Ed's Newsletter
DDD COPES WITH COVID . . .
ISC AUDIT HEADING TO FEDERAL COURT . . .
GOVERNOR FIGHTS HEALTHCARE DISCRIMINATION . . .
ED’s NEWSLETTER
No. 151 – April 24, 2020
McMANUS CONSULTING
DISABILITY SERVICES
847.256.0456, [email protected], Facebook, LinkedIn
DDD IS HANGING IN THERE . . .
The Division of Developmental Disabilities is still functioning, but not a whole lot is happening other than what is related to COVID-19.
But you knew that.
Day programs are closed. CILAs, ICFDDs, SODCs and Home-Based families are doing their best to care for their individuals at home. Gov. Pritzker is extending his stay-at-home order through May, so the Community Day Services programs will undoubtedly remain closed.
Director Stark announced in March that CILA rates would be increased by approximately 20% to cover the cost of keeping people at home. Another 10% was announced April 10. And, unrelated to the crisis, Medicaid on April 14 approved Illinois’ request for a small increase in the CILA rate to enable providers to pay DSPs the new minimum wages.
Sheltered Village, an ICFDD in Woodstock, has been hard hit by the virus. There have been eight deaths there—seven residents and one staff member. And as of Monday, 15 additional residents and 16 more staff had confirmed cases of COVID-19. (Our condolences to Bob Norris and his staff; Sheltered Village is one of our new affiliates.)
Three state-operated developmental centers also have been overwhelmed:
--Ludeman Center in Park Forest has reported three deaths—two residents and one staff member. 82 residents and 28 staff tested positive.
--Shapiro in Kankakee has had 58 residents and 40 staff testing positive.
--Murray in Centralia has had 22 residents and 19 staff testing positive.
Airmen from the Illinois National Guard started working Monday at Ludeman and Shapiro, helping with health screenings—22 at each facility.
ISC AUDIT IS LANDING IN JUDGE’S LAP . . .
The federal court challenge to the restructuring of the Independent Service Coordination system is entering a whole new phase. The three plaintiff agencies are about to file an amended lawsuit based on the explosive findings of the Office of the Auditor General, which submitted an audit report April 2 highly critical of the way DHS carried out the project.
The plaintiffs—Western IL Service Coordination, Central IL Service Access and DayOne Pact--told the U.S. District Court in Springfield April 14 that the audit describes “inexcusable deficiencies” in DHS’s planning process for conducting competitive bidding for contracts, “a multitude of egregious errors” in awarding the contracts, and “a seriously flawed appeals process.” The auditors also contended that DHS violated the Medicaid act, which exempts ISCs from competitive bidding.
The auditors uncovered 274 irregularities in the scoring of applications for contracts. Severaal agencies may have been improperly forced out of business as a result, they said. The 225-page audit report is on the Auditor General’s website, https://www.auditor.illinois.gov/.
LEGISLATIVE COMMITTEE PUNTS . . .
Another development in the ISC saga involves the legislature’s Joint Committee on Administrative Rules (JCAR). We reported last month that DHS was seeking JCAR’s approval to adopt a rule that would abolish Medicaid consumers’ freedom to choose which ISC they want to represent them. The rule also authorizes continuation of a competitive bidding process for funding ISC services. Both proposals allegedly violate federal Medicaid law.
The proposed rule was on the agenda for JCAR’s March 17 meeting, which wound up being called off because of the virus. And now, believe it or not, JCAR says it’s too late for them to do anything!
A committee official said the window for JCAR review of the rule expired the following day, March 18, before JCAR had an opportunity to take official action. The official said the IL Administrative Procedure Act provides that if JCAR takes no action on a rule, the “default” is that the agency is free to adopt it.
(What?? So DHS is free to adopt a blatantly illegal rule because the virus stood in JCAR’s way?? That’s ridiculous!)
DD SERVICES OF METRO EAST v. PRAIRIELAND . . .
In addition to the federal suit, another ISC, DD Services of Metro East, has a case still pending in St. Clair County Circuit Court. But earlier this month the court denied their petition to void DHS’s selection of Prairieland Service Coordination of Decatur as the new ISC agency for St. Clair and Madison counties.
Attorney Thomas E. Kennedy III of St. Louis, representing DD Services, charged that DHS “acted arbitrarily, capriciously and contrary to the law in violation of the IL Administrative Procedures Act” when they denied the agency’s application for renewal of its ISC contract. His petition said DHS’s process “resulted in Prairieland, an organization that never had a presence in St. Clair and Madison counties, receiving a higher score under the category of ‘capability to provide service by July 1, 2019,’ than DD Services, an agency that has been serving the area for over three decades.”
AND, PRETTY ODD: The auditors obtained an opinion from the IL Dept. of Healthcare & Family Services that Medicaid-funded ISC services should not be subject to competitive bidding. And the DHS general counsel told them that while the Rauner administration believed they were required to conduct a competitive process, the new (Pritzker) administration ultimately determined that they are exempt from that requirement.
BUT the State’s lawyers are still arguing in federal and state courts that they are NOT exempt!
COALITION ASKS FOR INCREASE ‘ABOVE MINIMUM WAGE’ . . .
The Illinois House has adjourned “until further notice”. The Senate is officially due back next week, but we know that isn’t happening. So the outlook for a meaningful spring session of the General Assembly is very doubtful at this point.
What does that mean for our disability community? Back in February, the They Deserve More coalition made a very big ask--a 20% rate increase. Also in February, Gov. Pritzker recommended that the legislature approve rates that would enable providers to increase DSP pay by $1.50 an hour.
Then the virus hit, and by April 16, the coalition’s ask had been scaled down. “Now more than ever,” the group said, “it is imperative that legislators include a permanent increase above minimum wage for DSP wages and provider operations when the General Assembly gets back to work on a very tight state budget.” The coalition also stressed that they appreciated the temporary 10% CILA increase.
Earlier in the month, IL Partners for Human Services sent a letter to the governor, signed by 200 organizations including McManus Consulting, urging him to make protecting the Illinois safety net a top priority in the FY21 budget. The letter said health and human service providers “are keenly aware that as the state moves into a recession, the people of Illinois will need more services and support.” https://www.illinoispartners.org/wp-content/uploads/2015/04/Illinois-Partners-letter-to-Governor-Pritzker.pdf
‘DON’T PUT US AT THE END OF THE LINE’ . . .
The U.S. Dept. of Health & Human Services has come out strongly in support of the rights of people with disabilities to be free from discrimination in emergency healthcare situations, and Gov. Pritzker has endorsed the federal statement. The governor’s action was the direct result of concerns expressed March 26 by more than 140 Illinois organizations in a letter to the State coordinated by Access Living. McManus Consulting and 28 of our affiliates are proud to have signed the letter.
“Persons with disabilities . . . should not be put at the end of the line for health services during emergencies,” HHS said March 28. “Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism.”
Here is the letter to the governor: https://www.accessliving.org/wp-content/uploads/2020/03/Treatment-Protocols-Request-from-Access-Living3.26.20.pdf
And here is the State’s “Guidance Relating to Non-Discrimination in Medical Treatment for Novel Coronavirus”, issued April 10: https://coronavirus.illinois.gov/sfc/servlet.shepherd/document/download/069t000000AiOFZAA3?operationContext=S1
Amber Smock, Access Living’s director of advocacy, said the organization has also asked the State to issue a directive “that lays out specific protocols for emergency healthcare triage. The guidance is a strong pronouncement, and we look forward to the issuance of protocols that operationalize the principles in the guidance.
“The COVID-19 virus may not discriminate in its infections, but marginalized groups have historically experienced deep-rooted bias in our healthcare and overall social systems. We are glad to see that the Pritzker administration has taken our concerns seriously and look forward to the development of a protocol.”
Allan Bergman had first alerted us March 24 to a very disturbing development in Alabama and Washington State regarding the rationing of ventilators. Alabama's Department of Public Health, according to a press release from the Center for Public Representation, was specifically stating that hospitals are "not to provide ventilators to people with certain intellectual and cognitive disabilities".
“This language from Alabama, the language in Washington - and the language used in Italy last week - scares the hell out of me,” Allan said in an email. “I trust this disgusting case from Alabama will encourage the proactive strategy I suggested earlier today for encouraging/advising Gov. Pritzker to build on his statements about all people in Illinois being treated equally during the pandemic.”
Access Living did just that, with great success.
IN OUR INBOX . . .
We reported Monday on a Facebook post by Jan D. Songer, former exec director at Prairieland Service Coordination, who said she “would almost guarantee the State knew what ISC agencies they wanted before the process.” She said she based her conclusions on information obtained from three knowledgeable individuals closely affiliated with Prairieland.
In response, we got this:
FROM THE HUSBAND OF A SUPERVISOR AT PRAIRIELAND: “So basically Mr. McManus has something in common with the mainstream media. When there is a lack of interesting facts to write about, he speculates.”
And lots of comments on the ISC audit:
FROM ROD PATTERSON, former CEO at Mosaic: “I have always noticed the bias in the Division, with some ISCs having ‘favored’ status.”
FROM MARY JANE FRIEDRICH, exec director, Western IL Service Coordination: “Just also keep in mind the staff responsible for this mess still works within DHS/DD.”
FROM SUSAN JENKINS BARNHART: “Absolutely unreal that this was so blatant.”
FROM CARLA SANDERS: “It gripes me beyond all because it purposely sets up regions which barely had had coverage before to be even more underserved now. But, I hardly expect a bunch of politicians and bureaucrats to get it.”
FROM MONICA PICKARD: “You wrote that ‘hopefully, the Department has learned a lesson and will not do something like this again.’ Hopefully! But what it taught them is that they can get away with it.”
FROM STEVE GRYS, former ISC case manager: “So what this audit is saying is that so many ISC staff lost their jobs through a faulty process. Impacting not only them, but the individuals they cared for, in some cases for decades. There ought to be some consequences for those involved with the process. . . . So is this binding, or is there going to need to be a court order enforcing the auditors’ decision?”
(No, the auditors’ findings are not binding; they are advisory.)
FROM KATHY EFFLAND, former case manager: “This is what we as ISCs knew all along. We did nothing wrong! Many of my co-workers had to sacrifice salaries, benefits and seniority and start from scratch. And no one cared or cares.”
FROM HEIDI ZIMMERMAN: “Although we knew all of this (audit info) to be true, it’s still sickening to read.”
FROM AMANDA SPROUSE, former case manager: “What a waste of taxpayer money, time and jobs! But that's how DHS rolls, right? . . . Let's do something stupid, and see if anyone notices, and then deal with the repercussions! . . . But what is done is done and they likely knew that. So in the end do they get their way with slap on the wrist, or will people be held accountable?”
FROM TRACY MILLER, former case manager: “This is another example of the secret nature of many funding processes, even those that purport to be transparent. And the summary scores were not even added correctly! What, they never heard of a calculator? Or better yet, they should have had this in digital format. Then at least there would not be math errors.”
-0-
We had an enormous reaction to the report on our Facebook page that several states are discriminating against people with disabilities in the rationing of ventilators and other equipment. Facebook said our post “reached” 24,634 people, with 6,335 “engagements”, 38 comments and 231 shares. A few of the comments:
PATRICIA FINKBOHNER VAHLE: “I am praying this is fake news! Otherwise this is disgusting on every humanitarian level.”
CINDY FUQUA CORBITT: “My daughter read about the decisions having to be made in Italy, and she read about the problems some hospitals here are already experiencing, and she read about protocols now being put in place--then she turned to me and said, ‘Mom, you know they would not even treat me.’ And she is not wrong. . . .”
PAT BRENNAN FINNIE: “Perfect people only. Chilling. We are asking our medical community to put those of us who become infected into the right line or the left line. To choose who lives or dies. The young, the strong, the able specimens--who have the best chance of being able to return to work--in one line. The ones they see as expendable . . . go into the line that will end their lives.”
GERI PINZINE: “Cannot comprehend this level of morals.”
JANET NOWICKI: “This just breaks my heart to even read this. I just cannot even begin to wrap my head around this discrimination. This HAS to be something that has been made up. Truly disgusting if it’s not.”
SHANE GERICKE: “What a rancid thing to do to those poor people. Don't the disabled suffer enough slings and arrows in life without THIS?”
HARRIET LEVY: “What have we come to? . . .”
MEGAN POOLE MUTTI: “I’m unable to find the right words here. So many, many critical failures (logistical, ethical, moral) in a system that would condone this.”
SHARON DRAZNER: “We can be disheartened but we shouldn’t be surprised. Even if no one in Illinois makes this statement, the history of lack of support for people with disabilities by both Republicans and Democrats reveals that our loved ones with disabilities have never been a priority!”
COMMENTS . . .
Send me your opinions, suggestions, criticisms, or responses to articles. I like feedback. Also tips.
PEOPLE . . .
HOWARD SITRON is retiring in July as CEO of Jewish Child & Family Services/Chicago and will be replaced by STACEY SHOR, currently COO. Shor started at JCFS 20 years ago as a group home childcare worker. A search is under way for a new COO.
MARY ANDREWS has been promoted to executive vice president at Community Alternatives Unlimited.
SHEILA EDSTROM, a longtime member of the staff at Kiley Developmental Center in Waukegan, has retired from state government--(What? You’re too young to retire, Sheila!)--and has joined the staff of Community Alternatives.
KATIE CARLEY, longtime residential director of behavioral health at Trinity Services, has been hired as intake manager at Our Children's Homestead.
DEBBIE HUMPHREY, associate director of the St. Clair County Mental Health Board, has been hired as executive director of the Madison County Mental Health Board.
COMING UP . . .
APRIL 29: Arc Webinar – Advocating for Your Children in Uncertain Times. Lynn Betts, Family Resource Center on Disabilities, 10-11 a.m. https://www.thearcofil.org/
MAY 12: Arc Webinar - Overview of Illinois Assistive Technology Program, 12-1 p.m.
JUNE 3: Annual TEC (Technology Enhancing Capabilities) conference in Naperville sponsored by Natl. Assn. of QIDPs. https://www.qddp.org/
JUNE 11-12: Annual Arc of IL convention in Lisle (rescheduled).
SEPT. 9-11: Annual joint conference of IL Assn. of Rehab Facilities (IARF) and IL Assn. for Behavioral Health (IABH), in Normal. https://www.iarf.org/
OTHER STUFF . . .
CHOATE: Three employees of Choate Mental Health & Developmental Center in Anna have been indicted in connection with alleged abuse of residents. They were charged with official misconduct. Details of the incidents were sketchy, but one involved causing a resident “to drink an entire cup of hot sauce” and another involved breaking a resident’s arm, according to local media. DHS says the three are no longer employed.
LARISSA: The Chicago Sun-Times reports on the very sad COVID-19 death of Larissa Maya, who was a friend of my daughter Laura at Arts of Life: https://chicago.suntimes.com/2020/4/23/21233141/down-syndrome-covid-19-deaths-coronavirus-young-skokie-obituary
THE CONSULTING PRACTICE . . .
MORE AFFILIATES: Two more organizations have signed up as affiliates of McManus Consulting . . .
ORCHARD VILLAGE, headquartered in Skokie, has been operating since 1972. They provide support to nearly 300 individuals with CILA, vocational and Home-Based services; they have created an urban farm; and they run a therapeutic day school. Susan Kaufman is the newly hired CEO.
MALCOLM EATON ENTERPRISES, established in 1966 in Freeport, provides CILA, day services and the Home-Based program to more than 200 persons. They have been the home of Spirit brand bathroom tissue since 2002. Tim Cook is the exec director.
RADIO: If you have half an hour to spare (who doesn’t these days?), you can listen to a tape of me being interviewed March 23 on Vicki Niswander’s Disability Beat program on WEFT Champaign. https://new.weft.org/publicaffairs/disabilitybeat.html
ARC: Speaking at a meeting sponsored by Keshet in Skokie March 4, Meg Cooch did a great job of laying out the Arc’s agenda for the spring legislative session, which unfortunately has ground to a halt. The Arc wants to end the waiting list and shift funding from institutions to the community.
-0-
McManus Consulting was founded in 2011 by Ed McManus, who worked for the Dept. of Human Services for 18 years--as an attorney in the Office of Inspector General, state coordinator of the Home-Based Program and facilitator of the DDD North Suburban Network, and before that as a reporter and editor for the Chicago Tribune in Springfield and Chicago. We have provided services to more than 75 agencies, including staff training on how the system works and phone consultation on a retainer basis when issues arise. We also can arrange for consultations with families or provide pro bono assistance to them over the phone.
Ed's Newsletter is published approximately once a month. Its publication is made possible by the support of the following affiliates who are on retainer: Access Living - Active Visions - A New Age Human Services - A+ Autism Solutions – Arts of Life - Aspire - At Home Mission - Avenues to Independence – Bethesda Lutheran Communities - CCAR Industries – Center for Enriched Living - Center for Independent Futures – Champaign County Developmental Disabilities Board - Clearbrook - Douglas Center - Encompass/Jewish United Fund - Friendship House - Garden Center Services - Gateway Services - Gateway to Learning - Glenkirk - Good Shepherd Manor - Helping Hand Center - Individual Advocacy Group - KCCDD/Knox County - Lambs Farm - Leeda Services - Little City - McHenry County Mental Health Board – Malcolm Eaton Enterprises - Milestone - Misericordia - Mulford Homes/Diane Home Care – Orchard Village - Pioneer Center for Human Services - Progressive Careers & Housing - Ray Graham Assn. - Rimland - Riverside Foundation - Royal Living Center - St. Coletta of WI - Sertoma Centre – Sheltered Village - Trinity Services - UCP Seguin – Warren Achievement Center - The Workshop/Galena.
Independent Service Coordination agencies: Central IL Service Access - Community Alternatives Unlimited.
Disability-related law firms: Chamberlin Law Group - Matt Cohen & Associates - Monahan Law Group - Rubin Law.