Please direct all program related information and questions to:

Victoria Jackson
535 W. Jefferson Street
Springfield, IL  62701
Phone:  217-524-5992

I. Introduction/Definition

The Provider will engage in activities developed to prevent premature births and improve student health.

II. Policies & Procedures

Requirements for school health centers are specified in 77 Ill. Adm. Code 2200. The Provider's activities should assist school health centers in meeting the requirements specified in these rules. Applicable rules also include Maternal and Child Health Services Code, 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/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 programs and services to support and enhance the provision of maternal and child health services through public and provider information campaigns statewide in accordance with all conditions and terms set forth herein.

  1. The Provider will provide the following services to improve the quality of care and the capabilities of service providers, to prevent preterm birth and low birth weight and to improve the quality of school-based health centers:
    1. Develop and facilitate quarterly meetings in the northern, central and southern areas of the State, focusing on current maternal and child health issues.
    2. Organize and conduct an annual statewide conference for organizations, entities and individuals with interest in maternal and child health wellness.
    3. Provide training and technical assistance for school health centers in conjunction with Family and Community Services, Bureau of Maternal and Child Health.
    4. The Provider's activities under this agreement will be developed and conducted in consultation with the Department's authorized representatives.
  2. Reports
    1. The Provider will submit a narrative progress report to the Department within 30 days of the end of each quarter, and within 30 days of the end of the contract year.
    2. The Provider shall submit a program outlining contract year activities and a spending plan to the Department by August 15th of each contract year.
  3. The Provider shall incorporate additional program objectives into the program plan as indicated and required by the Division of Community Health and Prevention, Bureau of Child and Adolescent Health.

VI. Department Responsibilities

The Department will provide technical assistance and monitoring for all programs operated under the Division of 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. 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

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. The Provider shall submit expenditure documentation by one of the following means:
    1. Mailing Address
      Tina Finley
      100 South Grand Avenue East 2nd FL
      Springfield, IL  62762
      Phone:  217-785-2991
    2. Fax
    3. Email
  4. 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 Programs operated by the Provider under this contract will be monitored in a schedule as determined by the Department to review the program's progress according to stated goals, measurable objectives, administrative operations and adherence to their spending plan.

X. Program Budget

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

XI. Appendices/Forms

 Not applicable.