the SRN and Section 811 unit inventory that will benefit Class Members. Section 811 units are continuously being added throughout the year to new developments and when projects come into refinance. As mentioned above, SRN units are added to most new Low-Income Housing Tax Credits (LIHTC) developments at IHDA and may have a rental subsidy, in addition to being rent restricted for households at or below 30% of the area median income. Both PSH programs provide direct benefits to Class Members through affordable rents.


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Barriers The 25% restriction on units for Class Members in a single building limits IHDA’s ability to make a larger impact on Class Member housing. The Section 811 regulations regarding environmental reviews and the need to use a HUD computer system for landlords to get paid rent limits participation from the private market. Timing is a barrier, as there is often limited time to connect Class Members ready to leave an institution to a vacant unit. The State also has a pipeline of new SRN/811 units that will be added to the PSH stock, but the time it takes to build/rehab a building is significant (1-2 years). Best Practices Please note that IHDA promotes PSH and supports the Housing First Model. We ensure all PSH apartment units contain their own kitchens and bathrooms. All units must have 12-month leases and individuals must be able to come and go as they wish. In addition to these housing opportunities, housing locator service providers also pursue additional housing opportunities through establishing and maintaining relationships with landlords across Cook County.

Type of housing/unit (PSH and other)

Eligibility Location # of Units Projected to be Offered to Class Members

Statewide Referral Network (SRN) units – PSH

Persons living in an institution (Colbert, Williams, Ligas), at risk of institutionalization, or experiencing or at risk of homelessness.

Statewide 250 annually, depending on awarded LIHTC projects*

Section 811 PBV – PSH Class Members in Williams, Colbert, Ligas, persons at risk of institutionalization, persons living in an SODC

Statewide IHDA anticipates 88 units will become available on PAIR during FY20*

* All units are first offered to Class Members (Colbert, Williams or Ligas). However, if the timing does not work after 90 days for new units or 30 days for turnover units, the unit may be rented to another extremely low-income household.

IHDA continues to improve the waiting list process and communications about available units for service providers so they can easily submit applications for SRN and Section 811 units and update clients’ applications. Some recent improvements include adding flexible filters for accessibility features, to increase matches to units with a range of accessibility options; improving reporting capabilities for waiting list managers and IHDA’s property side, to better track referrals progress for individual developments; and, beginning discussions on how to communicate with interagency partners on current unit availability. Additional training will be provided on the waiting lists to service providers as early as possible during FY20. In addition, DMH/DHS will work with the Public Housing Authorities and IHDA to move class members off of Bridge Subsidy to SRN units, Housing Choice Vouchers or through the Section 811 Match program.


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Obtain Housing Expert Analysis and Technical Assistance DMH will coordinate with IHDA and/or other contractual housing specialists on preparation of an analysis of funding and policy considerations for Housing First and Permanent Supportive Housing. The report will include identification and exploration of options and strategies that may not currently be utilized in Illinois, including but not limited to the following: mechanisms for funding housing and support services, policies that underlie successful programs, helping providers of mental health and substance abuse services improve their practices, and addressing housing instability. The analysts will have access to all pertinent housing information, Class Member demographics, geo-mapping results, and other materials that would assist in their analysis. A report on the findings and recommendations will be submitted to the Parties and Monitor for discussion. Training will also be provided on the Housing First Model to assist Resident Reviewers, providers, and others on Housing First principles in an effort to achieve more efficient and successful transitions of Class Members from SMHRFs and Nursing Facilities into Community-Based Settings. In the event it is determined that outside assistance is required for this analysis, an RFP will be issued. Strategy 2: Obtain Housing-Related Expert and Technical Assistance



Agency/ Key Staff

Begin Date


Outputs/ Outcome

C-7 Issue RFP to Identify Housing Experts (as needed)

36, 37 Colbert Lead DHS DMH IHDA

7/1/19* 9/1/19* First step toward obtaining additional guidance on potential housing strategies for Williams and Colbert

C-8 Contract with Housing Experts based on RFP (as needed)

36, 37 Colbert Lead DHS/DMH IHDA

12/1/19* 1/1/20* Second step toward obtaining additional guidance on potential housing strategies for Williams and Colbert

C-9 Issue Report 36, 37 Colbert Lead DHS/DMH Contracted Experts

1/1/20* 4/15/20* Identification of Housing Strategies or modifications to current system that can be applied to Williams and Colbert

C-10 Issue State Plan and Recommended Actions

36, 37 Colbert Lead DHS/DMH IHDA Other agencies as

4/15/20* 6/1/20* Identification of strategies or modification to current system; incorporation into FY21 IP


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needed

*Dates for this strategy are dependent on the agency/entity identified to conduct the analysis/training. To the extent a State agency or already contracted entity is able to conduct the analysis and/or training, the completion dates may be sooner than anticipated.

The Colbert team is eager for the opportunity to expand staff and have the resources to explore successes of other Olmstead plans. An examination of the housing process is needed. Develop and implement a robust services and housing capacity plan to help remedy Class Members who were placed on holds or had limited housing options due to programmatic inadequacies or process failures such as the unnecessarily lengthy documentation- gathering periods that prevent Class Members from timely transitions. Defendants will continue to support service expansion through the integrated healthcare grant, which is utilized to support nursing and occupational therapy services. (Commitment No. 4) Strategy 3: Streamline Housing Processes



Agency/ Key Staff

Begin Date


Outputs/Outcomes

C-11 Review all of the steps in the housing process


Pre-FY20

Ongoing Identify and remediate the bottlenecks and barriers resulting in placement of Class Members on various types of holds

C-12 Convene a core housing locator/housing options organization workgroup

40, 42 Colbert Lead IDHS IHDA

Pre- FY20

9/30/19 Increase the number of housing options available for Class Member choice

C-13 Update data management system to track community-based housing choices, including SRN/811 units

43 Colbert Lead DoIT DHS/ Statewide Housing Coordinator

Pre- FY20

10/30/19 Identify types of housing obtained by Class Members

C-14 Expand housing options available to members with complex co-morbid conditions

40, 42 Colbert Lead, IDHS IHDA

10/1/19 6/30/20 Increase housing choices for Class Members with complex conditions

C-15 Develop and implement

43 Colbert Lead

Pre-FY20

9/30/19 25% reduction in lengthy documentation holds by


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standardized process for obtaining necessary documentation from outside entities

end of FY20

C-16 Work with 811 Match to move Class Members from Bridge Subsidies to Housing Choice vouchers

36, 37 Colbert Lead Colbert Housing Specialist

7/1/19 Ongoing Work to move Class Members from Bridge Subsidized units to Section 811/Housing Choice voucher units

Provider Summit (Commitment No. 6) To better address the various concerns from Colbert (and Williams) providers and to better serve Class Members and facilitate tenure in the community, a series of Quarterly Provider Summits will be held. Summits will include Williams and Colbert Provider Agencies, MCOs, and State Staff, the Monitor and Counsel for Class Plaintiffs. During the first Summit, targeted to take place in August 2019, the following will be on the agenda:

1. Presentation by Class Members Living in Community Settings a. Discussion of Impediments to Transition b. Personal Outcomes/Recommendations

2. Capacity Issues 3. Class Member Needs

a. Services and Supports Needed to Transition b. Pipeline results c. Alternative Settings Needed

4. Transition Barriers (Pipeline Discussion) 5. Training on housing/PAIR module by (IHDA) 6. Transparency Regarding Performance Outcomes Accountability

The second Summit will take place in late November/early December 2019. Prior to that, Colbert (and Williams) staff will undertake a detailed review of provider contracts to determine what modifications may be made to specify deliverables, incentivize community tenure of transitioned Class Members and other modifications to further the purposes of the Decrees. To the extent timely and practicable, such modifications will be part of the Notice of Funding Opportunity process for Colbert and otherwise sought for existing agreements. Colbert staff are now reviewing Olmstead plans in other states to identify learning opportunities from activities in those states and will report on what is being reviewed and learned at a Large Parties Meeting. The Agenda for the second Summit will include:

1. Continued Discussion of Capacity Issues/Class Member Needs 2. Current Observations Regarding Class Member Characteristics/Challenges 3. Service Needs 4. Transition Barriers 5. Success Stories from other States Related to Olmstead Plans


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6. Contract Modifications Medicaid Service Reimbursement Rate Review (Commitment No. 8) In response to concerns raised by Williams and Colbert providers, HFS, as the single state Medicaid agency, will be conducting a review of targeted Medicaid Reimbursement Rates and Services. This review will be limited in scope, focusing on specific rate issues identified by DHS and IDoA, based on input obtained via the Provider Summits. Defendants will collect feedback from providers, including via the August 2019 Provider Summit, and will provide to HFS for consideration as part of, and for incorporation into the FY21 budget process. Development of a Service and Housing Provider Capacity Development Plan The Provider Summits, Rate Review, Pipeline Analysis and other available data and feedback (including service plans) will be utilized to develop a Service and Housing Provider Capacity Development Plan. This plan will outline the State’s vision and the concrete numeric investments needed to bring online the quality/type and quantity of services that will be expanded throughout the fiscal year responsive to need (including new provider types) and needed housing investments. Strategy 4: Provider Capacity Plan, Provider Summits, and Medicaid

Reimbursement Rate Review Task Task Description Prior

OOC/PC Finding

Agency/ Key Staff

Begin Date Required Completion Date

Outputs/ Outcome

C-17 Schedule and hold first Provider Summit

40, 41, 42, 43

DHS/DMH Director of Systems Rebalancing Colbert Lead HFS IHDA

7/1/19 No later than 8/30/19

Increase awareness of provider concerns/Class Members’ perspective

C-18 Create initial service and housing provider capacity development plan based on Provider Summit feedback and other data/information

40, 41, 42, 43

All Named Defendants & IHDA

7/1/19 1/1/20 with ongoing modifications

Identify quantity and type of needed housing and services and plan to adequately supply resources

C-19 Provider contract review and analysis-Identify modifications to further transitions and community tenure

40, 41, 42, 43

DHS/DMH Contracts

7/1/19 11/1/19 Identify contract modifications to increase transitions/ community tenure

C-20 Schedule and Hold Second Provider Summit

40, 41, 42, 43

DHS/DMH Deputy Director of Systems

8/30/19 No later than 12/15/19

Identify and discuss provider concerns to


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Rebalancing HFS Colbert Lead

help alleviate transition impediments

C-21 Prepare Summary of Outcomes/ Recommendations/Provider Contract Modifications

40, 41, 42, 43

DHS/DMH Deputy Director of Systems Rebalancing DHS/DMH Contracts Colbert Lead

11/1/19 12/30/19 Identify ways to use contracts to increase Provider participation and accountability

C-22 Identify recommended modifications for FY21 Provider Contracts

40, 41, 42, 43

DHS/DMH Contracts Colbert Lead

12/30/19 1/15/20 Implement contractual provisions to further transitions and accountability

C-23 Schedule and hold 3rd and 4th Quarter Provider Summits

40, 41, 42, 43

DHS/DMH Deputy Director of Systems Rebalancing HFS IDoA/Colbert IDPH IHDA

12/15/20 3/30/20

No later than 3/30/20 and 6/30/20

Identify and discuss provider concerns to help alleviate transition impediments

C-24 Identify potential specific Rates for review

40, 41, 42, 43

DMH Deputy Director of Systems Rebalancing Colbert Lead

7/1/19 9/1/19 Identify rates (Medicaid and/or other) for which modifications would positively impact providers and potentially increase transitions

C-25 Provide report to Plaintiffs and Monitor on which rates will be subject to review

40, 41, 42, 43

HFS 10/1/19 11/1/19 Identify feasibility of rate modifications

C-26 Conduct review of identified rates

40, 41, 42, 43

HFS 10/1/19 11/15/19

C-27 Provide rate recommendations to Governor’s Office of

40, 41, 42, 43

HFS 11/15/19 12/31/19


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Management and Budget in conjunction with FY20 budget

C-28 Provide report to Parties and Monitor on final rate changes as reflected in FY20 Governor’s budget

40, 41, 42, 43

HFS Whenever cleared by Governor’s Office to release information

2/20/20

(when Governor’s proposed budget is announced)

Section VII. Administration (Domain A) The Colbert Consent Decree has requisites in several administrative areas, including reporting requirements for the Defendants and Monitor; procedures to provide the Monitor with unfettered access to Class Members, staff, and contractor data and information; and the Defendants’ obligations to pay the Monitor, allow her to retain staff, and permit her to conduct unaccompanied interviews with Colbert staff and contractors. Defendants were previously found in compliance with the Administration requirements. Defendants intend to continue to comply with these requirements in FY20. Consolidation of Colbert/Williams Under DHS Oversight (Commitment No. 1) Primary oversight of the Colbert Decree implementation is being transferred from IDoA to DHS. This will allow for greater coordination of efforts to serve both Colbert and Williams Class Members; however, this is a significant undertaking that will immediately require a great deal of time and resources. Defendants are confident the short-term investment in consolidation is absolutely necessary to the long-term success of the Colbert program. In addition, in order to better integrate the multiple State Agency efforts involved in both Williams and Colbert, the routine meeting schedules are being adapted to encourage collaboration both among the various agencies as well as between the parties and Monitor. State-only meetings will be held in advance of meetings with the Monitor and/or parties to review activity, identify issues, and proactively address potential areas of concern and potential collaboration. A separate meeting will then be held with DHS, other State staff and the Monitor for strategic discussions, problem solving on programmatic issues, and proactively addressing compliance issues related to the Decrees. Finally, the meetings, known as the Large Parties Meetings, with the Parties and Monitor for Williams and Colbert, have been combined into a single meeting to focus on macro-level data and outcomes review and more on larger aspects of implementation and compliance to further progress under the Decrees. Office of Olmstead Compliance The State has established the Office of Olmstead Compliance within the Office of the Secretary of the Department of Human Services. This office will provide strong, centralized, integrated


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oversight of all aspects of the Colbert and Williams Consent Decrees, including overseeing performance monitoring, data analysis, contract management, staffing, and budgeting. The Office of Olmstead Compliance will be directed by the Olmstead Compliance Officer, a position reporting directly to the Secretary of DHS. The Olmstead Compliance Officer will possess a background suited to providing both programmatic and operational leadership to the Olmstead Consent Decrees. This individual will serve as primary liaison to leadership at all provider organizations supporting Olmstead Decree activities, ensuring streamlined, integrated resolution to various issues affecting performance and outcomes. Importantly, the Olmstead Compliance Officer will be empowered by the Secretary of DHS to work across all DHS divisions and with sister agencies to remove bureaucratic barriers to successful implementation. The Williams Administrator (also referred to as the Deputy Director of Systems Rebalancing), the Colbert Administrator, and all other dedicated Consent Decree functions (e.g. housing, employment) will report directly to the Olmstead Compliance Officer. This dedicated leadership and centralized oversight of all Consent Decree functions is expected to reduce redundancy and significantly expand the State’s capacity to quickly identify, analyze, and resolve barriers to the successful implementation of this plan. (Finding No. 77) The Colbert Consent Decree will transfer from IDoA to DHS in FY20. A transfer plan has been created which identifies major areas of focus, including personnel, fiscal/budget, information technology, and logistics. The plan is to transfer all listed positions and personnel/contractual members to DHS during the move. IDoA will be entering into six-month contracts with many of the providers—those whose areas are required to be competitively solicited by DHS through the Notice of Funding Opportunity grant process. IDoA and DHS will be working with providers, as permitted by law, to amend even those six-month agreements, in order to incorporate the additional funding and incentive concepts detailed in this IP as well as to discuss and, as appropriate, incorporate other funding or related provisions. Defendants will take all reasonable and necessary actions to make certain, including, but not limited to, in the Notice of Funding Opportunity grant process, to have and maintain appropriate reimbursement rates and other compensation to providers in order to ensure that the Defendants have the provider resources in order to accomplish the number of transitions and other requirements of the Consent Decree and this Implementation Plan. Strategy 1: Creation of Office of Olmstead Compliance



Agency/ Key Staff

Begin Date


Outputs/ Outcome

A-1 Hire Olmstead Compliance Officer to oversee Olmstead Consent Decrees

65 DHS Grace Hou

FY19 7/1/19* Olmstead Compliance Officer hired by 7/1/19*

A-2 Support efforts to hire Williams Administrator/ Deputy Director of Systems

-- DMH Diana Knaebe

FY19 7/1/19* Increased collaboration


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Rebalancing

A-3 Transition Colbert budget from IDoA to DHS

64 IDoA and DHS executive, legal, and fiscal

FY19 7/1/19 Approximately $10M appropriated to IDoA for six- month agreements and approximately $29M appropriated to DHS for other agreements, personnel, etc. and for all agreements, after 12/1/19

A-4 Identify organizational structure for Colbert staff within DHS

64 DHS executive, legal and fiscal staff

FY19 9/30/19 Colbert staff integrated into IDHS organizational structure

A-5 Complete NOFO process and enter into contracts between IDHS and Colbert providers

64 DHS executive, legal and fiscal staff

FY19 12/1/19 Execution of Colbert provider contracts with IDHS

A-6 Identify physical location for Colbert staff and relocate to DHS Office

64 DHS executive staff

7/1/19 12/31/19 Integration of Colbert staff into IDHS offices

A-7 Complete comprehensive analysis of staffing needs and resources

64, 65 DHS and DMH executive, program, and legal staff, including Olmstead Compliance Officer

7/1/19 9/30/19 Identify staffing needs and resources

A-8 Reassign and fill additional positions as identified

64, 65 DHS and DMH executive, program and legal staff, including Olmstead

10/1/19 12/31/19 New staff in place by 12/31/19*


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Compliance Officer

* Timing contingent, as applicable, on establishment of new position, hiring process, and availability of qualified candidates.

Position Title Working Title Status

Senior Public Service Administrator

Division Manager of Transitions and Community Relations (Senior Colbert Administrator)

Filled

Senior Public Service Administrator

Transitions and Research Administrator (TRA) (Deputy Administrator)

Vacant

Administrative Assistant I Colbert Administrative Assistant Filled (Will have to be posted as new position in being moved to DHS.)

Executive II (merit comp) Special Projects Liaison Approved to create the position

Personal Service Contract Colbert Special Assistant Vacant - Posted Personal Service Contract Housing and Transition Liaison Vacant – Re-Posted Personal Service Contract Data Analyst Filled Personal Service Contract Technical Support and Transition

Development Specialist Filled

Personal Service Contract Technical Support and Transition Development Specialist

Vacant - 4 positions posted

Personal Service Contract Medical Evaluator IPAR approved Personal Service Contract Quality Liaison Vacant/Posted Personal Service Contract Budget Specialist Position Posted Personal Service Contract Data Scientist/Lead Analyst Scope of Work drafted

Regular Consent Decree Meetings To support Consent Decree planning, strategy, and operations, the State will continue to host the following meetings in FY20:

• Monthly Large Parties Meetings • Monthly Meetings between DHS/DMH (IDoA until the complete transfer to DHS has

occurred) and Monitor • Monthly Meetings between State agency executives and staff • Regular Meetings between Monitor and Olmstead Compliance Officer, Colbert

Administrator, and other staff (as needed/appropriate)

Strategy 2: Convene Consent Decree Meetings Task Task


Agency/ Key Staff

Begin Date


Outputs/ Outcome

A-9 Convene monthly Large Parties Meetings

-- DHS/DMH FY19 Ongoing --

A-10 Convene monthly State-Only Meetings

-- DHS/DMH, Named Defendants,

FY19 Ongoing Support Consent Decree Planning, Strategy and


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IHDA Operations

A-11 Convene monthly DHS and Monitor Meetings

-- DHS/DMH FY19 Ongoing Support Consent Decree Planning, Strategy and Operations

A-12 Convene meetings between Olmstead Compliance Officer and her staff and Monitor

-- DHS/DMH FY19 Ongoing Support Consent Decree Planning, Strategy and Operations

Strategy 3. Implement Transfer Plan of Colbert from IDoA to DHS

Task Description Required Completion Date

Key Area Responsible

A-13. Identify and execute IGA with Housing Authority of Cook County

7/1/19 DHS

A-14. New agreements entered into with providers, including, as necessary, government entities (subject to NOFO requirements)

12/1/19 DHS

A-15. Move filled personnel positions and Personal Service Contracts to DHS (subject to required Class Members and, if applicable, Shakman Special Master approvals) (Note: The Administrative Assistant position will be moved, but also must be posted to fill.)

7/1/19 DHS, IDoA, CMS

A-16. Move vacant Personal Service Contracts to DHS 9/30/19 DHS A-17. IT systems and training 7/1/19 DoIT A-18. Budget (split between DHS and IDoA) 7/1/19 DHS/IDoA A-19. Determine operational location within DHS. 9/30/19 DHS A-20. Finalize physical location and move at DHS. 12/31/19 DHS

Semi-Annual Reports Defendants are to submit semi-annual (6-Month) reports to provide data and information on compliance and progress towards compliance with the Decree. Substantial revisions have been undertaken with respect to the first report for FY19 in consultation with the Monitor. Those modifications and others will continue for future reports to ensure compliance with this reporting requirement.


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Strategy 4: Modification to Semi-Annual Reports Task Task

Description Prior OOC/PC Compliance Finding

Agency/ Key Staff

Begin Date


Outputs/ Outcome

A-21 Revision and submission of semi-annual reports in consultation with Monitor

-- Colbert Lead

FY19 8/15/19, 2/15/20

Report timely submitted; containing information and data sufficient to determine achievement of compliance measures

Section VIII. Implementation Planning (Domain I) The Consent Decree requires development of an Implementation Plan (IP), at least annually, to guide a set of deliberate actions and activities to “accomplish the obligations and objectives” of the Consent Decree. Required elements of the annual IP include that year’s plans for hiring, training, and supervising personnel; methods to provide Outreach and disseminate information; any necessary changes in regulations to support greater transitions and compliance; and efforts to develop needed service and housing capacity, including the review and analysis of Class Members’ Service Plans to determine the requisite quality and quantity of services and housing. At this time, the Colbert team does not anticipate the need for any regulatory or legislative changes but suggests modification to the Consent Decree and/or several programs (such as IM+CANS) could increase the success of the Colbert program. The 2016 and Updated (2018) Cost Neutral Plans include additional requirements, calling for specific numeric targets for the pace of evaluations, Service Plans, service/housing capacity development, and transitions, as well as consideration and inclusion of the 2017 Consultant recommendations. The primary underlying reason for the non-compliance findings regarding the IP was because an IP for January 1, 2018 through June 30, 2018 was not finalized. The document was drafted, however, due to timing issues pertaining to work on the subsequent IP (FY19), Plaintiffs and Defendants agreed to focus on drafting and coming to an agreement on the FY19 IP rather than finalizing the January 1, 2018 through June 30, 2018 IP. Defendants fully intend to bring each of the out-of-compliance findings (63-76) into compliance with the FY20 IP. Strategy 1. Develop and Submit a Timely, Complete, and Operationally Sound IP



Agency/ Key Staff

Begin Date


Outputs/ Outcomes

I-1 IDoA and DHS, as appropriate, will establish an oversight process and updates to

63-76 Colbert Lead DHS

Pre- FY20

Pre- FY20 Timely filed FY 20 IP


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the IP I-2 Preparation of

and submission of initial FY21 IP draft to the Parties and Monitor

63-76 DHS Defendant Agencies

3/1/20 5/1/20 May 1, 2020 submission of initial draft of IP for Review and comment

I-3 Filing of final FY21 IP in compliance with compliance requirements

63-76 DHS Defendant Agencies

5/1/20 6/30/20 June 30, 2020 filing of IP that complies with compliance requirements or separate filings by Parties by June 30, 2020


New COLBERT v. PRITZKER CONSENT DECREE 07-4737 FY 2020 … · 2019. 8. 7. · COLBERT v. PRITZKER...

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