Addendum 3.3.10 - FCM Infant Cornerstone Workflow

• Participant Lookup - PA01 (Local & Statewide)
• Participant Enrollment - PA03
  • Address - Add/Edit as needed
• Participant Information - PA15
  • Address - Add/Edit as needed
• Additional Eligibility - PA42
• Participant Group Relationship - PA06
  • Group Head = Mother/Guardian
• Caseload Reassignment - AD17 (Admin Only)
• Medical Screens (As needed)
  • Birth Data - PA11 (Newborn Only)
• Service Entry - SV01
  • Record 806 - Well Child/EPSDT Visits
• Assessments - AS01 (Required)
  • 712 - Infant Risk Assessment
  • 701 - Other Service Barrier
  • 708 - Pediatric Primary Care Assessment (Non-FCM/WIC Integrated Only) Nutrition Q's 81-02
  • 706 - Home Assessment
  • 708 - Anticipatory Guidance (A-R Age Appropriate)
• Service Entry - SV01
  • 807 - Pediatric Health Education
  • 824 - Developmental Screening
  • 812 - Medicaid Determination - RF01
  • 813 - Transportation - RF01
  • 806 - Well Child/EPSDT Visits
  • IMED - Immunization Education
  • SSED - Safe Sleep Education

824 - Developmental Screening completed within the first 6 - 12 months of age. If not done on-site, a referral to the Child & Family Connections (CFC) is required. Document the referral on the RF01 screen.

• Case Notes - CM04
• Care Plan Development
  • Participant Goals - CM02 (Edit as needed)
• Planned Services/Care Plan - CM03
  • Schedule Appointment - SC02
  • Service Provider - RF01 (WIC, 814-0-3 EI, Specialty Care, DCFS Nurse, HRIF, 812-Medicaid Determination, 813-Medically necessary transportation, 821-Immunization etc.) Include outcomes of referral
• Care Plan Summary - CM09 (Inquiry Only)
• Participant Referral History - RF03 (Print Screen)
• Activity Entry - SV02 (record time spent on participant related contacts, i.e. home visits, F2F, referrals)
• Profile - PA02 (Optional)

*Assessments should be completed based upon FCM program expectations outlined in the Policy & Procedure Manual.