98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
SB2217

 

Introduced 2/15/2013, by Sen. Julie A. Morrison

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Early Intervention Services System Act. Adds nursing services, nutrition services, and sign language and cued language services to the list of services included in the definition of "early intervention services". Provides that before adopting any new policy or procedure needed to comply with certain provisions under the Individuals with Disabilities Education Act, the Department of Human Services must hold public hearings on the new policy or procedure, provide notice of the hearings at least 30 days before the hearings are conducted, and provide an opportunity for the general public, including individuals with disabilities and parents of infants and toddlers with disabilities, early intervention providers, and other specified persons to comment for at least 30 days on the new policy or procedure. Provides that the statewide system for early intervention services and programs shall include a central directory which includes public and private early intervention services (rather than early intervention services), resources, and experts available in this State, professional and other groups that provide assistance to infants and toddlers with disabilities and their families, and research and demonstration projects being conducted in this State (rather than early intervention research and demonstration projects) relating to infants and toddlers with disabilities. Makes changes to provisions concerning criminal background checks; the timeline for the initial evaluation and assessment of a child and his or her family under the individualized family service plan; and other matters. Repeals a provision requiring the Early Intervention Legislative Advisory Committee to convene for a period of 4 years no later that 60 days after August 9, 2001. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning children.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Early Intervention Services System Act is
5amended by changing Sections 3, 4, 5, 7, 9, 10, 11, 12, 13,
613.5, 13.10, 13.15, and 13.30 as follows:
 
7    (325 ILCS 20/3)  (from Ch. 23, par. 4153)
8    Sec. 3. Definitions. As used in this Act:
9    (a) "Eligible infants and toddlers" means infants and
10toddlers under 36 months of age with any of the following
11conditions:
12        (1) Developmental delays.
13        (2) A physical or mental condition which typically
14    results in developmental delay.
15        (3) Being at risk of having substantial developmental
16    delays based on informed clinical opinion judgment.
17        (4) Either (A) having entered the program under any of
18    the circumstances listed in paragraphs (1) through (3) of
19    this subsection but no longer meeting the current
20    eligibility criteria under those paragraphs, and
21    continuing to have any measurable delay, or (B) not having
22    attained a level of development in each area, including (i)
23    cognitive, (ii) physical (including vision and hearing),

 

 

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1    (iii) language, speech, and communication, (iv) social or
2    emotional psycho-social, or (v) adaptive self-help skills,
3    that is at least at the mean of the child's age equivalent
4    peers; and, in addition to either item (A) or item (B), (C)
5    having been determined by the multidisciplinary
6    individualized family service plan team to require the
7    continuation of early intervention services in order to
8    support continuing developmental progress, pursuant to the
9    child's needs and provided in an appropriate developmental
10    manner. The type, frequency, and intensity of services
11    shall differ from the initial individualized family
12    services plan because of the child's developmental
13    progress, and may consist of only service coordination,
14    evaluation, and assessments.
15    (b) "Developmental delay" means a delay in one or more of
16the following areas of childhood development as measured by
17appropriate diagnostic instruments and standard procedures:
18cognitive; physical, including vision and hearing; language,
19speech and communication; social or emotional psycho-social;
20or adaptive self-help skills. The term means a delay of 30% or
21more below the mean in function in one or more of those areas.
22    (c) "Physical or mental condition which typically results
23in developmental delay" means:
24        (1) a diagnosed medical disorder bearing a relatively
25    well known expectancy for developmental outcomes within
26    varying ranges of developmental disabilities; or

 

 

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1        (2) a history of prenatal, perinatal, neonatal or early
2    developmental events suggestive of biological insults to
3    the developing central nervous system and which either
4    singly or collectively increase the probability of
5    developing a disability or delay based on a medical
6    history.
7    (d) "Informed clinical opinion judgment" means both
8clinical observations and parental participation to determine
9eligibility by a consensus of a multidisciplinary team of 2 or
10more members based on their professional experience and
11expertise.
12    (e) "Early intervention services" means services which:
13        (1) are designed to meet the developmental needs of
14    each child eligible under this Act and the needs of his or
15    her family;
16        (2) are selected in collaboration with the child's
17    family;
18        (3) are provided under public supervision;
19        (4) are provided at no cost except where a schedule of
20    sliding scale fees or other system of payments by families
21    has been adopted in accordance with State and federal law;
22        (5) are designed to meet an infant's or toddler's
23    developmental needs in any of the following areas:
24            (A) physical development, including vision and
25        hearing,
26            (B) cognitive development,

 

 

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1            (C) communication development,
2            (D) social or emotional development, or
3            (E) adaptive development;
4        (6) meet the standards of the State, including the
5    requirements of this Act;
6        (7) include one or more of the following:
7            (A) family training,
8            (B) social work services, including counseling,
9        and home visits,
10            (C) special instruction,
11            (D) speech, language pathology and audiology,
12            (E) occupational therapy,
13            (F) physical therapy,
14            (G) psychological services,
15            (H) service coordination services,
16            (I) medical services only for diagnostic or
17        evaluation purposes,
18            (J) early identification, screening, and
19        assessment services,
20            (K) health services specified by the lead agency as
21        necessary to enable the infant or toddler to benefit
22        from the other early intervention services,
23            (L) vision services,
24            (M) transportation, and
25            (N) assistive technology devices and services, ;
26            (O) nursing services,

 

 

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1            (P) nutrition services, and
2            (Q) sign language and cued language services;
3        (8) are provided by qualified personnel, including but
4    not limited to:
5            (A) child development specialists or special
6        educators, including teachers of children with hearing
7        impairments (including deafness) and teachers of
8        children with vision impairments (including
9        blindness),
10            (B) speech and language pathologists and
11        audiologists,
12            (C) occupational therapists,
13            (D) physical therapists,
14            (E) social workers,
15            (F) nurses,
16            (G) dietitian nutritionists,
17            (H) vision specialists, including ophthalmologists
18        and optometrists,
19            (I) psychologists, and
20            (J) physicians;
21        (9) are provided in conformity with an Individualized
22    Family Service Plan;
23        (10) are provided throughout the year; and
24        (11) are provided in natural environments, to the
25    maximum extent appropriate, which may include the home and
26    community settings, unless justification is provided

 

 

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1    consistent with federal regulations adopted under Sections
2    1431 through 1444 of Title 20 of the United States Code.
3    (f) "Individualized Family Service Plan" or "Plan" means a
4written plan for providing early intervention services to a
5child eligible under this Act and the child's family, as set
6forth in Section 11.
7    (g) "Local interagency agreement" means an agreement
8entered into by local community and State and regional agencies
9receiving early intervention funds directly from the State and
10made in accordance with State interagency agreements providing
11for the delivery of early intervention services within a local
12community area.
13    (h) "Council" means the Illinois Interagency Council on
14Early Intervention established under Section 4.
15    (i) "Lead agency" means the State agency responsible for
16administering this Act and receiving and disbursing public
17funds received in accordance with State and federal law and
18rules.
19    (i-5) "Central billing office" means the central billing
20office created by the lead agency under Section 13.
21    (j) "Child find" means a service which identifies eligible
22infants and toddlers.
23    (k) "Regional intake entity" means the lead agency's
24designated entity responsible for implementation of the Early
25Intervention Services System within its designated geographic
26area.

 

 

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1    (l) "Early intervention provider" means an individual who
2is qualified, as defined by the lead agency, to provide one or
3more types of early intervention services, and who has enrolled
4as a provider in the early intervention program.
5    (m) "Fully credentialed early intervention provider" means
6an individual who has met the standards in the State applicable
7to the relevant profession, and has met such other
8qualifications as the lead agency has determined are suitable
9for personnel providing early intervention services, including
10pediatric experience, education, and continuing education. The
11lead agency shall establish these qualifications by rule filed
12no later than 180 days after the effective date of this
13amendatory Act of the 92nd General Assembly.
14(Source: P.A. 97-902, eff. 8-6-12.)
 
15    (325 ILCS 20/4)  (from Ch. 23, par. 4154)
16    Sec. 4. Illinois Interagency Council on Early
17Intervention.
18    (a) There is established the Illinois Interagency Council
19on Early Intervention. The Council shall be composed of at
20least 20 but not more than 30 members. The members of the
21Council and the designated chairperson of the Council shall be
22appointed by the Governor. The Council member representing the
23lead agency may not serve as chairperson of the Council. The
24Council shall be composed of the following members:
25        (1) The Secretary of Human Services (or his or her

 

 

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1    designee) and 2 additional representatives of the
2    Department of Human Services designated by the Secretary,
3    plus the Directors (or their designees) of the following
4    State agencies involved in the provision of or payment for
5    early intervention services to eligible infants and
6    toddlers and their families:
7            (A) Department of Insurance; and
8            (B) Department of Healthcare and Family Services.
9        (2) Other members as follows:
10            (A) At least 20% of the members of the Council
11        shall be parents, including minority parents, of
12        infants or toddlers with disabilities or children with
13        disabilities aged 12 or younger, with knowledge of, or
14        experience with, programs for infants and toddlers
15        with disabilities. At least one such member shall be a
16        parent of an infant or toddler with a disability or a
17        child with a disability aged 6 or younger;
18            (B) At least 20% of the members of the Council
19        shall be public or private providers of early
20        intervention services;
21            (C) One member shall be a representative of the
22        General Assembly;
23            (D) One member shall be involved in the preparation
24        of professional personnel to serve infants and
25        toddlers similar to those eligible for services under
26        this Act;

 

 

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1            (E) Two members shall be from advocacy
2        organizations with expertise in improving health,
3        development, and educational outcomes for infants and
4        toddlers with disabilities;
5            (F) One member shall be a Child and Family
6        Connections manager from a rural district;
7            (G) One member shall be a Child and Family
8        Connections manager from an urban district;
9            (H) One member shall be the co-chair of the
10        Illinois Early Learning Council (or his or her
11        designee); and
12            (I) Members representing the following agencies or
13        entities: the State Board of Education; the Department
14        of Public Health; the Department of Children and Family
15        Services; the University of Illinois Division of
16        Specialized Care for Children; the Illinois Council on
17        Developmental Disabilities; Head Start or Early Head
18        Start; and the Department of Human Services' Division
19        of Mental Health. A member may represent one or more of
20        the listed agencies or entities.
21    The Council shall meet at least quarterly and in such
22places as it deems necessary. Terms of the initial members
23appointed under paragraph (2) shall be determined by lot at the
24first Council meeting as follows: of the persons appointed
25under subparagraphs (A) and (B), one-third shall serve one year
26terms, one-third shall serve 2 year terms, and one-third shall

 

 

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1serve 3 year terms; and of the persons appointed under
2subparagraphs (C) and (D), one shall serve a 2 year term and
3one shall serve a 3 year term. Thereafter, successors appointed
4under paragraph (2) shall serve 3 year terms. Once appointed,
5members shall continue to serve until their successors are
6appointed. No member shall be appointed to serve more than 2
7consecutive terms.
8    Council members shall serve without compensation but shall
9be reimbursed for reasonable costs incurred in the performance
10of their duties, including costs related to child care, and
11parents may be paid a stipend in accordance with applicable
12requirements.
13    The Council shall prepare and approve a budget using funds
14appropriated for the purpose to hire staff, and obtain the
15services of such professional, technical, and clerical
16personnel as may be necessary to carry out its functions under
17this Act. This funding support and staff shall be directed by
18the lead agency.
19    (b) The Council shall:
20        (1) advise and assist the lead agency in the
21    performance of its responsibilities including but not
22    limited to the identification of sources of fiscal and
23    other support services for early intervention programs,
24    and the promotion of interagency agreements which assign
25    financial responsibility to the appropriate agencies;
26        (2) advise and assist the lead agency in the

 

 

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1    preparation of applications and amendments to
2    applications;
3        (3) review and advise on relevant regulations and
4    standards proposed by the related State agencies;
5        (4) advise and assist the lead agency in the
6    development, implementation and evaluation of the
7    comprehensive early intervention services system; and
8        (4.5) coordinate and collaborate with State
9    interagency early learning initiatives, as appropriate;
10    and
11        (5) prepare and submit an annual report to the Governor
12    and to the General Assembly on the status of early
13    intervention programs for eligible infants and toddlers
14    and their families in Illinois. The annual report shall
15    include (i) the estimated number of eligible infants and
16    toddlers in this State, (ii) the number of eligible infants
17    and toddlers who have received services under this Act and
18    the cost of providing those services, and (iii) the
19    estimated cost of providing services under this Act to all
20    eligible infants and toddlers in this State. , and (iv)
21    data and other information as is requested to be included
22    by the Legislative Advisory Committee established under
23    Section 13.50 of this Act. The report shall be posted by
24    the lead agency on the early intervention website as
25    required under paragraph (f) of Section 5 of this Act.
26    No member of the Council shall cast a vote on or

 

 

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1participate substantially in any matter which would provide a
2direct financial benefit to that member or otherwise give the
3appearance of a conflict of interest under State law. All
4provisions and reporting requirements of the Illinois
5Governmental Ethics Act shall apply to Council members.
6(Source: P.A. 97-902, eff. 8-6-12.)
 
7    (325 ILCS 20/5)  (from Ch. 23, par. 4155)
8    Sec. 5. Lead Agency. The Department of Human Services is
9designated the lead agency and shall provide leadership in
10establishing and implementing the coordinated, comprehensive,
11interagency and interdisciplinary system of early intervention
12services. The lead agency shall not have the sole
13responsibility for providing these services. Each
14participating State agency shall continue to coordinate those
15early intervention services relating to health, social service
16and education provided under this authority.
17    The lead agency is responsible for carrying out the
18following:
19        (a) The general administration, supervision, and
20    monitoring of programs and activities receiving assistance
21    under Section 673 of the Individuals with Disabilities
22    Education Act (20 United States Code 1473).
23        (b) The identification and coordination of all
24    available resources within the State from federal, State,
25    local and private sources.

 

 

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1        (c) The development of procedures to ensure that
2    services are provided to eligible infants and toddlers and
3    their families in a timely manner pending the resolution of
4    any disputes among public agencies or service providers.
5        (d) The resolution of intra-agency and interagency
6    regulatory and procedural disputes.
7        (e) The development and implementation of formal
8    interagency agreements, and the entry into such
9    agreements, between the lead agency and (i) the Department
10    of Healthcare and Family Services, (ii) the University of
11    Illinois Division of Specialized Care for Children, and
12    (iii) other relevant State agencies that:
13            (1) define the financial responsibility of each
14        agency for paying for early intervention services
15        (consistent with existing State and federal law and
16        rules, including the requirement that early
17        intervention funds be used as the payor of last
18        resort), a hierarchical order of payment as among the
19        agencies for early intervention services that are
20        covered under or may be paid by programs in other
21        agencies, and procedures for direct billing,
22        collecting reimbursements for payments made, and
23        resolving service and payment disputes; and
24            (2) include all additional components necessary to
25        ensure meaningful cooperation and coordination.
26        Interagency agreements under this paragraph (e) must

 

 

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1    be reviewed and revised to implement the purposes of this
2    amendatory Act of the 92nd General Assembly no later than
3    60 days after the effective date of this amendatory Act of
4    the 92nd General Assembly.
5        (f) The maintenance of an early intervention website.
6    Within 30 days after the effective date of this amendatory
7    Act of the 92nd General Assembly, the lead agency shall
8    post and keep posted on this website the following: (i) the
9    current annual report required under subdivision (b)(5) of
10    Section 4 of this Act, and the annual reports of the prior
11    3 years, (ii) the most recent Illinois application for
12    funds prepared under Section 637 of the Individuals with
13    Disabilities Education Act filed with the United States
14    Department of Education, (iii) proposed modifications of
15    the application prepared for public comment, (iv) notice of
16    Council meetings, Council agendas, and minutes of its
17    proceedings for at least the previous year, (v) proposed
18    and final early intervention rules, (vi) requests for
19    proposals, and (vii) all reports created for dissemination
20    to the public that are related to the early intervention
21    program, including reports prepared at the request of the
22    Council, and the General Assembly, and the Legislative
23    Advisory Committee established under Section 13.50 of this
24    Act. Each such document shall be posted on the website
25    within 3 working days after the document's completion.
26        (g) Before adopting any new policy or procedure

 

 

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1    (including any revisions to an existing policy or
2    procedure) needed to comply with Part C of the Individuals
3    with Disabilities Education Act, the lead agency must hold
4    public hearings on the new policy or procedure, provide
5    notice of the hearings at least 30 days before the hearings
6    are conducted to enable public participation, and provide
7    an opportunity for the general public, including
8    individuals with disabilities and parents of infants and
9    toddlers with disabilities, early intervention providers,
10    and members of the Council to comment for at least 30 days
11    on the new policy or procedure needed to comply with Part C
12    of the Individuals with Disabilities Education Act and with
13    34 CFR part 300 and part 303.
14(Source: P.A. 95-331, eff. 8-21-07.)
 
15    (325 ILCS 20/7)  (from Ch. 23, par. 4157)
16    Sec. 7. Essential Components of the Statewide Service
17System. As required by federal laws and regulations, a
18statewide system of coordinated, comprehensive, interagency
19and interdisciplinary programs shall be established and
20maintained. The framework of the statewide system shall be
21based on the components set forth in this Section. This
22framework shall be used for planning, implementation,
23coordination and evaluation of the statewide system of locally
24based early intervention services.
25    The statewide system shall include, at a minimum:

 

 

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1        (a) a definition of the term "developmentally
2    delayed", in accordance with the definition in Section 3,
3    that will be used in Illinois in carrying out programs
4    under this Act;
5        (b) timetables for ensuring that appropriate early
6    intervention services, based on scientifically based
7    research, to the extent practicable, will be available to
8    all eligible infants and toddlers in this State after the
9    effective date of this Act;
10        (c) a timely, comprehensive, multidisciplinary and
11    interdisciplinary evaluation of the functioning of each
12    potentially eligible infant and toddler with suspected
13    disabilities in this State, unless the child meets the
14    definition of eligibility based upon his or her medical and
15    other records; for a child determined eligible, a
16    multidisciplinary assessment of the unique strengths and
17    needs of that infant or toddler and the identification of
18    services appropriate to meet those needs and a
19    family-directed assessment of the resources, priorities,
20    and concerns of the family and the identification of
21    supports and services necessary to enhance the family's
22    capacity to meet the developmental needs of that infant or
23    toddler the concerns, priorities and resource needs of the
24    families to appropriately assist in the development of the
25    infant and toddler with disabilities;
26        (d) for each eligible infant and toddler, an

 

 

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1    Individualized Family Service Plan, including service
2    coordination (case management) services;
3        (e) a comprehensive child find system, consistent with
4    Part B of the Individuals with Disabilities Education Act
5    (20 United States Code 1411 through 1420 and as set forth
6    in 34 CFR 300.115), which includes timelines and provides
7    for participation by primary referral sources;
8        (f) a public awareness program focusing on early
9    identification of eligible infants and toddlers;
10        (g) a central directory which includes public and
11    private early intervention services, resources, and
12    experts available in this State, professional and other
13    groups (including parent support groups and training and
14    information centers) that provide assistance to infants
15    and toddlers with disabilities who are eligible for early
16    intervention programs assisted under Part C of the
17    Individuals with Disabilities Education Act and their
18    families, and early intervention research and
19    demonstration projects being conducted in this State
20    relating to infants and toddlers with disabilities;
21        (h) a comprehensive system of personnel development;
22        (i) a policy pertaining to the contracting or making of
23    other arrangements with public and private service
24    providers to provide early intervention services in this
25    State, consistent with the provisions of this Act,
26    including the contents of the application used and the

 

 

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1    conditions of the contract or other arrangements;
2        (j) a procedure for securing timely reimbursement of
3    funds;
4        (k) procedural safeguards with respect to programs
5    under this Act;
6        (l) policies and procedures relating to the
7    establishment and maintenance of standards to ensure that
8    personnel necessary to carry out this Act are appropriately
9    and adequately prepared and trained;
10        (m) a system of evaluation of, and compliance with,
11    program standards;
12        (n) a system for compiling data on the numbers of
13    eligible infants and toddlers and their families in this
14    State in need of appropriate early intervention services;
15    the numbers served; the types of services provided; and
16    other information required by the State or federal
17    government; and
18        (o) a single line of responsibility in a lead agency
19    designated by the Governor to carry out its
20    responsibilities as required by this Act.
21    In addition to these required components, linkages may be
22established within a local community area among the prenatal
23initiatives affording services to high risk pregnant women.
24Additional linkages among at risk programs and local literacy
25programs may also be established.
26    Within 60 days of the effective date of this Act, a

 

 

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1five-fiscal-year implementation plan shall be submitted to the
2Governor by the lead agency with the concurrence of the
3Interagency Council on Early Intervention. The plan shall list
4specific activities to be accomplished each year, with cost
5estimates for each activity. No later than the second Monday in
6July of each year thereafter, the lead agency shall, with the
7concurrence of the Interagency Council, submit to the
8Governor's Office a report on accomplishments of the previous
9year and a revised list of activities for the remainder of the
10five-fiscal-year plan, with cost estimates for each. The
11Governor shall certify that specific activities in the plan for
12the previous year have been substantially completed before
13authorizing relevant State or local agencies to implement
14activities listed in the revised plan that depend substantially
15upon completion of one or more of the earlier activities.
16(Source: P.A. 87-680.)
 
17    (325 ILCS 20/9)  (from Ch. 23, par. 4159)
18    Sec. 9. Role of Other State Entities. The Departments of
19Public Health, Human Services, Children and Family Services,
20and Healthcare and Family Services Public Aid; the University
21of Illinois Division of Specialized Care for Children; the
22State Board of Education; and any other State agency which
23directly or indirectly provides or administers early
24intervention services shall adopt compatible rules for the
25provision of services to eligible infants and toddlers and

 

 

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1their families within one year of the effective date of this
2Act.
3    These agencies shall enter into and maintain formal
4interagency agreements to enable the State and local agencies
5serving eligible children and their families to establish
6working relationships that will increase the efficiency and
7effectiveness of their early intervention services. The
8agreement shall outline the administrative, program and
9financial responsibilities of the relevant State agencies and
10shall implement a coordinated service delivery system through
11local interagency agreements.
12    There shall be created in the Office of the Governor an
13Early Childhood Intervention Ombudsman to assist families and
14local parties in ensuring that all State agencies serving
15eligible families do so in a comprehensive and collaborative
16manner.
17(Source: P.A. 89-507, eff. 7-1-97; 89-626, eff. 8-9-96.)
 
18    (325 ILCS 20/10)  (from Ch. 23, par. 4160)
19    Sec. 10. Standards. The Council and the lead agency, with
20assistance from parents and providers, shall develop and
21promulgate policies and procedures relating to the
22establishment and implementation of program and personnel
23standards to ensure that services provided are consistent with
24any State-approved or recognized certification, licensing,
25registration, or other comparable requirements which apply to

 

 

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1the area of early intervention program service standards. Only
2State-approved public or private early intervention service
3providers shall be eligible to receive State and federal
4funding for early intervention services. All early childhood
5intervention staff shall hold the highest entry requirement
6necessary for that position.
7    To be a State-approved early intervention service
8provider, an individual (i) shall not have served or completed,
9within the preceding 5 years, a sentence for conviction of any
10felony that the Department establishes by rule and (ii) shall
11not have been indicated as a perpetrator of child abuse or
12neglect, within the preceding 5 years, in an investigation by
13Illinois (pursuant to the Abused and Neglected Child Reporting
14Act) or another state. The Department is authorized to receive
15criminal background checks for such providers and persons
16applying to be such a provider and to receive child abuse and
17neglect reports regarding indicated perpetrators who are
18applying to provide or currently authorized to provide early
19intervention services in Illinois. Beginning January 1, 2004,
20every provider of State-approved early intervention services
21and every applicant to provide such services must authorize, in
22writing and in the form required by the Department, a State and
23FBI a criminal background check, as requested by the
24Department, and check of child abuse and neglect reports
25regarding the provider or applicant as a condition of
26authorization to provide early intervention services. The

 

 

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1Department shall use the results of the checks only to
2determine State approval of the early intervention service
3provider and shall not re-release the information except as
4necessary to accomplish that purpose.
5(Source: P.A. 93-147, eff. 1-1-04.)
 
6    (325 ILCS 20/11)  (from Ch. 23, par. 4161)
7    Sec. 11. Individualized Family Service Plans.
8    (a) Each eligible infant or toddler and that infant's or
9toddler's family shall receive:
10        (1) timely, comprehensive, multidisciplinary
11    assessment of the unique strengths and needs of each
12    eligible infant and toddler, and assessment of the concerns
13    and priorities of the families to appropriately assist them
14    in meeting their needs and identify supports and services
15    to meet those needs; and
16        (2) a written Individualized Family Service Plan
17    developed by a multidisciplinary team which includes the
18    parent or guardian. The individualized family service plan
19    shall be based on the multidisciplinary team's assessment
20    of the resources, priorities, and concerns of the family
21    and its identification of the supports and services
22    necessary to enhance the family's capacity to meet the
23    developmental needs of the infant or toddler, and shall
24    include the identification of services appropriate to meet
25    those needs, including the frequency, intensity, and

 

 

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1    method of delivering services. During and as part of the
2    initial development of the individualized family services
3    plan, and any periodic reviews of the plan, the
4    multidisciplinary team may seek consultation from shall
5    consult the lead agency's therapy guidelines and its
6    designated experts, if any, to help determine appropriate
7    services and the frequency and intensity of those services.
8    All services in the individualized family services plan
9    must be justified by the multidisciplinary assessment of
10    the unique strengths and needs of the infant or toddler and
11    must be appropriate to meet those needs. At the periodic
12    reviews, the team shall determine whether modification or
13    revision of the outcomes or services is necessary.
14    (b) The Individualized Family Service Plan shall be
15evaluated once a year and the family shall be provided a review
16of the Plan at 6 month intervals or more often where
17appropriate based on infant or toddler and family needs. The
18lead agency shall create a quality review process regarding
19Individualized Family Service Plan development and changes
20thereto, to monitor and help assure that resources are being
21used to provide appropriate early intervention services.
22    (c) The initial evaluation and initial assessment and
23initial Plan meeting must be held within 45 days after the
24initial contact with the early intervention services system.
25The 45-day timeline does not apply for any period when the
26child or parent is unavailable to complete the initial

 

 

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1evaluation, the initial assessments of the child and family, or
2the initial Plan meeting, due to exceptional family
3circumstances that are documented in the child's early
4intervention records, or when the parent has not provided
5consent for the initial evaluation or the initial assessment of
6the child despite documented, repeated attempts to obtain
7parental consent. As soon as exceptional family circumstances
8no longer exist or parental consent has been obtained, the
9initial evaluation, the initial assessment, and the initial
10Plan meeting must be completed as soon as possible. With
11parental consent, early intervention services may commence
12before the completion of the comprehensive assessment and
13development of the Plan.
14    (d) Parents must be informed that, at their discretion,
15early intervention services shall be provided to each eligible
16infant and toddler, to the maximum extent appropriate, in the
17natural environment, which may include the home or other
18community settings. Parents shall make the final decision to
19accept or decline early intervention services. A decision to
20decline such services shall not be a basis for administrative
21determination of parental fitness, or other findings or
22sanctions against the parents. Parameters of the Plan shall be
23set forth in rules.
24    (e) The regional intake offices shall explain to each
25family, orally and in writing, all of the following:
26        (1) That the early intervention program will pay for

 

 

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1    all early intervention services set forth in the
2    individualized family service plan that are not covered or
3    paid under the family's public or private insurance plan or
4    policy and not eligible for payment through any other third
5    party payor.
6        (2) That services will not be delayed due to any rules
7    or restrictions under the family's insurance plan or
8    policy.
9        (3) That the family may request, with appropriate
10    documentation supporting the request, a determination of
11    an exemption from private insurance use under Section
12    13.25.
13        (4) That responsibility for co-payments or
14    co-insurance under a family's private insurance plan or
15    policy will be transferred to the lead agency's central
16    billing office.
17        (5) That families will be responsible for payments of
18    family fees, which will be based on a sliding scale
19    according to the State's definition of ability to pay which
20    is comparing household size and income to the sliding scale
21    and considering out-of-pocket medical or disaster
22    expenses, and that these fees are payable to the central
23    billing office, and that if the family encounters a
24    catastrophic circumstance, as defined under subsection (f)
25    of Section 13 of this Act, making it unable to pay the
26    fees, the lead agency may, upon proof of inability to pay,

 

 

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1    waive the fees. Families who fail to provide income
2    information shall be charged the maximum amount on the
3    sliding scale.
4    (f) The individualized family service plan must state
5whether the family has private insurance coverage and, if the
6family has such coverage and parental consent has been
7obtained, must have attached to it a copy of the family's
8insurance identification card or otherwise include all of the
9following information:
10        (1) The name, address, and telephone number of the
11    insurance carrier.
12        (2) The contract number and policy number of the
13    insurance plan.
14        (3) The name, address, and social security number of
15    the primary insured.
16        (4) The beginning date of the insurance benefit year.
17    (g) A copy of the individualized family service plan must
18be provided to each enrolled provider who is providing early
19intervention services to the child who is the subject of that
20plan.
21    (h) Children receiving services under this Act shall
22receive a smooth and effective transition by their third
23birthday consistent with federal regulations adopted pursuant
24to Sections 1431 through 1444 of Title 20 of the United States
25Code.
26(Source: P.A. 97-902, eff. 8-6-12.)
 

 

 

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1    (325 ILCS 20/12)  (from Ch. 23, par. 4162)
2    Sec. 12. Procedural Safeguards. The lead agency shall adopt
3procedural safeguards that meet federal requirements and
4ensure effective implementation of the safeguards for families
5by each public agency involved in the provision of early
6intervention services under this Act.
7    The procedural safeguards shall provide, at a minimum, the
8following:
9        (a) The timely administrative resolution of State
10    complaints, due process hearings, and mediations by
11    parents as defined by administrative rule.
12        (b) The right to confidentiality of personally
13    identifiable information.
14        (c) The opportunity for parents and a guardian to
15    examine and receive copies of records relating to
16    evaluations and assessments assessment, screening,
17    eligibility determinations, and the development and
18    implementation of the Individualized Family Service Plan
19    provision of early intervention services, individual
20    complaints involving the child, or any part of the child's
21    early intervention record.
22        (d) Procedures to protect the rights of the eligible
23    infant or toddler whenever the parents or guardians of the
24    child are not known or unavailable or the child is a ward
25    of the State, including the assignment of an individual

 

 

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1    (who shall not be an employee of the State agency or local
2    agency providing services) to act as a surrogate for the
3    parents or guardian. The regional intake entity must make
4    reasonable efforts to ensure the assignment of a surrogate
5    parent not more than 30 days after a public agency
6    determines that the child needs a surrogate parent.
7        (e) Timely written prior notice to the parents or
8    guardian of the eligible infant or toddler whenever the
9    State agency or public or private service provider proposes
10    to initiate or change or refuses to initiate or change the
11    identification, evaluation, placement, or the provision of
12    appropriate early intervention services to the eligible
13    infant or toddler.
14        (f) Written prior notice to fully inform the parents or
15    guardians, in their native primary language or mode of
16    communication used by the parent, unless clearly not
17    feasible to do so, in a comprehensible manner, of these
18    procedural safeguards.
19        (g) During the pendency of any proceedings or action
20    involving a complaint, unless the State agency and the
21    parents or guardian otherwise agree, the child shall
22    continue to receive the appropriate early intervention
23    services currently being provided, or in the case of an
24    application for initial services, the child shall receive
25    the services not in dispute.
26(Source: P.A. 91-538, eff. 8-13-99.)
 

 

 

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1    (325 ILCS 20/13)  (from Ch. 23, par. 4163)
2    Sec. 13. Funding and Fiscal Responsibility.
3    (a) The lead agency and every other participating State
4agency may receive and expend funds appropriated by the General
5Assembly to implement the early intervention services system as
6required by this Act.
7    (b) The lead agency and each participating State agency
8shall identify and report on an annual basis to the Council the
9State agency funds utilized for the provision of early
10intervention services to eligible infants and toddlers.
11    (c) Funds provided under Section 633 of the Individuals
12with Disabilities Education Act (20 United States Code 1433)
13and State funds designated or appropriated for early
14intervention services or programs may not be used to satisfy a
15financial commitment for services which would have been paid
16for from another public or private source but for the enactment
17of this Act, except whenever considered necessary to prevent
18delay in receiving appropriate early intervention services by
19the eligible infant or toddler or family in a timely manner.
20"Public or private source" includes public and private
21insurance coverage.
22    Funds provided under Section 633 of the Individuals with
23Disabilities Education Act and State funds designated or
24appropriated for early intervention services or programs may be
25used by the lead agency to pay the provider of services (A)

 

 

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1pending reimbursement from the appropriate State agency or (B)
2if (i) the claim for payment is denied in whole or in part by a
3public or private source, or would be denied under the written
4terms of the public program or plan or private plan, or (ii)
5use of private insurance for the service has been exempted
6under Section 13.25, or (iii) parental consent has not been
7obtained for the use of private insurance. Payment under item
8(B)(i) may be made based on a pre-determination telephone
9inquiry supported by written documentation of the denial
10supplied thereafter by the insurance carrier.
11    (d) Nothing in this Act shall be construed to permit the
12State to reduce medical or other assistance available or to
13alter eligibility under Title V and Title XIX of the Social
14Security Act relating to the Maternal Child Health Program and
15Medicaid for eligible infants and toddlers in this State.
16    (e) The lead agency shall create a central billing office
17to receive and dispense all relevant State and federal
18resources, as well as local government or independent resources
19available, for early intervention services. This office shall
20assure that maximum federal resources are utilized and that
21providers receive funds with minimal duplications or
22interagency reporting and with consolidated audit procedures.
23    (f) The lead agency shall, by rule, create a system of
24payments by families, including a schedule of fees. No fees,
25however, may be charged for: implementing child find,
26evaluation and assessment, service coordination,

 

 

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1administrative and coordination activities related to the
2development, review, and evaluation of Individualized Family
3Service Plans, or the implementation of procedural safeguards
4and other administrative components of the statewide early
5intervention system.
6    The system of payments, called family fees, shall be
7structured on a sliding scale based on the family's ability to
8pay family income. The family's coverage or lack of coverage
9under a public or private insurance plan or policy shall not be
10a factor in determining the amount of the family fees.
11    Each family's fee obligation shall be established
12annually, and shall be paid by families to the central billing
13office in installments. At the written request of the family,
14the fee obligation shall be adjusted prospectively at any point
15during the year upon proof of a change in family income or
16family size. The inability of the parents of an eligible child
17to pay family fees due to catastrophic circumstances or
18extraordinary expenses shall not result in the denial of
19services to the child or the child's family. A family must
20document its extraordinary expenses or other catastrophic
21circumstances by showing one of the following: (i)
22out-of-pocket medical expenses in excess of 15% of gross
23income; (ii) a fire, flood, or other disaster causing a direct
24out-of-pocket loss in excess of 15% of gross income; or (iii)
25other catastrophic circumstances causing out-of-pocket losses
26in excess of 15% of gross income. The family must present proof

 

 

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1of loss to its service coordinator, who shall document it, and
2the lead agency shall determine whether the fees shall be
3reduced, forgiven, or suspended within 10 business days after
4the family's request.
5    (g) To ensure that early intervention funds are used as the
6payor of last resort for early intervention services, the lead
7agency shall determine at the point of early intervention
8intake, and again at any periodic review of eligibility
9thereafter or upon a change in family circumstances, whether
10the family is eligible for or enrolled in any program for which
11payment is made directly or through public or private insurance
12for any or all of the early intervention services made
13available under this Act. The lead agency shall establish
14procedures to ensure that payments are made either directly
15from these public and private sources, when parental consent
16has been obtained, instead of from State or federal early
17intervention funds, or as reimbursement for payments
18previously made from State or federal early intervention funds.
19(Source: P.A. 91-538, eff. 8-13-99; 92-10, eff. 6-11-01;
2092-307, eff. 8-9-01; 92-651, eff. 7-11-02.)
 
21    (325 ILCS 20/13.5)
22    Sec. 13.5. Other programs.
23    (a) When an application or a review of eligibility for
24early intervention services is made, and at any eligibility
25redetermination thereafter, the family shall be asked if it is

 

 

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1currently enrolled in any federally funded, Department of
2Healthcare and Family Services administered, medical programs
3Medicaid, KidCare, or the Title V program administered by the
4University of Illinois Division of Specialized Care for
5Children. If the family is enrolled in any of these programs,
6that information shall be put on the individualized family
7service plan and entered into the computerized case management
8system, and shall require that the individualized family
9services plan of a child who has been found eligible for
10services through the Division of Specialized Care for Children
11state that the child is enrolled in that program. For those
12programs in which the family is not enrolled, a preliminary
13eligibility screen shall be conducted simultaneously for (i)
14medical assistance (Medicaid) under Article V of the Illinois
15Public Aid Code, (ii) children's health insurance program (any
16federally funded, Department of Healthcare and Family Services
17administered, medical programs KidCare) benefits under the
18Children's Health Insurance Program Act, and (iii) Title V
19maternal and child health services provided through the
20Division of Specialized Care for Children of the University of
21Illinois.
22    (b) For purposes of determining family fees under
23subsection (f) of Section 13 and determining eligibility for
24the other programs and services specified in items (i) through
25(iii) of subsection (a), the lead agency shall develop and use,
26within 60 days after the effective date of this amendatory Act

 

 

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1of the 92nd General Assembly, with the cooperation of the
2Department of Public Aid (now Healthcare and Family Services)
3and the Division of Specialized Care for Children of the
4University of Illinois, a screening device that provides
5sufficient information for the early intervention regional
6intake entities or other agencies to establish eligibility for
7those other programs and shall, in cooperation with the
8Illinois Department of Public Aid (now Healthcare and Family
9Services) and the Division of Specialized Care for Children,
10train the regional intake entities on using the screening
11device.
12    (c) When a child is determined eligible for and enrolled in
13the early intervention program and has been found to at least
14meet the threshold income eligibility requirements for any
15federally funded, Department of Healthcare and Family Services
16administered, medical programs Medicaid or KidCare, the
17regional intake entity shall complete an application for any
18federally funded, Department of Healthcare and Family Services
19administered, medical programs a KidCare/Medicaid application
20with the family and forward it to the Department of Healthcare
21and Family Services' KidCare Unit for a determination of
22eligibility. A parent shall not be required to enroll in any
23federally funded, Department of Healthcare and Family Services
24administered, medical programs as a condition of receiving
25services provided pursuant to Part C of the Individuals with
26Disabilities Education Act.

 

 

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1    (d) With the cooperation of the Department of Healthcare
2and Family Services, the lead agency shall establish procedures
3that ensure the timely and maximum allowable recovery of
4payments for all early intervention services and allowable
5administrative costs under Article V of the Illinois Public Aid
6Code and the Children's Health Insurance Program Act and shall
7include those procedures in the interagency agreement required
8under subsection (e) of Section 5 of this Act.
9    (e) For purposes of making referrals for final
10determinations of eligibility for any federally funded,
11Department of Healthcare and Family Services administered,
12medical programs KidCare benefits under the Children's Health
13Insurance Program Act and for medical assistance under Article
14V of the Illinois Public Aid Code, the lead agency shall
15require each early intervention regional intake entity to
16enroll as an application agent a "KidCare agent" in order for
17the entity to complete the any federally funded, Department of
18Healthcare and Family Services administered, medical programs
19KidCare application as authorized under Section 22 of the
20Children's Health Insurance Program Act.
21    (f) For purposes of early intervention services that may be
22provided by the Division of Specialized Care for Children of
23the University of Illinois (DSCC), the lead agency shall
24establish procedures whereby the early intervention regional
25intake entities may determine whether children enrolled in the
26early intervention program may also be eligible for those

 

 

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1services, and shall develop, within 60 days after the effective
2date of this amendatory Act of the 92nd General Assembly, (i)
3the inter-agency agreement required under subsection (e) of
4Section 5 of this Act, establishing that early intervention
5funds are to be used as the payor of last resort when services
6required under an individualized family services plan may be
7provided to an eligible child through the DSCC, and (ii)
8training guidelines for the regional intake entities and
9providers that explain eligibility and billing procedures for
10services through DSCC.
11    (g) The lead agency shall require that an individual
12applying for or renewing enrollment as a provider of services
13in the early intervention program state whether or not he or
14she is also enrolled as a DSCC provider. This information shall
15be noted next to the name of the provider on the computerized
16roster of Illinois early intervention providers, and regional
17intake entities shall make every effort to refer families
18eligible for DSCC services to these providers.
19(Source: P.A. 95-331, eff. 8-21-07.)
 
20    (325 ILCS 20/13.10)
21    Sec. 13.10. Private health insurance; assignment. The lead
22agency shall determine, at the point of new applications for
23early intervention services, and for all children enrolled in
24the early intervention program, at the regional intake offices,
25whether the child is insured under a private health insurance

 

 

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1plan or policy. Parental consent must be obtained when the lead
2agency or enrolled provider who is providing a family with
3early intervention services seeks to use the child or parent's
4private insurance or benefits to pay for the initial provision
5of early intervention services in the Individualized Family
6Services Plan and anytime that an increase in frequency,
7length, duration, or intensity is made to existing services in
8the child's Individualized Family Services Plan. An
9application for early intervention services shall serve as a
10right to assignment of the right of recovery against a private
11health insurance plan or policy for any covered early
12intervention services that may be billed to the family's
13insurance carrier and that are provided to a child covered
14under the plan or policy.
15(Source: P.A. 92-307, eff. 8-9-01.)
 
16    (325 ILCS 20/13.15)
17    Sec. 13.15. Billing of insurance carrier.
18    (a) Subject to the restrictions against private insurance
19use on the basis of material risk of loss of coverage, as
20determined under Section 13.25, each enrolled provider who is
21providing a family with early intervention services shall bill
22the child's insurance carrier for each unit of early
23intervention service for which coverage may be available and
24parental consent has been obtained. The lead agency may exempt
25from the requirement of this paragraph any early intervention

 

 

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1service that it has deemed not to be covered by insurance
2plans. When the service is not exempted, providers who receive
3a denial of payment on the basis that the service is not
4covered under any circumstance under the plan are not required
5to bill that carrier for that service again until the following
6insurance benefit year. That explanation of benefits denying
7the claim, once submitted to the central billing office, shall
8be sufficient to meet the requirements of this paragraph as to
9subsequent services billed under the same billing code provided
10to that child during that insurance benefit year. Any time
11limit on a provider's filing of a claim for payment with the
12central billing office that is imposed through a policy,
13procedure, or rule of the lead agency shall be suspended until
14the provider receives an explanation of benefits or other final
15determination of the claim it files with the child's insurance
16carrier.
17    (b) In all instances when an insurance carrier has been
18billed for early intervention services, whether paid in full,
19paid in part, or denied by the carrier, the provider must
20provide the central billing office, within 90 days after
21receipt, with a copy of the explanation of benefits form and
22other information in the manner prescribed by the lead agency.
23    (c) When the insurance carrier has denied the claim or paid
24an amount for the early intervention service billed that is
25less than the current State rate for early intervention
26services, the provider shall submit the explanation of benefits

 

 

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1with a claim for payment, and the lead agency shall pay the
2provider the difference between the sum actually paid by the
3insurance carrier for each unit of service provided under the
4individualized family service plan and the current State rate
5for early intervention services. The State shall also pay the
6family's co-payment or co-insurance under its plan, but only to
7the extent that those payments plus the balance of the claim do
8not exceed the current State rate for early intervention
9services. The provider may under no circumstances bill the
10family for the difference between its charge for services and
11that which has been paid by the insurance carrier or by the
12State.
13(Source: P.A. 97-813, eff. 7-13-12.)
 
14    (325 ILCS 20/13.30)
15    Sec. 13.30. System of personnel development. The lead
16agency shall provide training to early intervention providers
17and may enter into contracts to meet this requirement. If such
18contracts are let, they shall be bid under a public request for
19proposals that shall be posted on the lead agency's early
20intervention website for no less than 30 days. This training
21shall include, at minimum, the following types of instruction:
22    (a) Courses in birth-to-3 evaluation and treatment of
23children with developmental disabilities and delays (1) that
24are taught by fully credentialed early intervention providers
25or educators with substantial experience in evaluation and

 

 

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

 

 

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

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    325 ILCS 20/3from Ch. 23, par. 4153
4    325 ILCS 20/4from Ch. 23, par. 4154
5    325 ILCS 20/5from Ch. 23, par. 4155
6    325 ILCS 20/7from Ch. 23, par. 4157
7    325 ILCS 20/9from Ch. 23, par. 4159
8    325 ILCS 20/10from Ch. 23, par. 4160
9    325 ILCS 20/11from Ch. 23, par. 4161
10    325 ILCS 20/12from Ch. 23, par. 4162
11    325 ILCS 20/13from Ch. 23, par. 4163
12    325 ILCS 20/13.5
13    325 ILCS 20/13.10
14    325 ILCS 20/13.15
15    325 ILCS 20/13.30
16    325 ILCS 20/13.50 rep.