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92nd General Assembly

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Public Act 92-0307

SB461 Enrolled                                 LRB9207772DJmb

    AN ACT in relation to children.

    Be it enacted by the People of  the  State  of  Illinois,
represented in the General Assembly:

    Section 5.  The Early Intervention Services System Act is
amended  by  changing  Sections  3,  4, 5, 11, 13, and 15 and
adding Sections 13.5,  13.10,  13.15,  13.20,  13.25,  13.30,
13.32, and 13.50 as follows:

    (325 ILCS 20/3) (from Ch. 23, par. 4153)
    Sec. 3.  Definitions.  As used in this Act:
    (a)  "Eligible  infants  and  toddlers" means infants and
toddlers under 36 months of age with  any  of  the  following
conditions:
         (1)  Developmental   delays   as   defined   by  the
    Department by rule.
         (2)  A physical or mental condition which  typically
    results in developmental delay.
         (3)  Being    at    risk   of   having   substantial
    developmental delays based on informed clinical judgment.
         (4)  Either (A) having entered the program under any
    of the circumstances listed in paragraphs (1) through (3)
    of this subsection but  no  longer  meeting  the  current
    eligibility   criteria   under   those   paragraphs,  and
    continuing to have  any  measurable  delay,  or  (B)  not
    having  attained  a  level  of  development in each area,
    including (i) cognitive, (ii) physical (including  vision
    and  hearing), (iii) language, speech, and communication,
    (iv) psycho-social, or (v) self-help skills, that  is  at
    least  at  the  mean of the child's age equivalent peers;
    and, in addition to either item  (A)  or  item  (B),  (C)
    having   been   determined   by   the   multidisciplinary
    individualized  family  service  plan team to require the
    continuation of early intervention services in  order  to
    support  continuing  developmental  progress, pursuant to
    the  child's  needs  and  provided  in   an   appropriate
    developmental manner.  The type, frequency, and intensity
    of  services shall differ from the initial individualized
    family services plan because of the child's developmental
    progress, and may consist of only  service  coordination,
    evaluation, and assessments.
    (b)  "Developmental  delay"  means a delay in one or more
of the following areas of childhood development  as  measured
by    appropriate   diagnostic   instruments   and   standard
procedures:  cognitive;  physical,   including   vision   and
hearing;  language,  speech and communication; psycho-social;
or self-help skills.
    (c)  "Physical  or  mental  condition   which   typically
results in developmental delay" means:
         (1)  a   diagnosed   medical   disorder   bearing  a
    relatively  well  known  expectancy   for   developmental
    outcomes   within   varying   ranges   of   developmental
    disabilities; or
         (2)  a  history  of prenatal, perinatal, neonatal or
    early  developmental  events  suggestive  of   biological
    insults  to  the  developing  central  nervous system and
    which  either  singly  or   collectively   increase   the
    probability  of developing a disability or delay based on
    a medical history.
    (d)  "Informed clinical  judgment"  means  both  clinical
observations   and   parental   participation   to  determine
eligibility by a consensus of a multidisciplinary team  of  2
or  more  members  based on their professional experience and
expertise.
    (e)  "Early intervention services" means services which:
         (1)  are designed to meet the developmental needs of
    each child eligible under this Act and the needs  of  his
    or her family;
         (2)  are  selected in collaboration with the child's
    family;
         (3)  are provided under public supervision;
         (4)  are provided at no cost except where a schedule
    of sliding scale fees or  other  system  of  payments  by
    families  has  been  adopted in accordance with State and
    federal law;
         (5)  are designed to meet an infant's  or  toddler's
    developmental needs in any of the following areas:
              (A)  physical development, including vision and
         hearing,
              (B)  cognitive development,
              (C)  communication development,
              (D)  social or emotional development, or
              (E)  adaptive development;
         (6)  meet  the standards of the State, including the
    requirements of this Act;
         (7)  include one or more of the following:
              (A)  family training,
              (B)  social    work     services,     including
         counseling, and home visits,
              (C)  special instruction,
              (D)  speech, language pathology and audiology,
              (E)  occupational therapy,
              (F)  physical therapy,
              (G)  psychological services,
              (H)  service coordination services,
              (I)  medical  services  only  for diagnostic or
         evaluation purposes,
              (J)  early   identification,   screening,   and
         assessment services,
              (K)  health  services  specified  by  the  lead
         agency as necessary to enable the infant or  toddler
         to   benefit   from  the  other  early  intervention
         services,
              (L)  vision services,
              (M)  transportation, and
              (N)  assistive technology devices and services;
         (8)  are provided by qualified personnel,  including
    but not limited to:
              (A)  child  development  specialists or special
         educators,
              (B)  speech  and  language   pathologists   and
         audiologists,
              (C)  occupational therapists,
              (D)  physical therapists,
              (E)  social workers,
              (F)  nurses,
              (G)  nutritionists,
              (H)  optometrists,
              (I)  psychologists, and
              (J)  physicians;
         (9)  are    provided    in    conformity   with   an
    Individualized Family Service Plan;
         (10)  are provided throughout the year; and
         (11)  are   provided   in   natural    environments,
    including  the  home  and  community  settings  in  which
    infants   and   toddlers   without   disabilities   would
    participate    to    the   extent   determined   by   the
    multidisciplinary Individualized Family Service Plan.
    (f)  "Individualized Family Service Plan" or "Plan" means
a written plan for providing early intervention services to a
child eligible under this Act and the child's family, as  set
forth in Section 11.
    (g)  "Local  interagency  agreement"  means  an agreement
entered into  by  local  community  and  State  and  regional
agencies receiving early intervention funds directly from the
State   and   made   in  accordance  with  State  interagency
agreements providing for the delivery of  early  intervention
services within a local community area.
    (h)  "Council"  means the Illinois Interagency Council on
Early Intervention established under Section 4.
    (i)  "Lead agency" means the State agency responsible for
administering this Act and receiving  and  disbursing  public
funds  received  in accordance with State and federal law and
rules.
    (i-5)  "Central billing office" means the central billing
office created by the lead agency under Section 13.
    (j)  "Child  find"  means  a  service  which   identifies
eligible infants and toddlers.
    (k)  "Regional  intake  entity"  means  the lead agency's
designated entity responsible for implementation of the Early
Intervention Services System within its designated geographic
area.
    (l)  "Early intervention provider"  means  an  individual
who  is  qualified, as defined by the lead agency, to provide
one or more types of early intervention services, and who has
enrolled as a provider in the early intervention program.
    (m)  "Fully  credentialed  early  intervention  provider"
means an individual who has met the standards  in  the  State
applicable to the relevant profession, and has met such other
qualifications as the lead agency has determined are suitable
for   personnel   providing   early   intervention  services,
including pediatric  experience,  education,  and  continuing
education.    The   lead   agency   shall   establish   these
qualifications by rule filed no later than 180 days after the
effective  date  of  this  amendatory Act of the 92nd General
Assembly.
(Source: P.A. 90-158, eff. 1-1-98; 91-538, eff. 8-13-99.)

    (325 ILCS 20/4) (from Ch. 23, par. 4154)
    Sec.   4.   Illinois   Interagency   Council   on   Early
Intervention.
    (a)  There  is  established  the   Illinois   Interagency
Council  on Early Intervention. The Council shall be composed
of at least 15 but not more than 25 members.  The members  of
the  Council  and  the  designated chairperson of the Council
shall be  appointed  by  the  Governor.  The  Council  member
representing  the lead agency may not serve as chairperson of
the Council.  The Council shall be composed of the  following
members:
         (1)  The  Secretary of Human Services (or his or her
    designee)  and  2  additional  representatives   of   the
    Department of Human Services designated by the Secretary,
    plus  the Directors (or their designees) of the following
    State agencies involved in the provision  of  or  payment
    for  early  intervention services to eligible infants and
    toddlers and their families:
              (A)  Illinois State Board of Education;
              (B)  (Blank);
              (C)  (Blank);
              (D)  Illinois Department of Children and Family
         Services;
              (E)  University   of   Illinois   Division   of
         Specialized Care for Children;
              (F)  Illinois Department of Public Aid;
              (G)  Illinois Department of Public Health;
              (H)  (Blank);
              (I)  Illinois Planning Council on Developmental
         Disabilities; and
              (J)  Illinois Department of Insurance.
         (2)  Other members as follows:
              (A)  At least 20% of the members of the Council
         shall be parents,  including  minority  parents,  of
         infants  or  toddlers  with disabilities or children
         with disabilities aged 12 or younger, with knowledge
         of, or experience with,  programs  for  infants  and
         toddlers  with  disabilities.   At  least  one  such
         member  shall  be  a  parent of an infant or toddler
         with a disability or a child with a disability  aged
         6 or younger;
              (B)  At least 20% of the members of the Council
         shall  be  public  or  private  providers  of  early
         intervention services;
              (C)  One  member  shall  be a representative of
         the General Assembly; and
              (D)  One  member  shall  be  involved  in   the
         preparation   of  professional  personnel  to  serve
         infants and toddlers similar to those  eligible  for
         services under this Act.
    The  Council  shall  meet  at least quarterly and in such
places as it deems necessary.  Terms of the  initial  members
appointed  under  paragraph (2) shall be determined by lot at
the  first  Council  meeting  as  follows:  of  the   persons
appointed  under  subparagraphs  (A) and (B), one-third shall
serve one year terms, one-third shall serve 2 year terms, and
one-third shall serve  3  year  terms;  and  of  the  persons
appointed  under subparagraphs (C) and (D), one shall serve a
2 year term and one shall serve a 3 year  term.   Thereafter,
successors  appointed  under paragraph (2) shall serve 3 year
terms.  Once appointed, members shall continue to serve until
their successors are appointed.  No member shall be appointed
to serve more than 2 consecutive terms.
    Council members  shall  serve  without  compensation  but
shall  be  reimbursed  for  reasonable  costs incurred in the
performance of their duties, including costs related to child
care, and parents may be paid a stipend  in  accordance  with
applicable requirements.
    The  Council  shall  prepare  and  approve a budget using
funds appropriated for the purpose to hire staff, and  obtain
the  services  of  such professional, technical, and clerical
personnel as may be necessary  to  carry  out  its  functions
under  this  Act.   This  funding  support and staff shall be
directed by the lead agency.
    (b)  The Council shall:
         (1)  advise  and  assist  the  lead  agency  in  the
    performance of its  responsibilities  including  but  not
    limited  to  the  identification of sources of fiscal and
    other support services for early  intervention  programs,
    and  the promotion of interagency agreements which assign
    financial responsibility to the appropriate agencies;
         (2)  advise  and  assist  the  lead  agency  in  the
    preparation   of   applications   and    amendments    to
    applications;
         (3)  review  and  advise on relevant regulations and
    standards proposed by the related State agencies;
         (4)  advise  and  assist  the  lead  agency  in  the
    development,  implementation  and   evaluation   of   the
    comprehensive early intervention services system; and
         (5)  prepare  and  submit  an  annual  report to the
    Governor and to the General Assembly  on  the  status  of
    early  intervention  programs  for  eligible  infants and
    toddlers and  their  families  in  Illinois.  The  annual
    report shall include (i) the estimated number of eligible
    infants  and  toddlers  in this State, (ii) the number of
    eligible infants and toddlers who have received  services
    under  this Act and the cost of providing those services,
    and (iii) the estimated cost of providing services  under
    this  Act  to  all  eligible infants and toddlers in this
    State,  and  (iv)  data  and  other  information  as   is
    requested  to  be  included  by  the Legislative Advisory
    Committee established under Section 13.50  of  this  Act.
    The  report  shall  be  posted  by the lead agency on the
    early intervention website as  required  under  paragraph
    (f) of Section 5 of this Act.
    No  member  of  the  Council  shall  cast  a  vote  on or
participate substantially in any matter which would provide a
direct financial benefit to that member or otherwise give the
appearance of a conflict of interest under State  law.    All
provisions   and   reporting  requirements  of  the  Illinois
Governmental Ethics Act shall apply to Council members.
(Source: P.A. 91-357; eff. 7-29-99.)

    (325 ILCS 20/5) (from Ch. 23, par. 4155)
    Sec. 5.  Lead Agency.  The Department of  Human  Services
is designated the lead agency and shall provide leadership in
establishing and implementing the coordinated, comprehensive,
interagency    and    interdisciplinary   system   of   early
intervention services.  The lead agency shall  not  have  the
sole  responsibility  for  providing  these  services.   Each
participating State agency shall continue to coordinate those
early   intervention  services  relating  to  health,  social
service and education provided under this authority.
    The lead agency  is  responsible  for  carrying  out  the
following:
         (a)  The  general  administration,  supervision, and
    monitoring   of   programs   and   activities   receiving
    assistance under Section  673  of  the  Individuals  with
    Disabilities Education Act (20 United States Code 1473).;
         (b)  The  identification  and  coordination  of  all
    available resources within the State from federal, State,
    local and private sources.;
         (c)  The  development  of  procedures to ensure that
    services are provided to eligible  infants  and  toddlers
    and  their  families  in  a  timely  manner  pending  the
    resolution  of  any  disputes  among  public  agencies or
    service providers.;
         (d)  The resolution of intra-agency and  interagency
    regulatory and procedural disputes.; and
         (e)  The  development  and  implementation of formal
    interagency  agreements,  and   the   entry   into   such
    agreements,   between   the   lead  agency  and  (i)  the
    Department of Public Aid, (ii) the University of Illinois
    Division of Specialized  Care  for  Children,  and  (iii)
    other relevant State agencies that:
              (1)  define  the  financial  responsibility  of
         each   agency  for  paying  for  early  intervention
         services (consistent with existing State and federal
         law and rules, including the requirement that  early
         intervention  funds  be  used  as  the payor of last
         resort), a hierarchical order of  payment  as  among
         the  agencies  for  early intervention services that
         are covered under or may  be  paid  by  programs  in
         other  agencies,  and procedures for direct billing,
         collecting reimbursements  for  payments  made,  and
         resolving service and payment disputes; and
              (2)  include    all    additional    components
         necessary   to  ensure  meaningful  cooperation  and
         coordination.
         Interagency agreements under this paragraph (e) must
    be reviewed and revised to implement the purposes of this
    amendatory Act of the 92nd General Assembly no later than
    60 days after the effective date of this  amendatory  Act
    of the 92nd General Assembly.
         (f)  The   maintenance   of  an  early  intervention
    website.    Within 30 days after the  effective  date  of
    this  amendatory  Act  of  the 92nd General Assembly, the
    lead agency shall post and keep posted  on  this  website
    the  following:  (i)  the  current annual report required
    under subdivision (b)(5) of Section 4 of  this  Act,  and
    the   annual  reports of the prior 3 years, (ii) the most
    recent Illinois  application  for  funds  prepared  under
    Section   637   of   the  Individuals  with  Disabilities
    Education Act filed with the United States Department  of
    Education,    (iii)   proposed   modifications   of   the
    application prepared for public comment, (iv)  notice  of
    Council  meetings,  Council  agendas,  and minutes of its
    proceedings for at least the previous year, (v)  proposed
    and  final  early  intervention  rules, (vi) requests for
    proposals,   and   (vii)   all   reports   created    for
    dissemination to the public that are related to the early
    intervention  program,  including reports prepared at the
    request of the Council, the  General  Assembly,  and  the
    Legislative  Advisory Committee established under Section
    13.50 of this Act.  Each such document shall be posted on
    the website within 3 working days  after  the  document's
    completion.
(Source: P.A. 90-158, eff. 1-1-98.)

    (325 ILCS 20/11) (from Ch. 23, par. 4161)
    Sec. 11.  Individualized Family Service Plans.
    (a)  Each eligible infant or toddler and that infant's or
toddler's family shall receive:
         (1)  (a)  timely,  comprehensive,  multidisciplinary
    assessment  of  the  unique needs of each eligible infant
    and  toddler,  and  assessment  of   the   concerns   and
    priorities  of  the families to appropriately assist them
    in meeting their needs  and  identify  services  to  meet
    those needs; and
         (2)  (b)  a  written  Individualized  Family Service
    Plan developed by a multidisciplinary team which includes
    the parent or guardian. The individualized family service
    plan shall  be  based  on  the  multidisciplinary  team's
    assessment  of the resources, priorities, and concerns of
    the family and its identification  of  the  supports  and
    services  necessary  to  enhance the family's capacity to
    meet the developmental needs of the  infant  or  toddler,
    and   shall   include   the  identification  of  services
    appropriate to meet those needs, including the frequency,
    intensity, and method of delivering services.  During and
    as part of the initial development of the  individualized
    family  services  plan,  and  any periodic reviews of the
    plan, the multidisciplinary team shall consult  the  lead
    agency's  therapy  guidelines and its designated experts,
    if any, to help determine appropriate  services  and  the
    frequency  and intensity of those services.  All services
    in  the  individualized  family  services  plan  must  be
    justified by  the  multidisciplinary  assessment  of  the
    unique  strengths  and needs of the infant or toddler and
    must be appropriate to meet those needs.  At the periodic
    reviews, the team shall determine whether modification or
    revision of the outcomes or services is necessary.
    (b)  The Individualized  Family  Service  Plan  shall  be
evaluated  once  a  year  and  the family shall be provided a
review of the Plan at 6 month intervals or more  often  where
appropriate based on infant or toddler and family needs.
    (c)  The  evaluation  and  initial assessment and initial
Plan meeting must be held within 45 days  after  the  initial
contact  with  the  early  intervention services system. With
parental consent, early intervention  services  may  commence
before  the  completion  of  the comprehensive assessment and
development of the Plan.
    (d)  Parents must be informed that, at their  discretion,
early   intervention  services  shall  be  provided  to  each
eligible infant and toddler in the natural environment, which
may include the home or other  community  settings.   Parents
shall  make  the  final  decision  to accept or decline early
intervention services. A decision to  decline  such  services
shall  not  be  a  basis  for administrative determination of
parental fitness, or other findings or sanctions against  the
parents. Parameters of the Plan shall be set forth in rules.
    (e)  The  regional  intake  offices shall explain to each
family, orally and in writing, all of the following:
         (1)  That the early intervention  program  will  pay
    for  all  early  intervention  services  set forth in the
    individualized family service plan that are  not  covered
    or  paid  under  the family's public or private insurance
    plan or policy and not eligible for payment  through  any
    other third party payor.
         (2)  That  services  will  not be delayed due to any
    rules or restrictions under the family's  insurance  plan
    or policy.
         (3)  That  the  family may request, with appropriate
    documentation supporting the request, a determination  of
    an  exemption  from  private  insurance use under Section
    13.25.
         (4)  That   responsibility   for   co-payments    or
    co-insurance  under  a family's private insurance plan or
    policy will be transferred to the lead  agency's  central
    billing office.
         (5)  That  families will be responsible for payments
    of family fees, which will be based on  a  sliding  scale
    according  to  income, and that these fees are payable to
    the central  billing  office,  and  that  if  the  family
    encounters  a catastrophic circumstance, as defined under
    subsection (f) of Section  13  of  this  Act,  making  it
    unable  to  pay the fees, the lead agency may, upon proof
    of inability to pay, waive the fees.
    (f)  The individualized family service  plan  must  state
whether the family has private insurance coverage and, if the
family  has such coverage, must have attached to it a copy of
the  family's  insurance  identification  card  or  otherwise
include all of the following information:
         (1)  The name, address, and telephone number of  the
    insurance carrier.
         (2)  The  contract  number  and policy number of the
    insurance plan.
         (3)  The name, address, and social  security  number
    of the primary insured.
         (4)  The  beginning  date  of  the insurance benefit
    year.
    (g)  A copy of the  individualized  family  service  plan
must  be  provided to each enrolled provider who is providing
early intervention services to the child who is  the  subject
of that plan.
(Source: P.A. 91-538, eff. 8-13-99.)

    (325 ILCS 20/13) (from Ch. 23, par. 4163)
    Sec. 13. Funding and Fiscal Responsibility.
    (a)  The  lead agency and every other participating State
agency may receive  and  expend  funds  appropriated  by  the
General Assembly to implement the early intervention services
system as required by this Act.
    (b)  The  lead agency and each participating State agency
shall identify and report on an annual basis to  the  Council
the  State  agency  funds utilized for the provision of early
intervention services to eligible infants and toddlers.
    (c)  Funds provided under Section 633 of the  Individuals
with  Disabilities Education Act (20 United States Code 1433)
and  State  funds  designated  or  appropriated   for   early
intervention  services or programs may not be used to satisfy
a financial commitment for services  which  would  have  been
paid  for  from  another public or private source but for the
enactment of this Act, except whenever  considered  necessary
to  prevent delay in receiving appropriate early intervention
services by the eligible infant or toddler  or  family  in  a
timely  manner.  Funds  provided  under  Section  633  of the
Individuals with Disabilities Education Act and  State  funds
designated or appropriated for early intervention services or
programs  may  be used by the lead agency to pay the provider
of services (A) pending reimbursement  from  the  appropriate
State agency or (B) if (i) the claim for payment is denied in
whole  or  in part by a public or private source, or would be
denied under the written terms of the public program or  plan
or  private  plan,  or  (ii) use of private insurance for the
service has been exempted under Section 13.25.  Payment under
item  (B)(i)  may  be  made  based  on  a   pre-determination
telephone  inquiry  supported by written documentation of the
denial supplied thereafter by the insurance carrier.
    (d)  Nothing in this Act shall be construed to permit the
State to reduce medical or other assistance available  or  to
alter  eligibility  under Title V and Title XIX of the Social
Security Act relating to the Maternal  Child  Health  Program
and Medicaid for eligible infants and toddlers in this State.
    (e)  The  lead  agency  shall  create  a  central billing
office to receive and dispense all relevant State and federal
resources,  as  well  as  local  government  or   independent
resources  available,  for  early intervention services. This
office  shall  assure  that  maximum  federal  resources  are
utilized  and  that  providers  receive  funds  with  minimal
duplications or interagency reporting and  with  consolidated
audit procedures.
    (f)  The  lead  agency  shall, by rule, may also create a
system of payments by families, including a schedule of fees.
No fees, however, may  be  charged  for:  implementing  child
find,   evaluation   and  assessment,  service  coordination,
administrative and coordination  activities  related  to  the
development,  review, and evaluation of Individualized Family
Service Plans, or the implementation of procedural safeguards
and other administrative components of  the  statewide  early
intervention system.
    The  system  of  payments,  called  family fees, shall be
structured on a sliding scale based  on  family  income.  The
family's  coverage  or  lack  of  coverage  under a public or
private insurance plan or policy shall not  be  a  factor  in
determining the amount of the family fees.
    Each   family's   fee  obligation  shall  be  established
annually, and shall  be  paid  by  families  to  the  central
billing office in installments. At the written request of the
family, the fee obligation shall be adjusted prospectively at
any  point  during  the year upon proof of a change in family
income or family size.  The inability of the  parents  of  an
eligible  child  to  pay  family  fees  due  to  catastrophic
circumstances  or  extraordinary expenses shall not result in
the denial of services to the child or the child's family.  A
family  must  document  its  extraordinary  expenses or other
catastrophic circumstances by showing one of  the  following:
(i)  out-of-pocket medical expenses in excess of 15% of gross
income; (ii) a fire,  flood,  or  other  disaster  causing  a
direct  out-of-pocket  loss in excess of 15% of gross income;
or   (iii)   other   catastrophic    circumstances    causing
out-of-pocket  losses  in  excess of 15% of gross income. The
family must present proof of loss to its service coordinator,
who shall document it, and the lead  agency  shall  determine
whether  the  fees  shall  be reduced, forgiven, or suspended
within 10 business days after the family's request.
    (g)  To ensure that early intervention funds are used  as
the payor of last resort for early intervention services, the
lead   agency   shall   determine   at  the  point  of  early
intervention intake, and again  at  any  periodic  review  of
eligibility   thereafter   or   upon   a   change  in  family
circumstances, whether the family is eligible for or enrolled
in any program for which payment is made directly or  through
public  or  private  insurance  for  any  or all of the early
intervention services made available under this Act. The lead
agency shall establish procedures to ensure that payments are
made either directly from these public  and  private  sources
instead of from State or federal early intervention funds, or
as  reimbursement  for payments previously made from State or
federal early intervention funds.
(Source: P.A. 91-538, eff. 8-13-99.)

    (325 ILCS 20/13.5 new)
    Sec. 13.5. Other programs.
    (a)  When an application or a review of  eligibility  for
early  intervention  services is made, and at any eligibility
redetermination thereafter, the family shall be asked  if  it
is  currently  enrolled  in Medicaid, KidCare, or the Title V
program administered by the University of  Illinois  Division
of Specialized Care for Children.   If the family is enrolled
in  any  of  these programs, that information shall be put on
the individualized family service plan and entered  into  the
computerized  case  management system, and shall require that
the individualized family services plan of a  child  who  has
been  found  eligible  for  services  through the Division of
Specialized  Care  for  Children  state  that  the  child  is
enrolled in that program. For those  programs  in  which  the
family  is  not  enrolled,  a  preliminary eligibility screen
shall be conducted simultaneously for (i) medical  assistance
(Medicaid)  under  Article V of the Illinois Public Aid Code,
(ii) children's health insurance program  (KidCare)  benefits
under  the Children's Health Insurance Program Act, and (iii)
Title V maternal and child health services  provided  through
the   Division  of  Specialized  Care  for  Children  of  the
University of Illinois.
    (b)  For  purposes  of  determining  family  fees   under
subsection  (f) of Section 13 and determining eligibility for
the other  programs  and  services  specified  in  items  (i)
through  (iii)  of  subsection  (a),  the  lead  agency shall
develop and use, within 60 days after the effective  date  of
this  amendatory  Act  of the 92nd General Assembly, with the
cooperation of the Department of Public Aid and the  Division
of  Specialized  Care  for  Children  of  the  University  of
Illinois,   a   screening  device  that  provides  sufficient
information  for  the  early  intervention  regional   intake
entities or other agencies to establish eligibility for those
other  programs  and  shall, in cooperation with the Illinois
Department of Public Aid and the Division of Specialized Care
for Children, train the regional intake entities on using the
screening device.
    (c)  When  a   child  is  determined  eligible  for   and
enrolled  in  the   early   intervention program and has been
found to at  least  meet  the  threshold  income  eligibility
requirements  for  Medicaid  or  KidCare, the regional intake
entity shall complete a KidCare/Medicaid application with the
family and forward it to the Illinois  Department  of  Public
Aid's KidCare Unit for a determination of eligibility.
    (d)  With  the  cooperation  of  the Department of Public
Aid, the lead agency shall establish procedures  that  ensure
the timely and maximum allowable recovery of payments for all
early  intervention  services  and  allowable  administrative
costs under Article V of the Illinois Public Aid Code and the
Children's  Health  Insurance  Program  Act and shall include
those procedures in the interagency agreement required  under
subsection (e) of Section 5 of this Act.
    (e)  For   purposes   of   making   referrals  for  final
determinations of eligibility for KidCare benefits under  the
Children's  Health  Insurance  Program  Act  and  for medical
assistance under Article V of the Illinois Public  Aid  Code,
the   lead  agency  shall  require  each  early  intervention
regional intake entity to enroll  as  a  "KidCare  agent"  in
order  for  the entity to complete the KidCare application as
authorized  under  Section  22  of  the   Children's   Health
Insurance Program Act.
    (f)  For purposes of early intervention services that may
be  provided by the Division of Specialized Care for Children
of the University of Illinois (DSCC), the lead  agency  shall
establish  procedures whereby the early intervention regional
intake entities may determine whether  children  enrolled  in
the early intervention program may also be eligible for those
services,  and  shall  develop,  within  60  days  after  the
effective  date  of  this  amendatory Act of the 92nd General
Assembly,  (i)  the  inter-agency  agreement  required  under
subsection (e) of Section 5 of this  Act,  establishing  that
early  intervention funds are to be used as the payor of last
resort when services required under an individualized  family
services  plan  may  be provided to an eligible child through
the DSCC,  and (ii)  training  guidelines  for  the  regional
intake  entities  and  providers that explain eligibility and
billing procedures for services through DSCC.
    (g)  The lead agency shall  require  that  an  individual
applying for or renewing enrollment as a provider of services
in  the early intervention program state whether or not he or
she is also enrolled as a  DSCC  provider.  This  information
shall  be  noted  next  to  the  name  of the provider on the
computerized roster of Illinois early intervention providers,
and regional intake entities shall make every effort to refer
families eligible for DSCC services to these providers.

    (325 ILCS 20/13.10 new)
    Sec. 13.10. Private health  insurance;  assignment.   The
lead agency shall determine, at the point of new applications
for   early  intervention  services,  and  for  all  children
enrolled in the early intervention program, at  the  regional
intake  offices, whether the child is insured under a private
health insurance plan or policy.  An  application  for  early
intervention services shall serve as a right to assignment of
the right of recovery against a private health insurance plan
or  policy  for  any covered early intervention services that
may be billed to the family's insurance carrier and that  are
provided to a child covered under the plan or policy.

    (325 ILCS 20/13.15 new)
    Sec. 13.15. Billing of insurance carrier.
    (a)  Subject   to   the   restrictions   against  private
insurance use on the  basis  of  material  risk  of  loss  of
coverage,  as  determined  under Section 13.25, each enrolled
provider who is providing a family  with  early  intervention
services  shall  bill  the child's insurance carrier for each
unit of early intervention service for which coverage may  be
available. The lead agency may exempt from the requirement of
this  paragraph  any  early  intervention service that it has
deemed not to be covered by insurance plans. When the service
is not exempted, providers who receive a denial of payment on
the  basis  that  the  service  is  not  covered  under   any
circumstance  under  the  plan  are not required to bill that
carrier for that service again until the following  insurance
benefit year. That explanation of benefits denying the claim,
once  submitted  to  the  central  billing  office,  shall be
sufficient to meet the requirements of this paragraph  as  to
subsequent  services  billed  under  the  same  billing  code
provided  to  that  child during that insurance benefit year.
Any time limit on a provider's filing of a claim for  payment
with  the  central  billing  office that is imposed through a
policy, procedure, or  rule  of  the  lead  agency  shall  be
suspended  until  the  provider  receives  an  explanation of
benefits or other final determination of the claim  it  files
with the child's insurance carrier.
    (b)  In  all instances when an insurance carrier has been
billed for early intervention services, whether paid in full,
paid in part, or denied by the  carrier,  the  provider  must
provide  the  central  billing  office,  within 90 days after
receipt, with a copy of the explanation of benefits form  and
other  information  in  the  manner  prescribed  by  the lead
agency.
    (c)  When the insurance carrier has denied the  claim  or
paid an amount for the early intervention service billed that
is  less  that  the current State rate for early intervention
services,  the  provider  shall  submit  the  explanation  of
benefits with a claim for payment, and the lead agency  shall
pay the provider the difference between the sum actually paid
by  the  insurance  carrier for each unit of service provided
under the individualized family service plan and the  current
State  rate  for early intervention services. The State shall
also pay the family's co-payment or  co-insurance  under  its
plan,  but  only  to  the extent that those payments plus the
balance of the claim do not exceed the current State rate for
early  intervention  services.  The  provider  may  under  no
circumstances bill the family for the difference between  its
charge  for  services  and  that  which  has been paid by the
insurance carrier or by the State.

    (325 ILCS 20/13.20 new)
    Sec. 13.20. Families with insurance coverage.
    (a)  Families  of  children  with   insurance   coverage,
whether  public  or  private,  shall incur no greater or less
direct out-of-pocket expenses for early intervention services
than families who are not insured.
    (b)  Managed care plans.
         (1)  Use of managed care network providers. When   a
    family's  insurance  coverage  is  through a managed care
    arrangement  with a network of  providers  that  includes
    one  or  more types of early intervention specialists who
    provide  the  services   set  forth   in   the   family's
    individualized  family  service plan, the regional intake
    entity shall require the  family  to  use  those  network
    providers, but only to the extent that:
              (A)  the   network   provider   is  immediately
         available to  receive  the  referral  and  to  begin
         providing services to the child;
              (B)  the  network  provider  is  enrolled  as a
         provider in the Illinois early  intervention  system
         and  fully  credentialed under the current policy or
         rule of the lead agency;
              (C)  the  network  provider  can  provide   the
         services  to the child in the manner required in the
         individualized service plan;
              (D)  the family would not have to  travel  more
         than  an  additional  15  miles  or an additional 30
         minutes to the network provider than it  would  have
         to travel to a non-network provider who is available
         to provide the same service; and
              (E)  the  family's  managed  care plan does not
         allow for billing (even at a reduced rate or reduced
         percentage of the  claim)  for   early  intervention
         services provided by non-network providers.
         (2)  Transfers    from    non-network   to   network
    providers.  If a child has been receiving services from a
    non-network  provider  and  the  regional  intake  entity
    determines, at  the  time  of  enrollment  in  the  early
    intervention program or at any point thereafter, that the
    family  is  enrolled in a managed care plan, the regional
    intake entity shall require the family to transfer  to  a
    network provider within 45 days after that determination,
    but  within no more than 60 days after the effective date
    of this amendatory Act of the 92nd General Assembly, if:
              (A)  all the requirements of subdivision (b)(1)
         of this Section have been met; and
              (B)  the child is less than 26 months of age.
         (3)  Waivers.   The  lead  agency   may   fully   or
    partially  waive  the  network enrollment requirements of
    subdivision (b)(1)  of  this  Section  and  the  transfer
    requirements  of subdivision (b)(2) of this Section as to
    a particular region, or narrower geographic area,  if  it
    finds  that  the  managed care plans in that area are not
    allowing  further  enrollment   of   early   intervention
    providers  and  it  finds  that referrals or transfers to
    network providers could  cause  an  overall  shortage  of
    early  intervention providers in that region of the State
    or could cause delays  in  families  securing  the  early
    intervention  services set forth in individualized family
    services plans.
         (4)  The  lead  agency,  in  conjunction  with   any
    entities  with  which  it  may  have  contracted  for the
    training  and  credentialing  of  providers,  the   local
    interagency  council for early intervention, the regional
    intake entity, and the enrolled providers in each  region
    who  wish to participate, shall cooperate in developing a
    matrix and action plan that (A) identifies both (i) which
    early intervention providers and which fully credentialed
    early intervention providers are members of  the  managed
    care  plans  that are used in the region by families with
    children in the  early  intervention  program,  and  (ii)
    which    early    intervention    services,   with   what
    restrictions, if any, are covered under those plans,  (B)
    identifies  which credentialed specialists are members of
    which  managed  care  plans  in  the  region,   and   (C)
    identifies  the  various  managed  care  plans  to  early
    intervention  providers,  encourages  their enrollment in
    the area plans, and provides them with information on how
    to enroll. These matrices shall be complete no later than
    7 months after the effective date of this amendatory  Act
    of  the  92nd  General Assembly, and shall be provided to
    the Early Intervention Legislative Advisory Committee  at
    that  time. The lead agency shall work with networks that
    may have closed enrollment  to  additional  providers  to
    encourage   their   admission   of   early   intervention
    providers,  and  shall  report  to the Early Intervention
    Legislative Advisory Committee on the initial results  of
    these efforts no later than February 1, 2002.

    (325 ILCS 20/13.25 new)
    Sec. 13.25. Private insurance; exemption.
    (a)  The  lead  agency  shall  establish procedures for a
family, whose child is eligible to receive early intervention
services, to apply for an exemption restricting  the  use  of
its  private  insurance plan or policy based on material risk
of loss of coverage as authorized  under  subsection  (c)  of
this Section.
    (b)  The  lead agency shall make a final determination on
a request for an exemption within 10 business days after  its
receipt of a written request for an exemption at the regional
intake  entity.  During  that 10 days, no claims may be filed
against the insurance plan or policy.  If  the  exemption  is
granted,  it  shall  be  noted  on  the individualized family
service plan, and the family and the  providers  serving  the
family shall be notified in writing of the exemption.
    (c)  An exemption may be granted on the basis of material
risk   of  loss  of  coverage  only  if  the  family  submits
documentation  with  its  request  for  an   exemption   that
establishes  (i)  that  the insurance plan or policy covering
the child is an individually purchased plan or policy and has
been purchased by a head of a household that is not  eligible
for  a  group medical insurance plan, (ii) that the policy or
plan has a lifetime cap that applies to one or more  specific
types   of  early  intervention  services  specified  in  the
family's  individualized  family  service  plan,   and   that
coverage  could be exhausted during the period covered by the
individualized family service plan, or (iii) proof of another
risk that the  lead  agency,  in  its  discretion,  may  have
additionally   established   and  defined  as  a  ground  for
exemption by rule.
    (d)  An exemption under this Section  based  on  material
risk  of loss of coverage may apply to all early intervention
services and all plans or policies insuring the child, may be
limited to one or more plans or policies, or may  be  limited
to  one  or  more types of early intervention services in the
child's individualized family services plan.

    (325 ILCS 20/13.30 new)
    Sec. 13.30. System of  personnel  development.  The  lead
agency shall provide training to early intervention providers
and  may  enter  into contracts to meet this requirement.  If
such contracts are let, they shall  be  bid  under  a  public
request  for  proposals  that  shall  be  posted  on the lead
agency's early intervention website for no less than 30 days.
This training shall include, at minimum, the following  types
of instruction:
    (a)  Courses  in  birth-to-3  evaluation and treatment of
children with developmental disabilities and delays (1)  that
are taught by fully credentialed early intervention providers
or  educators  with  substantial experience in evaluation and
treatment of children from birth to age 3 with  developmental
disabilities  and  delays, (2) that cover these topics within
each of the disciplines of audiology,  occupational  therapy,
physical   therapy,   speech   and  language  pathology,  and
developmental therapy, including the social-emotional  domain
of  development,  (3)  that  are  held no less than twice per
year, (4) that offer no fewer than 20 contact hours per  year
of course work, (5) that are held in no fewer than 5 separate
locales  throughout  the  State, and (6) that give enrollment
priority to early intervention providers who do not meet  the
experience,  education,  or continuing education requirements
necessary  to  be  fully  credentialed   early   intervention
providers; and
    (b)  Courses  held  no  less  than  twice per year for no
fewer than 4 hours each in no fewer than 5  separate  locales
throughout the State each on the following topics:
         (1)  Practice  and  procedures  of private insurance
    billing.
         (2)  The  role  of  the  regional  intake  entities;
    service coordination; program eligibility determinations;
    family  fees;  Medicaid,   KidCare,   and   Division   of
    Specialized    Care    applications,    referrals,    and
    coordination  with  Early  Intervention;  and  procedural
    safeguards.
         (3)  Introduction to the early intervention program,
    including provider enrollment and credentialing, overview
    of  Early  Intervention program policies and regulations,
    and billing requirements.
         (4)  Evaluation   and   assessment   of   birth-to-3
    children; individualized family service plan development,
    monitoring,   and   review;   best   practices;   service
    guidelines; and quality assurance.

    (325 ILCS 20/13.32 new)
    Sec. 13.32. Contracting. The lead agency may  enter  into
contracts  for some or all of its responsibilities under this
Act,  including  but  not  limited  to,   credentialing   and
enrolling    providers;   training   under   Section   13.30;
maintaining a central billing  office;  data  collection  and
analysis;  establishing  and  maintaining a computerized case
management system accessible to local  referral  offices  and
providers;  creating  and  maintaining  a system for provider
credentialing and enrollment; creating  and  maintaining  the



central  directory required under subsection (g) of Section 7
of this Act;  and  program  operations.  If  contracted,  the
contract  shall  be subject to a public request for proposals
as   described   in   the    Illinois    Procurement    Code,
notwithstanding  any exemptions or alternative processes that
may be allowed for such a contract under that Code,  and,  in
addition  to  the posting requirements under that Code, shall
be posted on the early intervention website maintained by the
lead agency during the entire bid period. Any of these listed
responsibilities currently under contract or grant that  have
not  met  these  requirements  shall be subject to public bid
under this request for proposal process no later than July 1,
2002 or the date of termination of any contract in place.

    (325 ILCS 20/13.50 new)
    Sec.  13.50.  Early  Intervention  Legislative   Advisory
Committee.  No later than 60 days after the effective date of
this amendatory Act of 92nd General Assembly, there shall  be
convened   the   Early   Intervention   Legislative  Advisory
Committee. The majority and minority leaders of  the  General
Assembly  shall  each appoint 2 members to the Committee. The
Committee's term  is  for  a  period  of  2  years,  and  the
Committee  shall  publicly  convene  no less than 4 times per
year. The Committee's responsibilities shall include, but not
be  limited  to,  providing  guidance  to  the  lead   agency
regarding    programmatic    and    fiscal   management   and
accountability,  provider  development  and   accountability,
contracting,  and  program outcome measures.  During the life
of the Committee, on a quarterly basis, or more often as  the
Committee  may  request, the lead agency shall provide to the
Committee, and simultaneously to the public, through postings
on the lead agency's early  intervention  website,  quarterly
reports  containing monthly data and other early intervention
program information that the Committee  requests.  The  first
data  report  must  be  supplied  no later than September 21,
2001, and must include the previous 2 quarters of data.

    (325 ILCS 20/15) (from Ch. 23, par. 4165)
    Sec. 15.  The Auditor General of the State shall  conduct
a  follow-up  an  evaluation  of the system established under
this Act, in order  to  evaluate  the  effectiveness  of  the
system  in  providing services that enhance the capacities of
families throughout Illinois to meet  the  special  needs  of
their  eligible infants and toddlers, and provide a report of
the evaluation to the Governor and the  General  Assembly  no
later  than  April  30,  2002 1993.  Upon receipt by the lead
agency, this report shall be posted on the early intervention
website.
(Source: P.A. 87-680.)

    Section 99.  Effective date.  This Act takes effect  upon
becoming law.
    Passed in the General Assembly May 31, 2001.
    Approved August 09, 2001.

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