Question and Answer High Risk Family Case Management (25-444-80-3383-01)

Question and Answer

May 9, 2024

  1. Question: Will there be any low risk FCM services or funding opportunities offered for FY 25?
    • Answer: The Bureau of Maternal and Child Health does not plan to post a SFY25 Notice of Funding opportunity for low-risk Family Case Management services. Low risk families will continue to be served through WIC, Early Childhood Home Visiting, and Managed Care Organization Case Management programs, among others.
  2. Question: I am curious if the LHDs were consulted in making such a significant and last-minute decision?
    • Answer: IDHS acknowledges that this is a significant decision. The existing programs are not meeting the needs of Illinois' most vulnerable populations. Racial disparities in maternal morbidity and mortality are high, and infant mortality rates remain unchanged despite our efforts. Since the establishment of these "legacy" programs (FCM, HRIF and BBO), other agencies, organizations, and Managed Care Organizations have launched programs with similar offerings. To avoid the duplication of services, and to fulfill the mandates set forth by the Improving Health Care for Pregnant and Postpartum Individuals Act, it is time for IDHS to expand our high-risk clinical case management program. While it might appear last minute with the timing of the posting of the NOFO, discussions of possible solutions to the unacceptable rates of maternal and infant morbidity and mortality have been discussed across the state for the past several years with a variety of MCH and Early Childhood stakeholders.
  3. Question: Can you clarify that memo that came out yesterday evening? Is APORS being discontinued but now it will be under a different program/grant that we can apply for? Does regular Family Case Management continue or is it being discontinued?
    • Answer: The memo sent to SFY24 providers on 5/8/24 after the NOFO was posted indicated the following programs will be discontinued on 6/30/24:
        • Family Case Management High Risk Infant Follow Up program (444-80-2535)
        • Better Birth Outcomes program (444-80-0226)
      • The memo also indicated that instead, a single, comprehensive new program would be launched on 7/1/24:
        • High Risk Family Case Management Program (444-80-3383)
      • APORS is not a IDHS program. IDHS partners with IDPH Adverse Pregnancy Outcomes Reporting System to ensure that when specific diagnoses are reported to IDPH at time of hospital discharge, the family will be offered follow-up nurse visits through IDHS programs. IDPH is not discontinuing APORS and families with an infant meeting the criteria will be referred for services through the IDHS High Risk Family Case Management program. HRFCM will be the only case management program offered through IDHS with the goal of services for high-risk dyads to be available statewide.
  4. Question: I don't understand this memo. Could you please explain if I'm reading this correctly? There will be no family case management program!?
    • Answer: See answer to #3 above
  5. Question: This link isn't working. This just takes me to the MCH PPM with the HRIF/FCM/BBO guidance. Is there somewhere where the NEW HRFCM PPM is located??
  6. Question: One question I had was if FCM will remain intact with the change in the High-Risk program?
    • Answer: See answer to #3 above
  7. Question: What's going to happen to the FCM's families that we are currently helping? And the staff? Is this a final decision?
  8. Question: Will this NOFO replace only HRIF and BBO, or does this mean low risk FCM itself will no longer be offered statewide?
    • Answer: See answer to #3 above
  9. Question: Would you please share when we might hear news about the Family Case Management funding for FY2025?
    • Answer: See answer to #3 above
  10. Question: Will current Case Managers with Bachelor's degrees in health related fields be grandfathered in or will they no longer be qualified to hold the position of Case Manager?
  11. Question: Would this program have the same qualifications as HRIF or are there additional conditions that would qualify a client?
  12. Question: In light of this major announcement, does this mean that the staff we currently have will not qualify for the new program because you only have nurses in the grant?
    • Answer: see answer to #10 above
  13. Question: I tried to complete the required application, however, it does not show as available…is there an issue on your end?
  14. Question: Will the Technical Assistance webinar be recorded?
    • Answer: Yes. It will be recorded and instructions for viewing will be shared.
  15. Question: What does this mean and what will it look like for us? What does this mean for my local family case management team?
    • Answer: We encourage all local teams to explore the NOFO and strongly consider applying for the new High Risk Infant Case Management program Notice of Funding Opportunity (25-444-80-3383-01). If you are a provider who does not currently offer clinical/nursing services to high-risk clients, you may choose not to apply for FY25. If you would like to start offering clinical/nursing services to high-risk clients, we encourage you to review the full FY25 HRFCM Notice of Funding Opportunity. Should you choose to apply and be selected to receive a grant, grantees must have the required staffing model in place within 90 days of the contract start date.
  16. Question: Will our current APORS/HRIF case loads terminate if the infants are over 1 year old after the HRFCM program begins? If so, will there be a script provided to help explain the change in duration of program?
  17. Question: What notification system will we (coordinators) receive when we have an eligible high risk pregnant woman? What is that process going to look like?
    • Answer: Referrals will come directly to local provider agencies through various ways, including but not limited to Medicaid MCOs, primary care providers, hospitals, and other health or social service providers. HRFCM providers are encouraged to provide outreach tailored to their community. Families may also self-refer through the IDHS Office Locator. Infants with specific diagnoses reported to IDPH at hospital discharge via the APORS system will also be referred directly to local agencies.
  18. Question: I understand that the HRIF program will cease to exist, does that include APORS or will APORS remain?
    • Answer: See answer to #3 above.
  19. Question: Is the Family Case Management Program being eliminated?
    • Answer: See answer to #3 above.
  20. Question: Is there no longer a DHS program for lower risk pregnant and infants to help reduce infant mortality?
  21. Question: My agency currently does not have a nurse on staff for case management. The projected caseload and funding listed for my county does not support a full caseload or full FTE. It's very difficult to find part-time nurses. How can we offer this service in our area?
    • Answer: For counties projecting to need less than a full FTE, we encourage collaboration to explore subaward agreements with neighboring counties to allow for shared staff and reduction of administrative burden.
  22. Question: Regarding the recent NOFO, does this affect the FCM program? Are the HRIF and BBO programs the only ones being discontinued??
    • Answer:  See answer to #3 above.
  23. Question: What are the staffing qualifications for case manager?
    • Answer: see answer to #10 above.
  24. Question: What is the expectation for timeline of services starting, given it will likely take time to implement?
    • Answer: We recognize this new model may require shifts in your current staffing plan. The required staffing model is expected to be in place within 90 days of the contract start date. Those agencies with the capacity or staff to start up services sooner in SFY25 are welcome to do so. Training and technical assistance will be provided to all SFY25 grantees starting in July.

    • May 10, 2024

  25. Question: Does this mean FCM ends 6/30/24? Was this in legislation?
    • Answer: See answer to #3 above. HRFCM is administered in accordance with the Family Case Management Act (410 ILCS 212) and in alignment with the Improving Health Care for Pregnant and Postpartum Individuals Act. (20 ILCS 1305/10-23) which mandates IDHS to expand and update its maternal child health programs to serve pregnant and postpartum individuals determined to be high-risk.
  26. Question: Will the high-risk dyads be following a curriculum or is that up to the bidders?
  27. Question: Are you open to a hybrid model with virtual check ins and leaning into technology as appropriate? Or this is all on cornerstone?
    • Answer: Nurse visits are expected to occur exclusively in the home setting monthly for the duration of pregnancy and at least the first three months after birth. Cornerstone is the current MIS system for Bureau of Maternal Child program data collection.
  28. Question: With the national workforce shortage, why specifically do you want RNs/APRNs or is this designed for existing clinical staff within these county health depts?
    • Answer: This program was not designed for a specific provider type. Eligible applicants are inclusive of units of local government, hospitals, community-based organizations, federally qualified health centers, and nonprofit organizations that serve the eligible community in the geographical area applied for. While many existing programs provide screening and referrals, there are currently no statewide programs that provide nursing assessment and intervention. IDHS seeks to fill this gap with the HRFCM program.
  29. Question: Will this program intersect with Family Connect Chicago and alongside doulas? And will they work with MIECHV home visitors? Or totally separate?
    • Answer: While those are all separate programs, collaborations have begun and will continue. IDHS seeks to ensure that cross-program referrals occur to support low and high-risk families. This collaboration will help to ensure that families understand the various services available to them to make informed choices to meet their needs.
  30. Question: In order to be eligible for the Healthworks program do you have to be a FCM grant recipient?
    • Answer: The Healthworks program is administered by YouthCare. We recommend that you reach out to your YouthCare/Centene or DCFS contacts to inquire about Healthworks provider eligibility.
  31. Question: The registration link for the above referenced NOFO Bidder's Conference goes directly to a WebEx meeting, not to a registration page. Do I have to register?
    • Answer: Registration is not required. The meeting can be joined using the link provided at the listed meeting date/time.
  32. Question: Will we continue to receive IDRs from IDPH?
    • Answer: IDPH is not discontinuing APORS and families with an infant meeting the criteria will be referred for services through the IDHS High Risk Family Case Management program. IDRs (Infant Discharge Records) will still be utilized for these referrals.
  33. Question: How was funding determined? Our population is over 700k yet we are anticipating $350k while much smaller counties will receive 4-5x that amount.
    • Answer: To ensure all communities in Illinois will have equitable access to HRFCM services, the Department's goal is to achieve statewide coverage for HRFCM programming. The department has identified anticipated average monthly caseloads of high-risk family units/dyads based on previous years' clients referred and/or served who were determined to be high-risk by identified risk factors in each geographical area.
  34. Question: What will happen to our current APORS and BBO clients? Do they roll over into this program?
    • Answer: Eligible high-risk families may continue to receive services from a SFY25 High Risk Family Case Management provider. Technical assistance will be provided to SFY24 providers and SFY25 providers on transitioning families who will need continued services.
  35. Question: Our CM programs have not had an income requirement-why the change? We could potentially miss a large group of high-risk families that are not lower income. How do we determine their financial eligibility?
    • Answer: This HRFCM program is administered in accordance with the Family Case Management Act (410 ILCS 212) which defines "Eligible participant" as any pregnant woman or child through the age of one year enrolled in the Medicaid program or whose income is up to 200% of the federal poverty level. Technical assistance will be provided to SFY25 providers on how to determine eligibility.
  36. Question: Do we follow a particular curriculum for the pregnant individuals?
    • Answer: See answer to question #26 above.
  37. Question: Can we have high risk infants even though mom was not in our program during her pregnancy?
    • Answer: The HRFCM program serves the dyad as a unit. The purpose of the program is to improve maternal and infant outcomes. Therefore, it is our expectation to engage with birthing families as early in pregnancy as possible. If a dyad is referred after birth, the family is still eligible for services. In a situation where the birthing person is not the primary caregiver for the infant or the birthing person and the infant live in separate households, it would be appropriate to provide services separately.
  38. Question: Is the "regular" Family Case Management program also being terminated (as it was not listed as a resource for low-risk families in the announcement on 5/8/24)
    • Answer: See answer to #3 above.
  39. Question: What is the educational requirement to be a high-risk family case manager? I see in the NOFO the discussion of using a multidisciplinary team but am unclear if the scope and capacity of employees with different educational backgrounds. For example, will an RN and a community health worker be able to complete the same exact tasks? Or are there tasks that are only able to be completed by an RN?
    • Answer: See answer to #10 above. The assigned HRFCM RN Case Manager must provide face to face contact with the family as specified in Section 3 of theIDHS: Maternal and Child Health Programs Policy and Procedure Manual (state.il.us) Throughout the duration of pregnancy and throughout the first three months after birth: families must receive a monthly nurse home visit. Throughout the fourth to twelfth month after birth, or for the duration of time in the program: families must receive a monthly nurse face to face contact (in the clinic or home setting). As much additional contact as necessary may be provided by the RN or by the multidisciplinary team per the nurse's discretion, to assist the family in meeting their health goals. Agencies using a multi-disciplinary approach for client contacts above and beyond of the core RN components, must maintain documentation ensuring active, unencumbered Licenses and/or Certifications when applicable and ensure that all duties are provided within scope and training.
  40. Question: Are you required to take the amount that is listed on the NOFO for expected caseload and funding? Can you make an application for less without negative consideration?
    • Answer: The Department has identified these anticipated average monthly caseloads of high-risk family units/dyads based on previous years' data. If an applicant is aware of a more accurate estimate, it should be indicated in the applicant's proposal. However, applicants must still plan to serve the entire geographical area for which they are applying. If unable to provide full coverage in the area, the applicant would need to collaborate with another party through a subaward or lead-agency approach. Please note that if an applicant agency is proposing to serve more than 1 service area listed in the NOFO using a lead-agency model approach, bonus points are offered in the NOFO.
  41. Question: Are providers paid by caseload assigned or personnel costs in this grant?
    • Answer: HRFCM grants are not paid per caseload. IDHS disburses funds to organizations in accordance with the payment method specified in grant agreements. Reimbursement payment method is used unless another payment method is specifically stipulated in the grant agreement. With the Reimbursement method, payments are made only after incurring specific expenditures and submitting supporting documentation to IDHS. IDHS will disburse payments to the grantee based on actual allowable costs incurred as reported in the monthly financial invoice submitted for the respective month. Grantees must submit monthly invoices in a format prescribed by grant program management to the respective grant Program Manager in the method prescribed in the grant program of the grantees executed Uniform Grant Agreement Exhibits.
  42. Question: I wanted to make sure I am completing the correct grant. Previously the grant has always been called Family Case Management / High Risk Infant Follow-Up. The only NOFO I see is called High Risk Family Case Management. Are these one and the same?
    • Answer: See answer to #3 above.
  43. Question: Since the APORS/HRIF budget was included in the overall FCM budget, how much would our FCM program lose if we did not receive the award or choose not to participate?
    • Answer: See answer to #3 above. High Risk Family Case Management is the only statewide program being funded by Bureau of Maternal and Child Health in SFY25.
  44. Question: Under the "Need" category of the narrative, (b) states to provide data on community needs and include leading causes of maternal and infant morbidity and mortality in the area served. It states to provide a source of the data used. Do you have a recommendation on where to find this data for our specific counties? I am not seeing specific county information on leading causes, only Illinois.
    • Answer: We would encourage you to search the Illinois Department of Public Health website for birth statistics and morbidity and mortality reports. We also encourage collaboration with your regional perinatal network administrator.
  45. Question: I need to know if my health department does not apply for this program are we still eligible to do Healthworks under contract with Centene?
    • Answer: See answer to question #30 above

    • May 13, 2024

  46. Question: Can we have a transition period of 6 months to one year?
    • Answer: Available funding and the GATA process are prohibitive to the Department continuing the current programs while launching the new SFY25 program. See answer to question #24 above.
  47. Question: How do we close out current FCM clients?
    • Answer: See answer to #16 above.
  48. Question: So many clients without services and some are identified later in pregnancy or infancy. Is there any way to see medium risk clients?
    • Answer: See answer to #11 above.
  49. Question: Will we still follow APORS infants up to age two?
    • Answer: See answer to #16 above.
  50. Question: Many of our APORS infants do not meet the FCM income guidelines, will they still be eligible?
    • Answer: The existing programs are not meeting the needs of Illinois' most vulnerable populations. Racial disparities in maternal and morbidity and mortality are high, and infant mortality rates remain unchanged despite our efforts. See answer to #16.
  51. Question: If APORS is integrated into this new program, can they update the eligible diagnoses?
    • Answer: See answer to #11 above.
  52. Question: Will we still use the Case Finding Report?
    • Answer: See answers to #17 and #32 above.
  53. Question: In this labor market will there a longer grace period of hiring home visiting nurses?
    • Answer: See answer to #24 above.
  54. Question: Do we keep opening FCM clients at this point?
    • Answer: We recommend no longer enrolling new low risk client cases and beginning transitioning them to other programs, as appropriate. High risk pregnant and infant cases should continue to be enrolled.
  55. Question: Will there be a new pamphlet brochure that will be available for agencies to provide information to potential participants and at outreach events?
    • Answer: Program brochures will be revised and available to assist SFY25 grantees with outreach.
  56. Question: Will there be new categories e.g. high-risk mothers that will be available to select when we are adding them into Cornerstone? Will it change to high risk postpartum or just postpartum/delivered after infant is born?
    • Answer: Cornerstone changes will be communicated to SFY25 grantees prior to implementation.
  57. Question: Will Family Case Management continue in any form for FY24-FY25?
    • Answer: See answer to #3 above.
  58. Question: In addition to what's listed for staffing for HRFCM are bachelor's degree people able to become case manager's assistants?
    • Answer: See answer to #10 above.
  59. Question: I currently send a letter w/ a description of HRIF and follow up w/ a phone call. Am I switching up the terms on the phone and in the letter NOW even though HRFCM isn't in effect yet and our application hasn't been submitted yet?
    • Answer: See answer to #54 above.
  60. Question: When will we be able to view the new chart review tool for HRFCM?
    • Answer: See answer to #56 above.
  61. Question: Will we be reviewing changes to charting/assessments (AS01) questions/frequency on the session Tuesday morning?
    • Answer: No. The Bidder's Conference is strictly related to the NOFO application process.
  62. Question: Are we going to require copy of proof of eligibility for medical reasons (summary of hospital stay for DVT?)
    • Answer: Training on eligibility determination will be provided to SFY25 grantees.

    • May 15, 2024

  63. Question: What will be the timeframe to transition current participants out of FCM services?
    • Answer: IDHS funding for the legacy FCM program will be discontinued on 6/30/24. Technical assistance will be offered to current providers to assist with transitioning clients on or before that date. See answer to #16 above.
  64. Question: Will the WIC program be changing its allowances to provide additional services beyond minimal referrals to displaced FCM low risk participants?
    • Answer: The WIC program does not need to make any changes. There is a robust referral policy already in WIC. The DHS WIC team and local WIC providers are aware of this policy. When participants are screened for WIC, they must be referred to other health-related and public assistance programs (7 CFR 246). Each local agency must make a current, Local Referral List available to all staff via paper or from the WIC MIS.
      1. The local agency must develop, implement and maintain a written procedure for:
        1. providing appropriate referral information and updating at least annually, the local Referral List.
        2. Obtaining consent, in compliance with confidentiality policy, to make the referral.
      2. Referrals can include but are not limited to SNAP-Ed, domestic violence programs, educational programs, food assistance programs, medical services including public and mental health services, shelters, housing and utilities resources, SNAP and TANF
      3. This procedure and the Local Referral List will be reviewed during the WIC Management Evaluation/Quality Assurance Review.
  65. Question: What safety net is being designed for counties outside of Chicago in similar situations as ours? (challenges with MMCO transportation)
    • Answer: DHS is committed to ensuring that all families are not only referred to the Medicaid Managed Care Organization but have access to all of the benefits available through their MCO.