The Reduction of Infant Mortality in Illinois
2012 Annual Report
The IDHS administers maternal and child health (MCH) strategy for the reduction of infant mortality. The strategy integrates two large-scale programs, the Special Supplemental Nutrition Program for Women, Infants and Children, more commonly known as WIC, and the Family Case Management (FCM) program. The Department supplements these basic services with programs targeted to women who have a greater chance of giving birth prematurely, i.e., the Chicago Healthy Start Initiative (CHSI).
The integration of these programs is supported and enhanced by the shared use of Cornerstone, the Department's maternal and child health management information system. This system collects and reports all of the information necessary for the operation of the WIC, FCM and Healthy Start programs. Cornerstone provides an integrated record of the services provided to each participant and a service plan that identifies the services that the family requires. Staff members within and among agencies have access to a comprehensive record of the services provided to participating families. This avoids the problem of duplicative data collection and recording. Cornerstone promotes the integration and streamlines the delivery of MCH services.
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) seeks to improve the health of women, infants, and children; to reduce the incidence of infant mortality, premature births and low birth weight; to promote breastfeeding; and to aid in the growth and development of children. The program serves income-eligible pregnant, breastfeeding and postpartum women, and infants and children up to five years of age who have a nutritional risk factor.
Participants receive food "prescriptions" based on their nutritional needs. WIC foods include milk, cheese, eggs, adult and infant cereal and juice, peanut butter, tuna, salmon, whole grains, carrots, beans, and infant formula. Food-specific vouchers are printed on site at WIC clinics statewide. Participants obtain their WIC foods by redeeming the vouchers at program-approved grocery stores throughout the state and at WIC Food Centers in certain areas of Chicago. The Department grants funds to 97 local agencies to provide WIC services, including local health departments, not-for-profit health care agencies and social service agencies.
Family Case Management is a statewide program that provides comprehensive service coordination to pregnant women, infants, and high-risk children. The Department funds 105 agencies, including local health departments, community-based organizations and Federally Qualified Health Centers, to conduct FCM activities. Assessments are conducted and care plans are developed to address a wide range of needs, including health care, mental health, educational, vocational, child care, transportation, psychosocial, nutritional, environmental, developmental, and other services. Contacts with clients include home and office visits at a frequency necessary to meet the client's needs. Most FCM providers are authorized to complete Medicaid Presumptive Eligibility applications for pregnant women and children and function as Application Agents for All Kids, Illinois' health insurance program for children.
In FY2012, IDHS began the process of redesigning the Family Case Management program to focus on the needs of high-risk pregnant women at risk of a premature birth. A prototype of the redesigned program will be initiated in 22 communities throughout the state in January 2013. The prototype, known as Intensive Prenatal Case Management (IPCM), will differ from Family Case Management in that its focus will be care for high-risk pregnant women. A standardized assessment tool that distinguishes high risk women from those of lower risk will be utilized and validated throughout the prototype. Prenatal education will be provided using a standardized curriculum across all programs. Care coordination among medical and social service providers will be the hallmark of the prototype. Communication mechanisms between prenatal care providers and IPCM care coordinators will be firmly settled through formal and systematic processes. Interfaces between the state's large information systems (Medicaid Claims, Vital Statistics and Cornerstone) will alert care coordinators of at risk women, inform the care providers and coordinators of the services being delivered and report performance in terms of services delivered and pregnancy outcome.
The Chicago Healthy Start Initiative provides services through four Chicago Healthy Start Family Centers that serve as "one-stop shopping centers" for intensive case management and linkage to prenatal care, pediatric primary care, family support, early intervention, substance abuse prevention, domestic violence prevention, and mental health counseling. The centers also provide two essential enabling services -- episodic child care and transportation -- to remove common barriers to care. CHSI targets the Hermosa, Near West Side, Near South Side, Douglas, Grand Boulevard, Washington Park and Greater Grand Crossing Community Areas in the city of Chicago. This project is supported by a grant from the federal Maternal and Child Health Bureau.