STANLEY LIGAS, et al. v. JULIE HAMOS, et al. First Annual Report of the Monitor

1. STANLEY LIGAS, et al. v. JULIE HAMOS, et al.First Annual Report of the Monitor September 27, 2012 Tony Records, Monitor traconsult@mindspring.com

2. Introduction • Organized into Five Sections • Activities of the Monitor • Full Cooperation from All • Parties’ Meetings • Information Sessions • Work with Defendants • Contact with providers, families and class members • Compliance Evaluation Standards

3. Overall Activities of the Defendants • Ligas Implementation Team Established • Ligas Budget Developed • Some New Policies Established/Modified • Ligas Website Established and Modified • Significant Progress on Class Member List

4. Resources and Capacity • Ligas Budget Developed • FY13 - $38.9 Million (less 4%) • Costs Projected over 6 Years • Recent Rates Adjustments • Increase in Benefits for Staff • Modifications to Remove Disincentives for Smaller (1-4 Person) Homes • New Ligas Team Members Hired • Enhancements for PAS Agency Reimbursement • Waiver Amendments for Expansion Approved • Rates Workgroup to Be Re-Assembled

5. Resources and Capacity (Cont.) • Much More Needs to be Done! • Only 8 of 18 Ligas Implementation Team Members Hired • Overall, DDD Seriously Understaffed • Rates Still Among Lowest in the Country • Budget for Consultants and Contractors Has Not Been Utilized • Payment Cycle is Still Looming as A Problem

6. Class Member List • Two Class Lists • ¶2 (a) ICF/DD Class Members • Current Total 697 • List Established and Documentation Maintained • List Has Improved Over Time • ¶2 (b) Waiting List Class Members • Current Total 10,894 • Accuracy of PUNS List Data Deeply Flawed • Inaccuracies Have Affected Funding Selection Process • Highlights the Need for Comprehensive Data System

7. Transition Services Plans • Defendants Developed Transition Plan Documents Through Stakeholder Involvement – Finalized in July 2012 • 2 PAS Agencies Selected for Pilot • Have Been Trained (8/23/12) • Implementation Started September 2012 • Initial Sample Size 141 • Monthly Updates • Crisis Transition Planning Process is in Place • Transition Planning Training Consultant Needs to be Hired

8. Transition for Class Members in ICFs/DD • 697 Class Members in This Category • 153 Have Received Funding Approval • 113 Have Actually Started Services (4 in Home Based) • 19 Individuals Have Changed Their Mind and Chosen to Stay • Updates on Remainder of Class Member are Obtained Monthly • Voluntary Downsizing and Closure Agreement have and will Continue to have Significant Impact on this List

9. Crisis Services • Notification of Non-Compliance, May 1, 2102 • Corrective Action Plan Developed, with Input from Class Counsel. Includes: • Internal Quality Assurance Controls • Streamlined Processing Steps • Adjustments to Data-Base • Changes Review Meeting Structure • Authorization for Network Coordinators to Issue Pre-Award Letters • Training of Network Staff and PAS Agencies • Management Review will be Included In Data Reports Document

10. Transition for Class Members on Waiting List • 10,894 class Members in This Category (9/12/12) • Two Selection Events (735 Class Members in February 2012 and 604 in June 2012) • Third Selection Event Imminent (1,500 Class Members) • Serious Flaws in List Eliminated Nearly Half of Individuals from Selection Process • Services Initiated for 135 Class Members • Funding Approved for Additional 30 Class Members • 73 Packets Have Been Submitted for Approval • 343 Being Screened • 114 Confirmed That They Want Community Services

11. Transition for Class Members on Waiting List (Cont.) • An Optimistic Projection would Result in Services for Around 700 Class Members – Far Below the 1,000 Required • Additional Steps are Needed • Immediate Third Selection Event • Additional Staff Supports in working with PS Agencies on PUNS List • Develop Technical Assistance Arm to Assist PAS Agencies • Steps to Streamline Application Process • Poll Provider to Identify Existing Opportunities • Recommend Specific Review of These Activities with Class Counsel in January 2013

12. OUTREACH • Training Activities for PAS Agencies • Development and Refinement of Ligas Website • Outreach RFP • Released September 13, 2012 • Proposal Due Date of October 16, 2012

13. Implementation Plan • Approved by Court on February 15, 2012 • Defendants Should Resubmit Revised Plan Prior to Next Parties’ Meeting

14. Data Reports • Latest Submission on August 20, 2012 for Data through FY 12. • Next Due February 15 2013 for Data Through December 15, 2012

15. Services to Named Class Members Compliance Achieved

16. Dispute Resolution • Corrective Action Plan Developed to Include: • Hiring of 3 New Hearing Officers • New Hearing Officers Trained • Application Process is Being Streamlined • Rights Statement is Being Modified • PAS Agencies to be retrained on Submitting Appeals Request • Crisis Appeals to be Given Top Priority • Management Reports to Be Generated and Provided with Data Reports Submission

17. Final Comments • At Least 323 Class Members Are Have Received Funding Approval for Services as a Direct Result of Ligas!! • This is the end of the First Year of at Least a Nine-Year case! • Ligas Activities Have Exposed and Will Continue to Expose many Weaknesses in the System!