Persons with ASD in Illinois face significant challenges in accessing family focused, culturally competent, affordable, coordinated health care and related services. Although many components of the system of care are present; poor linkage, inadequate funding and the fact that many providers have not been appropriately trained and supported to serve the ASD/DD population has created tremendous gaps in intensive services (per medical home) continuous screening, evaluation, diagnosis and intervention; and successful transition across the lifespan.
The system of care for individuals with ASD and developmental disabilities in Illinois struggles to reverse a longstanding reliance upon an outdated service model that has resulted in: 1) Funding for costly, restrictive institutional services, 2) Inadequate funding for and under-appreciation of community-based services, 3) Fragmentation and poor coordination of care across service providers and at transitional junctures, and 4) Delayed or inadequate treatment leading to the development of extreme, entrenched behaviors that perpetuate the need for intensive institutional care. Formal medical home efforts in Illinois have specifically neglected attention to the ASD and DD population.
Statement of Project
The current proposal will enhance Illinois’ service capacity for its population of persons with ASD and DD via provision of three regional Health Service Facilitators and a Financing Specialist. These entities are charged with expanding and strengthening linkages between The Autism Program (TAP) Service Network, comprised of 30 agencies and universities whose missions include system development and evidence-based service provision. Access to the medical home model is emphasized in grant-initiated activities.
TAP, established in FY2003 through a contract with Illinois Department of Human Services (IDHS), has developed and implemented a system development model that links and equips universities and existing community agencies to provide early, effective treatment and support for individuals with ASD. This model has the capacity to reduce Illinois’ reliance on intensive institutional care and to ensure greater independence and integration for individuals with ASD and developmental disabilities. TAP’s model is built upon linkage and support to the existing system, including the larger developmental disabilities community. In that same vein, the present proposal will advance integration and mutual support between the ASD and DD communities resulting in enduring system-level change.
This proposal will augment the existing system of care in Illinois, streamlined and largely supported via the efforts of TAP, through provision of Regional System Supports consisting of Regional Health Services Facilitators (HSF) and a Statewide Financial Specialist (FS) utilizing training, linkage, and collaboration resulting increased capacity, coordination and quality of services. HSFs will create, implement and monitor policies, procedures and supports to ensure that families served through TAP Network agencies have care consistent with the medical home. HSFs will promote a regional emphasis on developmental screening and integrated care with an emphasis on medical home and engage and support primary care physicians (PCPs) enrolled as Medicaid providers. HSFs will coordinate with TAP Centers and a variety of family advocacy groups for futures planning, including transition points for families of children with ASD and related developmental disabilities.
Working collaboratively with multiple agencies and TAP Centers, the FS will create, implement and monitor referral and billing practices leading to maximum benefits via EI services, Home-based Supports, general Medicaid funding, private insurance, and fees. FS will engage in political advocacy for streamlined population tracking and outcome monitoring and explore increased billing opportunities. FS will also provide the data monitoring for the project.