Springfield IL, (May 16, 2019) Central Illinois Service Access (CISA), DayOne PACT and Western Illinois Service Coordination (WISC) filed a lawsuit today against the State of Illinois, Department of Human Services, Division of Developmental Disabilities alleging violations of the Illinois Administrative Procedure Act and the Medicaid Act. As plaintiffs, the agencies allege the state illegally bid its Medicaid contracts for Independent Service Coordination through a Notice of Funding Opportunity (NOFO) process without first going through the agency rulemaking process as required by law. The agencies also allege the state NOFO process violates the Medicaid Act because it improperly curtails the right of Medicaid recipients to choose their ISC service provider. As remedy for these violations, the agencies are asking for a preliminary injunction from the United States District Court for the Central District of Illinois to halt the illegal NOFO and the irreversible harm it would have on the agencies and the individuals served by the agencies if allowed to proceed.
CISA, DayOne PACT and WISC have provided independent service coordination on a contractual basis for well over 25 years. Independent Service Coordination (ISC) was mandated by the federal government. This federal mandate was created due to an audit in the late 1980’s that determined ISC services were the best way to address the abuse and neglect found in the Medicaid waiver program for persons with developmental disabilities who live in the community. These three ISC agencies currently provide lifelong advocacy, service planning and linkage, oversight of services and assure choice for 6496 persons with developmental disabilities in 19 counties.
In July of 2018, the State of Illinois Department of Human Services, Division of Developmental Disabilities announced plans to issue a Notice of Funding Opportunity (NOFO) for ISC grants state wide. This would be the first time in over 25 years that these contracts would be put to bid. At the same time, the state indicated that they would be reducing the number of ISC agency areas from 17 to 12. The state claimed this new bidding process was a way to create areas that were more rationally drawn, to ensure compliance with other, new government contracting requirements and to reallocate funds.
The NOFO solicitation process was opened for bids in September of 2018 and closed on November 12, 2018. The state then began a review process that lasted until the end of December 2018. The NOFO indicated that bids would be evaluated on the basis of the description of need for the area applied for, the qualifications of the agency and their organizational capacity to provide services, and finally the quality of their services.
All three agencies lost their bids and parts of or all of their contracts in spite of long records of excellent service to their communities, quality supports for persons with DD and their families. Further, the state did not and could not point to any problem with the quality of services provided by these agencies. In fact, the annual audits for the State of Illinois show services were provided in accordance with state and federal regulations and met quality standards for over two decades by each of the agencies bringing the lawsuit. This decision was made even though all three agencies demonstrated a clear and thorough understanding of the needs of the area for which each of the organizations applied and despite demonstrated capacity to deliver services to their areas far more effectively than any new agency could accomplish starting July 1, 2019.
Two of the agencies, DayOne PACT and WISC, filed an appeal of the NOFO decision and the appeals were denied by the state. As word of this decision was made public, consumers and disability organizations across the state began to support a movement in the state legislature to rescind the ISC agencies from the regulation that allegedly compelled the state to issue the NOFO bids.
Thousands of families and individuals with disabilities served by these agencies across the state are impacted by this decision. CISA, DayOne PACT and WISC have been the primary source of information, linkage to residential and vocational services and the independent voice advocating for these people. Relationships forged over decades of service have provided a stable center of support for people who typically see half of their support staff change every year. Since the awards were made public in January the public has been given minimal information about the changes. For instance, the state sent a letter dated March 29, 2019 to some consumers indicating more information regarding the provider changes would be sent at the end of March.
As of the date of this press release, no such information has been provided. The last update to the State of Illinois website providing information to families was on March 1, 2019 with minimal information. CISA, DayOne PACT and WISC join in this lawsuit because the state’s ISC NOFO process is illegal and because it violates the Illinois Administrative Procedure Act and the Medicaid Act. The agencies seek a preliminary injunction aimed at putting an end to the implementation of the NOFO results. Plaintiffs also seek to stop the ISC agency transition process, and to restore funding to the agencies that will lose their contracts as of July 1, 2019. The NOFO process has placed continuity of care in jeopardy and left a very vulnerable population with less oversight and limited access to people that know their needs and services that assure health and safety are addressed.