Full Text of SB2217 98th General Assembly
SB2217 98TH GENERAL ASSEMBLY |
| | 98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014 SB2217 Introduced 2/15/2013, by Sen. Julie A. Morrison SYNOPSIS AS INTRODUCED: |
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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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| 1 | | AN ACT concerning children.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Early Intervention Services System Act is | 5 | | amended by changing Sections 3, 4, 5, 7, 9, 10, 11, 12, 13, | 6 | | 13.5, 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 | 10 | | toddlers
under 36 months of age with any of the following | 11 | | conditions:
| 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 | 16 | | the following
areas of childhood development as measured by | 17 | | appropriate diagnostic
instruments and standard procedures: | 18 | | cognitive; physical, including vision
and hearing; language, | 19 | | speech and communication; social or emotional psycho-social ;
| 20 | | or adaptive self-help skills . The term means a delay of 30% or | 21 | | more below the mean in
function in one or more of those areas.
| 22 | | (c) "Physical or mental condition which typically results | 23 | | in 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 | 8 | | clinical observations and
parental participation to determine | 9 | | eligibility by a consensus of a
multidisciplinary team of 2 or | 10 | | more members based on their professional
experience and | 11 | | expertise.
| 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 | 4 | | written plan for
providing early intervention services to a | 5 | | child eligible under this Act
and the child's family, as set | 6 | | forth in Section 11.
| 7 | | (g) "Local interagency agreement" means an agreement | 8 | | entered into by
local community and State and regional agencies | 9 | | receiving early
intervention funds directly from the State and | 10 | | made in accordance with
State interagency agreements providing | 11 | | for the delivery of early
intervention services within a local | 12 | | community area.
| 13 | | (h) "Council" means the Illinois Interagency Council on | 14 | | Early
Intervention established under Section 4.
| 15 | | (i) "Lead agency" means the State agency
responsible for | 16 | | administering this Act and
receiving and disbursing public | 17 | | funds received in accordance with State and
federal law and | 18 | | rules.
| 19 | | (i-5) "Central billing office" means the central billing | 20 | | office created by
the lead agency under Section 13.
| 21 | | (j) "Child find" means a service which identifies eligible | 22 | | infants and
toddlers.
| 23 | | (k) "Regional intake entity" means the lead agency's | 24 | | designated entity
responsible for implementation of the Early | 25 | | Intervention Services System within
its designated geographic | 26 | | area.
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| 1 | | (l) "Early intervention provider" means an individual who | 2 | | is qualified, as
defined by the lead agency, to provide one or | 3 | | more types of early intervention
services, and who has enrolled | 4 | | as a provider in the early intervention program.
| 5 | | (m) "Fully credentialed early intervention provider" means | 6 | | an individual who
has met the standards in the State applicable | 7 | | to the relevant
profession, and has met such other | 8 | | qualifications as the lead agency has
determined are suitable | 9 | | for personnel providing early intervention services,
including | 10 | | pediatric experience, education, and continuing education. The | 11 | | lead
agency shall establish these qualifications by rule filed | 12 | | no later than 180
days
after the effective date of this | 13 | | amendatory 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 | 17 | | Intervention.
| 18 | | (a) There is established the Illinois Interagency Council | 19 | | on Early
Intervention. The Council shall be composed of at | 20 | | least 20 but not more than
30 members. The members of the | 21 | | Council and the designated chairperson of the
Council shall be | 22 | | appointed by the Governor. The Council member representing the
| 23 | | lead agency may not serve as chairperson of the Council. The | 24 | | Council 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 | 22 | | places as it deems
necessary. Terms of the initial members | 23 | | appointed under paragraph (2) shall be
determined by lot at the | 24 | | first Council meeting as follows: of the persons
appointed | 25 | | under subparagraphs (A) and (B), one-third shall serve one year
| 26 | | terms, one-third shall serve 2 year terms, and one-third shall |
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| 1 | | serve 3 year
terms; and of the persons appointed under | 2 | | subparagraphs (C) and (D), one
shall serve a 2 year term and | 3 | | one shall serve a 3 year term. Thereafter,
successors appointed | 4 | | under paragraph (2) shall serve 3 year terms. Once
appointed, | 5 | | members shall continue to serve until their successors are
| 6 | | appointed. No member shall be appointed to serve more than 2 | 7 | | consecutive
terms.
| 8 | | Council members shall serve without compensation but shall | 9 | | be reimbursed
for reasonable costs incurred in the performance | 10 | | of their duties, including
costs related to child care, and | 11 | | parents may be paid a stipend in accordance
with applicable | 12 | | requirements.
| 13 | | The Council shall prepare and approve a budget using funds | 14 | | appropriated
for the purpose to hire staff, and obtain the | 15 | | services of such
professional, technical, and clerical | 16 | | personnel as may be necessary to
carry out its functions under | 17 | | this Act. This funding support and staff
shall be directed by | 18 | | the 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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| 1 | | participate substantially
in any matter which would provide a | 2 | | direct financial benefit to that member
or otherwise give the | 3 | | appearance of a conflict of interest under State law.
All | 4 | | provisions and reporting requirements of the Illinois | 5 | | Governmental 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 | 9 | | designated the
lead agency and shall
provide leadership in | 10 | | establishing and implementing the coordinated,
comprehensive, | 11 | | interagency and interdisciplinary system of early intervention
| 12 | | services. The lead agency shall not have the sole | 13 | | responsibility for
providing these services. Each | 14 | | participating State agency shall continue
to coordinate those | 15 | | early intervention services relating to health, social
service | 16 | | and education provided under this authority.
| 17 | | The lead agency is responsible for carrying out the | 18 | | following:
| 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 | 17 | | System. As
required by federal laws and regulations, a | 18 | | statewide system of
coordinated, comprehensive, interagency | 19 | | and interdisciplinary programs shall
be established and | 20 | | maintained. The framework of the statewide system shall
be | 21 | | based on the components set forth in this Section. This | 22 | | framework shall
be used for planning, implementation, | 23 | | coordination and evaluation of the
statewide system of locally | 24 | | based 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 | 22 | | established
within a local community area among the prenatal | 23 | | initiatives affording
services to high risk pregnant women. | 24 | | Additional linkages among at risk
programs and local literacy | 25 | | programs may also be established.
| 26 | | Within 60 days of the effective date of this Act, a |
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| 1 | | five-fiscal-year
implementation plan shall be submitted to the | 2 | | Governor by the lead agency
with the concurrence of the | 3 | | Interagency Council on Early Intervention. The
plan shall list | 4 | | specific activities to be accomplished each year, with cost
| 5 | | estimates for each activity. No later than the second Monday in | 6 | | July of
each year thereafter, the lead agency shall, with the | 7 | | concurrence of the
Interagency Council, submit to the | 8 | | Governor's Office a report on
accomplishments of the previous | 9 | | year and a revised list of activities for
the remainder of the | 10 | | five-fiscal-year plan, with cost estimates for each.
The | 11 | | Governor shall certify that specific activities in the plan for | 12 | | the
previous year have been substantially completed before | 13 | | authorizing relevant
State or local agencies to implement | 14 | | activities listed in the revised plan
that depend substantially | 15 | | upon 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 | 19 | | Public
Health, Human Services, Children and Family
Services , | 20 | | and Healthcare and Family Services Public Aid ; the University | 21 | | of Illinois Division of Specialized
Care for Children; the | 22 | | State Board of Education;
and any other State agency which | 23 | | directly or
indirectly provides or administers early | 24 | | intervention services shall adopt
compatible rules for the | 25 | | provision of services to eligible infants and
toddlers and |
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| 1 | | their families within one year of the effective date of this | 2 | | Act.
| 3 | | These agencies shall enter into and maintain formal | 4 | | interagency
agreements to enable the State and local agencies | 5 | | serving eligible children
and their families to establish | 6 | | working relationships that will increase
the efficiency and | 7 | | effectiveness of their early intervention services. The
| 8 | | agreement shall outline the administrative, program and | 9 | | financial
responsibilities of the relevant State agencies and | 10 | | shall implement a
coordinated service delivery system through | 11 | | local interagency agreements.
| 12 | | There shall be created in the Office of the Governor an | 13 | | Early Childhood
Intervention Ombudsman to assist families and | 14 | | local parties in ensuring
that all State agencies serving | 15 | | eligible families do so in a comprehensive
and collaborative | 16 | | manner.
| 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 | 20 | | assistance
from parents and providers, shall develop and | 21 | | promulgate policies and
procedures relating to the | 22 | | establishment and implementation of program and
personnel | 23 | | standards to ensure that services provided are consistent with
| 24 | | any State-approved or recognized certification, licensing, | 25 | | registration, or
other comparable requirements which apply to |
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| 1 | | the area of early intervention
program service standards. Only | 2 | | State-approved public or private early
intervention service | 3 | | providers shall be eligible to receive State and
federal | 4 | | funding for early intervention services. All early childhood
| 5 | | intervention staff shall hold the highest entry requirement | 6 | | necessary for that
position.
| 7 | | To be a State-approved early intervention service | 8 | | provider, an individual
(i) shall
not have served or completed, | 9 | | within the preceding 5 years, a sentence for
conviction of any | 10 | | felony that the Department establishes by rule and (ii) shall
| 11 | | not have been indicated as a perpetrator of child abuse or | 12 | | neglect, within the
preceding 5 years, in an investigation by | 13 | | Illinois (pursuant to the Abused and
Neglected Child Reporting | 14 | | Act) or another state. The Department is authorized
to receive | 15 | | criminal background checks for such providers and persons | 16 | | applying
to be such a provider and to receive child abuse and | 17 | | neglect reports regarding
indicated perpetrators who are | 18 | | applying to provide or currently authorized to
provide early | 19 | | intervention services in Illinois. Beginning January 1, 2004,
| 20 | | every provider of State-approved early intervention services | 21 | | and every
applicant to provide
such services must authorize, in | 22 | | writing and in the form required by the
Department, a State and | 23 | | FBI a criminal background check , as requested by the | 24 | | Department, and check of child abuse and neglect
reports | 25 | | regarding the provider or applicant as a condition of | 26 | | authorization to
provide early intervention services. The |
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| 1 | | Department shall use the results of
the checks only to | 2 | | determine State approval of the early intervention service
| 3 | | provider and shall not re-release the information except as | 4 | | necessary 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 | 9 | | toddler'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 | 15 | | evaluated once a year
and the family shall be provided a review | 16 | | of the Plan at 6 month intervals or
more often where | 17 | | appropriate based on infant or toddler and family needs.
The | 18 | | lead agency shall create a quality review process regarding | 19 | | Individualized
Family Service Plan development and changes | 20 | | thereto, to monitor
and help assure that resources are being | 21 | | used to provide appropriate early
intervention services.
| 22 | | (c) The initial evaluation and initial assessment and | 23 | | initial
Plan meeting must be held within 45 days after the | 24 | | initial
contact with the early intervention services system. | 25 | | The 45-day timeline does not apply for any period when the | 26 | | child or parent is unavailable to complete the initial |
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| 1 | | evaluation, the initial assessments of the child and family, or | 2 | | the initial Plan meeting, due to exceptional family | 3 | | circumstances that are documented in the child's early | 4 | | intervention records, or when the parent has not provided | 5 | | consent for the initial evaluation or the initial assessment of | 6 | | the child despite documented, repeated attempts to obtain | 7 | | parental consent. As soon as exceptional family circumstances | 8 | | no longer exist or parental consent has been obtained, the | 9 | | initial evaluation, the initial assessment, and the initial | 10 | | Plan meeting must be completed as soon as possible. With | 11 | | parental consent,
early intervention services may commence | 12 | | before the completion of the
comprehensive assessment and | 13 | | development of the Plan.
| 14 | | (d) Parents must be informed that , at their discretion, | 15 | | early
intervention
services shall be provided to each eligible | 16 | | infant and toddler , to the maximum extent appropriate, in the | 17 | | natural
environment, which may include the home or other | 18 | | community settings. Parents
shall make
the final decision to | 19 | | accept or decline
early intervention services. A decision to | 20 | | decline such services shall
not be a basis for administrative | 21 | | determination of parental fitness, or
other findings or | 22 | | sanctions against the parents. Parameters of the Plan
shall be | 23 | | set forth in rules.
| 24 | | (e) The regional intake offices shall explain to each | 25 | | family, 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 | 5 | | whether the family
has private insurance coverage and, if the | 6 | | family has such coverage and parental consent has been | 7 | | obtained , must
have attached to it a copy of the family's | 8 | | insurance identification card or
otherwise
include all of the | 9 | | following 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 | 18 | | be provided to
each enrolled provider who is providing early | 19 | | intervention services to the
child
who is the subject of that | 20 | | plan.
| 21 | | (h) Children receiving services under this Act shall | 22 | | receive a smooth and effective transition by their third | 23 | | birthday consistent with federal regulations adopted pursuant | 24 | | to Sections 1431 through 1444 of Title 20 of the United States | 25 | | Code. | 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 | 3 | | procedural safeguards that meet federal
requirements and | 4 | | ensure effective implementation of the safeguards
for families
| 5 | | by each
public agency involved in the provision of early | 6 | | intervention
services under this Act.
| 7 | | The procedural safeguards shall provide, at a minimum, the | 8 | | following:
| 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 | 4 | | agency may receive and expend funds appropriated
by the General | 5 | | Assembly to implement the early intervention services system
as | 6 | | required by this Act.
| 7 | | (b) The lead agency and each participating State agency | 8 | | shall identify
and report on an annual basis to the Council the | 9 | | State agency funds utilized
for the provision of early | 10 | | intervention services to eligible infants and
toddlers.
| 11 | | (c) Funds provided under Section 633 of the Individuals | 12 | | with
Disabilities Education Act (20 United States Code 1433) | 13 | | and State funds
designated or appropriated for early | 14 | | intervention services or programs
may not be used to satisfy a
| 15 | | financial commitment for services which would have been paid | 16 | | for from
another public or private source but for the enactment | 17 | | of this Act, except
whenever considered necessary to prevent | 18 | | delay in receiving appropriate early
intervention services by | 19 | | the eligible infant or toddler or family in a
timely manner. | 20 | | "Public or private source" includes public and private
| 21 | | insurance coverage.
| 22 | | Funds provided under Section 633 of the Individuals with
| 23 | | Disabilities Education Act
and State funds designated or | 24 | | appropriated for early intervention services or
programs
may be | 25 | | used by the lead agency to pay the
provider of services (A) |
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| 1 | | pending reimbursement from the appropriate State
agency
or (B) | 2 | | if (i) the claim for payment is denied in whole or in part by a | 3 | | public
or private source, or would be denied under the written | 4 | | terms of the public
program or plan or private plan, or (ii) | 5 | | use of private insurance for the
service has been exempted | 6 | | under Section 13.25 , or (iii) parental consent has not been | 7 | | obtained for the use of private insurance . Payment under item | 8 | | (B)(i) may
be made based on a pre-determination telephone | 9 | | inquiry supported by written
documentation of the denial | 10 | | supplied thereafter by the insurance carrier.
| 11 | | (d) Nothing in this Act shall be construed to permit the | 12 | | State to reduce
medical or other assistance available or to | 13 | | alter eligibility under Title V
and Title XIX of the Social | 14 | | Security Act relating to the Maternal Child
Health Program and | 15 | | Medicaid for eligible infants and toddlers in this State.
| 16 | | (e) The lead agency shall create a central billing office | 17 | | to receive and
dispense all relevant State and federal | 18 | | resources, as well as local
government or independent resources | 19 | | available, for early intervention
services. This office shall | 20 | | assure that maximum federal resources are
utilized and that | 21 | | providers receive funds with minimal duplications or
| 22 | | interagency reporting and with consolidated audit procedures.
| 23 | | (f) The lead agency shall, by rule, create a system of
| 24 | | payments by families, including
a schedule of fees. No fees, | 25 | | however, may be charged for: implementing
child find,
| 26 | | evaluation and assessment, service coordination, |
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| 1 | | administrative and
coordination activities related to the | 2 | | development, review, and evaluation of
Individualized Family | 3 | | Service Plans, or the implementation of procedural
safeguards | 4 | | and other administrative components of the statewide early
| 5 | | intervention system.
| 6 | | The system of payments, called family fees, shall be
| 7 | | structured on a sliding
scale based on the family's ability to | 8 | | pay family income . The family's coverage
or lack
of coverage | 9 | | under a public or private insurance plan or
policy
shall not be | 10 | | a factor in determining the amount of the
family fees.
| 11 | | Each family's fee obligation shall be
established | 12 | | annually, and shall be paid by
families to
the central billing | 13 | | office in
installments. At the written request of the family, | 14 | | the fee obligation shall be
adjusted prospectively at any point | 15 | | during the year upon proof of a change in
family income or | 16 | | family size. The inability of the parents
of an eligible child | 17 | | to pay family fees due to catastrophic
circumstances or | 18 | | extraordinary expenses shall not result in
the denial of | 19 | | services to the child or the child's family.
A family must | 20 | | document its extraordinary expenses or other catastrophic
| 21 | | circumstances
by showing one of the following: (i) | 22 | | out-of-pocket medical expenses in excess
of 15% of gross | 23 | | income; (ii) a fire, flood, or other disaster causing a direct
| 24 | | out-of-pocket loss in excess of 15% of gross income; or (iii) | 25 | | other
catastrophic
circumstances causing out-of-pocket losses | 26 | | in excess of 15% of gross income.
The family must present proof |
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| 1 | | of loss to its service coordinator, who shall
document it, and | 2 | | the lead agency shall determine
whether the fees shall be | 3 | | reduced, forgiven, or suspended within 10 business
days after
| 4 | | the family's request.
| 5 | | (g) To ensure that early intervention funds are used as the | 6 | | payor of last
resort for early intervention services, the lead | 7 | | agency shall determine at the
point of early intervention | 8 | | intake, and again at any periodic review of
eligibility | 9 | | thereafter or upon a change in family circumstances, whether | 10 | | the
family is eligible for or enrolled in any program for which | 11 | | payment is made
directly or through public or private insurance | 12 | | for any or all of the early
intervention services made | 13 | | available under this Act. The lead agency shall
establish | 14 | | procedures to ensure that payments are made either directly | 15 | | from
these public and private sources , when parental consent | 16 | | has been obtained, instead of from State or federal early
| 17 | | intervention funds, or as reimbursement for payments | 18 | | previously made from State
or federal early intervention funds.
| 19 | | (Source: P.A. 91-538, eff. 8-13-99; 92-10, eff. 6-11-01; | 20 | | 92-307, 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 | 24 | | early
intervention services is made, and at any
eligibility | 25 | | redetermination
thereafter, the family shall be asked if it
is |
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| 1 | | currently enrolled in
any federally funded, Department of | 2 | | Healthcare and Family Services administered, medical programs | 3 | | Medicaid, KidCare , or the Title V program
administered by the | 4 | | University of Illinois
Division of
Specialized Care for | 5 | | Children. If the
family is enrolled in any of these
programs, | 6 | | that information shall be put on
the individualized family | 7 | | service
plan and entered into the computerized case
management | 8 | | system, and shall
require that the individualized family
| 9 | | services plan of a child who has been
found eligible for | 10 | | services through the
Division of Specialized Care for
Children | 11 | | state that the child is enrolled
in that program. For those
| 12 | | programs in which the family is not
enrolled, a preliminary | 13 | | eligibility
screen shall be
conducted simultaneously
for (i) | 14 | | medical assistance
(Medicaid) under
Article V of the Illinois | 15 | | Public Aid Code, (ii)
children's
health insurance program ( any | 16 | | federally funded, Department of Healthcare and Family Services | 17 | | administered, medical programs KidCare ) benefits
under the
| 18 | | Children's Health Insurance Program Act, and (iii)
Title V
| 19 | | maternal and child health services provided
through the
| 20 | | Division of Specialized Care for Children of the
University
of | 21 | | Illinois.
| 22 | | (b) For purposes of determining family fees
under
| 23 | | subsection (f) of Section 13 and determining
eligibility for
| 24 | | the other programs and services specified in
items (i)
through | 25 | | (iii) of subsection (a), the lead agency
shall
develop and use, | 26 | | within 60 days after the effective
date of
this amendatory Act |
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| 1 | | of the 92nd General Assembly,
with the
cooperation of the | 2 | | Department of Public Aid (now Healthcare and Family Services)
| 3 | | and the
Division
of Specialized Care for Children of the
| 4 | | University of
Illinois, a screening device that provides
| 5 | | sufficient
information for the early intervention regional
| 6 | | intake
entities or other agencies to establish eligibility for
| 7 | | those
other programs
and shall, in cooperation with the | 8 | | Illinois
Department of Public Aid (now Healthcare and Family | 9 | | Services) and the Division
of Specialized Care for Children, | 10 | | train the
regional intake entities
on using the screening | 11 | | device.
| 12 | | (c) When a child is
determined eligible for and enrolled
in | 13 | | the early intervention
program and has been found to at least | 14 | | meet
the threshold income
eligibility requirements for any | 15 | | federally funded, Department of Healthcare and Family Services | 16 | | administered, medical programs Medicaid or
KidCare , the | 17 | | regional intake entity
shall complete an application for any | 18 | | federally funded, Department of Healthcare and Family Services | 19 | | administered, medical programs a KidCare/Medicaid
application | 20 | | with the family and forward it
to the
Department of Healthcare | 21 | | and Family Services ' KidCare
Unit for a determination of
| 22 | | eligibility. A parent shall not be required to enroll in any | 23 | | federally funded, Department of Healthcare and Family Services | 24 | | administered, medical programs as a condition of receiving | 25 | | services provided pursuant to Part C of the Individuals with | 26 | | Disabilities Education Act.
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| 1 | | (d) With the cooperation of the Department of Healthcare | 2 | | and Family Services, the lead agency shall establish procedures | 3 | | that
ensure
the timely and maximum allowable recovery of | 4 | | payments
for all
early intervention services and allowable
| 5 | | administrative
costs under Article V of the Illinois Public Aid
| 6 | | Code and the
Children's Health Insurance Program Act and shall | 7 | | include
those procedures in the interagency agreement required | 8 | | under subsection (e) of
Section 5 of this Act.
| 9 | | (e) For purposes of making referrals for final
| 10 | | determinations of eligibility for any federally funded, | 11 | | Department of Healthcare and Family Services administered, | 12 | | medical programs KidCare benefits
under the Children's Health | 13 | | Insurance Program Act and for medical assistance
under Article | 14 | | V of the Illinois Public Aid Code,
the lead agency shall | 15 | | require each early intervention regional intake entity to
| 16 | | enroll as an application agent a "KidCare agent" in order for | 17 | | the entity to complete the any federally funded, Department of | 18 | | Healthcare and Family Services administered, medical programs | 19 | | KidCare
application as authorized under Section 22 of the | 20 | | Children's Health Insurance
Program Act.
| 21 | | (f) For purposes of early intervention services that may be | 22 | | provided
by the Division of Specialized Care for Children of | 23 | | the University of Illinois
(DSCC), the lead agency shall | 24 | | establish procedures whereby the early
intervention regional
| 25 | | intake entities may determine whether children enrolled in the | 26 | | early
intervention program may also be eligible for those |
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| 1 | | services, and shall
develop, within 60 days after the effective | 2 | | date of this amendatory Act of the
92nd General Assembly, (i) | 3 | | the inter-agency agreement required under subsection
(e) of | 4 | | Section 5 of this Act, establishing that early intervention | 5 | | funds are to
be used as the payor of last resort when services | 6 | | required under an
individualized family services plan may be | 7 | | provided to an eligible child
through the DSCC, and (ii) | 8 | | training
guidelines for the regional intake entities
and | 9 | | providers that explain eligibility and billing procedures for
| 10 | | services through DSCC.
| 11 | | (g) The lead agency shall require that an
individual | 12 | | applying for or renewing
enrollment as a provider of services | 13 | | in the
early intervention program state whether or
not he or | 14 | | she is also enrolled as a DSCC
provider. This information shall | 15 | | be noted
next to the name of the provider on the
computerized | 16 | | roster of Illinois early
intervention providers, and regional | 17 | | intake
entities shall make every effort to refer
families | 18 | | eligible 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 | 22 | | agency
shall determine, at the point of new applications
for | 23 | | early
intervention services, and for all children enrolled
in | 24 | | the early
intervention program, at the regional intake offices,
| 25 | | whether
the child is insured under a private health insurance
|
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| 1 | | plan or
policy. Parental consent must be obtained when the lead | 2 | | agency or enrolled provider who is providing a family with | 3 | | early intervention services seeks to use the child or parent's | 4 | | private insurance or benefits to pay for the initial provision | 5 | | of early intervention services in the Individualized Family | 6 | | Services Plan and anytime that an increase in frequency, | 7 | | length, duration, or intensity is made to existing services in | 8 | | the child's Individualized Family Services Plan. An | 9 | | application for early intervention
services shall
serve as a | 10 | | right to assignment of the right of
recovery against a
private | 11 | | health insurance plan or policy for any covered
early | 12 | | intervention services that may be billed to the family's | 13 | | insurance
carrier and that are provided to a child
covered | 14 | | under 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 | 19 | | use on the basis of material risk of
loss of
coverage, as | 20 | | determined under Section 13.25, each
enrolled
provider who is | 21 | | providing a family with early
intervention
services shall bill | 22 | | the child's insurance carrier for
each
unit
of early | 23 | | intervention service for
which coverage may be
available and | 24 | | parental consent has been obtained . The lead agency may exempt | 25 | | from the
requirement of this paragraph any early intervention |
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| 1 | | service
that it has deemed not to be covered by insurance | 2 | | plans.
When the service is not exempted, providers who
receive | 3 | | a denial of payment on the basis that the service is
not | 4 | | covered under any circumstance under the plan are not
required | 5 | | to bill that carrier for that service again until the following
| 6 | | insurance benefit year. That
explanation of benefits denying | 7 | | the claim, once submitted to
the central billing office, shall | 8 | | be sufficient to meet the
requirements of this paragraph as to | 9 | | subsequent services billed under the same
billing code provided | 10 | | to that child during that insurance benefit year. Any
time | 11 | | limit on a
provider's filing of a claim for payment with the | 12 | | central
billing office that is
imposed through a
policy, | 13 | | procedure, or rule of the lead agency shall be
suspended
until | 14 | | the provider receives an explanation of
benefits or
other final | 15 | | determination of the claim it files
with the
child's insurance | 16 | | carrier.
| 17 | | (b) In all instances when an insurance carrier has
been | 18 | | billed for early intervention services, whether paid in
full, | 19 | | paid in part, or denied by the carrier, the provider must
| 20 | | provide the central billing office, within 90 days after | 21 | | receipt, with a copy
of the explanation
of benefits form and | 22 | | other information in the manner prescribed by the lead
agency.
| 23 | | (c) When the insurance carrier has denied the
claim or paid | 24 | | an amount for the early intervention service
billed that is | 25 | | less than the current State rate for early
intervention | 26 | | services, the provider shall submit the
explanation of benefits |
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| 1 | | with a claim for payment, and the lead
agency shall pay the | 2 | | provider the difference between the sum
actually paid by the | 3 | | insurance carrier for each unit of service
provided under the | 4 | | individualized family service plan and
the current State rate | 5 | | for early intervention services.
The State shall also pay the | 6 | | family's co-payment or co-insurance under its
plan, but only to | 7 | | the extent that those
payments plus the balance of the claim do | 8 | | not exceed the
current State rate for early intervention | 9 | | services. The
provider may under no circumstances bill the | 10 | | family for the
difference between its charge for services and | 11 | | that which
has been paid by the insurance carrier or by the | 12 | | State.
| 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 | 16 | | agency shall provide training to early intervention providers | 17 | | and may
enter into contracts to meet this requirement. If such | 18 | | contracts are let, they
shall be bid under a public request for
| 19 | | proposals that shall be posted on the lead agency's early | 20 | | intervention website
for
no less than 30 days. This training | 21 | | shall include, at
minimum, the following types of instruction:
| 22 | | (a) Courses
in birth-to-3 evaluation and treatment of | 23 | | children with
developmental disabilities and delays
(1) that | 24 | | are taught by fully credentialed early intervention providers | 25 | | or
educators with
substantial experience in evaluation and |
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| 1 | | treatment of
children from birth to age 3 with developmental
| 2 | | disabilities and delays, (2) that cover these topics within | 3 | | each of
the disciplines of audiology, occupational therapy,
| 4 | | physical therapy, speech and language pathology, and
| 5 | | developmental therapy, including the social-emotional domain | 6 | | of development,
(3) that are held no less than
twice per year, | 7 | | (4) that offer no fewer than 20 contact
hours per year of | 8 | | course work, (5) that are held in no
fewer than 5 separate | 9 | | locales throughout the State, and
(6) that give enrollment
| 10 | | priority to early intervention providers who do not meet
the
| 11 | | experience, education, or continuing education requirements
| 12 | | necessary to be fully credentialed early intervention | 13 | | providers; and
| 14 | | (b) Courses held no less than twice per year for
no fewer | 15 | | than 4 hours each in no fewer than 5 separate
locales | 16 | | throughout 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 | 11 | | amended is amended by repealing Section 13.50.
| 12 | | Section 99. Effective date. This Act takes effect upon | 13 | | becoming law.
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| 1 | |
INDEX
| 2 | |
Statutes amended in order of appearance
| | 3 | | 325 ILCS 20/3 | from Ch. 23, par. 4153 | | 4 | | 325 ILCS 20/4 | from Ch. 23, par. 4154 | | 5 | | 325 ILCS 20/5 | from Ch. 23, par. 4155 | | 6 | | 325 ILCS 20/7 | from Ch. 23, par. 4157 | | 7 | | 325 ILCS 20/9 | from Ch. 23, par. 4159 | | 8 | | 325 ILCS 20/10 | from Ch. 23, par. 4160 | | 9 | | 325 ILCS 20/11 | from Ch. 23, par. 4161 | | 10 | | 325 ILCS 20/12 | from Ch. 23, par. 4162 | | 11 | | 325 ILCS 20/13 | from 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. | |
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