Please direct all program related information and questions to:

Glendean Sisk
401 South Clinton, 4th Floor
Chicago, IL  60607
Phone:  312-793-5246
Fax:  312-793-4666
Email:  Glendean.Sisk@illinois.gov

I. Introduction/Definition

The purpose of this grant is to provide a program for selected children with special health care needs (CSHCN) which includes diagnostic and treatment services for children who are impaired as a result of a congenital and/or acquired condition or have a condition which may lead to chronic impairment. Services include comprehensive evaluation, medical care and related habilitative services appropriate to the child's needs as well as financial support of such care subject to financial eligibility.

II. Policies & Procedures

Funds for this program are provided from the Federal Maternal and Child Health Services Block Grant.(42 USC 701, et seq.) Provision of these funds to the University of Illinois at Chicago's Division of Specialized Care for Children is required by 10 ILCS.345/0.01, et seq. and the following Administrative Rule: Title 89: Social Services, Chapter 10: The Board of Trustees of the University of Illinois, Part 1200, Program Content and Guidelines for Division of Specialized Care for Children. 

III. Contract and Amendment Process

Contract Process

The contract between the Department and the Provider is generally referred to as the Agreement and consists of several parts:

  1. Community Service Agreement, containing the standard contract language used for all Department contracts
  2. Exhibit A, containing Scope of Services/Purpose of Grant
  3. Exhibit B, containing Deliverables
  4. Exhibit C, containing Payment Information
  5. Exhibit D, containing Contact Information
  6. Exhibit E, containing Performance Measures
  7. Exhibit F, containing Performance Standards
  8. Exhibit G, containing State Agency Contracts
  9. Attachment E
  10. The Program Manual, attached by reference to the Agreement, contains the program service provisions.

The Department will initiate the contract by having it online for the Provider to obtain and sign.  The Provider will fax signature page to the Department to obtain the Secretary's signature and the Department will return a copy of the executed signature page of the contract to the Provider via pdf email.

Amendment Process

There are two types of amendments to an executed Community Service Agreement.

  1. Letters of increase or decrease - A letter is sent to the Provider stating the intent to increase or decrease dollars to specific program services existing in the Community Service Agreement. There is no need for the Provider to sign and return this document.
  2. Formal amendments A two-party signed agreement to an executed Agreement is a formal amendment. The following process is required for a formal amendment to be processed:
    1. Adding new program services - An amendment to add a new program service must contain a detailed summary of services to be provided under the executed Community Services Agreement and a method of payment.
    2. Extending the service dates of the Community Services Agreement* - An amendment to extend the service dates of the Community Services Agreement must contain the following information: Agreement number as it appears on the original Community Services Agreement; Provider name; clause stating the new term of the Agreement; signatures of the Provider and the Secretary of the Department of Human Services.

      *NOTE: A Community Services Agreement end date should only be June 30 due to mandates in the State Finance Act regarding audit period. Language on pages one through nine in the Community Services Agreement may not be changed.

    3. Extending the service dates of an existing program attachment - An amendment to extend the date of a specific attachment in the existing Community Services Agreement must contain the following information: Agreement number as it appears on the original Community Services Agreement; Provider name; clause stating the new term and the specific attachment name and number; signatures of the Provider and the Secretary of the Department of Human Services.
    4. Changing language within an existing program attachment - An amendment to change language in an existing program attachment of the Community Services Agreement must contain the following information:  Agreement number as it appears on the Community Services Agreement; Provider name; clause(s) stating the new language; signatures of the Provider and the Secretary of the Department of Human Services

IV. Deliverables/Costs/Payments

  1. Payments to the Provider will be made on a prospective basis, rounded to the nearest $100.00. The final prospective payment may be greater or lesser than the previous payments due to rounding.
  2. The Department will compare the amount of the prospective payments made to date with the documented expenditures provided to the Department by the Provider. In the event the documented services provided by the Provider do not justify the level of award being provided to the Provider, future payments may be withheld or reduced until such time as the services documentation provided by the Provider equals the amounts previously provided to the Provider. Failure of the Provider to provide timely documentation may result in a reduction to the total award.
  3. The final payment from the Department under this Agreement shall be made upon the Department's determination that all requirements under this Agreement have been completed, which determination shall not be unreasonably withheld. Such final payment will be subject to adjustment after the completion of a review of the Provider's records as provided in the Agreement.

V. Provider Responsibilities

The Provider will provide the programs and services in accordance with all conditions and terms set forth herein.

The Provider, through its Division of Specialized Care for Children (DSCC), will provide a program for selected children with special health care needs (CSHCN) which includes diagnostic and treatment services for children who are impaired as a result of a congenital and/or acquired condition or have a condition which may lead to chronic impairment, as well as comprehensive evaluation, medical care and related habilitative services appropriate to the child's needs and financial support of such care subject to financial eligibility. The CSHCN program administered through the Provider will:

  1. Serve children with medically eligible conditions in the following general categories: Orthopedic Impairments, Nervous System Impairments, Cardiovascular Impairments, External Body Impairments, Hearing Impairments, Speech Impairments, Cystic Fibrosis, Hemophilia, Inborn Errors of Metabolism, Eye Impairments, and/or Urinary System Impairments.
  2. Provide initial diagnostic evaluation services to discover children with medical conditions eligible for DSCC services.
  3. Develop individual service plans to provide case management assistance, financial support and treatment services through established specialized medical care and related habilitative services.
  4. Improve services for CSHCN by working closely with other public and private entities to identify and access benefits for children who are eligible for other health care programs.
  5. Provide children who have eligible severe, long-term disabilities with continued DSCC assistance in programming and managing care.
  6. Continue to develop, promote and improve the standards of care required by children with special health care needs.
  7. Support the Supplemental Security Income-Disabled Children's Program (SSI-DCP) under which children are evaluated as eligible for this program by the Social Security Administration of the United States Government and its regional offices and by the Department of Rehabilitation Services of the State of Illinois through its Disability Adjudication Unit. Children deemed eligible for SSI-DCP by those agencies and who are referred to the Provider will be offered DSCC assistance. Children found not medically eligible for DSCC services will be referred to other programs, services or institutions providing assistance to children when such programs are available.
  8. Provide the Department with information needed to complete the application and annual report for the Maternal and Child Health Services Block Grant. Failure to submit these reports may result in suspension of monthly payments until they are received by the Department.
  9. Certify that state revenue expenditures used to match the Maternal and Child Health Block Grant funds granted to the Provider were used for the programs described above and will not be used as match for any other federal programs.

VI. Department Responsibilities

The Department will provide technical assistance and monitoring for all programs operated under Community Health and Prevention.

VII. Support Services

Utilization of Community Resources

It shall be the responsibility of each project director to coordinate the services provided through the project with other sources of care in the community, such as:

  1. The Illinois Medical Assistance Program
  2. Local Health Departments
  3. Neighborhood Health Centers
  4. Local Child Development Clinics
  5. Local Hospitals
  6. Local Children and Family Services Programs
  7. Local Schools
  8. Vocational Rehabilitation Services
  9. Regional Perinatal Centers
  10. Local Early Intervention Programs for Infants and Toddlers with Handicaps
  11. Other related social service agencies

Please refer to 77 Ill. Adm. Code 630.160 and 630.170, Other Applicable Rules, and to the program-specific Exhibits for additional requirements.

VIII. Billing Instructions

Providers shall use the following methodology to document the use of these funds:

  1. The Provider shall provide summary documentation by line item of actual expenditures incurred for the purchase of goods and services necessary for conducting program activities. The Provider shall use generally accepted accounting practices to record expenditures and revenues as outlined in DHS Rule 509, Fiscal Administrative Recordkeeping and Requirements.
  2. Expenditures shall be recorded in the Provider's records in such a manner as to establish an audit trail for future verification of appropriate use of Agreement funds.
  3. Expenditure documentation shall be submitted in a format, defined by the Division of Community Health and Prevention, to the Department on a quarterly basis, within 30 days after the end of each calendar quarter. However, the Provider shall have the option to report monthly.
  4. The Provider shall submit expenditure documentation by one of the following means:
    1. Mailing Address
      Tina Finley
      815-823 East Monroe Street
      Springfield, IL 62701
      Phone:  217-785-2991
    2. Fax
      217-524-2491
    3. Email
      tina.finley@illinois.gov
  5. All financial record keeping on the part of the Provider shall be in accordance with generally accepted accounting principles consistently applied.

Expenditure Documentation Form Instructions

Expenditure Documentation Form (pdf)

IX. Program Monitoring

Programs operated by the Provider under this contract will be monitored by the Department to review the program's progress according to stated goals, measurable objectives and administrative operations.

X. Program Budget

Providers agree to establish and utilize a budget approved by the Provider's Board of Directors.

XI. Appendices/Forms

Not applicable.