MIECHV Program Manual

Bureau of Early Childhood Development
MIECHV Program Manual FY22

I. Introduction/Definition

The Bureau of Early 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 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program provides 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 America (HFA) - Assists expectant and new parents identified as having a significant risk for child abuse/neglect to reduce that risk through intensive home visiting services.

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

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. Providers must follow the eligibility requirements of their model and give priority in providing services to the following populations as required by statute:
  • Low-income eligible families; 
  • Eligible families with pregnant women who have not attained age 21; 
  • Eligible families that have a history of child abuse or neglect or have had interactions with child welfare services;
  • Eligible families that have a history of substance abuse or need substance abuse treatment;
  • Eligible families that have users of tobacco products in the home;
  • Eligible families that have attained low student achievement or have children with low student achievement; 
  • Eligible families with children with developmental delays or disabilities; and 
  • Eligible families that include individuals who are serving or formerly served in the Armed Forces, including such families that have members of the Armed Forces who have had multiple deployments outside of the United States.

2. Among eligible families living in at-risk communities and representing priority populations listed above, providers may target subpopulations, either based on the home visiting model selected or community needs within selected at-risk communities including, but not limited to, geographic area, age, race, ethnicity, language and income. (ie, pregnant and parenting adolescents, substance-using caregivers, homeless families, etc).

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. The Grant Agreement, containing the standard contract language used for all Department contracts, including Part One (the Uniform Terms), Part Two (the Grantor-Specific Terms), and Part Three (the Project-Specific Terms).
  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 Specific Conditions

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 email the signature page to the Department to obtain the Secretary's signature and once executed, will be able to download the signed contract.

Amendment Process

Formal amendments - A two-party signed agreement to an executed Agreement is a formal amendment.

  1. The formal amendment process must be used to make changes to amend the Agreement exhibits (even if the budget is not amended), increase or decrease total Agreement revenue, and/or to reallocate funding between expenditure line items.
  2. Extending the service dates of the Agreement* - An amendment to extend the service dates of the Agreement must contain the following information: Agreement number as it appears on the original 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: The Agreement end date should be June 30, due to mandates in the State Finance Act regarding audit period. Aside from the exhibits, language in the Community Services Agreement may not be changed.
  3. The Provider must contact the IDHS program manager to initiate the formal amendment process to modify the language in the Agreement exhibits or modify the Agreement budget.

IV. Deliverables/Costs/Payments

  1. Deliverables are listed in Exhibit B of the Agreement.

  2. Payments to the Provider will be made on a reimbursement basis. The Department will compare the amount of the 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 Illinois Department of Human Services payment policy complies with 2 CFR 200.302, 2 CFR 200.305, 44 Ill. Admin. Code 7000.120, and the Cash Management Improvement Act and the Treasury-State Agreement (TSA) default procedures codified at 31 CFR 205.
  5. Funding is contingent upon and subject to availability of funds. Amendments to award amounts may be necessary within the grant cycle.
Expenditure Reporting Requirements: 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.
  2. Expenditures shall be recorded in the Provider's records in such a matter as to establish an audit trail for future verification of appropriate use of Agreement funds. 
  3. Expenditure documentation must be submitted in the format defined by the Division of Family and Community Services on a monthly basis within fifteen days of the end of the month reported or 30 days after the Agreement's end of the period of performance or termination. Additional data may be requested by the Department. The Department shall withhold payments to the entity if a report is more than 15 calendar days past the due date. If the report is more than 30 calendar days delinquent, without any approved written explanation by the grantee, the entity will be placed on the Illinois Stop Payment List.
  4. The Provider shall submit expenditure documentation as follows: Email: DHS.HomeVisiting@illinois.gov
  5. All financial record keeping on the part of the Provider shall be in accordance with generally accepted accounting principles consistently applied.
  6. Working Capital Advance
    1. Upon request, DHS will issue a working capital advance of 2/12 of the Award amount to be reconciled monthly. Subsequent payments will be issued on a reimbursement basis and will consider all previously submitted documented expenditures. 
    2. The Department will compare the amount of the prospective payment 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

  • Services - Illinois MIECHV aims to address social risk factors and improve child outcomes by implementing two evidence-based home visiting (EBHV) models in 13 at-risk communities (ARCs). Additional components include the following: infant mental health consultation (IMHC); advanced trainings on maternal depression, substance use, and the FAN; state-aligned cross-model program monitoring; home visiting professionalization; coordinated intake (CI); child welfare-home visiting partnership; universal newborn screening; and comprehensive early childhood system (ECS) development. Benchmark data and continuous quality improvement (CQI) are pivotal components of the project.

  • Reports -
    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 Periodic Performance Report (PPR) by the 15th day of the month following the end of each quarter.
    3. With written consent from the participant, the provider will use the Visit Tracker 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.
  • Performance Measures
    1. Percentage of staff vacancies filled within 180 days of the position becoming vacant. 
    2. Percentage of staff receiving core training within 90 days of hire.
    3. Percentage of staff participating in MIECHV training provided by Start Early, the Bureau of Early Childhood Development in the Illinois Department of Human Services (IDHS), and other training entities.
    4. Percentage of staff receive training on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Family Educational Rights and Privacy Act (FERPA). (FERPA training is only required for staff at educational institutions). 
    5. Percentage of home visitors and supervisors join the Gateways to Opportunity Registry by completing and submitting the Registry Membership form either online (https://www.ilgateways.com/) or by mail. 
    6. Follow program home visiting model's required supervisor/home visitor ratio to ensure adequate supervision. 
    7. Home visitors must receive the minimum number of hours of individual reflective supervision as required by their model. 
    8. 100% of MIECHV participants will access MIECHV home visiting services through the Coordinated Intake process and through Visit Tracker or other approved referral data system. If a referral comes directly to the home visiting agency, that agency is responsible for ensuring there is a record of the referral provided to Coordinated Intake.
    9. Percentage of participants meeting at least one MIECHV Priority Population criteria will be prioritized.
      • * Low income household
      • * Household contains an enrollee who is pregnant and under age 21
      • * Household has a history of child abuse or neglect or had had interactions with child welfare
      • * Household has a history of substance abuse or needs substance abuse treatment
      • * Someone in the household uses tobacco products in the home
      • * Someone in the household has attained low student achievement or has a child with low student achievement * Household has a child with developmental delays or disabilities
      • * Household includes individuals who are serving or formerly served in the United States armed forces
    10. Implement one of the following two evidence-based home visiting models with fidelity:
      • * Healthy Families America (Illinois);
      • * Parents as Teachers;
    11. Programs that have been active for a year or longer will be evaluated on the service percentage of their maximum service capacity.
      • * Maximum service capacity is the highest number of households that could potentially be enrolled at the end of the quarterly reporting period if the program were operating with a full complement of hired and trained home visitors.
      • * The maximum service capacity number does not change if program is not fully staffed. Inability to meet proposed caseloads may impact future funding.
    12. Home visiting staff will complete comprehensive assessment (Life Skills Progression, Parent Survey, or other assessment approved by your model) on each participant within the timeframe required by the model.
    13. Home visiting staff will develop and update a service or goal plan with each participant within the timeframe required by the model.
    14. Program has the capacity to provide family-centered and culturally respectful services. Program services take into account the culture of families such that staff understands, acknowledges, and respects cultural differences of families; staff and materials used by the site reflect to the greatest extent possible the cultural, language, geographic, racial and ethnic diversity of the population served. Participation in the following five (5) trainings/educational offerings listed in contract exhibits.
    15. Participate in Home Visit Rating Scale (HOVRS) as part of the quality assessment monitoring process.
    16. Percentage of participants that receive all relevant MIECHV benchmark interventions and program documentation of same in the MIECHV data system (Visit Tracker) by end of business the last day of each month.
    17. Percentage of participants who have received referrals and follow up on referral completion.
    18. Percentage of home visitors who maintain, at a minimum, an individual case record for each family enrolled in the home-visiting program and enter the required information into the MIECHV data system by the end of month.
    19. Percentage of prenatal participants screened using the 4 Ps Plus and provided with a brief intervention (if indicated) by 6 weeks postpartum, preferably prenatally.
    20. Each agency will establish a CQI team with a designated leader. CQI teams will participate in CQI activities annually as directed by the Illinois Department of Human Services (MIECHV).
    21. Number of public awareness events or outreach activities planned, implemented and/or participated in.
    22. Number of meetings of the local early childhood collaborative convened and participated in. (If there is a pre-existing Early Childhood collaborative, such as an AOK network, this network should be supported by MIECHV staff.)
    23. Number of narrative reports (PPRs) submitted within 15 days of the end of every quarter in the format required by the Illinois Department of Human Services (IDHS).
    24. Accurate and timely billing submitted by the 15th of each month for previous month's activities.
    25. Percentage of MIECHV-related programmatic and fiscal monitoring activities supervisors and/or staff participate in including Erikson Institute Program Assessments, IDHS Fiscal Monitoring and MIECHV mid-year provider calls.
    26. Program will develop and/or review/revise and incorporate policies, procedures and best practices, including the following:
      • * Guidance for MIECHV for Continued Community Collaboration Efforts
      • * Policy and Procedure for Quality Assurance Site Review
      • * MIECHV Disengagement and Re-enrollment Policy
      • * MIECHV Parental Engagement and Retention Policy
      • * MIECHV Recruitment Policy
      • * MIECHV Transition Policy
      • * MIECHV Policy to Avoid Dual Enrollment
      • * MIECHV Participant incentive
      • * Breastfeeding policy
      • * Coordinated Intake Policy and Procedure Manual Template
      • * Home Visiting Task Force Health Recommendations
      • * State Home Visit Vision
      • * Safety and Home Visiting Best Practices
  • Performance Standards
    1. 100% of staff vacancies filled within 180 days of the position becoming vacant. 
    2. 100% of staff receive and complete core training within 90 days of hire.
    3. Home visitors and supervisors complete 80% of required trainings as outlined in MIECHV training logs.
    4. 100% of staff receive and complete training on HIPAA and/or FERPA. 
    5. 100% of home visitors and supervisors registered in Gateways to Opportunity. 
    6. Describe ratio requirements of the program's home visiting model and list the program's ratios. 
    7. Describe requirements of the program's home visiting model and list the hours the program's home visitors received over the quarter.
    8. Home visiting agency receives at least one (1) Coordinated Intake Assessment Tool per caseload vacancy from Coordinated Intake agency each quarter that home visitor caseload is below 100% and CI and HV agencies are staffed.
    9. Program provides home visiting services to participants meeting priority population criteria.
    10. Program implements evidence-based home visiting model with fidelity. 
    11. Programs that have been active for a year or longer will maintain at least 85% of their maximum service capacity.
    12. Program staff complete comprehensive participant assessment in the timeframe required
    13. Service or goal plan for each program participant is developed and/or updated.
    14. Program has the appropriate staff, materials, and community partners to meet the cultural and language needs of the major population groups within the service population. 
    15. Program participation in HOVRS if quality assessment is occurring during this contract period.
    16. 80% of primary caregivers will be screened for depression using the Edinburgh Postnatal Depression Scale within 3 months of enrollment (for those not enrolled prenatally) or within 3 months of delivery (for those enrolled prenatally).
    17. 75% of participants with positive scores (21+ for Futures and 11+ for Baylor) on initial IPV screen will receive referrals to IPV resources.
    18. Home visitors provide valid, consistent, and complete information via the MIECHV data system (Visit Tracker) to record all information on program participants, and the activities of program staff. Information is entered by the last day of every month.
    19. 100% of prenatal participants will be screened using the 4 Ps Plus and provided with a brief intervention (if indicated) by 6 weeks postpartum, preferably prenatally.
    20. Establishment of CQI team and participation in annual CQI activity.
    21. Plan, implement, and/or participate in at least four public awareness events or outreach activities per year.
    22. Convene and/or participate in a minimum of 6 meetings of the local early childhood collaborative per year.
    23. Submission of quarterly narrative reports (PPRs) submitted within 15 days of the end of every quarter in the format required by the Illinois Department of Human Services.
    24. Submission of accurate and timely billing by the 15th of each month for previous month's activities.
    25. Participate in 100% of MIECHV-related programmatic and fiscal monitoring activities.
    26. Policies and procedures manual within the first 6 months of the grant year.
  • * There is a possibility of custom exhibits with responsibilities related to professional development, technical assistance and other support to home visiting providers including family recruitment, evaluation, and data collection.

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. Victims Services 
  2. Early Intervention 
  3. Medical Providers 
  4. School Districts 
  5. WIC 
  6. Family Planning providers 
  7. Better Birth Outcomes program 
  8. Accountable Care Entities, MCO's 
  9. 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.

TOP

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.
  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 must be submitted in the format defined by the Division of Family and Community Services on a monthly basis within fifteen days of the end of the month reported and 30 days after the Agreement's end of the period of performance or termination. Additional data may be requested by the Department. The Department shall withhold payments to the entity if a report is more than 15 calendar days past the due date. If the report is more than 30 calendar days delinquent, without any approved written explanation by the grantee, the entity will be placed on the Illinois Stop Payment List.
  4. The Provider shall submit the expenditure documentation for MIECHV by email to: DHS.HomeVisiting@illinois.gov
  5. All financial record keeping on the part of the Provider shall be in accordance with generally accepted accounting principles consistently applied.

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. 2 CFR 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements
  2. 42 CFR 430 et seq.: Medicaid provisions of Title XIX of the Social Security Act and its rules 
  3. 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" 
  4. 42 CFR Part 50, Subpart C: Policies of General Applicability, Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service 
  5. 42 CFR 54.1 et seq.: U.S. Department of Health and Human Services provisions regarding Charitable Choice 
  6. 45 CFR Part 16: Procedures of the Departmental Grant Appeals Board 
  7. 45 CFR 74 and 45 CFR 75: U.S. Department of Health and Human Services provisions regarding Administration of Grants 
  8. 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 44 Illinois Administrative Code

  1. Part 7000: Grant Accountability and Transparency Act

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. 30 ILCS 708: Grant Accountability and Transparency Act
  19. 225 ILCS 10: Child Care Act of 1969 
  20. 225 ILCS 460/1: Solicitation for Charity Act 
  21. 305 ILCS 5/4-12, 9-1, 12-4.5 through 12-4.7, and 12-13: Illinois Public Aid Code 
  22. 325 ILCS 5: Abused and Neglected Child Reporting Act 
  23. 410 ILCS 213: Hearing Screening for Newborns Act 
  24. 750 ILCS 30: Emancipation of Minors Act 
  25. 750 ILCS 60/227: Illinois Domestic Violence Act of 1986 
  26. 760 ILCS 55/1: Charitable Trust Act 
  27. 805 ILCS 5: Business Corporation Act

Note on Provider Audit Requirements

The MIECHV program uses Federal Funds and the Provider may fall under the audit requirements of 2 CFR 200, Subpart F. This knowledge can be used to avoid unnecessary additional costs when requesting year-end fiscal audits. The Grantee is therefore advised to notify their independent auditor (CPA) of this possibility.