The Illinois Department of Human Services (IDHS), Division of Family and Community Services, contracts for the establishment and maintenance of an Early Intervention (EI) Monitoring Program, to provide compliance monitoring and focused verification monitoring reviews of Child and Family Connections (CFC) offices and compliance monitoring reviews for EI Providers, in compliance with Part C of the Individuals with Disabilities Education Act (IDEA), and 89 IL Admin Code 500.65.

The EI Monitoring Program will:

    • Perform complete monitoring review processes that includes:
    • sending necessary correspondence,
    • schedule and conduct compliance monitoring reviews and focused verification monitoring reviews; develop final reports and conduct exit conferences;
    • provide technical assistance;
    • request, review and approve corrective action plans (CAP) as needed;
    • conduct follow up in an effort to ensure correction of non-compliance;
    • make notification of refunds and prepare files for collections, when necessary; and
    • Submit documentation of monitoring activities to IDHS.
  • Utilize and update IDHS-approved monitoring tools based on federal and state regulation/rule, program policies and procedures, and Payee agreements for Authorization to Provide Early Intervention Services.

Annually, the Vendor will provide on-site compliance monitoring reviews of all 25 CFC offices. Reviews will include compliance determinations for administrative processes and procedures and file reviews, with the number of files determined by size of the CFC office's caseload for a one month time period and the number of children transitioning from EI during a designated time period. A specific CFC office may receive a review on a more frequent basis, based upon a formal complaint or at the request of the Department. The minimum number of files to be reviewed in a CFC office is based upon caseload. If the number of children transitioning from EI during a designated time period exceeds the minimum number of files to be reviewed in a CFC office, additional files will be reviewed to meet annual federal reporting requirements. Only files for children transitioning from EI during a designated time period are reviewed in CFC offices that also receive a focused verification monitoring review during the same fiscal year. There are a number of variables that impact the amount of time it takes to travel to and complete a CFC compliance monitoring visit, including the size of the agency's caseload, the location of the agency, the location of EI Monitoring office(s), monitoring staff's level of experience, and the size of the monitoring team sent to complete the review.

  • Provide focused verification monitoring reviews to all CFC offices at a minimum of once every three years or upon the request of IDHS. Focused verification visits include in depth file reviews, program manager and service coordinator interviews, and family, provider, and stakeholder surveys.
  • Provide annual compliance monitoring reviews of 65 percent of the EI payees that billed for services during the preceding fiscal year.
  • Monitor EI payees that have been monitored by scheduling subsequent compliance monitoring reviews or administrative reviews based upon the outcome of the previous reviews or upon the initial order of the review. Payees that have not been previously monitored will be scheduled for visits on a random basis. A specific EI payee/provider may be monitored outside of the routine schedule based upon a formal complaint or at the request of IDHS. Reviews are included in the count of payees monitored. These reviews may be done onsite or offsite.
  • Review for compliance determination for administrative processes and procedures, file reviews (with the number of files determined by size of caseload and randomly selected), and a family satisfaction survey process. Payees with no corrective actions in their previous review will be monitored for compliance with administrative processes and procedures only, unless a complaint has been made or unusual practice detected.
  • Request reports from the EI Central Billing Office who maintains a list of children for which the payee has submitted claims during the designated fiscal year.
  • Work with the IDHS, the EI Training Program, the EI Credentialing Office, EI Clearinghouse and the EI Central Billing Office to support the monitoring review process.
  • Maintain an EI Monitoring Program Database, which includes developing and maintaining a compliance monitoring database to document the outcomes of monitoring activities, generating reports of these activities, and completing administrative functions relative to this contract.
  • Generating and maintaining a CFC/EI provider compliance monitoring schedule; creating quarterly reports; providing data for the EI Annual Performance Report; and responding to other requests from IDHS for monitoring data.
  • Maintain an EI Monitoring Program Website, which includes maintaining a website to include contact information, monitoring tools, information for EI providers and CFC offices regarding the monitoring process; and information and resources to help address areas of non-compliance.
  • Provide Technical Assistance to the EI services system in the scope of interpretation of policy and procedure with IDHS approval, including CFC offices and EI providers, on the implementation of program policies and procedures and on issues identified through compliance monitoring, as directed by the Bureau of Early Intervention.
  • Provide specific citation of current policy and procedure to instruct those monitored on proper policy and procedure.
  • Resolve of Parent Explanation of Benefits (EOB) Incident Reports which includes contacting families that have identified issues with provider billing, called EOB incidents, investigate these incidents, sending all necessary correspondence, and , when necessary, review provider documentation; provide technical assistance; make notification of refunds, prepare files for collections; and submit documentation of EOB incident report resolution to IDHS.
  • Work with families, CFC offices, and EI Providers to address conflict resolution and representation at Mediations, by resolving issues and conflicts prior to the initiation of a formal the complaint process consistent with IDHS's interests, policies, and procedures. In addition, EI Monitoring Program staff may be asked by the IDHS to participate in mediation activities.
  • Provide support staff workgroups of the Illinois Interagency Council on Early Intervention (IICEI) as directed by the Bureau of EI. This support may involve scheduling meetings, preparing agendas, taking meeting notes, researching and producing work products, as needed.
  • Submit a quarterly report via an email to the Chief of the Bureau of EI, including progress/status of milestones and deliverables in a format approved by IDHS. These reports will include, but are not limited to, the following:
  • Progress/status of the following performance measures: the number of compliance monitoring reviews of CFC offices conducted annually; the number of focused verification reviews of CFC offices conducted annually; the number of compliance monitoring reviews of EI payees conducted annually; the number of calendar days from receipt of the complaint from the EI Central Billing Office to contact families to resolve an EOB incident reports; and the number of days from exit conference with an EI provider/payee for refunds letters to be mailed out.
  • Number of parent EOB incident reports investigated and resolved;
  • Information about any additional monitoring activities conducted and reasons for the activities;
  • Number of requested reports from the EI Central Billing Office and any delays in receiving reports required for monitoring;
  • Specific issues the Department should be aware of related to the monitoring activities, and
  • Any other information requested by IDHS.

At the commencement of the contract, the vendor shall provide a detailed plan to transition activities from the previous vendor to minimize disruption to the monitoring program and its staff. The plan shall include onboarding of existing staff; issuing notifications for upcoming visits; developing a monitoring schedule; providing office space as needed; securing a technology infrastructure; managing equipment, furniture and supplies; developing the external web site; creating an Intranet and project dashboard, and related activities.

  • Provide all data and related records and information to IDHS or a successor vendor in a mutually prescribed format at the expiration of a contract.

Annually, the EI Monitoring Program will:

  • Conduct compliance monitoring reviews of all 25 CFC offices.
  • Conduct focused verification reviews of at least one-third of the 25 CFC offices.
  • Conduct compliance monitoring reviews of 65 percent of the EI payees that billed for services during the preceding fiscal year.
  • Contact families to resolve EOB incident reports within 14 calendar days of the receipt of the complaint from the EI Central Billing Office.
  • Mail all refund letters within two weeks from exit conference with EI provider/payee.