Please direct all program related information and questions to:

Kennye Westbrook
401 South Clinton, 4th Floor
Chicago, IL  60607
Phone:  312-793-4605
Fax:  312-793-4666
Email:  Kennye.Westbrook@illinois.gov

I. Introduction/Definition

The Provider will operate and maintain a Healthy Start Family Center to provide case management services to high risk women, and their children up to two years of age, who reside in the catchment area.  The Healthy Start Family Center must provide medical care on site.  The medical care must be provided by a licensed physician or advance practice nurse that is supervised by a physician.

II. Policies & Procedures

Maternal and Child Health Services Code, 77 Illinois Administrative Code 630 (77 Ill. Adm. Code 630).

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/Cost/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

  1. The Provider will operate and maintain a Healthy Start Family Center to provide case management services to high risk women, and their children up to two years of age, who reside in the catchment area. The Healthy Start Family Center must provide medical care on site. The medical care must be provided by a licensed physician or advance practice nurse that is supervised by a physician.
  2. The Provider will employ a total of four case managers, a full-time supervisor, and a social worker.
  3. The Provider will attend Healthy Start meetings, including Contractor and Consortium meetings, as required by the Department.
  4. The Provider will employ persons who have either a Bachelor of Science Degree in Nursing with an emphasis on maternal and child health, community health nursing, or public health nursing, or, a Masters of Social Work with an emphasis on services for women and children.
    1. The caseload of high-risk pregnant women assigned to these case managers may not exceed 40 at any one time.
    2. All eligible clients must have a prenatal high risk assessment 707G completed in Cornerstone.
    3. The case managers will have at least two face-to-face contacts with each assigned client each month between enrollment and termination of pregnancy. At least half of the contacts should occur in the pregnant woman's home.
    4. The social worker will be used to assess and provide referrals and links to appropriate services for women at risk of perinatal depression up to two years after delivery.
  5. The Provider must use 100% of Healthy Start funds to support staffing and other program efforts. Healthy Start funds may not be used to support other initiatives.
  6. The Provider will use the Cornerstone Information Management system to record demographic health status and service delivery information about each high-risk pregnant woman, and infant up to age two, that receives services.
    1. Data entry must include a risk assessment (707G), care plan, documentations of and referrals for mental health, substance abuse treatment, smoking cessation services, domestic violence intervention services, and each child's birth date, birth place, and birth weight. All referrals are to be documented on the RFO1. The referral field is to be used to type in the reason for referral or to give the client written instructions. Clients are to be given a copy of the referral. The Provider will document the client's completion or failure to complete the referral in the comment section of the RF01 screen.
    2. The Provider may use some of the funds provided for this program to purchase these services for high-risk women if no other third-party source can be identified.
  7. The Provider will conduct additional outreach efforts to identify and recruit high-risk pregnant women to participate in this program.
    1. The Provider may use some of the funds provided for this program to purchase supplies of patient incentives or gift certificates to motivate high-risk pregnant women to participate in the services.
    2. Gift certificates may not be used to purchase alcoholic beverages or tobacco products.
    3. All funding used to purchase incentives (of any type) must have a clear documentation of how these funds were used. Documentation must include:
      1. what was purchased
      2. date purchased
      3. where purchased (receipt of purchase is to be available for audit)
      4. how much was spent
      5. who was the incentive to given to (list client's name, Cornerstone Identification number)
      6. secure client's signature
      7. secure signature of staff member dispensing said incentive
      8. date dispensed
      9. a spreadsheet illustrating the above shall be available to Program Manager and staff at nursing program reviews and as requested
  8. Health Education

    The Provider will provide training for Healthy Start clients. The health education components will develop the knowledge base of Healthy Start mothers and help them understand the importance of interconception care, developmental milestones and growth of their children. Staff education programs will be conducted to develop the ability of case managers, case manager assistants, and outreach workers to interact effectively with the families they serve.

    The Provider will host not less than 3 health education workshops. These workshops are to be attended by both case management and health education staff from all Healthy Start Centers. Topics are to be selected from the following: Breastfeeding; SIDS/Hazards of Co-sleeping; Fetal Alcohol Spectrum Disorders; Pregnancy Induced Hypertension; Gestational Diabetes; Pre-Term Labor; Family Planning / Pre & Interconceptional Care; Immunizations; Sexually Transmitted Diseases / HIV/AIDS; Prenatal Mood Disorders; Substance Abuse; and Domestic Violence

    1. Staff training - Staff training will occur at one central location. Staff training may or may not be provided by existing state resources, but the provider will be responsible to setup the training. Training to be provided shall include, but not be limited to the following:
      1. Smoking during pregnancy,
      2. Sudden Infant Death Syndrome,
      3. Assessment skills, risks of, and strategies to prevent pre-term labor,
      4. Intervention for women who are experiencing domestic violence,
      5. HIV and STD prevention.
      6. Diseases that impact pregnancy (diabetes, blood pressure, asthma, etc.)
      7. Perinatal mood disorders
      8. Family Planning Method
    2. Client Education Workshops - One day workshops for clients will occur at the Healthy Start site. Training to be provided shall include the following topics:
      1. Smoking cessation,
      2. Normal growth & development - infant development and health services,
      3. Women's health after pregnancy - interconception care, family planning, HIV and STD prevention,
      4. Pre-term labor prevention and identification of postpartum depression, and
      5. Diseases that impact pregnancy i.e., diabetes, blood pressure, asthma, etc.
      6. Parenting skills
      7. Perinatal mood disorders
      8. Sudden Infant Death Syndrome
      9. HIV and STD Prevention
    3. Equipment - Purchasing equipment and supplies for training (including projectors and presentation software) will be the responsibility of the Provider.
      1. Provider will maintain an inventory list of all equipment purchased with Healthy Start funds.
    4. Reports - Provider shall submit reports to the Department on a quarterly basis, format to be determined by the Department. Provider will submit additional reports as requested by the Department. Reports shall include, but not be limited to:
      1. the number of training classes held,
      2. topics covered, and
      3. the number of client participants in each class.
      4. All clients will be given "All Kids" information and will be given information about "All Kids" application agent closest to them.
  9. All clients will receive educational materials about the importance of well-child visits and EPSDT services; to include but not limited to, immunizations, dental/oral health, lead, etc.

    All Medicaid/Medicaid-eligible clients will receive information on the availability of free transportation assistance and how to access the transportation. A note on "free of charge" transportation service assistance for all Medicaid and Medicaid-eligible clients will be posted so all Medicaid and Medicaid-eligible clients can view such information.

  10. All Healthy Start budgets will be sent in to the Healthy Start Project Manager for approval. Budgets must be accompanied by a budget narrative that clearly describes all changes from the previous submission and that clearly defines why changes were made.

    All staff paid for with Healthy Start dollars must work in Healthy Start and are to never work in other programs.

  11. The Provider will ensure that all Healthy Start Case Managers and relative clinical staff attend and participate in the Healthy Start Consortium meetings held approximately every other month.
  12. Licensed health care workers providing Healthy Start prenatal care and postnatal care to woman shall assess new mothers for postpartum mood disorder symptoms at a prenatal check-up visit in the third trimester of pregnancy and at the initial postnatal check-up visit thereafter until the infant's first birthday.

    Healthy Start licensed health care workers providing pediatric care to an infant shall assess the infant's mother for postpartum mood disorder symptoms at any well-baby check-up at which the mother is present prior to the infant's first birthday in order to ensure that the health and well-being to the infant are not compromised by an undiagnosed postpartum mood disorder in the mother.

    Healthy Start licensed health care workers providing prenatal and postnatal care to a woman shall include fathers and other family members, as appropriate; in both the education and treatment processes to help them better understand the nature and causes of postpartum mood disorders.

    All Healthy Start licensed health care workers will provide perinatal depression educational materials to include but not be limited to at minimum the DHS Perinatal Depression Brochure which can be ordered from DHS at no charge to the Provider.

    For purposes of the PPMD Act, assessment shall consist of the Edinburg Postnatal Depression Scale, which the new mother shall complete upon checking in for her appointment or the infant's appointment prior to being seen by the physician or other licensed health care worker.

  13. The Department will give the provider the document titled the Healthy Start Manual. The provider will operate the Healthy Start Program in accordance with those policies outlined in this document.

VI. Department Responsibilities

The Department will provide technical assistance and monitoring for all programs operated under Family and Community Services.

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. Division of Specialized Care for Children
  6. Local Hospitals
  7. Local Children and Family Services Programs
  8. Local Schools
  9. Vocational Rehabilitation Services
  10. Regional Perinatal Centers
  11. Local Early Intervention Programs for Infants and Toddlers with Handicaps
  12. 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

  1. The Department will pay the Provider $125.00 per month for each high-risk pregnant woman who is active in the Healthy Start Program.
  2. The Department will pay the Provider $50.00 per month for each infant up to age two that is active in the Healthy Start Program.
  3. The Department will pay for outreach activities, services, and incentives as described within the Project Description.
  4. 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 Family and Community Services, 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
        Tom Evering
        100 South Grand Ave East 2nd FL
        Springfield, IL  62762
        Phone:  217-557-2936
      2. Fax
        217-524-2491
      3. Email
        tom.evering@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

The Provider shall permit Department staff to conduct accompanied and unaccompanied site visits of service delivery providers for the purpose of observation and discussion of programmatic and operational content and understanding.

X. Program Budget

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

XI. Appendices/Forms 

Not applicable.