Please direct all program related information and questions to:

Glendean Sisk, Project Director
401 South Clinton, 4th floor
Chicago, IL  60607
Phone: 312-814-1354
Fax: 312-793-4666
Email:  glendean.sisk@illinois.gov

I. Introduction/Definition

  1. The mission of the Family Planning Program is to provide voluntary comprehensive family planning services to low-income individuals of reproductive age in order to lower the incidence of unintended pregnancy, improve maternal and infant health and reduce the incidence of abortion.
  2. The program promotes the well-being of families, responsible behavior, and pre and interconceptional health for healthy babies. The program prevents unintended pregnancies by providing comprehensive family planning services, which includes medical, social and educational services related to the avoidance, achievement, timing and spacing of pregnancy.
  3. Family Planning does not discriminate on the basis of age, sex, race, color, religion, national origin, sexual preference, income, marital status, number of pregnancies, residency, or contraceptive choice.
  4. The program operates on the premise that everyone has the right to informed consent regarding their reproductive choices and birth control methods.
  5. The program provides confidential, accessible, quality reproductive health care at free or reduced fees. No one is refused services because of inability to pay. Fees are assessed by income and number of dependents, utilizing the Federal Poverty Level guidelines.
  6. Services are provided by delegate agencies, which include health departments, Planned Parenthood, hospital-based clinics, single service not-for-profit agencies, federally qualified health centers and community-based organizations.
  7. The delegate agencies are required to have community education plans, which include linkages with programs such as Family Case Management; local DHS offices; Pregnancy Prevention; Teen Parent Services; Women, Infant & Children Supplemental Food Program (WIC); the Illinois Healthy Women Waiver and Medicaid programs; Genetics Program; STD clinics; school-based health centers; and school districts.

II. Policies & Procedures

The Provider will administer the Family Planning Program in accordance with the following:

  1. The Code of Federal Regulations (CFR) Title 45, Subtitle A - Department of Health and Human Services General Administration, Part 74 (for non-profits) and Part 92 (for state and local government) - Administration of Grants; Title X of the Public Health Service Act, (42 USC 300, et. seq.); Grants for Family Planning Program Services (42 CFR Part 59, Subpart A); Policies of General Applicability (42 CFR Part 50, Subpart B); and Program Guidelines for Project Grants for Family Planning Services (Title X Guidelines), developed by the Office of Population Affairs (OPA), U.S. Department of Health and Human Services (DHHS), January 2001.
  2. Appropriate rules promulgated by the United States Office of Management and budget, such as Circulars A-87, A-102, A-128 and A-133.
  3. The Occupational Safety and Health Administration (OSHA), Clinical Laboratories Improvement Amendments (CLIA) and Health Insurance Portability and Accountability Act (HIPAA).
  4. The Illinois Family Planning Services Code (77 Ill. Adm. Code 635) and Illinois Professions and Occupations Statutes including 225 ILCS 60 - Medical Practice Act of 1987, 225 ILCS 65 - Nursing and Advanced Practice Nursing Act and 225 ILCS 95 - Physician Assistance Practice Act of 1987.
  5. The IDHS Family Planning Program Guidelines Manual (IDHS Guidelines), March 2006.
  6. Program guidance announcements and the signed statement of "Title X Assurance of Compliance."

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/Payment

  1. The Department will pay the Provider for services provided at the fee for service rates shown in the "SFY 2013 Illinois Family Planning Program Rate Schedule" effective July 1, 2012.
  2. Payments to the Provider will be made on a prospective basis during the first quarter of the fiscal year, rounded to the nearest $100. The final prospective payment may be greater or lesser than the previous payments due to rounding.
  3. Beginning with the October payment, the Department will compare the amount of payments made to date with the documented expenditures provided by the Department's billing contractor, Ahlers & Associates. In the event the documented services provided by the Provider do not justify the level of award previously paid to the Provider, future payments may be withheld or reduced until such time as the services documentation provided by the Provider equals or exceeds the amount previously paid to the Provider.
  4. Failure of the Provider to provide timely documentation of services provided to Ahlers & Associates may result in a reduction to the total award.
  5. Quarterly a comparison of the Provider's Federal Financial Report (FFR) that documents expenditures by funding stream and line item, will be compared to the fee for service documentation total for the fiscal year. In the event the FFR documentation is less than the documented services provided by the Provider, future payments may be withheld or reduced until such time as the documentation of actual program costs submitted on the FFR equals or exceeds the amount of documented services provided.
  6. Total payments for a fiscal year are limited to the least of 1) the award amount, 2) documented services and 3) the FSR total for the program funds.
  7. 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. 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

  1. Medical/Educational Services
    1. The Provider will provide the following services and agrees to act in accordance with all state and federal statutes and administrative rules applicable to the provision of services pursuant to this Attachment. Services to be provided include, but are not limited to medical and laboratory procedures, education and counseling, medication and supplies, and translation (interpreter) services as specified in the IDHS Family Planning Program Guidelines Manual.
      1. Comply with all required entities regarding operation of Family Planning Services:
        1. Code of Federal Regulations (CFR) Title 45, Subtitle A - Department of Health and Human Services General Administration, Part 74 and Part 92 - Administration of Grants;
        2. Title X of the Public Health Service Act, 42 USC 300, et. seq.);
        3. Grants for Family Planning Program Services (42 CFR Part 59, Subpart A);
        4. Policies of General Applicability (42 CFR Part 50, Subpart B)
        5. Program Guidelines for Project Grants for Family Planning Services (Title X Guidelines), developed by the Office of Population Affairs (OPA), U.S. Department of Health and Human Services (DHHS), January 2001;
        6. The Illinois Family Planning Services Code (77 Ill. Adm. Code 635);
        7. IDHS Family Planning Program Guidelines Manual (IDHS Guidelines), March 2006;
        8. Title X Assurance of Compliance;
        9. Occupational Safety and Health Administration (OSHA);
        10. Clinical Laboratories Improvement Amendments (CLIA);
        11. Health Insurance Portability and Accountability Act (HIPAA); and
        12. Illinois Professions and Occupations Statutes -
          1. 225 ILCS 60 - Medical Practice Act of 1987;
          2. 225 ILCS 65 - Nursing and Advanced Practice Nursing Act; and
          3. 225 ILCS 95 - Physician Assistant Practice Act of 1987.
      2. Submit applicable portions of the Family Planning Annual Report (FPAR) in accordance with the Department of Health and Human Services (DHHS) instructions and all other required reports within the time frame set by the Department or be subject to penalty. Deviations from DHHS administrative and clinical indicators may also lead to penalty. Required reports include:
        1. Client Visit Record (CVR) - Electronic Data and Billing Instrument;
        2. FPAR (Family Planning Annual Report): for the periods January-June and January-December;
        3. Title X Family Planning Work Plan Progress Report for the periods of July-December and January-June;
        4. Federal Financial Report (FFR) base on quarterly periods:  January-March (due April 13), April-June, July-September, and October-December;
        5. Community Education Report for the periods of July-December and January-June;
        6. Equipment Inventory Report for the period of July-June;
        7. Title X Training Attendance Report for the periods of July-December and January-June;
        8. Information and Education Committee Meeting Minutes for the period of July-June;
        9. Timeliness to Treatment Report from agencies not utilizing the Illinois Department of Public Health Laboratory for Chlamydia and Gonorrhea testing for the periods of July-December and January-June and;
        10. Periodic Special Project Reports.
      3. Provide Title X services on a voluntary basis without subjecting individuals to any coercion to accept services or coercion to employ or not to employ any particular methods of family planning. Acceptance of services must be solely on a voluntary basis and may not be made a prerequisite to eligibility for, or receipt of, any other services.
      4. Provide services without regard to religion, race, color, national origin, residency/geographic location, disabilities, age, sex, number of pregnancies, or marital status.
      5. Provide services in a manner that protects the dignity of the individual.
      6. Meet confidentiality requirements of Title X:client and facility privacy, client billing, staff disclosures, referrals and follow-up results, reporting abnormal test results, medical records and employee records.
      7. Not provide abortion services as a method of family planning or use project funds to pay for abortions.
      8. Provide that priority in the provision of services will be given to persons from low-income families. Services will be targeted to individuals with incomes 0-150% of the federal poverty level (FPL) with priority given to individuals with incomes 0-100% of FPL. Must assess fees using current FPL and must adhere to Sliding Fee Schedule Guidelines for all clients.
      9. Offer a broad range of acceptable, effective and medically approved family planning methods, including emergency contraception.
      10. Will not require or request written consent of parents or guardians for the provision of services to minors. Nor can the project notify parents or guardians before or after a minor has requested and received Title X family planning services.
      11. Provide non-directive, non-judgmental counseling on all pregnancy options.
      12. Encourage family participation in the decision of a minor seeking family planning services.
      13. Provide counseling to minors on how to resist coercive attempts to engage in sexual activities.
      14. Provide assistance to clients with Limited English Proficiency (LEP) to prevent barriers to care.
      15. Maintain medical records in a systematic, complete and confidential manner. Signed informed consent forms must be on file for treatment, contraceptive methods and procedures performed.
      16. Develop and implement written referral procedures for all Title X services not provided onsite.
      17. Identify and maintain an Information and Education Committee in compliance with Federal and State regulations.
      18. Certify that services named on the Clinic Visit Record (CVR) have met all required standards set forth in this agreement. Clients must not be denied program services or be subjected to any variation in the quality of services because of inability to pay.
      19. Title X is the payer of last resort. Third party payers are utilized as sources of funding to the fullest extent possible.
      20. Determine a schedule of discounts and sliding fee scale based on periodic cost analysis of family planning services. The Department will determine the frequency of the cost analysis. The initial Schedule of Discounts and Sliding Fee Scale must be utilized throughout the fiscal year, unless a revision has been submitted and approved by Department staff.
      21. Third party payers must be billed using total charges without applying any discount.
      22. Receipts (clinic visit statement) to clients must show total charges less any allowable discount. All clients must receive a receipt at the time of services.
      23. Declare and budget income generated by the project, (i.e., Title XIX, private insurance, client payments and other related income) pursuant to Federal and State regulations.
      24. Assure that the delegate agency coordinator provides program updates, education and technical assistance to all personnel providing family planning services in each clinic site.
      25. Assure that family planning staff has appropriate licensure, credentials, and training to provide clinic services to clients. Assure that mid-level practitioners maintain a current collaborative agreement with a licensed physician, and physician assistant maintains a current contract with the sponsoring physician.
      26. Assure that at least 10% of the project cost will be paid by funds other than those received in this contract from family planning.
    2. The Provider shall submit client services information to the Department's Family Planning data and billing contractor, Ahlers & Associates, utilizing the automated Clinic Visit Record System no later than 5 p.m. CST on the 5th day of each month.
      1. Final submission of CVRs for July 1, 2012 through December 31, 2012 must be submitted to the Department's billing contractor no later than 5 p.m. CST on February 5, 2013.
      2. Final submission of CVRs for January 1, 2013 through June 30, 2013 must be submitted to the Department's billing contractor no later than 5 p.m. CST on August 5, 2013.
      3. Payment may be denied for client services provided in the above periods if service documentation is received after the date specified.
      4. Client services information shall continue to be submitted after all DHS grant funding has been received by the Provider to reflect the actual funding necessary to provide client services throughout the fiscal year.
    3. Community Outreach - Outreach services will be provided as described in the Department's applicable rules for Maternal and Child Health, Family Planning Services Code 77 Illinois Administrative Code Chapter X, Subchapter i, Section 635.140, "Community Education, Information and Education Advisory Committee" and as defined in Maternal and Child Health Services Code 77 Illinois Administrative Code Chapter X, Subchapter i, Section 630.70, "Definitions," as follows:

      "Outreach' means any activity to find and inform potential program participants of available services. Outreach, therefore, can include community campaigns as diverse as door-to-door canvassing, production and distribution of handbills, design and publication of newspaper announcements and production and broadcast of public service announcements or paid advertising on radio or television. The primary objective of outreach activities is to inform potential program participants of available services, eligibility criteria and method of accessing services (for example, the name, address and phone number of the provider). This is not to preclude the use of nontraditional methods of outreach that may be necessary to identify potential participants in hard-to-reach populations, such as persons who abuse substances or engage in prostitution."

VI. Department Responsibilities

The Department will provide technical assistance and monitoring for all programs operated under Family and Community Services in order to comply with DHHS reporting requirements.

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. STD Clinics
  2. HIV/AIDS Testing and Treatment Programs
  3. Illinois Breast and Cervical Cancer Program
  4. The Illinois Medical Assistance Program
  5. Local Health Departments
  6. Neighborhood Health Centers
  7. Local Hospitals
  8. Local Children and Family Services Programs
  9. Local Schools
  10. Vocational Rehabilitation Services
  11. Regional Perinatal Centers
  12. Other related social service agencies

Please refer to Maternal and Child Health Services Code 77 Illinois Administrative Code Chapter X, Subchapter i, Section 630.160 and Section 630.170; and other Applicable Rules for additional requirements.

VIII. Billing Instructions

  1. The billing mechanism for family planning services is through the Clinic Visit Record (CVR). The Department's Family Planning Program billing contractor, Ahlers & Associates, provides the monthly CVR Billed Procedures Summary, which documents billed services.
  2. Providers shall provide an FFR quarterly documenting actual expenditures incurred for the goods and services necessary to support the listed program activities by line item and funding stream.
  3. The Provider shall use generally accepted accounting practices to record expenditures and revenues as outlined in DHS Rule 509, Fiscal Administrative Recordkeeping and Requirements.
  4. 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.
  5. An FFR shall be submitted in a format, defined by the Division of Family and Community Services, Family Planning Program, to the Department on a quarterly basis, within 30 days after the end of each federal quarter. However, the Provider shall have the option to report monthly.
  6. The Provider shall submit the FFR by one of the following means:
    1. Mailing Address
      Illinois Department of Human Services
      Family Planning Program
      823 East Monroe
      Springfield, IL 62701
    2. Fax
      217-782-4890
    3. Email
      dhs.familyplanning@illinois.gov
  7. All financial record keeping on the part of the Provider shall be in accordance with generally accepted, consistently applied accounting principles.

IX. Program Monitoring

The Department will monitor program operations in accordance with federal, state and program regulations and guidelines. Awards may be reduced and contracts may be terminated if a delegate agency does not comply with federal, state and program regulations and guidelines.

X. Program Budget

The Provider is required to submit a categorical budget annually. Budget revisions are to be submitted if the Provider is notified of an increase or decrease in award unless instructed otherwise by program.

XI. Appendices/Forms

Not applicable