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1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by adding
5Section 367m as follows:
 
6    (215 ILCS 5/367m new)
7    Sec. 367m. Early intervention services. A policy of
8accident and health insurance that provides coverage for early
9intervention services must conform to the following criteria:
10        (1) The use of private health insurance to pay for
11    early intervention services under Part C of the federal
12    Individuals with Disabilities Education Act may not count
13    towards or result in a loss of benefits due to annual or
14    lifetime insurance caps for an infant or toddler with a
15    disability, the infant's or toddler's parent, or the
16    infant's or toddler's family members who are covered under
17    that health insurance policy.
18        (2) The use of private health insurance to pay for
19    early intervention services under Part C of the federal
20    Individuals with Disabilities Education Act may not
21    negatively affect the availability of health insurance to
22    an infant or toddler with a disability, the infant's or
23    toddler's parent, or the infant's or toddler's family

 

 

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1    members who are covered under that health insurance policy,
2    and health insurance coverage may not be discontinued for
3    these individuals due to the use of the health insurance to
4    pay for services under Part C of the federal Individuals
5    with Disabilities Education Act.
6        (3) The use of private health insurance to pay for
7    early intervention services under Part C of the federal
8    Individuals with Disabilities Education Act may not be the
9    basis for increasing the health insurance premiums of an
10    infant or toddler with a disability, the infant's or
11    toddler's parent, or the infant's or toddler's family
12    members covered under that health insurance policy.
13    For the purposes of this Section, "early intervention
14services" has the same meaning as in the Early Intervention
15Services System Act.
 
16    Section 10. The Early Intervention Services System Act is
17amended by changing Sections 3, 4, 5, 7, 9, 10, 11, 12, 13,
1813.5, 13.10, and 13.30 as follows:
 
19    (325 ILCS 20/3)  (from Ch. 23, par. 4153)
20    Sec. 3. Definitions. As used in this Act:
21    (a) "Eligible infants and toddlers" means infants and
22toddlers under 36 months of age with any of the following
23conditions:
24        (1) Developmental delays.

 

 

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1        (2) A physical or mental condition which typically
2    results in developmental delay.
3        (3) Being at risk of having substantial developmental
4    delays based on informed clinical opinion judgment.
5        (4) Either (A) having entered the program under any of
6    the circumstances listed in paragraphs (1) through (3) of
7    this subsection but no longer meeting the current
8    eligibility criteria under those paragraphs, and
9    continuing to have any measurable delay, or (B) not having
10    attained a level of development in each area, including (i)
11    cognitive, (ii) physical (including vision and hearing),
12    (iii) language, speech, and communication, (iv) social or
13    emotional psycho-social, or (v) adaptive self-help skills,
14    that is at least at the mean of the child's age equivalent
15    peers; and, in addition to either item (A) or item (B), (C)
16    having been determined by the multidisciplinary
17    individualized family service plan team to require the
18    continuation of early intervention services in order to
19    support continuing developmental progress, pursuant to the
20    child's needs and provided in an appropriate developmental
21    manner. The type, frequency, and intensity of services
22    shall differ from the initial individualized family
23    services plan because of the child's developmental
24    progress, and may consist of only service coordination,
25    evaluation, and assessments.
26    (b) "Developmental delay" means a delay in one or more of

 

 

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1the following areas of childhood development as measured by
2appropriate diagnostic instruments and standard procedures:
3cognitive; physical, including vision and hearing; language,
4speech and communication; social or emotional psycho-social;
5or adaptive self-help skills. The term means a delay of 30% or
6more below the mean in function in one or more of those areas.
7    (c) "Physical or mental condition which typically results
8in developmental delay" means:
9        (1) a diagnosed medical disorder bearing a relatively
10    well known expectancy for developmental outcomes within
11    varying ranges of developmental disabilities; or
12        (2) a history of prenatal, perinatal, neonatal or early
13    developmental events suggestive of biological insults to
14    the developing central nervous system and which either
15    singly or collectively increase the probability of
16    developing a disability or delay based on a medical
17    history.
18    (d) "Informed clinical opinion judgment" means both
19clinical observations and parental participation to determine
20eligibility by a consensus of a multidisciplinary team of 2 or
21more members based on their professional experience and
22expertise.
23    (e) "Early intervention services" means services which:
24        (1) are designed to meet the developmental needs of
25    each child eligible under this Act and the needs of his or
26    her family;

 

 

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1        (2) are selected in collaboration with the child's
2    family;
3        (3) are provided under public supervision;
4        (4) are provided at no cost except where a schedule of
5    sliding scale fees or other system of payments by families
6    has been adopted in accordance with State and federal law;
7        (5) are designed to meet an infant's or toddler's
8    developmental needs in any of the following areas:
9            (A) physical development, including vision and
10        hearing,
11            (B) cognitive development,
12            (C) communication development,
13            (D) social or emotional development, or
14            (E) adaptive development;
15        (6) meet the standards of the State, including the
16    requirements of this Act;
17        (7) include one or more of the following:
18            (A) family training,
19            (B) social work services, including counseling,
20        and home visits,
21            (C) special instruction,
22            (D) speech, language pathology and audiology,
23            (E) occupational therapy,
24            (F) physical therapy,
25            (G) psychological services,
26            (H) service coordination services,

 

 

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1            (I) medical services only for diagnostic or
2        evaluation purposes,
3            (J) early identification, screening, and
4        assessment services,
5            (K) health services specified by the lead agency as
6        necessary to enable the infant or toddler to benefit
7        from the other early intervention services,
8            (L) vision services,
9            (M) transportation, and
10            (N) assistive technology devices and services, ;
11            (O) nursing services,
12            (P) nutrition services, and
13            (Q) sign language and cued language services;
14        (8) are provided by qualified personnel, including but
15    not limited to:
16            (A) child development specialists or special
17        educators, including teachers of children with hearing
18        impairments (including deafness) and teachers of
19        children with vision impairments (including
20        blindness),
21            (B) speech and language pathologists and
22        audiologists,
23            (C) occupational therapists,
24            (D) physical therapists,
25            (E) social workers,
26            (F) nurses,

 

 

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1            (G) dietitian nutritionists,
2            (H) vision specialists, including ophthalmologists
3        and optometrists,
4            (I) psychologists, and
5            (J) physicians;
6        (9) are provided in conformity with an Individualized
7    Family Service Plan;
8        (10) are provided throughout the year; and
9        (11) are provided in natural environments, to the
10    maximum extent appropriate, which may include the home and
11    community settings, unless justification is provided
12    consistent with federal regulations adopted under Sections
13    1431 through 1444 of Title 20 of the United States Code.
14    (f) "Individualized Family Service Plan" or "Plan" means a
15written plan for providing early intervention services to a
16child eligible under this Act and the child's family, as set
17forth in Section 11.
18    (g) "Local interagency agreement" means an agreement
19entered into by local community and State and regional agencies
20receiving early intervention funds directly from the State and
21made in accordance with State interagency agreements providing
22for the delivery of early intervention services within a local
23community area.
24    (h) "Council" means the Illinois Interagency Council on
25Early Intervention established under Section 4.
26    (i) "Lead agency" means the State agency responsible for

 

 

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1administering this Act and receiving and disbursing public
2funds received in accordance with State and federal law and
3rules.
4    (i-5) "Central billing office" means the central billing
5office created by the lead agency under Section 13.
6    (j) "Child find" means a service which identifies eligible
7infants and toddlers.
8    (k) "Regional intake entity" means the lead agency's
9designated entity responsible for implementation of the Early
10Intervention Services System within its designated geographic
11area.
12    (l) "Early intervention provider" means an individual who
13is qualified, as defined by the lead agency, to provide one or
14more types of early intervention services, and who has enrolled
15as a provider in the early intervention program.
16    (m) "Fully credentialed early intervention provider" means
17an individual who has met the standards in the State applicable
18to the relevant profession, and has met such other
19qualifications as the lead agency has determined are suitable
20for personnel providing early intervention services, including
21pediatric experience, education, and continuing education. The
22lead agency shall establish these qualifications by rule filed
23no later than 180 days after the effective date of this
24amendatory Act of the 92nd General Assembly.
25(Source: P.A. 97-902, eff. 8-6-12.)
 

 

 

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1    (325 ILCS 20/4)  (from Ch. 23, par. 4154)
2    Sec. 4. Illinois Interagency Council on Early
3Intervention.
4    (a) There is established the Illinois Interagency Council
5on Early Intervention. The Council shall be composed of at
6least 20 but not more than 30 members. The members of the
7Council and the designated chairperson of the Council shall be
8appointed by the Governor. The Council member representing the
9lead agency may not serve as chairperson of the Council. The
10Council shall be composed of the following members:
11        (1) The Secretary of Human Services (or his or her
12    designee) and 2 additional representatives of the
13    Department of Human Services designated by the Secretary,
14    plus the Directors (or their designees) of the following
15    State agencies involved in the provision of or payment for
16    early intervention services to eligible infants and
17    toddlers and their families:
18            (A) Department of Insurance; and
19            (B) Department of Healthcare and Family Services.
20        (2) Other members as follows:
21            (A) At least 20% of the members of the Council
22        shall be parents, including minority parents, of
23        infants or toddlers with disabilities or children with
24        disabilities aged 12 or younger, with knowledge of, or
25        experience with, programs for infants and toddlers
26        with disabilities. At least one such member shall be a

 

 

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1        parent of an infant or toddler with a disability or a
2        child with a disability aged 6 or younger;
3            (B) At least 20% of the members of the Council
4        shall be public or private providers of early
5        intervention services;
6            (C) One member shall be a representative of the
7        General Assembly;
8            (D) One member shall be involved in the preparation
9        of professional personnel to serve infants and
10        toddlers similar to those eligible for services under
11        this Act;
12            (E) Two members shall be from advocacy
13        organizations with expertise in improving health,
14        development, and educational outcomes for infants and
15        toddlers with disabilities;
16            (F) One member shall be a Child and Family
17        Connections manager from a rural district;
18            (G) One member shall be a Child and Family
19        Connections manager from an urban district;
20            (H) One member shall be the co-chair of the
21        Illinois Early Learning Council (or his or her
22        designee); and
23            (I) Members representing the following agencies or
24        entities: the State Board of Education; the Department
25        of Public Health; the Department of Children and Family
26        Services; the University of Illinois Division of

 

 

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1        Specialized Care for Children; the Illinois Council on
2        Developmental Disabilities; Head Start or Early Head
3        Start; and the Department of Human Services' Division
4        of Mental Health. A member may represent one or more of
5        the listed agencies or entities.
6    The Council shall meet at least quarterly and in such
7places as it deems necessary. Terms of the initial members
8appointed under paragraph (2) shall be determined by lot at the
9first Council meeting as follows: of the persons appointed
10under subparagraphs (A) and (B), one-third shall serve one year
11terms, one-third shall serve 2 year terms, and one-third shall
12serve 3 year terms; and of the persons appointed under
13subparagraphs (C) and (D), one shall serve a 2 year term and
14one shall serve a 3 year term. Thereafter, successors appointed
15under paragraph (2) shall serve 3 year terms. Once appointed,
16members shall continue to serve until their successors are
17appointed. No member shall be appointed to serve more than 2
18consecutive terms.
19    Council members shall serve without compensation but shall
20be reimbursed for reasonable costs incurred in the performance
21of their duties, including costs related to child care, and
22parents may be paid a stipend in accordance with applicable
23requirements.
24    The Council shall prepare and approve a budget using funds
25appropriated for the purpose to hire staff, and obtain the
26services of such professional, technical, and clerical

 

 

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1personnel as may be necessary to carry out its functions under
2this Act. This funding support and staff shall be directed by
3the lead agency.
4    (b) The Council shall:
5        (1) advise and assist the lead agency in the
6    performance of its responsibilities including but not
7    limited to the identification of sources of fiscal and
8    other support services for early intervention programs,
9    and the promotion of interagency agreements which assign
10    financial responsibility to the appropriate agencies;
11        (2) advise and assist the lead agency in the
12    preparation of applications and amendments to
13    applications;
14        (3) review and advise on relevant regulations and
15    standards proposed by the related State agencies;
16        (4) advise and assist the lead agency in the
17    development, implementation and evaluation of the
18    comprehensive early intervention services system; and
19        (4.5) coordinate and collaborate with State
20    interagency early learning initiatives, as appropriate;
21    and
22        (5) prepare and submit an annual report to the Governor
23    and to the General Assembly on the status of early
24    intervention programs for eligible infants and toddlers
25    and their families in Illinois. The annual report shall
26    include (i) the estimated number of eligible infants and

 

 

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1    toddlers in this State, (ii) the number of eligible infants
2    and toddlers who have received services under this Act and
3    the cost of providing those services, and (iii) the
4    estimated cost of providing services under this Act to all
5    eligible infants and toddlers in this State. , and (iv)
6    data and other information as is requested to be included
7    by the Legislative Advisory Committee established under
8    Section 13.50 of this Act. The report shall be posted by
9    the lead agency on the early intervention website as
10    required under paragraph (f) of Section 5 of this Act.
11    No member of the Council shall cast a vote on or
12participate substantially in any matter which would provide a
13direct financial benefit to that member or otherwise give the
14appearance of a conflict of interest under State law. All
15provisions and reporting requirements of the Illinois
16Governmental Ethics Act shall apply to Council members.
17(Source: P.A. 97-902, eff. 8-6-12.)
 
18    (325 ILCS 20/5)  (from Ch. 23, par. 4155)
19    Sec. 5. Lead Agency. The Department of Human Services is
20designated the lead agency and shall provide leadership in
21establishing and implementing the coordinated, comprehensive,
22interagency and interdisciplinary system of early intervention
23services. The lead agency shall not have the sole
24responsibility for providing these services. Each
25participating State agency shall continue to coordinate those

 

 

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1early intervention services relating to health, social service
2and education provided under this authority.
3    The lead agency is responsible for carrying out the
4following:
5        (a) The general administration, supervision, and
6    monitoring of programs and activities receiving assistance
7    under Section 673 of the Individuals with Disabilities
8    Education Act (20 United States Code 1473).
9        (b) The identification and coordination of all
10    available resources within the State from federal, State,
11    local and private sources.
12        (c) The development of procedures to ensure that
13    services are provided to eligible infants and toddlers and
14    their families in a timely manner pending the resolution of
15    any disputes among public agencies or service providers.
16        (d) The resolution of intra-agency and interagency
17    regulatory and procedural disputes.
18        (e) The development and implementation of formal
19    interagency agreements, and the entry into such
20    agreements, between the lead agency and (i) the Department
21    of Healthcare and Family Services, (ii) the University of
22    Illinois Division of Specialized Care for Children, and
23    (iii) other relevant State agencies that:
24            (1) define the financial responsibility of each
25        agency for paying for early intervention services
26        (consistent with existing State and federal law and

 

 

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1        rules, including the requirement that early
2        intervention funds be used as the payor of last
3        resort), a hierarchical order of payment as among the
4        agencies for early intervention services that are
5        covered under or may be paid by programs in other
6        agencies, and procedures for direct billing,
7        collecting reimbursements for payments made, and
8        resolving service and payment disputes; and
9            (2) include all additional components necessary to
10        ensure meaningful cooperation and coordination.
11        Interagency agreements under this paragraph (e) must
12    be reviewed and revised to implement the purposes of this
13    amendatory Act of the 92nd General Assembly no later than
14    60 days after the effective date of this amendatory Act of
15    the 92nd General Assembly.
16        (f) The maintenance of an early intervention website.
17    Within 30 days after the effective date of this amendatory
18    Act of the 92nd General Assembly, the lead agency shall
19    post and keep posted on this website the following: (i) the
20    current annual report required under subdivision (b)(5) of
21    Section 4 of this Act, and the annual reports of the prior
22    3 years, (ii) the most recent Illinois application for
23    funds prepared under Section 637 of the Individuals with
24    Disabilities Education Act filed with the United States
25    Department of Education, (iii) proposed modifications of
26    the application prepared for public comment, (iv) notice of

 

 

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1    Council meetings, Council agendas, and minutes of its
2    proceedings for at least the previous year, (v) proposed
3    and final early intervention rules, (vi) requests for
4    proposals, and (vii) all reports created for dissemination
5    to the public that are related to the early intervention
6    program, including reports prepared at the request of the
7    Council, and the General Assembly, and the Legislative
8    Advisory Committee established under Section 13.50 of this
9    Act. Each such document shall be posted on the website
10    within 3 working days after the document's completion.
11        (g) Before adopting any new policy or procedure
12    (including any revisions to an existing policy or
13    procedure) needed to comply with Part C of the Individuals
14    with Disabilities Education Act, the lead agency must hold
15    public hearings on the new policy or procedure, provide
16    notice of the hearings at least 30 days before the hearings
17    are conducted to enable public participation, and provide
18    an opportunity for the general public, including
19    individuals with disabilities and parents of infants and
20    toddlers with disabilities, early intervention providers,
21    and members of the Council to comment for at least 30 days
22    on the new policy or procedure needed to comply with Part C
23    of the Individuals with Disabilities Education Act and with
24    34 CFR Part 300 and Part 303.
25(Source: P.A. 95-331, eff. 8-21-07.)
 

 

 

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1    (325 ILCS 20/7)  (from Ch. 23, par. 4157)
2    Sec. 7. Essential Components of the Statewide Service
3System. As required by federal laws and regulations, a
4statewide system of coordinated, comprehensive, interagency
5and interdisciplinary programs shall be established and
6maintained. The framework of the statewide system shall be
7based on the components set forth in this Section. This
8framework shall be used for planning, implementation,
9coordination and evaluation of the statewide system of locally
10based early intervention services.
11    The statewide system shall include, at a minimum:
12        (a) a definition of the term "developmentally
13    delayed", in accordance with the definition in Section 3,
14    that will be used in Illinois in carrying out programs
15    under this Act;
16        (b) timetables for ensuring that appropriate early
17    intervention services, based on scientifically based
18    research, to the extent practicable, will be available to
19    all eligible infants and toddlers in this State after the
20    effective date of this Act;
21        (c) a timely, comprehensive, multidisciplinary and
22    interdisciplinary evaluation of the functioning of each
23    potentially eligible infant and toddler with suspected
24    disabilities in this State, unless the child meets the
25    definition of eligibility based upon his or her medical and
26    other records; for a child determined eligible, a

 

 

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1    multidisciplinary assessment of the unique strengths and
2    needs of that infant or toddler and the identification of
3    services appropriate to meet those needs and a
4    family-directed assessment of the resources, priorities,
5    and concerns of the family and the identification of
6    supports and services necessary to enhance the family's
7    capacity to meet the developmental needs of that infant or
8    toddler the concerns, priorities and resource needs of the
9    families to appropriately assist in the development of the
10    infant and toddler with disabilities;
11        (d) for each eligible infant and toddler, an
12    Individualized Family Service Plan, including service
13    coordination (case management) services;
14        (e) a comprehensive child find system, consistent with
15    Part B of the Individuals with Disabilities Education Act
16    (20 United States Code 1411 through 1420 and as set forth
17    in 34 CFR 300.115), which includes timelines and provides
18    for participation by primary referral sources;
19        (f) a public awareness program focusing on early
20    identification of eligible infants and toddlers;
21        (g) a central directory which includes public and
22    private early intervention services, resources, and
23    experts available in this State, professional and other
24    groups (including parent support groups and training and
25    information centers) that provide assistance to infants
26    and toddlers with disabilities who are eligible for early

 

 

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1    intervention programs assisted under Part C of the
2    Individuals with Disabilities Education Act and their
3    families, and early intervention research and
4    demonstration projects being conducted in this State
5    relating to infants and toddlers with disabilities;
6        (h) a comprehensive system of personnel development;
7        (i) a policy pertaining to the contracting or making of
8    other arrangements with public and private service
9    providers to provide early intervention services in this
10    State, consistent with the provisions of this Act,
11    including the contents of the application used and the
12    conditions of the contract or other arrangements;
13        (j) a procedure for securing timely reimbursement of
14    funds;
15        (k) procedural safeguards with respect to programs
16    under this Act;
17        (l) policies and procedures relating to the
18    establishment and maintenance of standards to ensure that
19    personnel necessary to carry out this Act are appropriately
20    and adequately prepared and trained;
21        (m) a system of evaluation of, and compliance with,
22    program standards;
23        (n) a system for compiling data on the numbers of
24    eligible infants and toddlers and their families in this
25    State in need of appropriate early intervention services;
26    the numbers served; the types of services provided; and

 

 

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1    other information required by the State or federal
2    government; and
3        (o) a single line of responsibility in a lead agency
4    designated by the Governor to carry out its
5    responsibilities as required by this Act.
6    In addition to these required components, linkages may be
7established within a local community area among the prenatal
8initiatives affording services to high risk pregnant women.
9Additional linkages among at risk programs and local literacy
10programs may also be established.
11    Within 60 days of the effective date of this Act, a
12five-fiscal-year implementation plan shall be submitted to the
13Governor by the lead agency with the concurrence of the
14Interagency Council on Early Intervention. The plan shall list
15specific activities to be accomplished each year, with cost
16estimates for each activity. No later than the second Monday in
17July of each year thereafter, the lead agency shall, with the
18concurrence of the Interagency Council, submit to the
19Governor's Office a report on accomplishments of the previous
20year and a revised list of activities for the remainder of the
21five-fiscal-year plan, with cost estimates for each. The
22Governor shall certify that specific activities in the plan for
23the previous year have been substantially completed before
24authorizing relevant State or local agencies to implement
25activities listed in the revised plan that depend substantially
26upon completion of one or more of the earlier activities.

 

 

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1(Source: P.A. 87-680.)
 
2    (325 ILCS 20/9)  (from Ch. 23, par. 4159)
3    Sec. 9. Role of Other State Entities. The Departments of
4Public Health, Human Services, Children and Family Services,
5and Healthcare and Family Services Public Aid; the University
6of Illinois Division of Specialized Care for Children; the
7State Board of Education; and any other State agency which
8directly or indirectly provides or administers early
9intervention services shall adopt compatible rules for the
10provision of services to eligible infants and toddlers and
11their families within one year of the effective date of this
12Act.
13    These agencies shall enter into and maintain formal
14interagency agreements to enable the State and local agencies
15serving eligible children and their families to establish
16working relationships that will increase the efficiency and
17effectiveness of their early intervention services. The
18agreement shall outline the administrative, program and
19financial responsibilities of the relevant State agencies and
20shall implement a coordinated service delivery system through
21local interagency agreements.
22    There shall be created in the Office of the Governor an
23Early Childhood Intervention Ombudsman to assist families and
24local parties in ensuring that all State agencies serving
25eligible families do so in a comprehensive and collaborative

 

 

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1manner.
2(Source: P.A. 89-507, eff. 7-1-97; 89-626, eff. 8-9-96.)
 
3    (325 ILCS 20/10)  (from Ch. 23, par. 4160)
4    Sec. 10. Standards. The Council and the lead agency, with
5assistance from parents and providers, shall develop and
6promulgate policies and procedures relating to the
7establishment and implementation of program and personnel
8standards to ensure that services provided are consistent with
9any State-approved or recognized certification, licensing,
10registration, or other comparable requirements which apply to
11the area of early intervention program service standards. Only
12State-approved public or private early intervention service
13providers shall be eligible to receive State and federal
14funding for early intervention services. All early childhood
15intervention staff shall hold the highest entry requirement
16necessary for that position.
17    To be a State-approved early intervention service
18provider, an individual (i) shall not have served or completed,
19within the preceding 5 years, a sentence for conviction of any
20felony that the Department establishes by rule and (ii) shall
21not have been indicated as a perpetrator of child abuse or
22neglect, within the preceding 5 years, in an investigation by
23Illinois (pursuant to the Abused and Neglected Child Reporting
24Act) or another state. The Department is authorized to receive
25criminal background checks for such providers and persons

 

 

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1applying to be such a provider and to receive child abuse and
2neglect reports regarding indicated perpetrators who are
3applying to provide or currently authorized to provide early
4intervention services in Illinois. Beginning January 1, 2004,
5every provider of State-approved early intervention services
6and every applicant to provide such services must authorize, in
7writing and in the form required by the Department, a State and
8FBI a criminal background check, as requested by the
9Department, and check of child abuse and neglect reports
10regarding the provider or applicant as a condition of
11authorization to provide early intervention services. The
12Department shall use the results of the checks only to
13determine State approval of the early intervention service
14provider and shall not re-release the information except as
15necessary to accomplish that purpose.
16(Source: P.A. 93-147, eff. 1-1-04.)
 
17    (325 ILCS 20/11)  (from Ch. 23, par. 4161)
18    Sec. 11. Individualized Family Service Plans.
19    (a) Each eligible infant or toddler and that infant's or
20toddler's family shall receive:
21        (1) timely, comprehensive, multidisciplinary
22    assessment of the unique strengths and needs of each
23    eligible infant and toddler, and assessment of the concerns
24    and priorities of the families to appropriately assist them
25    in meeting their needs and identify supports and services

 

 

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1    to meet those needs; and
2        (2) a written Individualized Family Service Plan
3    developed by a multidisciplinary team which includes the
4    parent or guardian. The individualized family service plan
5    shall be based on the multidisciplinary team's assessment
6    of the resources, priorities, and concerns of the family
7    and its identification of the supports and services
8    necessary to enhance the family's capacity to meet the
9    developmental needs of the infant or toddler, and shall
10    include the identification of services appropriate to meet
11    those needs, including the frequency, intensity, and
12    method of delivering services. During and as part of the
13    initial development of the individualized family services
14    plan, and any periodic reviews of the plan, the
15    multidisciplinary team may seek consultation from shall
16    consult the lead agency's therapy guidelines and its
17    designated experts, if any, to help determine appropriate
18    services and the frequency and intensity of those services.
19    All services in the individualized family services plan
20    must be justified by the multidisciplinary assessment of
21    the unique strengths and needs of the infant or toddler and
22    must be appropriate to meet those needs. At the periodic
23    reviews, the team shall determine whether modification or
24    revision of the outcomes or services is necessary.
25    (b) The Individualized Family Service Plan shall be
26evaluated once a year and the family shall be provided a review

 

 

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1of the Plan at 6 month intervals or more often where
2appropriate based on infant or toddler and family needs. The
3lead agency shall create a quality review process regarding
4Individualized Family Service Plan development and changes
5thereto, to monitor and help assure that resources are being
6used to provide appropriate early intervention services.
7    (c) The initial evaluation and initial assessment and
8initial Plan meeting must be held within 45 days after the
9initial contact with the early intervention services system.
10The 45-day timeline does not apply for any period when the
11child or parent is unavailable to complete the initial
12evaluation, the initial assessments of the child and family, or
13the initial Plan meeting, due to exceptional family
14circumstances that are documented in the child's early
15intervention records, or when the parent has not provided
16consent for the initial evaluation or the initial assessment of
17the child despite documented, repeated attempts to obtain
18parental consent. As soon as exceptional family circumstances
19no longer exist or parental consent has been obtained, the
20initial evaluation, the initial assessment, and the initial
21Plan meeting must be completed as soon as possible. With
22parental consent, early intervention services may commence
23before the completion of the comprehensive assessment and
24development of the Plan.
25    (d) Parents must be informed that, at their discretion,
26early intervention services shall be provided to each eligible

 

 

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1infant and toddler, to the maximum extent appropriate, in the
2natural environment, which may include the home or other
3community settings. Parents shall make the final decision to
4accept or decline early intervention services. A decision to
5decline such services shall not be a basis for administrative
6determination of parental fitness, or other findings or
7sanctions against the parents. Parameters of the Plan shall be
8set forth in rules.
9    (e) The regional intake offices shall explain to each
10family, orally and in writing, all of the following:
11        (1) That the early intervention program will pay for
12    all early intervention services set forth in the
13    individualized family service plan that are not covered or
14    paid under the family's public or private insurance plan or
15    policy and not eligible for payment through any other third
16    party payor.
17        (2) That services will not be delayed due to any rules
18    or restrictions under the family's insurance plan or
19    policy.
20        (3) That the family may request, with appropriate
21    documentation supporting the request, a determination of
22    an exemption from private insurance use under Section
23    13.25.
24        (4) That responsibility for co-payments or
25    co-insurance under a family's private insurance plan or
26    policy will be transferred to the lead agency's central

 

 

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1    billing office.
2        (5) That families will be responsible for payments of
3    family fees, which will be based on a sliding scale
4    according to the State's definition of ability to pay which
5    is comparing household size and income to the sliding scale
6    and considering out-of-pocket medical or disaster
7    expenses, and that these fees are payable to the central
8    billing office, and that if the family encounters a
9    catastrophic circumstance, as defined under subsection (f)
10    of Section 13 of this Act, making it unable to pay the
11    fees, the lead agency may, upon proof of inability to pay,
12    waive the fees. Families who fail to provide income
13    information shall be charged the maximum amount on the
14    sliding scale.
15    (f) The individualized family service plan must state
16whether the family has private insurance coverage and, if the
17family has such coverage, must have attached to it a copy of
18the family's insurance identification card or otherwise
19include all of the following information:
20        (1) The name, address, and telephone number of the
21    insurance carrier.
22        (2) The contract number and policy number of the
23    insurance plan.
24        (3) The name, address, and social security number of
25    the primary insured.
26        (4) The beginning date of the insurance benefit year.

 

 

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1    (g) A copy of the individualized family service plan must
2be provided to each enrolled provider who is providing early
3intervention services to the child who is the subject of that
4plan.
5    (h) Children receiving services under this Act shall
6receive a smooth and effective transition by their third
7birthday consistent with federal regulations adopted pursuant
8to Sections 1431 through 1444 of Title 20 of the United States
9Code.
10(Source: P.A. 97-902, eff. 8-6-12.)
 
11    (325 ILCS 20/12)  (from Ch. 23, par. 4162)
12    Sec. 12. Procedural Safeguards. The lead agency shall adopt
13procedural safeguards that meet federal requirements and
14ensure effective implementation of the safeguards for families
15by each public agency involved in the provision of early
16intervention services under this Act.
17    The procedural safeguards shall provide, at a minimum, the
18following:
19        (a) The timely administrative resolution of State
20    complaints, due process hearings, and mediations by
21    parents as defined by administrative rule.
22        (b) The right to confidentiality of personally
23    identifiable information.
24        (c) The opportunity for parents and a guardian to
25    examine and receive copies of records relating to

 

 

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1    evaluations and assessments assessment, screening,
2    eligibility determinations, and the development and
3    implementation of the Individualized Family Service Plan
4    provision of early intervention services, individual
5    complaints involving the child, or any part of the child's
6    early intervention record.
7        (d) Procedures to protect the rights of the eligible
8    infant or toddler whenever the parents or guardians of the
9    child are not known or unavailable or the child is a ward
10    of the State, including the assignment of an individual
11    (who shall not be an employee of the State agency or local
12    agency providing services) to act as a surrogate for the
13    parents or guardian. The regional intake entity must make
14    reasonable efforts to ensure the assignment of a surrogate
15    parent not more than 30 days after a public agency
16    determines that the child needs a surrogate parent.
17        (e) Timely written prior notice to the parents or
18    guardian of the eligible infant or toddler whenever the
19    State agency or public or private service provider proposes
20    to initiate or change or refuses to initiate or change the
21    identification, evaluation, placement, or the provision of
22    appropriate early intervention services to the eligible
23    infant or toddler.
24        (f) Written prior notice to fully inform the parents or
25    guardians, in their native primary language or mode of
26    communication used by the parent, unless clearly not

 

 

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1    feasible to do so, in a comprehensible manner, of these
2    procedural safeguards.
3        (g) During the pendency of any proceedings or action
4    involving a complaint, unless the State agency and the
5    parents or guardian otherwise agree, the child shall
6    continue to receive the appropriate early intervention
7    services currently being provided, or in the case of an
8    application for initial services, the child shall receive
9    the services not in dispute.
10(Source: P.A. 91-538, eff. 8-13-99.)
 
11    (325 ILCS 20/13)  (from Ch. 23, par. 4163)
12    Sec. 13. Funding and Fiscal Responsibility.
13    (a) The lead agency and every other participating State
14agency may receive and expend funds appropriated by the General
15Assembly to implement the early intervention services system as
16required by this Act.
17    (b) The lead agency and each participating State agency
18shall identify and report on an annual basis to the Council the
19State agency funds utilized for the provision of early
20intervention services to eligible infants and toddlers.
21    (c) Funds provided under Section 633 of the Individuals
22with Disabilities Education Act (20 United States Code 1433)
23and State funds designated or appropriated for early
24intervention services or programs may not be used to satisfy a
25financial commitment for services which would have been paid

 

 

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1for from another public or private source but for the enactment
2of this Act, except whenever considered necessary to prevent
3delay in receiving appropriate early intervention services by
4the eligible infant or toddler or family in a timely manner.
5"Public or private source" includes public and private
6insurance coverage.
7    Funds provided under Section 633 of the Individuals with
8Disabilities Education Act and State funds designated or
9appropriated for early intervention services or programs may be
10used by the lead agency to pay the provider of services (A)
11pending reimbursement from the appropriate State agency or (B)
12if (i) the claim for payment is denied in whole or in part by a
13public or private source, or would be denied under the written
14terms of the public program or plan or private plan, or (ii)
15use of private insurance for the service has been exempted
16under Section 13.25. Payment under item (B)(i) may be made
17based on a pre-determination telephone inquiry supported by
18written documentation of the denial supplied thereafter by the
19insurance carrier.
20    (d) Nothing in this Act shall be construed to permit the
21State to reduce medical or other assistance available or to
22alter eligibility under Title V and Title XIX of the Social
23Security Act relating to the Maternal Child Health Program and
24Medicaid for eligible infants and toddlers in this State.
25    (e) The lead agency shall create a central billing office
26to receive and dispense all relevant State and federal

 

 

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1resources, as well as local government or independent resources
2available, for early intervention services. This office shall
3assure that maximum federal resources are utilized and that
4providers receive funds with minimal duplications or
5interagency reporting and with consolidated audit procedures.
6    (f) The lead agency shall, by rule, create a system of
7payments by families, including a schedule of fees. No fees,
8however, may be charged for: implementing child find,
9evaluation and assessment, service coordination,
10administrative and coordination activities related to the
11development, review, and evaluation of Individualized Family
12Service Plans, or the implementation of procedural safeguards
13and other administrative components of the statewide early
14intervention system.
15    The system of payments, called family fees, shall be
16structured on a sliding scale based on the family's ability to
17pay family income. The family's coverage or lack of coverage
18under a public or private insurance plan or policy shall not be
19a factor in determining the amount of the family fees.
20    Each family's fee obligation shall be established
21annually, and shall be paid by families to the central billing
22office in installments. At the written request of the family,
23the fee obligation shall be adjusted prospectively at any point
24during the year upon proof of a change in family income or
25family size. The inability of the parents of an eligible child
26to pay family fees due to catastrophic circumstances or

 

 

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1extraordinary expenses shall not result in the denial of
2services to the child or the child's family. A family must
3document its extraordinary expenses or other catastrophic
4circumstances by showing one of the following: (i)
5out-of-pocket medical expenses in excess of 15% of gross
6income; (ii) a fire, flood, or other disaster causing a direct
7out-of-pocket loss in excess of 15% of gross income; or (iii)
8other catastrophic circumstances causing out-of-pocket losses
9in excess of 15% of gross income. The family must present proof
10of loss to its service coordinator, who shall document it, and
11the lead agency shall determine whether the fees shall be
12reduced, forgiven, or suspended within 10 business days after
13the family's request.
14    (g) To ensure that early intervention funds are used as the
15payor of last resort for early intervention services, the lead
16agency shall determine at the point of early intervention
17intake, and again at any periodic review of eligibility
18thereafter or upon a change in family circumstances, whether
19the family is eligible for or enrolled in any program for which
20payment is made directly or through public or private insurance
21for any or all of the early intervention services made
22available under this Act. The lead agency shall establish
23procedures to ensure that payments are made either directly
24from these public and private sources instead of from State or
25federal early intervention funds, or as reimbursement for
26payments previously made from State or federal early

 

 

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1intervention funds.
2(Source: P.A. 91-538, eff. 8-13-99; 92-10, eff. 6-11-01;
392-307, eff. 8-9-01; 92-651, eff. 7-11-02.)
 
4    (325 ILCS 20/13.5)
5    Sec. 13.5. Other programs.
6    (a) When an application or a review of eligibility for
7early intervention services is made, and at any eligibility
8redetermination thereafter, the family shall be asked if it is
9currently enrolled in any federally funded, Department of
10Healthcare and Family Services administered, medical programs
11Medicaid, KidCare, or the Title V program administered by the
12University of Illinois Division of Specialized Care for
13Children. If the family is enrolled in any of these programs,
14that information shall be put on the individualized family
15service plan and entered into the computerized case management
16system, and shall require that the individualized family
17services plan of a child who has been found eligible for
18services through the Division of Specialized Care for Children
19state that the child is enrolled in that program. For those
20programs in which the family is not enrolled, a preliminary
21eligibility screen shall be conducted simultaneously for (i)
22medical assistance (Medicaid) under Article V of the Illinois
23Public Aid Code, (ii) children's health insurance program (any
24federally funded, Department of Healthcare and Family Services
25administered, medical programs KidCare) benefits under the

 

 

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1Children's Health Insurance Program Act, and (iii) Title V
2maternal and child health services provided through the
3Division of Specialized Care for Children of the University of
4Illinois.
5    (b) For purposes of determining family fees under
6subsection (f) of Section 13 and determining eligibility for
7the other programs and services specified in items (i) through
8(iii) of subsection (a), the lead agency shall develop and use,
9within 60 days after the effective date of this amendatory Act
10of the 92nd General Assembly, with the cooperation of the
11Department of Public Aid (now Healthcare and Family Services)
12and the Division of Specialized Care for Children of the
13University of Illinois, a screening device that provides
14sufficient information for the early intervention regional
15intake entities or other agencies to establish eligibility for
16those other programs and shall, in cooperation with the
17Illinois Department of Public Aid (now Healthcare and Family
18Services) and the Division of Specialized Care for Children,
19train the regional intake entities on using the screening
20device.
21    (c) When a child is determined eligible for and enrolled in
22the early intervention program and has been found to at least
23meet the threshold income eligibility requirements for any
24federally funded, Department of Healthcare and Family Services
25administered, medical programs Medicaid or KidCare, the
26regional intake entity shall complete an application for any

 

 

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1federally funded, Department of Healthcare and Family Services
2administered, medical programs a KidCare/Medicaid application
3with the family and forward it to the Department of Healthcare
4and Family Services' KidCare Unit for a determination of
5eligibility. A parent shall not be required to enroll in any
6federally funded, Department of Healthcare and Family Services
7administered, medical programs as a condition of receiving
8services provided pursuant to Part C of the Individuals with
9Disabilities Education Act.
10    (d) With the cooperation of the Department of Healthcare
11and Family Services, the lead agency shall establish procedures
12that ensure the timely and maximum allowable recovery of
13payments for all early intervention services and allowable
14administrative costs under Article V of the Illinois Public Aid
15Code and the Children's Health Insurance Program Act and shall
16include those procedures in the interagency agreement required
17under subsection (e) of Section 5 of this Act.
18    (e) For purposes of making referrals for final
19determinations of eligibility for any federally funded,
20Department of Healthcare and Family Services administered,
21medical programs KidCare benefits under the Children's Health
22Insurance Program Act and for medical assistance under Article
23V of the Illinois Public Aid Code, the lead agency shall
24require each early intervention regional intake entity to
25enroll as an application agent a "KidCare agent" in order for
26the entity to complete the any federally funded, Department of

 

 

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1Healthcare and Family Services administered, medical programs
2KidCare application as authorized under Section 22 of the
3Children's Health Insurance Program Act.
4    (f) For purposes of early intervention services that may be
5provided by the Division of Specialized Care for Children of
6the University of Illinois (DSCC), the lead agency shall
7establish procedures whereby the early intervention regional
8intake entities may determine whether children enrolled in the
9early intervention program may also be eligible for those
10services, and shall develop, within 60 days after the effective
11date of this amendatory Act of the 92nd General Assembly, (i)
12the inter-agency agreement required under subsection (e) of
13Section 5 of this Act, establishing that early intervention
14funds are to be used as the payor of last resort when services
15required under an individualized family services plan may be
16provided to an eligible child through the DSCC, and (ii)
17training guidelines for the regional intake entities and
18providers that explain eligibility and billing procedures for
19services through DSCC.
20    (g) The lead agency shall require that an individual
21applying for or renewing enrollment as a provider of services
22in the early intervention program state whether or not he or
23she is also enrolled as a DSCC provider. This information shall
24be noted next to the name of the provider on the computerized
25roster of Illinois early intervention providers, and regional
26intake entities shall make every effort to refer families

 

 

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1eligible for DSCC services to these providers.
2(Source: P.A. 95-331, eff. 8-21-07.)
 
3    (325 ILCS 20/13.10)
4    Sec. 13.10. Private health insurance; assignment. The lead
5agency shall determine, at the point of new applications for
6early intervention services, and for all children enrolled in
7the early intervention program, at the regional intake offices,
8whether the child is insured under a private health insurance
9plan or policy. An application for early intervention services
10shall serve as a right to assignment of the right of recovery
11against a private health insurance plan or policy for any
12covered early intervention services that may be billed to the
13family's insurance carrier and that are provided to a child
14covered under the plan or policy.
15(Source: P.A. 92-307, eff. 8-9-01.)
 
16    (325 ILCS 20/13.30)
17    Sec. 13.30. System of personnel development. The lead
18agency shall provide training to early intervention providers
19and may enter into contracts to meet this requirement. If such
20contracts are let, they shall be bid under a public request for
21proposals that shall be posted on the lead agency's early
22intervention website for no less than 30 days. This training
23shall include, at minimum, the following types of instruction:
24    (a) Courses in birth-to-3 evaluation and treatment of

 

 

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1children with developmental disabilities and delays (1) that
2are taught by fully credentialed early intervention providers
3or educators with substantial experience in evaluation and
4treatment of children from birth to age 3 with developmental
5disabilities and delays, (2) that cover these topics within
6each of the disciplines of audiology, occupational therapy,
7physical therapy, speech and language pathology, and
8developmental therapy, including the social-emotional domain
9of development, (3) that are held no less than twice per year,
10(4) that offer no fewer than 20 contact hours per year of
11course work, (5) that are held in no fewer than 5 separate
12locales throughout the State, and (6) that give enrollment
13priority to early intervention providers who do not meet the
14experience, education, or continuing education requirements
15necessary to be fully credentialed early intervention
16providers; and
17    (b) Courses held no less than twice per year for no fewer
18than 4 hours each in no fewer than 5 separate locales
19throughout the State each on the following topics:
20        (1) Practice and procedures of private insurance
21    billing.
22        (2) The role of the regional intake entities; service
23    coordination; program eligibility determinations; family
24    fees; any federally funded, Department of Healthcare and
25    Family Services administered, medical programs Medicaid,
26    KidCare, and Division of Specialized Care applications,

 

 

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1    referrals, and coordination with Early Intervention; and
2    procedural safeguards.
3        (3) Introduction to the early intervention program,
4    including provider enrollment and credentialing, overview
5    of Early Intervention program policies and regulations,
6    and billing requirements.
7        (4) Evaluation and assessment of birth-to-3 children;
8    individualized family service plan development,
9    monitoring, and review; best practices; service
10    guidelines; and quality assurance.
11(Source: P.A. 92-307, eff. 8-9-01.)
 
12    (325 ILCS 20/13.50 rep.)
13    Section 15. The Early Intervention Services System Act is
14amended by repealing Section 13.50.
 
15    Section 99. Effective date. This Act takes effect upon
16becoming law.