Choices Community Stakeholder Committee
Thursday, June 4, 2015
5:30 PM – 7:30 PM
Champaign Public Library
200 W. Green St., Champaign, IL 61820
MINUTES
Attendees: Shi Lynn Coleman, Matthew Stinson, Katrina Roberts, Regina Crider, Erica Vassar, Kristine
Herman (co-chair), Thom Pollock (co-chair), Shannon Van Deman, Kristin Owen (co-chair), Shawn Cole
(co-chair), Kati Hinshaw, Clete Winkelmann, Pat Ege, Dee Ann Ryan, Sheila Ferguson, Laurelyn Cropek,
Michael Goldberg, Chris Bruns, Abby Alger, Deloris Henry, Elizabeth de Gruy, Tracy Parsons, Jonte Rollins
1. Introductions – Shawn Cole started the meeting at approximately 5:33 PM. Attendees
introduced themselves, and the four committee co-chairs were introduced.
2. Why are we here?
a. Ground rules – Shannon Van Deman overviewed the Ground Rules handout. Moving
forward, she will hold the group accountable for following these rules.
b. Shawn Cole discussed the purpose of this committee. HFS and DCFS are both
committed to the Choices Demonstration Projects being piloted in the four counties.
The two departments are pleased with where the project is at, but recognize there is
room for growth and want to hear the community’s feedback so that any issues can be
addressed.
3. Overview of the Choices Demonstration and Care Coordination Model – Kristin Owen provided
the group with an overview of the HFS Choices Demonstration project. The project is based
upon the principles and philosophy of Systems of Care and Wraparound. Choices serves
children and youth under the age of 21 who live in Champaign, Ford, Vermilion, and Iroquois
counties. Key components of the project include:
 Intensive care coordination that manages behavioral health and coordinates physical
health.
 The development of a Child and Family Team (CFT). The CFT is made up of the child, the
family, any service providers involved with the child, and natural supports identified by
the family. The CFT works to develop an Individual Plan of Care (IPoC) for the child.
 All Choices clients have an IPoC. This is how Choices authorizes services.
 All Choices clients also receive a CANS assessment at the time of enrollment and
periodically after, depending on the level of care coordination they receive.
 Families are able to choose the providers they want to work with.
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Urbana, IL 61801 217.366.3310
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Choices has the ability to purchase services not available under Medicaid through their
Demonstration Risk Pool.
Choices will be responsible for mobile crisis response services in the four counties
beginning July 1.
The goals of the project are: (1) improved clinical outcomes for children and families, (2)
increased access to needed behavioral health services, and (3) better coordinated care that is
less confusing for families to navigate.
Choices has a variety of contractually required committees that contribute to the project’s
governance:
1. Family Leadership Council – designed to support family voice. It is just getting started;
the Council has had two meetings to date.
2. Quality Management Committee – also just getting started; this committee looks at
what quality measures are most critical to the project and sets benchmarks for Choices
to meet that can impact some of their funding. The Family Leadership Council must
approve all members of the Quality Management Committee.
3. Network Advisory Committee – will be working to establish in the beginning of the new
fiscal year.
Choices Care Coordination Model
 Built around a 4-tiered system, with Tier 1 representing the highest intensity of care
coordination and Tier 4 the lowest intensity.
 The model is reviewed by HFS, DHS-DMH, and DCFS on a quarterly basis.
 Tier 1 youth receive high-fidelity wraparound and the care coordinators maintain a 10:1
caseload. Tier 2 maintains a caseload of 20:1; Tier 3 = 40:1; and, Tier 4 = 70:1.
 The Tier a youth is assigned determines the minimum frequency of contact they have with
their care coordinator. Families are always able to request more frequent contact.
 Caseloads for all care coordinators are maintained using a point value system. At full
capacity, care coordinators maintain an average value of 20 points.
 All youth in Tiers 1-3 have a CFT established.
Question: What version of the CANS is used? Is the CANS only used for Tier assignment?
Answer: Choices uses the Indiana version of the CANS. Although the results may not be directly
reviewed by the CFT, the CANS should be used to inform the CFT process and should drive the
development of the IPoC.
Q: Do families know what Tier they are in? Can they ask for more frequent assessments to be
conducted in order to move Tiers?
A: Care coordinators don’t specifically talk to families about which Tier they are in, unless they
are a Tier 4 youth. Youth initially assigned to Tier 4 might change to a higher intensity Tier after
their CANS assessment is completed. If this happens, the family would switch to a different care
coordinator. Choices discusses this with Tier 4 families in the beginning so they are prepared if
they need to switch care coordinators. Each Tier has a regular timeframe in which a CANS
102 E. Main St, Suite 200
Urbana, IL 61801 217.366.3310
assessment must be completed, but there are other events that can trigger a CANS to be
performed outside of those timeframes, such as multiple activations of the youth’s crisis safety
plan.
It was suggested that families should be engaged in a conversation about the Tier system and
should be informed about what Tier their child is in. This will further empower families and
keep them fully informed so that they can keep their care coordinator accountable to the
expectations of their Tier.
4. Overview of process for Community Stakeholder Committee – Thom Pollock overviewed how
this committee came to be and what process was taken to develop the first meeting. The
startup of the Choices Demonstration has experienced some implementation and
communication issues with the community. There is a desire to move forward past any
challenges that have occurred and start building towards a successful, collaborative future.
The co-chairs planned for this first meeting by identifying a list of key stakeholders to invite.
This is an open meeting, but the co-chairs felt it was important to not have a committee that
was so big the conversations couldn’t be productive. Anyone with additional suggestions for key
stakeholders to invite should send them to Kati Hinshaw (kati.hinshaw@illinois.gov).
a. Key stakeholders invited – Schools, community providers, hospitals, families, family run
organization, 708 boards, physicians, and advocates.
b. Are we missing anyone? – The group suggested inviting representatives from the
court/probation system, permanency workers, and youth.
c. Logistics – the intention is to host these meetings monthly, rotating the location across
the four counties. The co-chairs will look into possibly electronic interface options.
5. Eligibility and enrollment in the Choices Demonstration – For the HFS project, an initial group
of youth were determined eligible to participate in Choices based on historical involvement with
the SASS program. HFS manages all enrollments into the project and disenrollments from the
project. The basic criteria for being eligible for the project:
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Must be under the age of 21.
Must live in one of the 4 counties.
Must have Medicaid eligibility and not be a ward of DCFS.
Cannot have a significant amount of private insurance.
Cannot be enrolled in another managed care plan.
Choices currently serves approximately 430 youth. HFS is working to identify additional criteria
for enrollment into the project. Families receive a letter from HFS notifying them of enrollment
into the project. They have 90 days from their enrollment date to opt out and another
opportunity to opt out for 60 days prior to their anniversary date with Choices. The program is
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Urbana, IL 61801 217.366.3310
completely voluntary and no one has to participate. At any point a family can contact HFS and
request to be disenrolled from Choices.
Q: There is a rumor that families that don’t choose Choices are sanctioned or lose their benefits.
Is this true?
A: No. There is not impact to a family’s Medicaid eligibility or benefits if they choose not to
participate in Choices. There are no sanctions.
Q: Does Choices accept referrals from providers for enrollment?
A: At the moment, no. A family can call the Choices Benefits Line (866-858-7722) and talk with
the Choices Benefits Navigator about their specific situation and possible eligibility for the
project.
6. Family Leadership – Katrina Roberts, the Choices Family Support Coordinator, overviewed the
role of family leadership in the Choices project.
 Family leadership is an important piece of the Choices project and is a key component of
Systems of Care.
 Under the Choices model, families have a voice in determining what services are
provided and they decide who participates in the CFT.
 Family leadership occurs at all levels in the Choices project; Katrina participates as part
of the Executive Management Team representing family voice.
 The Family Leadership Council acts as a place for families to come together to share
experiences and provide feedback. They are able to communicate their needs from
experience and represent the broader needs of the community. This council is able to
directly impact some of Choices’ financing through their approval of the members of the
Quality Management Committee.
 The Youth and Family Peer Support Alliance (YFPSA), a family-run organization, partner
with Choices to provide support and training to Katrina in her role. They also provide
peer support services to Choices families.
Shawn Cole added that this is a component that HFS takes very seriously. All of the State’s
managed care plans serving children have a requirement to establish their own family
leadership councils. HFS is looking to learn from Choices and the MCOs about how best to
support family voice.
Q: Does the definition of family include youth?
A: Choices: Yes. They are working to build out what the youth voice component looks like.
Q: Does YFPSA serve Champaign County only?
A: Through Choices, YFPSA is looking to expand service to all 4 counties.
7. Crisis Response Model and the SASS Program – The SASS program has existed since 2005. The
state is proud of what has been accomplished under SASS, but national experts advise Illinois
that the SASS program must be updated to improve outcomes. Annually, the state spends
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Urbana, IL 61801 217.366.3310
approximately $34 million on SASS services and performs around 28,000 SASS screenings, about
50% of which result in inpatient hospitalization. With the roll-out of managed care, the SASS
program has begun to shift to the health plans. The managed care version of SASS is called
Mobile Crisis Response.
Choices will take over the management of Mobile Crisis Response for youth served in the feefor-service system in the four counties on July 1. From a service delivery standpoint, services
should look the same on July 1 as they did on June 30. Choices is working with the existing SASS
providers on a transition plan for a six month period to ensure stability. This transition of
management of crisis services is not intended to take dollars away from the existing providers,
but rather to upgrade the SASS intervention and help providers transition their capacity to
provide additional services. Some of the anticipated enhancements to the existing crisis
response model include: a higher level of clinician performing the screening event, a more
flexibility funding stream that moves away from a per-event rate, and access to additional
stabilization services, such as crisis stabilizers and crisis respite. Choices is responsible for
managing the crisis response, not providing the clinical services themselves.
Q: Who to call on July 1 in the event of a crisis?
A: CARES will remain the central access point for crisis dispatch. This is true across the state,
regardless of whether the child is enrolled in managed care or not. CARES is working with all
managed care plans and is instructed to dispatch a crisis worker for any eligible managed care
child.
Q: What should a caller or family do if no crisis responder shows up after calling CARES?
A: Call CARES back.
Q: Currently, response times are not within the two-hour window. Will this improve under
Choices?
A: This should not be an issue now. The crisis response timeframes are something the three
state departments take very seriously. If a problem currently exists, it means the state is not
aware of the issue. If this is being experienced, individuals should notify CARES, who must
report to the
It was noted how vital it is to communicate any changes to the crisis response program to
schools, detention centers, and families in particular. A lot of changes have occurred over the
past year with managed care coming online and it can be very confusing and overwhelming.
8. Provider Network – Choices is responsible for developing and maintaining a provider network of
mental health and substance abuse providers, physicians, non-traditional providers such as
mentors and tutors, and social service agencies. There have been some challenges in building
out the network. Choices is working with both HFS and DCFS to address some of the barriers
and streamline the process for providers.
Q: Do providers participate as part of the CFT?
102 E. Main St, Suite 200
Urbana, IL 61801 217.366.3310
A: Care coordinators strive to have all providers participate on the CFT, but it’s not always
possible due to scheduling. However, all services being provided to a youth should be
authorized by the CFT.
Q: The scheduling of CFTs is not always very timely, making it difficult for providers to attend at
the last minute. Can this be addressed?
A: Choices has heard this feedback before and is working to address with the care coordinators.
It can be difficult for the first CFT, but subsequent CFT meetings should be scheduled at the CFT
so that all members are informed in a timely manner.
Q: Is the CANS shared with providers?
A: The CANS should be incorporated into the CFT agenda and minutes and should be the base
for discussing the child’s needs. The messaging from care coordinators on this is not always
consistent, and is something Choices will take back and work on.
Comment: The stability of care coordinators is very important. It is difficult for families when
care coordinators are switched, especially if the communication between the care coordinators
is not good. It has lead to families not having services put in place that were discussed and not
having strong communication with the care coordinator.
Response: Choices takes this feedback very seriously and is glad to be made aware of the issue.
Choices feels continuity of care is vital and wants to make it a reality for their families.
9. Funding and the Demonstration Risk Pool – Choices has access to an annual funding stream
called the Demonstration Risk Pool that is unique to this project. Choices can use these dollars
to purchase additional care coordination, alternative services not billable under Medicaid,
alternative service delivery modes, or HFS-approved system enhancements to build capacity for
new services or services without enough capacity. In the current fiscal year, Choices has used
their Demonstration Risk Pool dollars to purchase alternative services and alternative modes of
service, as well as the following system enhancements:
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Grant to build peer support capacity through YFPSA
Partnership with the University of Maryland to purchase training on high-fidelity
wraparound and peer support. This will be a train-the-trainer model, allowing for
additional capacity building to occur over time.
Mini-planning grants to support up to 12 community providers’ participation in a
community service development planning process. This process will inform the design
of new community services Choices anticipates buying in FY16 and beyond.
10. Future topics for discussion – Please send to Kati Hinshaw.
11. Next meeting – Thursday, July 9 at 5:30 PM at the Danville Area Community College (2000 E.
Main St., Danville, IL 61832).
102 E. Main St, Suite 200
Urbana, IL 61801 217.366.3310