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Division of Family and Community Services
High Risk Infant Follow-up (HRIF) Program Manual
For
Local Health Departments and Community Agencies
January 1, 2017
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Table of Contents I. Purpose of Document
A. Purpose of Local Health Nursing Follow-up for the High Risk Infant
II. Program Goal
III. Program Objectives
IV. Program Definition
V. Introduction
VI. Provider Responsibilities A. Illinois Administrative Code: Section 630.40 Health Services for Children in the
First Year of Life B. Illinois Administrative Code: Section 630.50 Health Services for Children from
One Year of Age to Early Adolescence C. Illinois Administrative Code: Section 840.210 Newborn Case Reporting D. IDPH APORS Case Definition - Conditions for Hospital Reporting E. APOPRS and High Risk Infant Follow-up (HRIF) Policies and Procedures F. Procedure for Primary Care Physician (PCP) Notification G. Illinois Administrative Code: Section 630.90 Record Retention Guidelines H. APORS Procedure for Illinois Department of Children and Family Services
(DCFS) Wards in Health Works of Illinois (HWIL)
VII. Procedure for DHS HRIF Clinical Review
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Appendices A. IDPH APORS Case Definition Chart B. IDHS Primary Care Physician (PCP) Notification Form C. IDHS HealthWorks (HWIL) of Illinois Narrative D. HRIF / APORS program coordinator list E. HealthWorks Lead Agencies (HWLA) and Contact Directory
F. Frequently Asked Questions (FAQ) G. *Cornerstone Documentation and Procedures
1) Cornerstone Documentation 2) Cornerstone Case Management Screen Flow – APORS Infant or Child 3) 3.7 Birth Data (PA11) 4) 4.1 Service Entry (SV01) 5) 4.3 Activity Entry (SV02) 6) 4.4 Staff Time Entry (SV04) 7) 4.9 Well Child Visit Summary (SV10) 8) 4.10 Well Child Visit Forecast (SV11) 9) 3.6.6 Immunization (PA12) 10) 3.6.7 Immunization History (PA13) 11) 3.6.8 Future Immunizations (PA14) 12) 3.4.1 Program Information (PA15) 13) 11.6.4 Ad Hoc Mailing Register (HSPR0604) 14) Ad Hoc List for Local Health Departments
*Refer to Cornerstone Manual
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I. Purpose of Document The manual is intended to provide guidance to both the Illinois Department of Human Services (DHS) staff and local health departments or community agency staffs in performing their respective responsibilities to the High Risk Infant Follow-up (HRIF)/APORS Program. Requirements, duties, and instructions are included to assist personnel with program implementation. The manual can orientate new staff to HRIF/APORS procedures and provide reference material for staff. A. Purpose of Nursing Follow-up for the High Risk/APORS Infant The purpose of the infant follow-up program is to minimize disability in high risk infants by identifying as early as possible conditions requiring further evaluation, diagnosis, and treatment and by assuring an environment that will promote optimal growth and development as cited in 77 Ill. Adm. Code Section 630.50 b).1. II. Program Goal The goal of HRIF/APORS Program is to promote optimal growth and development, teach family care of the high risk infant, prevent complications, decrease morbidity and mortality, decrease stress and potential for abuse, and ensure early identification and referral for further treatment and evaluation. III. Program Objectives To provide case-management services through local health departments or community agencies that adhere to the provisions of the Maternal and Child Health Services Code 77 Illinois Administrative Code 630 cited in Appendix A and B. In particular, to provide case management services to:
A. Infants who have any of the following conditions: 1. Gestational age of 30 weeks or less; 2. Multiple births (triplets or higher order birth); 3. A serious congenital infection; 4. An endocrine, metabolic or immune disorder; 5. A blood disorder; 6. A diagnosis of drug toxicity or withdrawal; 7. A positive toxicology test for any drug except marijuana or
drugs administered during labor and delivery; 8. A maternal admission of illicit drug use, except marijuana; 9. A congenital anomaly; 10. Other conditions included in the Adverse Pregnancy Outcomes Reporting System (APORS) case definition; or 11. Other conditions needing case-management in the professional judgment of the Public Health Nurse
B. Families who experience neonatal death.
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IV. Program Definition High Risk Infant Follow-up (HRIF)/APORS is a component of Family Case Management and relates to many other programs offered by the local health departments and a very limited number of community based agencies. Referrals are initiated by hospitals, drug-testing laboratories, the IPDH Newborn Metabolic Screening Program, the IDPH Early Hearing Detection and Early Intervention Program, as well as other sources. Information about referred cases is documented in the APORS module of the Illinois Vital Record Reporting System. The IDPH APORS Program manages the database and facilitates data collection. Local health department and community agency public health nurses provide case management services. DHS Maternal and Child Health Nurse Consultants provide oversight of the public health nurse activities and can provide advice and guidance on case management activities. There is a linkage between high risk follow-up/APORS with numerous programs such as WIC, Primary Care, Early Intervention, Perinatal Follow-up/APORS and with others depending on the needs of the family. A minimum of six (6) face-to-face visits should be made by the public health nurse: as soon as possible after newborn hospital discharge (within two (2) weeks of receipt of an APORS Referral), and at approximate infant chronological ages 4, 6, 12, 18 and 24 months. Contacts and required services may occur during WIC/FCM integrated appointments. V. Introduction The HRIF Program is funded by Illinois General Revenue dollars to provide case management services to families with high risk infants identified by the APORS Program; infants diagnosed with a high risk condition after newborn hospital discharge; and/or infants and children at medical and/or environmental risk because of an adolescent parent, drug- abusing parent, or high risk situation identified by the public health nurse(s). Health Support Services/Outreach funds, Medicaid and non-Medicaid funds may also be used to provide services to high-risk clients. VI. Provider Responsibilities
A. Providers should be in compliance with the following Illinois Administrative Code: Section 630.220 Outreach and Case Management (http://www.ilga.gov/commission/jcar/admincode/077/077006300D02200R.html). Section 630.40 Health Services for Children in the First Year of Life
(http://www.ilga.gov/commission/jcar/admincode/077/077006300B00400R.html). B. Section 630.50 Health Services for Children from One Year of Age to Early Adolescence
(http://www.ilga.gov/commission/jcar/admincode/077/077006300C00500R.html).
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C. Section 840.210 Newborn Case Reporting (http://www.ilga.gov/commission/jcar/admincode/077/077008400C02100R.html).
D. APORS Case Definition: see Appendix A.
E. APORS and HRIF Policies and Procedures 1. Eligibility for Services All infants/children meeting APORS and HRIF criteria will be case managed by a Licensed Professional Registered Nurse. 2. APORS Referrals APORS staff at IDPH collect case information from hospitals and other sources, such as the Newborn Metabolic Screening Program and the Newborn Hearing and Screening Program. IDPH APORS staff will proceed as follows once data has been collected:
a. Review the information provided by the hospitals and other sources, checking for inconsistencies and missing information. IDPH APORS refers any identified problems to the reporting hospital for resolution.
b. Review and code the list of diagnoses provided by hospitals and other sources. If the codes so not meet the APORS case criteria/definition, (Examples: the baby did not die, was not less than 31 weeks gestation, the mother was not Hepatitis B positive or infant has a genetic disorder, etc. per case diagnosis listed in Appendix A, then the case does not meet eligibility criteria for APORS.
c. Enter the case into the APORS database if the report was received by paper. d. The IDPH APORS Review field in the software system is completed with a “Y” if
there are no problems with the case, and the baby has not gone to an equal or higher level reporting facility.
e. Once these steps are completed, the record is made available electronically to the local health department or community agency staff thru the IDPH APORS referral portal.
If further assistance is needed with APORS Referrals, please contact the APORS IDPH Manager: Jane Fornoff at 217-785-7133 or [email protected]
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3. Follow-up Services All infants/children meeting APORS and HRIF criteria will be followed until 24 months of age unless a complete assessment and the professional judgment of the nurse case manager at the first visit or subsequent visits indicates that services are no longer needed. APORS services take precedence over HealthWorks of Illinois Medical Case Management. The APORS nurse should notify the HealthWorks Lead Agency (HWLA) when an APORS case is closed. The HWLA Contact Directory is located in Appendix E. Nursing Case Management must adhere to the provision of the Maternal and Child Health Services Code (77 Ill. Adm. Code 630.220). Section 630.220 Outreach and Case Management
Physical Assessment – to be completed by a registered nurse who has successfully completed a pediatric assessment course. The physical assessment will be documented in Cornerstone: 708, questions 27–52, and 81-90. Each physical assessment should be documented by the nurse in the SV01 Cornerstone screen. A Maternal Child Health Nurse (MCH) will review documentation of physical assessments during program review. Complete required 700, 701, and 706 assessments and any additional assessments in Cornerstone as indicated in the professional judgment of the nurse case manager. The AS01 712 Assessment should not be completed on known HRIF/APORS referred client at the time of the face to face contact as it confounds data collection. Developmental Assessments to be completed by a registered nurse who has training in administering any of the Department of Healthcare and Family Services (HFS) approved developmental assessment tools. A developmental assessment will be completed between 2 and 6 months of age, and again at 12, 18 and 24 months of age. The Denver Developmental Screening Tool II (DDST II) is no longer an acceptable validated and reliable tool for use as the company is no longer in business. The nurse shall document these developmental assessments in Cornerstone on the SV01 screen and a hard copy of the screening tool used will be placed in the client file/record. Additional assessments may be completed and documented as necessary.
4. Home Visits/Face-to-Face Contact The first contact should be made within seven (7) calendar days after receiving the APORS referral from the IDPH APORS Program data web portal. The first contact may be a letter, phone call, or face-to-face visit. The initial face-to-face contact or home visit should occur within 14 calendar days of receipt of the APORS Referral and may be counted as the two (2) month visit. Subsequent visits should occur at 4, 6, 12, 18, and 24 months. Required visits may vary depending on age at discharge. At least one home visit is required for all APORS infants by 12 months of age. For
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complex APORS conditions, three to four home visits may be needed. If the APORS condition is non-complex and the family is mobile, additional home visits will be based upon the professional judgment of the case manager. The nurse should document evidence of contact and location on the SV02 screen in Cornerstone for each contact. 5. Reimbursement Reimbursement for HRIF/APORS Nurse Case Management services will be paid from Illinois Department of Human Services (IDHS) Medicaid funds or non-Medicaid funds in Cornerstone code 100 on Time and Activity Log. A Cornerstone memo dated July 3, 2014 and sent to Agency administrators and FCM Coordinators, stated; “To maintain program income eligibility requirements, over-income APORS/HRIF participants will continue to need to be enrolled in Cornerstone as Title XX”. Adjustments will be made by Cornerstone and the Fiscal system to pay providers for those Non-Medicaid participants. 6. Procedure to Provide Services to an Infant without a Receipt of an APORS Referral Contact the APORS Program by email at [email protected] to request the APORS report. Before requesting such a report, nurse should review the IDPH APORS Case Definition Chart (Appendix A) to verify that the child meets the APORS case definition. Do not add “Y” (yes) APORS on Cornerstone PA11 screen until an APORS report is received. If an infant has a high risk condition that is not reportable to APORS, the infant may be provided HRIF services. Do not add “Y” (yes) to the APORS question on Cornerstone PA11 Birth Screen; it remains “N” (No).
F. Procedure for Primary Care Physician (PCP) Notification Form The purpose of the Primary Care Physician (PCP) Notification form (Appendix B) is to inform the PCP of any abnormal/unusual or questionable findings resulting from the assessment of the infant by the public health nurse. It is not required that this form be sent to the primary physician after each assessment. The use of professional judgment is recommended. All pertinent information should be shared between the local public health nurse and the primary care physician. However, the primary physician should be notified that the infant/child is active in APORS/FCM program services.
G. Section 630.90. Record Retention Guidelines http://www.ilga.gov/commission/jcar/admincode/077/077006300D00900R.html
H. APORS Procedures for DCFS Wards in HealthWorks of Illinois (HWIL)
The Illinois Department of Children and Family Services (DCFS) caseworker that accepts
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custody of an infant from a hospital and places the infant into substitute care is routinely required to sign a hospital release form. This form indicates who took responsibility of the infant at hospital discharge. Each hospital has their individualized form, which includes information regarding the address, county, and telephone number of the infant’s destination. If the substitute care placement is unknown at the time of discharge, the APORS Program staff will contact DCFS to determine where to send APORS Report. The HealthWorks of Illinois Lead Agency (HWLA) will contact the HRIF Agency’s APORS Nurse if the infant changes residence. A list of HealthWorks of Illinois Lead Agencies and Contact Directory is included in Appendix E.
I. The APORS to DCFS notification procedure for The Chicago Department of Public Health (CDPH)
The APORS to DCFS notification procedure is to ensure awareness and collaboration between the Department of Children and Family Services (DCFS), and Chicago Department of Public Health (CDPH) APORS in order to promote continuity of comprehensive health and developmental services for high risk APORS ages 0-24 months infants/children. The procedure follows:
1. CDPH will fax the attached monthly notification log to the attention of DCFS Acting Chief Nurse, Michelle Ealy RN at fax number 312-328-2261 by the 5th day of each month.
2. If the DCFS Chief of Nursing has not received prior notification from the Lead Agency quality assurance nurse for a name documented on the log, the assigned DCFS regional nurse will contact the assigned CDPH nurse and initiate communication to assure collaborative efforts to promote needed comprehensive health and preventive well-being services.
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VII. Procedure for DHS HRIF Clinical Review During scheduled annual review visits, the HRIF/APORS Clinical Review Tool and Chart Review Tool are used by DHS MCH Nurse Consultants to determine performance outcomes. Local health departments and community agencies must meet the performance standards established by DHS. Please refer to your annual Contract Exhibits for performance standards regarding APORS/HRIF. Please access APORS/HRIF Clinical Review Tools via the DHS Website at http://www.dhs.state.il.us/page.aspx?item=31155 . A. All families enrolled in case management for high risk clients shall receive
comprehensive needs assessment and case management care plan within forty-five (45) calendar days of successful contact. 1. This will include Assessments 700, 701, 708a-i and 708 questions 27-52 & 81-90
Cornerstone Assessments and will be measured through program review. 2. The performance of a needs assessment and development of an individualized care
plan will be measured through the Cornerstone data reporting system during the scheduled review visit.
3. The performance standard for the comprehensive need Assessment and Nurse Case Management care plan is 90%.
B. The provision of home visits will be measured through DHS automated Cornerstone
data reporting system. The content of home visits will be measured through Cornerstone chart review during the scheduled annual review visit. All HRIF/APORS families with one or more infants less than 12 months of age shall receive home visits. The 706 Assessment must be completed at the time of the home visit and will be measured through performance review. The performance standard for the home visit goal is 75%.
C. The occurrence of face-to-face contacts will be measured through the DHS automated
quarterly Cornerstone data reporting system. 1 . All families active in HRIF/APORS case management services shall receive the
APORS required face to face contacts and appropriate referrals. 2. Contacts and referrals will be measured through quarterly agency reports from
Cornerstone and performance review. 3. The performance standard for face-to-face contacts goal is 80% and for referrals,
including follow-up is 100%.
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D. Medical Care Coordination will be measured through the Cornerstone chart review during the scheduled review visit. Evidence of medical care coordination shall include the following performance standard goals:
1. Childhood immunization is 90%; 2. EPSDT participation at periodic intervals within the first 24 months of life is 80%; 3. Linkage with a primary care provider is 95%; 4. EI referral (if applicable) is 100%; 5. All referrals (specialty care, mental health, housing, etc.) are documented
in the Cornerstone system referral screens (RF01), in case notes, or on the care plan, including follow-up. The performance standard is 100%.
E. Standardized Developmental Screenings should be done by a registered nurse trained in
administering the screening between 2 and 6 months of age and at 12, 18,and 24 months, unless infant is receiving Early Intervention services Compliance with this requirement will be determined during the scheduled review visit using Cornerstone documentation and chart review.
A l l infants in HRIF/APORS are to receive a Medicaid-approved objective developmental screening (i.e. Ages & Stages, Baileys, etc.). The Denver is no longer acceptable. An approved tools list is on the HFS website for the designated ages.
The performance standard for the standardized developmental screening goal is 95%.
F. The outcome of the initial contact with the family should be maintained either in the APORS database or in another manner. A review of the APORS/HRIF log of APORS referrals for the time period under review will take place during the scheduled review visit. The log should detail:
1) The number of APORS referrals received for the time period; 2) The outcomes for the referrals. The number who:
a. Accepted services; b. Were lost to follow-up; c. Refused services because there was no problem with child; d. Refused services because they were already in place; e. Refused services without giving a reason; f. Moved out of state; g. Moved within state and were referred to another agency; h. Were referred inappropriately (ex: wrong county) or who were not referred
to another agency; i. Were deceased and whose families were referred to services;
j. Were deceased and whose families were not referred to services; k. Had another outcome, including a child not eligible for services.
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G. The local health department or community agency may be placed on Provisional Certification (pursuant to the Maternal and Child Health Services Code) at any time during the full certification period if the agency fails to meet most standards as set forth in the Performance Standards presented above and, or the standards set forth in the Maternal and Child Health Code. If placed on Provisional Certification, the local health agency must submit to DHS their written corrective action plan within thirty (30) calendar days of notification of the provisional certification. A full certification visit will occur in 6 months from the provisional certification review. Technical assistance and training will be provided during the 6 month interim before the next scheduled review at which time full certification status is expected. DRAFT
Illinois Department of Public Health Appendix A
APORS Case Definition Gestational age of 30 weeks or less (based on physician’s assessment)
Multiple birth, triplets or higher order
Death (fetal death or death before discharge from the newborn stay)
Prenatal drug exposure Diagnosis of a positive toxicology for any drug (except marijuana or drugs administered during labor and delivery)
Signs of drug toxicity or withdrawal (in the infant) Children of mothers who admit to illicit drug use during this pregnancy (except marijuana)
Birth defect or congenital anomaly (except as listed below) Congenital pigment anomalies
(stork bites, Mongolian spots etc.) Peripheral pulmonic stenosis (PPS) Tongue tie
Persistent fetal circulation Two-vessel cord
Dacrostenosis Polydactyly Umbilical hernia
Incomplete or redundant penile foreskin Preauricular sinus Undescended testes
Isolated simian crease Prenatal diagnosis of hydronephrosis, caliectasis or pelviectasis Vascular harmatomas (small or insignificant birth marks, port wine stains, strawberry nevi etc.)
Patent ductus arteriosus (PDA) Skin tag Patent foraman ovale (PFO) Syndactyly
Serious congenital infections (Excludes: neonatal candidiasis (thrush), conjunctivitis, dacrocystitis, infective mastitis and omphalitis, and prenatal exposure to HIV/AIDS.)
Chlamydia Hepatitis B (disease or perinatal exposure) Rubella Confirmed septicemia (sepsis) Herpes Syphilis Cytomegalovirus Listeriosis Tetanus neonatorum Gonococcal conjunctivitis neonatorium Meningitis Group B streptococcus Necrotizing enterocolitis leading to surgery
Endocrine, metabolic or immune disorders Adrenogenital syndrome Combined immunity deficiency Cystic Fibrosis Inborn errors of metabolism
Blood disorder Coagulation defects Constitutional aplastic anemia Hereditary hemolytic anemia Leukemia Other conditions IVH grade III or IV Bronchopulmonary dysplasia Endocardial fibroelastosis Neurofibromatosis
Cerebral lipidoses Erb’s palsy Occlusion of cerebral arteries Chorioretinitis Fetal alcohol syndrome Retinopathy of prematurity Conditions leading to ECMO HIE leading to cooling treatment Strabismus Conditions leading to > 72 hours on a ventilator Intrauterine growth restriction Seizures
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Optional Use Form Appendix B
Illinois Department of Human Services Primary Care Physician (PCP) Notification Form Report of High Risk Infant Follow-up Program
Agency Reporting: ______________________________________________________________
Public Health Nurse Case Manager: ________________________________________________
Contact Number: _______________________________________________________________
Last Name of Infant: ____________________________________________________________
First Name of Infant: ____________________________________________________________
Infant’s Date of Birth: ___________________________________________________________
Chronological Age: _____ Wks. _____ Mos. Gestational Age: _____ Wks. _____ Mos.
Street Address: _________________________________________________________________
City: ____________________________________________________ State: _______________
Mother’s Last & First Name: ______________________________________________________
Date of Most Recent Public Health Nurse Visit: ______________________________________
Assessment Findings during Last Visit:
• Physical Exam (*):________________________________________________________
_______________________________________________________________________
_______________________________________________________________________ (* Attach copies of the child’s immunization history and EPSDT visits.)
• Development Assessment: _________________________________________________
• Anticipatory Guidance Provided: ____________________________________________
• Referrals Made (as needed): ________________________________________________
________________________________________________________________________
Comments: __________________________________________________________________
____________________________________________________________________________.
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Appendix C Illinois Department of Human Services
HealthWorks of Illinois (HWIL) HealthWorks of Illinois (HWIL) is a collaborative effort of the Illinois Department of Human Services (DHS) and the Illinois Department of Children and Family Services (DCFS). The purpose of HWIL is to ensure that wards (0-21) in DCFS custody receive comprehensive, quality health care services. DCFS is mandated by the B.H. Consent Decree to provide basic health care services for wards. DCFS contracted with the DHS, Division of Family and Community Services (DFCS) to assist in the development of the HWIL System. Medical Case Management (MCM) refers to medically-related services provided by a person trained or experienced in medical or social services as described in 77 Ill. Adm. Code 630.220, as amended. DCFS has agreements with twenty downstate agencies to develop healthcare networks. These agencies are referred to as HealthWorks Lead Agencies (HWLA) and are responsible for:
• recruiting primary care physicians (PCPs) and specialty care providers; • training the MCM agencies, DCFS staff, Substitute Care Giver (SCG) and providers
about the HWIL system; • managing the communication and documentation among providers; and • consulting with DCFS regarding best practices.
DCFS contracts with one lead agency in Chicago to implement HWIL for Cook County. DHS assists the Cook County lead agency, Aunt Martha’s/Chrysalis, with MCM program implementation for Chicago and Cook County. According to the B.H. Consent Decree, all children taken into custody by DCFS must receive an Initial Health Screening (IHS) within 24 hours, preferably before placement into substitute care. The IHS sites must be accessible 24 hours a day, must be within one hours travel, and must complete the screening exam within one hour of arrival. Hospital emergency rooms are the primary IHS sites with a few health departments or other medical clinics in the county serving as IHS sites as well. The purpose of the IHS is to:
• treat any acute medical needs; • document the presence or absence of medical problems; • document and treat any signs of physical abuse or neglect or sexual abuse; • assess and treat any infectious or communicable diseases; • provide the DCFS caseworker with medical information to be used in making an
appropriate placement decision for the child.
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Within 21 days after the IHS, new wards are to receive a Comprehensive Health Evaluation (CHE) based on Early Periodic Screening Diagnostic and Treatment (EPSDT) standards. The MCM lead agencies are responsible for:
• assisting the substitute care giver with the selection of a PCP; • obtaining health care information from previous physicians and other medical
providers; • assuring that medical services – CHE’s, yearly physicals, EPSDT visits, and other
medical /immunizations/dental/vision/hearing services are obtained; • compiling health care information to send to the physician for the CHE’s, assuring
that medical needs are being met; • developing an individualized Health Care Plan, and complete the HealthWorks
Health Summary (which includes information for the health section of the ward’s caseworker to be used for administrative case reviews (ACR), which the MCM provider attends if requested. The ward’s caseworker will use the information to develop the client service plan.
The first report is due 30 -45 days after DCFS takes custody of the child. The subsequent reports are done every 6 months; entering all data on wards into the IDHS/Cornerstone system, maintaining a medical record for each ward, forwarding medical information to DCFS and ongoing medical case management for the DCFS wards, ages birth through age 5. Ongoing Medical Case Management services are transferred to the Health Works Medical Case Management IHWIL) designated agencies by the Health Works Lead Agency (HWLA). Downstate, the older ward population, ages 6-21, is medically case managed by HWLA. If an infant is taken into custody after birth at the hospital, the birth records may suffice for initial health screening (HIS) and hospital discharge Physical Exam for comprehensive health evaluation (CHE). The APORS nurse will need to collaborate with MCM agencies to complete health care information for Health Services Summary/Transfer Tool (for use by Medical Case Management Agency) to send to HWLA as needed. An infant or child(ren) living with their mother, who is a DCFS ward, are to be case managed under the same Family Case Management (FCM) APORS guidelines, with a few additional requirements. HRIF Program Coordinator: Todd Doyle at 217-558-4104 or [email protected].
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LHD Contacts
LHD0010 Adams County Health Department Primary HRIF HRIF NMS12366
[email protected] Buckner 217-222-8440 x 104
[email protected] Jung 217-222-8440 x 115
[email protected] Lead Agency Amy Morrell 217-222-5440 x 122
[email protected] CoordinatorEllen Vonderheide 217-222-8440 x 137
LHD1831 Aunt Martha's Healthcare Network Primary HRIF HRIF NMS12436
[email protected] CoordinatorMarti Cooper 217-444-8959
[email protected] Davis 217-444-8962
217-444-8959
LHD0050 Bond County Health Department Primary HRIF HRIF NMS12368
[email protected] Markell 618-664-1442 x 136
LHD0070 Boone County Health Department Primary HRIF HRIF NMS12369
[email protected] Mehl 815-547-8591
[email protected] CoordinatorSue Schweitzer 815-547-8419
LHD0090 Brown County Health Department Primary HRIF HRIF NMS12370
[email protected]/FCM CoordinatorMary Reich 217-773-2714
LHD0130 Calhoun County Health Department Primary HRIF HRIF NMS12371
[email protected]/CMSandy Teichmann 618-576-2428
LHD0150 Carroll County Health Department Primary HRIF HRIF NMS12372
[email protected] Holland 815-244-8855
[email protected] Miller 815-244-8855
[email protected] Senneff 815-244-8855
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LHD0170 Cass County Health Department Primary HRIF HRIF NMS12373
[email protected] Child Health Jamie Epping 217-323-2182 x 315
[email protected] Sargent 217-323-2182
LHD0190 Champaign-Urbana Public Health District Primary HRIF HRIF NMS12374
[email protected] Brooks 217-531-4290
Cindy Conlin 217-531-4312
[email protected] Hearne 217-531-4292
[email protected] Ito 217-531-4311
[email protected] Meline 217-531-4308
[email protected] Raila 217-531-4285
[email protected] Lead Agency Amy Walker 217-531-4313
LHD0311 Chicago Department of Public Health Primary HRIF HRIF NMS12381
[email protected] Colloton 312-477-9770
[email protected] Public Health Luchrisha FisherPronounced Lucretia
312-745-3982
[email protected] Hoskins-Wroten 312-474-1629
[email protected] Igbinosun 312-744-0178
[email protected] Health Nurse IIICecilia Libunao 312-747-9690
[email protected] Marcano 312-746-5926
[email protected] DirectorLisa Masinter 312-747-5472
[email protected] Tabidze 312-747-9867
[email protected] TurykRoom 879
312-355-4673
[email protected] IVKingsley Weaver (312) 747-9438
[email protected] White 312-747-9688
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LHD0210 Christian County Health Department Primary HRIF HRIF NMS12375
[email protected] CoordinatorTracie Riggs 217-824-4113
[email protected] Schmitz 217-824-4113
[email protected] Taylor 217-824-4113 ext 121
LHD0231 Clark County Health Department Primary HRIF HRIF NMS12376
[email protected] Mullen 217-382-4207
[email protected] Vaughn 217-382-4207
LHD0250 Clay County Health Department Primary HRIF HRIF NMS12377
[email protected] Keyser 618-662-4406
[email protected] Waller 618-662-4406
[email protected] Young 618-662-4406
LHD0270 Clinton County Health Department Primary HRIF HRIF NMS12378
[email protected] Albers 618-594-2723
[email protected] Boyd 618-594-8942
LHD0290 Coles County Health Department Primary HRIF HRIF NMS12379
[email protected] Cooper 217-348-0530
[email protected] Hildebrand 217-348-0530
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LHD0310 Cook County Department of Public Health Primary HRIF HRIF NMS12380
[email protected] BrooksPhone number is for assistant, MariaReplaced Sandra
708-786-4057
[email protected] NurseChristine Burke 708 633 9613
[email protected] AssistantKathy Dugalper portal database 708-836-8635
708-786-4061
[email protected] Dunn 312-446-1597
[email protected] Assistant IVMary Ellen Dwyer 708-836-8643
[email protected] Gibb 708-232-4506
[email protected] Manager, Purisima LinchangcoPer portal database 708-492-2177. Portal ID used for Hep B only
847-818-4020
[email protected] CoordinatorJeannie Taverne 708-786-4054
[email protected] Valdiviaper portal database 708-836-8636
708-786-4066
LHD7070 Coordinated Youth and Human Services Primary HRIF HRIF NMS12410
[email protected] SupervisorSarah Jones 618-877-3433
[email protected] CoordinatorLinda Toombs 618-877-3433 x 110
LHD0330 Crawford County Health Department Primary HRIF HRIF NMS12383
[email protected] Free 618-544-8798
[email protected] ClerkRenita Joles 618-544-8798
[email protected] SupervisorTerry Shaffer 618-544-8798
LHD0350 Cumberland County Health Department Primary HRIF HRIF NMS12384
[email protected] CoordinatorCrystal Ingram 217-849-3211 x 224
[email protected] CoordinatorSherry Kearns 217-849-3211
LHD0370 DeKalb County Health Department Primary HRIF HRIF NMS12385
[email protected]/FCM Program Kay Chase 815-748-2438
[email protected] LaPointe 815-748-2401
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LHD0390D DeWitt-Piatt Bi-County Health Department Primary HRIF HRIF NMS12464
[email protected] NURSETara WicklineDuplicated because needs to be linked to DeWitt and Piatt
217-935-3427
[email protected] NURSETara WicklineDuplicated because needs to be linked to DeWitt and Piatt
217-935-3427
LHD0410 Douglas County Health Department Primary HRIF HRIF NMS12386
[email protected] of NursingSusan Hays 217-253-4137
LHD0430 DuPage County Health Department Primary HRIF HRIF NMS12387
[email protected] AjmeriHealth Works
630-221-7514
[email protected] Chavez 630-221-7694
[email protected] Flores 630-221-7325
[email protected] Lead Agency Marysely Gomez 630-221-7169
[email protected] Gonzalez (630) 221-3554
[email protected] Director of Michelle Lanzi (630) 221-6170
[email protected] Prignano 630-221-7566
[email protected] Quinones 630-221-7531
LHD1631 East Side Health District Primary HRIF HRIF NMS12434
[email protected] NurseTina Partelow 618-874-7413 x 242
[email protected] Shelton 618-874-4718
[email protected] ManagerRegina Washington 618-874-4713 x 222
LHD1045 Edgar County Health Department Primary HRIF HRIF NMS12388
[email protected] of NursingJean McConkey 217-466-3567
LHD0490 Effingham County Health Department Primary HRIF HRIF NMS12389
Kathy Bailey 309-246-8074
[email protected] CoordinatorShawn Bourland 217-342-9237
[email protected] Lead Agency Linda Hampton 217-342-9237
Tuesday, December 06, 2016 Page 5 of 15
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LHD0590S Egyptian Health Department Primary HRIF HRIF NMS12457
[email protected] of NursingGail Barton (618) 273-3326
[email protected]/HRIF CoordinatorNickie EvansSharepoint rights added, not IVRS. Request resent 4/21/16
618-273-3326
LHD0510 Fayette County Health Department Primary HRIF HRIF NMS12390
[email protected] of Family and Heather JacksonHeather is taking over as APORS coordinator in October 2016. Dee Sanders is retiring.
618-283-1044
[email protected] of Family and Dee Sandersupdated user name 9/16/16 JS
Dee is retiriing in Oct. 2016; Heather Jackson is taking over APORS position.
618-283-1044
LHD0531 Ford County Public Health Department Primary HRIF HRIF NMS12556
[email protected] Benoit 217-579-1087
[email protected] Cramer 217-784-2510
[email protected] SalyardsProvides APORS follow-up for clients of Ford County at Gibson Area Hospital/Ford WIC Clinic.
217-784-2398
LHD0550 Franklin-Williamson Bi-County Health Department Primary HRIF HRIF NMS12462
[email protected] Allen 618-435-2693
[email protected] Burton 618-993-8111
[email protected] English 618-439-0951 x 233
[email protected] CoordinatorKim Spruell 618-993-8111
LHD0570 Fulton County Health Department Primary HRIF HRIF NMS12391
[email protected] Programs ManagerLouise Hiett 309-647-1134
LHD0610 Greene County Health Department Primary HRIF HRIF NMS12392
[email protected]/APORS CoordinatorDawn Ballard 217-942-6961
[email protected] NurseTraci Whitlockno form ever received...request came from the PRA Linda Snyder.Spoke with Dawn Ballard the email is appropriate they have no other CHD email addresses left to give her.
217-942-6961
Tuesday, December 06, 2016 Page 6 of 15
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LHD0630 Grundy County Health Department Primary HRIF HRIF NMS12393
[email protected] of NursingJudy BaileyRetiring 12/31/15 per email frrom Katie Harrison
815-841-3126
[email protected] of NursingKatie Harrison 815-941-3126
LHD0650 Hamilton County Health Department Primary HRIF HRIF NMS12394
[email protected] Lasater 618-643-3522
LHD0710 Henderson County Health Department Primary HRIF HRIF NMS12395
[email protected] DowellWill be primary contact in January 2016 when Mary Reed retires.
Name changed from Anderson to Dowell. She has set up a new portalID, I have added the new IVRS role under this name and sent email to Vicky to void old one of eanders1. Email remains with the name of erin.anderson as correct. Jodi
309-627-2812
Ginger MartinServes Warren County
309.734.8368
LHD0730 Henry County Health Department Primary HRIF HRIF NMS12460
[email protected] Aldred 309-852-7223
[email protected] Beckstrom 309-852-7256
[email protected] of Clinic ServiceSandy Sommer 309-852-0197
LHD0750 Iroquois Community Health and Social Services Primary HRIF HRIF NMS12557
[email protected] Programs Karry HinesProviding APORS follow-up through Iroquois Memorial Hosital/WIC Clinic (also associated with 0392).
815-432-1088
LHD0770 Jackson County Health Department Primary HRIF HRIF NMS12396
[email protected] of NursingKaren Brown 618-684-3143X105
[email protected]/FCM ManagerSarah Fager 618-684-3143
[email protected] nurseDeborah Golden 618-684-3143 x 146
[email protected] Lead Agency Cheryl Golliher 618-684-3143 x 164
[email protected] Vineyard-Most 618-684-3143
Tuesday, December 06, 2016 Page 7 of 15
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LHD0790 Jasper County Health Department Primary HRIF HRIF NMS12466
[email protected] CoordinatorMelanie Ochs 618-783-4436
[email protected] Ochs 618-392-3226
[email protected] CoordinatorSandy Zumbahlen 618-783-4436
LHD0815 Jefferson County Health Department Primary HRIF HRIF NMS12397
[email protected] Welch 618-244-7134 x222
LHD0830 Jersey County Health Department Primary HRIF HRIF NMS12398
[email protected] Child Health Becky Shipley 618-498-9565
LHD5060 Kane County Health Department Primary HRIF HRIF NMS12399
[email protected]/APORS SupervisorDina Amoo
[email protected] AssociateDiane Dawson 630-264-7696
[email protected] AssociateSol Figueroa 630.264.7651
[email protected]/APORS NurseCheryl Kane
[email protected]/APORS NurseJuliana Okapal 630-264-7679
[email protected] Sillitti 630-264-7667
[email protected] Walsh 630-444-3188
LHD0910 Kankakee County Health Department Primary HRIF HRIF NMS12400
[email protected] CoordinatorGlynis CailteuxGlynis is also the HealthWorks Lead Agency Coordinator for DCFS placements.Going on FMLA leave 11/30
815-802-9325
[email protected] Irvinsubbing
815-802-8341
[email protected] Sztuba 815-802-9341
LHD0930 Kendall County Health Department Primary HRIF HRIF NMS12401
[email protected] Jordan-Licht 630-553-8048
[email protected] Lehman 630-553-8090
[email protected] Health Terri Olson 630-553-8047
[email protected] CoordinatorNancy Villa 630-553-9100
Tuesday, December 06, 2016 Page 8 of 15
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LHD0950 Knox County Health Department Primary HRIF HRIF NMS12402
[email protected] Bollivar 309-344-3314
[email protected] of Family Health Heather Kuslerper portal database 309-344-3314
309-344-2224 - ext. 231
LHD0970 Lake County Health Department Primary HRIF HRIF NMS12403
[email protected] Dursun 847-377-8149
[email protected] and Planning Seth Kidder 847-984-5014
[email protected] Leal 847-377-8126
[email protected] Maravilla 847-377-8157
[email protected] Program Damaris MontanoDamaris is also the HealthWorks Lead Agency Coordinator for DCFS placements.
847-377-8152
LHD5110 LaSalle County Health Department Primary HRIF HRIF NMS12404
[email protected]/APORS CoordinatorHolly BressnerThis is a duplicate entry due to multiple e-mail addresses. E-mail [email protected] does not always go through. Requested we also use the [email protected] also.
815-433-3366 x 252
[email protected] BressnerThis is a duplicate entry due to multiple e-mail addresses. E-mail [email protected] does not always go through. Requested we also use the [email protected] also.
815-433-3366 x252
[email protected] Lead Agency Pauline Kirkton 815-433-3366 x 249
[email protected] Larsenreactivate per JS
815-433-3366 x 244
[email protected] Health CoordinatorBonny Pietrowski 815-433-3366 x 250
LHD1010 Lawrence County Health Department Primary HRIF HRIF NMS12405
[email protected] Co-ordinatorDonna Bandy 618-943-3302 ext. 226
Tuesday, December 06, 2016 Page 9 of 15
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LHD1030 Lee County Health Department Primary HRIF HRIF NMS12406
[email protected] Dempsey6/3/2016: Megan replaced Kathy Shutz as HRIF primary contact.
815-284-3371
[email protected] Dennis 815-284-3371
[email protected] Krueger 815-284-3371
[email protected] Lemmer 615-284-3371
[email protected] Wiggins 815-284-3371
LHD1050 Livingston County Health Department Primary HRIF HRIF NMS12407
[email protected] of NursingJackie Dever 815-844-7174 x228
[email protected] Kennell 815-844-7174 x 223
[email protected] Knauer 815-844-7174 x 230
[email protected] Lehman 815-844-7174 x 231
[email protected] Stadel 815-844-7174 x 225
LHD1070 Logan County Health Department Primary HRIF HRIF NMS12408
[email protected] of Kara Davis 217.735.2317
[email protected] Lead Agency Charity Jarmakas 217-735-2317 x 238
[email protected] OltmannsWishes to be listed as contact.
217-735-2317
[email protected] Onken 217-735-2317
[email protected] Samson 217-735-2317
LHD1160 Macon County Health Department Primary HRIF HRIF NMS12409
[email protected] Lead Agency Michelle Boatman 217-423-6983 x 1313
[email protected] McNurlan 217-423-6988 x 1334
[email protected]/FCM DirectorKaren ShiflettKaren's Administrative Assistant is Lori Kimler: 217-423-6988 x 1323
217-423-6988 x1343
LHD1210 Marion County Health Department Primary HRIF HRIF NMS12411
[email protected] Adams 618-532-6518
Tuesday, December 06, 2016 Page 10 of 15
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LHD1231 Marshall County Health Department Primary HRIF HRIF NMS12412
[email protected] KingPutnam being adminstered by Bureau
309-246-8074
LHD1250 Mason County Health Department Primary HRIF HRIF NMS12413
[email protected] Health NurseJessica Towery 309-543-2201 x235
LHD1110 McHenry County Department of Health Primary HRIF HRIF NMS12414
Michelle
[email protected] CoordinatorKathy BennettKathy is also the HealthWorks Lead Agency Coordinator for DCFS placements
815-334-4518
[email protected] Engle 815-334-4594
[email protected] Myers 815-334-4553
LHD1130 McLean County Health Department Primary HRIF HRIF NMS12415
[email protected] Counts 309-888-5956
[email protected] Emerson 309-888-5462
[email protected] Jones 309-888-5467
[email protected] Lead Agency Marie McCurdy 309-888-5461
[email protected] McKay 309-434-6529
[email protected] Case Management Sophie Rebert 309-888-5540
[email protected] Smith 309-434-6529
LHD1310 Mercer County Health Department Primary HRIF HRIF NMS12417
[email protected] COORDINATORWendy Bighamper portal database 309-582-3759
309-582-3762 x 225
[email protected] Joseph 309-582-3759
LHD1330 Monroe County Health Department Primary HRIF HRIF NMS12418
[email protected] Case Management Kim CastelloClinical
618-939-3871 x 24
[email protected] Dietz 618-939-3871 x 20
LHD1350 Montgomery County Health Department Primary HRIF HRIF NMS12419
[email protected] Child Health Carolyn Dewerff 217-532-2001 ext. 157
Tuesday, December 06, 2016 Page 11 of 15
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LHD1370 Morgan County Health Department Primary HRIF HRIF NMS12420
[email protected] Case Management Karin Chumley 217-245-5111 x33
[email protected] of NursingMary Gray 217-245-5111 x 32
LHD1390 Moultrie County Health Department Primary HRIF HRIF NMS12421
[email protected] Ard 217-728-4114
[email protected] Hogan 217-728-4114
[email protected] CoordinatorJanine Matthews 217-728-4114
[email protected] CoordinatorKim SwinfordHealth Dept is located in the basement of a medical clinic.
217-728-4114
LHD0314 Oak Park Department of Public Health Primary HRIF HRIF NMS12382
[email protected] Newberry Schwartz 708-613-6122
LHD1410 Ogle County Health Department Primary HRIF HRIF NMS12422
[email protected] Lee 815-732-7330 x373
LHD1450 Perry County Health Department Primary HRIF HRIF NMS12424
[email protected]/FCM Registered NurseMarilyn Fisher 618-357-5371 x107
LHD1490 Pike County Health Department Primary HRIF HRIF NMS12425
[email protected] CoordinatorBeth Fencik 217-285-4407 x 109
LHD1550 Putnam County Health Department Primary HRIF HRIF NMS12426
[email protected]/HRIF/WIC Christy KelleyName used to be KemmerlingPer Portal database 815-872-5091
815-925-7326
LHD1570 Randolph County Health Department Primary HRIF HRIF NMS12427
[email protected] Murphy 618-826-5007
[email protected] Schuwerk 618-826-5007
[email protected] Vieregge 618-826-5007 x 129
Tuesday, December 06, 2016 Page 12 of 15
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LHD1610 Rock Island County Health Department Primary HRIF HRIF NMS12428
[email protected] Carroll 309-558-2852
[email protected] Lead Agency Brooke Hendrickx 309-558-2858
[email protected]/Family Case Traci Owensreplacing Franki.
309-558-2881
[email protected] Tubbs 309-558-2859
LHD1672 Sangamon County Department of Public Health Primary HRIF HRIF NMS12429
[email protected] Tisckos 217-535-3100 x3770
[email protected] Tulipanaper portal database 217-321-2620
217-535-3102 x 3767
LHD1690 Schuyler County Health Department Primary HRIF HRIF NMS12430
[email protected] McCurdy 217-322-6775
LHD1710 Scott County Health Department Primary HRIF HRIF NMS12431
[email protected]/CD CoordinatorPhyllis Jefferson 217-742-8203
LHD1730 Shelby County Health Department Primary HRIF HRIF NMS12432
[email protected] Vaughn4/11/2016- Asked to be sent routine correspondance on cases.
217-774-9555
[email protected] Verdeyen 217-774-9555
LHD0030 Southern Seven Health Department Primary HRIF HRIF NMS12444
[email protected]/FCM Program Linda Crosslandper portal database 618-524-2658 x 112
618-634-2297 Ext. 157
[email protected] Lead Agency Stacy Larry 618-634-2297 x 144
[email protected] CoordinatorBrenda Larry 618-634-9461 x 115
LHD1190 St. Clair County Health Department Primary HRIF HRIF NMS12433
[email protected] of NursingRobin Hannon 618-233-6170
[email protected] Sandman 618-825-4488
[email protected] CoordinatorKaroline Stock 618-825-4776
[email protected] CoordinatorCarmoleta Youck 618-233-6170 x 4485
Tuesday, December 06, 2016 Page 13 of 15
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LHD1770 Stephenson County Health Department Primary HRIF HRIF NMS12451
[email protected] of Public Health Julia Marynus 815-235-8394
LHD1790 Tazewell County Health Department Primary HRIF HRIF NMS12435
[email protected] Bakota (309) 925-5511 ext 281
[email protected]/APORS CoordinatorBeth Beachy 309-925-5511 x 234
[email protected] Graber 309-925-5511 ext 335
Case ManagerShelley LerchSupervised by Pam
618-783-4436
[email protected] Litwiller 309-925-5511
[email protected] Peplow309-267-7714 per portal database
309-925-5511 x277
[email protected] Roberts 309-925-5511 x 294
[email protected] AssistantLuann Rowell 309-925-5511 x 248
[email protected]/APORS CoordinatorSarah Williams 309-925-5511 x 295
LHD1850 Wabash County Health Department Primary HRIF HRIF NMS12453
[email protected] of NursingKendra Grounds 618-263-3873 x240
LHD1870 Warren County Health Department Primary HRIF HRIF NMS12468
[email protected] CoordinatorSabrina Cook 309-734-1314 x 227
[email protected] Ferrenburgper portal database 309-734-1314
309-734-1315
[email protected] Linkper portal databse 309-734-1314
309-732-1314
LHD1890 Washington County Health Department Primary HRIF HRIF NMS12437
[email protected] Carson 618-327-3644
[email protected] Lehde 618-327-3644
LHD1911 Wayne County Health Department Primary HRIF HRIF NMS12438
[email protected] Case Susan Bullard 618-842-5166 x 105
LHD1950 Whiteside County Health Department Primary HRIF HRIF NMS12439
[email protected] VanderVinne 815-626-2230 x 1213
Tuesday, December 06, 2016 Page 14 of 15
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LHD1970 Will County Health Department Primary HRIF HRIF NMS12440
[email protected] Bettenhausen 815-740-8994
[email protected] Hernandez 815-727-8505
[email protected] Lara 815-727-8779
[email protected] Morris-Jones 815-774-7389
[email protected] Lead Agency Loy Rosen 815-774-7302
[email protected] Roxworthy 815-727-8511
LHD2010 Winnebago County Health Department Primary HRIF HRIF NMS12441
[email protected] Case Management Cheryl Floyd 815-720-4315
[email protected] Gonzalez
Disease Intervention Gerrica Sallis 815.720.4049
Tuesday, December 06, 2016 Page 15 of 15
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Appendix E
Page 1 of 6
HealthWorks Contacts AGENCY: Adams County Health Dept. COUNTIES SERVED: ADDRESS: 330 Vermont St., Quincy, IL 62301 Adams MAIN PHONE: 217-222-8440 Brown FAX: 217-277-2013 Calhoun STAFF TITLE PHONE # Greene Anne Klene FCM & BBO Coordinator 217-222-8440 Hancock Ellen Vonderheide
Dir. Family Health & Community Education 217-222-8440 Jersey
Pike Schuyler
AGENCY: Champaign Urbana Public Health District COUNTIES SERVED: ADDRESS: 201 W. Kenyon Rd., Champaign, IL 61820 Champaign MAIN PHONE: 217-352-7961 Ford FAX: 217-351-5174 Iroquois STAFF TITLE PHONE # Vermilion Amy Walker HealthWorks Program Mgr 217-531-4313 Cindy Conlon Medical Case Manager 217-531-4312 Cathy Ito MCH Program 217-531-4311
AGENCY: Cook-Aunt Martha’s Youth Service Center COUNTIES SERVED: ADDRESS: 191 West 155th Place Harvey, IL 60426 Cook MAIN PHONE: 708-331-0735 FAX: 708-331-3154 STAFF TITLE PHONE # Angela Johnson Program Director 708-210-2264 Trina Springs Interim Case Manager Supv. 708-210-2261 *Gladys Lagunas Medical Records Coordinator 708-210-2254 *Receives doc. for processing Margaret Carter Health Resolution Manager 708-210-2251 Suzanne Gulino Data/Quality Assurance Mgr 708-697-7207 Wendy Maeder Medical Case Mgmt Cord. 708-210-2256
AGENCY: DuPage County Health Department COUNTIES SERVED: ADDRESS: 111 N County Farm Road Wheaton, IL 60187 DuPage MAIN PHONE: 630-221-7098 Kane FAX: 630-510-5435 Kendall STAFF TITLE PHONE # Karen Williams Intensive Svc Supervisor 630-221-7364 Marysely Gomez Case Manager 630-221-7169 Regina(Maria) Franco Case Manager 630-221-7514 Janette Quinones Case Manager 630-221-7531 Araceli Chavez Admin Clerk 630-221-7057 Michelle Lanzi Asst. Dir. of Fam Health 630-221-6170
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Appendix E
Page 2 of 6
AGENCY: Effingham County Health Dept. COUNTIES SERVED: ADDRESS: 901 W. Virginia, Effingham, IL 62401 Clay MAIN PHONE: 217-342-9237, Ext. 3 for HealthWorks Crawford FAX: 217-342-9324 Edwards STAFF TITLE PHONE # Effingham Linda Hampton HealthWorks Supervisor 217-342-9237 Fayette Judy Overbeck HealthWorks Assistant 217-342-9237 Hamilton Judy Bierman Medical Case Manager 217-342-9237 Jasper Jefferson Lawrence Marion Richland Wabash Wayne
AGENCY: Jackson County Health Dept. COUNTIES SERVED:
ADDRESS: PO Box 307, 415 Health Dept. RD, Murphysboro IL 62966 Jackson
MAIN PHONE: 618-684-3143 (see extension #s below) Perry FAX: 618-684-8600; Alt #618-687-1255 Franklin STAFF TITLE PHONE # Williamson Cheryl Golliher Program Manager 618-684-3143 x 164 Gallatin Connie Edgar FCM / MCM 618-684-3143 x 182 White Karen Brown Family Services/Nursing Dir 618-684-3143 x 105 Saline
AGENCY: Kankakee Health Dept. COUNTIES SERVED: ADDRESS: 2390 W. Station St., Kankakee, IL 60901-3000 Kankakee MAIN PHONE: 815-802-9320 FAX: 815-802-9321 STAFF TITLE PHONE # Glynis Cailteux Program Coordinator 815-802-9325 Rachel Yeast MCH Division Office Mgr 815-802-9322 Jeana Irvin HealthWorks Nurse 815-802-9341
AGENCY: LaSalle County Health Dept. COUNTIES SERVED: ADDRESS: 717 Etna Rd., Ottawa, IL 61350 LaSalle MAIN PHONE: 815-433-3366 (see extension #s below) FAX: 815-433-9522; Alt #815-433-2876 STAFF TITLE PHONE # Pauline Kirkton HealthWorks Case Mgr. 815-433-3366 x 249 Bonny Pietrowski Personal Health Supervisor 815-433-3366 x250 Cathy Larsen Personal Health Div. Dir. 815-433-3366 x244
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Appendix E
Page 3 of 6
AGENCY: Lake County Health Dept. COUNTIES SERVED: ADDRESS: 3010 Grand Avenue, Waukegon, IL 60085 Lake MAIN PHONE: 847-377-8070 FAX: 847-984-5808 STAFF TITLE PHONE # Damaris Montano Program Coordinator 847-377-8152 Tracy Raasch HealthWorks Case Mgr. 847-377-8175 Debra O’Neil RN Case Manager 847-377-8153 Elia Hill Sr. Public Health Assistant 847-377-8177
AGENCY: Logan Co. Department of Public Health COUNTIES SERVED: ADDRESS: 109 Third Street, P.O. Box 508, Lincoln, IL 62656 Cass MAIN PHONE: 217-735-2317 (see extension #s below) Christian FAX: 217-732-1534 Fulton STAFF TITLE PHONE # Logan Charity Jarmakas Program Coordinator 217-735-2317 x238 Macoupin Lisa Rippon HealthWorks Clerk 217-735-2317 x239 Mason Molly Donnelly Medical Case Manager 217-735-2317 x255 Menard Montgomery Morgan Sangamon Scott Tazewell Woodford
AGENCY: Macon County Health Dept. COUNTIES SERVED: ADDRESS: 1221 E. Condit St., Decatur, IL 62521-1405 Clark MAIN PHONE: 217-423-6988 Coles FAX: 217-423-5079 Cumberland STAFF TITLE PHONE # Douglas Tiffany Harris Program Coordinator 217-423-6988 x1313 Edgar Dawn Musick Program Assistant 217-423-6988 x1312 Macon Moultrie Shelby
AGENCY: McHenry County Dept. of Health COUNTIES SERVED:
ADDRESS: 2200 N Seminary Ave -Annex A, Woodstock, IL 60098 McHenry
MAIN PHONE: 815-334-4510 FAX: 815-334-0192 STAFF TITLE PHONE # Kathy Bennett Program Coordinator 815-334-4518 Lisa Hanley RN Case Manager 815-334-4532 Lori Seagren Admin Tech 815-334-4526
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Appendix E
Page 4 of 6
AGENCY: McLean County Health Department COUNTIES SERVED: ADDRESS: 200 W. Front Street, Bloomington, IL 61701 McLean County MAIN PHONE: 309-888-5461 or 309-888-5465 DeWitt County FAX: 309-888-5543 Piatt County STAFF TITLE PHONE # Livingston County Marie McCurdy Program Coordinator 309-888-5461 Mandy McCambridge Office Support Specialist 309-888-5465 Hannah Emerson Back-up HWLA OSS 309-888-5462 Sabrina Lawrence MCM McLean Co. 309-888-5535 Tara Wickline DeWitt/Piatt MCM 217-935-3427 x202 Tondra Harris Livingston Co. MCM 815-844-7174 x236
AGENCY: Rock Island County Health Dept. COUNTIES SERVED: ADDRESS: 2112 25th Ave., Rock Island, IL 61201 Bureau MAIN PHONE: 309-558- 2922 Henderson FAX: 309-793-0405 Henry STAFF TITLE PHONE # Knox Kathleen Flynn HealthWorks Supervisor 309-558-2858 McDonough Estefana Gore Program Specialist 309-558-2922 Mercer Janet Hill Chief Operating Officer 309-558-2881 Putnum Rock Island Stark Warren
AGENCY: Southern Seven Health Department COUNTIES SERVED: ADDRESS: 37 Rustic Campus Dr., Ullin, IL 62992 Alexander MAIN PHONE: 618-634-9405 Hardin FAX: 618-634-2656 Johnson STAFF TITLE PHONE # Massac Stacy Larry Program Coordinator 618-634-2297 x144 Pope Cheryl Manus Dir. of Nursing/Admin 618-634-2297 x112 Pulaski Linda Crossland WIC Program Manager 618-634-2297 Union AGENCY:
Southern Illinois Healthcare Foundation COUNTIES SERVED:
ADDRESS: 100 N. 8th St., Suite 208, East St. Louis, IL 62201 Bond
MAIN PHONE: 618-332-8917 or 618-332-0041 Clinton FAX: 618-337-6021 Madison (Coord Youth & Human Services) STAFF TITLE PHONE # Monroe Monica Hurt Program Manager 618-332-8917 Randolph Robin Latham Program Assistant 618-332-8917 St. Clair (St. Clair Co. Health & East Side Hlth Dist.) Mona Thier Program Assistant 618-332-8917 Washington
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Appendix E
Page 5 of 6
AGENCY: TASC, Inc. COUNTIES SERVED: ADDRESS: 108 SW Madison Avenue, Peoria, IL 61602 Peoria MAIN PHONE: 309-673-3769 Marshall FAX: 309-673-4076 STAFF TITLE PHONE # Mary Knutson HealthWorks Supervisor 309-673-3769, x10412 Kathyrn Gray Medical Case Manager 309-673-3769, x10418 Shundra Parker Family Case Mgmt Sup. 309-673-3769, x10410
AGENCY: Will County Health Dept, HealthWorks of Will Cty COUNTIES SERVED: ADDRESS: 501 Ella Ave., Joliet, IL 60433 Grundy MAIN PHONE: 815-727-8863 Will FAX: 815-774-4481 STAFF TITLE PHONE # Loy Rosen HealthWorks Program Manager 815-774-7302 Magda Lara Nurse Case Manager 815-727-8779 AGENCY: Winnebago County Health Dept. COUNTIES SERVED: ADDRESS: P.O. Box 4009, Rockford, IL 61110-0509 Boone MAIN PHONE: 800-355-8909 Carroll FAX: 815-720-4305 DeKalb STAFF TITLE PHONE # Jo Daviess Cheryl Floyd Family Case Management Supv 815-720-4315 Lee Antwon George HW Coordinator 815-720-4341 Ogle Samantha Grigsby HealthWorks Assistant 815-720-4342 Stephenson Jeannie Alonzo HealthWorks Medical Manager 815-720-4351 Whiteside Alisa McGuire HealthWorks Assistant 815-720-4389 Winnebago Bldg. Location: 555 N. Court, Rockford, IL 61103 (Physical location; Mailing address listed above)
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Appendix E
Page 6 of 6
HealthWorks of Illinois Illinois Department of Children and Family Services Division of Service Intervention - Health Services ADDRESS: 100 W. Randolph, 6th Floor, Chicago, IL 60601 FAX NUMBER: 312-814-3064 STAFF TITLE PHONE NUMBER Hendiz Flynn Health Services Manager for Cook County 312-814-6976 ADDRESS: 401 Brown St. , Bloomington, IL 61701 FAX NUMBER: 309-829-3302 STAFF TITLE PHONE NUMBER Donna Lindemulder Health Services Administrator 309-828-0022 (Main) ADDRESS: 406 E. Monroe St., Stn. # 22, Springfield, IL 62701 Main Phone #: 217-557-2689 FAX NUMBER: 217-557-5796 STAFF TITLE PHONE NUMBER Karen Moredock Downstate Health Services Coordinator 217-557-5792 Elaine Schmidt Downstate Health Services Manager 217-557-5782 Melissa Simpson Quality Assurance Specialist 217-557-5783
Family Case Management: Illinois Department of Human Services Bureau of Maternal and Infant Health ADDRESS: 207 Prospect Rd., Suite 4, Bloomington, IL 61704 STAFF TITLE PHONE NUMBER FAX NUMBER Lise Jankowski Acting Bureau Chief 312-814-1354 312-793-4666
ADDRESS: 401 S. Clinton 4th Floor, Chicago, IL 60617 STAFF TITLE PHONE NUMBER FAX NUMBER Felicia Fair-Thompson Program Coordinator 708-717-9424 ADDRESS: STAFF TITLE PHONE NUMBER FAX NUMBER
Updated 12/28/2016 TD
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Appendix F
Illinois Department of Human Services High Risk Infant Follow-up Program Frequently Asked Questions (FAQ) Q 1. Will a face to face visit in WIC be counted as a nurse follow-up visit with infant? A: No, a face to face visit in WIC does not necessarily mean that the requirements for a High Risk Infant Follow-up visit have been met. The public health nurse visit provided to an APORS qualified infant or a non-IDR HRIF infant should include, at a minimum, the physical assessment, developmental assessment and age specific anticipatory guidance. When an infant is receiving services at the health department, such as WIC, a follow-up visit may be conducted by the public health nurse at that time. Q 2. On the Cornerstone Birth Screen (PA11), does ‘Y’ for APORS get changed to ‘N’ if the child is no longer APORS? A: No, do not change the ‘Y’ indicator under any circumstances. Q 3. Sometimes the agency can’t enter infant and activate for HRIF program if they can’t reach the family or the family can’t be found because the APORS Report information is not complete. How are these reported? Infant will count on IDPH Reports as referral but no follow- up services will be provided. A: The agency will need to document on a tracking log to be kept at the agency all infants; 1) those whose families could not be contacted, 2) those whose families refuse APORS services, 3) those whose families accept services but refuse to sign a Cornerstone consent, or 4) for any other circumstances which differ from APORS program policy. If the agency chooses to do so, response can be documented in APORS database. Q 4. If an infant is found to meet APORS criteria after hospital discharge, the agency indicated ‘Y’ APORS on Birth Screen (PA11). Is this correct? A: No, only infants meeting APORS criteria that are identified during the inpatient hospitalization following birth are considered APORS eligible and should be marked as ‘Y’ for APORS on the PA11 Birth Screen in Cornerstone. Q 5. What should the agency do when an APORS Report is not received from the hospital for an APORS infant? A: If no APORS Report is sent to the agency, work with IDPH’s APORS Hospital Liaison at [email protected] to resolve the problem. If further assistance is needed, contact the DHS’s HRIF Program Coordinator: Todd Doyle at 217-558-4104 or [email protected].
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