Illinois Compiled Statutes
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CHILDREN325 ILCS 20/1
(325 ILCS 20/) Early Intervention Services System Act.
(325 ILCS 20/1)
(from Ch. 23, par. 4151)
This Act may be cited as the
Early Intervention Services System Act.
(Source: P.A. 87-680.)
325 ILCS 20/2
(325 ILCS 20/2)
(from Ch. 23, par. 4152)
Legislative Findings and Policy.
(a) The General Assembly finds that there is an urgent and substantial
(1) enhance the development of all eligible infants
and toddlers in the State of Illinois in order to minimize developmental delay and maximize individual potential for adult independence;
(2) enhance the capacity of families to meet the
special needs of eligible infants and toddlers including the purchase of services when necessary;
(3) reduce educational costs by minimizing the need
for special education and related services when eligible infants and toddlers reach school age;
(4) enhance the independence, productivity and
integration with age-appropriate peers of eligible children and their families;
(5) reduce social services costs and minimize the
need for institutionalization; and
(6) prevent secondary impairments and disabilities by
improving the health of infants and toddlers, thereby reducing health costs for the families and the State.
(b) The General Assembly therefore intends that the policy of this
State shall be to:
(1) affirm the importance of the family in all areas
of the child's development and reinforce the role of the family as a participant in the decision making processes regarding their child;
(2) provide assistance and support to eligible
infants and toddlers and their families to address the individual concerns and decisions of each family;
(3) develop and implement, on a statewide basis,
locally based comprehensive, coordinated, interdisciplinary, interagency early intervention services for all eligible infants and toddlers;
(4) enhance the local communities' capacity to
provide an array of quality early intervention services;
(5) identify and coordinate all available resources
for early intervention within the State including those from federal, State, local and private sources;
(6) provide financial and technical assistance to
local communities for the purposes of coordinating early intervention services in local communities and enhancing the communities' capacity to provide individualized early intervention services to all eligible infants and toddlers in their homes or in community environments; and
(7) affirm that eligible infants and toddlers have a
right to receive early intervention services to the maximum extent appropriate, in natural environments in which infants and toddlers without disabilities would participate.
(c) The General Assembly further finds that early intervention services
are cost-effective and effectively serve the developmental needs of
eligible infants and toddlers and their families. Therefore, the purpose
of this Act is to provide a comprehensive, coordinated, interagency,
interdisciplinary early intervention services system for eligible infants
and toddlers and their families by enhancing the capacity to provide quality
early intervention services, expanding and improving existing services, and
facilitating coordination of payments for early intervention services from
various public and private sources.
(Source: P.A. 91-538, eff. 8-13-99.)
325 ILCS 20/3
(325 ILCS 20/3)
(from Ch. 23, par. 4153)
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 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) psycho-social, or (v) 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; psycho-social;
or 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
(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 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
(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
(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,
(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
(J) early identification, screening, and
(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;
(8) are provided by qualified personnel, including
(A) child development specialists or special
(B) speech and language pathologists and
(C) occupational therapists,
(D) physical therapists,
(E) social workers,
(I) psychologists, and
(9) are provided in conformity with an Individualized
(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
(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
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
(325 ILCS 20/4)
(from Ch. 23, par. 4154)
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
(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
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
(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, (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
(325 ILCS 20/5)
(from Ch. 23, par. 4155)
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, 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.
(Source: P.A. 95-331, eff. 8-21-07.)
325 ILCS 20/6
(325 ILCS 20/6)
(from Ch. 23, par. 4156)
Local Structure and Interagency Councils.
The lead agency,
in conjunction with the Council
and as defined by
define local service areas and define the
geographic boundaries of each so that all areas of the State are included
in a local service area but no area of the State is included in more than
one service area. In each local service area, the lead agency
shall designate a regional entity responsible for the
eligibility and services and a local interagency council responsible for
coordination and design of child find and public awareness. The regional
entity shall be responsible for
staffing the local council, carrying out child find and public awareness
activities, and providing advocacy for eligible families within the given
geographic area. The regional entity is the prime
responsible to the lead agency for implementation of this
The lead agency, in conjunction with the Council, shall create local
interagency councils. Members of each local interagency council shall
include, but not be limited to, the following: parents; representatives
from coordination and advocacy service providers; local education agencies;
other local public and private service providers; representatives from
State agencies at the local level; and others deemed necessary by the local
Local interagency councils shall:
(a) assist in the development of collaborative
agreements between local service providers, diagnostic and other agencies providing additional services to the child and family;
(b) assist in conducting local needs assessments and
(c) identify and resolve local access issues;
(d) conduct collaborative child find activities;
(e) coordinate public awareness initiatives;
(f) coordinate local planning and evaluation;
(g) assist in the recruitment of specialty personnel;
(h) develop plans for facilitating transition and
integration of eligible children and families into the community;
(i) facilitate conflict resolution at the local
(j) report annually to the Council.
(Source: P.A. 91-538, eff. 8-13-99.)
325 ILCS 20/7
(325 ILCS 20/7)
(from Ch. 23, par. 4157)
Essential Components of the Statewide Service System.
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 will be available to all eligible infants and toddlers in this State after the effective date of this Act;
(c) a timely, comprehensive and interdisciplinary
evaluation of the functioning of each infant and toddler with suspected disabilities in this State and 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 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), 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 early
intervention services, resources, and experts available in this State and early intervention research and demonstration projects being conducted in this State;
(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
(k) procedural safeguards with respect to programs
(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,
(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
(Source: P.A. 87-680.)
325 ILCS 20/8
(325 ILCS 20/8)
(from Ch. 23, par. 4158)
Authority to Promulgate Rules and Regulations.
agency shall develop rules and regulations under this Act within one year
of the effective date of this Act. These rules shall reflect the intent of
federal regulations adopted under Part C of the Individuals with Disabilities Education Improvement Act of 2004 (Sections 1431 through 1444 of Title 20 of the United States Code).
(Source: P.A. 97-902, eff. 8-6-12.)
325 ILCS 20/9
(325 ILCS 20/9)
(from Ch. 23, par. 4159)
Role of Other State Entities.
The Departments of Public
Health, Human Services, Children and Family
Services and 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
(325 ILCS 20/10)
(from Ch. 23, par. 4160)
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
To be a State-approved early intervention service provider, an individual
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 criminal background check 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
(325 ILCS 20/11)
(from Ch. 23, par. 4161)
Individualized Family Service Plans.
(a) Each eligible infant or toddler and that infant's or toddler's family
(1) timely, comprehensive, multidisciplinary
assessment of the unique 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 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 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
(c) The evaluation and initial assessment and initial
Plan meeting must be held within 45 days after the initial
contact with the early intervention services system. 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
services shall be provided to each eligible infant and toddler in the natural
environment, which may include the home or other community settings. Parents
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
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 income, 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.
(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
include all of the following information:
(1) The name, address, and telephone number of the
(2) The contract number and policy number of the
(3) The name, address, and social security number of
(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
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
(325 ILCS 20/12)
(from Ch. 23, par. 4162)
The lead agency shall adopt procedural safeguards that meet federal
requirements and ensure effective implementation of the safeguards
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
complaints by parents as defined by administrative rule.
(b) The right to confidentiality of personally
(c) The opportunity for parents and a guardian to
examine and receive copies of records relating to assessment, screening, eligibility determinations, and the development and implementation of the Individualized Family Service Plan.
(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.
(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 primary language, 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
(325 ILCS 20/13)
(from Ch. 23, par. 4163)
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
(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
Funds provided under Section 633 of the Individuals with
Disabilities Education Act
and State funds designated or appropriated for early intervention services or
may be used by the lead agency to pay the
provider of services (A) pending reimbursement from the appropriate State
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
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
The system of payments, called family fees, shall be
structured on a sliding
scale based on family income. The family's coverage
of coverage under a public or private insurance plan or
shall not be a factor in determining the amount of the
Each family's fee obligation shall be
established annually, and shall be paid by
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
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
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
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
(325 ILCS 20/13.5)
(a) When an application or a review of
eligibility for early
intervention services is made, and at any
thereafter, the family shall be asked if it
is currently enrolled in
Medicaid, KidCare, or the Title V program
administered by the University of Illinois
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
for (i) medical assistance
Article V of the Illinois Public Aid Code, (ii)
health insurance program (KidCare) benefits
Children's Health Insurance Program Act, and (iii)
maternal and child health services provided
Division of Specialized Care for Children of the
(b) For purposes of determining family fees
subsection (f) of Section 13 and determining
the other programs and services specified in
through (iii) of subsection (a), the lead agency
develop and use, within 60 days after the effective
this amendatory Act of the 92nd General Assembly,
cooperation of the Department of Public Aid (now Healthcare and Family Services)
of Specialized Care for Children of the
Illinois, a screening device that provides
information for the early intervention regional
entities or other agencies to establish eligibility for
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 Medicaid or
KidCare, the regional intake entity
shall complete a KidCare/Medicaid
application with the family and forward it
Department of Healthcare and Family Services' KidCare
Unit for a determination of
(d) With the cooperation of the Department of Healthcare and Family Services, the lead agency shall establish procedures that
the timely and maximum allowable recovery of payments
early intervention services and allowable
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 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 a "KidCare agent" in order for the entity to complete the KidCare
application as authorized under Section 22 of the Children's Health Insurance
(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
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
(Source: P.A. 95-331, eff. 8-21-07.)
325 ILCS 20/13.10
(325 ILCS 20/13.10)
Private health insurance;
assignment. The lead agency
shall determine, at the point of new applications
intervention services, and for all children enrolled
in the early
intervention program, at the regional intake offices,
the child is insured under a private health insurance
policy. An application for early intervention
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 20/13.15
(325 ILCS 20/13.15)
Billing of insurance carrier.
(a) Subject to the restrictions against
insurance use on the basis of material risk of
coverage, as determined under Section 13.25, each
provider who is providing a family with early
services shall bill the child's insurance carrier for
of early intervention service for
which coverage may be
available. The lead agency may exempt from the
requirement of this paragraph any early intervention service
that it has deemed not to be covered by insurance plans.
When the service is not exempted, providers who
receive a denial of payment on the basis that the service is
not covered under any circumstance under the plan are not
required to bill that carrier for that service again until the following
insurance benefit year. That
explanation of benefits denying the claim, once submitted to
the central billing office, shall be sufficient to meet the
requirements of this paragraph as to subsequent services billed under the same
billing code provided to that child during that insurance benefit year. Any
time limit on a
provider's filing of a claim for payment with the central
billing office that is
imposed through a
policy, procedure, or rule of the lead agency shall be
until the provider receives an explanation of
other final determination of the claim it files
child's insurance carrier.
(b) In all instances when an insurance carrier has
been billed for early intervention services, whether paid in
full, paid in part, or denied by the carrier, the provider must
provide the central billing office, within 90 days after receipt, with a copy
of the explanation
of benefits form and other information in the manner prescribed by the lead
(c) When the insurance carrier has denied the
claim or paid an amount for the early intervention service
billed that is less than the current State rate for early
intervention services, the provider shall submit the
explanation of benefits with a claim for payment, and the lead
agency shall pay the provider the difference between the sum
actually paid by the insurance carrier for each unit of service
provided under the individualized family service plan and
the current State rate for early intervention services.
The State shall also pay the family's co-payment or co-insurance under its
plan, but only to the extent that those
payments plus the balance of the claim do not exceed the
current State rate for early intervention services. The
provider may under no circumstances bill the family for the
difference between its charge for services and that which
has been paid by the insurance carrier or by the State.
(Source: P.A. 97-813, eff. 7-13-12.)
325 ILCS 20/13.20
(325 ILCS 20/13.20)
Families with insurance coverage.
(a) Families of children with insurance
whether public or private, shall incur no greater
direct out-of-pocket expenses for early intervention
than families who are not insured.
(b) Managed care plans.
(1) Use of managed care network providers. When a
family's insurance coverage is through a managed care arrangement with a network of providers that includes one or more types of early intervention specialists who provide the services set forth in the family's individualized family service plan, the regional intake entity shall require the family to use those network providers, but only to the extent that:
(A) the network provider is immediately available
to receive the referral and to begin providing services to the child;
(B) the network provider is enrolled as a
provider in the Illinois early intervention system and fully credentialed under the current policy or rule of the lead agency;
(C) the network provider can provide the services
to the child in the manner required in the individualized service plan;
(D) the family would not have to travel more than
an additional 15 miles or an additional 30 minutes to the network provider than it would have to travel to a non-network provider who is available to provide the same service; and
(E) the family's managed care plan does not allow
for billing (even at a reduced rate or reduced percentage of the claim) for early intervention services provided by non-network providers.
(2) Transfers from non-network to network providers.
If a child has been receiving services from a non-network provider and the regional intake entity determines, at the time of enrollment in the early intervention program or at any point thereafter, that the family is enrolled in a managed care plan, the regional intake entity shall require the family to transfer to a network provider within 45 days after that determination, but within no more than 60 days after the effective date of this amendatory Act of the 92nd General Assembly, if:
(A) all the requirements of subdivision (b)(1) of
this Section have been met; and
(B) the child is less than 26 months of age.
(3) Waivers. The lead agency may fully or partially
waive the network enrollment requirements of subdivision (b)(1) of this Section and the transfer requirements of subdivision (b)(2) of this Section as to a particular region, or narrower geographic area, if it finds that the managed care plans in that area are not allowing further enrollment of early intervention providers and it finds that referrals or transfers to network providers could cause an overall shortage of early intervention providers in that region of the State or could cause delays in families securing the early intervention services set forth in individualized family services plans.
(4) The lead agency, in conjunction with any entities
with which it may have contracted for the training and credentialing of providers, the local interagency council for early intervention, the regional intake entity, and the enrolled providers in each region who wish to participate, shall cooperate in developing a matrix and action plan that (A) identifies both (i) which early intervention providers and which fully credentialed early intervention providers are members of the managed care plans that are used in the region by families with children in the early intervention program, and (ii) which early intervention services, with what restrictions, if any, are covered under those plans, (B) identifies which credentialed specialists are members of which managed care plans in the region, and (C) identifies the various managed care plans to early intervention providers, encourages their enrollment in the area plans, and provides them with information on how to enroll. These matrices shall be complete no later than 7 months after the effective date of this amendatory Act of the 92nd General Assembly, and shall be provided to the Early Intervention Legislative Advisory Committee at that time. The lead agency shall work with networks that may have closed enrollment to additional providers to encourage their admission of early intervention providers, and shall report to the Early Intervention Legislative Advisory Committee on the initial results of these efforts no later than February 1, 2002.
(Source: P.A. 92-307, eff. 8-9-01.)
325 ILCS 20/13.25
(325 ILCS 20/13.25)
Private insurance; exemption.
(a) The lead
agency shall establish procedures for a
family, whose child is eligible to receive early
services, to apply for an exemption restricting the
its private insurance plan or policy based on
of loss of coverage as authorized under subsection (c) of this Section.
(b) The lead agency shall make a final determination on a request
exemption within 10 business days after its receipt of a
request for an exemption at the regional intake
During that 10 days, no claims may be filed
insurance plan or policy. If the exemption is
shall be noted on the individualized family service
the family and the providers serving the family
notified in writing of the exemption.
(c) An exemption may be granted on the basis of material risk of loss of
coverage only if the family
submits documentation with its request for an exemption that
establishes (i) that the
insurance plan or policy covering the child is an
purchased plan or policy and has been purchased by a
head of a
household that is not eligible for a group medical insurance
plan, (ii) that the policy or plan has a
lifetime cap that applies to one or more specific types of early
intervention services specified in the family's individualized family service
plan, and that coverage could be exhausted during the period covered by the
family service plan, or
(iii) proof of another risk that the lead agency, in its discretion, may have
additionally established and defined as a ground for exemption by rule.
(d) An exemption under this Section based on material risk of loss of
coverage may apply
early intervention services and all plans or
insuring the child, may be limited to one or more
policies, or may be limited to one or more types
intervention services in the child's individualized
(Source: P.A. 92-307, eff. 8-9-01.)
325 ILCS 20/13.30
(325 ILCS 20/13.30)
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
no less than 30 days. This training shall include, at
minimum, the following types of instruction:
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
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
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
(2) The role of the regional intake entities; service
coordination; program eligibility determinations; family fees; 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 20/13.32
(325 ILCS 20/13.32)
The lead agency may enter into contracts for some
or all of its responsibilities under this Act, including but not limited to,
credentialing and enrolling providers; training under Section 13.30;
maintaining a central billing office; data collection and analysis;
establishing and maintaining a computerized case management system accessible
to local referral offices and providers; creating and maintaining a system for
provider credentialing and enrollment; creating and maintaining the central
directory required under subsection (g) of Section 7 of this Act; and program
operations. If contracted, the contract shall be subject to a public request
for proposals as described in the Illinois Procurement Code, notwithstanding
any exemptions or alternative processes that may be allowed for such a contract
under that Code, and, in addition to the posting requirements under that Code,
shall be posted on the early intervention website maintained by the lead agency
during the entire bid period. With the exception of contracts with or grants to
regional intake entities, any of these listed responsibilities currently under
contract or grant that have not met these requirements shall be subject to
public bid under this request for proposal process no later than July 1, 2002
or the date of termination of any contract in place.
Contracts with or grants to regional intake entities must be made subject to
public bid under a request for proposals process no later than July 1, 2005.
(Source: P.A. 92-307, eff. 8-9-01; 93-147, eff. 1-1-04.)
325 ILCS 20/13.50
(325 ILCS 20/13.50)
Early Intervention Legislative Advisory
No later than 60 days after August 9, 2001 (the effective date
of Public Act 92-307), there shall
be convened the Early Intervention Legislative Advisory
Committee. The majority and minority leaders of the General
Assembly shall each appoint 2 members to the Committee.
The Committee's term is for a period of 4 years, and the
Committee shall publicly convene no less than 4 times per
year. The Committee's responsibilities shall include, but
not be limited to, providing guidance to the lead agency
regarding programmatic and fiscal management and
accountability, provider development and accountability,
contracting, and program outcome measures. During the life of the Committee,
on a quarterly basis, or more often as the Committee may request, the lead
agency shall provide to the Committee,
and simultaneously to the public, through postings on the lead agency's early
intervention website, quarterly
reports containing monthly data
and other early intervention program information that the Committee requests.
The first data report must be supplied no later than September 21, 2001, and
must include the previous 2 quarters of data.
(Source: P.A. 96-1000, eff. 7-2-10.)
325 ILCS 20/14
(325 ILCS 20/14)
(from Ch. 23, par. 4164)
(Source: P.A. 87-680. Repealed by P.A. 91-538, eff. 8-13-99.)
325 ILCS 20/15
(325 ILCS 20/15)
(from Ch. 23, par. 4165)
The Auditor General of the State shall conduct a follow-up
evaluation of the system established under this Act, in order to evaluate
the effectiveness of the system in providing services that enhance the
capacities of families throughout Illinois to meet the special needs of
their eligible infants and toddlers, and provide a report of the evaluation
to the Governor and the General Assembly no later than April 30, 2002. Upon
receipt by the lead agency, this report shall be posted on
the early intervention website.
(Source: P.A. 92-307, eff. 8-9-01.)
325 ILCS 20/16
(325 ILCS 20/16)
(from Ch. 23, par. 4166)
This Act takes effect upon becoming law.
(Source: P.A. 87-680.)
325 ILCS 20/20
(325 ILCS 20/20)
Early Intervention Services Revolving Fund.
There is created a
revolving fund to be known as the Early Intervention Services Revolving Fund,
to be held by the lead agency.
The Early Intervention Services Revolving Fund shall be used to the extent
determined necessary by the lead agency to pay for early intervention services.
Local Accounts for such purposes may be established by the lead agency.
Expenditures from the Early Intervention Services Revolving Fund shall be
made in accordance with applicable program provisions and shall be limited to
those purposes and amounts specified under applicable program guidelines.
Funding of the Fund shall be from family fees, insurance company payments,
federal financial participation received as reimbursement for expenditures from
the Fund, and appropriations made to the State agencies involved in the
payment for early intervention services under this Act.
Disbursements from the Early Intervention Services Revolving Fund shall be
made as determined by the lead agency or its designee. Funds in the Early
Intervention Services Revolving Fund or the local accounts created under this
Section that are not immediately required for expenditure may be invested in
certificates of deposit or other interest bearing accounts.
Any interest earned shall be deposited in the Early
Intervention Services Revolving Fund.
(Source: P.A. 89-106, eff. 7-7-95; 89-499, eff. 6-28-96.)