Section 635.10  Legislative Base

The Family Planning Services and Population Research Act of 1970 (Public Law 91-572 (42 USC 300(a)-300(a)(6)(a))) added Title X to the Public Health Service Act.  The Secretary of the Department of Health and Human Services (DHHS) is authorized to make grants to assist in the establishment and operation of voluntary family planning projects.  The administration of this program in Illinois became the responsibility of the Illinois Department of Public Health on July 1, 1983 upon the approval of its application for a statewide Family Planning Program.

Section 635.20  Administration

a)         Planning for all Maternal and Child Health (MCH) programs, including family planning services, is the responsibility of the Illinois Department of Public Health (Department).  The Department will develop a program plan for maternal and child health services each year which will assess current needs within the State and provide goals and objectives for improving the health of mothers and children and for reducing infant mortality.

b)         Highest priority for funding will be given to those areas in Illinois having high concentrations of low-income or marginal-income families and underserved areas.  The Department shall fund delegate agencies which will provide family planning services consistent with the intent of Family Planning legislation.

c)         The Department will arrange for the provision of family planning services through agreements with delegate agencies.  Each delegate shall be required to enter into a written agreement with the Department.

d)         Agencies eligible to apply for funding must be recognized by the Department, i.e. public or private not-for-profit organizations having documented capability of administering and providing qualified family planning services.  Each delegate shall operate according to an approved plan written in accordance with this Part which is consistent with Federal and State Regulations (see Section 635.30).

e)         The Department will annually evaluate the need for family planning services by using inspections, records and reports in order to develop a statewide plan for the effective and efficient provision of family planning services.  Inspections will involve an on-site review of delegate agencies to ensure that implementation of program plans, which are required, are consistent with this Part.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.30  Definitions

"Agreement" means the written contract between the Department and delegate agency prepared by the Department and authorized by both parties.

"Delegate agency" means a public or private not-for-profit entity which provides family planning services under a negotiated written agreement with the Department.

"Family" means a social unit composed of one person, or two or more persons living together, as a household.

"Family planning services" means those medical, social, educational and referral services related to the avoidance, achievement, timing or spacing of pregnancy.

"Federal and State Regulations" governing Family Planning Services means printed regulations found in the following sources:  42 CFR Subpart B, 50.201-50.209; 42 CFR, Subpart C, 50.301-50.310; 45 CFR 16, 74, 80, 84 and 90.

"Low income family" means a family whose total annual income does not exceed 100 percent of the most recent DHHS Income Poverty Guidelines 54 FR 31, February 16, 1989.

"Marginal income family" means a family whose total annual income is above 100% and does not exceed 250% of the most recent DHHS Income Poverty Guidelines.

"Program Income" means gross income earned by a delegate agency and budgeted in the award period for activities described in the project and generated as a result of that delegate agency having received a grant from the Department.  Such income shall include fees for services performed and proceeds from the usage or rental of equipment funded by the grant.  Revenues received from taxes, levies, and fines are not considered program income.  However, the receipt and expenditure of such revenues shall be recorded as part of the grant or subgrant project budget when such revenues are specifically earmarked for the project's Family Planning Program.

"Project Funds" means all sources of money related to the family planning services program and identified in the agency's family planning budget.

"Satisfactory Performance" means having met or exceeded the program objectives of serving a target population of which 85 percent of the unduplicated users are at or below 150 percent of the Federal Poverty Income Guidelines, as set by the state agency in their agreements with delegate agencies and meeting both the clinical and administrative indicators of the Bureau of Community Health Services (BCHS) of Common Reporting Requirements (BCRR).

"Underserved area" means geographic areas (county or Chicago Community Area) where less than 80 percent of the estimated number of women in need of family planning services are being served.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.35  Incorporated Materials

The following materials are incorporated or referenced in this Part:

a)         Federal Statutes and Regulations:

1)         Family Planning Services and Population Research Act of 1970, Public Law 91-572, 42 U.S.C. 300 (a)(6)(a).

2)         Poverty Income Guidelines, 54 FR 31, February 16, 1989.

3)         Title VI, Civil Rights Act of 1964 (42 U.S.C. 2000e et seq).

4)         42 CFR Subpart B, 50.201-50.209; 42 CFR, Subpart C, 50.301-50.310; 45 CFR 16, 74, 80, 84, 90.

5)         Accreditation Manual for Hospitals (1989).  The Joint Commission, 1 Renaissance Blvd., Oakbrook Terrace IL 60181.

b)         State of Illinois Statutes and Regulations:

1)         The Ambulatory Surgical Treatment Center Act [210 ILCS 5].

2)         Section 15a of State Finance Act [30 ILCS 105].

3)         Fiscal Control and Internal Auditing Act [30 ILCS 10].

4)         Administrative Review Law [735 ILCS 5/Art. III].

5)         Minimum Qualifications for Public Health Personnel Employed by Full-Time Local Health Departments (77 Ill. Adm. Code 600).

6)         Ambulatory Surgical Treatment Center Licensing Requirements (77 Ill. Adm. Code 205).

7)         Travel (80 Ill. Adm. Code 2800).

8)         Rules of Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100).

c)         Other Materials

1)         Professional Standards of American Institute of Certified Public Accountants (Volume 1, Section 150, November 1982).  American Institute of Certified Public Accountants, 1211 Avenue of the Americas, New York, New York 10036-8775

2)         Program Guidelines for Project Grants for Family Planning Services published by the U.S. Department of Health and Human Services (U.S. G.P.O. 1981, 0-341-166/6348), U.S. Department of Health and Human Services, Public Health Service, Health Services Administration, Bureau of Community Health Services, Office for Family Planning, 5600 Fishers Lane, Rockville, Maryland 20857.

3)         Department of Health and Human Services Instruction Manual for BCHS Common Reporting Requirements (1982).  U.S. Department of Health and Human Services, Public Health Service, Health Services Administration, Rockville, Maryland 20857.

4)         BCHS Ambulatory Health Care Standards.  U.S. Department of Health and Human Services, Public Health Service, Health Services Administration, Bureau of Community Health Services, Rockville, Maryland 20857.

5)         Accreditation Manual for Hospitals (1989).  The Joint Commission, 1 Renaissance Blvd., Oakbrook Terrace IL 60181.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.40  Standards and Policies for Personnel of Delegate Agencies

a)         The qualifications of persons employed by delegate agencies shall meet as a minimum the Department's rules titled Certified Local Health Department Code (77 Ill. Adm. Code 600). Delegate agencies must have a medical director who is a physician licensed to practice medicine in all its branches with Obstetrics/Gynecology training or experience in the delivery of family planning services.  The medical director shall be responsible for and supervise the medical care component of the program and approve written policies under which physicians, nurse practitioners, certified nurse midwives, nutritionists and physician assistants provide family planning services.  Staff shall possess the appropriate licensure to perform their duties.  Copies of licenses must be on file at the agency.  Any person employed at an individual delegate agency prior to July 6, 1983, may continue to serve at that agency only; even though the person may not meet the qualifications cited above.

b)         Delegate agencies shall have written personnel policies which are in compliance with Title VI, the Civil Rights Act of 1964, (42 U.S.C. 2000e et seq.), available and distributed to all personnel.  These shall include staff recruitment, selection, performance evaluation, promotion, termination, compensation, benefits, organizational chart and grievance procedures.  All agencies shall also ensure:

1)         That personnel records are kept confidential;

2)         That personnel policies shall assure that no persons shall be subjected to discrimination on the grounds of age, handicap, race, color, creed, religion, sex or national origin.  Affirmative action shall be taken to ensure equality of opportunity in all aspects of employment.  Annual comprehensive reviews of operating procedures shall be made to assure that practices continue to be in conformity with the above requirements;

3)         That written job descriptions are available for all positions, and that these are reviewed annually and updated when necessary to reflect changes in duties;

4)         That an evaluation and review of job performance of all project personnel be conducted annually.

c)         That orientation and in-service training of all staff, must be provided. An in-service training policy and plan for skill development and documentation of staff attendance at continuing education activities and other training sessions must be maintained by the delegate agency.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.50  Standards for Facilities of Delegate Agencies

Clinic facilities of delegate agencies shall be located in areas accessible to clients and should be open at times convenient to those seeking service.  Provisions must be made for access by handicapped persons.  All facilities must meet applicable local fire and building codes (as evidenced by documentation of approval of authorities charged with enforcing those codes), must provide adequate space, and must ensure privacy for examination and counseling services and must comply with the BCHS Ambulatory Health Care Standards.  In addition, all hospital based providers must meet The Joint Commission's Ambulatory Care Program standards.  If surgical procedures are to be performed, the facility must be in full compliance with the State's Ambulatory Surgical Treatment Center Licensing Act.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.60  Financial Management Systems and Audits of Delegate Agencies

a)         Budgets – All delegate agencies and potential delegate agencies shall submit a budget proposal for each fiscal year for approval by the Department based on subsection (b) of this Section.  This budget must include all program income related to family planning and provide for all such income to be retained by the delegate agency and used for program purposes. At least ten percent of the budget must come from sources other than the Family Planning Program grant award.

b)         Use of project funds – Funds will be used only for the direct cost of administering, operating and maintaining a project.  The following direct costs are examples of those which may be incurred when specified in the Agreement:

1)         Personal services costs, including salaries and fringe benefits for full-time and part-time employees of the project.

2)         Fees for consultants, specialists and other operating contractual requirements, pursuant to Section 15 of the State Finance Act exclusive of consultant services for patient care.

3)         Travel of personnel, consultants and specialists in carrying out the activities approved for the applicant's program.  Travel costs are the expenses for transportation, lodging, and subsistence for personnel who are on travel status on official business for the organization.  Such costs will be charged on an actual basis, i.e., mileage and per diem when necessary; however, reimbursement shall not exceed the maximum rate established in the Travel Regulations promulgated by the Travel Regulation Council (80 Ill. Adm. Code 3000) effective on the date of travel, unless otherwise agreed upon and specified in the contract drawn between the applicant agency and the Department.

4)         Supplies/commodities (see Section 15b of the State Finance Act), as required in the operation of the project, which are directly related to its operations.

5)         Direct costs of installation, operation and maintenance of equipment previously included in the project application and directly related to the provision of the service(s) funded.  All equipment purchased in total or in part with project funds shall be the property of the Federal Government.  A complete and current inventory of equipment shall be maintained and be available for audit.  No property shall be sold, leased, or otherwise disposed of without prior written authorization from the Department ("equipment" as defined in Section 20 of the State Finance Act).

6)         Purchase of outpatient care.

c)         Program Income

1)         Program income shall be retained by the delegate agency and used to fund project activities.

2)         The delegate agency will charge recipients for services not required in Section 635.90, that are provided by the project, but must apply a schedule of discounts consistent with requirements of Section 635.70(b), and 635.70(c) of this Part and 42 CFR 59.5(a)(8).

d)         Reimbursement Procedures

1)         Delegate agencies with service grants shall receive reimbursement based upon client service information submitted to the Department's agent through an automated clinic visit record system.  The CVR is Appendix A of this Part.

A)        The Department will reimburse the delegate agency at the rates shown for those family planning services listed in Appendix C of this Part.

B)        Service information for July 1st through December 31^st shall be submitted no later than February 5^th of the contract year.  Service information for January 1^st through June 30^th of the contract year shall be submitted no later than August 5^th of the contract year.

C)        Payments shall be made to the delegate agency based upon monthly billings prepared by the Department's agent.

D)        Delegate agencies must identify each expenditure submitted for reimbursement  with a voucher or check number in order to maintain a clearly defined audit trail.  All expenditures relating to the Family Planning funded program must be traceable through the delegate agency's internal record system.  Invoices, bills, purchase orders, etc., must be attached or cross-referenced on the agency vouchers or check stubs and kept on file for three years beyond the end of the grant award period.

E)        Expenditures must be documented by dates of issue of voucher or check, name and address of organization or individual to whom payment was made, and purpose of the expenditure.  For periodic charges such as salaries, fringe benefits, rent, utilities, etc., the time period covered must be documented.

F)         In cases in which references to patients must be made to maintain an audit trail, agencies shall use record numbers or other means of identification rather than patient names.

G)        The delegate agency director or her/his authorized agent must sign the reimbursement request.

2)         Delegate agencies will receive sterilization reimbursement based upon submission and program approval of sterilization consent and request for financial assistance.

e)         Audits – Audits of the delegate agencies will be conducted at least every two years and will be performed in accordance with the following standards such as, but not limited to, Fiscal Control and Internal Auditing Act in accordance with the standards promulgated by the United States General Accounting Office (45 CFR 74, Appendix G & H) and the Professional Standards of the American Institute of Certified Public Accountants  (Volume I, Section 150, November, 1982).  Interim audits of the delegate agencies may be conducted at any time by the Department to ensure fiscal/compliance integrity.  Agencies shall retain, for at least three years after the end of the grant period all financial records of expenditures, third-party reimbursements and other program income, and inventory records of all equipment with a unit cost in excess of $100.00 purchased from project funds.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.70  Charges and Billing Procedures of Delegate Agencies

a)         Cost Analysis - An annual cost analysis of required services shall be completed by each delegate agency utilizing methodology prescribed by the Department in the Guide to Cost Analysis, Developing Cost Based Fees and Sliding Fee Scale is Appendix B of this Part.

b)         Charges - persons with incomes above 250 percent of poverty level are to be charged the full cost for services received, based on the delegate agency's cost analysis.  Low income persons are not to be charged for the services provided.  No one may be denied services due to an inability to pay.  Charges for services provided to minors who request that parents or guardians not be informed must be based only on the resources of the minor.  Each delegate agency shall have written policies regarding the procedure to be used to determine the appropriate fee discount for marginal income families, who will be responsible for determining a client's discount, what information shall be collected to determine discount and how that information will be recorded in the client's record, procedures for updating client information, and who is responsible for notifying the client of charges.

c)         Billing - Bills to clients shall show total charges less allowable discounts.  Every reasonable effort to collect bills must be made; however, client confidentiality must be preserved in any such attempts.  Third parties (including a governmental agency) must be billed in full to the extent they are authorized to or are under legal obligation to pay the charge.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.80  Written Policies, Protocols and Procedures of  Delegate Agencies

a)         The delegate agency must develop written policies, protocols and procedures for family planning services.  Written policies, protocols and procedures under which physicians, nurse practitioners, certified nurse midwives, physician assistants and nutritionists provide family planning  services must be approved by the delegate agency's medical director.

b)         Policies regarding eligibility for services shall not exclude anyone on the basis of duration of residency, age, race, marital status, religion, color, national origin, creed, handicap, sex, number of pregnancies, method of referral, or contraceptive preference.  Services shall be provided only on a voluntary basis.  These documents shall be updated as needed based on current state of the art in family planning and Federal and State Regulations.  Agency protocols will be subject to intensive review at site visits by Department staff to determine their completeness and compliance with this Part.

c)         Written policies, protocols and procedures must include:

1)         Intake procedures for new clients

2)         Patient education

3)         Obtaining written informed consent

4)         Schedule and content of visits

A)        Initial

B)        Annual

C)        Scheduled return visits, specific to type of method of contraception

D)        Problem visits, specific to type of problem

5)         Counseling procedures

6)         Referral procedures

7)         Follow-up procedures for appointments, failed appointments, and referrals

8)         Maintenance of client records

9)         Approved medical orders

10)         Maintenance and distribution of pharmaceuticals

11)         Organizational structure of the unit and functional responsibilities of medical, nursing and ancillary personnel

12)         Medical Procedures

A)        Pap smears and gonorrhea cultures

B)        Intrauterine device (IUD) insertions

C)        Fitting diaphragms/cervical caps

D)        Treatment of sexually transmitted diseases (STD)

E)        Initiating oral contraceptives

F)         Laboratory procedures

G)        Treatment of minor gynecologic problems

H)        Other medical procedures performed

13)         Release of patient records

14)         Emergency procedures

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.90  Required Services

Delegate agencies are required to deliver the following services and components either directly on-site or by referral.  Minimum requirements for routine contraceptive management which shall be met are included in "Program Guidelines for Project Grants for Family Planning Services" published by the U.S. Department of Health and Human Services (42 CFR 59.5). Abortions shall not be provided by delegate agencies as a method of birth control.

a)         Client education

1)         Male and female anatomy and physiology

2)         Conception - the importance of prenatal care, and risks associated with childbearing at the extremes of the reproductive age span; i.e., less than 17 years of age and over 34 years of age

3)         Contraception - including action, effectiveness, use benefits, risks and side effects

A)        Male and female sterilization

B)        Oral contraceptives

C)        IUDs

D)        Contraceptive sponge

E)        Foam, condoms and vaginal contraceptive film

F)         Diaphragm and cream/jelly (cervical cap if available)

G)        Natural family planning (NFP) (ovulation/sympto-thermal)

H)        Withdrawal

I)         Post-coital contraception (i.e., Diethylstilbesterol (DES)

J)         Abstinence

4)         Human immune deficiency virus/AIDS education

b)         Counseling

1)         Method selection

2)         Compliance with treatment

A)        Method used

B)        Return appointments

C)        Follow through with referrals

3)         Special Counseling

A)        Nutrition problems

B)        Sexual/social problems

C)        Pregnancy options

D)        Genetics

E)        Sterilization

c)         Examination

1)         History

A)        Initial history

i)          Menstrual history including age of menarche, when periods became regular, date of last normal menstrual period, abnormal periods or intermenstrual bleeding

ii)         Past medical/surgical history including allergies, sexually transmitted diseases (STD), immunizations (especially rubella status), medications, review of systems

iii)        Pertinent history of biological parents and immediate family including heart disease, strokes before age 50, high blood cholesterol or fats, kidney disease, diabetes, high blood pressure, cancer, genetic problems

iv)        Reproductive history, number of pregnancies, outcome, complications and weight of infant at birth

v)         Social history including sexual activity, age at first intercourse, frequency of intercourse, number of partners, and drug/tobacco use/abuse

vi)        Contraceptive history, including methods used, length of use, major side effects and complications

vii)       In utero exposure to diethylstilbestrol (DES)

B)        Interim history

i)          Interim medical/surgical history

ii)         Assessment of any side effects of contraceptive, specific to method used

iii)        Menstrual history

2)         Physical Exam

A)        Initial exam and annual exam

i)          Height and weight

ii)         Blood Pressure

iii)        Thyroid

iv)        Heart

v)         Lungs

vi)        Abdomen

vii)       Extremities

viii)      Breast with instruction in self-breast exam

ix)        Pelvic exam, including external genitalia; speculum exam including vagina, visualization of cervix; bi-manual exam, including uterus, adnexa; and rectal exam as needed

B)        Special return visits

i)          Intrauterine device (IUD) - abdominal palpation, bi-manual exam and speculum exam for visualization of IUD string (two to six weeks after insertion)

ii)         Pill (for women at high risk) - Blood pressure with interim history after initial three months of use, after second three months of use, again after six months of use (3-3-7) and then every six months thereafter alternating with annual exams (6-7), for women at high risk because of factors including, but not limited to, age, weight, blood pressure, liver disease, and/or personal habits

iii)        Pill (for women not at high risk) - Blood pressure with interim history after initial three months of use then annual history and examination (including weight, blood pressure, and hematocrit and/or hemoglobin)

iv)        Diaphragm/cervical cap - recheck fit (approximately two weeks after initial fitting)

v)         Problem visit - review of related system(s), appropriate laboratory tests

vi)        Norplant - incision check (approximately two weeks after insertion)

vii)       Gonorrhea culture as indicated (previous history of Pelvic Inflammatory Disease (PID), previous history of Gonorrhea Culturing (GC), potential exposure, symptoms, multiple partners)

3)         Laboratory tests

A)        Initial visit

i)          Hemoglobin or hematocrit

ii)         Pap smear

iii)        Gonorrhea culture for clients requesting IUD insertion, for those with high potential or exposure, or on request

iv)        Urinalysis for protein and glucose

B)        Annual visits

i)          Hemoglobin or hematocrit

ii)         Pap smear

iii)        Gonorrhea culture for clients with previous history of pelvic inflammatory disease (PID), previous history of gonorrhea, multiple partners, new partner(s), on client request and clients requesting IUD insertion

C)        Special tests as indicated

i)          Pregnancy test

ii)         Wet smear

iii)        Urine culture and sensitivities

iv)        Blood sugars

v)         T(3), T(4), TSH (thyroid hormones)

vi)        White blood count (WBC) and differential

vii)       Rubella titer if not known

viii)      Sickle cell screen if indicated and not known

ix)        Herpes titer/culture

x)         Blood group and Rh type

xi)        VDRL/RPR/serology (test for syphilis)

xii)       Liver studies

xiii)      Chlamydia test

d)         Infertility services

1)         Initial infertility history

2)         Education

3)         Physical exam (same as initial visit)

4)         Laboratory tests (same as initial visit)

5)         Counseling

6)         Referral as indicated

e)         Pregnancy Services

1)         Pregnancy testing

2)         History and physical exam for confirmation

3)         Nondirective counseling on all options if test is positive, and referral as requested

4)         Family planning information if test is negative

f)         Adolescent Services

1)         Counseling in all methods

2)         History and physical exam as indicated including laboratory tests

3)         Parental involvement via agency plan for family participation and as required by applicable federal and State Regulations and administrative rules promulgated pursuant thereto

g)         STD Services

1)         Laboratory screenings

2)         Reporting of positive cases to the State STD Program or its designated agent as required by state or local ordinance

3)         Education, counseling, treatment and follow-up of infected individuals

4)         Follow-up of contacts for testing/treatment

h)         Identification and follow-up of Diethylstilbestrol (DES) exposed clients

1)         DES history for clients born between 1940 and 1970

2)         Counseling of exposed individuals regarding potential risks/problems

3)         Colposcopy or referral for exposed females

(Source:  Amended at 18 Ill. Reg. 5969, effective April 1, 1994)

Section 635.100  Referrals and Follow-Up

a)         All required family planning services, and all methods of birth control must be provided either directly by the delegate agency or through referrals.  When required family planning services are to be provided by referral, written letters of agreement must be maintained at the delegate agency detailing the services to be provided by each party.

b)         A directory of agencies with which the delegate agency has referral agreements shall be maintained and available to all delegate agency staff responsible for patient services.  This directory shall include the agency name, address, phone number an hours of operation, contact person at the agency, services available, eligibility requirements, and fees for services, if any.

c)         Client records should be provided to the referral agency, to facilitate service provision.  When requested by the referral agency, these records shall be released only after obtaining written consent of the client.  All follow-up activities must respect the confidentiality of the client.  A specific method for contacting the client shall be established at the time of entry into services.

Section 635.110  Quality Assurance

A system of quality assurance shall be established by each delegate agency.  The quality assurance system, at a minimum, will include a monthly chart review to evaluate the completeness of records and compliance of services with approved medical standards and protocols, annual staff evaluation to ensure quality of services, utilization of community needs assessment to ensure targeting of services, log book for documentation and follow-up of referrals, documentation and follow-up for patients with abnormal findings, a methodology to provide follow-up for patients with failed appointments.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.120  Clinic Schedule

A clinic schedule must be developed by each delegate agency which will assure that services are provided on the days and at the times when clients can make maximum use of services consistent with efficient clinic management.

Section 635.130  Clinic Management

a)         Equipment and supplies used in the facility must be safe and adequate in number for the clinic size.  Supplies such as syringes, needles and pharmaceuticals must be kept in a secure place with access limited to appropriate agency staff per agency protocol.  An inventory shall be maintained of all supplies.

b)         Prescriptions must be filed and filled, or medication supplied under the order of the delegate agency's medical director.  Emergency drugs for resuscitation must be on hand and readily available to the examination rooms for use if needed.  If rubella vaccines are not provided by the agency, information concerning treatment for the client must be provided.

c)         Medical records must be maintained in a systematic, complete, and confidential fashion.  These records shall include at a minimum personal data including mechanism for client contact, history, physical exam, lab test, referral with notations regarding follow-up, problem lists, counseling session notations, telephone contacts between client and agency, and educational checklist.  All entries in progress notes, physical exams and histories must be signed by the clinician performing the service. Signed informed consent forms must be on file for all  treatments and procedures performed.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.140  Community Education, Information and Education Advisiory Committee

a)         Delegate agencies are required to plan and implement a community education program which shall be supportive to the acceptance and use of family planning services.

b)         Plans shall include:

1)         A listing of local entities which serve persons of reproductive age such as clinics, mental health facilities, health departments, churches, hospitals, schools, youth organizations, and other volunteer and community organizations;

2)         A curriculum and schedule of contact of in-service training for the staff of the above agencies to provide information on the purpose of family planning, to assist with client counseling, and to develop referral linkages;

3)         Provisions for information campaigns to inform the potential user groups of the availability and accessibility of family planning services; and

4)         Provision for a community education program to provide information on the benefits of family planning services as well as to provide encouragement to parents to be actively involved in the reproductive health education of their children.

c)         Each delegate agency shall have an Information and Education Advisory Committee composed of individuals representative of the community served and knowledgeable about  family planning services.  The Committee shall have at least five and no more than nine members.  The function of the Committee is to review and approve all materials prepared for Family Planning program clients or community information or education.  The Committee will be responsible for assuring the accuracy of facts presented and the suitability of the material for the intended audience.  Copies of minutes of Committee meetings must be kept on file at the delegate agency and submitted annually to the Department.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.150  Family Participation Plan

a)         Each delegate agency must prepare and implement a plan and procedures to encourage families to participate in the education, counseling, and contraceptive activities of their  children who are agency clients.

b)         Examples of activities which plans may include are:

1)         Special education sessions for parents;

2)         Workshops for parents on sexuality education of their children;

3)         Encouraging minors to bring their parents with them on clinic visits; and

4)         Special counseling procedures for adolescents requesting services concerning parental involvement.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.160  Applications

a)         Distribution of Applications

1)         All application materials will be developed and distributed by the Department to existing agencies or new projects in underserved areas based on need in the service area, experience in provision of services and plans to accomplish goals.  These are included as Appendix C of this Part.

2)         Distribution of application materials will occur on or before March 15th of the prior grant year.

b)         Processing of Applications

1)         All forms will be provided by the Department.  These are included as Appendix C of this Part.

2)         Application forms shall be submitted to the Department no later than thirty calendar days from the date of distribution.

3)         The Department shall review the applications and request any additional information from the applicant as necessary, to complete or clarify the application.

4)         Upon review of the application and recommendations from staff, the Director shall award grant funds to the approved applicants.  The Department may award funds for amounts less than requested in the grant application contingent upon the number of applications, Federal funding levels, and State appropriations.

5)         The Department will communicate final decisions to each applicant within 45 days of receipt of the completed application or upon notification of appropriation of funds.

c)         Budget

1)         As part of the project application, all applicants shall submit a budget proposal for the project period.  The budget proposal shall be submitted on forms provided by the Department and shall include all information required in the instructions for their completion.

2)         The budget shall be divided into major categories of cost.  Not all categories will apply to all projects.  In preparing its budget, each project should use only those categories applicable to its own operation, including justification for all equipment purchases.

d)         Revisions

1)         All changes in any delegate agency's project plan and/or budget reflecting increases or decreases in the IDPH grant award, must be submitted in writing and must be determined by the Department to be in compliance with this Part, prior to the implementation of such change.

2)         Each proposal for change shall include, at a minimum, a description of the proposed change and a justification stating why such change is necessary.  Budget revisions shall specify the number of dollars involved, the type of changes proposed, and the reasons thereof.

3)         Revisions may be required by the Department pertaining to a project's funding, duration and amount contingent upon changes in Federal and/or State funding allocations to the Department.  Delegate agencies will be notified in writing of any required revisions.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.170  Reporting Requirements

All reports will be submitted on forms provided by the Department excluding the Information and Education Advisory Committee minutes. Delegate agencies are required to submit the following in accordance with the Family Planning Program annual calendar:

a)         A Clinic Visit Record (CVR) form provided by the Department for each client visit to the contracting computer firm.  The visit form is the input document for the computer-based information system.

b)         Applicable portions of the Bureau of Community Health Services Common Reporting Requirements (BCRR) of the Department of Health and Human Services (DHHS) to the Department (Title X of the Public Health Service Act, 42 U.S.C. 1009, (a), (b), and (c)).  Each report shall be submitted in accordance with the DHHS Instruction Manual for the BCHS Common Reporting Requirements included as Appendix D of this Part.  Late submission of this report will result in a decrease of 5% in the following year's award.

c)         Semiannual and annual performance reports to the Department addressing the following points:

1)         Comparison of the objectives in the approved project plan with the actual achievements of the project.

2)         Changes in the project; e.g., in facilities or equipment, services and activities, population served, etc.

3)         Unresolved problems, e.g., with fiscal resources, external relationships, met and unmet grant conditions and issues which need to be addressed in the future.

d)         All minutes of the local Information and Education Advisory Committee activity to the Department.

e)         Annual inventory report identifying equipment purchased with project funds during the award period.

f)         Semiannual and annual financial status report including all funds utilized for the Family Planning Program to the Department.

g)         Quarterly reports to the Department addressing:

1)         Community education activity;

2)         Sterilization service activity if no annual sterilization waiver letter was provided; and

3)         Sexually transmitted diseases (STD) testing activity.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.180  Termination

a)         All grants shall terminate on the dates specified in the contracts and shall not be extended or renewed except as provided for in this Part.

b)         A delegate agency with unsatisfactory performance for two consecutive years may have funding terminated.

c)         The grant contract may be terminated by either party upon a 30 day written notice.  The Department will distribute unallocated monies to expand existing projects or to fund new projects in underserved areas based on need such as number of low income women in the service area not receiving services in the service area, experience in provision of services, including the availability of an agency willing to provide the services, and plans to accomplish goals.

d)         Notice shall be effected by registered mail, by certified mail, or by personal service setting forth the particular reasons for the proposed action and fixing a date, not less than 15 days from the date of such mailing or service, at which time the delegate agency shall be given an opportunity for a hearing.  Such hearing shall be conducted by the Director or by a person designated in writing by the Director as Hearing Officer to conduct the hearing.  On the basis of any such hearing, or upon default of the delegate agency, the Director shall make a determination specifying his findings and conclusions.  A copy of such determination shall be sent by registered mail, by certified mail, or served personally upon the delegate agency.  The decision shall become final 35 days after it is so mailed or served, unless the grantee, within such 35 day period, petitions for review pursuant to Section 635.190.

e)         The Director, after notice and opportunity for hearing to the delegate agency, may suspend or terminate the grant in any case in which there is or has been a violation of this Part.

f)         The procedure governing hearings authorized by this Part shall be in accordance with Rules of Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100).

g)         If, however, the Department finds that:

1)         The public interest, including financial interest, health, safety, or welfare requires emergency action; (emergency action would result from such instances as, but not limited to bankruptcy or insolvency, fraud, and financial instability) and;

2)         Unless the Department receives assurances adequate to the Department from the delegate agency that grant funds held by the delegate agency are secure, and;

3)         If the Director incorporates a finding to that effect in the order; then

4)         Summary suspension of the grant shall be ordered pending proceedings for termination or referral to State orFederal authorities, which proceedings shall be instituted within one week of summary suspension and promptly determined.

h)         In no case where summary suspension has been ordered shall reimbursement be made to the delegate agency for costs incurred or funds expended after the date of summary suspension unless, after conclusion of the proceedings, such reimbursement or payment is ordered by the hearing officer, administrative law judge or court of competent jurisdiction.

(Source:  Amended at 14 Ill. Reg. 20783, effective January 1, 1991)

Section 635.190  Review Under Administrative Review Law

Whenever the Department suspends or terminates a grant the grantee may have such decision judicially reviewed.  The provisions of the Administrative Review Law and the rules adopted pursuant thereto shall apply to and govern all proceedings for the judicial review of final administrative decisions of the Department hereunder.

(Source:  Added at 14 Ill. Reg. 20783, effective January 1, 1991)