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.