As I mentioned last week, Illinois decided not to subject Misericordia’s Developmental Training Program to “heightened scrutiny.”

  In its revised transition plan, the State explains what caused it to take DT off the heightened scrutiny list: “Of the 220 total comments, 70 expressed support for Misericordia’s continued participation in Illinois’ HCBS system, and expressed dismay that Misericordia had been considered for the list of sites to be submitted to CMS for heightened scrutiny.  As a response to this public input, and after reviewing other available evidence, including information gathered in Misericordia’s on-site visit and through follow-up correspondence with the setting, the State agrees that Misericordia does not have the effect of isolating individuals. On the strength of this evidence, the Plan has been revised to reflect that the State, in accordance with CMS guidance, has moved Misericordia from Category 4 [heightened scrutiny] to Category 1 [compliance with the CMS rule], so that it is no longer presumed to be institutional under the federal rule.”
Thus, it is clear that it was the comments submitted by our families that made the difference.  In fact, our families submitted almost one-third of all the comments submitted throughout Illinois.  Almost every family that has a family member living in a Misericordia CILA submitted a comment in support of DT.  In some cases families submitted several comments from parents and siblings.  The State’s response to our uniform voice shows the power we have when we act together.  Of course, the personalized information that each family included in their individual comment about the life their family member leads at Misericordia was extremely important.  This is the evidence that the State relied on to conclude that our DT program does not isolate individuals from the broader community.
Illinois’s revised transition plan also included an important statement regarding campus settings generally.  As expected there were a small number of comments submitted by “community” advocates arguing that campus settings should automatically be considered noncompliant with the CMS rule and should either be closed or excluded from receiving Medicaid waiver funding.  Illinois rejected this argument and supported the view that individuals should have choice:
“The State disagrees with this position, for two reasons. First, one of the philosophical underpinnings of the HCBS Rule, and of LTSS provision in general, is that to the fullest extent possible clients should be accorded a choice in their mode and location of treatment. The wholesale exclusion of a category of setting would undercut this goal. Second, by allowing States to submit campus-based settings for heightened scrutiny approval and by allowing States to deem compliant non-isolating campus settings, CMS has indicated that it believes that some campus-based settings should be deemed compliant with the HCBS Rule. The course CMS has taken—to allow campus based settings to continue to participate in HCBS programs only where the State has determined they are non-isolating or CMS has approved them through heightened scrutiny—ensures that those settings will be examined closely for compliance while also ensuring that truly integrated campus settings will continue to be able to serve clients.”
Misericordia is very grateful that our families once again responded to our call for action.  We will call on you to act only when an issue is of such importance to your family members that our government officials must hear your voice.  It is very comforting to know that when we do call on you, you respond, and when you act, your government responds.  This is how democracy is supposed to work.
Scott Mendel (This email address is being protected from spambots. You need JavaScript enabled to view it.)