Section 500.80  Individualized Family Service Plan Development

 

a)         The service coordinator shall:

 

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

 

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

 

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

 

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

 

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

 

6)         Explain to each family, orally and in writing, all of the following:

 

A)        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.

 

B)        That services will not be delayed due to any rules or restrictions under the family's insurance plan or policy.

 

C)        That the family may request, with appropriate documentation supporting the request, a determination of an exemption from private insurance use under Section 13.25 of the Act.

 

D)        That responsibility for co-payments or co-insurance under a family's private insurance plan or policy, but only to the extent that those payments plus the balance to be claimed do not exceed the current State rate for early intervention services, will be transferred to the lead agency's central billing office.

 

E)         That families will be responsible for payments of family fees, which will be based on a sliding scale according to income, and that these fees are payable to the central billing office, and that if the family encounters a catastrophic circumstance, as defined under Section 500.130(g)(1), making it unable to pay the fees, the lead agency may, upon proof of inability to pay, waive the fees.

 

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

 

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

 

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

 

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

 

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

 

1)         Arrange for a meeting to be held, at a time and place convenient for the family, between  the child's parent and other family members by parental request, the service coordinator, a person or persons directly involved in conducting the evaluations/assessments, potential service providers within the EI Service System as appropriate, and others, such as an advocate or person outside the family by parental request, to develop the Individualized Family Service Plan; and

 

2)         Provide reasonable prior written notice to the family and other participants of this meeting.

 

d)         At the meeting to develop the Individualized Family Service Plan, the service coordinator shall:

 

1)         Coordinate and participate in the meeting.

 

2)         Ensure that the meeting is conducted in the parent's native language or mode of communication, unless it is clearly not feasible to do so, or that an interpreter is present to translate what is discussed.

 

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

 

4)         If no consensus is reached, the service coordinator shall establish a Department approved service plan reviewed by Department designated experts, and shall provide the parents with prior written notice, pursuant to Section 500.165, of the Department's proposed service plan.  The parents may seek mediation or an impartial administrative resolution regarding other requested services.

 

e)         The Individualized Family Service Plan must:

 

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

 

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

 

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

 

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

 

5)         State the natural environments in which services shall be appropriately provided and justification of why early intervention cannot be achieved satisfactorily in a natural environment if any services are to be provided elsewhere.

 

6)         Include all components as required by the Department.

 

7)         Provide a statement of the child's present developmental levels in the following areas, based on professionally acceptable objective criteria:

 

A)        physical development, including vision and hearing;

 

B)        cognitive development;

 

C)        language, speech and communication development;

 

D)        social or emotional development; and

 

E)         adaptive self-help skills development.

 

8)         Provide a statement of the family's resources, priorities and concerns related to enhancing the development of the child.

 

9)         Provide a statement of the functional outcomes expected to be achieved for the child and family, and the criteria, procedures and timelines used to determine:

 

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

 

B)        Whether modifications or revisions of the outcomes or services are necessary.

 

10)         A statement of the specific EI services to be provided, including:

 

A)        The frequency and intensity for each service, meaning the number of times a service will be provided within a given period and the length of time the service will be provided during each session;

 

B)        The method of delivering the services, meaning whether the service will be provided on a group or individual basis;

 

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

 

D)        The projected beginning dates as soon as possible after development of the IFSP and the duration or ending dates of the services.

 

11)        A statement of any other services, such as medical services, that the child needs but that are not required early intervention services.  The statement should include the funding sources to be used in paying for those services or the steps that will be taken to secure those services through public or private sources.  Routine medical services such as immunization or well child care do not need to be listed unless the child is not receiving those services and needs them.

 

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

 

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

 

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

 

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

 

C)        With informed parental consent, the transmission of information about the child to the local educational agency to ensure continuity of services, including evaluation information and copies of the IFSP.

 

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

 

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

 

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

 

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

 

D)        The beginning date of the insurance benefit year.

 

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

 

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

 

h)        The service coordinator shall determine if an Interim Individualized Family Service Plan, as set forth in sections 303.322(e)(2) and 303.345 of Part C of IDEA, is needed to initiate partial services for an eligible child while intake is being completed.  An Interim IFSP may be needed if some early intervention services have been determined to be needed immediately for the child or family.

 

i)          If an Interim IFSP is needed, the service coordinator shall:

 

1)         Document the reasons an Interim IFSP is needed;

 

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

 

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

 

4)         Arrange for the Interim IFSP to be implemented;

 

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

 

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

 

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

 

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