Division of Family and Community Services

High Risk Infant Follow-up (HRIF) Program Manual

For

Local Health Departments and Community Agencies

January 1, 2017

DRAFT

i

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

DRAFT

ii

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

DRAFT

3

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.

DRAFT

4

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).

DRAFT

5

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 Jane.Fornoff@illinois.gov

DRAFT

6

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

DRAFT

7

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 dph.apors@illinois.gov 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

DRAFT

8

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.

DRAFT

9

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%.

DRAFT

10

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.

DRAFT

11

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

DRAFT

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: __________________________________________________________________

____________________________________________________________________________.

DRAFT

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.

DRAFT

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 todd.doyle@illinois.gov.

DRAFT

LHD Contacts

LHD0010 Adams County Health Department Primary HRIF HRIF NMS12366

tbuckner@co.adams.il.usTammi Buckner 217-222-8440 x 104

sjung@co.adams.il.usShelly Jung 217-222-8440 x 115

amorrell@co.adams.il.usHealthWorks Lead Agency Amy Morrell 217-222-5440 x 122

evonderheide@co.adams.il.usHRIF CoordinatorEllen Vonderheide 217-222-8440 x 137

LHD1831 Aunt Martha's Healthcare Network Primary HRIF HRIF NMS12436

mcooper@auntmarthas.orgHRIF CoordinatorMarti Cooper 217-444-8959

aldavis@auntmarthas.orgAline Davis 217-444-8962

217-444-8959

LHD0050 Bond County Health Department Primary HRIF HRIF NMS12368

jmarkell@bchd.usJudi Markell 618-664-1442 x 136

LHD0070 Boone County Health Department Primary HRIF HRIF NMS12369

amehl@boonehealth.orgAmanda Mehl 815-547-8591

sschweitzer@boonehealth.orgAPORS CoordinatorSue Schweitzer 815-547-8419

LHD0090 Brown County Health Department Primary HRIF HRIF NMS12370

mreich@bchd1.orgWIC/FCM CoordinatorMary Reich 217-773-2714

LHD0130 Calhoun County Health Department Primary HRIF HRIF NMS12371

steichmann@ezl.comMCH/CMSandy Teichmann 618-576-2428

LHD0150 Carroll County Health Department Primary HRIF HRIF NMS12372

dhollandcchd@grics.netDawn Holland 815-244-8855

jmillercchd@grics.netJennifer Miller 815-244-8855

ssenneffcchd@grics.netSarah Senneff 815-244-8855

Tuesday, December 06, 2016 Page 1 of 15

DRAFT

LHD0170 Cass County Health Department Primary HRIF HRIF NMS12373

jepping@casscohealth.orgMaternal Child Health Jamie Epping 217-323-2182 x 315

ksargent@casscohealth.orgKayla Sargent 217-323-2182

LHD0190 Champaign-Urbana Public Health District Primary HRIF HRIF NMS12374

tbrooks@c-uphd.orgTracy Brooks 217-531-4290

Cindy Conlin 217-531-4312

khearne@c-uphd.orgKelly Hearne 217-531-4292

cito@c-uphd.orgCathy Ito 217-531-4311

bmeline@c-uphd.orgDirectorBrandon Meline 217-531-4308

sraila@c-uphd.orgSheila Raila 217-531-4285

awalker@c-uphd.orgHealthWorks Lead Agency Amy Walker 217-531-4313

LHD0311 Chicago Department of Public Health Primary HRIF HRIF NMS12381

elizabeth.Colloton@cityofchicago.orgElizabeth Colloton 312-477-9770

luchrisha.fisher@cityofchicago.orgRegional Public Health Luchrisha FisherPronounced Lucretia

312-745-3982

jacqueline.wroten@cityofchicago.orgJacqueline Hoskins-Wroten 312-474-1629

osagie.igbinosun@cityofchicago.orgOsagie Igbinosun 312-744-0178

cecilia.libunao@cityofchicago.orgPublic Health Nurse IIICecilia Libunao 312-747-9690

mary.marcano@cityofchicago.orgMary Marcano 312-746-5926

lisa.masinter@cityofchicago.orgMedical DirectorLisa Masinter 312-747-5472

Irina.Tabidze@cityofchicago.orgEpidemiologistIrina Tabidze 312-747-9867

mturyk1@uic.eduMary TurykRoom 879

312-355-4673

Kingsley.Weaver@cityofchicago.orgEpidemiologist IVKingsley Weaver (312) 747-9438

freddie.white@cityofchicago.orgFreddie White 312-747-9688

Tuesday, December 06, 2016 Page 2 of 15

DRAFT

LHD0210 Christian County Health Department Primary HRIF HRIF NMS12375

tracie.riggs@christiancountyhealth.orgAPORS CoordinatorTracie Riggs 217-824-4113

cindy.schmitz@christiancountyhealth.orgCynthia Schmitz 217-824-4113

vanessa.taylor@christiancountyhealth.orgVanessa Taylor 217-824-4113 ext 121

LHD0231 Clark County Health Department Primary HRIF HRIF NMS12376

vmullen@clarkcountyhealthdept.orgValerie Mullen 217-382-4207

kvaughn@clarkcountyhealthdept.orgKatie Vaughn 217-382-4207

LHD0250 Clay County Health Department Primary HRIF HRIF NMS12377

tkeyser@healthdept.orgTeresa Keyser 618-662-4406

lwaller@healthdept.orgLyn Waller 618-662-4406

myoung@healthdept.orgMiriam Young 618-662-4406

LHD0270 Clinton County Health Department Primary HRIF HRIF NMS12378

health@clintonco.illinois.govJanice Albers 618-594-2723

Jennifer.boyd@clintonco.illinois.govJennifer Boyd 618-594-8942

LHD0290 Coles County Health Department Primary HRIF HRIF NMS12379

bcooper@co.coles.il.usBrenda Cooper 217-348-0530

mhildebrand@co.coles.il.usMara Hildebrand 217-348-0530

Tuesday, December 06, 2016 Page 3 of 15

DRAFT

LHD0310 Cook County Department of Public Health Primary HRIF HRIF NMS12380

dbrooks@cookcountyhhs.orgDebbie BrooksPhone number is for assistant, MariaReplaced Sandra

708-786-4057

cburke@cookcountyhhs.orgMCH NurseChristine Burke 708 633 9613

kdugal@cookcountyhhs.orgAdministrative AssistantKathy Dugalper portal database 708-836-8635

708-786-4061

kdunn@cookcountyhhs.orgKathy Dunn 312-446-1597

medwyer@cookcountyhhs.orgAdministrative Assistant IVMary Ellen Dwyer 708-836-8643

mgibb@cookcountyhhs.orgMary Gibb 708-232-4506

pclinchango@cookcountyhhs.orgProgram Manager, Purisima LinchangcoPer portal database 708-492-2177. Portal ID used for Hep B only

847-818-4020

jtaverne@cookcountyhhs.orgGenetics CoordinatorJeannie Taverne 708-786-4054

mvaldivia@cookcountyhhs.orgMaria Valdiviaper portal database 708-836-8636

708-786-4066

LHD7070 Coordinated Youth and Human Services Primary HRIF HRIF NMS12410

sjones@cyhs.comSite SupervisorSarah Jones 618-877-3433

lindat@cyhs.comHRIF CoordinatorLinda Toombs 618-877-3433 x 110

LHD0330 Crawford County Health Department Primary HRIF HRIF NMS12383

ksfree@cchd.netKaren Free 618-544-8798

rjoles@cchd.netWIC ClerkRenita Joles 618-544-8798

teshaffer@cchd.netNursing SupervisorTerry Shaffer 618-544-8798

LHD0350 Cumberland County Health Department Primary HRIF HRIF NMS12384

cirn@cumberlandhealth.orgHRIF CoordinatorCrystal Ingram 217-849-3211 x 224

skrn@cumberlandhealth.orgMCH CoordinatorSherry Kearns 217-849-3211

LHD0370 DeKalb County Health Department Primary HRIF HRIF NMS12385

kchase@dekalbcounty.orgWIC/FCM Program Kay Chase 815-748-2438

clapointe@dekalbcounty.orgCathy LaPointe 815-748-2401

Tuesday, December 06, 2016 Page 4 of 15

DRAFT

LHD0390D DeWitt-Piatt Bi-County Health Department Primary HRIF HRIF NMS12464

twickline@dewittpiatthealth.comPH NURSETara WicklineDuplicated because needs to be linked to DeWitt and Piatt

217-935-3427

twickline@dewittpiatthealth.comPH NURSETara WicklineDuplicated because needs to be linked to DeWitt and Piatt

217-935-3427

LHD0410 Douglas County Health Department Primary HRIF HRIF NMS12386

susan.hays@douglascountyil.comDirector of NursingSusan Hays 217-253-4137

LHD0430 DuPage County Health Department Primary HRIF HRIF NMS12387

majmeri@dupagehealth.orgMubeena AjmeriHealth Works

630-221-7514

archavez@dupagehealth.orgAraceli Chavez 630-221-7694

mflores@dupagehealth.orgMartha Flores 630-221-7325

mgomez@dupagehealth.orgHealthWorks Lead Agency Marysely Gomez 630-221-7169

cgonzale@dupagehealth.orgCatherine Gonzalez (630) 221-3554

mlanzi@dupagehealth.orgAssistant Director of Michelle Lanzi (630) 221-6170

mprignan@dupagehealth.orgMary Prignano 630-221-7566

Jquinone@dupagehealth.orgHealthWorksJanette Quinones 630-221-7531

LHD1631 East Side Health District Primary HRIF HRIF NMS12434

rwashington@eshd.orgAPORS NurseTina Partelow 618-874-7413 x 242

lshelton@eshd.orgLynn Shelton 618-874-4718

rwashington@eshd.orgProgram ManagerRegina Washington 618-874-4713 x 222

LHD1045 Edgar County Health Department Primary HRIF HRIF NMS12388

jmcconkey@ecphd.orgDirector of NursingJean McConkey 217-466-3567

LHD0490 Effingham County Health Department Primary HRIF HRIF NMS12389

Kathy Bailey 309-246-8074

shawnb@effcohealth.orgWIC CoordinatorShawn Bourland 217-342-9237

lindah@effcohealth.orgHealthWorks Lead Agency Linda Hampton 217-342-9237

Tuesday, December 06, 2016 Page 5 of 15

DRAFT

LHD0590S Egyptian Health Department Primary HRIF HRIF NMS12457

gbarton@egyptian.orgDirector of NursingGail Barton (618) 273-3326

nevans@egyptian.orgAPORS/HRIF CoordinatorNickie EvansSharepoint rights added, not IVRS. Request resent 4/21/16

618-273-3326

LHD0510 Fayette County Health Department Primary HRIF HRIF NMS12390

hjackson@fayettehealthdept.orgDirector of Family and Heather JacksonHeather is taking over as APORS coordinator in October 2016. Dee Sanders is retiring.

618-283-1044

dsanders@fayettehealthdept.orgDirector 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

Anna_benoit@gibsonhospital.orgAnn Benoit 217-579-1087

kris_cramer@gibsonhospital.orgKristina Cramer 217-784-2510

kristin_salyards@gibsonhospital.orgKristin 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

lallen@bicountyhealth.orgLaurie Allen 618-435-2693

kburton@bicountyhealth.orgKarla Burton 618-993-8111

senglish@bicountyhealth.orgSheila English 618-439-0951 x 233

kspruell@bicountyhealth.orgMCH CoordinatorKim Spruell 618-993-8111

LHD0570 Fulton County Health Department Primary HRIF HRIF NMS12391

lhiett@fultonco.orgMCH Programs ManagerLouise Hiett 309-647-1134

LHD0610 Greene County Health Department Primary HRIF HRIF NMS12392

dballard@greenecountyhealth.comHRIF/APORS CoordinatorDawn Ballard 217-942-6961

twhitlockrn@gmail.comStaff 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

DRAFT

LHD0630 Grundy County Health Department Primary HRIF HRIF NMS12393

jbailey@grundyhealth.comDirector of NursingJudy BaileyRetiring 12/31/15 per email frrom Katie Harrison

815-841-3126

kharrison@grundyhealth.comDirector of NursingKatie Harrison 815-941-3126

LHD0650 Hamilton County Health Department Primary HRIF HRIF NMS12394

health@hamiltonco.usLaDonna Lasater 618-643-3522

LHD0710 Henderson County Health Department Primary HRIF HRIF NMS12395

erin.anderson@hendcohealth.comErin 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

haldred@henrystarkhealth.orgHeather Aldred 309-852-7223

mbeckstrom@henrystarkhealth.orgMichele Beckstrom 309-852-7256

ssommer@henrystarkhealth.orgDirector of Clinic ServiceSandy Sommer 309-852-0197

LHD0750 Iroquois Community Health and Social Services Primary HRIF HRIF NMS12557

karry.hines@iroquoismemorial.comMCH 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

karenb@jchdonline.orgDirector of NursingKaren Brown 618-684-3143X105

sarahf@jchdonline.orgWIC/FCM ManagerSarah Fager 618-684-3143

deborahg@jchdonline.orgWIC nurseDeborah Golden 618-684-3143 x 146

cherylg@jchdonline.orgHealthWorks Lead Agency Cheryl Golliher 618-684-3143 x 164

paulam@jchdonline.orgPaula Vineyard-Most 618-684-3143

Tuesday, December 06, 2016 Page 7 of 15

DRAFT

LHD0790 Jasper County Health Department Primary HRIF HRIF NMS12466

mochs@jasperhealth.orgHRIF CoordinatorMelanie Ochs 618-783-4436

tochs@jasperhealth.orgTammy Ochs 618-392-3226

szumbahlen@jasperhealth.orgHRIF CoordinatorSandy Zumbahlen 618-783-4436

LHD0815 Jefferson County Health Department Primary HRIF HRIF NMS12397

kwelch@jchdil.orgKathy Welch 618-244-7134 x222

LHD0830 Jersey County Health Department Primary HRIF HRIF NMS12398

bshipley@jerseycountyhealth.orgMaternal Child Health Becky Shipley 618-498-9565

LHD5060 Kane County Health Department Primary HRIF HRIF NMS12399

amoodina@co.kane.il.usHRIF/APORS SupervisorDina Amoo

DawsonDiane@co.kane.il.usSupport AssociateDiane Dawson 630-264-7696

FigueroaSol@co.kane.il.usSupport AssociateSol Figueroa 630.264.7651

kanecheryl@co.kane.il.usHRIF/APORS NurseCheryl Kane

okapaljuliana@co.kane.il.usHRIF/APORS NurseJuliana Okapal 630-264-7679

sillittisharon@co.kane.il.usSharon Sillitti 630-264-7667

WalshJeannie@co.kane.il.usJeannie Walsh 630-444-3188

LHD0910 Kankakee County Health Department Primary HRIF HRIF NMS12400

gcailteux@kankakeehealth.orgFCM CoordinatorGlynis CailteuxGlynis is also the HealthWorks Lead Agency Coordinator for DCFS placements.Going on FMLA leave 11/30

815-802-9325

jboswell@kankakeehealth.orgJeana Irvinsubbing

815-802-8341

lsztuba@kankakeehealth.orgLaura Sztuba 815-802-9341

LHD0930 Kendall County Health Department Primary HRIF HRIF NMS12401

klicht@co.kendall.il.usKelly Jordan-Licht 630-553-8048

blehman@co.kendall.il.usBrandy Lehman 630-553-8090

tolson@co.kendall.il.usCommunity Health Terri Olson 630-553-8047

nvilla@co.kendall.il.usHRIF CoordinatorNancy Villa 630-553-9100

Tuesday, December 06, 2016 Page 8 of 15

DRAFT

LHD0950 Knox County Health Department Primary HRIF HRIF NMS12402

pbollivar@knoxcountyhealth.orgPenny Bollivar 309-344-3314

hkusler@knoxcountyhealth.orgDirector of Family Health Heather Kuslerper portal database 309-344-3314

309-344-2224 - ext. 231

LHD0970 Lake County Health Department Primary HRIF HRIF NMS12403

rdursun@lakecountyil.govRenee Dursun 847-377-8149

SKidder@lakecountyil.govAssessment and Planning Seth Kidder 847-984-5014

rleal@lakecountyil.govRosa Leal 847-377-8126

lmaravilla@lakecountyil.govLourdes Maravilla 847-377-8157

dmontano@lakecountyil.govAssistant 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

babynurse0@msn.comHRIF/APORS CoordinatorHolly BressnerThis is a duplicate entry due to multiple e-mail addresses. E-mail babynurse0@gmail.com does not always go through. Requested we also use the babynurse0@msn.com also.

815-433-3366 x 252

babynurse0@gmail.comHolly BressnerThis is a duplicate entry due to multiple e-mail addresses. E-mail babynurse0@gmail.com does not always go through. Requested we also use the babynurse0@msn.com also.

815-433-3366 x252

pkirkton@lasallecounty.orgHealthWorks Lead Agency Pauline Kirkton 815-433-3366 x 249

clarsen@lasallecounty.orgCathy Larsenreactivate per JS

815-433-3366 x 244

bpietrowski@lasallecounty.orgFamily Health CoordinatorBonny Pietrowski 815-433-3366 x 250

LHD1010 Lawrence County Health Department Primary HRIF HRIF NMS12405

dbandy@lchealth.comLead Co-ordinatorDonna Bandy 618-943-3302 ext. 226

Tuesday, December 06, 2016 Page 9 of 15

DRAFT

LHD1030 Lee County Health Department Primary HRIF HRIF NMS12406

mdempsey@lchd.comMegan Dempsey6/3/2016: Megan replaced Kathy Shutz as HRIF primary contact.

815-284-3371

mdennis@lchd.comMegan Dennis 815-284-3371

mkrueger@lchd.comMichelle Krueger 815-284-3371

jlemmer@lchd.comJessica Lemmer 615-284-3371

lwiggins@lchd.comLisa Wiggins 815-284-3371

LHD1050 Livingston County Health Department Primary HRIF HRIF NMS12407

jdever@lchd.usDirector of NursingJackie Dever 815-844-7174 x228

kkennell@lchd.usKathy Kennell 815-844-7174 x 223

nknauer@lchd.usNancy Knauer 815-844-7174 x 230

slehman@lchd.usSue Lehman 815-844-7174 x 231

dstadel@lchd.usDianne Stadel 815-844-7174 x 225

LHD1070 Logan County Health Department Primary HRIF HRIF NMS12408

kdavis@lcdph.orgDirector of Kara Davis 217.735.2317

cjarmakas@lcdph.orgHealthWorks Lead Agency Charity Jarmakas 217-735-2317 x 238

doltmanns@lcdph.orgDana OltmannsWishes to be listed as contact.

217-735-2317

jonken@lcdph.orgJennifer Onken 217-735-2317

ksamson@lcdph.orgKatherine Samson 217-735-2317

LHD1160 Macon County Health Department Primary HRIF HRIF NMS12409

michelleh@maconcountyhealth.orgHealthWorks Lead Agency Michelle Boatman 217-423-6983 x 1313

fcm@maconcountyhealth.orgJill McNurlan 217-423-6988 x 1334

wic@maconcountyhealth.orgWIC/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

tadams@ussonet.netTerri Adams 618-532-6518

Tuesday, December 06, 2016 Page 10 of 15

DRAFT

LHD1231 Marshall County Health Department Primary HRIF HRIF NMS12412

kking@bchealthdepartment.orgKathleen KingPutnam being adminstered by Bureau

309-246-8074

LHD1250 Mason County Health Department Primary HRIF HRIF NMS12413

wicrn@grics.netPublic Health NurseJessica Towery 309-543-2201 x235

LHD1110 McHenry County Department of Health Primary HRIF HRIF NMS12414

Michelle

ksbennet@co.mchenry.il.usProgram CoordinatorKathy BennettKathy is also the HealthWorks Lead Agency Coordinator for DCFS placements

815-334-4518

aaengle@co.mchenry.il.usAletha Engle 815-334-4594

kamyers@co.mchenry.il.usKim Myers 815-334-4553

LHD1130 McLean County Health Department Primary HRIF HRIF NMS12415

mary.counts@mcleancountyil.govMary Counts 309-888-5956

hannah.emerson@mcleancountyil.govHannah Emerson 309-888-5462

lacy.jones@mcleancountyil.govLacy Jones 309-888-5467

marie.mccurdy@mcleancountyil.govHealthWorks Lead Agency Marie McCurdy 309-888-5461

ashley.mckay@mcleancountyil.govAshley McKay 309-434-6529

sophie.rebert@mcleancountyil.govFamily Case Management Sophie Rebert 309-888-5540

ashley.smith@mcleancountyil.govAshley Smith 309-434-6529

LHD1310 Mercer County Health Department Primary HRIF HRIF NMS12417

wendy.bigham@mchdept.orgCD COORDINATORWendy Bighamper portal database 309-582-3759

309-582-3762 x 225

molly.joseph@mchdept.orgMolly Joseph 309-582-3759

LHD1330 Monroe County Health Department Primary HRIF HRIF NMS12418

kcastello@monroecountyhealth.orgFamily Case Management Kim CastelloClinical

618-939-3871 x 24

pdietz@monroecountyhealth.orgPenny Dietz 618-939-3871 x 20

LHD1350 Montgomery County Health Department Primary HRIF HRIF NMS12419

cdewerff@consolidated.netMaternal Child Health Carolyn Dewerff 217-532-2001 ext. 157

Tuesday, December 06, 2016 Page 11 of 15

DRAFT

LHD1370 Morgan County Health Department Primary HRIF HRIF NMS12420

karin.chumley@morganhd.comFamily Case Management Karin Chumley 217-245-5111 x33

mary.gray@morganhd.comDirector of NursingMary Gray 217-245-5111 x 32

LHD1390 Moultrie County Health Department Primary HRIF HRIF NMS12421

trisha@moultriehealth.orgTrisha Ard 217-728-4114

angela@moultriehealth.orgAngela Hogan 217-728-4114

Janine@moultriehealth.orgAPORS CoordinatorJanine Matthews 217-728-4114

kimberly@moultriehealth.orgHRIF 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

cnewberry@collab4kids.orgCarolyn Newberry Schwartz 708-613-6122

LHD1410 Ogle County Health Department Primary HRIF HRIF NMS12422

klee@oglecounty.orgKathy Lee 815-732-7330 x373

LHD1450 Perry County Health Department Primary HRIF HRIF NMS12424

mfisher@perryhealth.netWIC/FCM Registered NurseMarilyn Fisher 618-357-5371 x107

LHD1490 Pike County Health Department Primary HRIF HRIF NMS12425

bfencik@pikecoilhealth.orgMCH CoordinatorBeth Fencik 217-285-4407 x 109

LHD1550 Putnam County Health Department Primary HRIF HRIF NMS12426

ckelley@bchealthdepartment.orgAPORS/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

nmurphy@randolphco.orgNickie Murphy 618-826-5007

jschuwerk@randolphco.orgJessica Schuwerk 618-826-5007

yvieregge@randolphco.orgYvonne Vieregge 618-826-5007 x 129

Tuesday, December 06, 2016 Page 12 of 15

DRAFT

LHD1610 Rock Island County Health Department Primary HRIF HRIF NMS12428

kcarroll@co.rock-island.il.usKelly Carroll 309-558-2852

bhendrickx@co.rock-island.il.usHealthWorks Lead Agency Brooke Hendrickx 309-558-2858

towens@co.rock-island.il.usWIC/Family Case Traci Owensreplacing Franki.

309-558-2881

rtubbs@co.rock-island.il.usRadney Tubbs 309-558-2859

LHD1672 Sangamon County Department of Public Health Primary HRIF HRIF NMS12429

debrat@co.sangamon.il.usDebbie Tisckos 217-535-3100 x3770

ShelleyT@co.sangamon.il.usShelley Tulipanaper portal database 217-321-2620

217-535-3102 x 3767

LHD1690 Schuyler County Health Department Primary HRIF HRIF NMS12430

judymccurdy@casscomm.comJudy McCurdy 217-322-6775

LHD1710 Scott County Health Department Primary HRIF HRIF NMS12431

pjefferson@scottchd.comClinic/CD CoordinatorPhyllis Jefferson 217-742-8203

LHD1730 Shelby County Health Department Primary HRIF HRIF NMS12432

sarah@shelbyhealth.netSarah Vaughn4/11/2016- Asked to be sent routine correspondance on cases.

217-774-9555

brooke@shelbyhealth.netBrooke Verdeyen 217-774-9555

LHD0030 Southern Seven Health Department Primary HRIF HRIF NMS12444

lcrossland@s7hd.orgWIC/FCM Program Linda Crosslandper portal database 618-524-2658 x 112

618-634-2297 Ext. 157

slarry@s7hd.orgHealthWorks Lead Agency Stacy Larry 618-634-2297 x 144

blarry@s7hd.orgHealthWorks CoordinatorBrenda Larry 618-634-9461 x 115

LHD1190 St. Clair County Health Department Primary HRIF HRIF NMS12433

robin.hannon@co.st-clair.il.usDirector of NursingRobin Hannon 618-233-6170

donna.sandman@co.st-clair.il.usDonna Sandman 618-825-4488

karoline.stock@co.st-clair.il.usHRIF CoordinatorKaroline Stock 618-825-4776

carmoleta.youck@co.st-clair.il.usHRIF CoordinatorCarmoleta Youck 618-233-6170 x 4485

Tuesday, December 06, 2016 Page 13 of 15

DRAFT

LHD1770 Stephenson County Health Department Primary HRIF HRIF NMS12451

julia.marynus@aeroinc.netDirector of Public Health Julia Marynus 815-235-8394

LHD1790 Tazewell County Health Department Primary HRIF HRIF NMS12435

ebakota@tchd.netEpidemiologistEric Bakota (309) 925-5511 ext 281

bbeachy@tchd.netHRIF/APORS CoordinatorBeth Beachy 309-925-5511 x 234

lgraber@tchd.netLori Graber 309-925-5511 ext 335

Case ManagerShelley LerchSupervised by Pam

618-783-4436

clitwiller@tchd.netChristina Litwiller 309-925-5511

cpeplow@tchd.netCarrie Peplow309-267-7714 per portal database

309-925-5511 x277

kroberts@tchd.netKeri Roberts 309-925-5511 x 294

lrowell@tchd.netAdministrative AssistantLuann Rowell 309-925-5511 x 248

swilliams@tchd.netHRIF/APORS CoordinatorSarah Williams 309-925-5511 x 295

LHD1850 Wabash County Health Department Primary HRIF HRIF NMS12453

kgrounds@wabashhealth.orgDirector of NursingKendra Grounds 618-263-3873 x240

LHD1870 Warren County Health Department Primary HRIF HRIF NMS12468

scook@warrencohealth.comHRIF CoordinatorSabrina Cook 309-734-1314 x 227

rferrenburg@warrencohealth.comRebecca Ferrenburgper portal database 309-734-1314

309-734-1315

jlink@warrencohealth.comAdministratorJenna Linkper portal databse 309-734-1314

309-732-1314

LHD1890 Washington County Health Department Primary HRIF HRIF NMS12437

wchd189@yahoo.comJoyce Carson 618-327-3644

el_rn_wchd@yahoo.comElizabeth Lehde 618-327-3644

LHD1911 Wayne County Health Department Primary HRIF HRIF NMS12438

sbullard@wchdil.comFamily Case Susan Bullard 618-842-5166 x 105

LHD1950 Whiteside County Health Department Primary HRIF HRIF NMS12439

pvandervinne@whitesidehealth.orgPam VanderVinne 815-626-2230 x 1213

Tuesday, December 06, 2016 Page 14 of 15

DRAFT

LHD1970 Will County Health Department Primary HRIF HRIF NMS12440

dquinlan-bettenhause@willcountyhealth.orgDebra Bettenhausen 815-740-8994

shernandez@willcountyhealth.orgSylvia Hernandez 815-727-8505

Mlara@willcountyhealth.orgMagda Lara 815-727-8779

smorris@willcountyhealth.orgStacey Morris-Jones 815-774-7389

lrosen@willcountyhealth.orgHealthWorks Lead Agency Loy Rosen 815-774-7302

lroxworthy@willcountyhealth.orgLaurie Roxworthy 815-727-8511

LHD2010 Winnebago County Health Department Primary HRIF HRIF NMS12441

cfloyd@wchd.orgFamily Case Management Cheryl Floyd 815-720-4315

lgonzalez@wchd.orgLisa Gonzalez

Disease Intervention Gerrica Sallis 815.720.4049

Tuesday, December 06, 2016 Page 15 of 15

DRAFT

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

DRAFT

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

DRAFT

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

DRAFT

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

DRAFT

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)

DRAFT

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

DRAFT

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 dph.apors@illinois.gov to resolve the problem. If further assistance is needed, contact the DHS’s HRIF Program Coordinator: Todd Doyle at 217-558-4104 or todd.doyle@illinois.gov.

DRAFT

Appendix G

DRAFT

Appendix G

DRAFT