AUTHORITY: Implementing and authorized by the Early Intervention Services System Act [325 ILCS 20] and Part C of the Individuals with Disabilities Education Act (IDEA) (20 USC 1400).

SOURCE: Adopted at 25 Ill. Reg. 8190, effective July 1, 2001; amended at 27 Ill. Reg. 2611, effective February 7, 2003; amended at 27 Ill. Reg. 13438, effective July 24, 2003; amended at 28 Ill. Reg. 8727, effective June 1, 2004; amended at 29 Ill. Reg. 2254, effective January 31, 2005; amended at 32 Ill. Reg. 2161, effective January 23, 2008; amended at 33 Ill. Reg. 8206, effective June 8, 2009; amended at 38 Ill. Reg. 11086, effective May 12, 2014; amended at 39 Ill. Reg. 14900, effective October 27, 2015; amended at 40 Ill. Reg. 9491, effective June 29, 2016; amended at 44 Ill. Reg. 12739, effective July 20, 2020; amended at 47 Ill. Reg. 1318, effective January 12, 2023.

SUBPART A: GENERAL PROVISIONS

 

Section 500.10  Purpose

 

The requirements contained in this Part are to define implementation of the Early Intervention Services System Act [325 ILCS 20] (hereafter "Act"), and Part C of the Individuals with Disabilities Education Act (IDEA) (20 U.S.C. 1400).  The requirements describe the statewide early intervention (EI) service program for children, birth to 36 months old, or a child eligible for Extended Services, who have disabilities due to developmental delay, have an eligible mental or physical condition that typically results in developmental delay, or are at risk of substantial developmental delay according to informed clinical opinion.

 

(Source:  Amended at 47 Ill. Reg. 1318, effective January 12, 2023)

 

Section 500.15  Incorporation by Reference

 

Any rules or standards of an agency of the United States or of a nationally recognized organization or association that are incorporated by reference in this Part are incorporated as of the date specified, and do not include any later amendments or editions.

 

Section 500.20  Definitions

 

"Act" means the Early Intervention Services System Act [325 ILCS 20].

 

"Assessment" means the ongoing procedures used by qualified personnel to identify the child's unique strengths and needs and the early intervention services appropriate to meet those needs throughout the period of the child's eligibility and includes the assessment of the child and the child's family.  An initial assessment refers to the assessment of the child and family conducted prior to the child's first Individualized Family Service Plan (IFSP) meeting.

 

"Child" means children under 36 months of age, or a child eligible for Extended Services.

 

"Child find" means an activity that identifies potentially eligible infants and toddlers.

 

"Complaining Party" means, for purposes of Section 500.140, the persons or entities filing a request for a Due Process Hearing.

 

"Council" or "IICEI" means the Illinois Interagency Council on Early Intervention established under Section 4 of the Early Intervention Services System Act.

 

"Credential" means an official documentation from the Department's credentialing office that an individual has met pertinent licensing, degree, and certification requirements as set forth in Appendix C, as well as the applicable education, experience, continuing professional education, and ongoing professional development requirements as set forth in Section 500.60.

 

"Day", for purposes of this Part, means calendar day.

 

"Department" or "DHS" means the Illinois Department of Human Services.

 

"Destruction" means physical destruction or removal of personal identifiers from information so that the information is no longer personally identifiable.

 

"EI" means early intervention.

 

"Early intervention services" or "EI services" means services that:

 

are designed to meet the developmental needs of an infant or toddler with a disability and the needs of the family to assist appropriately in the infant's or toddler's development, based on scientifically-based research to the extent practicable and as identified by the IFSP team, in the areas of development listed in this definition;

 

are related to enhancing the child's development;

 

are selected in collaboration with the child's family;

 

are provided under public supervision;

 

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;

 

are designed to meet an infant's or toddler's developmental needs in any of the following areas:

 

cognitive development;

 

physical development, including vision and hearing;

 

communication development;

 

social or emotional development; or

 

adaptive development;

 

meet the standards of this Part, including the requirements of the Act;

 

include one or more of the services set forth in Section 500.55;

 

are provided by qualified personnel, as set forth in Section 500.60;

 

are provided in conformity with an IFSP;

 

are provided throughout the year; and

 

are provided to the maximum extent appropriate in natural environments, including settings that are natural or typical for a same-age infant or toddler without a disability and may include home or community settings.

 

"Early Intervention Services System" or "System" means the system of service delivery described in this Part that implements Part C of IDEA in Illinois and the Illinois Early Intervention Services System Act.

 

"Eligible children" or "eligible child" means infants and toddlers under 36 months of age or children engaged with Extended Services with any of the following conditions:

 

Developmental delay;

 

A physical or mental condition that has a high probability of resulting in a developmental delay; or

 

At risk of having substantial developmental delays, according to informed clinical opinion.

 

"Developmental delay" means a Department determined eligible level of delay (30% and above) in one or more of the following areas of childhood development:  cognitive; physical; communication; social or emotional; or adaptive, as measured by Department approved diagnostic instruments and standard procedures or as confirmed through informed clinical opinion of qualified staff based upon multidisciplinary evaluation and assessment if the child is unable to be appropriately and accurately tested by the standardized measures available.

 

"Physical or mental condition that has a high probability of resulting in a developmental delay" means a medical diagnosis (see Appendix E) approved by the Department as an eligible condition or confirmed by a qualified family physician, pediatrician or pediatric sub-specialist as being a condition with a relatively well known expectancy for developmental outcomes within varying ranges of developmental disabilities.  Pediatric subspecialists included are those such as pediatric neurologists, geneticists, pediatric orthopedic surgeons and pediatricians with special interest in disabilities.

 

"At risk of substantial developmental delay, according to informed clinical opinion," means that there is consensus of qualified staff based upon multidisciplinary evaluation and assessment that development of a Department determined eligible level of delay is probable if early intervention services are not provided, because a child is experiencing either:

 

a parent who has been medically diagnosed as having a mental illness or serious emotional disorder defined in the Diagnostic and Statistical Manual V (DSM V) (American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209-3901) that has resulted in a significant impairment in the client's level of functioning in at least one major life functional area or a developmental disability; or

 

three or more of the following risk factors:

 

current alcohol or substance abuse by the primary caregiver;

 

primary caregiver who is currently less than 15 years of age;

 

current homelessness of the child;

 

chronic illness of the primary caregiver;

 

alcohol or substance abuse by the mother during pregnancy with the child;

 

primary caregiver with a level of education equal to or less than the 10^th grade, unless that level is appropriate to the primary caregiver's age;

 

an indicated case of abuse or neglect regarding the child and the child has not been removed from the abuse or neglect circumstances.

 

Services for children determined to be "at risk" shall not be funded under Federal Part C funding, nor subject to its requirements.

 

"Enroll" means to enter into a Service Provider Agreement that establishes duties, expectations and relationships between the Department and the individual or agency provider that provides early intervention services to eligible children and their families.  A provider must be enrolled to bill and receive payment for services from the Early Intervention Program.

 

"Evaluation" means the procedures used by qualified personnel to determine a child's initial and continuing eligibility under this Part consistent with the definition of "eligible children" or "eligible child".  Initial evaluation refers to the child's evaluation to determine his or her initial eligibility under this Part.

 

“Extended Services” or "ES" means that the family who is receiving EI services whose child meets all three criteria below, will be able to choose to continue EI/ES beyond the child’s third birthday until the start of the school year following the child’s third birthday as outlined in 34 CFR 303.211(a)(2)(i) and 325 ILCS 20/11(h). If, in the same calendar year, a child’s third birthday occurs after the start of that school year, the child will not be eligible for EI/ES.  Those services must continue to be provided in the modality of the family's choice.

 

This option for extended services through Part C to children over age three applies only if the child:

 

has been determined eligible for early intervention with services identified and consented to on the IFSP; and

 

has their third birthday between May 1 and August 31; and

 

has been found eligible for early childhood special education services under IDEA and 325 ILCS 20/11(h) and at the discretion of the LEA an Individualized Education Program (IEP) is developed at that time or by the time the school year begins at the latest.

 

"FERPA" means Family Educational Rights and Privacy Act (20 U.S.C. 1232(g)) and the regulations promulgated under that Act (34 CFR 99).

 

"HFS" means the Illinois Department of Healthcare and Family Services.

 

"HIPAA" means the Health Insurance Portability and Accountability Act (42 U.S.C. 1320(d)) and the regulations promulgated thereunder at 45 CFR 160, 162 and 164 (Transaction, Privacy and Security).

 

"IDEA" means the Individuals with Disabilities Education Act (20 U.S.C. 1400, as amended in 2004).

 

"Individualized Family Service Plan" or "Plan" or "IFSP" means a written plan for providing early intervention services to an eligible child and the child's family, as set forth in Subpart C.

 

"Individualized Family Service Plan Team", sometimes referred to as the "multidisciplinary team" or "IFSP Team", means a group of people concerned with the developmental needs of the child, including the child's parent/guardian or parents; other family members, as requested by the parent, if feasible to do so; an advocate or person outside of the family, if the parent requests that person to participate; the Service Coordinator; a person or persons directly involved in conducting the child's evaluations and assessments; and, as appropriate, persons who will be providing EI services to the child or family.  The multidisciplinary team/IFSP team determines appropriate EI services by consensus as set forth in this Part.

 

"Infant" or "Toddler" means any child under 36 months of age or a child eligible for Extended Services.

 

"Informed clinical opinion" means the way in which qualified personnel utilize their cumulative knowledge and experience in evaluating and assessing a child and in interpreting the results of evaluation and assessment instruments.

 

"Lead agency" means the State agency, as designated by the Governor and the Act, responsible for administering the Act and this Part in accordance with federal laws and rules.  The Illinois Department of Human Services (DHS) has been so designated.

 

"Local Education Agency" or "LEA" means a public board of education or other public authority legally constituted within Illinois for either administrative control or direction of, or to perform a service function for, public elementary schools or secondary schools in a city, county, township, school district or other political subdivision of this State, or for a combination of school districts or counties as are recognized in this State as an administrative agency for its public elementary or secondary schools.

 

"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.

 

"Local interagency council" or "LIC" means a local advisory body established for each designated geographic intake region as set forth in Section 6 of the Early Intervention Services System Act.

 

"Local service area" means a local interagency council region.

 

"Multidisciplinary team", sometimes referred to as the "IFSP team", means a group of people concerned with the developmental needs of the child, including the child's parent/guardian or parents; other family members, as requested by the parent, if feasible to do so; an advocate or person outside of the family, if the parent requests that person to participate; the Service Coordinator; a person or persons directly involved in conducting the child's evaluations and assessments; and, as appropriate, persons who will be providing EI services to the child or family.  The multidisciplinary team/IFSP team determines appropriate EI services by consensus as set forth in this Part. 

 

"Native language", when used with respect to an individual who is limited English proficient, means the language normally used by that individual, or in the case of a child, the language normally used by the parents of the child.  For evaluations and assessments of a child, native language means the language normally used by the child, if determined developmentally appropriate for the child by qualified personnel conducting the evaluation or assessment.  Unless clearly not feasible to do so, family assessments must be conducted in the native language of the family members being assessed.  Native language, when used with respect to an individual who is deaf or hard of hearing, blind or visually impaired, or for an individual with no written language, means the mode of communication that is normally used by the individual (such as sign language, Braille, or oral communication).

 

"Natural environment" means settings that are natural or typical for a same-aged infant or toddler without a disability and may include home or community settings.

 

"Parent liaison" means an individual who holds an EI Parent Liaison credential and draws from his/her knowledge and personal experience to bring support to families as they learn about the EI Program.

 

"Parents" means, except as provided in 34 CFR 303.27(b)(1) and (2), a biological or adoptive parent of a child; a foster parent; a guardian generally authorized to act as the parent, or authorized to make early intervention, educational, health or developmental decisions for the child (but not the State if the child is a ward of the State); an individual acting in the place of a biological or adoptive parent (including a grandparent, stepparent or other relative) with whom the child lives, or an individual who is legally responsible for the child's welfare; and a surrogate parent who has been appointed in accordance with Section 500.160.

 

"Part B" means Part B of the Individuals with Disabilities Education Act (IDEA) governing "Assistance for Education of All Children with Disabilities".

 

"Part C" means Part C of IDEA governing "Infants and Toddlers with Disabilities".

 

"Participating agency" means any individual, agency, entity or institution that collects, maintains or uses Personally Identifiable Information (PII) to implement the requirements of this Part.

 

"Parties" means the persons or entities filing an allegation and the persons or entities against whom the allegations are made.  For purposes of Section 500.140, Parties include both the Complaining Party and the Responding Party.

 

"Personally Identifiable Information" or "PII" means the information governed by FERPA regulations at 34 CFR 99.3.

 

"Plan" means a written plan for providing EI services to an eligible child and the child's family, as set forth in Subpart C.

 

"Protected health information" means the health information governed by the HIPAA Privacy and Security regulations at 45 CFR 164.501.

 

"Qualified personnel" means personnel who have met State approved or recognized certification, licensing, registration or other comparable requirements that apply to the areas in which the individuals are conducing evaluations or assessments or providing EI services.

 

"Records" means all records regarding a child that are required to be collected, maintained or used under Part C of the Individuals with Disabilities Education Act (20 U.S.C. 1400) and 34 CFR 303. 

 

"Regional intake entity" means the Department's designated entity responsible for implementation of the Early Intervention Services System within its designated geographic area as set forth in Section 500.45.

 

"Responding Party" means, for purposes of Section 500.140, the persons or entities against whom a Part C allegation is made.

 

"Service Coordinator" means an individual who holds an EI Service Coordination credential and assists and enables eligible infants and toddlers and their families to receive the services and rights, including procedural safeguards, provided through the EI Program.

 

"Service Provider Agreement" means the binding written agreement that establishes the duties, expectations and relationship between the Department and the provider of service pursuant to the Illinois Early Intervention Services System Act [325 ILCS 20], Part C of the Individuals with Disabilities Education Act (IDEA) (20 U.S.C. 1431), the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Family Educational Rights and Privacy Act Regulations (FERPA) (20 U.S.C. 1232(g)), and this Part.

 

"Transition" is the process of transferring eligible children receiving early intervention services under this Part out of such services to Part B services or to other appropriate developmental or educational services.

 

(Source:  Amended at 47 Ill. Reg. 1318, effective January 12, 2023)

SUBPART B: COMPONENTS OF THE STATEWIDE SYSTEM

 

Section 500.25  Public Awareness and Child Find

 

a)         The Department shall provide ongoing and continuous public awareness efforts focused on the early identification of eligible children throughout the State.

 

1)         The Department shall prepare information on the availability of EI services under this Part. 

 

2)         With the assistance of the regional intake entities and local interagency councils, the Department will disseminate to all primary referral sources (especially hospitals and physicians) the information to be given to parents of infants and toddlers, especially parents with premature infants or infants with other physical risk factors associated with learning or developmental complication.  The information to be provided shall include:

 

A)        description of the availability of EI services under this Part;

 

B)        description of the child find system and how to refer a child under the age of three for an evaluation or EI services; and

           

C)        information about the Central Directory (see Section 500.30).

 

3)         The Department may make direct mailings to primary referral sources as defined in this Part, distribute pamphlets and posters at pertinent locations and use media releases and campaigns to the public and professional organizations as necessary to create awareness, in addition to the activities set forth in this Part.

 

4)         Primary referral sources are required to make referrals to the EI System as soon as possible, but in no case more than five business days after a potentially eligible child is identified. Primary referral sources, as listed in subsection (b), with assistance of the regional intake entities and local interagency councils, will disseminate information on the availability of EI services under this Part to parents of infants and toddlers, especially parents with premature infants or infants with other physical risk factors associated with learning or developmental complication.

 

b)         The regional intake entity as set forth in Section 500.45 serves as the central intake for each eligible child within its geographical area.  By use of the Central Directory set forth in Section 500.30, primary referral sources can identify and contact the appropriate regional entity.  Primary referral sources include:

 

1)         hospitals, including prenatal and post-natal care facilities;

 

2)         physicians;

 

3)         parents, including parents of infants and toddlers;

 

4)         child care programs and early learning programs, including, Early Head Start Programs;

 

5)         local educational agencies and schools;

 

6)         public health facilities;

 

7)         other public health and social services agencies;

 

8)         other clinics and health care providers;

 

9)         Public agencies and staff in the child welfare system, including child protective service and foster care;

 

10)         Homeless family shelters; and

 

11)         Domestic violence shelters and agencies.

 

c)         The local interagency council shall be responsible for coordination, design and implementation of child find and public awareness activities for their geographic region.  Such efforts shall take into consideration the region's cultural, communication, geographical and socio-economic make-up.

 

d)         The regional intake entity and the local interagency council shall assure that activities are coordinated with comprehensive local and statewide efforts and shall provide information to the Department as requested and required in order for the Department to monitor the effectiveness of the efforts and determine possible gaps in public awareness and child find.  If gaps are determined, the regional intake entity and the local interagency council shall increase efforts as required.

 

e)         Local interagency councils shall assist in:

 

1)         Development of collaborative agreements between local service providers, diagnostic and other agencies providing additional services to the child and family and agreements related to transition and integration of eligible children and families into the community;

 

2)         Local needs assessment, planning and evaluation efforts;

 

3)         Identification and resolution of local access issues;

 

4)         Provider recruitment; and

 

5)         Development of an annual report to the Council regarding child find and public awareness.

 

f)         The Department has entered into interagency agreement with the Illinois State Board of Education (ISBE) regarding coordinating ISBE's responsibility under Part B of IDEA to conduct child find of 0-21 year olds with the Department responsibility under Part C.  Local education agencies (LEAs) are responsible to ISBE for carrying out specific obligations regarding child find.

 

1)         LEAs shall:

 

A)        conduct public awareness activities targeting families and other primary referral sources;

 

B)        conduct screenings (by developmental checklists) to actively seek out infants and toddlers with disabilities or delays, report to the Department on these screenings and maintain procedures to assure compliance with the five-day referral time frame (schedules of screening dates and locations will be provided to the regional intake entity, other providers and the local advisory body);

 

C)        work closely with their regional intake entity to assure evaluations of identified children; and

 

D)        participate actively in their local advisory body (and as a member participate in coordination of public awareness and child find).

 

2)         ISBE will:

 

A)        provide technical assistance to LEAs to carry out screening and identification;

 

B)        monitor to assure that services are available in each LEA jurisdiction; and

 

C)        if notified by the Department that an LEA is not providing appropriate public awareness and child find, contact the LEA to assure the establishment of appropriate awareness, screening and identification (and report effort and screening dates back to the Department).

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.30  Central Directory

 

a)         The State is required by Section 632(7) of IDEA and 34 CFR 303.117 to maintain a Central Directory that is accessible to the general public, including persons with disabilities (i.e., through the lead agency's website and other appropriate means) and includes accurate, up-to-date information about:

 

1)         Public and private EI services, resources and experts available in the State;

 

2)         Professional and other groups (including parent support, and training and information centers) that provide assistance to infants and toddlers with disabilities eligible under Part C of IDEA and their families;

 

3)         Research and demonstration projects being conducted in the State relating to infants and toddlers with disabilities; and

 

4)         Access to the information needed to identify and contact the appropriate  regional intake entity.

           

b)         Public and private EI service providers, resources, experts, professionals and other groups providing assistance to eligible children and their families shall provide information as required (e.g., location of regional intake entities and/or toll free numbers) to the Department in order to maintain the Central Directory.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.35  Local Interagency Councils

 

There will be local interagency councils designated by the Department in conjunction with the IICEI for each regional intake geographical area throughout the State.  The councils shall be composed of parents, providers and others that provide services to the birth to three population as set forth in Section 6 of the Act.

 

Section 500.40  Illinois Interagency Council on Early Intervention

 

The Illinois Interagency Council on Early Intervention (IICEI) established in Section 4 of the Act shall carry out statewide responsibilities regarding the Early Intervention Services System as set forth in this Part.

 

Section 500.45  Regional Intake Entities

 

The Department will assure the designation of regional intake points as necessary to accomplish consistent System intake and service coordination throughout the State.  The regional entity shall be the contracted entity responsible for implementation of the EI Services System within its designated geographic area.  The regional entity shall:

 

a)         Participate in public awareness and child find activities by disseminating information to primary referral sources and working with local interagency councils.

 

b)         Provide adequate accessible and secure space/facilities to store permanent EI records and to house staff.

 

c)         Select, train and supervise qualified staff to carry out the following tasks within the System specified time frames:

 

1)         Receive referrals.

 

2)         Provide service coordination as defined in Section 500.55(l).

 

3)         Develop, maintain and process the permanent EI case record in accordance with policies set forth by the Department.

 

4)         Provide information about the EI Services System, including rights and procedural safeguards and available advocacy services, to families and initiate intake with parental consent.

                       

5)         Comply with family fee and public and private insurance policies and procedures as set by the Department.

                       

6)         Monitor that the Part C funds are the "payor of last resort" to the extent allowed by law.  This includes assistance in accessing resource supports, including but not limited to the Division of Specialized Care for Children (Title V) and, with the parent's or guardian's informed consent, Medicaid (Title XIX), the State Child Health Insurance Program (Title XXI), and private insurance.

                                     

7)         Be knowledgeable of and comply with all applicable federal and State laws, guidelines, procedures, rules, regulations, and executive orders applicable to its activities, including, but not limited to:

 

A)        The Individuals with Disabilities Education Act.  The United States Department of Education regulations for the EI program for Infants and Toddlers with Disabilities (34 CFR 303) and the Illinois EI Services System Act [325 ILCS 20].

 

B)        The federal Family Education Rights and Privacy Act (FERPA) (20 USC 1232g, 1232h)  and the United States Department of Education implementing regulations (34 CFR 99) and the Illinois School Student Records Act [105 ILCS 10].

 

C)        The Americans With Disabilities Act (42 USC 12131-12134).

 

D)        The Health Insurance Portability and Accountability Act  and the regulations promulgated under that Act (45 CFR 160, 162 and 164) regarding transactions, privacy and security.

 

d)         Maintain a directory of non-EI financial resources and support services for use with families.

 

e)         Assist families in accessing non-EI financial resources and support services by making appropriate referrals while the child is enrolled with the EI Services System and at transition.  Children found ineligible should be offered referrals for non-EI community resources prior to case closure.

 

f)         Maintain administrative and programmatic contact with all EI service providers in the service area.

 

g)         Participate in routine monitoring and technical assistance activities as required by the Department, including on-site monitoring, data collection and reporting obligations, record reviews, financial audits, complaint investigations, and consumer satisfaction surveys.

 

h)         Enroll as an "All Kids agent" in order to complete the All Kids application as authorized under Section 22 of the Children's Health Insurance Program Act.

 

i)          Facilitate IFSP team discussions for every child to determine his/her status relative to each of the federal Office of Special Education Program's (OSEP) identified child outcomes and document the rating in the statewide data system. 

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.50  Eligibility

 

a)         An Illinois child under the age of 36 months of age and his or her family are eligible for services set forth in this Part if the child:

 

1)         is experiencing a Department determined eligible level of developmental delay; or

 

2)         is experiencing a medically diagnosed physical or mental condition that typically results in developmental delay; or

 

3)         is, according to informed clinical opinion of qualified staff based upon a multidisciplinary evaluation and assessment, at risk of substantial developmental delay.

 

b)         Eligibility must be determined, with parental consent, using one or more of the following criteria:

 

1)         The child is experiencing a Department determined eligible level of developmental delay by consensus of qualified staff based upon a timely, comprehensive, multidisciplinary evaluation of the child using one or more standardized evaluations or criterion referenced measures approved by the Department.  A provider may request Department approval of a developmental test by submitting, in writing, documentation that the test meets the following criteria: is listed in the Mental Measurement Yearbook Series (Burros Center for Testing, University of Nebraska-Lincoln, 21 Teachers College Hall, Lincoln NE 68588-0348 (2005, no later editions or amendments included)); is nationally distributed; is formally validated; is age appropriate; and is individually administered.  The Mental Measurement Yearbook Series can be found at the Early Childhood Intervention Clearinghouse, many local libraries and via the Internet.  

 

A)        Qualified personnel must use informed clinical opinion when conducting an evaluation and assessment of the child.  Informed clinical opinion may be used as an independent basis to establish a child's eligibility under this Part even when other instruments do not establish eligibility; however, in no event may informed clinical opinion be used to negate the results of evaluation instruments used to establish eligibility.  Activities to determine clinical opinion shall include observation and parent report and shall be described in the written report documenting the informed clinical opinion of qualified staff that the child is experiencing delay at a level determined by the Department to be eligible.

 

B)        In conducting an evaluation, procedures must include administering an evaluation instrument; taking the child's history (including interviewing the parent); identifying the child's level of functioning in each of the areas of development; gathering information from other sources such as family members, other caregivers, medical providers, social workers and educators, if necessary, to understand the full scope of the child's unique strengths and needs; and reviewing medical, educational and other records.

 

2)         The child is experiencing a medically diagnosed physical or mental condition that typically results in a developmental delay, as determined by the Department and listed in Appendix E.  If a child exhibits a medical condition not approved by the Department as being an eligible condition, written verification by a qualified pediatrician or pediatric sub-specialist (pediatric neurologist, geneticist, pediatric orthopedic surgeon, pediatrician with special interest in disabilities) that the child's medical condition typically results in substantial developmental delay within the varying ranges of developmental disabilities may be used; or

 

3)         The child is at risk of substantial developmental delay, based on informed clinical opinion. Development of substantial developmental delay is probable if EI services are not provided to the child who is experiencing risk factors as defined in Section 500.20.  Risk factors that the child is experiencing must be identified.

 

c)         A child's medical and other records may be used to establish eligibility (without conducting an evaluation of the child) if those records indicate that the child's level of functioning in one or more of the developmental areas constitutes a delay at a level determined by the Department to be eligible or that the child otherwise meets the criteria for an infant or toddler with a disability under subsection (a).  If the child's Part C eligibility is established under this Section, the evaluators must conduct assessments of the child and family in accordance with subsection (d).

 

d)         If the child is determined eligible, with parental consent, a multidisciplinary assessment of the unique strengths and needs of the infant or toddler and the identification of services appropriate to meet those needs must occur.  This assessment must include a review of the results of the evaluation, personal observations of the child, and identification of the child's needs in each of the developmental areas.  Unless the child's eligibility is established as defined in subsection (c), this assessment is conducted with the evaluation.

 

e)         With parental consent, a family-directed assessment of the resources, priorities and concerns of the family and the identification of the supports and services necessary to enhance the family's capacity to meet the developmental needs of that infant or toddler must be conducted by the Service Coordinator.

 

f)         Qualified personnel must use informed clinical opinion when conducting an evaluation and assessment of the child.  All evaluations and assessment of the child and family must be conducted by qualified personnel, in a nondiscriminatory manner, and selected and administered so as not to be racially or culturally discriminatory.  Unless clearly not feasible to do so, all evaluations and assessments of a child must be conducted in the native language of the child.

 

g)         Eligibility shall be determined annually.  Children will continue to be eligible if they:

 

1)         have entered the program under any of the eligibility criteria in subsection (a) but no longer meet the current eligibility criteria under this Section; and

 

2)         either:

 

A)        continue to have any measurable delay; or

 

B)        have not attained a level of development in each area, including cognitive, physical (including vision and hearing), language, speech and communication, psycho-social, or self-help skills, that is at least at the mean of the child's age equivalent peers; and

 

3)         have been determined by the multidisciplinary team to require the continuation of EI 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 will differ from the initial individualized family service plan (IFSP) because of the child's developmental progress, and may consist of only service coordination, evaluation and assessments.

 

h)         If a family removes a child from services prior to reaching age three years and the child is later referred again, the child must meet eligibility criteria in effect at the time of the subsequent referral in order to be re-enrolled.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.55  Early Intervention Services/Devices

 

EI services may include the following as deemed necessary under the IFSP:

 

a)         Assistive technology, including:

 

1)         Assistive technology devices, meaning any item, piece of equipment or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain or improve the functional capabilities of children with disabilities.  The term does not include a medical device that is surgically implanted, including cochlear implant, or the optimization (e.g., mapping), maintenance or replacement of that device.  Devices must be approved prior to purchase by the Department. Prior approval will not exclude assistive technology devices as defined in this Part that are required in order to meet the child's EI needs.  Devices that meet the medical, life sustaining or routine daily needs of the child do not fall within the definition of assistive technology device.

 

2)         Assistive technology services, meaning services that directly assist an infant or toddler with a disability in selection, acquisition or use of an assistive technology device. Assistive technology services include:

 

A)        Evaluating the needs of an infant or toddler with a disability, including a functional evaluation of the infant or toddler with a disability in the child's customary environment;

 

B)        Selecting, designing, fitting, customizing, adapting, maintaining or repairing assistive technology devices;

 

C)        Coordinating and using other therapies, interventions or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs; and

 

D)        Training or technical assistance for an infant or toddler with a disability or, if appropriate, that child's family.

 

b)         Audiology, aural rehabilitation/other related services for the purposes of:

 

1)         Identification of children with auditory impairment, using at risk criteria and appropriate audiologic screening techniques;

 

2)         Determination of the range, nature, and degree of hearing loss and communication functions by use of audiological evaluation procedures;

 

3)         Referral for medical and other services necessary for the habilitation or rehabilitation of an infant or toddler with a disability who has an auditory impairment;

 

4)         Provision of auditory training, aural rehabilitation, speech reading and listening device orientation and training, and other related services;

 

5)         Determination of the child's individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices;

 

6)         Provision of services for prevention of hearing loss; and

 

7)         Family training, education and support provided to assist the child's family in understanding the child's special needs as related to audiology, aural rehabilitation and other related services and to enhancing the child's development.

 

c)         Developmental therapy services for the purposes of:

 

1)         Evaluation to determine a child's developmental status and need for EI services;

 

2)         The design of learning environments and activities that promote the infant's or toddler's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;

 

3)         Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the IFSP for the infant or toddler with a disability;

 

4)         Providing families with information, skills and support related to enhancing the skill development of the child;

 

5)         Working with the infant or toddler with a disability to enhance the child's development; and

 

6)         Family training, education and support provided to assist the child's family in understanding the child's special needs as related to developmental therapy services and to enhance the child's development.

 

d)         Family training and support that can include education provided to assist the family of an eligible child in understanding the needs of the child as related to the provider's specific discipline and to enhance the child's development.

 

e)         Health consultation by a licensed physician who has provided recent and/or ongoing medical treatment for the child with service providers who are identified on a child's IFSP as members of the child's multidisciplinary team concerning the health care needs of infants and toddlers with disabilities that will need to be addressed in the course of providing other EI services.

 

f)         Medical services for diagnostic or evaluation purposes provided by a licensed physician to determine a child's developmental status and need for EI services.

 

g)         Nursing services for the purposes of:

 

1)         Evaluation to determine a child's developmental status and need for EI services;

 

2)         Assessment to determine a child's health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems;

 

3)         Provision of required nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development during the time the child is receiving other EI services, such as:

 

A)        administration of medications, treatments, and regimens prescribed by a licensed physician; and

 

B)        clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services as required to allow the child to participate in other EI services;

 

4)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to nursing services and to enhancing the child's development.  Nursing services do not include hospital or home health nursing care required due to surgical or medical intervention or medical health services such as immunizations and regular "well child" care that are routinely recommended for all children.

 

h)         Nutrition services for the purposes of:

 

1)         Conducting individual assessments in nutritional history and dietary intake, anthropometric, biochemical, and clinical variables, feeding skills and feeding problems, and food habits and food preferences;

 

2)         Developing and monitoring appropriate plans to address the nutritional needs of the eligible child based upon individual assessment;

 

3)         Making referrals to appropriate community resources to carry out nutrition goals; and

 

4)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to nutrition services and to enhancing the child's development.

 

i)          Occupational therapy services to address the functional needs of an infant or toddler with a disability related to adaptive development; adaptive behavior and play; and sensory, motor, and postural development.  These services are designed to improve the child's functional ability to perform tasks in home, school, and community settings and include:

 

1)         Identification, evaluation, assessment and intervention;

 

2)         Adaptation of the environment and selection, design and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills;

 

3)         Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability; and

 

4)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to occupational therapy services and to enhancing the child's development.

 

j)          Physical therapy services to address the promotion of sensorimotor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation.  These services include:

 

1)         Evaluation, screening and assessment of infants and toddlers to identify movement dysfunction;

 

2)         Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems;

 

3)         Providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and

 

4)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to physical therapy services and to enhancing the child's development.

 

k)         Psychological services for the purposes of:

 

1)         Evaluation to determine a child's developmental status and need for EI services;

 

2)         Administering psychological and developmental tests and assessment procedures to determine the need for psychological or other counseling services;

 

3)         Interpreting assessment results;

 

4)         Obtaining, integrating and interpreting information about child behavior and child and family conditions related to learning, mental health and development;

 

5)         Planning and managing a program of psychological or other counseling services, including psychological or other counseling for children and parents, family counseling, consultation on child development, parent training and education programs;

 

6)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to psychological or other counseling services and to enhancing the child's development; and

 

7)         Identifying, mobilizing and coordinating community resources and services to enable the child and family to receive maximum benefit from EI services.

 

l)          Service coordination carried out by a Service Coordinator to assist and enable an infant or toddler with a disability and the child's family to receive the services and rights, including procedural safeguards, and services that are authorized to be provided through the State's EI Program, including:

 

1)         Assisting parents of infants and toddlers with disabilities in obtaining access to needed EI services and other services identified in the IFSP, including making referrals to providers for needed services and scheduling appointments for infants and toddlers with disabilities and their families;

 

2)         Coordinating the provision of EI services and other services (such as educational, social and medical services that are not provided for diagnostic or evaluative purposes) that the child needs or is being provided;

 

3)         Coordinating evaluations and assessment;

 

4)         Facilitating and participating in the development, review and evaluation of IFSPs;

 

5)         Conducting referral and other activities to assist families in identifying available EI services providers;

 

6)         Coordinating, facilitating and monitoring the delivery of EI services to ensure that the services are provided in a timely manner;

 

7)         Conducting follow-up activities to determine that appropriate Part C services are being provided;

 

8)         Informing families of their rights and procedural safeguards and related resources;

 

9)         Coordinating the funding sources for services required under this Part;

 

10)         Facilitating the development of a transition plan to preschool, school or, if appropriate, other services;

 

11)         Contacting the child/family at a minimum of one time per month to coordinate and monitor the provision of needed evaluation/assessments and services;

 

12)         Developing and maintaining the child's permanent and electronic EI record at the regional intake entity; and

 

13)         Informing families of the availability of advocacy services.

 

m)        Sign language and cued language services, including teaching sign language, cued language, and auditory/oral language, providing oral transliteration services (such as amplification), and providing sign and cued language interpretation.  These services shall be covered under the existing EI services.

 

n)         Social work services for the purposes of:

 

1)         Evaluation to determine a child's developmental status and need for EI services;

 

2)         Making home visits to evaluate a child's living conditions and patterns of parent-child interaction to determine the need for social work or other counseling services;

 

3)         Preparing a social or emotional developmental assessment of the infant or toddler within the family context;

 

4)         Providing individual and family group counseling with parents and other family members, and appropriate social skill building activities with the infant or toddler and parents;

 

5)         Working with those problems in the living situation (home, community, and any center where EI services are provided) of an infant or toddler with a disability and the family of that child that affect the child's maximum utilization of EI services;

 

6)         Identifying, mobilizing, and coordinating community resources and services to enable the infant or toddler with a disability and family to receive maximum benefit from EI services; and

 

7)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to social work or other counseling services and to enhancing the child's development.

 

o)         Speech-language pathology services for the purposes of:

 

1)         Evaluation/assessment activities to identify children with communicative or language disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders, and delays in those skills;

 

2)         Referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communicative or language disorders and delays in development of communication skills;

 

3)         Provision of services for the habilitation, rehabilitation, or prevention of communication or language disorders and delays in development of communication skills; and

 

4)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to speech therapy services and to enhancing the child's development.

 

p)         Transportation services and related costs include the cost of travel (e.g., loaded mileage for travel by taxi, service car or private auto) provided in accordance with the Department's EI transportation policies that are necessary to enable an infant or toddler with a disability and the child's family to travel to and from the location where the child receives another EI service.

 

q)         Vision services for the purposes of:

 

1)         Evaluation/assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays and abilities that affect early childhood development;

 

2)         Referral for medical or other professional services necessary for the habilitation and/or rehabilitation of visual functioning disorders;

 

3)         Communication skills training, orientation and mobility training for all environments, visual training, and additional training necessary to activate visual motor abilities; and

 

4)         Family training, education and support provided to assist the child's family in understanding the child's needs as related to vision services and to enhancing the child's development.

 

r)          Other Services 

 

1)         The services and personnel do not comprise exhaustive lists of the types of services that may constitute early intervention services.  Nothing prohibits the identification in the IFSP of another type of service as long as the service meets the criteria identified under Section 500.20 under the definition of "EI services" and personnel have met the requirements of Section 500.60 and Appendix C.

 

2)         EI services do not include services that are surgical in nature; purely medical in nature; related to the implementation, optimization, maintenance or replacement of a medical device that is surgically implanted, including a cochlear implant; devices (such as heart monitors, respirators and oxygen, and gastrointestinal feeding tubes and pumps) necessary to control or treat a medical condition; and medical-health services (such as immunizations and regular "well-baby" care that are routinely recommended for all children).

 

(Source:  Amended at 39 Ill. Reg. 14900, effective October 27, 2015)

 

Section 500.60  Provider Qualifications/Credentialing and Enrollment

 

a)         Credentialing and enrollment, as set forth in this Part, is only for the purpose of providing and being reimbursed for EI services as set forth in this Part. It is not a license.

 

b)         An individual shall meet the pertinent licensing, degree, education and/or certification requirements for the service to be provided, as set forth in Appendix C, as well as the requirements set forth in this Section, in order to qualify for and maintain a credential to provide EI services.  Credentialed providers must also enroll in order to be reimbursed for services.

 

c)         To be credentialed and maintain the credential the individual shall also:

 

1)         not be delinquent in paying a child support order as specified in Section 10-65 of the Illinois Administrative Procedure Act [5 ILCS 100/10-65];

 

2)         not be in default of an educational loan in accordance with Section 3 of the Education Loan Default Act [5 ILCS 385/3];

 

3)         not have served or completed a sentence for a conviction of any of the felonies set forth in Section 25(a) and (b) of the Health Care Worker Background Check Act [225 ILCS 46] within the preceding five years (see Section 50-10 of the Illinois Procurement Code [30 ILCS 500]);

 

4)         not have been determined to be a perpetrator of an indicated incident of child abuse or neglect in an investigation by Illinois under the Abused and Neglected Child Reporting Act [325 ILCS 5] or by another state under that state's laws for at least the previous five years;

 

5)         be in compliance with pertinent laws, rules, and government directives regarding the delivery of services for which they seek credentialing.

 

d)         Applicants for a credential shall consent to a background check as set forth in 89 Ill. Adm. Code 385.30(c) through the Illinois Department of Children and Family Services, consisting of review of CANTS/SACWIS, Illinois Sex Offender Registry and criminal history.

 

e)         Temporary Credential

An individual who is not currently credentialed and has submitted an application to the Department's credentialing office, including an acceptable plan for ongoing professional development as required in subsection (k)(2), and has met the  pertinent requirements provided in Appendix C, as well as documentation of completion of EI systems training as defined in subsection (f)  and other requirements in this Part, will be issued a temporary credential and may provide EI services.

 

f)         EI Systems Training

 

1)         In order to qualify for a credential, an individual must document the completion of EI systems training as required and provided by the Department.  Parent Liaisons and Service Coordinators must complete this training within 90 days after the receipt of the temporary credential for such service.  This training shall include at least:

 

A)        Practice and procedures of private insurance;

 

B)        The role of the regional intake entities, service coordination, program eligibility determinations, family fees, All Kids, and the Division of Specialized Care for Children (DSCC) applications, referrals and coordination with EI, and procedural safeguards;

 

C)        Introduction to the EI Program, including provider enrollment and credentialing, overview of EI Program policies and regulations, and billing requirements; and

 

D)        Evaluation and assessment of birth-to-three children, individualized family service plan development, monitoring and review, EI philosophy and best practices, and quality assurance.

 

2)         A temporary credential may be issued to  a Parent Liaison or Service Coordinator, who shall document completion of training as required and approved by the Department, within 90 days after the receipt of the temporary credential for such service.  This training shall include at least the EI systems training, set forth in subsections (f)(1)(A) through (D), as well as:

 

A)        Use of the management information system;

 

B)        Regional intake entity operating philosophies and procedures; and

 

C)        Transition.

Extensions of up to 90 days may be granted upon written request setting forth facts concerning noncompliance with this requirement. The Department's credentialing office will consider extreme hardship and other extenuating circumstances and determine if an extension should be granted on an individual basis.

 

g)         Education

 

1)         Individuals who hold a credential on July 1, 2007, other than individuals who hold a professional license in the State of Illinois, as set forth in Appendix C, as part of the first subsequent credential renewal application process, must provide documentation of the completion of educational experiences, as approved by the Department, that include at least two semester college hours or the equivalent (30 clock hours or continuing education unit (CEU) credit hours) in each of the following EI core knowledge content areas.  Parent Liaisons are not required to provide this documentation.

 

A)        The Development of Young Children:  Typical and Atypical;

 

B)        Working with Families of Young Children with Disabilities;

 

C)        Intervention Strategies for Young Children with Special Needs; and

 

D)        Assessment of Young Children with Special Needs.

 

2)         To qualify for a temporary credential, developmental therapists must document completion of educational experiences, as approved by the Department, that include at least two semester college hours or the equivalent (30 clock hours or CEU credit hours) in each of the EI core knowledge content areas listed in subsection (g)(1).  As of July 1, 2007, all other applicants for a temporary credential, other than individuals that hold a professional license in the State of Illinois, as set forth in Appendix C, shall document completion of these educational experiences within 18 months after issuance of a temporary credential.  Extensions of up to six months may be allowed upon request in writing, received at least 30 days before the expiration of the credential, setting forth the facts concerning noncompliance with this requirement.  The Department's credentialing office will consider hardship and other extenuating circumstances and determine if an extension should be granted on an individual basis.

 

h)         Consultation Requirement Either Prior to or During Temporary Credential

 

1)         In order to qualify for full credential, an individual must complete and document consultation while providing 240 hours of direct services, for which they are being credentialed, to children ages birth to three with special needs and their families, except that Developmental Therapists/Vision, Orientation and Mobility Developmental Therapists, Developmental Therapists/Hearing, and providers credentialed under the EI service categories of Clinical Assessment, Counseling and other Therapeutic Services, Nursing, Nutrition and Social Services, as defined in Appendix C, need only document 120 hours.   Documentation must show that the individual participated in consultation with an appropriately experienced individual of the same discipline/EI service group who has experience working with children ages birth to three with special needs and their families.  The consultation shall be in compliance with the professional standards of the individual seeking the credential, as determined and documented by the consultant.

 

2)         Individuals who do not meet the consultation requirement in subsection (h)(1) shall complete and document such experience within 18 months after issuance of their temporary credential.  Extensions of up to six months may be granted upon written request, received at least 30 days before the expiration of the credential, setting forth the facts concerning noncompliance with this requirement.  The Department's credentialing office will consider extreme hardship and other extenuating circumstances and determine if an extension should be granted on an individual basis.

 

i)          Full Credential

Once an individual with a temporary credential has documented satisfactory completion of the requirements in subsections (g) and (h), as well as the ongoing professional development requirement in subsection (k)(2), he/she is eligible to be fully credentialed.

 

j)          Evaluation and Assessment Services

             Evaluation and assessment services for the purpose of determining initial eligibility, participating in the development of an initial comprehensive IFSP, and adding new types of services to existing IFSPs must be provided by a provider with a credential for Evaluation/Assessment as set forth in Appendix C in addition to an EI Specialist credential in the discipline required by the service being evaluated.

 

k)         Renewal of Credential

Full credentials are valid for three years.  60 to 90 days before his/her credential expires, a provider shall submit a renewal application to the Department in a form required by the Department.  To qualify for renewal, the provider must have met and provide documentation of the following continuing professional education and development activities, as well as documentation of maintenance of pertinent licensure/certification requirements and compliance with this Part.  Failure to receive a renewal notice from the Department shall not excuse the submission of a renewal application for one's credential.

 

1)         Continuing Professional Education

During the three years that the full credential is valid, a credentialed provider shall receive a total of 30 hours of continuing professional education as approved by the Department.  Up to 20 of those hours shall be provided by the Department, or its training designee.  The provider credential notification and renewal letters will define the number of hours that shall be provided by the Department or its training designee.  The remaining training hours shall include one or more of the EI core knowledge content areas set forth in subsections (g)(1)(A) through (D).  Extensions of up to three months may be granted upon written request, received at least 30 days before the expiration of the credential, setting forth the facts concerning noncompliance with this subsection (k)(1).  The Department's credentialing office will consider extreme hardship and other extenuating circumstances and determine if an extension should be granted on an individual basis.  The extension shall not extend the time within which the subsequent year's training requirements must be received.

 

2)         Ongoing Professional Development

 

A)        A credentialed provider (including temporary) shall participate in a system of ongoing professional development that  includes a once a month non-billable meeting held either face-to-face or over the telephone with either an individual specialist-level credentialed provider or a group, of which at least one member is a specialist-level credentialed provider in order to facilitate best practices through case review.  Each provider shall submit an ongoing professional development plan with his/her initial and renewal credential application in a format provided by the Department, and shall also report ongoing professional development activities when moving from temporary to a full credential status and upon credential renewal to the Department's credentialing office or upon request of the Department or its designee in a format provided by the Department.  Documentation of ongoing professional development must demonstrate that a credentialed provider participated in ongoing professional development meetings in at least 75 percent of the months in his/her temporary or full credential period.

 

B)        Service Coordinators and Parent Liaisons employed by regional intake entities shall participate in ongoing professional development experience as defined and implemented through a contractual agreement between the Department and the regional intake entity, instead of the requirement of this subsection (k)(2).

 

l)          Restoration of Lapsed Credential

A credential that has lapsed for one year or less may be restored upon application proving the receipt of 30 hours of continuing professional education, as continuing professional education is defined in subsection (k)(1), and documentation of ongoing professional development as defined in subsection (k)(2).

 

m)        Enrollment

Credentialed providers (including temporary) must enroll with the Department in order to bill and receive payment for EI services.  Enrollment requires the payee entity to enter into a Service Provider Agreement  with the Department that establishes the duties, expectations, and relationships between the Department and the Individual Provider or the Provider Agency.  Providers shall submit an enrollment application packet at the same time they submit an application for a credential.  Providers credentialed as an "associate", as defined in Appendix C, are not required to enroll, but shall be supervised by a specialist who is credentialed and enrolled in the same discipline, as set forth in Appendix D.  The payee entity will bill for the services provided by the associate level provider under the name of the associate's supervisor.  The payee entity, supervisor and associate will comply with all directives and policy and procedural changes.  Failure to receive Department payments, directives and policy and procedural changes, due to failure to comply with this subsection, shall not excuse compliance with those directives and changes.

 

n)         Change of Name or Address

Credentialed providers shall notify the Department's credentialing office of any change of name or address within 30 days prior to billing under the new name and/or address, or 30 days after such change, whichever comes first.  Correct information is  required for a provider to receive payment for services.

 

o)         Providers shall also enroll with HFS to become an All Kids provider, simultaneously with EI enrollment.

 

p)         An individual applying for or renewing enrollment shall state whether he or she is also enrolled as a DSCC provider.

 

q)         Termination of Credential/Enrollment

 

1)         Credentialing/enrollment, as set forth in this Section, is not a license. Rights of credential and enrollment are set forth in the Service Provider Agreement.  In addition to the provisions of this subsection (q), the Department may exercise any rights it has under the Service Provider Agreement to terminate the agreement.

 

2)         The following shall result in immediate automatic termination of a provider's credential and enrollment:

 

A)        Failure to comply with the requirements of subsection (g) and/or (h) within the time period or within a Department-granted extension not exceeding the maximum extension time allowed.

 

B)        Failure to successfully enroll in, exclusion from or termination from participation in All Kids and/or other programs of federal or State agencies.

 

C)        Lapse of credential/enrollment  for over 1 year without complying with subsection (l) or failure to bill for services for more than 12 consecutive months.

 

D)        Suspension or termination of the license and/or certification required for the service for which one is credentialed.

 

E)        Failure to meet or maintain other credential and enrollment requirements set forth in this Section.

 

3)         The following shall also result in termination of a provider's credential and enrollment:

 

A)        Failure to comply with provisions of this Part, or with EI Service Provider Agreements, or with other laws and regulations relevant to the services for which there is a credential.

 

B)        Unprofessional conduct.

 

C)        Complaints the Department has determined are founded and significant.

 

D)        Professional performance not consonant with recognized standard of care or adverse action of a professional society or other professional organization.

 

E)        Lack of timely cooperation regarding the submission of and adequacy of reports, the development of appropriate goals and objectives and the development of  multidisciplinary treatment plans.

 

F)         Inappropriate billing practices.

 

4)         The provider shall be notified of the date of termination and the reason, and shall help to transition clients to new providers.  The provider may request an informal hearing, but the request shall not affect the termination date, which may proceed prior to the informal hearing.  The request must be made within 30 days after the notice of the termination.

 

5)         The provider may present relevant information, witnesses and evidence to the Secretary or his/her designee, in person or in writing.  The Secretary or the designee will review the information presented and any supplemental investigation performed by the Department and issue a decision within 30 days after the hearing.

 

6)         The decision of the Secretary or the designee shall be final.

 

r)          The Department may deny an application for credential and enrollment or a Service Provider Agreement if the applicant's past conduct resulted in the termination of his or her credential and enrollment or Service Provider Agreement.  An applicant may appeal a denial for a credential and enrollment or Service Provider Agreement based on a prior termination pursuant to subsection (q).

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.65  Monitoring

 

a)         The Department, or its designee, will conduct comprehensive on-site monitoring visits at the regional intake entities.  Other visits may occur at any time.  Desk reviews may also be performed and families may be interviewed.  The regional intake entities shall help the Department or its designee in obtaining representative family interviews.

 

b)         The Department or its designee will prepare a written report of its findings that shall be sent to the regional intake entity.  The report shall identify issues of non-compliance and may make recommendations about other areas of concern.

 

c)         The regional intake entity shall send a corrective action plan to the Department or its designee within 30 days after receipt of the report, proposing timelines for addressing each compliance issue.

 

d)         The Department or its designee will approve, within 14 days, an acceptable corrective action plan and timelines and may make follow-up visits as necessary to determine progress and compliance as soon as possible and in no case later than one year after the lead agency's identification of noncompliance.

 

e)         If the corrective action plan is not acceptable to the Department, it may within 14 days provide a reasonable plan and timelines, and make follow-up visits as necessary to determine progress and compliance as soon as possible and in no case later than one year after the lead agency's identification of noncompliance.

 

f)         In addition to any other rights the Department may have under contract with the regional intake entity the Department may suspend the contract, or withhold or suspend payments to the regional intake entity due to noncompliance with this Part and with Part C.  Suspensions and holds may be lifted upon completion of, or demonstration of satisfactory progress towards, satisfactory corrective action.  If an acceptable corrective action plan is not submitted in the required timeframe or the terms of the corrective action plan are not met by the provider, the Department may terminate the contract.  This Section does not preclude the Department from exercising any rights it may have under its contract with the regional intake entity.

 

g)         The Department or its designee may also visit and review records of individual providers within the area to assure compliance with applicable laws, regulations and Service Provider Agreements.  Visits may occur at any time.  The Department may withhold or suspend payments to the provider for noncompliance with this Part or with Part C, as set forth in the Service Provider Agreement.

 

h)         The Department or its designee may also submit written reports to individual providers regarding provider non-compliance and issues of concern. Technical assistance will be provided as necessary.

 

i)          Providers receiving such reports shall submit a corrective action plan within 30 days proposing timelines for addressing issues of compliance.  The Department or its designee shall follow subsections (d) and (e) if necessary regarding the provider.

 

j)          In addition to other rights the Department may have, it may terminate its Service Provider Agreement with a provider due to non-compliance with this Part, and arrange for the provision of services to eligible children by other providers.  This Section does not preclude the Department from exercising any rights it may have under the Service Provider Agreement.

 

k)         The time frames set forth in this Section shall not preclude the Department from taking action immediately, if necessary, to protect the public interest, safety and welfare or to prevent ongoing violation of federal and State laws or threat of such violation.  Nothing contained in this Section shall preclude the Department from taking action even if the provider is taking or has taken corrective action.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

SUBPART C: SERVICE DELIVERY REQUIREMENTS

 

Section 500.70  Intake

 

a)         Upon receiving a referral, regional intake entities shall ensure that evaluation, eligibility determination, assessments in all five developmental domains as set forth in Section 500.75(a)(3), and development of the initial IFSP are completed with the family within 45 calendar days.  The 45-day timeline does not apply for any period when the child or parent is unavailable to complete the initial evaluation, the initial assessments of the child and family, or the initial IFSP meeting due to the exceptional family circumstances that are documented in the child's EI records, or the parent has not provided consent for the initial evaluation or the initial assessment of the child despite documented, repeated attempts to obtain parental consent.  The initial evaluation, the initial assessments (of the child and family), and the initial IFSP meeting should be completed as soon as possible, but not more than 45 days, after the documented exceptional family circumstances no longer exist or parental consent is obtained for the initial evaluation and the initial assessment of the child.  An interim IFSP should be developed, to the extent appropriate pursuant to Section 500.80(h). 

 

b)         Service coordination, evaluation, assessment, eligibility determination, IFSP development, IFSP review, and IFSP updating, and procedural safeguards shall be provided at no cost to families.

 

           

c)         The Service Coordinator shall request appointment of a surrogate parent upon referral and prior to evaluation of a child who would not otherwise have parental representation, as set forth in Section 500.160.

 

d)         The Service Coordinator shall provide the family with orientation to the Illinois EI Services System, shall inform the child's parents of their rights and shall give 10 days written prior notice whenever the Department or service providers propose or refuse to initiate or change the identification, evaluation, or placement of the child or the provision of EI services.

 

e)         Upon receipt of informed consent from the child's parent, the Service Coordinator shall proceed with initial intake activities that shall include:

 

1)         Establishment of the child's permanent and electronic record with the regional intake entity;

 

2)         Completion of Department required intake forms;

 

3)         Completion of a family-directed assessment of the resources, priorities and concerns of the family and the identification of the supports and services necessary to enhance the family's capacity to meet the developmental needs of the infant or toddler.  The family-directed assessment must be voluntary on the part of each family member participating in the assessment, be based on information obtained through an assessment tool and also through an interview with those family members who elect to participate in the assessment, and include the family's description of its resources, priorities and concerns related to enhancing the child's development.  Unless clearly not feasible to do so, family assessment must be conducted in the native language of the family members being assessed.  The initial family assessment must be conducted within the 45-day timeline if the parent concurs and even if other family members are unavailable. 

 

4)         Request for existing records regarding the child's need for services; and

 

5)         Review of existing records to identify whether additional information is needed to determine if the child meets federal and State established eligibility criteria.

 

f)         The parent shall also be provided with notice regarding the uses and disclosures of personally identifiable information that will be collected and maintained for service delivery, and the rights provided by FERPA with respect to that information.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.75  Eligibility Determination

 

a)         The Service Coordinator shall, with informed parental consent:

 

1)         Assist the family in developing an evaluation plan that lists testing activities needed to collect the information and the appropriate available enrolled providers chosen by the family to conduct the tests;

 

2)         Arrange for the evaluation plan to be implemented; and

 

3)         Obtain evaluation reports, including statements of evaluator findings related to the child's eligibility status and the child's functioning level, unique strengths and needs in the developmental areas tested and the services appropriate to meet those needs in all of the following five developmental domains:

 

A)        cognitive development;

 

B)        physical development;

 

C)        communication development;

 

D)        social or emotional development; and

 

E)        adaptive development.

 

b)         A provider must hold an Evaluation/Assessment credential to conduct evaluations and assessments to determine initial eligibility or the need to add a new service to the IFSP.  Providers shall conduct authorized evaluations and provide reports to the Service Coordinator within 14 calendar days after the receipt of the request to perform an evaluation.

 

c)         After sufficient information has been collected to determine eligibility status, the Service Coordinator shall ensure that eligibility is determined as set forth in Section 500.50.  Existing records and evaluation reports may be used to assist with the evaluation and assessment process.  Evaluations and assessments used in the eligibility determination and/or IFSP development process must have been completed no more than six months prior to the child's eligibility determination and/or IFSP development.

 

d)         If the child is determined eligible, the Service Coordinator shall:

 

1)         Inform the parent in writing that the child was determined eligible; and

 

2)         Assure completion of further comprehensive evaluation/assessment activities with the family.

 

e)         If the child is determined ineligible, the Service Coordinator shall provide the parent with prior written notice and include in the notice information about the parent's right to dispute the eligibility determination through the dispute resolution mechanisms such as requesting a Due Process Hearing under Section 500.140 or Mediation under Section 500.145 or filing a State Complaint under Section 500.170.  The Service Coordinator shall close the case as set forth in Section 500.105.  Written notice shall be consistent with the requirements of Section 500.165.

 

f)         With informed parental consent, the Service Coordinator shall notify the referral source in writing of the status of the referral.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.80  Individualized Family Service Plan Development

 

a)         The Service Coordinator shall:

 

1)         Review existing records to identify whether additional information is needed to determine the child's current health status and medical history and, if so, shall request the information upon receipt of informed parental consent.

 

2)         Review existing records and evaluation reports to identify whether additional information is needed to determine the child's functioning levels, unique strengths and needs and the services appropriate to meet those needs in the five developmental domains (cognitive development; physical development; communication development; social or emotional development; and adaptive development) and, if not, shall arrange for additional evaluation and assessment activities using methods described in Section 500.75.

 

3)         Assist the family in determining its resources, priorities and needs related to being able to enhance its child's development and the supports and services appropriate to meet those needs.

 

4)        Assist the family initially, and annually thereafter or more often as required by change of circumstances, in determining its ability to participate in the cost of services that are subject to family fees.  The inability of a family to participate in the cost of services shall not result in the denial of services to the child or the child's family.

 

5)         At the point of EI intake, and again at any periodic review of eligibility thereafter or upon a change in family circumstances, collect information regarding any and all public and private insurance under which the child's services may be covered.

 

6)         Explain to each family, orally and in writing, information about the use of public benefits or private insurance and the system of payments and fees, as outlined in Sections 500.125 and 500.130.

 

                                                           

b)         The Department shall not pay for services listed on the IFSP that the Department is not required to fund.  EI funding is the payor of last resort for IFSP services that the Department is required to fund.  When an application or a review of eligibility for EI services is made, and at any eligibility redetermination, or upon a change in family circumstances, the family shall be asked if it is currently enrolled in Medicaid, All Kids, or the Title V program administered by the University of Illinois Division of Specialized Care for Children (DSCC).

 

1)         If the family is enrolled in any of these programs, that information shall be put on the IFSP and entered into the computerized case management system, and shall require that the IFSP of a child who has been found eligible for services through DSCC state that the child is enrolled in that program.

 

2)         For those programs in which the family is not enrolled, a preliminary eligibility screen shall be conducted simultaneously for medical assistance  under Article V of the Illinois Public Aid Code; children's health insurance program benefits under the Children's Health Insurance Program Act; and Title V maternal and child health services provided through DSCC.

 

3)         When a child is determined eligible for and enrolled in the EI program and has been found to at least meet the threshold income eligibility requirements for medical assistance under Article V of the Illinois Public Aid Code or benefits under the Children's Health Insurance Program Act, with parental consent, complete an All Kids application with the family and forward it to HFS All Kids Unit for a determination of eligibility.  

 

c)         Prior to development of the initial or annual Individualized Family Service Plan, the Service Coordinator shall:

 

1)         Arrange for a meeting to be held, at a time and place convenient for the family, with the IFSP team.  The meeting must include the child's parent or parents, other family members, as requested by the parent, if feasible to do so, the Service Coordinator, a person or persons directly involved in conducting the evaluations and assessments, service providers within the EI Service System as appropriate, and others, such as an advocate or person outside the family by parental request, to develop the IFSP; and

 

2)         Provide reasonable prior written notice to the family and other participants of this meeting early enough before the meeting date to ensure that they will be able to attend.

 

d)         At the meeting to develop the IFSP, the Service Coordinator shall:

 

1)         Coordinate and participate in the meeting.

 

2)         Ensure that the meeting is conducted in the  native language of the family or other mode of communication used by the family, unless it is clearly not feasible to do so.

 

3)         Seek a consensus by the multidisciplinary team regarding child outcomes, functional goals and objectives and an integrated plan to meet the goals and objectives set forth in subsection (e).

 

4)         If no consensus is reached, the Service Coordinator shall establish a Department approved service plan reviewed by Department designated experts, and shall provide the parents with prior written notice, pursuant to Section 500.165, of the Department's proposed service plan.  The parents may seek Mediation under Section 500.145 or a Due Process Hearing under Section 500.140 or file a State Complaint under Section 500.170 regarding other requested services.

 

e)         The Individualized Family Service Plan must:

 

1)         Be developed by a multidisciplinary team, including the Service Coordinator and the parent as set forth in subsection (g).

 

2)         Be based on a multidisciplinary assessment of the unique strengths and needs of the child and a voluntary family-directed assessment of resources, priorities and concerns of the family.

 

3)         Include services necessary to provide appropriate developmental benefits for the identified needs.

 

4)         Include supports and services necessary to enhance the family's capacity to meet the identified developmental needs.

 

5)         State the natural environments in which services shall be appropriately provided and justification of why EI cannot be achieved satisfactorily in a natural environment if any services are to be provided elsewhere. The determination must be made by the IFSP team (which includes the parents and other team members), consistent with the definition of natural environment in Section 500.20 and with the requirements that services for infants and toddlers with disabilities are provided, to the maximum extent appropriate, in natural settings.  Only when EI services cannot be achieved satisfactorily in a natural environment, services may be provided in settings other than the natural environment that are most appropriate as determined by the parent and the IFSP team.  The determination must be based on the child's outcomes that are identified by the IFSP team.

 

6)         Include all components as required by the Department.

 

7)         Provide a statement of the infant or toddler with disability's present developmental levels in the following areas, based on information from that child's evaluations and assessment:

 

A)        physical development, including vision and hearing;

 

B)        cognitive development;

 

C)        communication development;

 

D)        social or emotional development; and

 

E)        adaptive development.

 

8)         With permission of the family, provide a statement of the family's resources, priorities and concerns related to enhancing the development of the child as identified through the assessment of the family.

 

9)         Provide a statement of the functional outcomes expected to be achieved for the child (including pre-literacy and language skills, as developmentally appropriate for the child) and family, and the criteria, procedures and timelines used to determine:

 

A)        The degree to which progress toward achieving the outcomes is being made; and

 

B)        Whether modifications or revisions of the outcomes or EI services identified in the IFSP are necessary.

 

10)         Include a statement of the specific EI services, based on peer-reviewed research (to the extent practical), that are necessary to meet the unique needs of the child and the family to achieve the outcomes identified in subsection (e)(9), including:

 

A)        The frequency and intensity for each service, meaning the number of days or sessions that a service will be provided, and whether the services are provided on an individual or group basis;

 

B)        The length of each service, meaning the length of time the service is provided during each session of that service;

 

C)        The method, meaning how a service is provided;

 

D)        The location in which EI services will be provided, including whether the location would be considered a natural environment for the child and family, as described in subsection (e)(5); and

 

E)        The projected beginning dates, which shall be as soon as possible after the parent consents to the services, and the duration or the projected ending date when a given service will no longer be provided.

 

11)        Include a statement of any other services, such as medical services, that the child needs or is receiving through other sources, but that are not required or funded EI services.  The statement should include the funding sources to be used in paying for those services or the steps that will be taken to secure those services through public or private sources.  Routine medical services such as immunization or well child care do not need to be listed unless the child is not receiving those services and needs them. If those services are not currently being provided, include a description of the steps the Service Coordinator or the family may take to assist the child and family in securing those services.

 

12)        Include the name of the Service Coordinator qualified to carry out all applicable responsibilities who will be responsible for implementation of the IFSP and coordination with other agencies and persons.

 

13)        Include the steps and services to be taken to support the smooth transition of the child to preschool services under Part B of IDEA to the extent that those services are considered appropriate or to other services that may be available, if appropriate.  The steps include:

 

A)        Discussions with and training of parents regarding future placements and other matters related to the child's transition at age three years;

 

B)        Procedures to prepare the child for changes in service delivery, including steps to help the child adjust to and function in a new setting;

 

C)        Confirmation that child find information about the child has been transmitted to the local education agency or other relevant agency by the State;

 

D)        With informed parental consent, the transmission of additional information about the child to the local educational agency to ensure continuity of services, including a copy of the most recent evaluation and a copy of the most recent IFSP; and

 

E)        Identification of transition services and other activities that the IFSP team determines are necessary to support the transition of the child.

 

14)        State whether the family has private insurance coverage and, if the family has such coverage, with parental consent, include with the IFSP a copy of the family's insurance identification card or otherwise include all of the following information:

 

A)        The name, address and telephone number of the insurance carrier.

 

B)        The contract number and policy number of the insurance plan.

 

C)        The name, address and social security number of the primary insured.

 

D)        The beginning date of the insurance benefit year.

 

f)         During and as part of the IFSP development, and any changes to the IFSP, the IFSP team may seek consultation from Department designated experts, if any, to help determine appropriate services, and frequency and intensity of those services.  Services must be justified by the IFSP team in order to be included on the IFSP.   

 

g)        The contents of the IFSP shall be fully explained to the parents and informed written consent obtained prior to the provision of EI services described in the IFSP.  If the parents do not provide consent for a particular service, the EI services to which consent is obtained shall be provided.

 

h)        The Service Coordinator shall determine if an Interim IFSP, as set forth in section 303.345 of Part C of IDEA, is needed to initiate partial services for an eligible child while intake is being completed.  EI services for an eligible child and the child's family may commence before the completion of the evaluations and assessments if parental consent is obtained and an Interim IFSP is developed that includes the name of the Service Coordinator and the EI services that have been determined to be needed immediately by the child and the child's family.  Evaluations and assessments must be completed within the 45-day timeline.

 

i)          If an Interim IFSP is needed, the Service Coordinator shall:

 

1)         Document the reasons an Interim IFSP is needed;

 

2)         Assist the family in determining its ability to participate in the cost of services that are subject to family fees;

 

3)         Complete the Department required IFSP form with the child's parent and with input from the IFSP team members who recommended immediate services for the child and family;

 

4)         Arrange for the Interim IFSP to be implemented;

 

5)         Request service reports at the end of the Interim IFSP period and monitor provision of services; and

 

6)         Maintain the child's permanent and electronic record with the regional intake entity during the Interim IFSP period.

 

j)          The implementation of an Interim IFSP shall not be used to extend  the 45 day intake period.  A fee may be assessed for services subject to family fee if the family is assessed as having the ability to participate in the costs of its child's services.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.85  Individualized Family Service Plan Implementation

 

a)         Upon receiving informed written consent from the child's parent to implement the IFSP, the Service Coordinator shall:

 

1)         Arrange for implementation of the IFSP utilizing available enrolled providers.  Every effort shall be made to refer families eligible for DSCC services to DSCC-enrolled providers;

 

2)         Provide copies of the IFSP to each person the parent has consented to receive a copy, including each enrolled provider who is providing EI services to the child who is the subject of that plan;

 

3)         Request direct service reports and monitor provision of services; and

 

4)         Update and maintain the child's permanent and electronic record with the regional intake entity during the IFSP period.

 

b)         The parent has the right to accept or decline any or all services without jeopardy to other services under this Part as set forth in Section 500.155(c).  Refusals of services or referrals shall be documented in writing.

 

c)         Providers shall render authorized services as indicated in the IFSP.  They shall provide direct service reports to the Service Coordinator at least every six months and prior to each IFSP update/review or more often if the child's progress/lack of progress warrants.

 

d)         The Illinois EI Services System is not responsible for funding EI services the parent seeks from providers not enrolled with the system unless an enrolled provider cannot be made available to the family.  Services outside the System in such situations must be pre-approved by the Department.

 

e)         With the parent's informed consent to use private insurance and when a family's insurance coverage is through a managed care arrangement with a network of providers that includes one or more types of EI Specialists who provide the services set forth in the family's IFSP, the family shall use those network providers, but only to the extent that:

 

1)         the network provider is immediately available to  receive the referral and to begin providing services to the child;

 

2)         the  network  provider is enrolled as a provider in the Illinois EI system and fully credentialed under the current policy or rule of the Department;

 

3)         the network provider can provide the services to the child in the manner required in the IFSP;

 

4)         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

 

5)         the family's managed care plan does not allow for billing (even at a reduced rate or reduced  percentage of the claim) for EI services provided by non-network providers.   

 

f)         If the parent has provided informed consent to use private insurance and a child has been receiving services from a non-network provider and the regional intake entity determines, at the time of enrollment in the EI Program or at any point thereafter, that the family is enrolled in a managed care plan, the family shall transfer to a network provider within 45 days after that determination if all the requirements of subsection (e) have been met.

 

g)           If an exemption to use of insurance is granted, it shall be noted on the IFSP, and the family and the providers serving the family shall be notified in writing of the exemption.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.90  Individualized Family Service Plan Updating

 

a)         The IFSP shall be reviewed at least every six months, or more frequently if conditions warrant or upon reasonable request of the infant's or toddler's parent.  The review may be carried out by a meeting with multidisciplinary team members.

 

1)         The purpose of the review is to determine:

 

A)        The degree to which progress toward achieving the outcomes is being made; and

 

B)        Whether modification or revision of the outcomes, services or supports in the IFSP is necessary.

 

2)         The Service Coordinator shall facilitate the review and implementation of any changes that are agreed upon by consensus of the multidisciplinary team and that are consistent with requirements of Section 500.80(f). Upon informed parental consent, the child's permanent and electronic record shall be updated.

 

b)         Providers shall conduct authorized assessments using a Department approved test instrument as indicated on the IFSP as an ongoing process throughout the period of the child's eligibility and shall provide assessment reports to the Service Coordinator prior to IFSP updates/reviews.  A provider may request Department approval of a developmental test by submitting, in writing, documentation that the test meets the following criteria:  is listed in the Mental Measurement Yearbook Series; is nationally distributed; is formally validated; is age appropriate; and is individually administered.  The Mental Measurement Yearbook Series can be found at the Early Childhood Intervention Clearinghouse, many local libraries and via the Internet.

 

c)         At least once a year, the Service Coordinator shall arrange for an annual IFSP meeting to evaluate and revise, as appropriate, the IFSP for the child and the child's family.  The results of any current evaluations and other information available from the assessments of the child and child's family must be used in determining the EI services that are needed and shall be provided. The Service Coordinator shall facilitate development of the annual IFSP by conducting the activities outlined in Section 500.80.

 

d)         The Service Coordinator shall facilitate implementation of the annual IFSP by conducting the activities outlined in Section 500.85.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.95  Case Transfer

 

When an eligible child moves or is anticipating a move to another intake region within Illinois:

 

a)         With consent of the parent, the service coordinator at the prior regional intake entity shall transfer a copy of the child's permanent and electronic record to the new regional intake entity, maintaining a copy of the child's permanent record as a closed file.

 

b)         With consent of the parent, the new regional intake entity shall assist the family in initiating services in the new region.  The new service coordinator shall meet with the family as soon as possible (no later than 15 days) to arrange new providers for the services in the child's IFSP if the original providers are not able to continue serving the child and family in the new region.

 

Section 500.100  Transition to Part B or Other Appropriate Services at Age Three

 

Children receiving services under this Part shall receive a smooth and effective transition to appropriate preschool programs under Part B of IDEA or to other appropriate services for three through five year olds, by their third birthday, unless Part C services are extended until the start of the school year that begins the same year as the child’s third birthday if the child has their third birthday between May 1 and August 31 (Extended Services).  The Service Coordinator shall make all reasonable efforts to ensure the continuity and coordination of services.

 

a)         No later than six months prior to the child's third birthday, the Service Coordinator shall begin to communicate with the child's family about transition. 

 

b)         If a toddler with a disability may be eligible for preschool services under Part B, the lead agency will notify the State education agency and the local education agency for the area in which the toddler resides, not fewer than 90 days before the child's third birthday, that the toddler, on his or her birthday, will reach the age of eligibility for services under Part B.  The lead agency will disclose the child's name, the child's date of birth, and parent contact information (including parents' names, addresses and telephone numbers).  With parental consent, the Service Coordinator will transmit additional information to the LEA or other relevant agency to ensure continuity of services from the Part C program to the Part B program, including a copy of the most recent evaluation and assessment of the child and the family and the most recent IFSP.

 

c)         If a toddler with a disability may be eligible for Part B, the Service Coordinator shall convene a conference (upon the parent's approval), consisting of at least the family, the local educational agency and the IFSP team, including the Service Coordinator, to discuss service options for the child.  The conference shall also include a review of the child's program options for the period from the child's third birthday through the remainder of the school year, including a review of potential eligibility for Extended Services with Part C, until the start of the next school year.  The meeting shall be held at least 90 days and, at the discretion of all parties, not more than 9 months before the toddler's third birthday to discuss any services the toddler may receive under Part B.  The Service Coordinator shall inform the parent in writing of educational rights of students with disabilities under Part B.  If the child is not potentially eligible for preschool services under Part B, the Services Coordinator shall make reasonable efforts to convene a conference (upon the parent's approval) among the coordinator, the family and providers of other appropriate services for the toddler to discuss appropriate services that the toddler may receive.

 

d)         The Service Coordinator shall convene an IFSP team meeting no more than 120 days prior to the child's third birthday, if an annual IFSP meeting is not otherwise due, to discuss and document progress toward child outcomes and functional goals.  If the IFSP team is able to participate in the transition conference described in subsection (c) and progress measures can be measured at that time, it is not necessary to convene a separate IFSP team meeting.

 

e)         For all children receiving services under this Part, not fewer than 90 days and, at the discretion of all parties, not more than 9 months before the child's third birthday the Service Coordinator shall establish a written transition plan in the IFSP.  The transition plan in the IFSP includes, as appropriate, steps for the toddler with a disability and his or her family to exit from the Part C program and any transition services that the IFSP team identifies as needed by that toddler and his or her family.

 

f)         This plan will document all referrals to other services and all refusals of services by the parents.

 

g)         The local educational agency has an obligation under the law to participate in transition planning conferences.

 

h)         On the child's third birthday or the start date of the next school year for children eligible for Extended Services, the Service Coordinator shall close the case pursuant to Section 500.105.

 

(Source:  Amended at 47 Ill. Reg. 1318, effective January 12, 2023)

 

Section 500.105  Case Closure

 

a)         When a child exits EI services other than at transition to Part B or other appropriate services, as described in Section 500.100, the Service Coordinator shall convene an IFSP team meeting no more than 120 days prior to the child's exit, if an annual IFSP meeting is not otherwise due, to discuss and document progress toward child outcomes and functional goals.

 

b)         When a child exits EI services, the Service Coordinator shall update and close the child's permanent and electronic record and maintain the child's permanent record as a closed file.

 

c)         If an eligible child moves to another state:

 

1)         The Service Coordinator and regional intake entity shall:

 

A)        With consent of the parent, refer the child to the EI program in the new state and transfer a copy of the child's permanent record to the new state; and

 

B)        Update and close the child's permanent and electronic record with the Illinois regional intake entity.

           

2)         The Illinois EI Services System is not responsible for funding services to a child and family who no longer reside in Illinois.

 

d)         The regional intake entity and providers shall store closed records as set forth in Section 500.110.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.110  Recordkeeping

 

a)         All service providers, service coordinators, and regional intake entities shall collect, compile and maintain appropriate records as required in this Part and as required by pertinent professional standards regarding services provided under this Part.

 

b)         The early intervention record shall contain at least:

 

1)         Identifying information, including name, All Kids recipient identification number, address and telephone number, sex, date of birth, primary language or method of communication, emergency contact or parent or parent substitute, date of initial contact and initiation of early intervention services, third party coverage, and source of referral;

 

2)         Documentation of appropriate consents for early intervention services and releases of information;

 

3)         Evaluation reports;

 

4)         A current and any past IFSP, progress notes and reviews, and documentation of the relationship of the services to the IFSP goals and child and family progress;

 

5)         Documentation of known child and family movement (referral/transfer) during any active service period to or from the provider's programs or to or from other providers;

 

6)         Documentation of any refusal of services and/or referrals;

 

7)         Direct service reports to support each early intervention service rendered;

 

8)         Periodic reviews, minimally at six month intervals, describing the child's overall progress; and

 

9)         If closed, a case closure summary documenting the outcome of interventions and, as necessary, the linkages for continued services.

 

c)         Service providers, service coordinators and regional intake entities shall permit access to records by the Department as the lead agency, by the federal Office of Special Education Programs or its designees, and by its regional intake entity. Each shall obtain consent from clients, upon initiation of services, as may be necessary, to allow the release of records to the State and federal entities for the purpose of providing services, paying for services, and monitoring the provision of services.

 

d)         The compilation, maintenance, storage of and access to records shall be governed by written policies and procedures that comply with the confidentiality provisions of Sections 500.150 and 500.155.

 

e)         Facilities for the handling, processing and storage of records, whether hard copy, magnetic tapes, computer files, or other automated systems, shall be secured from unauthorized access, theft, loss, or fire or other natural occurrences.

 

f)         All entries to records shall be current, legible and dated and the author shall be designated.  If hard copy, the author shall sign the entry.

 

g)         The regional intake entity is responsible for maintaining a complete early intervention record as set forth in subsection (b) for each enrolled child in the intake region.

 

h)         Each service provider is required to keep documentation adequately supporting early intervention services provided.

 

i)          All records described in this Section shall be maintained for at least six years from the child's discharge from early intervention services, or until any outstanding audit reviews or exceptions are closed to the satisfaction of the Department, or until any active or pending legal action, hearing request, complaint or other administrative or legal proceedings regarding them are resolved, whichever comes later.  Destruction of records shall be consistent with pertinent laws.

 

(Source:  Amended at 32 Ill. Reg. 2161, effective January 23, 2008)

 

Section 500.115  Service Provider Requirements

 

Service providers shall:

 

a)         Not bill families for authorized EI services.

 

b)         Participate in evaluation/assessment activities and the development, review and revision of IFSPs in a timely and comprehensive manner, and provide EI services in a family centered, ethical and culturally competent manner.  Family members are to be an integral part of service planning, the child's participation in EI services, and the outcomes identified in the IFSP.

 

c)         Provide accurate services as set forth in the IFSP in a timely manner.

 

d)         Contact the Service Coordinator to request multidisciplinary team approval for proposed changes in the delivery of services to eligible children and to request parental consent prior to implementing any changes to services listed on the IFSP.

 

e)         Agree that they shall not bill or receive reimbursement from the Department's centralized billing system for services in excess of what is authorized in the IFSP.

 

f)         Agree not to terminate services for an eligible child without written notification to the child's Service Coordinator and family at least 30 days prior to the anticipated date of service termination.

 

g)         Meet and maintain all applicable standards and regulations for individual and program licensure, certification and credentialing.  Comply with all applicable State and federal laws and regulations for physical facilities in which services are made available.

 

h)         Provide evaluation reports and direct service reports to the Service Coordinator as required by this Part and as necessary to the provision of EI services consistent with federal and State requirements.

 

i)          Submit invoice of charges for billable services following service delivery, according to Department billing requirements.

 

j)          With the parent's informed consent to use private insurance, unless an exemption is granted to a family, bill private insurance and/or any and all other third party payors before submitting invoices for EI reimbursement.

 

1)         Bill the child's insurance carrier for each unit of EI service for which coverage may be available.

 

2)         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 subsection (j)(2) as to subsequent services billed under the same billing  code provided to that child during that insurance benefit year.

 

3)         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 Department 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.

 

4)         In all instances when an insurance carrier has been billed for EI 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, a copy of the explanation of benefits form and other required information.

 

5)         When the insurance carrier has denied the claim  or paid an amount for the EI service billed that is less than the current State rate for EI services, the  provider shall submit the explanation of benefits with a claim for payment, and the Department shall pay the provider the difference between the sum actually paid by the insurance carrier for each unit of service provided under the IFSP and the current State rate for EI services.

 

6)         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 EI services.

 

7)         The provider may under no circumstances bill the family for the difference between its charge for  services and that paid by the insurance carrier or by the State.

 

k)         Allow the Department to recoup money improperly submitted to provider by:

 

1)         offset from future reimbursements; or

 

2)         submitting repayment in full or in installments negotiated with the Department.

 

l)          Participate in routine monitoring and supervision activities as set forth by the Department, including self-assessment, on-site monitoring, data collection and reporting obligations, record reviews, financial audits, complaint investigation, and consumer satisfaction surveys.

 

m)        Comply with any and all federal and State statutes and regulations, policies, guidelines, directives and procedures, including but not limited to those listed in Section 500.45(c)(7), and others that are applicable to the services being provided.

 

n)         Provide services and communications to clients in a language or mode of communication understood by the client.  If necessary, interpreters may be used.

 

o)         Be knowledgeable about and inform families of their rights and procedural safeguards, including requirements set forth in IDEA (20 USC 1439 and 34 CFR 303.400 et seq.), and comply with those rights and procedural safeguard requirements.

 

p)         Make himself/herself available as required for Due Process Hearings, Mediation and State Complaint or legal proceedings involving services under this Part.

 

q)         Assist as required in maintaining the child's EI record at the regional intake entity.

 

r)          The evaluators/assessors shall meet criteria as set forth in this Part.

 

1)         Evaluators/assessors shall attend additional training as set forth by the Department and shall agree in writing to operate within the framework of the DHS EI philosophy and best practices, prior to being authorized to perform and bill for evaluations and assessments.

 

2)         In order to be paid for an evaluation/assessment, evaluators/assessors shall meet all deadlines for submitting evaluations/assessments as set forth in this Part and in the EI Service Provider Agreement.

 

3)         Evaluators/assessors shall participate in the IFSP meeting, for which they will be reimbursed.  The meeting shall be held within 45 days after the child is referred to the system, unless there is a delay over which they have no control.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

SUBPART D: FINANCIAL MATTERS

 

Section 500.120  Billing Procedures

 

a)         Authorized services and devices shall be billed through the Department's centralized billing system.

 

b)         Individual providers enrolled pursuant to requirements set forth in Section 500.60 may receive payment for authorized services and devices.

 

c)         Direct services, equipment and supplies shall be reimbursed at a Department established rate.

 

d)         Services and devices shall be authorized prior to delivery in order to be reimbursable.

 

e)         EI providers shall bill the Department's centralized billing system as payor of last resort for authorized services, equipment and supplies pursuant to requirements set forth in Section 500.115.  Bills must be submitted to the Early Intervention Services System in accordance with billing instructions provided to the EI provider by the System.

 

f)         Providers shall maintain and make available to the System, for a minimum of 6 years, adequate books, records and supporting documents regarding provision of and billing for services and devices, and shall comply with other recordkeeping requirements set forth in Section 500.110.

 

g)         Payments are subject to the restrictions set forth in the Illinois Public Aid Code [305 ILCS 5/11-3].

 

(Source:  Amended at 40 Ill. Reg. 9491, effective June 29, 2016)

 

Section 500.125  Payor of Last Resort

 

EI program money provided to the State under Part C may not be used to satisfy a financial commitment for services that would otherwise have been paid for from another public or private source had Part C not been enacted.  Part C funds may be used only for services that a child is not otherwise entitled to, with existing Inter-Agency Agreements, under any other federal or State source (including, but not limited to, the Division of Specialized Care for Children (Title V) program, Medicaid (Title XIX), the State Child Health Insurance Program (Title XXI), and, with parental consent, other public or private sources (including but not limited to private insurance or children not yet enrolled in Medicaid (Title XIX) and the State Child Health Insurance Program (Title XXI)).  Nothing contained in this Part shall authorize or require the Department to provide payment for services or devices that fall within the criteria outlined in this Section.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.130  Family Fee/Insurance

 

a)         A statewide sliding fee schedule shall be established by the Department and updated annually for direct EI services and assistive technology devices set forth in Section 500.55, except for those services that are required to be provided at no cost to families, including evaluation and assessment, service coordination, IFSP development and review, and procedural safeguards. (See Appendix A.)

 

b)         Each family's fee obligation shall be established annually.  Family participation fees will be billed and collected in installments through the centralized billing system.  Families that fail to provide requisite income information will be charged the maximum amount on the sliding scale.  Families shall not be required to pay more in annual fees than the cost of EI services and assistive technology devices received during the year and paid by the EI system.  At the written request of the family, the fee obligation shall be adjusted prospectively at any point during the year upon proof of change in family income or family size.

 

c)         With parental consent, families shall have their private insurance billed for services and devices set forth in Section 500.55, except for those services and devices that are required to be provided at no cost to the families.

 

d)         Recipients of medical assistance under Article V of the Illinois Public Aid Code or the Children's Health Insurance Program Act and WIC Program recipients shall not be charged an EI family participation fee.  Parents of children eligible for Medicaid shall be encouraged but not mandated to enroll their children with Medicaid so Medicaid funds can be accessed for EI services and devices.

 

e)         DHS' definition of ability to pay compares a family's household size and income to the sliding scale found in Appendix A and considers excessive out-of-pocket medical/disaster expenses.  A family meets the definition of ability to pay if the family falls within the scale and does not have excessive, proven out-of-pocket medical expenses.  Medical expenses must be expenses identified by the Internal Revenue Service as allowable deductions, and disaster expenses must be directly related to fire, flood or other act of nature. A family meets the definition of inability to pay if the family does not fall within the scale or does fall within the scale but has excessive proven out-of-pocket medical/disaster expenses exceeding 15% of income.

           

f)         Exemptions:

 

1)         A family may request exemption through the regional intake entity from the family participation fee due to documentation of catastrophic circumstances or extraordinary expense, by showing either:

 

A)        current (within 12 calendar months) out-of-pocket medical expense in excess of 15% of gross income; or

 

B)        current (within 12 calendar months) out-of-pocket losses in excess of 15% of gross income caused by disaster, such as fire, flood or tornado.

 

2)         A family that consents to insurance may request exemption through the regional intake entity from insurance use upon documentation showing a material risk of losing coverage because:

 

A)        the insurance plan/policy covering the child is an individually purchased policy/plan purchased by a head of household who is not eligible for group medical insurance; or

 

B)        the insurance plan/policy has a lifetime cap that applies to one or more specific types of EI services specified in the IFSP that coverage could be exhausted during the period covered by the service plan.  The exemption will only apply to the EI service and/or plan or policy for which there is a showing of material risk of loss of coverage.

 

3)         Regional intake entities shall submit requests for exemptions to the Department or its designee on the day that they are received, and the Department or its designee shall decide within 10 business days whether to grant the exemption and notify the regional intake entity to inform the family.

 

g)         A parent wishing to contest his/her family participation fee assessment should contact the regional intake entity as soon as possible.  The family who wishes to contest the imposition of the family participation fee may request Mediation under Section 500.145 or a Due Process Hearing under Section 500.140 or file a State Complaint under Section 500.170.

 

h)         DHS will not use the public Medicaid benefits or insurance of a child to pay for Part C services without written notification to the family (see subsection (h)(3)).  DHS will also meet the no-cost protections identified in subsections (h)(l) and (h)(2).

 

1)         Parents of children eligible for Medicaid shall be encouraged, but not mandated, to enroll their children with Medicaid so Medicaid funds can be accessed for reimbursement for EI services and devices.  Parental consent must be obtained to use public benefits of a child or parent that is not already enrolled in Medicaid.

 

2)         Consent must be obtained prior to using a child's parents' public benefits to pay for EI services or devices if that cost would:

 

A)        Decrease available lifetime coverage or any other benefit for the child or parent.

 

B)        Result in the family paying for services that would otherwise be covered by the public benefits plan.

 

C)        Result in any increase in premiums or discontinuation of the public benefits plan for the child or parents.

 

D)        Risk loss of eligibility for the child or parents for home and community-based waivers based on aggregate health-related expenditures.

 

3)         Prior to using a child's or parent's public benefits or insurance, DHS will provide written notification to the family that includes a statement:

 

A)        That parental consent must be obtained before the personally identifiable information (PII) of the child or parent is sent to HFS;

 

B)        Of the no-cost protection provisions described in subsections (h)(l) and (h)(2) and, if the parent does not provide consent, that Part C service or services the parent has consented to receive will be included in the IFSP;

 

C)        Of the parental right to withdraw at any time consent to disclose PII to the public benefits program; and

 

D)        Of the general categories of cost the parent would incur as a result of participating in the public benefits program (such as co-payments or deductibles, or required use of private insurance benefits as primary insurance).

 

4)         If a parent is required to pay any costs outlined in subsection (h)(3)(D), DHS can only charge those costs to the parent if DHS provides the parent with a statement of DHS' system of payments and fees as outlined and included in the Child Family & Connection (CFC) Procedure Manual at www.dhs.state.il.us/ei and provides the parent with notification pursuant to subsection (h)(3).

 

i)          DHS will not use the private insurance benefits of a parent or child unless the parent provides consent, pursuant to subsection (i)(1), including the use of private insurance when such use is a prerequisite for the use of public benefits or insurance as outlined in 34 CFR 303.520(b).

 

1)         Consent is required:

 

A)        When seeking to use a private insurance plan not covered by the Illinois Insurance Code [215 ILCS 5] to pay for EI services under the IFSP; and

 

B)        Each time IFSP services change or increase (frequency, length, duration or intensity).

 

2)         If DHS requires payment from the parent for any costs incurred as a result of the use of the private insurance to pay for EI services (such as co-payments, deductibles), DHS will identify any potential costs in the system of payments and fees; otherwise, DHS must not charge the parent these costs.

 

3)         When obtaining consent, the parent shall be provided a copy of DHS' system of payments and fees, as directed in the CFC Procedure Manual, identifying potential costs when using private insurance for EI services (such as co-payments, premiums or deductibles and other long-term costs such as loss of benefits because of annual or lifetime health insurance coverage caps).

 

4)         DHS must not delay or deny services if a parent meeting the definition of inability to pay does not consent to use of private health insurance to pay for EI services.

 

j)          A statement of DHS' system of payments and fees, as provided in the CFC Procedure Manual, shall be given to the family in writing, specifying which functions or services, if any, are subject to fees.  The statement shall include:

 

1)         Assurances that:

 

A)        Fees will not be charged to parents for services that the child/family is entitled to receive at no cost to families;

 

B)        The inability of the parents to pay for services will not result in a delay or denial of services if the parent meets the State's definition of inability to pay the services must be provided at no cost;

 

C)        Families will not be charged any more than the actual cost of the service (factoring in payment from other sources for that service); and

 

D)        Families with public benefits or private insurance will not be charged disproportionately more than families who do not have public benefits or private insurance.

 

2)         Provisions that failure to provide requisite income information and documentation may result in a charge of a fee on the schedule and that the fee will equal the highest monthly installment.

 

3)         Provisions governing how DHS will pay costs such as co-payments and deductibles.

 

k)         The following functions are required at no cost to the child or family:

 

1)         Child find requirements;

 

2)         Evaluation and assessment and functions related to evaluation and assessment;

 

3)         Service Coordination services: and

 

4)         Administrative and coordinative activities related to:

 

A)        IFSP development, review and evaluation for IFSP and Interim IFSP.

 

B)        Implementation of procedural safeguards and other components of the statewide system of EI services.

 

l)          Fees or costs collected from a parent or family to pay for EI services under the system of payments and fees are program income and must be used for the purposes of the grant under Part C of IDEA.

 

m)        Funds received from the family participation fees are considered program income under 34 CFR 80.25.  These funds:

 

1)         Are not deducted from the total allowable costs charged under Part C of IDEA;

 

2)         Must be used for DHS'  Part C EI services program; and

 

3)         Are considered neither State nor local funds under 34 CFR 303.225(b).

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

SUBPART E: PROCEDURAL SAFEGUARDS/CLIENT RIGHTS

 

Section 500.135  Minimum Procedural Safeguards

 

a)         The following minimal procedural safeguards are required by IDEA, regarding Part C EI services:

 

1)         The timely administrative resolution of complaints by parents and the right to bring civil action with respect to the complaint in State or federal court, consistent with Section 500.140;

 

2)         The right to confidentiality of personally identifiable information, including the right of parents to written notice and written consent to exchange of information among agencies, consistent with federal and State law, consistent with Section 500.150;

 

3)         The right of the parents to determine whether they, their child or other family members will accept or decline any EI service under this Part without jeopardizing other EI services under this Part, consistent with Section 500.155;

 

4)         The opportunity for parents to examine records relating to evaluation, screening, eligibility determination, and the development and implementation of the IFSP, consistent with Section 500.150;

 

5)         Procedures to protect the rights of the child when the parents are not known or cannot be found, or the child is a ward of the State, including the assignment of an individual (who is not an employee of a State agency, a family member or an EI services provider) to act as a surrogate, consistent with Section 500.160;

 

6)         Written prior notice to the parents of the child when the State agency or service provider proposes to initiate or change, or refuses to initiate or change, the identification, evaluation, or placement of the child in, or the provision of, appropriate EI services, consistent with Section 500.165;

 

7)         Procedures designed to ensure that the written prior notice in subsection (a)(6) fully informs the parents in the parents' native language, consistent with Section 500.155;

 

8)         The right of parents to use Mediation under Section 500.145, file a State Complaint under Section 500.170 or request a Due Process Hearing under Section 500.140, in accordance with IDEA (20 USC 1439(a)(6) through (7)).

 

b)         Regional intake entities and other providers of Part C EI services shall not violate the procedural safeguards and rights set forth in subsection (a). Furthermore, to the extent that they participate in any activity requiring procedures and rights in subsection (a), they shall comply with those procedures, assure the protection of those rights, and give clients timely and effective notice of those rights.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.140  Request for a Due Process Hearing

 

a)         Who May File:  The parents of a child between birth and 36 months, a provider, a regional intake entity or the Department (Complaining Party) may submit a Request for Due Process Hearing to resolve a dispute regarding the evaluation, identification, placement, delivery of services, or provision of appropriate services for their child (or if a public agency, for a child for whom it has responsibility).

 

b)         Where to Send:  A Request for Due Process Hearing form shall be used and submitted in writing to the Department at:

 

Chief

Bureau of Hearings

Illinois Department of Human Services

69 W. Washington Street, 4^th Floor

Chicago, Illinois 60602

 

                        with copies to the regional intake entity serving the child and to:

 

Part C Coordinator

EI Program

Illinois Department of Human Services

823 East Monroe

Springfield, Illinois 62701

 

c)         The Request for Due Process Hearing shall be confidential and only used for purposes of resolution of the dispute and as agreed to by the child's parents. The Request for Due Process Hearing shall include:

 

1)         the name of the child;

 

2)         the address of the residence of the child;

 

3)         the name of the provider serving the child;

 

4)         in the case of a homeless child, available contact information for the child and the name of the provider serving the child;

 

5)         a description of the nature of the problem of the child relating to the proposed or refused initiation or change, including facts relating to the problem;

 

6)         a proposed resolution of the problem to the extent known and available to the party at the time;

 

7)         the name, address and telephone number of the child's parent, of the person making the request, if it is someone other than the child's parent, or, if no address, available contact information;

 

8)         the child's date of birth;

 

9)         the name and address of the child's regional intake entity;

           

10)        authorization for release of the child's EI service records to the Department and the hearing officer;

           

11)        the native language spoken by the parents; and

           

12)        evidence supporting the remedy or proposed resolution (i.e., IFSP, family fee calculation form, bill payment, etc.).

             

d)        Determination of Sufficiency:  A Complaining Party may not have a Due Process Hearing until the Complaining Party or the attorney representing the Complaining Party files a request for hearing containing all the information listed in subsections (c)(1) through (6).  The Request for Due Process Hearing form shall be used, but the request will not be denied if the information is otherwise provided in writing.  The Due Process Complaint required by this Section must be deemed sufficient unless the party receiving the request for Due Process Complaint notifies the hearing officer and the other party in writing within 15 days after receipt of the request for Due Process Complaint, that the receiving party believes the request for Due Process Complaint does not meet the requirements of this Section.  The hearing officer shall make a determination on the face of the notice as to whether it is sufficient, within five calendar days after receipt of the notification, and shall notify the Complaining Party, the Responding Party and the Department in writing after that determination. Within 10 days, the Responding Party shall send to the Complaining Party a Response that specifically addresses the issues raised in the Request for Due Process Hearing.

 

e)         Child's Record to Department:  The regional intake entity shall disclose the complete record of the child to the Department within five calendar days after receipt of the Complaint requesting a proceeding in accordance with this Section.

 

f)         Content and Assurance of Prior Notice:  If "prior written notice" pursuant to CFR 303.421 was not provided to the parent regarding the subject matter of the parent's request for a Due Process Hearing, the regional intake entity shall send the parent a response within ten calendar days after receiving the Complaint.  This response shall not preclude the assertion that the parent's request for hearing is insufficient, where appropriate.  The response shall include:

 

1)         an explanation of why the regional intake entity or payee/provider proposed or refused to take the action raised in the Complaint;

 

2)         a description of other options the IFSP team considered and the reason why those options were rejected;

 

3)         a description of the evaluation procedure, assessment, record or report the agency used as the basis for the proposed or refused action; and

 

4)         a description of factors relevant to the regional intake entity or payee's/provider's proposed or refused action.

 

g)         Amendment of Request:  A Complaining Party may amend its Request for Due Process Hearing if the other Responding Parties consent in writing to the amendment and are given the opportunity to resolve the complaint through a resolution meeting as described in subsection (h), or if the hearing officer grants permission no later than five business days before the Due Process Hearing occurs.  The timelines for the resolution meeting, described in subsection (h), and for resolution of the hearing request, begin anew with the filing of the amended request.

 

h)         Resolution Period:  Upon receipt of a sufficient Request for Due Process Hearing, the Department must convene a resolution meeting with the parent and the relevant member or members of the IFSP Team who have specific knowledge of the facts identified in the Complaint and with a Department representative if necessary.  The parent and the Department must determine the relevant members of the IFSP team to attend the meeting. The purpose of this meeting is to provide the parents with an opportunity to resolve the complaint. 

 

1)         The resolution meeting must be held within 15 calendar days after receipt of the request for hearing.

 

2)         The resolution meeting must include a representative who is authorized to make decisions on behalf of each party.

 

3)         The Department may not be represented by an attorney at the resolution meeting unless the parent is accompanied by an attorney.

 

4)         If a resolution to the dispute is reached, the parent and the Department shall execute a  document that is enforceable in any State court of competent jurisdiction or in a district court of the United States.

 

5)         The Department or the parent may void this agreement within three business days after the agreement's execution.

 

6)         Though recommended, the resolution meeting is not mandatory if the Complaining Party and the Responding Party agree to waive it or agree to use Mediation.

 

i)          Mediation Option:  Upon receipt of a Request for Due Process Hearing, the parent and the Department may agree to Mediation as set forth in Section 500.145.

 

j)          Services During Proceeding:  During the pendency of the Due Process Hearing, unless the parent and the Department agree otherwise, the child must continue to receive the appropriate Part C EI services identified in the most recent IFSP to which the parents consented.  If the Request for Due Process Hearing involves application for initial Part C services, the child must receive those services that are not in dispute.

 

k)         Free and Low-Cost Services:  The parent shall be informed of free or low cost legal and other related services available in the area if the parent requests that information or the parent, provider, regional intake entity or Department initiates a resolution under these provisions.  Regional intake entities shall maintain the information and make it available upon request or if a proceeding is initiated under this Section.

 

l)          Hearing Officer:  Upon receipt of a Request for Due Process Hearing, the Department shall appoint an impartial hearing officer.  The Department shall maintain a list of hearing officers that includes a statement of the qualifications of each person hearing Due Process complaints.  An impartial hearing officer must:

 

1)         be licensed to practice law in Illinois;

 

2)         have knowledge about the provisions of IDEA Part C and the Illinois EI Services System Act, the needs of eligible children and their families, and services available to them;

 

3)         not be an employee of the Department or a State educational agency, LEA or private service provider involved in the provision of EI services or care of the child; and

 

4)         not have a personal or professional interest that would conflict with his/her objectivity in implementing the process.

 

m)        Time Limit to File:  A Request for Due Process Hearing must be submitted to the Department as soon as possible, but at least within three months after the date when the complainant knew or should have known about the alleged action that forms the basis of the complaint.  This timeline does not apply during any period of time that the parent was prevented from requesting the hearing due to:

 

1)         specific misrepresentations by the Department, provider or regional intake entity that the problem forming the basis of the complaint has been resolved; or

 

2)         the Department, regional intake entity or provider withholding information from the parent that is required to be provided to the parent.

           

n)         30-Day Resolution Period Prior to Hearing:  If the Department has not resolved the complaint to the satisfaction of the parent within 30 days after the receipt of the Request for Due Process Hearing, the hearing may occur and the 45-day timeline for resolution of the complaint by the hearing officer begins.  This 30-day time period will be delayed by any length of time the parent fails to participate in the resolution meeting, unless the Department and the parent have jointly agreed to waive the resolution meeting or to use Mediation.

 

o)         Parent or Regional Intake Entity Non-participation:  If the Department is unable to obtain participation of the parent in the resolution meeting after reasonable efforts have been made and documented, the hearing officer may dismiss the complaint.  If the Department fails to hold the resolution meeting within 15 days after receiving notice of the complaint or fails to participate in the meeting, the parent may request the hearing officer to begin the 45-day timeline for resolution of the complaint.

 

p)         45-Day Hearing Resolution Time Period: 

 

1)         The hearing must be resolved within 45 days, with final decision completed and mailed to the parties.  The 45-day time period begins the day after one of the following: 

 

A)        the parties agree in writing to waive the resolution meeting; or

 

B)        a Mediation or resolution meeting starts but the parties agree in writing before the end of the 30-day period that no agreement is possible; or

 

C)        the parties agree in writing to continue the Mediation at the end of the 30-day resolution period, but the parent or regional intake entity later withdraws from the Mediation process.

 

2)         The parties shall immediately notify the appointed hearing officer and the Department in writing as soon as any of the events described in subsection (p)(1) occurs.

 

q)         Setting a Hearing:  Within five days after receiving written notification that the 45-day time period for resolution has begun pursuant to subsection (p), the appointed hearing officer shall contact the parties to determine a time and place reasonably convenient to the parties for a hearing and any pre-hearing conferences.  The hearing officer shall provide the parties and the Department at least 10 days' written notice of the dates, times, and locations of any pre-hearing conferences and of the hearing.

 

r)          Pre-hearing Conference:  The hearing officer may conduct a pre-hearing conference either in person or by telephone in order to narrow the issues, determine stipulations by the parties, exchange evidence and names of witnesses, and consider other matters that may aid in efficient disposition of the case.  At the conclusion of the pre-hearing conference, the hearing officer will prepare a written report of the conference to be entered into the hearing record memorializing the discussion, any stipulations and orders, and scheduling accommodations made for parties or witnesses.

 

s)         Party's Rights:  Any party to a hearing has a right to:

 

1)         be accompanied (at the party's expense) and advised by counsel and by individuals with special knowledge or training with respect to children with disabilities;

 

2)         present evidence and confront, cross-examine, and compel the attendance of witnesses;

 

3)         prohibit the introduction of any evidence at the proceeding that has not been disclosed to that party at least five days before the proceedings;

 

4)         obtain a written or, at the option of the parent, electronic verbatim record of the hearing; and

 

5)         obtain written or, at the option of the parent, electronic findings of fact and decision.

 

t)          Parents' Rights:  Parents involved in hearings must be given the right to:

             

1)         have the child who is the subject of the hearing present;

 

2)         open the hearing to the public (hearings shall be closed to the public unless the parent requests them to be open); and

 

3)         have the record of the hearing, the findings of fact and decision provided at no cost to the parents.

 

u)         Disclosure of Evidence and Witnesses:  As soon as possible, but at least five business days prior to the hearing, each party shall disclose to all other parties all evaluations completed by that date and recommendations based on those evaluations that the party intends to use at the hearing, as well as other evidence to be offered at hearing, names of all witnesses and the nature of their testimony, and any other relevant documentation whether or not it will be offered at the hearing.

 

v)         Barring Evidence and Witnesses:  The hearing officer may bar any party failing to comply with subsection (u) from introducing evidence or calling witnesses at hearing that were not produced as required in subsection (u).

 

w)        Scope of Hearing:  No party shall be allowed to raise issues at the hearing that were not raised in the request for resolution, unless the other parties agree.

 

x)         Hearing Office Authority:  The hearing officer is authorized to conduct the hearing, administer oaths, issue subpoenas to compel testimony or production of documents, rule on motions, grant continuances, call or examine witnesses, and take such other action as may be necessary to provide the parties with an opportunity to be heard fairly and expeditiously.

 

y)         Burden of Proof:  At the hearing, the party who requested the hearing has the burden of proceeding first and demonstrating by a preponderance of the evidence that the provision or proposed provision of EI services for the child violates the laws or rules governing EI services.

 

z)         Closing Arguments:  Upon completion of the submission of evidence and testimony, parties shall be given a reasonable period of time to present written or oral arguments to complete the process within 45 days.

 

aa)       Substantive Versus Procedural Violations:  The hearing officer's determination as to whether the child received appropriate EI services shall be made on substantive grounds.  In matters alleging a procedural violation, the hearing officer may find that a child did not receive appropriate EI services only if the procedural inadequacy impeded the child's right to appropriate EI services; or significantly impeded the parent's opportunity to participate in the decision-making process regarding the provision of appropriate EI services; or caused deprivation of developmental benefit.  This does not preclude the hearing officer from ordering the Department or payee/provider to comply with procedural requirements.

 

bb)       Hearing Record:  The hearing officer shall maintain and prepare a record of the proceeding and shall prepare written findings and a decision that shall be served upon the parties.  The record shall contain the request for the proceeding, evidence submitted at the hearing, a transcript or recording of the hearing, prehearing conference reports, motions, orders and all other material that is part of the record.

 

cc)       Findings Made Public:  Any and all written findings and decisions shall be transmitted to the Illinois Interagency Council on EI and be made available to the public without personally identifying information.

 

dd)      Request for Delay:  Either party may request a delay in convening the hearing and/or the pre-hearing conference for good cause.  The party requesting the delay shall do so in writing to the hearing officer, with a copy served at the same time to all parties.  The requesting party shall set forth the reasons for the request and the hearing officer shall, upon receiving the request, either grant or deny the request, taking into account the right to resolution as set forth in subsection (p), which may be waived.

 

ee)       Appeal:  Any party aggrieved by the findings and decision made in the hearing has a right to bring civil action in a State court of competent jurisdiction or in a district court of the United States regardless of the amount in controversy.

 

ff)        Calculation of Time:  Time periods set forth  in this Section are calendar days unless otherwise specified.

 

(Source:  Amended at 40 Ill. Reg. 9491, effective June 29, 2016)

 

Section 500.145  Mediation

 

a)         Parties/Purpose

 

1)         Any party having a dispute involving any matter under Part C, including the identification, evaluation or placement of a child for EI services, or the provision of EI services, may request Mediation to resolve the disputes.  Mediation may be used at any time, regardless of whether a request for a Due Process Hearing or a State Complaint is filed.

 

2)         One purpose of a Mediation process is to provide an alternative to the Due Process Hearing as a way to resolve disagreements.  In virtually all cases, it is less costly and less adversarial than a Due Process Hearing.  Neither party is asked to abandon its beliefs about the child's ability.  Rather, the parties are asked to consider alternatives that could be incorporated into the child's IFSP and to be aware of the concerns and problems expressed by the other party.

 

b)         The form, Request for Mediation, shall be submitted in writing to:

 

Chief

Bureau of Hearings

Illinois Department of Human Services

69 W. Washington Street, 4^th Floor

Chicago, Illinois 60602

 

with a copy sent to the regional intake entity serving the child and to:

 

Part C Coordinator, Bureau of EI

Department of Human Services

823 East Monroe

Springfield, Illinois 62701

 

c)         The written request shall include the name and address of the child and of the person requesting Mediation, a description of the nature of the problem of the child, including the facts related to the problem, a proposed resolution to the problem, supporting relevant documentation of the facts, and the name and address of service providers.

 

d)         If a request for a Due Process Hearing is made, Mediation will be offered. Mediation may not be used to delay or deny a parent's right to a Due Process Hearing or other rights under Part C.

 

e)         The Mediation will be conducted by a qualified and impartial mediator who is trained in effective Mediation techniques and who is knowledgeable  in laws and regulations relating to EI services under Part C.  The Department must maintain a list of individuals who meet these criteria and the Department must select mediators on a random, rotational or other impartial basis.  A mediator may not be an employee of an agency providing services to the child at issue nor of the Department, nor have a personal or professional interest that conflicts with the person's objectivity.

 

f)         The Department shall bear the cost of the Mediation process.  It must be voluntary by all parties.

 

g)         The mediator shall assure that a Mediation conference is convened within 10 days after the request for Mediation and concluded in a timely fashion and in no event later than the Due Process Hearing, if one was requested.

 

h)         The mediator will contact the parties to set a mutually convenient date, time and location for the Mediation conference, to answer any questions the parties may have regarding the process, and to request additional information from the parties.

 

i)          The role of the mediator is that of a neutral facilitator assisting parents and EI personnel to resolve their disagreement.  Although the mediator is in control of the session, he/she is not the decision maker and may not compel action by either party.  The mediator allows the parties to present their positions, establishes an understanding of the disagreement, determines points of agreement, and offers suggestions/proposals for resolution, attempting to help the parties achieve a mutual solution that is in the best interests of the child.  The mediator facilitates the process and may help the parties consider possible alternatives.

 

j)          If agreement is reached by the parties, it shall be set forth in a written Mediation agreement signed by authorized representatives of the parties to the dispute who have authority to bind the parties.  The Mediation agreement will record only the date of the Mediation, the parties to the Mediation and terms agreed upon and the following statement:  All discussions that occurred during the Mediation process shall be confidential and may not be used as evidence in any subsequent Due Process Hearing or civil proceeding.

 

k)         Discussions that occur during the Mediation process shall be confidential and may not be used as evidence in any subsequent administrative hearing or civil proceeding.  The parties will be asked to sign a confidentiality pledge prior to the commencement of the Mediation.  Only the fact that Mediation occurred and the terms of any Mediation agreement reached are admissible in subsequent proceedings.

 

l)          Participants in the Mediation conference should be limited to those necessary to resolution of the dispute and shall include persons authorized to act on behalf of the parties.  In determining participants, the parties and mediator should be guided by desire to achieve mutual non-adversarial problem solving with the child's interests and the interests of the EI Services System as the goal.

 

m)        The parties are expected to approach the Mediation session in good faith and with the intention of attempting to reach an agreement.  It is important that all parties approach the session with a willingness to listen and to consider all aspects of the issues in the interests of the child and of the EI Services System.  They are active participants in the session and, if agreement is reached, develop the terms of the agreement with the assistance of the mediator.

 

n)         The Mediation allows an uninterrupted opportunity for both parties to present their views in a non-adversarial setting.  It allows parents and EI Program personnel to focus on their common concerns, rather than their differences.  Even if an agreement is not reached, there is the potential of both parties leaving the session with an enhanced perspective of the issues, and with a more positive working relationship.

 

o)         Regional intake entities, Service Coordinators and other participants in the EI Services System shall encourage resolution of disputes by Mediation.

 

p)         Services During Proceeding:  During the pendency of the Mediation proceedings, unless the parent and the Department agree otherwise, the child must continue to receive the appropriate Part C services identified in the most recent IFSP to which the parents consented.  If the Request for Mediation involves application for Part C services, the child must receive services that are not in dispute.

 

(Source:  Amended at 40 Ill. Reg. 9491, effective June 29, 2016)

 

Section 500.150  Confidentiality/Privacy

 

a)         The regional intake entity shall ensure the confidentiality of all PII collected or maintained pursuant to Part C in accordance with FERPA (20 USC 1323(g)), FERPA regulations (34 CFR 99), this Part and IDEA regulations (34 CFR 303.101 through 303.417).

 

b)         The regional intake entity shall give parents a Confidentiality Notice when a child is referred to Part C services.  The Confidentiality Notice shall include:

 

1)         a description of the children on whom PII is maintained;

 

2)         the type of information sought;

 

3)         the methods the State intends to use in gathering the information;

 

4)         the sources from whom the information is gathered;

 

5)         the uses of the information;

 

6)         a summary of the policies and procedures the regional intake entity and providers must follow regarding storage, disclosure to third persons, retention and destruction of PII;

 

7)         a description of the rights of parents and children regarding the PII; and

 

8)         a description of the extent to which the notice is provided in native languages in various population groups in the State.

                                   

c)         Access rights:

 

1)         Each participating agency shall permit parents to inspect and review any records relating to their children that are collected, maintained, or used by the agency under this Part (including records relating to evaluations or assessments, screenings, eligibility determinations, development and implementation of IFSPs, provision of EI services, individual complaints dealing with the eligible child, and any other area under this Part involving records about the child and the child's family).  The agency shall comply with a request without unnecessary delay and before any meeting regarding an IFSP or any Due Process Hearing.  In all cases, the regional intake entity shall comply within 10 calendar days after the request has been made.

2)         The right to inspect and review records under this Section includes:

 

A)        The right to a response from the participating agency to reasonable requests for explanations and interpretations of the EI records;

 

B)        The right to request copies of the records containing the information if failure to provide those copies would effectively prevent the parent from exercising the right to inspect and review the records; and

 

C)        The right to have a representative of the parent inspect and review the EI records.

 

3)         A participating agency may presume that the parent has authority to inspect and review records relating to his or her child unless the agency has been advised that the parent does not have the authority under applicable State law governing such matters as guardianship, separation, and divorce.

           

d)         Record of access/Accounting of disclosure

            Each participating agency shall keep a record of persons obtaining access to records collected, maintained, or used under this Part (except access by parents and authorized employees of the participating agency), including the name of the person, the date access was given, and the purpose for which the person is authorized to use the records.  

 

e)         Records on more than one child

            If any record includes information on more than one child, the parents of those children shall have the right to inspect and review only the information relating to their child or to be informed of that specific information.

 

f)         List of types and locations of information

            Each participating agency shall provide parents on request a list of the types and locations of records collected, maintained, or used by the agency.

 

g)         Fees

 

1)         The parents shall be provided, at no cost, a copy of each evaluation, assessment of the child, family assessment and IFSP as soon as possible after each IFSP meeting.

 

2)         Each participating agency may charge a reasonable fee for additional copies of records that are made for parents under this Part if the fee does not effectively prevent the parents from exercising their right to inspect and review those records, except as provided in subsection (g)(1).

 

3)         A participating agency may not charge a fee to search for or to retrieve information under this Part.

 

h)         Amendment of records at parent's request

 

1)         A parent who believes that information in the records collected, maintained, or used under this Part is inaccurate or misleading or violates the privacy or other rights of the child may request the participating agency that maintains the information to amend the information.

 

2)         The agency shall decide whether to amend the information in accordance with the request within five business days after  the request.  If the agency denies the request to amend the records, the agency must:

 

A)        inform the parent;

 

B)        advise the parent of a right to an informal hearing; and

 

C)        notify the DHS Bureau of Early Intervention (Bureau of EI) within the five business day time period.

 

3)         If the agency decides to refuse to amend the information in accordance with the request, it shall inform the parent of the refusal, and advise the parent of his or her right to a hearing as set forth in subsection (i).

           

i)          Hearing regarding records

 

1)         The Department shall give the parent an opportunity for a hearing to challenge the content of the EI records on the grounds that the information in the records is inaccurate, misleading or in violation of privacy rights of the child.

 

2)         The Department will set the informal hearing within seven business days after receiving notice of the dispute.

 

3)         The Department shall give the parent notice of the date, time and place reasonably in advance of the hearing.

 

4)         The hearing may be conducted by an individual, including an official of the participating agency, who does not have a direct interest in the outcome of the hearing. The hearing officer will be designated by the Part C Coordinator.

 

5)         The Department shall give the parent a full and fair opportunity to present evidence relevant to the grounds of challenge to the records.

 

6)         The parent may at his/her own expense be assisted or represented by one or more individuals of choice, including an attorney.

 

7)         The Department shall make its decision within 10 business days after the hearing.  The decision shall be based solely on the evidence presented at the hearing and shall include a summary of the evidence and reason for the decision.

 

8)         If the decision of the Department is that the information challenged is inaccurate, misleading or in violation of the child's privacy rights, the Department shall:

 

A)        amend the record accordingly; and

 

B)        inform the parent of the amendment in writing.

 

9)         If the decision is that the challenged information is not inaccurate, misleading or in  violation of privacy rights, the Department shall inform the parent of the right to place a statement in the record commenting on the contested information and stating why he or she disagrees with the decision.

 

10)         If a statement is placed in the record pursuant to subsection (i)(9), the Department shall:

 

A)        maintain the statement with the contested part of the record for as long as the record is maintained;

 

B)        disclose the statement whenever it discloses the contested part of the record; and

 

C)        at the parent's written request, disclose the statement to individuals to whom the contested part of the record was previously sent.

 

j)          Safeguards:

 

1)         Each participating agency shall protect the confidentiality of personally identifiable information at collection, storage, disclosure and destruction stages.

 

2)         Each agency shall require one official to assume responsibility for ensuring the confidentiality of the information.

 

3)         All persons collecting or using the information shall be trained regarding confidentiality requirements.

 

4)         Each participating agency shall maintain, for public inspection, a current listing of those employees having access to the information.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.155  Right to Consent

 

a)         As used in this Subpart:

 

1)         "Consent" means that:

 

A)        The parent has been fully informed of all information relevant to the activity for which consent is sought, in the parent's native language or other mode of communication;

 

B)        The parent understands and agrees in writing to the carrying out of the activity for which consent is sought, and the consent describes that activity and lists the records (if any) that will be released and to whom;

 

C)        The parent understands that the granting of consent is voluntary on the part of the parent and may be revoked at any time; and

 

D)        If a parent revokes consent, that revocation is not retroactive (i.e., it does not apply to the action that occurred before the consent was revoked).

           

2)         "Personally identifiable" means that information includes:

 

A)        The name of the child, the child's parent, or other family member;

 

B)        The address of the child;

 

C)        A personal identifier, such as the child's or parent's social security number; or

 

D)        A list of personal characteristics or other information that would make it possible to identify the child with reasonable certainty.

 

b)         Parental consent

 

1)         Written parental consent must be obtained before:

 

A)        All evaluations and assessments of a child; and

 

B)        Initiating the provision of EI services.

 

2)         If consent is not given pursuant to subsection (b)(1), the regional intake entity, the local provider or other participating agency shall make reasonable efforts to ensure that the parent:

 

A)        Is fully aware of the nature of the evaluations, assessments or services that would be available; and

 

B)        Understands that the child will not be able to receive the evaluations, assessments or services unless consent is given.

 

c)         Right to decline services

            The parents of a child eligible under this Part may determine whether they, their child, or other family members will accept or decline any EI services under this Part in accordance with the Illinois Early Intervention Services System Act [325 ILCS 20], and may decline a service after first accepting it, without jeopardizing other EI services under this Part.

 

d)         Right to written consent regarding exchange of information.

 

1)         Each regional intake entity, local service provider and participating agency shall obtain consent in writing from parents before they collect, maintain or use records as defined in Section 500.150 regarding eligible children.

 

2)         Each agency shall use the records only for the purpose for which they are collected or maintained.

 

3)         Each agency shall maintain the records in a confidential, secure manner, allowing access only as required to serve the eligible child as consented to by the parent, and access as described in Section 500.150.

 

4)         The exchange of records and any personally identifiable information collected, used, or maintained under this Part is precluded without written notice of and written consent to the exchange of information among agencies consistent with federal and State law, or as otherwise allowed by that law.

 

5)         Each agency shall have procedures in writing to ensure compliance with this Section.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.160  Surrogate Parents

 

a)         The Service Coordinator shall request that ISBE assign an individual to act as surrogate parent of a child who would not otherwise have parental representation, including:

 

1)         Each child under the legal responsibility of the State, meaning that the child is a ward of the Court or a State agency has been designated by the Court as the child's legal guardian or legal custodian with the right to consent for major medical treatment; and

 

2)         Each child for whom no parents can be identified or whose parents' whereabouts cannot be discovered after reasonable efforts.

 

b)         A foster parent may be appointed as a surrogate if he/she meets the requirements of subsection (d).  A foster parent may also act as a parent if:

 

1)         the natural parents' authority to make parental decisions required for EI services have been extinguished under State law; and

 

2)         the foster parent has an ongoing, long term parental relationship with the child; is willing to make decisions required of parents in this Part; and has no interest that would conflict with the interests of the child.

 

c)         Surrogates shall be requested through ISBE.

 

d)         Surrogates may be selected in any way permitted by 34 CFR 303.422 (2013), but shall:

 

1)         Have no personal or professional interest that conflicts with the interests of the child he or she represents;

 

2)         Have knowledge and skills that ensure adequate representation of the child; and

 

3)         Not be an employee of any State agency or a person or an employee of a person providing EI services, education, car or other services to the child or to any family member of the child.  A person who otherwise qualifies to be a surrogate parent under this Section is not an employee solely because he or she is paid by a public agency to serve as a surrogate parent.

 

e)         A surrogate parent may represent the child in all matters related to:

 

1)         The evaluation/assessment of the child;

 

2)         Development and implementation of the child's IFSP, including annual evaluations and periodic reviews;

 

3)         The ongoing provision of EI services to the child; and

 

4)         Any other rights established under this Part.

 

f)         The assignment of a surrogate parent at no times supersedes, terminates or suspends the parent's or guardian's legal authority relative to the child.

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.165  Written Prior Notice

 

a)         General

            Written prior notice must be given to the parents of a child eligible under this Part a reasonable time before a participating agency proposes, or refuses, to initiate or change the identification, evaluation or placement of the child, or the provision of appropriate EI services to the child and the child's family.

 

b)         Content of Notice

            The notice must be in sufficient detail to inform the parents about:

 

1)         The action that is being proposed or refused;

 

2)         The reasons for taking the action; and

 

3)         All procedural safeguards that are available under this Part, including a description of Mediation under Section 500.145, the State Complaint procedure under Section 500.170 and the due process procedures under Section 500.140, including the timelines under those procedures.

             

c)         Native language

 

1)         The notice must be written in language understandable to the general public and provided in the native language of the parents or other mode of communication used by the parent, unless it is clearly not feasible to do so.

 

2)         If the native language or other mode of communication of the parent is not a written language, the public agency or designated service provider shall take steps to ensure that:

 

A)        the notice is translated orally or by other means to the parent in the parent's native language or other mode of communication;

 

B)        the parent understands the notice; and

 

C)        there is written evidence that the requirements of subsection (c) have been met.

 

3)         If a parent is deaf or hard of hearing, blind or visually impaired, or has no written language, the mode of communication must be that normally used by the parent (such as sign language, Braille, oral communication or other mode of communication as determined through consultation with the parent).

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)

 

Section 500.170  State Complaint Procedure

 

a)         Individuals or organizations (hereinafter referred to as Complainant) may file a written, signed State Complaint with DHS stating that the Department, regional intake entity or payee/provider (hereinafter referred to as Respondent) is violating a law or rule regarding the Part C EI program.  The form Request for Investigation of State Complaint shall be used and shall include:

 

1)         A statement that the Respondent has violated a requirement of Part C of the Act;

 

2)         A recital of facts on which the statement is based;

 

3)         The signature and contact information of the complainant;

 

4)         If violations pertain to a specific child;

 

A)        the name of the child and the address of the residence of the child;

 

B)        the name of the provider serving the child;

 

C)        a description of the nature of the problem of the child, including facts relating to the problem; and

 

D)        a proposed resolution of the problem to the extent known and available to the party at the time the Complaint is filed.

 

b)         A Request for Investigation of a State Complaint shall not be denied if the information required by subsection (a) is otherwise provided in writing.

 

c)         State Complaints must be submitted in writing to:

 

Part C Coordinator, Bureau of EI

Department of Human Services

823 East Monroe

Springfield, Illinois 62701

 

d)         The Complainant must forward a copy of the State Complaint to the Respondent at the same time the Complainant files the State Complaint with the Department.

 

e)         The alleged violation must have occurred not more than one year before the date the State Complaint is received by the Department.

 

f)         The Department shall have 60 calendar days after receipt of the State Complaint to investigate and issue a written decision to the Complainant and interested parties, addressing each allegation in the State Complaint.  During this time, the Department may carry out an independent on-site investigation if deemed necessary and must give the Complainant an opportunity to submit additional information, either orally or in writing, about the allegations made in the Complaint.  The Department shall give an opportunity for the Complainant and the Respondent to voluntarily engage in Mediation as set forth in Section 500.145.

 

g)         After reviewing all relevant information, the Department must issue a written decision to the Complainant and the Respondent as to whether the Respondent is violating a requirement of Part C. The Department shall address each allegation in the State Complaint and include findings of fact, as well as conclusions, and the reasons for the Department's final decision. If the Department determines the Respondent failed to provide appropriate services, the Department shall address:

 

1)         corrective actions required to correct the causes of the Complaint, which may include compensatory services or monetary damages; and

 

2)         whether changes in policy and procedures that impact the future provision of service for children with disabilities and their families is required.

 

h)         Final decisions are enforceable and binding.  They may be amended only upon agreement in writing between the Department and the Respondent.

 

i)          The Respondent may request reasonable technical assistance or alternative corrective actions. However, these requests do not change the final decision unless it is amended in writing between the Department and the Respondent.

 

j)          The 60 day time period in subsection (f) may be extended if exceptional circumstances exist with respect to a particular State Complaint.

 

k)         The Department shall monitor implementation of the final decision to determine that corrective actions and timelines have been met.

 

l)          The payee/providers may be terminated from participation in Part C programs if corrective actions are not appropriate and/or not met.

 

m)        If an issue raised in a written State Complaint (or any part of a State Complaint) is also the subject of a Due Process Hearing under Section 500.140, the Department must set aside any part that is being addressed in a Due Process Hearing but resolve any other issues within the 60 day timeline.

 

n)         If an issue is raised in a written Complaint that has already been decided in a Due Process Hearing, the previous decision is binding and the complainant must be so informed.

 

o)         A State Complaint alleging failure of the Respondent to implement a decision pursuant to a Request for Due Process Hearing must be resolved by the Department.

 

p)         After completing an investigation, in response to the Complaint, the Department may find that a corrective action plan is not appropriate given the circumstances.  With good cause shown that the public interest, safety or welfare may be at risk, the provider's credential and enrollment or Provider Agreement may be immediately terminated pursuant to Section 500.60(q).

 

(Source:  Amended at 38 Ill. Reg. 11086, effective May 12, 2014)




Section 500.APPENDIX A   Sliding Fee Schedule

 

$0/ Month	$10/ Month	$20/ Month	$30/ Month	$50/ Month	$70/ Month	$100/ Month	$150/ Month	$200/ Month
1-185% FPL	186-200% FPL	201-250% FPL	251-300% FPL	301-350% FPL	351-400% FPL	401-500% FPL	501-600% FLP	above 600% FPL

 

Fee table is based on the Federal Poverty Level Guidelines as reported in the Federal Register.




Section 500.APPENDIX B   Assessment Instruments (Repealed)

 

(Source:  Repealed at 32 Ill. Reg. 2161, effective January 23, 2008)




Section 500.APPENDIX C   Requirements for Professional and Associate Level Early Intervention (EI) Credentialing and Enrollment to Bill

 

Nothing in this Appendix C shall exempt any individual from compliance with any and all State licensing requirements and/or supervisory requirements pertinent to the individual's delivery of services.

 

EI SERVICE	QUALIFIED STAFF
Assistive Technology	Durable medical equipment and supplies; providers may enroll to bill. No credential required.
Audiology, Aural Rehabilitation/Other Related Services	Audiologists with a current license in the state where they provide services to Illinois children may enroll to bill.  Audiologists are not required to obtain a credential.  (Provider is automatically enrolled under assistive technology and aural rehabilitation categories.)
	Speech/Language Pathologists with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Speech/Language Pathologist credential and enroll to bill for aural rehabilitation services.  (Provider is automatically enrolled under aural rehabilitation and speech therapy categories.)
	Individuals with a masters in speech-language pathology who are participating in a supervised professional experience and hold a temporary license in the state where they provide services to Illinois children may apply for an EI Associate:  Speech/Language Pathologist in supervised professional experience credential. Associate services are billed under the enrolled supervisor's name.
	Individuals with a current Special Education degree for Deaf and Hard of Hearing may apply for an EI Specialist: Developmental Therapist/Hearing credential and enroll to bill for aural rehabilitation services. May also provide Developmental Therapy Services.  (Provider is automatically enrolled under aural rehabilitation category.)
Clinical Assessment, Counseling, and Other Therapeutic Services	Clinical Psychologists with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Clinical Psychologist credential and enroll to bill.
	Clinical Professional Counselors with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Clinical Professional Counselor credential and enroll to bill.
	Marriage and Family Therapists with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Marriage and Family Therapist credential and enroll to bill.
	Clinical Social Workers with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Clinical Social Worker credential and enroll to bill.
	Behavior Analysts with current national certification as a Board Certified Behavior Analyst from the Behavior Analyst Certification Board may apply for an EI Specialist:  Behavior Analyst credential and enroll to bill.
	Unlicensed individuals employed by school districts as School Psychologists who will only be providing services through their school employment may apply for an EI Specialist:  School Psychologist credential.
	Graduate students in clinical psychology or clinical counseling who submit a letter from the graduate school verifying that they are providing psychological or clinical counseling services in a supervised internship setting in order to complete a comprehensive, culminating training experience prior to granting of a graduate degree in psychology may apply for an EI Associate:  Psychology/Counseling Intern credential.  Associate services are billed under the enrolled supervisor's name.
Developmental Therapy	Individuals with an EI Specialist Developmental Therapist credential on January 1, 2004 or who are applying for an EI Specialist Developmental Therapist credential prior to January 1, 2004 must have (1) a minimum of Teacher Endorsement in Early Childhood Education (ECE) or Special Education or bachelors degree in ECE, Early Childhood Special Education, Special Education, or human service field with one year of experience working hands on with children birth to 3 with developmental disabilities (Persons with a degree in a human service field must submit proof of training on the use of a formal assessment tool that would allow the provider to perform global evaluations/assessments.); or (2) a current license in art, music, recreation, or other type of therapy, rehabilitative or habilitative in nature, in the state where they provide services to Illinois children may apply for credential renewal or, prior to January 1, 2004, may apply for an EI Specialist Developmental Therapist credential and enroll to bill.
	Individuals who do not hold an EI Specialist Developmental Therapist credential on January 1, 2004 must have a bachelors degree or higher in Early Childhood Education, Early Childhood Special Education, Special Education, Special Education:  Deaf/Hard of Hearing or Blind/Partially Sighted, Child Development/Family Studies, EI, Elementary Education, Developmental Psychology, or Social Work; or with a bachelors degree or higher and a full specialist credential in the EI Program; or a current license in art, music, recreation, or other type of therapy, rehabilitative or habilitative in nature, in the state where they provide services to Illinois children; and can document the completion of educational experiences as approved by the Department that include at least 2 semester college hours or the equivalent (30 clock hours or CEU credit hours) in each of the following EI core knowledge content areas:  the Development of Young Children; Typical and Atypical; Working with Families of Young Children with Disabilities; Intervention Strategies for Young Children with Special Needs; and Assessment of Young Children with Special Needs; and can submit proof of training on the use of a formal assessment tool that would allow the provider to perform global evaluations/assessments may apply for an EI Specialist:  Developmental Therapist credential and enroll to bill.
	Individuals who do not hold an EI Specialist Developmental Therapist credential on July 1, 2013 may apply for an EI Specialist Developmental Therapist credential and enroll to bill if they:   (1) have a bachelors degree or higher in Early Childhood, Early Childhood Special Education, Special Education, Special Education:  Deaf/Hard of Hearing or Blind/Partially Sighted, Child Development, EI or Elementary Education, or from an EI approved college/university program (i.e., a program for which the Department or its designee has determined that the degree is equivalent to one of the above stated degrees); and (2) can document the completion of educational experiences as approved by the Department that include at least 2 semester college hours of, or the equivalent (30 clock hours or CEU credit hours) in, each of the following EI core knowledge content areas: the Development of Young Children, Typical and Atypical; Working with Families of Young Children with Disabilities; Intervention Strategies for Young Children with Special Needs; and Assessment of Young Children with Special Needs; and (3) can submit proof of training on the use of a formal assessment tool that would allow the provider to perform global evaluations and assessments.
	An emergency waiver of educational requirements for developmental therapists may be applied for and must be accompanied by the recommendation of a regional intake entity manager documenting the need for developmental therapy services in the service area.  A bachelors degree or higher is required.  If approved, the resulting temporary credential will be awarded for a maximum of 18 months.  A training plan toward qualification for full credential status must be submitted with the emergency waiver application.
	Individuals with a Special Education degree for Deaf and Hard of Hearing may apply for an EI Specialist:  Developmental Therapist/Hearing credential and enroll to bill.  They may also provide aural rehabilitation services based on their qualifications and experience.  (Provider is automatically enrolled under aural rehabilitation category.)
	Individuals with (1) a bachelors degree or higher in Orientation and Mobility or (2) a Special Education degree for Blind and Partially Seeing may apply for an EI Specialist:  Developmental Therapist/Vision credential and enroll to bill.  They may provide Developmental and/or Vision Therapy services related to visual functioning based on their qualifications and experience.  (Provider is automatically enrolled under the vision category.)
Evaluation/Assessment	Individuals with a current EI Full Specialist credential and who also meet all the following requirements may apply for an Evaluation/Assessment credential:
	Documentation of a minimum of three years (full time equivalent) pediatric experience within the EI Specialist credentialed discipline is required with no less than 20% of that experience (750 direct service hours) related to infants and toddlers between birth and three years of age or the equivalent, with a minimum of one year (full time equivalent) pediatric experience within the EI Specialist credentialed discipline with no less than 60% of that experience (750 direct service hours) related to infants and toddlers;
	Documentation of a minimum of six months pediatric post degree supervision;
	Demonstration of training in using and interpreting a variety of approved assessment tools related to his/her discipline by participating in evaluator specific training;
	Agreement to work with the Service Coordinator, other evaluators, and the family as an effective team member;
	Agreement to participate in IFSP meetings as specified in this Part;
	Agreement to perform evaluation/assessments and present recommendations thereon, that are consistent with DHS EI philosophy and best practices, and to provide adequate justification for recommendations based thereon;
	Agreement to participate in routine quality assurance and/or EI monitoring activities conducted by the Department or its Designee, or the U.S. Department of Education, Office of Special Education Programs;
	Agreement to comply with all applicable federal and/or State laws, rules, regulations, policies, provider agreement and procedure and guidelines;
	Documentation of completion of the EI Systems Training that includes evaluation/assessment and evaluation/assessment training as required and provided by the Department in other formats.
	The expiration date of an Evaluation/Assessment credential will coincide with the EI Specialist discipline specific credential.  Renewal of the Evaluation/Assessment credential is contingent on the successful renewal of the EI Specialist discipline specific credential.
Family Training and Support	Individuals with a high school diploma or equivalent who are the parent or guardian of a child with special needs and are employed by an entity such as an agency or hospital that provides EI services as a Parent Liaison may apply for an EI Parent Liaison credential and enroll to bill. Completion of Parent Liaison Training is required within 90 days after being issued a temporary credential for full credential status and continued enrollment.
	Individuals who are bilingual or an interpreter for the deaf may enroll to bill as an interpreter.  Upon application for enrollment, the bilingual applicant must identify the languages for which he/she is applying to interpret and/or translate and document completion of EI Systems Training as defined in Section 500.60(f) and training for bilingual interpreter/translators as required and provided by the Department and oral and/or written language proficiency demonstrated through testing procedures as required and provided by the Department or through documentation of a nationally recognized certification based upon comparable proficiency testing procedures.  Oral and/or written proficiency testing procedures test the language skills of a written translator and oral interpreter for comprehension of the source language and the extent that translated and/or interpreted text/speech conveys the full meaning of the source language.  In addition, the proficiency testing for the written translator determines if the translated text is coherent and grammar, punctuation, spelling, syntax, usage and style are appropriate.  By January 1, 2009, all enrolled bilingual interpreters must have documented completion of EI approved training for bilingual interpreters/translators and oral and/or written language proficiency demonstrated through testing procedures as required and provided by the Department or through documentation of a nationally recognized certification based upon comparable proficiency testing procedures to maintain enrollment.  Prior to January 1, 2009, interpreters for the deaf must meet the requirements set forth in the Interpreters for the Deaf Act [225 ILCS 442] and on or after January 1, 2009 must comply with the licensure requirements set forth in the Interpreter for the Deaf Licensure Act of 2007 [225 ILCS 443] or the licensure, certification or screening requirements in the state where services are provided to children if not in Illinois, and document completion of EI Systems Training as defined in Section 500.60(f).
	Deaf adults who have been certified by Hearing and Vision Connections as a language mentor for the deaf may enroll to bill.  Language mentors are not required to obtain a credential.
Health Consultation	Physicians with a current license in the state where they provide services to Illinois children may enroll to bill.  Physicians are not required to obtain a credential.
Medical Services (Diagnostic/Evaluation Purposes Only)	Physicians with a current license in the state where they provide services to Illinois children may enroll to bill.  Physicians are not required to obtain a credential.
	Individuals on the physician's service team should refer to the service area appropriate to their discipline for credentialing requirements.
Nursing	Registered Nurses with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Registered Nurse credential and enroll to bill.  (Provider is automatically enrolled under nutrition category.)
Nutrition	Licensed Dietitian Nutritionists with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Dietitian credential and enroll to bill.
	Registered Nurses with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Registered Nurse credential and enroll to bill.
Occupational Therapy	Occupational Therapists with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Occupational Therapist credential and enroll to bill.
	Certified Occupational Therapy Assistants with a current license in the state where they provide services to Illinois children may apply for an EI Associate:  Licensed Certified Occupational Therapy Assistant credential.  Associate services are billed under the enrolled supervisor's name.
Physical Therapy	Physical Therapists with a current license in the state where they provide Part C EI service to Illinois children may apply for an EI Specialist:  Licensed Physical Therapist credential and enroll to bill.
	Physical Therapist Assistants with a current license in the state where they provide services to Illinois children may apply for an EI Associate:  Licensed Physical Therapist Assistant credential.  Associate services are billed under the enrolled supervisor's name.
Service Coordination	Individuals with an EI Service Coordination credential on January 1, 2003 and either (1) an EI Specialist credential of any type, (2) a bachelors degree or higher in human services, behavioral science, social science or health related field, (3) a current license as a Registered Nurse, (4) current employment as a Service Coordinator in a Family Case Management Agency, or (5) an associates degree in human services, education, behavioral science, social science, or health related field plus 2 years of experience working with children birth to 5 to provide intervention services or service coordination in a community agency serving children and families may apply for renewal of their credential.
	Individuals who do not hold an EI Service Coordination credential on January 1, 2003 and with a bachelors degree or higher in human services, behavioral science, social science or health related field or a current license as a Registered Nurse may apply for an EI Service Coordination Credential and enroll as an employee of a Child and Family Connections office.  Additional training is required within 90 days after being issued a temporary credential for full credential status and continued enrollment.
Social Services	Social Workers with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Social Worker credential and enroll to bill.
	Professional Counselors with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Professional Counselor credential and enroll to bill.
	Unlicensed individuals employed by school districts as School Social Workers who will only be providing services through their school employment may apply for an EI Specialist:  School Social Worker credential and enroll to bill.
	Graduate students in social work who submit a letter from their graduate school verifying that they are providing social work services in a supervised internship setting in order to complete a comprehensive, culminating training experience prior to granting of a graduate degree in social work may apply for an EI Associate:  Social Work Intern credential. Associate services are billed under the enrolled supervisor's name.
Speech Therapy	Speech/Language Pathologists with a current license in the state where they provide services to Illinois children may apply for an EI Specialist:  Licensed Speech/Language Pathologist credential and enroll to bill.  (Provider is automatically enrolled under aural rehabilitation and speech therapy categories.)
	Individuals with a masters in speech-language pathology who are participating in a supervised professional experience and hold a temporary license in the state where they provide services to Illinois children may apply for an EI Associate:  Speech/Language Pathologist in supervised professional experience credential.  Associate services are billed under the enrolled supervisor's name.
	Speech/Language Pathology Assistants with a current license in the state where they provide services to Illinois children may apply for an EI Associate:  Speech/Language Therapy Assistant credential.  Associate services are billed under the enrolled supervisor's name.
Transportation	Individuals with an appropriate vehicle registration number, insurance and current driver's license may enroll to bill.  Not required to obtain a credential.
Vision	Optometrists or Opthalmologists with a current license in the state where they provide services to Illinois children may enroll to bill.  Not required to obtain a credential.
	Individuals with (1) a bachelors degree or higher in Orientation and Mobility or (2) a Special Education degree for Blind and Partially Seeing may apply for an EI Specialist:  Developmental Therapist/Vision credential and enroll to bill. They may provide Developmental and/or Vision services related to visual functioning based on their qualification and experience.

 

Other Services                                 Personnel who have met State approved or recognized certification, licensing, registration or other comparable requirements that apply to the areas in which the individuals are conducting evaluations or assessments or providing EI services.

 

(Source:  Amended at 39 Ill. Reg. 14900, effective October 27, 2015)




Section 500.APPENDIX D   Use of Associate Level Providers

 

Nothing in this Appendix D shall exempt any individual from compliance with any and all State licensing requirements and/or supervisory requirements pertinent to the individual's delivery of services.

 

In order to enlist the widest pool of qualified service providers, the EI System will support the appropriate use of credentialed, non-enrolled associate level providers who function under the following guidelines and whose services are billed for by their credentialed, enrolled supervisor.

 

GUIDELINES

 

Each credentialed associate level provider shall be supervised by a specialist credentialed/enrolled in the same discipline.  (Appendix C identifies the requirements for professional and associate level credentialing and enrollment.)

 

1)         The credentialed/enrolled specialist shall:

 

a)         evaluate/assess the child, develop the plan for intervention services required to accomplish Service Plan outcomes and submit evaluation/assessment report prior to Service Plan development/update/review;

 

b)         instruct the associate level provider about the intervention services to be provided;

 

c)         reassess the child as determined by the child's Service Plan and any licensure requirement for the enrolled specialist or associate level staff at least prior to each Service Plan update/review;

 

d)         revise the intervention activities as needed;

 

e)         approve all methods and materials selected to implement the intervention plan;

 

f)         for each child to which an associate level provider provides intervention services, conduct direct supervision during client services at a minimum of once each month;

 

g)         submit direct service report prior to each Service Plan update/review and more often if the child's progress/lack of progress warrants;

 

h)         submit bills for services provided by the associate level provider;

 

i)          participate in Service Plan development/update/review; and

 

j)          follow supervision requirements as set forth in his/her licensure or other certification standards.

 

2)         The credentialed associate level provider shall:

 

a)         provide services only as instructed by the supervising specialist;

 

b)         record all early intervention services provided;

 

c)         report all changes in child's condition to the supervising specialist;

 

d)         check authorization to make sure the associate is identified in the comment field as the provider of direct service under the supervisor; and

 

e)         if the associate's name does not appear in the comment field of the authorization, contact the child's service coordinator to correct the oversight.

 

3)         The credentialed associate level Speech/Language Pathologist in his/her supervised professional experience shall:

 

a)         provide services under the supervision of a specialist who is credentialed/enrolled in the same discipline;

 

b)         provide services consistent with the Illinois Speech/Language Pathology and Audiology Practice Act that includes evaluation/assessment and service plan development; and

 

c)         follow the guidelines as listed in (1) and (2), except the restriction in (1)(a) that does not allow the associate to provide evaluation/assessment or service plan development and (1)(f) that requires supervision during client services at a minimum of once each month.

 

NOTE:  Supervisory time is non-billable time and is considered to be administrative time that is part of the rate paid.

 

(Source:  Amended at 32 Ill. Reg. 2161, effective January 23, 2008)




Section 500.APPENDIX E   Medical Conditions Resulting in High Probability of Developmental Delay (not an exclusive list)

 

1.         Anomalies of Central Nervous System

 

Spina Bifida/Mylomeningolecele

Spina Bifida with Hydrocephaly

Anomalies of the Spinal Cord

Encephalocele

Hydroencephalapathy

Microencephaly

Congenital Hydrocephalus

Reduction Deformities of Brain, including but not limited to:

 

Absence

Agenesis

Agyria

Aplasia

Arhinecephaly

Holoprosencephaly

Hypoplasia

Lissencephaly

Microgyria

Schizencephaly

 

2.         Birth weight:  <1000 gm.

 

3.         Chromosomal Disorders (most common, not to be used as an exclusive list)

 

Trisomy 21 (Down's Syndrome)

Trisomy 13

Trisomy 18

Autosomal Deletion Syndromes

Fragile X Syndrome

Williams Syndrome

Angelmann's Syndrome

Prader-Willi Syndrome

 

4.         Congenital Infections

 

Toxoplasmosis

Rubella

Sytomegalovirus

Herpes Simplex with CNS involvement

 

5.         Neonatal Meningitis

 

6.         Cerebral Palsy

 

7.         Craniofacial Anomalies (Major)

 

Cleft Palate

 

8.         Disorders of the Sense Organs

 

Hearing loss of 30 decibels (dB) or greater at any two of the following frequencies: 500, 1000, 2000, 4000, and 8000 Hertz (Hz) involving one or both ears, or hearing loss of 35 dB or greater at any one of the following frequencies:  500, 1000, and 2000 Hz involving one or both ears.

Visual Impairment

Bilateral Amblyopia

Severe Retinopathy of Prematurity ROP 3+

Bilateral Cataracts

Myopia of 3 Dioptors or More

Albinism

 

9.         Disorders of the Central Nervous System

 

Hypsarrhythmia

Acquired Hydrocephalus

Stroke

Traumatic Brain Injury

Intraventricular Hemorrhage – Grade III, IV

Hypoxic Ischemic Encephalopathy (with organ failure, seizures, renal failure, cardiac failure)

Unspecified Encephalopathy

Spinal Cord Injury

Neonatal Seizures (secondary to asphyxia or hypoglycemia)

Central Nervous System Cysts

Central Nervous System Tumors

Periventricular Leukomalacia

 

10.       Inborn Errors of Metabolism

 

11.       Neuromuscular Disorders

 

Congenital Muscular Dystrophy

Myotonic Dystrophy

Werdnig-Hoffman (Spinal Muscular Atrophy)

Congenital Myopathy

Duchenne

 

12.       Pervasive Developmental Disorder/Autistic Spectrum

 

13.       Syndromes (*see further instructions for Division of Specialized Care for Children (DSCC) referral)

 

Cornelia de Lange

Lowe's

Rett

Rubenstein-Taybi

CHARGE (multiple anomalies)

VATER

 

14.       Fetal Alcohol Syndrome

 

Not just exposure to alcohol in utero or fetal alcohol effects, but a diagnosis of the syndrome

 

15.       Orthopedic Abnormalities

 

Brachioplexus at Birth

Caudal Regression

Proximal Focal Femoral Deformities

Partial Amputations

Holt-Oram

Acquired Amputations

Arthrogryposis Multiplex Congenita

Osteogenesis Imperfecta (*see further instruction for DSCC referral)

 

16.       Technology Dependent

 

Tracheostomy

Ventilator Dependent (*see further instruction for DSCC referral)

 

17.       Social Emotional Disorders

 

Attachment or Relationship Disorder

 

18.       Lead Poisoning (as defined in 77 Ill. Adm. Code 845.20) confirmed by a venous blood test

 

Children with medical conditions that are not listed may be determined eligible for services by a qualified family physician, pediatrician, or pediatric subspecialist (pediatric neurologist, geneticist, pediatric orthopedic surgeon, pediatrician with special interest in disabilities) who provides written verification that the child's medical condition is associated with a high probability of developmental delay as listed in eligibility criteria.

 

Children with undiagnosed medical conditions or who require further medical evaluation may be referred by Child and Family Connections (regional intake entity) for a medical diagnostic evaluation.

 

*    Referring to DSCC – Children with Cleft Palate, Orthopedic Abnormalities, or other potential DSCC-eligible diagnoses associated with physical disabilities should be referred to the DSCC.  DSCC may provide medical diagnostic support at no cost to the family.  Simultaneously Child and Family Connections offices should complete the intake process as usual.  DSCC will determine the type of ongoing assistance that they can provide.

 

(Source:  Amended at 44 Ill. Reg. 12739, effective July 20, 2020)