Home Visiting Programs Manual

Helping Families. Supporting Communities. Empowering Individuals.

Bureau of Childhood Development
Program Manual FY18

I. Introduction/Definition

The Bureau of Childhood Development administers community-based prevention and intervention programs to strengthen capacity of children, adolescents, women and men to make healthy decisions, utilize support systems, access opportunities, and achieve self-sufficiency.

Using the following evidence based models, the Healthy Families Illinois (HFI), Maternal, Infant, and Early Childhood Home Visiting (MIECHV), and Parents Too Soon (PTS) programs provide intensive home-visitation services to new and expectant families to strengthen the parent child relationship, encourage healthy child growth and development and nurture parents in their role as the child's first teacher and prevent child abuse and neglect.

Healthy Families Illinois (HFI) - Assists expectant and new parents identified as having a significant risk for child abuse/neglect to reduce that risk through intensive home visiting services.

Nurse Family Partnership (NFP) - Utilizes Nurse Home Visitors to assist low-income first time mothers and their children to improve their health and life-course.

Parents as Teachers (PAT) - Provides information, support and encouragement to expectant parents and parents with children ages zero to five.

Early Head Start - Home Based (EHS/HB) - Supports and enhances the continuum of infant and toddler growth and development; support parents to fulfill their parental roles and move toward self-sufficiency.

Each MIECHV community will have a coordinated intake process to assure that families have a central point of entry for services. The coordinated intake provider will assist families in determining the services and supports that are best suited for their needs.

II. Policies and Procedures

Subject to Department review and approval, providers will maintain and adhere to written policies and procedures for at least the following elements.

  1. The characteristics of the population targeted for services include, but are not limited to, geographic area, age, race, ethnicity, language and income. Programs must, at a minimum, adhere to the following eligibility criteria:
    1. HFI - determined through either the eligibility screen or Family Stress Checklist to be at risk for child abuse and/or neglect
    2. NFP - first-time parents at or below 185% of the Federal Poverty Level
    3. PAT - parents at or below 185% of the Federal Poverty Level
  2. Identification and referral of potentially eligible participants within the following time frames:
    1. HFI - Prenatally or within two weeks of birth
    2. NFP - Prenatally, prior to the 28th week of gestation
    3. PAT - Prenatally or prior to the child's first birth date

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

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 once executed, will be able to download the signed contract.

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 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.
  4. The Department may provide a staffing formula for the program.

V. Provider Responsibilities

Healthy Families Illinois/MIECHV

  1. Providers must submit for Department approval a Program Plan in a format/time frame provided by the Department.
  2. Providers must maintain local policies and procedures for the following activities:
    1. Tracking trends related to the target population and adjustment to program plans as indicated
    2. Provision of services that are culturally relevant to the population served
    3. Cultural relevance includes, at a minimum, age, race, ethnicity and language
    4. Increase/decrease in the intensity of home visiting services
    5. Termination of home visiting services
    6. Outreach and re-engagement
    7. Monitoring by caseload and program, the percentage of families who receive 75% or more of the expected home visits
    8. Maintenance of a supervisory log/ledger containing documentation of supervision, team meetings, field observations, training and other staff development
    9. Maintenance of training log for each direct service staff and supervisor documenting the completion of all job specific and ancillary training
    10. Benchmarks for annual acceptance and retention rates
    11. On-going quality assurance, including client/staff survey
    12. Community advisement
    13. Compliance with mandated reporting requirements
    14. Compliance with the Health Insurance Portability and Accountability Act of 1996
    15. Developmental Delay Screening, utilizing a research-based screening tool, must be completed at the intervals required by the program model. (For Parents As Teachers programs, Hearing and Vision Screenings must also be completed at the intervals specified by the program model).
  3. Providers will assist participating families to connect with medical providers, and when appropriate, Family Case Management and the Women, Infants and Children (WIC) program.
  4. Providers will participate in the Department's efforts to improve the health and well-being of families enrolled in program services.
  5. Prior approval from the Department must be secured prior to any anticipated change to the program model.
  6. The Provider is required to comply with performance standards as delineated by the Department.
  • Staffing, Education and Training Requirements
  1. Program staff should be representative of the ethnic/cultural diversity of the community served and meet the following educational requirements. The ratio of supervisors to direct service staff must be in compliance with the program model requirements.
    1. HFI - Supervisors, hired after September 1, 2004, must have at least a Bachelor's degree; Family Assessment and Family Support Workers must have at least a high school diploma, or its equivalent.
    2. NFP- Supervisors must be Bachelor's degree prepared Registered Nurses; Nurse Home Visitors must be Registered Nurses
    3. PAT - Supervisors must have a Bachelor's degree in early childhood education; Parent Educators must have at least a high school diploma, or its equivalent
  2. Program staff, Supervisors, and Home Visitors, must have role-specific training, as required by the specified program model, within six months of hire. Additional training required by the program models must be completed within the time frames specified by the model.
  • Reporting Requirements
  1. Providers will maintain, at a minimum, an individual case record for each family enrolled in the home-visiting program.
  2. Utilizing a format provided by the Department, providers will submit a quarterly data collection form by the last day of the month following the end of each quarter.
  3. With written consent from the participant, the provider will use the Cornerstone information management system, or its successor(s) to record all information on program participants, and the activities of program staff.
  4. The Provider will submit data, in a manner specified by the Department, which documents the program's performance on the federally mandated benchmarks for the Maternal, Infant, and Early Childhood Home Visiting program.

Parents Too Soon

The Provider shall subcontract with community service agencies to offer the Parents Too Soon/Healthy Families Illinois, Parents Too Soon/Nurse Family Partnership and Parents Too Soon/Parents as Teachers, home visiting program services. The sub-contracts are to be approved by the Department prior to execution.

  1. Program and Spending Plan
    The Provider shall submit to the Department the Parents Too Soon/Parents as Teachers, Parents Too Soon/Healthy Families Illinois and Nurse Family Partnership and Educare program and spending plans by subcontractor agency by the 45th day after the start of the fiscal year.
  2. Reports
    1. The Provider shall submit to the Department the subcontractor quarterly Ounce net report by Provider and overall for the State within 45 days after the end of each quarter.
    2. The Provider shall submit quarterly to the Department the subcontractor OunceNet report by Provider and overall for the State within 45 days after the end of each quarter.
    3. The Provider shall submit to the Department the annual report 45 days after the end of the fiscal year. Format of the annual report to be determined by the Department.
    4. The Pregnant and Parenting subcontractor agency services include, but are not limited to:
      1. weekly parent group meetings and home visits,
      2. developmental delay screening utilizing a research-based screening tool (e.g., ASQ, Denver Developmental screen) must be completed for each target child at intervals prescribed by the tool until the child is 3 years of age,
      3. parenting skills education,
      4. immunization and EPSDT compliance,
      5. education on family planning including abstinence education, and prevention of sexually transmitted infections and HIV/AIDS
      6. upon completion of training and with consent of the families, provider will videotape parent-child interaction twice yearly,
      7. promotion of delay of subsequent pregnancy,
      8. monitoring of below post secondary school progress, and
      9. Family Life Education
  3. Parents Too Soon/Healthy Families Illinois subcontractor agencies shall abide by the provisions of the Healthy Families Illinois program as described in the Department Program Manual.
  4. Funds are provided to support salary, fringe benefits, travel and equipment for an adolescent development program coordinator as identified by the Department. The Department will approve the time reporting for such staff on a basis consistent with the Provider's payment frequency.
  5. The Provider is required to comply with performance standards as delineated by the Department and referenced in letter.
  • For Programs Using the Cornerstone Data System
    1. The agency must purchase and maintain a business class contract with an Internet Service Provider (ISP).
    2. Interruption of communication and/or connectivity must be reported within 24 hours to the agency's ISP and the Cornerstone Service Desk.
    3. Cornerstone User access must be approved and terminated by an appropriate section manager responsible for Cornerstone security management within the Cornerstone agency.
    4. Security training is required before Cornerstone users are allowed access to the system and annually thereafter.
    5. Reasonable action, due care, and due diligence must be taken to prevent inappropriate use, disclosure, destruction or theft of Cornerstone-designated IT resources. Reasonable actions include but are not limited to prevention, detective and corrective measures such as encryption, anti-viral software and application of security patches.
    6. Disclosure of Cornerstone information is restricted only to authorized parties and in a manner consistent with the form of data classification.
    7. Cornerstone-designated IT resources are for approved use only.  Approved use is limited to authorized users, sanctioned Cornerstone business and job responsibility.
    8. Only approved software and hardware are authorized to be loaded on Cornerstone-owned IT resources:
      1. Users are not authorized to run software that has not been approved by Cornerstone technical staff.
      2. Users are not authorized to attach hardware not approved by Cornerstone technical staff including but not limited to modems or non-Cornerstone-designated IT resources such as portable computers or other digital storage or writing devices.
      3. Only approved software may be used to develop applications or to manipulate data.

VI. Department Responsibilities

The Department will provide technical assistance and monitoring for all programs operated under the Division of 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/Medical Providers
  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. Expenditure documentation shall be submitted in a format defined by the Division of Family and Community Services on a monthly basis, within fifteen days of the end of the month reported.
  4. The Provider shall submit the expenditure documentation for HFI and Parents Too Soon by email to:
  5. The Provider shall submit the expenditure documentation for MIECHV by email to:
  6. All financial record keeping on the part of the Provider shall be in accordance with generally accepted accounting principles consistently applied.
  7. Expenditure Documentation Form (xls)

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 spending plan approved by the Provider's Board of Directors.

XI. Applicable Rules and Statues

The Provider shall provide services as set forth in the pertinent portions of the FCS Program Manual and shall act in accordance with all state and federal statutes and administrative rules applicable to the provision of the services, including, but not limited to the following:

Federal Rules:

  1. 42 CFR 430 et seq.: Medicaid provisions of Title XIX of the Social Security Act and its rules
  2. 42 CFR 431.300 - 431.307: Medicaid provisions of Title XIX of the Social Security Act and its rules, specifically provisions regarding "Safeguarding Information on Applicants and Recipients"
  3. 42 CFR Part 50, Subpart C: Policies of General Applicability, Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service
  4. 42 CFR 54.1 et seq.: U.S. Department of Health and Human Services provisions regarding Charitable Choice
  5. 45 CFR Part 16: Procedures of the Departmental Grant Appeals Board
  6. 45 CFR 74 and 45 CFR 75: U.S. Department of Health and Human Services provisions regarding Administration of Grants
  7. 45 CFR 260: General Temporary Assistance for Needy Families (TANF) Provisions

Federal Statutes:

  1. 22 U.S. Code 7102 et seq.: Victims of Trafficking and Violence Protection Act
  2. 42 U.S. Code 290aa et seq.: Public Health Service Act
  3. 42 U.S. Code 701 et seq.: Maternal and Child Health Services Block Grant
  4. 42 U.S. Code 5101 et seq.: Child Abuse Prevention and Treatment Act of 1996
  5. 42 U.S. Code 5601 et seq.: Juvenile Justice and Delinquency Prevention Act
  6. 42 U.S. Code 10401 et seq.: Family Violence Prevention and Services Act
  7. 42 U.S. Code 12501 et seq.: National and Community Service Act of 1990 as amended by the National and Community Service Trust Act of 1993
  8. 42 U.S. Code 13701 et seq.: Violent Crime Control and Law Enforcement Act of 1994
  9. 42 U.S. Code Chapter 7, Subchapter V, Section 701: Authorization of Appropriations

State Rules: Title 77 Illinois Administrative Code

  1. Part 630: Maternal and Child Health Services Code
  2. Part 2030: Award and Monitoring of Funds

State Rules: Title 89 Illinois Administrative Code

  1. Part 130.200: Administration of Social Service Programs, Domestic Violence Shelter and Service Programs
  2. Part 310: Delivery of Youth Services Funded by the Department of Human Services
  3. Part 313: Community Services
  4. Part 334: Administration and Funding of Community-Based Services to Youth
  5. Part 507: Audit Requirements of DHS
  6. Part 509: Fiscal/Administrative Recordkeeping and Requirements
  7. Part 511: Grants and Grant Funds Recovery

State Statutes

  1. 5 ILCS 420/1-101 et seq: Illinois Governmental Ethics Act
  2. 5 ILCS 430 et seq: State Officials and Employees Ethics Act
  3. 20 ILCS 405/405-300 Civil Administrative Code of Illinois
  4. 20 ILCS 505/17: Children and Family Services Act
  5. 20 ILCS 710: Illinois Commission on Volunteerism and Community Services Act
  6. 20 ILCS 1305: Department of Human Services Act
  7. 20 ILCS 2310/55.05: Civil Admin. Code of Illinois
  8. 30 ILCS 105/9.04: State Finance Act
  9. 30 ILCS 105/15a: State Finance Act
  10. 30 ILCS 50/1-1 et seq: Illinois Procurement Code
  11. 30 ILCS 435/15: Human Services Provider Bond Reserve Payment Act
  12. 30 ILCS 500/1-15.60: Illinois Procurement Code
  13. 30 ILCS 500/20-80: Illinois Procurement Code
  14. 30 ILCS 540/1 et seq: State Prompt Payment Act
  15. 30 ILCS 575/0.01 et seq: Business Enterprise Program for Minorities, Females and Persons with Disabilities
  16. 30 ILCS 590/1 et seq: State Agency Employees Child Care Services Act
  17. 30 ILCS 705/1: Illinois Grant Funds Recovery Act
  18. 225 ILCS 10: Child Care Act of 1969
  19. 225 ILCS 460/1: Solicitation for Charity Act
  20. 305 ILCS 5/4-12, 9-1, 12-4.5 through 12-4.7, and 12-13: Illinois Public Aid Code
  21. 325 ILCS 5: Abused and Neglected Child Reporting Act
  22. 410 ILCS 213: Hearing Screening for Newborns Act
  23. 750 ILCS 30: Emancipation of Minors Act
  24. 750 ILCS 60/227: Illinois Domestic Violence Act of 1986
  25. 760 ILCS 55/1: Charitable Trust Act
  26. 805 ILCS 5: Business Corporation Act

Note on Provider Audit Requirements

The State General Revenue Funds disbursed through the Department of Human Services, Division of Family and Community Services, are usually Maintenance of Effort (MOE) or Temporary Assistance for Needy Families (TANF) matching funds. Therefore, these funds are generally treated as FEDERAL FUNDS at the end of the fiscal year. Such treatment of State General Revenue Funds as Federal Funds may cause the Provider to fall under the audit requirements of OMB Circular A-133. This knowledge can be used to avoid unnecessary additional costs when requesting year-end fiscal audits. The Provider is therefore advised to notify their independent auditor (CPA) of this possibility.