Bill Text: IL SB0626 | 2013-2014 | 98th General Assembly | Chaptered


Bill Title: Amends the Cable and Video Competition Law of 2007 in the Public Utilities Act. Makes a technical change in a Section concerning the short title of the Article.

Spectrum: Moderate Partisan Bill (Democrat 9-1)

Status: (Passed) 2013-06-28 - Public Act . . . . . . . . . 98-0041 [SB0626 Detail]

Download: Illinois-2013-SB0626-Chaptered.html



Public Act 098-0041
SB0626 EnrolledLRB098 04441 JWD 34469 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Insurance Code is amended by adding
Section 367m as follows:
(215 ILCS 5/367m new)
Sec. 367m. Early intervention services. A policy of
accident and health insurance that provides coverage for early
intervention services must conform to the following criteria:
(1) The use of private health insurance to pay for
early intervention services under Part C of the federal
Individuals with Disabilities Education Act may not count
towards or result in a loss of benefits due to annual or
lifetime insurance caps for an infant or toddler with a
disability, the infant's or toddler's parent, or the
infant's or toddler's family members who are covered under
that health insurance policy.
(2) The use of private health insurance to pay for
early intervention services under Part C of the federal
Individuals with Disabilities Education Act may not
negatively affect the availability of health insurance to
an infant or toddler with a disability, the infant's or
toddler's parent, or the infant's or toddler's family
members who are covered under that health insurance policy,
and health insurance coverage may not be discontinued for
these individuals due to the use of the health insurance to
pay for services under Part C of the federal Individuals
with Disabilities Education Act.
(3) The use of private health insurance to pay for
early intervention services under Part C of the federal
Individuals with Disabilities Education Act may not be the
basis for increasing the health insurance premiums of an
infant or toddler with a disability, the infant's or
toddler's parent, or the infant's or toddler's family
members covered under that health insurance policy.
For the purposes of this Section, "early intervention
services" has the same meaning as in the Early Intervention
Services System Act.
Section 10. The Early Intervention Services System Act is
amended by changing Sections 3, 4, 5, 7, 9, 10, 11, 12, 13,
13.5, 13.10, and 13.30 as follows:
(325 ILCS 20/3) (from Ch. 23, par. 4153)
Sec. 3. Definitions. As used in this Act:
(a) "Eligible infants and toddlers" means infants and
toddlers under 36 months of age with any of the following
conditions:
(1) Developmental delays.
(2) A physical or mental condition which typically
results in developmental delay.
(3) Being at risk of having substantial developmental
delays based on informed clinical opinion judgment.
(4) Either (A) having entered the program under any of
the circumstances listed in paragraphs (1) through (3) of
this subsection but no longer meeting the current
eligibility criteria under those paragraphs, and
continuing to have any measurable delay, or (B) not having
attained a level of development in each area, including (i)
cognitive, (ii) physical (including vision and hearing),
(iii) language, speech, and communication, (iv) social or
emotional psycho-social, or (v) adaptive self-help skills,
that is at least at the mean of the child's age equivalent
peers; and, in addition to either item (A) or item (B), (C)
having been determined by the multidisciplinary
individualized family service plan team to require the
continuation of early intervention services in order to
support continuing developmental progress, pursuant to the
child's needs and provided in an appropriate developmental
manner. The type, frequency, and intensity of services
shall differ from the initial individualized family
services plan because of the child's developmental
progress, and may consist of only service coordination,
evaluation, and assessments.
(b) "Developmental delay" means a delay in one or more of
the following areas of childhood development as measured by
appropriate diagnostic instruments and standard procedures:
cognitive; physical, including vision and hearing; language,
speech and communication; social or emotional psycho-social;
or adaptive self-help skills. The term means a delay of 30% or
more below the mean in function in one or more of those areas.
(c) "Physical or mental condition which typically results
in developmental delay" means:
(1) a diagnosed medical disorder bearing a relatively
well known expectancy for developmental outcomes within
varying ranges of developmental disabilities; or
(2) a history of prenatal, perinatal, neonatal or early
developmental events suggestive of biological insults to
the developing central nervous system and which either
singly or collectively increase the probability of
developing a disability or delay based on a medical
history.
(d) "Informed clinical opinion judgment" means both
clinical observations and parental participation to determine
eligibility by a consensus of a multidisciplinary team of 2 or
more members based on their professional experience and
expertise.
(e) "Early intervention services" means services which:
(1) are designed to meet the developmental needs of
each child eligible under this Act and the needs of his or
her family;
(2) are selected in collaboration with the child's
family;
(3) are provided under public supervision;
(4) are provided at no cost except where a schedule of
sliding scale fees or other system of payments by families
has been adopted in accordance with State and federal law;
(5) are designed to meet an infant's or toddler's
developmental needs in any of the following areas:
(A) physical development, including vision and
hearing,
(B) cognitive development,
(C) communication development,
(D) social or emotional development, or
(E) adaptive development;
(6) meet the standards of the State, including the
requirements of this Act;
(7) include one or more of the following:
(A) family training,
(B) social work services, including counseling,
and home visits,
(C) special instruction,
(D) speech, language pathology and audiology,
(E) occupational therapy,
(F) physical therapy,
(G) psychological services,
(H) service coordination services,
(I) medical services only for diagnostic or
evaluation purposes,
(J) early identification, screening, and
assessment services,
(K) health services specified by the lead agency as
necessary to enable the infant or toddler to benefit
from the other early intervention services,
(L) vision services,
(M) transportation, and
(N) assistive technology devices and services, ;
(O) nursing services,
(P) nutrition services, and
(Q) sign language and cued language services;
(8) are provided by qualified personnel, including but
not limited to:
(A) child development specialists or special
educators, including teachers of children with hearing
impairments (including deafness) and teachers of
children with vision impairments (including
blindness),
(B) speech and language pathologists and
audiologists,
(C) occupational therapists,
(D) physical therapists,
(E) social workers,
(F) nurses,
(G) dietitian nutritionists,
(H) vision specialists, including ophthalmologists
and optometrists,
(I) psychologists, and
(J) physicians;
(9) are provided in conformity with an Individualized
Family Service Plan;
(10) are provided throughout the year; and
(11) are provided in natural environments, to the
maximum extent appropriate, which may include the home and
community settings, unless justification is provided
consistent with federal regulations adopted under Sections
1431 through 1444 of Title 20 of the United States Code.
(f) "Individualized Family Service Plan" or "Plan" means a
written plan for providing early intervention services to a
child eligible under this Act and the child's family, as set
forth in Section 11.
(g) "Local interagency agreement" means an agreement
entered into by local community and State and regional agencies
receiving early intervention funds directly from the State and
made in accordance with State interagency agreements providing
for the delivery of early intervention services within a local
community area.
(h) "Council" means the Illinois Interagency Council on
Early Intervention established under Section 4.
(i) "Lead agency" means the State agency responsible for
administering this Act and receiving and disbursing public
funds received in accordance with State and federal law and
rules.
(i-5) "Central billing office" means the central billing
office created by the lead agency under Section 13.
(j) "Child find" means a service which identifies eligible
infants and toddlers.
(k) "Regional intake entity" means the lead agency's
designated entity responsible for implementation of the Early
Intervention Services System within its designated geographic
area.
(l) "Early intervention provider" means an individual who
is qualified, as defined by the lead agency, to provide one or
more types of early intervention services, and who has enrolled
as a provider in the early intervention program.
(m) "Fully credentialed early intervention provider" means
an individual who has met the standards in the State applicable
to the relevant profession, and has met such other
qualifications as the lead agency has determined are suitable
for personnel providing early intervention services, including
pediatric experience, education, and continuing education. The
lead agency shall establish these qualifications by rule filed
no later than 180 days after the effective date of this
amendatory Act of the 92nd General Assembly.
(Source: P.A. 97-902, eff. 8-6-12.)
(325 ILCS 20/4) (from Ch. 23, par. 4154)
Sec. 4. Illinois Interagency Council on Early
Intervention.
(a) There is established the Illinois Interagency Council
on Early Intervention. The Council shall be composed of at
least 20 but not more than 30 members. The members of the
Council and the designated chairperson of the Council shall be
appointed by the Governor. The Council member representing the
lead agency may not serve as chairperson of the Council. The
Council shall be composed of the following members:
(1) The Secretary of Human Services (or his or her
designee) and 2 additional representatives of the
Department of Human Services designated by the Secretary,
plus the Directors (or their designees) of the following
State agencies involved in the provision of or payment for
early intervention services to eligible infants and
toddlers and their families:
(A) Department of Insurance; and
(B) Department of Healthcare and Family Services.
(2) Other members as follows:
(A) At least 20% of the members of the Council
shall be parents, including minority parents, of
infants or toddlers with disabilities or children with
disabilities aged 12 or younger, with knowledge of, or
experience with, programs for infants and toddlers
with disabilities. At least one such member shall be a
parent of an infant or toddler with a disability or a
child with a disability aged 6 or younger;
(B) At least 20% of the members of the Council
shall be public or private providers of early
intervention services;
(C) One member shall be a representative of the
General Assembly;
(D) One member shall be involved in the preparation
of professional personnel to serve infants and
toddlers similar to those eligible for services under
this Act;
(E) Two members shall be from advocacy
organizations with expertise in improving health,
development, and educational outcomes for infants and
toddlers with disabilities;
(F) One member shall be a Child and Family
Connections manager from a rural district;
(G) One member shall be a Child and Family
Connections manager from an urban district;
(H) One member shall be the co-chair of the
Illinois Early Learning Council (or his or her
designee); and
(I) Members representing the following agencies or
entities: the State Board of Education; the Department
of Public Health; the Department of Children and Family
Services; the University of Illinois Division of
Specialized Care for Children; the Illinois Council on
Developmental Disabilities; Head Start or Early Head
Start; and the Department of Human Services' Division
of Mental Health. A member may represent one or more of
the listed agencies or entities.
The Council shall meet at least quarterly and in such
places as it deems necessary. Terms of the initial members
appointed under paragraph (2) shall be determined by lot at the
first Council meeting as follows: of the persons appointed
under subparagraphs (A) and (B), one-third shall serve one year
terms, one-third shall serve 2 year terms, and one-third shall
serve 3 year terms; and of the persons appointed under
subparagraphs (C) and (D), one shall serve a 2 year term and
one shall serve a 3 year term. Thereafter, successors appointed
under paragraph (2) shall serve 3 year terms. Once appointed,
members shall continue to serve until their successors are
appointed. No member shall be appointed to serve more than 2
consecutive terms.
Council members shall serve without compensation but shall
be reimbursed for reasonable costs incurred in the performance
of their duties, including costs related to child care, and
parents may be paid a stipend in accordance with applicable
requirements.
The Council shall prepare and approve a budget using funds
appropriated for the purpose to hire staff, and obtain the
services of such professional, technical, and clerical
personnel as may be necessary to carry out its functions under
this Act. This funding support and staff shall be directed by
the lead agency.
(b) The Council shall:
(1) advise and assist the lead agency in the
performance of its responsibilities including but not
limited to the identification of sources of fiscal and
other support services for early intervention programs,
and the promotion of interagency agreements which assign
financial responsibility to the appropriate agencies;
(2) advise and assist the lead agency in the
preparation of applications and amendments to
applications;
(3) review and advise on relevant regulations and
standards proposed by the related State agencies;
(4) advise and assist the lead agency in the
development, implementation and evaluation of the
comprehensive early intervention services system; and
(4.5) coordinate and collaborate with State
interagency early learning initiatives, as appropriate;
and
(5) prepare and submit an annual report to the Governor
and to the General Assembly on the status of early
intervention programs for eligible infants and toddlers
and their families in Illinois. The annual report shall
include (i) the estimated number of eligible infants and
toddlers in this State, (ii) the number of eligible infants
and toddlers who have received services under this Act and
the cost of providing those services, and (iii) the
estimated cost of providing services under this Act to all
eligible infants and toddlers in this State. , and (iv)
data and other information as is requested to be included
by the Legislative Advisory Committee established under
Section 13.50 of this Act. The report shall be posted by
the lead agency on the early intervention website as
required under paragraph (f) of Section 5 of this Act.
No member of the Council shall cast a vote on or
participate substantially in any matter which would provide a
direct financial benefit to that member or otherwise give the
appearance of a conflict of interest under State law. All
provisions and reporting requirements of the Illinois
Governmental Ethics Act shall apply to Council members.
(Source: P.A. 97-902, eff. 8-6-12.)
(325 ILCS 20/5) (from Ch. 23, par. 4155)
Sec. 5. Lead Agency. The Department of Human Services is
designated the lead agency and shall provide leadership in
establishing and implementing the coordinated, comprehensive,
interagency and interdisciplinary system of early intervention
services. The lead agency shall not have the sole
responsibility for providing these services. Each
participating State agency shall continue to coordinate those
early intervention services relating to health, social service
and education provided under this authority.
The lead agency is responsible for carrying out the
following:
(a) The general administration, supervision, and
monitoring of programs and activities receiving assistance
under Section 673 of the Individuals with Disabilities
Education Act (20 United States Code 1473).
(b) The identification and coordination of all
available resources within the State from federal, State,
local and private sources.
(c) The development of procedures to ensure that
services are provided to eligible infants and toddlers and
their families in a timely manner pending the resolution of
any disputes among public agencies or service providers.
(d) The resolution of intra-agency and interagency
regulatory and procedural disputes.
(e) The development and implementation of formal
interagency agreements, and the entry into such
agreements, between the lead agency and (i) the Department
of Healthcare and Family Services, (ii) the University of
Illinois Division of Specialized Care for Children, and
(iii) other relevant State agencies that:
(1) define the financial responsibility of each
agency for paying for early intervention services
(consistent with existing State and federal law and
rules, including the requirement that early
intervention funds be used as the payor of last
resort), a hierarchical order of payment as among the
agencies for early intervention services that are
covered under or may be paid by programs in other
agencies, and procedures for direct billing,
collecting reimbursements for payments made, and
resolving service and payment disputes; and
(2) include all additional components necessary to
ensure meaningful cooperation and coordination.
Interagency agreements under this paragraph (e) must
be reviewed and revised to implement the purposes of this
amendatory Act of the 92nd General Assembly no later than
60 days after the effective date of this amendatory Act of
the 92nd General Assembly.
(f) The maintenance of an early intervention website.
Within 30 days after the effective date of this amendatory
Act of the 92nd General Assembly, the lead agency shall
post and keep posted on this website the following: (i) the
current annual report required under subdivision (b)(5) of
Section 4 of this Act, and the annual reports of the prior
3 years, (ii) the most recent Illinois application for
funds prepared under Section 637 of the Individuals with
Disabilities Education Act filed with the United States
Department of Education, (iii) proposed modifications of
the application prepared for public comment, (iv) notice of
Council meetings, Council agendas, and minutes of its
proceedings for at least the previous year, (v) proposed
and final early intervention rules, (vi) requests for
proposals, and (vii) all reports created for dissemination
to the public that are related to the early intervention
program, including reports prepared at the request of the
Council, and the General Assembly, and the Legislative
Advisory Committee established under Section 13.50 of this
Act. Each such document shall be posted on the website
within 3 working days after the document's completion.
(g) Before adopting any new policy or procedure
(including any revisions to an existing policy or
procedure) needed to comply with Part C of the Individuals
with Disabilities Education Act, the lead agency must hold
public hearings on the new policy or procedure, provide
notice of the hearings at least 30 days before the hearings
are conducted to enable public participation, and provide
an opportunity for the general public, including
individuals with disabilities and parents of infants and
toddlers with disabilities, early intervention providers,
and members of the Council to comment for at least 30 days
on the new policy or procedure needed to comply with Part C
of the Individuals with Disabilities Education Act and with
34 CFR Part 300 and Part 303.
(Source: P.A. 95-331, eff. 8-21-07.)
(325 ILCS 20/7) (from Ch. 23, par. 4157)
Sec. 7. Essential Components of the Statewide Service
System. As required by federal laws and regulations, a
statewide system of coordinated, comprehensive, interagency
and interdisciplinary programs shall be established and
maintained. The framework of the statewide system shall be
based on the components set forth in this Section. This
framework shall be used for planning, implementation,
coordination and evaluation of the statewide system of locally
based early intervention services.
The statewide system shall include, at a minimum:
(a) a definition of the term "developmentally
delayed", in accordance with the definition in Section 3,
that will be used in Illinois in carrying out programs
under this Act;
(b) timetables for ensuring that appropriate early
intervention services, based on scientifically based
research, to the extent practicable, will be available to
all eligible infants and toddlers in this State after the
effective date of this Act;
(c) a timely, comprehensive, multidisciplinary and
interdisciplinary evaluation of the functioning of each
potentially eligible infant and toddler with suspected
disabilities in this State, unless the child meets the
definition of eligibility based upon his or her medical and
other records; for a child determined eligible, a
multidisciplinary assessment of the unique strengths and
needs of that infant or toddler and the identification of
services appropriate to meet those needs and a
family-directed assessment of the resources, priorities,
and concerns of the family and the identification of
supports and services necessary to enhance the family's
capacity to meet the developmental needs of that infant or
toddler the concerns, priorities and resource needs of the
families to appropriately assist in the development of the
infant and toddler with disabilities;
(d) for each eligible infant and toddler, an
Individualized Family Service Plan, including service
coordination (case management) services;
(e) a comprehensive child find system, consistent with
Part B of the Individuals with Disabilities Education Act
(20 United States Code 1411 through 1420 and as set forth
in 34 CFR 300.115), which includes timelines and provides
for participation by primary referral sources;
(f) a public awareness program focusing on early
identification of eligible infants and toddlers;
(g) a central directory which includes public and
private early intervention services, resources, and
experts available in this State, professional and other
groups (including parent support groups and training and
information centers) that provide assistance to infants
and toddlers with disabilities who are eligible for early
intervention programs assisted under Part C of the
Individuals with Disabilities Education Act and their
families, and early intervention research and
demonstration projects being conducted in this State
relating to infants and toddlers with disabilities;
(h) a comprehensive system of personnel development;
(i) a policy pertaining to the contracting or making of
other arrangements with public and private service
providers to provide early intervention services in this
State, consistent with the provisions of this Act,
including the contents of the application used and the
conditions of the contract or other arrangements;
(j) a procedure for securing timely reimbursement of
funds;
(k) procedural safeguards with respect to programs
under this Act;
(l) policies and procedures relating to the
establishment and maintenance of standards to ensure that
personnel necessary to carry out this Act are appropriately
and adequately prepared and trained;
(m) a system of evaluation of, and compliance with,
program standards;
(n) a system for compiling data on the numbers of
eligible infants and toddlers and their families in this
State in need of appropriate early intervention services;
the numbers served; the types of services provided; and
other information required by the State or federal
government; and
(o) a single line of responsibility in a lead agency
designated by the Governor to carry out its
responsibilities as required by this Act.
In addition to these required components, linkages may be
established within a local community area among the prenatal
initiatives affording services to high risk pregnant women.
Additional linkages among at risk programs and local literacy
programs may also be established.
Within 60 days of the effective date of this Act, a
five-fiscal-year implementation plan shall be submitted to the
Governor by the lead agency with the concurrence of the
Interagency Council on Early Intervention. The plan shall list
specific activities to be accomplished each year, with cost
estimates for each activity. No later than the second Monday in
July of each year thereafter, the lead agency shall, with the
concurrence of the Interagency Council, submit to the
Governor's Office a report on accomplishments of the previous
year and a revised list of activities for the remainder of the
five-fiscal-year plan, with cost estimates for each. The
Governor shall certify that specific activities in the plan for
the previous year have been substantially completed before
authorizing relevant State or local agencies to implement
activities listed in the revised plan that depend substantially
upon completion of one or more of the earlier activities.
(Source: P.A. 87-680.)
(325 ILCS 20/9) (from Ch. 23, par. 4159)
Sec. 9. Role of Other State Entities. The Departments of
Public Health, Human Services, Children and Family Services,
and Healthcare and Family Services Public Aid; the University
of Illinois Division of Specialized Care for Children; the
State Board of Education; and any other State agency which
directly or indirectly provides or administers early
intervention services shall adopt compatible rules for the
provision of services to eligible infants and toddlers and
their families within one year of the effective date of this
Act.
These agencies shall enter into and maintain formal
interagency agreements to enable the State and local agencies
serving eligible children and their families to establish
working relationships that will increase the efficiency and
effectiveness of their early intervention services. The
agreement shall outline the administrative, program and
financial responsibilities of the relevant State agencies and
shall implement a coordinated service delivery system through
local interagency agreements.
There shall be created in the Office of the Governor an
Early Childhood Intervention Ombudsman to assist families and
local parties in ensuring that all State agencies serving
eligible families do so in a comprehensive and collaborative
manner.
(Source: P.A. 89-507, eff. 7-1-97; 89-626, eff. 8-9-96.)
(325 ILCS 20/10) (from Ch. 23, par. 4160)
Sec. 10. Standards. The Council and the lead agency, with
assistance from parents and providers, shall develop and
promulgate policies and procedures relating to the
establishment and implementation of program and personnel
standards to ensure that services provided are consistent with
any State-approved or recognized certification, licensing,
registration, or other comparable requirements which apply to
the area of early intervention program service standards. Only
State-approved public or private early intervention service
providers shall be eligible to receive State and federal
funding for early intervention services. All early childhood
intervention staff shall hold the highest entry requirement
necessary for that position.
To be a State-approved early intervention service
provider, an individual (i) shall not have served or completed,
within the preceding 5 years, a sentence for conviction of any
felony that the Department establishes by rule and (ii) shall
not have been indicated as a perpetrator of child abuse or
neglect, within the preceding 5 years, in an investigation by
Illinois (pursuant to the Abused and Neglected Child Reporting
Act) or another state. The Department is authorized to receive
criminal background checks for such providers and persons
applying to be such a provider and to receive child abuse and
neglect reports regarding indicated perpetrators who are
applying to provide or currently authorized to provide early
intervention services in Illinois. Beginning January 1, 2004,
every provider of State-approved early intervention services
and every applicant to provide such services must authorize, in
writing and in the form required by the Department, a State and
FBI a criminal background check, as requested by the
Department, and check of child abuse and neglect reports
regarding the provider or applicant as a condition of
authorization to provide early intervention services. The
Department shall use the results of the checks only to
determine State approval of the early intervention service
provider and shall not re-release the information except as
necessary to accomplish that purpose.
(Source: P.A. 93-147, eff. 1-1-04.)
(325 ILCS 20/11) (from Ch. 23, par. 4161)
Sec. 11. Individualized Family Service Plans.
(a) Each eligible infant or toddler and that infant's or
toddler's family shall receive:
(1) timely, comprehensive, multidisciplinary
assessment of the unique strengths and needs of each
eligible infant and toddler, and assessment of the concerns
and priorities of the families to appropriately assist them
in meeting their needs and identify supports and services
to meet those needs; and
(2) a written Individualized Family Service Plan
developed by a multidisciplinary team which includes the
parent or guardian. The individualized family service plan
shall be based on the multidisciplinary team's assessment
of the resources, priorities, and concerns of the family
and its identification of the supports and services
necessary to enhance the family's capacity to meet the
developmental needs of the infant or toddler, and shall
include the identification of services appropriate to meet
those needs, including the frequency, intensity, and
method of delivering services. During and as part of the
initial development of the individualized family services
plan, and any periodic reviews of the plan, the
multidisciplinary team may seek consultation from shall
consult the lead agency's therapy guidelines and its
designated experts, if any, to help determine appropriate
services and the frequency and intensity of those services.
All services in the individualized family services plan
must be justified by the multidisciplinary assessment of
the unique strengths and needs of the infant or toddler and
must be appropriate to meet those needs. At the periodic
reviews, the team shall determine whether modification or
revision of the outcomes or services is necessary.
(b) The Individualized Family Service Plan shall be
evaluated once a year and the family shall be provided a review
of the Plan at 6 month intervals or more often where
appropriate based on infant or toddler and family needs. The
lead agency shall create a quality review process regarding
Individualized Family Service Plan development and changes
thereto, to monitor and help assure that resources are being
used to provide appropriate early intervention services.
(c) The initial evaluation and initial assessment and
initial Plan meeting must be held within 45 days after the
initial contact with the early intervention services system.
The 45-day timeline does not apply for any period when the
child or parent is unavailable to complete the initial
evaluation, the initial assessments of the child and family, or
the initial Plan meeting, due to exceptional family
circumstances that are documented in the child's early
intervention records, or when the parent has not provided
consent for the initial evaluation or the initial assessment of
the child despite documented, repeated attempts to obtain
parental consent. As soon as exceptional family circumstances
no longer exist or parental consent has been obtained, the
initial evaluation, the initial assessment, and the initial
Plan meeting must be completed as soon as possible. With
parental consent, early intervention services may commence
before the completion of the comprehensive assessment and
development of the Plan.
(d) Parents must be informed that, at their discretion,
early intervention services shall be provided to each eligible
infant and toddler, to the maximum extent appropriate, in the
natural environment, which may include the home or other
community settings. Parents shall make the final decision to
accept or decline early intervention services. A decision to
decline such services shall not be a basis for administrative
determination of parental fitness, or other findings or
sanctions against the parents. Parameters of the Plan shall be
set forth in rules.
(e) The regional intake offices shall explain to each
family, orally and in writing, all of the following:
(1) That the early intervention program will pay for
all early intervention services set forth in the
individualized family service plan that are not covered or
paid under the family's public or private insurance plan or
policy and not eligible for payment through any other third
party payor.
(2) That services will not be delayed due to any rules
or restrictions under the family's insurance plan or
policy.
(3) That the family may request, with appropriate
documentation supporting the request, a determination of
an exemption from private insurance use under Section
13.25.
(4) That responsibility for co-payments or
co-insurance under a family's private insurance plan or
policy will be transferred to the lead agency's central
billing office.
(5) That families will be responsible for payments of
family fees, which will be based on a sliding scale
according to the State's definition of ability to pay which
is comparing household size and income to the sliding scale
and considering out-of-pocket medical or disaster
expenses, and that these fees are payable to the central
billing office, and that if the family encounters a
catastrophic circumstance, as defined under subsection (f)
of Section 13 of this Act, making it unable to pay the
fees, the lead agency may, upon proof of inability to pay,
waive the fees. Families who fail to provide income
information shall be charged the maximum amount on the
sliding scale.
(f) The individualized family service plan must state
whether the family has private insurance coverage and, if the
family has such coverage, must have attached to it a copy of
the family's insurance identification card or otherwise
include all of the following information:
(1) The name, address, and telephone number of the
insurance carrier.
(2) The contract number and policy number of the
insurance plan.
(3) The name, address, and social security number of
the primary insured.
(4) The beginning date of the insurance benefit year.
(g) A copy of the individualized family service plan must
be provided to each enrolled provider who is providing early
intervention services to the child who is the subject of that
plan.
(h) Children receiving services under this Act shall
receive a smooth and effective transition by their third
birthday consistent with federal regulations adopted pursuant
to Sections 1431 through 1444 of Title 20 of the United States
Code.
(Source: P.A. 97-902, eff. 8-6-12.)
(325 ILCS 20/12) (from Ch. 23, par. 4162)
Sec. 12. Procedural Safeguards. The lead agency shall adopt
procedural safeguards that meet federal requirements and
ensure effective implementation of the safeguards for families
by each public agency involved in the provision of early
intervention services under this Act.
The procedural safeguards shall provide, at a minimum, the
following:
(a) The timely administrative resolution of State
complaints, due process hearings, and mediations by
parents as defined by administrative rule.
(b) The right to confidentiality of personally
identifiable information.
(c) The opportunity for parents and a guardian to
examine and receive copies of records relating to
evaluations and assessments assessment, screening,
eligibility determinations, and the development and
implementation of the Individualized Family Service Plan
provision of early intervention services, individual
complaints involving the child, or any part of the child's
early intervention record.
(d) Procedures to protect the rights of the eligible
infant or toddler whenever the parents or guardians of the
child are not known or unavailable or the child is a ward
of the State, including the assignment of an individual
(who shall not be an employee of the State agency or local
agency providing services) to act as a surrogate for the
parents or guardian. The regional intake entity must make
reasonable efforts to ensure the assignment of a surrogate
parent not more than 30 days after a public agency
determines that the child needs a surrogate parent.
(e) Timely written prior notice to the parents or
guardian of the eligible infant or toddler whenever the
State agency or public or private service provider proposes
to initiate or change or refuses to initiate or change the
identification, evaluation, placement, or the provision of
appropriate early intervention services to the eligible
infant or toddler.
(f) Written prior notice to fully inform the parents or
guardians, in their native primary language or mode of
communication used by the parent, unless clearly not
feasible to do so, in a comprehensible manner, of these
procedural safeguards.
(g) During the pendency of any proceedings or action
involving a complaint, unless the State agency and the
parents or guardian otherwise agree, the child shall
continue to receive the appropriate early intervention
services currently being provided, or in the case of an
application for initial services, the child shall receive
the services not in dispute.
(Source: P.A. 91-538, eff. 8-13-99.)
(325 ILCS 20/13) (from Ch. 23, par. 4163)
Sec. 13. Funding and Fiscal Responsibility.
(a) The lead agency and every other participating State
agency may receive and expend funds appropriated by the General
Assembly to implement the early intervention services system as
required by this Act.
(b) The lead agency and each participating State agency
shall identify and report on an annual basis to the Council the
State agency funds utilized for the provision of early
intervention services to eligible infants and toddlers.
(c) Funds provided under Section 633 of the Individuals
with Disabilities Education Act (20 United States Code 1433)
and State funds designated or appropriated for early
intervention services or programs may not be used to satisfy a
financial commitment for services which would have been paid
for from another public or private source but for the enactment
of this Act, except whenever considered necessary to prevent
delay in receiving appropriate early intervention services by
the eligible infant or toddler or family in a timely manner.
"Public or private source" includes public and private
insurance coverage.
Funds provided under Section 633 of the Individuals with
Disabilities Education Act and State funds designated or
appropriated for early intervention services or programs may be
used by the lead agency to pay the provider of services (A)
pending reimbursement from the appropriate State agency or (B)
if (i) the claim for payment is denied in whole or in part by a
public or private source, or would be denied under the written
terms of the public program or plan or private plan, or (ii)
use of private insurance for the service has been exempted
under Section 13.25. Payment under item (B)(i) may be made
based on a pre-determination telephone inquiry supported by
written documentation of the denial supplied thereafter by the
insurance carrier.
(d) Nothing in this Act shall be construed to permit the
State to reduce medical or other assistance available or to
alter eligibility under Title V and Title XIX of the Social
Security Act relating to the Maternal Child Health Program and
Medicaid for eligible infants and toddlers in this State.
(e) The lead agency shall create a central billing office
to receive and dispense all relevant State and federal
resources, as well as local government or independent resources
available, for early intervention services. This office shall
assure that maximum federal resources are utilized and that
providers receive funds with minimal duplications or
interagency reporting and with consolidated audit procedures.
(f) The lead agency shall, by rule, create a system of
payments by families, including a schedule of fees. No fees,
however, may be charged for: implementing child find,
evaluation and assessment, service coordination,
administrative and coordination activities related to the
development, review, and evaluation of Individualized Family
Service Plans, or the implementation of procedural safeguards
and other administrative components of the statewide early
intervention system.
The system of payments, called family fees, shall be
structured on a sliding scale based on the family's ability to
pay family income. The family's coverage or lack of coverage
under a public or private insurance plan or policy shall not be
a factor in determining the amount of the family fees.
Each family's fee obligation shall be established
annually, and shall be paid by families to the central billing
office in installments. At the written request of the family,
the fee obligation shall be adjusted prospectively at any point
during the year upon proof of a change in family income or
family size. The inability of the parents of an eligible child
to pay family fees due to catastrophic circumstances or
extraordinary expenses shall not result in the denial of
services to the child or the child's family. A family must
document its extraordinary expenses or other catastrophic
circumstances by showing one of the following: (i)
out-of-pocket medical expenses in excess of 15% of gross
income; (ii) a fire, flood, or other disaster causing a direct
out-of-pocket loss in excess of 15% of gross income; or (iii)
other catastrophic circumstances causing out-of-pocket losses
in excess of 15% of gross income. The family must present proof
of loss to its service coordinator, who shall document it, and
the lead agency shall determine whether the fees shall be
reduced, forgiven, or suspended within 10 business days after
the family's request.
(g) To ensure that early intervention funds are used as the
payor of last resort for early intervention services, the lead
agency shall determine at the point of early intervention
intake, and again at any periodic review of eligibility
thereafter or upon a change in family circumstances, whether
the family is eligible for or enrolled in any program for which
payment is made directly or through public or private insurance
for any or all of the early intervention services made
available under this Act. The lead agency shall establish
procedures to ensure that payments are made either directly
from these public and private sources instead of from State or
federal early intervention funds, or as reimbursement for
payments previously made from State or federal early
intervention funds.
(Source: P.A. 91-538, eff. 8-13-99; 92-10, eff. 6-11-01;
92-307, eff. 8-9-01; 92-651, eff. 7-11-02.)
(325 ILCS 20/13.5)
Sec. 13.5. Other programs.
(a) When an application or a review of eligibility for
early intervention services is made, and at any eligibility
redetermination thereafter, the family shall be asked if it is
currently enrolled in any federally funded, Department of
Healthcare and Family Services administered, medical programs
Medicaid, KidCare, or the Title V program administered by the
University of Illinois Division of Specialized Care for
Children. If the family is enrolled in any of these programs,
that information shall be put on the individualized family
service plan and entered into the computerized case management
system, and shall require that the individualized family
services plan of a child who has been found eligible for
services through the Division of Specialized Care for Children
state that the child is enrolled in that program. For those
programs in which the family is not enrolled, a preliminary
eligibility screen shall be conducted simultaneously for (i)
medical assistance (Medicaid) under Article V of the Illinois
Public Aid Code, (ii) children's health insurance program (any
federally funded, Department of Healthcare and Family Services
administered, medical programs KidCare) benefits under the
Children's Health Insurance Program Act, and (iii) Title V
maternal and child health services provided through the
Division of Specialized Care for Children of the University of
Illinois.
(b) For purposes of determining family fees under
subsection (f) of Section 13 and determining eligibility for
the other programs and services specified in items (i) through
(iii) of subsection (a), the lead agency shall develop and use,
within 60 days after the effective date of this amendatory Act
of the 92nd General Assembly, with the cooperation of the
Department of Public Aid (now Healthcare and Family Services)
and the Division of Specialized Care for Children of the
University of Illinois, a screening device that provides
sufficient information for the early intervention regional
intake entities or other agencies to establish eligibility for
those other programs and shall, in cooperation with the
Illinois Department of Public Aid (now Healthcare and Family
Services) and the Division of Specialized Care for Children,
train the regional intake entities on using the screening
device.
(c) When a child is determined eligible for and enrolled in
the early intervention program and has been found to at least
meet the threshold income eligibility requirements for any
federally funded, Department of Healthcare and Family Services
administered, medical programs Medicaid or KidCare, the
regional intake entity shall complete an application for any
federally funded, Department of Healthcare and Family Services
administered, medical programs a KidCare/Medicaid application
with the family and forward it to the Department of Healthcare
and Family Services' KidCare Unit for a determination of
eligibility. A parent shall not be required to enroll in any
federally funded, Department of Healthcare and Family Services
administered, medical programs as a condition of receiving
services provided pursuant to Part C of the Individuals with
Disabilities Education Act.
(d) With the cooperation of the Department of Healthcare
and Family Services, the lead agency shall establish procedures
that ensure the timely and maximum allowable recovery of
payments for all early intervention services and allowable
administrative costs under Article V of the Illinois Public Aid
Code and the Children's Health Insurance Program Act and shall
include those procedures in the interagency agreement required
under subsection (e) of Section 5 of this Act.
(e) For purposes of making referrals for final
determinations of eligibility for any federally funded,
Department of Healthcare and Family Services administered,
medical programs KidCare benefits under the Children's Health
Insurance Program Act and for medical assistance under Article
V of the Illinois Public Aid Code, the lead agency shall
require each early intervention regional intake entity to
enroll as an application agent a "KidCare agent" in order for
the entity to complete the any federally funded, Department of
Healthcare and Family Services administered, medical programs
KidCare application as authorized under Section 22 of the
Children's Health Insurance Program Act.
(f) For purposes of early intervention services that may be
provided by the Division of Specialized Care for Children of
the University of Illinois (DSCC), the lead agency shall
establish procedures whereby the early intervention regional
intake entities may determine whether children enrolled in the
early intervention program may also be eligible for those
services, and shall develop, within 60 days after the effective
date of this amendatory Act of the 92nd General Assembly, (i)
the inter-agency agreement required under subsection (e) of
Section 5 of this Act, establishing that early intervention
funds are to be used as the payor of last resort when services
required under an individualized family services plan may be
provided to an eligible child through the DSCC, and (ii)
training guidelines for the regional intake entities and
providers that explain eligibility and billing procedures for
services through DSCC.
(g) The lead agency shall require that an individual
applying for or renewing enrollment as a provider of services
in the early intervention program state whether or not he or
she is also enrolled as a DSCC provider. This information shall
be noted next to the name of the provider on the computerized
roster of Illinois early intervention providers, and regional
intake entities shall make every effort to refer families
eligible for DSCC services to these providers.
(Source: P.A. 95-331, eff. 8-21-07.)
(325 ILCS 20/13.10)
Sec. 13.10. Private health insurance; assignment. The lead
agency shall determine, at the point of new applications for
early intervention services, and for all children enrolled in
the early intervention program, at the regional intake offices,
whether the child is insured under a private health insurance
plan or policy. An application for early intervention services
shall serve as a right to assignment of the right of recovery
against a private health insurance plan or policy for any
covered early intervention services that may be billed to the
family's insurance carrier and that are provided to a child
covered under the plan or policy.
(Source: P.A. 92-307, eff. 8-9-01.)
(325 ILCS 20/13.30)
Sec. 13.30. System of personnel development. The lead
agency shall provide training to early intervention providers
and may enter into contracts to meet this requirement. If such
contracts are let, they shall be bid under a public request for
proposals that shall be posted on the lead agency's early
intervention website for no less than 30 days. This training
shall include, at minimum, the following types of instruction:
(a) Courses in birth-to-3 evaluation and treatment of
children with developmental disabilities and delays (1) that
are taught by fully credentialed early intervention providers
or educators with substantial experience in evaluation and
treatment of children from birth to age 3 with developmental
disabilities and delays, (2) that cover these topics within
each of the disciplines of audiology, occupational therapy,
physical therapy, speech and language pathology, and
developmental therapy, including the social-emotional domain
of development, (3) that are held no less than twice per year,
(4) that offer no fewer than 20 contact hours per year of
course work, (5) that are held in no fewer than 5 separate
locales throughout the State, and (6) that give enrollment
priority to early intervention providers who do not meet the
experience, education, or continuing education requirements
necessary to be fully credentialed early intervention
providers; and
(b) Courses held no less than twice per year for no fewer
than 4 hours each in no fewer than 5 separate locales
throughout the State each on the following topics:
(1) Practice and procedures of private insurance
billing.
(2) The role of the regional intake entities; service
coordination; program eligibility determinations; family
fees; any federally funded, Department of Healthcare and
Family Services administered, medical programs Medicaid,
KidCare, and Division of Specialized Care applications,
referrals, and coordination with Early Intervention; and
procedural safeguards.
(3) Introduction to the early intervention program,
including provider enrollment and credentialing, overview
of Early Intervention program policies and regulations,
and billing requirements.
(4) Evaluation and assessment of birth-to-3 children;
individualized family service plan development,
monitoring, and review; best practices; service
guidelines; and quality assurance.
(Source: P.A. 92-307, eff. 8-9-01.)
(325 ILCS 20/13.50 rep.)
Section 15. The Early Intervention Services System Act is
amended by repealing Section 13.50.
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