AUTHORITY: Implementing and authorized by the Problem Pregnancy Health Services and Care Act [410 ILCS 230].

SOURCE: Emergency rules adopted at 4 Ill. Reg. 7, p. 156, effective February 6, 1980, for a maximum of 150 days; adopted at 4 Ill. Reg. 26, p. 182, effective June 19, 1980; peremptory amendment at 8 Ill. Reg. 2704, effective February 21, 1984; codified at 8 Ill. Reg. 17503; amended at 8 Ill. Reg. 24761, effective December 14, 1984; amended at 8 Ill. Reg. 25121, effective December 15, 1984; transferred from the Department of Public Health to the Department of Human Services pursuant to P.A. 89-507 on July 1, 1997 and recodified at 21 Ill. Reg. 9323; transferred from the Department of Human Services to the Department of Public Health pursuant to P.A. 99-901 on August 26, 2016 and recodified at 42 Ill. Reg. 12356.


Section 655.10  General Considerations


a)         For some, pregnancy can present social, emotional, financial and/or health problems. A wide array of services which can assist women who have problem pregnancies is not available in all communities, and in communities where such services are available, they often are fragmented. State policy therefore encourages the development of appropriate health, education, and social services where they are now lacking or inadequate, and the better coordination of existing services where they are available, in order to assist women with problem pregnancies and to help them to become productive independent contributors to family and community life.


b)         Authorization

The Department of Public Health will allocate funds for Problem Pregnancy Health Services and Care Projects under authority of the Problem Pregnancy Health Services and Care Act [410 ILCS 230].


c)         Purpose

The purpose of these projects if to assist women with problem pregnancies in obtaining appropriate services, through provision of those services directly, or by referral; to expand the availability of services for women with problem pregnancies in communities which need them; and to promote innovative, comprehensive and integrated approaches to the delivery of such services.


d)         Eligibility

Public and private nonprofit agencies and organizations are eligible for project grants if they do not use such grants to refer or counsel for, or perform abortions; and which coordinate and establish linkages among services, that will further the purposes of this act and, where appropriate, will provide, supplement, or improve the quality of such services.


(Source:  Amended at 8 Ill. Reg. 25121, effective December 15, 1984)


Section 655.20  Policies


a)         Content of Projects


1)         Projects shall be directed toward the provision and coordination of services which assist women with problem pregnancies or women at risk of initial or repeat problem pregnancies in accordance with accepted maternal and child health principles.  Such services include:


A)        Prenatal and Post-Partum Health Care


B)        Nutrition Services


C)        Social services, including counseling, financial assistance, legal aid, day care, homemaker services and housing


D)        Employment Counseling and Vocational Services


E)        Education concerning Sexuality and Parenting, both individually and community-wide


F)         Mental Health Services


G)        Special Services to enable pregnant adolescents to remain in school or to continue their education


H)        Residential Care for pregnant adolescents


I)         Outreach and Follow-up to assure that those in need of these services are receiving appropriate assistance.


2)         Projects may also provide:


A)        Technical assistance to enable other communities to develop problem pregnancy prevention programs and problem pregnancy-related services and


B)        Training (but not including institutional training or training assistance provided by consultants) to providers of services, including skills and multidisciplinary approaches to problem pregnancy-related services and in the provision of such services.


b)         Priority Areas

In approving applications for grants for problem pregnancy health services and care projects, priority will be given to applicants who:


1)         Serve an area where there is a high incidence of adolescent and problem pregnancy;


2)         Show evidence of having the ability to bring together a wide range of needed services in comprehensive single site projects or to establish a well integrated network of services in a community including outreach to, and services for, problem pregnancies;


3)         Will use as a base, existing programs and facilities such as neighborhood and primary health care centers, children and youth centers, maternity and infant care centers, designated Regional Perinatal Care facilities, School Education Programs, Mental Health Programs, Nutrition Programs, Recreation Programs, and other ongoing problem pregnancy-related services;


4)         Make use, to the maximum extent feasible, or other federal, state and local funds, programs, contributions, and other third party reimbursements;


5)         Can demonstrate a community commitment to the program by making available to the project nonfederal funds, personnel, and facilities; and


6)         Have involved the community to be served, including public and private agencies, in the planning and implementation of the project.


c)         Population to be Served


1)         Those eligible to receive services through these project funds include women who are pregnant, women who have delivered in the past year, and/or women who are at risk of becoming pregnant, and for whom the pregnancy or parenthood represents or would represent a social, emotional, financial or health problem.  Priority shall be given to adolescents 17 years old and younger.  Adolescent fathers, families of pregnant adolescents, and families of adolescent parents, are eligible to receive counseling services through these projects.


2)         No income eligibility requirements shall be made but grantees shall ensure that priority is given to those persons who are not able to obtain assistance through other means.


d)         Funding

Projects will be funded for up to one year on the basis of the State fiscal year (July 1 - June 30).  Reapplications for continued funding will receive priority consideration in succeeding years based on appropriation of funds by the General Assembly and performance showing progress toward stated goals.


e)         Matching Requirements

A grant may cover not to exceed 70% of the cost of the project in the first and second years.  For purposes of these matching requirements, a funding period of 6 months or more shall constitute the first year of a project.  Projects initially funded for less than 6 months shall provide a minimum of 30% of total project costs in the initial funding period, as well as in the full first and second years of the project.  In the third and each succeeding year, the amount of the state grant shall decrease by at least 10% of the amount of the state grant under this act in the preceding year.


Section 655.30  Standards


a)         Comprehensiveness

Provisions shall be made for the development of a care plan for each client that assures effective interdisciplinary provision of comprehensive services.  Comprehensive means completeness to ensure that all needed services are available, and continuity to ensure that services are received in an orderly fashion.


b)         Standards for Personnel


1)         Applicants shall give assurance that services will be provided by qualified personnel.  Any personnel required under State or local law to be licensed, certified, or registered shall be appropriately licensed, certified, or registered.


2)         Recommended minimum personnel qualifications are as follows:


A)        Physicians − certification by specialty board (obstetrics and gynecology, neonatology pediatrics) or in practice to complete requirements for examination for boards (board eligible).


B)        Nurses − Certification of graduation from an approved school of nursing and a Bachelor of Science degree in Nursing, with experience, preferably in obstetrics or maternity nursing or in pediatric nursing.


C)        Social Workers − Master's degree from an accredited school of social work with previous experience in a health agency.


D)        Nutritionists − A Bachelor's degree from an accredited 4 year college or university with a major in foods and nutrition, experience as a nutritionist or dietician, and completion of a hospital dietetic internship, or training and experience which meets the requirements for membership in the American Dietetic Association.


E)        Health Educators − Bachelor's degree with courses in health education and areas of concentration in the behavioral and biological sciences and experience in community health education.


F)         Counselors − Bachelor's degree from an accredited college or university in social work, psychology, or closely related behavioral science discipline, and counseling experience in related area.


3)         Each project shall have a full time project director.  However, the Department may approve the appointment of a project director who is employed less than full time where the Department finds that such an appointment is consistent with the purposes of the program.


c)         Standards for Facilities


1)         Hospitals to which project clients are referred shall meet the requirements as published in the following documents:


A)        Illinois Hospital Licensing Act [210 ILCS 85] and 77 Ill. Adm. Code 250.


B)        Hospital Licensing Requirements, Part XV, as promulgated by the Illinois Department of Public Health.


2)         Projects shall ensure that space is adequate to provide separate interviewing areas which maintain privacy and preserve confidentiality.


d)         Standards for Care


1)         Projects should meet standards published in the following documents:


A)        Standards for Obstetric-Gynecologic Services, American College of Obstetricians and Gynecologists, One E. Wacker Dr., Chicago, IL 60601, and


B)        Ambulatory Maternal Health Care and Family Planning Services, Policies, Principles, Practices, American Public Health Association, available from March of Dimes Foundation, 600 Maryland Avenue, S.W. Washington D.C. 20024.


2)         Physicians and hospitals providing medical services to project clients shall use authorized Perinatal Centers for necessary hospitalization of high risk maternity and newborn patients.


3)         Projects shall use, when necessary, specialty services developed or recognized by the Division of Specialized Care for Children.


Section 655.40  Use of Project Funds



1)         When approved in the plan and budget, funds may be used for the direct costs of operating and maintaining the project.


2)         The following direct costs may be incurred:


A)        Salaries, including fringe benefits, for full or part-time professional personnel such as physicians, nurses, social workers, counselors, nutritionists, dieticians, physical therapists, technicians, health educators, and nonprofessional personnel such as secretaries, typists, and clerks.  The rate for personal services shall not be more than that paid by the grantee to other comparable employees in comparable positions, or if the grantee has no comparable positions, the rate shall not be more than that paid for such services elsewhere in the community. The fringe benefit rate shall not exceed that paid to other employees of the agency.


B)        Travel of personnel in carrying out the activities approved in the plan.


3)         Transportation of patients.  Only payment of the usual rates for the mode of travel that is consistent with the needs of patients shall be included.


4)         Supplies, except for oral contraceptives or other birth control devices.


5)         Rental of facilities where adequate space cannot be provided by the grantee agency.  Rental charges shall not exceed the lowest rate for comparable space in the community.


6)         Purchase of care, including hospital in-patient and out-patient, and other services from community facilities such as homemaker and visiting nurses.  All other available sources of reimbursement shall be exhausted first.


7)         Other expenditures directly related to the operation of the project such as telephone service, mimeographing, postage, advertising, and other like items.


b)         Project funds shall not be used to pay the following:


1)         Purchase, construction, or renovation of buildings.


2)         Depreciation of existing buildings or equipment.


3)         Dues to societies, organizations or federations.


4)         Entertainment costs.


5)         General agency overhead.


6)         Purchase of equipment.


7)         Cost of dispensing oral contraceptives or other birth control devices.  (This does not exclude from eligibility agencies which provide family planning services with support from other sources.  Project funds may be used for provision of counseling or education services regarding birth control.)


8)         Any other costs not approved in the plan and budget.


c)         In no case may a grantee use in excess of 50% of its grant under this act in any year to cover the cost of any single service category. Categories of service are those listed under II.A. Technical assistance and training each constitute a service category.


Section 655.50  Application Content and Process


a)         Applications for grants under this authority shall be made in the format specified in the "Application and Plan for Health Services Grant" (Form EBA 1, available from the Department of Public Health, 535 West Jefferson, Springfield, Illinois 62706).


b)         Applications shall include a program narrative which incorporates:


1)         An identification of the incidence of problem pregnancy and related problems in the area to be served by the project;


2)         A description of the economic conditions and income level in the geographic area to be served;


3)         A description of existing problem pregnancy-related services including where, how, by whom and to whom they are provided and the extent to which they are coordinated in the geographic area to be served;


4)         A description of major unmet needs for services for those persons at risk of initial or repeat problem pregnancies, the number of persons currently served in the area and the number of persons not being served in the area;


5)         A description of the core services to be included in the project or provided by the grantee, to whom they will be provided, how they will be linked, and their source of funding, to include some, but not necessarily all, of the following:


A)        Health and Mental Health Counseling


B)        Vocational Counseling


C)        Education services which supplement regular school programs to help prevent adolescent pregnancy and to assist pregnant adolescents and adolescent parents to remain in school or to continue their education


D)        Primary and Preventive Health Services including Pre- and Post-Natal Care


E)        Nutrition Services and Nutrition Information and Counseling


F)         social services;


6)         A description of how those persons needing services other than those provided directly by the grantee will be identified and how access and appropriate referral to those services will be provided;


7)         A description of the fee schedule, if any, to be used for any services provided directly by the grantee and the method by which it was derived;


8)         A description of all the services and activities to be linked, the results expected from the provision of such services and activities, and a description of the procedures to be used for evaluating those results;


9)         A description of the administrative structure of the agency or organization and its staff, including curriculum vitae of professional staff (including volunteer staff) of the agency who will be providing project services;


10)         Policies and procedures manual of agency; and


11)         Written agreements with service providers and agencies with which the project will be linked.


c)         A detailed budget shall be submitted on the forms described above and shall include all information and signatures required in the instructions for their completion.


d)         Applications for continuation of funding in subsequent years shall include a detailed budget, a performance report, and a plan of activities for the new project year.  Continuation applications shall be submitted to the Department no later than April 1 of each year.


Section 655.60  General Requirements


a)         Grantees may charge fees for services paid with funds under this authority, but only pursuant to an approved fee schedule which bases fees charged by the grantee on the family size and the income of the service recipients, and an assurance that the agency takes into account the difficulties some persons face in obtaining resources to pay for services.


b)         The grantee shall implement the program within three months of the date when authorization to proceed is given.  Funds for programs not implemented within three months shall revert to unawarded status unless a special extension is approved.  A special extension shall be approved if a grantee has made reasonable efforts to implement the project but it is unable to do so within three months due to circumstances beyond its control.


c)         The grantee agency shall allow periodic onsite review of its program and records by the staff of the Department of Public Health or their authorized representatives.


d)         The grantee agency shall submit quarterly and annually fiscal, statistical, and narrative reports to the Department of Public Health within 15 days at the end of each quarter.


e)         Fees collected for services provided by the project shall be used to further the purposes of the project and shall not be used for match. Matching funds must not have been used for matching in any other grant. In-kind contributions may be used for match.


f)         Authorization for services for which payments are made from project funds shall be maintained by the grantee.  A form for each patient shall show the services authorized and the amounts expended for the specific types of services approved.  The method proposed for authorizing services allowable under project policies should be outlined in the project plan.


g)         Payment for inpatient services shall be based on the lesser of reasonable cost of services or the customary charges to the general public for such services.


h)         Grantees shall not amend the plan or budget without prior approval of the Department.  The Department shall approve amendments to a project plan or budget if such amendments are consistent with the purposes and rules of the program and are reasonably justified.


i)          The applicant shall maintain adequate records to show disposition of all funds expended for activities for which the grant was made.  All records shall be retained for five years after the close of the fiscal year in which the grant was made and shall be made available for audit purposes upon request of the Department.


j)          Failure by the grantee to comply with these requirements shall be cause for discontinuance of funds or termination of the grant.