The state of Illinois is making significant strides in improving the care and support provided to individuals with intellectual and developmental disabilities (IDD). The state has implemented IDD case management services as a key component of its care policy, and these services are helping individuals with IDD live independently and participate fully in their communities.
IDD case management in Illinois is a comprehensive approach to providing individually tailored services and supports to individuals with IDD. It involves developing a personalized plan that meets the unique needs and goals of each person. This approach helps to ensure that members of the IDD community receive the services and support they need to live independently, maintain their health, and achieve their goals.
One of the strengths of the Illinois IDD care policy is the focus on improving the quality of care provided to individuals with IDD. The state has implemented a number of quality assurance measures, including regular monitoring of service providers and annual reviews of individual care plans. These measures provide a benchmark for the standard of care necessary to ensure that individuals with intellectual and developmental disabilities receive quantifiable, high-quality support.
Another important component of the state’s IDD care policy is the emphasis on community inclusion. The state has implemented a number of initiatives aimed at helping individuals with IDD to live, work, and participate fully in their communities. IDD case management services are often involved in these initiatives, helping individuals to identify and easily access the services and support they need to achieve their goals.
One such initiative is the Home-Based Support Services program. This program provides individuals with IDD the opportunity to live in their own homes or apartments while receiving the support they need to maintain their independence—support that would otherwise only be available in an institutional setting. IDD case management services play a critical role in this program, assisting individuals in identifying their specific care needs, developing a personalized plan, and accessing the particular services and support they require to maintain this level of community-based inclusion.
Illinois has also implemented a number of employment initiatives for individuals with IDD. These initiatives include job training programs and tax incentives for employers who hire individuals with intellectual and developmental disabilities. IDD case management services play an important role in helping individuals identify, secure, and maintain employment, giving them the ability to achieve greater self-reliance and opportunity for accomplishment.
In recent years, Illinois has made significant progress in reducing the waiting list for services and support. Currently, there are more than 34,000 individuals with intellectual and developmental disabilities receiving services and support through the Division of Developmental Disabilities (DDD), with the waitlist being reduced by more than 5,000 individuals in 2022 alone. This progress is a testament to the state’s commitment to providing high-quality, effective care and support to the IDD population. (Visit Illinois Department of Human Services for more)
Illinois’ emphasis on personalized, community-based care and support, as well as the focus on quality assurance, is helping individuals with intellectual and developmental disabilities live independently, participate fully in their communities, and achieve their personal and financial goals. IDD case management services play a critical role in this process, helping individuals to easily access the services and support they need to thrive. As Illinois continues to make significant strides in its IDD care policy, it is clear that the state is committed to improving the lives of individuals with IDD and their families.
Click HERE to learn more about how TMP supports IDD service providers.
Intellectual and developmental disabilities (IDD) are lifelong conditions that impact an individual’s ability to learn, communicate, and engage with their surroundings. People with IDD require specialized support and care to lead fulfilling lives, but access to such care can be challenging due to a range of societal, economic, and policy-related barriers.
In terms of IDD policy in Michigan, the state government has implemented several policies and programs to address the needs of individuals with IDD and provide support to their families and caretakers.
The Michigan Department of Health and Human Services (MDHHS) oversees the majority of programs in the state that provide assistance and support services related to IDD care, including employment assistance, educational opportunities, assessments, diagnosis, treatment, care coordination, and assistance with daily living activities.
One of the most significant IDD programs administered by the state is the Medicaid Home and Community-Based Services (HCBS) Waiver. The Medicaid HCBS Waiver allows people with IDD to receive essential care and support services in their homes or community-based settings by providing financial assistance for personal care, respite care, transportation, and therapy.
The program has been instrumental in providing individuals the opportunity to live in their communities, rather than in institutions. This is consistent with the growing trend toward person-centered IDD care, which emphasizes individual choice and autonomy. An added benefit is that providing care in the community is less expensive than providing care in institutional settings.
Another far-reaching state-coordinated service for IDD care is the Michigan Rehabilitation Services (MRS) program. The MRS program, which is a statewide network of vocational rehabilitation (VR) professionals, provides vocational rehabilitation services to teens and adults with intellectual or developmental disabilities. The program offers a range of IDD services such as job coaching, skills training, and job placement assistance. The goal of the MRS program is to help people with IDD prepare for, pursue, and retain appropriate employment opportunities, fostering independence, self-esteem, and quality of life for this community. (more on IDD policy in Michigan here)
Additionally, providing equitable access to educational opportunities is an essential element of caring for individuals living with IDD. The Michigan Office of Special Education (OSE) is the agency responsible for implementing and coordinating support and resources for these individuals. This office is designed to help children and young adults with IDD achieve their educational goals and succeed in school. The agency provides educational support to those with IDD from birth to age 25, offering a range of services such as individualized education plans (IEPs), specialized instruction, and assistive technology. Assistance and training for families and guardians are also provided.
Michigan also has an active group within the state created to respond to and advocate for the needs of the IDD community at a policy level. The Michigan Developmental Disabilities Council—or MiDDC—is a federally funded, self-governing body that promotes the inclusion and integration of individuals with IDD in Michigan communities. The council is made up of people with disabilities, family members of people with disabilities, and professionals from state and local agencies who provide supports and services to people with developmental disabilities. Among their missions is working to advance policies and programs that further inclusion, economic opportunity, and independence for individuals with IDD. The basic tenets of the council are formed around the Developmental Disabilities Assistance and Bill of Rights Act of 2000.
The state of Michigan has established a robust Department of Health and Human Services, responsible for overseeing and enacting policies and programs to address the needs of individuals with IDD and their families. These policies and programs have been successful in providing access to care, promoting inclusion and autonomy, and improving the overall well-being of those living with intellectual and developmental disabilities. However, there are still challenges in IDD care, such as limited funding and a shortage of trained professionals. It remains crucial that policymakers and stakeholders continue to work together to address these challenges and improve IDD care in Michigan.
Larry Hill is the founder of TMP, an IDD systems and workflow software platform that serves some of the largest providers in the country. He also founded Hill Resources Inc. and Living Resources LLC, which are ICF and waiver providers, and is a founding member of PACSTX—the Providers Alliance for Community Services of Texas.
For additional context, Larry is also heavily involved in lobbying efforts for the IDD community at the Texas State Capitol and before regulatory bodies, and TMP has been at the table advocating on providers’ behalf to make the ISS program as flexible as possible.
We sat down with Larry to get his thoughts on the progress of the new Texas ISS program.
Q.Due to your history in the state of Texas, you are in a unique position to talk about the efforts being made at a legislative level to improve the ISS program in Texas, as well as the changes to the program that took effect on March 1, 2023. Can you give us a breakdown of what is happening?
Larry: The overarching goal of the Individual Socialization Skills program (ISS) is to move clients’ day activities out of traditional day-habituation situations (where they would spend their time at one location) and into the community. Moving into an integrated community environment provides clients with many more opportunities to practice these skills.
The preliminary rules proposed around April 2022 would have moved all day activities off-site, but as of March 1, that was changed to offer clients a combination of on-site and off-site activities. This is something that is being pushed at the federal and state levels, though each state has its own set of rules.
Another big change to the Texas ISS program is how the provider’s time is billed. In the past, the provider’s time was billed at a daily rate, but it’s now billed on an hourly basis, regardless of whether the service is on-site or off-site.
“TMP’s goal is to advocate for a more positive system for the providers and those they serve. This advocacy has helped create a wider variety of activities and greater flexibility for the clients and the providers. And our ISS module makes implementing the changes a simple, straightforward process.”
Larry Hill – Founder of Taskmaster Pro (TMP)
Q: What sort of impact will these changes have on the providers’ day-to-day operations?
Larry: Providers are going to experience significant changes as a result of the new rules. Not only to how they bill their time, but to how they manage daily activities. And because the rules for provider-to-client ratios off-site are different from what they are on-site, providers will now need to adjust staff/client numbers on a per-outing basis. Keep in mind that off-site numbers can change from one day to the next—they can even change as the clients are boarding the van. Altogether it becomes a very fluid environment.
It’s important for providers to understand that this is more than just completing a billing log with the individuals. With this degree of client choice and movement, providers now have to plan for and differentiate between on-site and off-site locations and activities and contend with fluctuating staff-to-client numbers. For example, if you have seven people who are level needs ones and fives on the van, and a level needs eight wants to board, then your staffing ratios have to be adjusted before you can even leave the parking lot. If the ratios are off, you can be recouped.
And all of these adjustments have to be documented on an hourly basis. If providers don’t have a system in place that can accommodate that degree of flexibility and choice, they’ll be spending an hour every day on documentation, as opposed to one or two minutes using an ISS management system like TMP.
Providers are absolutely going to need our ISS workflow platform in order to navigate this efficiently and successfully, especially in a workforce crisis where providers are already struggling.
Q: Will those being served experience significant differences as well?
Larry: Absolutely. In the past, clients stayed in a single day-habituation setting where they worked on specific skills. Today however, clients have the opportunity to visit a variety of places in the community that meet the basic requirements of ISS. Having the freedom to choose on-site and off-site locations and activities not only fosters a sense of independence in these individuals—it provides a more dynamic environment in which they’re able to develop socialization skills as well.
Q:Can you contextualize the difference between trying to navigate the system without an EHR versus using an EHR like TMP? It seems like it’s going to be substantial.
Larry: It is substantial. There are a lot of moving parts to this. Without an EHR, the providers could spend up to an hour each day documenting on their eight individuals or their 16 individuals, as opposed to only a couple of minutes using an EHR like TMP. And because there are rules that have to be adhered to in TMP’s EHR that validate the forms, the accuracy of the documentation will be much greater.
Recognizing the difficult environment that providers are operating in right now, TMP wanted to create tools to make implementation so much simpler—tools to alert staff, to quickly and seamlessly document shifting circumstances, and to prevent providers from being recouped.
Q: Were there additional reforms that TMP and other Texas providers were advocating for?
Larry: We advocated for relaxing the ratio requirements and did get that changed to one-to-eight for off-sites, though we did not get what we asked for in terms of the eights and sixes. It’s currently a one-to-two ratio, which we feel is too restrictive, especially in a workforce crisis. We advocated for on-site ratios as well.
We advocated for the fee schedule, in terms of reimbursing your staff, to be at a higher rate, given the workforce crisis and the highly competitive environment. We pointed out that the rate adjustments in Texas have been deferred for many years so there’s a lot of catching up to do.
We also advocated for the use of electronic systems in place of paper forms. The initial decision was that providers had to use the state’s official forms with the official state insignia, which we felt wasn’t necessary for an EHR. TMP has been involved considerably in getting this reversed. We have workflows and management capabilities that could achieve the same outcome in a much more efficient manner, which would give staff more time to spend with clients, as opposed to spending that time documenting. We pointed out too that electronic records could be audited much more efficiently than paper forms.
We felt like it was a win-win on all three fronts.
Q: Is there anything you want to see changed about the Texas ISS program?
Larry: Yes. TMP and I have pretty much been leading the charge on the issue of competitive and supportive employment opportunities. I’m hoping that parents are paying attention because, as the rule stands, the majority of IDD individuals in the state of Texas do not have the capability to be competitively employed. There is a portion of our individuals that can and should be afforded this opportunity through supportive employment to develop the skills that will enable them to become competitively employed.
There is also a large segment of our population that simply does not have the ability to be competitively employed. However, they should have the right to work in a protected setting where they’re being taught and supported, even if they’re only able to work for half an hour. We used to be able to do that in day habilitation centers, but now in ISS, you have to check your clients out of that IDD program. And the state says the client can still work, but the state is not going to pay providers to monitor them, support them, and help them. The state is basically asking the providers to do that for free, in order to give our clients an opportunity, and for the provider to pay them for working, which is a big issue. That’s coming from a settings rule, and whether it’s coming from Washington or Texas, it needs to be changed so people don’t fall through the cracks. Right now, it’s all or nothing—you can either be competitively employed through the support of an employment track or you just visit the community without the opportunity to earn a small paycheck. Even if a person can only work for an hour a day, it’s still wrong for us to take that opportunity away from the individuals we serve in Texas. Texas is greater than this and we need to stand up for these folks.
Q: Do you see this program as a step in a good direction when compared to the way it was?
Larry: It’s a step in the right direction. As it stands, it’s a good program, but there is still work to do. The state needs to correct the ability to earn money while in ISS, and they need to correct the ratios for sixes and eights. If they do this, it will be a great program. TMP’s goal is to advocate for a more positive system for the providers and those that they serve. This advocacy has helped create a wider variety of activities and greater flexibility for the clients and the providers. And our ISS module makes implementing the changes a simple, straightforward process.
But in order to make the most of these changes, providers are absolutely going to need TMP.
Intellectual and Developmental Disabilities (IDD) policy, at both the federal and state levels, is a critical component of safeguarding and improving the necessary services and support that intellectually or developmentally disabled individuals need in order to lead productive and fulfilling lives.
In Missouri, significant progress has been made in implementing such policies. Read on to learn about four key IDD policies and programs in Missouri and the positive impact these initiatives are having within the IDD community.
One of the most vital IDD programs in Missouri is the Medicaid Home and Community-Based Services (HCBS) waiver program. This program, which is administered by the Missouri Department of Mental Health (DMH), provides funding for specific care services and support to be given to intellectually or developmentally disabled individuals within their homes and communities, avoiding the need for them to be housed in an institutional setting.
The waivers afford a wide range of services, including personal care, transportation, and respite care. Having in-home access to these otherwise-costly services means that persons with IDD have the resources to live more independent and less-sequestered lives.
In addition to providing financial assistance for critical care services, the Missouri Department of Mental Health has established a standardized procedure to promote quality of life for the intellectually and developmentally disabled individual. The Missouri Quality Outcomes (MOQO)—six separate guidelines meant to define quality of life for those being cared for—are based on a set of goals that the IDD person and their families or guardians determine.
Using data that is collected annually, the Division of Developmental Disabilities addresses any corrections to the individual’s services and supports that are needed in order to meet these goals. The MOQO initiative has proven effective in raising the caliber of support through continuous enhancements to the care that the IDD population receives.
Missouri’s Employment First policy, which is designed to help individuals with IDD find and maintain appropriate employment, is another example of the state’s commitment to furthering the independence of intellectually or developmentally disabled persons.
The Missouri Employment First initiative provides job training, job coaching, and other support services to help these individuals obtain suitable employment opportunities that align with their skills, abilities, goals, and personal circumstances. The policy empowers individuals with IDD to contribute to their communities and earn an income, which in turn fosters within them a sense of belonging and purpose.
Missouri also has a strong advocacy network for individuals with IDD. The Missouri Developmental Disabilities Council (MODDC) is a federally funded organization that advocates for people with IDD and their families. The MODDC works to promote policies and drive legislation that improves the lives of people with IDD, as well as providing support and resources to individuals and their caregivers.
The MODDC is an essential resource for people with IDD in Missouri and, through its lobbying efforts, has played a significant role in advancing and reforming IDD policy in the state.
IDD policy in Missouri is critical to ensure that individuals with IDD consistently receive the services and support they need to live life to their fullest potential, integrated into their communities as contributing members of society, as independently and productively as possible.
Policies and IDD programs such as the Medicaid HCBS waiver program, the Missouri Quality Outcomes initiative, the Employment First program, and the Missouri Developmental Disabilities Council have all been instrumental in improving the lives of people with IDD in Missouri. However, there is always more work to be done—the state must continue to prioritize IDD policy in order to uphold and protect the rights of the IDD community, empowering intellectually or developmentally disabled individuals to lead their best lives.
Intellectual and Developmental Disability (IDD) care is a critical issue in the United States. When it comes to IDD policy in Georgia, there are several policies and programs that aim to improve the quality of care for individuals with IDD. These policies and programs are designed to provide individuals with the necessary support to achieve their full potential and to lead fulfilling lives.
One of the most significant laws affecting the IDD community in Georgia is the federal Developmental Disabilities Assistance and Bill of Rights Act (DD Act). This law provides funding for programs and services that help people with IDD and their families. The DD Act aims to ensure that individuals with IDD have access to appropriate and effective services, that their rights are protected, and that they are able to live full and meaningful lives within their communities.
In Georgia, this law is the driving force behind the many IDD programs and institutions that provide support to individuals with IDD. The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) provides a range of services, including residential services, day programs, employment support, and behavioral health services. The Georgia Council on Developmental Disabilities (GCDD) is another important organization that works to promote the independence and inclusion of people with IDD in Georgia.
One of the most significant challenges facing intellectually and developmentally disabled persons in Georgia is the lack of access to healthcare services. The state has one of the highest rates of uninsured residents in the country, and this lack of access to healthcare can be particularly challenging for individuals with IDD. The Affordable Care Act (ACA) has helped to improve access to healthcare for many Georgians, including those with IDD, but there is still work to be done to ensure that everyone has access to the care they need.
Another challenge facing individuals with IDD in Georgia is the lack of access to education and employment opportunities. Many people with IDD face significant barriers to obtaining equitable education and employment resources, which can make it difficult for them to realize their full potential. The state has several programs and initiatives aimed at addressing these barriers, including vocational rehabilitation services and special education programs.
Additionally, it is essential to recognize that the IDD community is a diverse group of people with unique needs and experiences. It is important for policies and programs to take into account this diversity and to ensure that individuals receive the support and services they need to achieve their full potential. This may include providing specialized services for individuals with specific needs or working to ensure that services are accessible to people with different cultural backgrounds or language needs.
Recent improvements to IDD policy in Georgia have made significant strides in upgrading the quality of care for individuals with IDD. Through policies such as the DD Act and programs provided by organizations like Georgia’s DBHDD and GCDD, individuals with IDD have access to a range of services and support. However, there is still work to be done to improve access to healthcare, education, and employment opportunities for individuals with IDD. By continuing to prioritize the needs of this vulnerable population, Georgia can ensure that everyone has the support they need to live full and meaningful lives.
A. The Pharmacy Interface connects the TMP platform to your pharmacy, providing great value to providers, their clients, and the pharmacy as well.
Medication orders, as well as required documentation associated with those orders (doctor’s orders, benefits, side effects, etc.) are brought into TMP and nurses can review that information in real time. Nurses can process orders without having to receive faxes, drive to pick up paperwork or get on the phone. This streamlined process vastly reduces the nurse’s workload as it pertains to the medication process.
The Pharmacy Interface also drives improved functionality of other sections of TMP as certain data is automatically cross-populated throughout the system. When thinking about the Pharmacy Interface on a macro level, it mitigates risk, reduces stress, and increases billable time while decreasing non-billable time.
Q. Where did the idea of creating the pharmacy interface come from?
A. Since the conception of TMP, our main goal has been to interface with as many parts of the care process as possible, including the pharmacy, hospitals, doctors, etc.
The overarching idea is to maximize the amount of care in one ecosystem, reducing paperwork and opportunities for failure while achieving the goal of maximizing efficiency so that provider teams can spend more time with those in their care. This will directly contribute to better outcomes and better lives for everyone involved.
In terms of why we prioritized the Pharmacy Interface in development, we feel this interface will create the most impact on the nurses (reduction of workload) and a great financial impact for our provider clients.
As an industry dealing with the ongoing workforce crisis massively impacting providers, it is imperative that we place an emphasis on improving the day-to-day lives of our direct service professionals.
This interface is just one of many TMP features that contribute to why nurses and direct service professionals enjoy working with our platform and often share it as a prerequisite when considering new job opportunities.
Q. What is the overall goal of the pharmacy interface and how will it impact providers?
A. The main objective of the Pharmacy Interface is to reduce stress on everyone involved.
This is accomplished through decreased opportunities for errors (risk mitigation), improved quality of care, and increased billable activity for nursing staff.
Your nursing staff will see a direct impact via a reduction in workload, which will open up opportunities elsewhere. They will not need to make calls to ask about the status of medications, and the instructions for those medications will be easily referenced in the system, giving them clear and concise guidance.
Providers will see an increase in billable activity and a decrease in non-billable activity due to the removal of tedious, redundant, or time-consuming activities. Perhaps just as important, they will see a reduction in liability (risk management) as alerts are built into the system to notify the right team members right away if anything is not completed as assigned.
Those in your care receiving medication will see a reduction in errors. The implementation and distribution of medications are more timely, accurate, and safer. For us as developers, this is perhaps the greatest impact.
This level of care can be and should be free of stress, and the Pharmacy Interface will add great value to providers in these ways.
“With our Pharmacy Integration module, TMP is redefining how providers partner with their pharmacy. This enhanced relationship will streamline operations and lighten the load for your nurses and support staff, resulting in more time with those in your care and improved outcomes.”
Larry Hill – Founder of Taskmaster Pro (TMP), CEO of Hill Resources
Q. Can you help us visualize the process of not having the PI versus what the process is like once you implement the PI into your system?
A. This is a very simple process to visualize when broken down into the following steps.
Without the Pharmacy Interface…
Person served visits a doctor
Order travels back to the provider
The provider delivers the order to the pharmacy
The pharmacy sends fax/mail confirmation to the provider.
The nurse must enter data into the system (adding more to their already overloaded plate)
Medications are dispensed
With the Pharmacy Interface…
The person served goes to the doctor
Data appears in TMP
Medications are dispensed
Q. What sort of impact do you expect providers to see from implementing the Pharmacy Interface?
A. One of the greatest impacts will be a higher degree of timely implementation and distribution of medications.
The Pharmacy Interface greatly speeds up the communication process, which can be the difference between getting an order back prior to the end of the day, or the end of the week, which can be extremely impactful. We want Individuals to be served as quickly as they need care, and anyone in this space knows that even a 24-hour delay can make a big difference.
On the staffing side, we remove stress and work from nurses and direct support professionals, directly leading to happier and more fulfilled nurses and less turnover in your workforce.
Q. How does the new PI create value for the pharmacies?
A. The Pharmacy Interface allows pharmacists to enter data into their system once and not have to take the time and energy to duplicate that information into another system.
This practice will save time and reduce the potential for error.
When the pharmacist enters information into the system, they know it is showing up in the provider’s system. Their instructions and other information are NOT being translated or cross-populated by another party, which is a great risk mitigation tool.
This workflow allows the pharmacist to support the provider in a more comprehensive way, eliminating previous areas of responsibility from the provider side, which is another massive reduction in the opportunity for error.
Q. What has the feedback been like from TMP clients and your providership?
A. The initial release of our Pharmacy Interface has been received very well. Our clients are loving the design, workflow, and anticipated impact of the implementation. As we continue to measure the real-world impact, we look forward to sharing more data.
Q. How can prospective or current clients get more information on the Pharmacy Interface to see how it can help them?
A. We are always happy to share information on our new releases, and the best way to learn more is to contact our amazing sales and support staff, who can walk you through all your questions directly.
The TMP IDD software platform was created out of the need for our provider organization (Hill Resources Inc.) to have a great documentation software, and current market offerings falling short of what we knew was possible. After over a decade of development and use in the IDD community, we are proud to share stories like Debbie’s to show how better care is not only possible, it is our responsibility. Read how TMP software can improve mental health as part of overall wellbeing.
Dianna’s Story
Dianna loves plants and nature. One of her biggest challenges was harming herself and verbally putting herself down. Her family of origin was abusive therefore left many scars to overcome.
Through monitoring real-time reports within the TMP software ecosystem, the behaviorist quickly realized that Dianna’s behavioral incidents occurred in all locations with the exception of when she was in the greenhouse or working with plants.
Upon further review of TMPs data, the behaviorist discovered several important factors. Two of the greenhouse staff were very affirming and made a point to express multiple affirmations on each shift. They equated her to a flower that was blooming and becoming more beautiful as time went on.
The behaviorist immediately expanded this approach of encouragement and affirmations throughout all points of care by deploying a short training video to assure staff turnover did not impede the progress others were making with Dianna.
Today she is literally a different person. A person filled with joy and hope!
Our data, combined with some thoughtful and caring staff, proved to be the key in unlocking Dianna’s dreams.
We assigned Dianna to a customer-facing job in the greenhouse serving community members as they purchase plants.
Now Dianna is blossoming and spends countless hours in the greenhouse working, teaching others her craft, and providing plants to local businesses.
