Illinois General Assembly - Full Text of HB3308
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Full Text of HB3308  102nd General Assembly


Sen. Napoleon Harris, III

Filed: 5/25/2021





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2    AMENDMENT NO. ______. Amend House Bill 3308 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.8 as follows:
6    (5 ILCS 100/5-45.8 new)
7    Sec. 5-45.8. Emergency rulemaking; Illinois Insurance
8Code. To provide for the expeditious and timely implementation
9of changes made to the Illinois Insurance Code by this
10amendatory Act of the 102nd General Assembly, emergency rules
11implementing the changes made to the Illinois Insurance Code
12by this amendatory Act of the 102nd General Assembly may be
13adopted in accordance with Section 5-45 by the Department of
14Insurance. The adoption of emergency rules authorized by
15Section 5-45 and this Section is deemed to be necessary for the
16public interest, safety, and welfare. This Section is repealed



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1on January 1, 2022.
2    Section 10. The Illinois Insurance Code is amended by
3changing Section 356z.22 as follows:
4    (215 ILCS 5/356z.22)
5    Sec. 356z.22. Coverage for telehealth services.
6    (a) For purposes of this Section:
7    "Asynchronous store and forward system" has the meaning
8given to that term in Section 5 of the Telehealth Act.
9    "Distant site" has the meaning given to that term in
10Section 5 of the Telehealth Act means the location at which the
11health care provider rendering the telehealth service is
13    "E-visits" has the meaning given to that term in Section 5
14of the Telehealth Act.
15    "Facility" means any hospital facility licensed under the
16Hospital Licensing Act or the University of Illinois Hospital
17Act, a federally qualified health center, a community mental
18health center, a behavioral health clinic, a substance use
19disorder treatment program licensed by the Division of
20Substance Use Prevention and Recovery of the Department of
21Human Services, or other building, place, or institution that
22is owned or operated by a person that is licensed or otherwise
23authorized to deliver health care services.
24    "Health care professional" has the meaning given to that



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1term in Section 5 of the Telehealth Act.
2    "Interactive telecommunications system" has the meaning
3given to that term in Section 5 of the Telehealth Act. As used
4in this Section, "interactive telecommunications system" does
5not include virtual check-ins means an audio and video system
6permitting 2-way, live interactive communication between the
7patient and the distant site health care provider.
8    "Originating site" has the meaning given to that term in
9Section 5 of the Telehealth Act.
10    "Telehealth services" has the meaning given to that term
11in Section 5 of the Telehealth Act. As used in this Section,
12"telehealth services" do not include asynchronous store and
13forward systems, remote patient monitoring technologies,
14e-visits, or virtual check-ins means the delivery of covered
15health care services by way of an interactive
16telecommunications system.
17    "Virtual check-in" has the meaning given to that term in
18Section 5 of the Telehealth Act.
19    (b) An If an individual or group policy of accident or
20health insurance that is amended, delivered, issued, or
21renewed on or after the effective date of this amendatory Act
22of the 102nd General Assembly shall cover telehealth services,
23e-visits, and virtual check-ins rendered by a health care
24professional when clinically appropriate and medically
25necessary to insureds, enrollees, and members in the same
26manner as any other benefits covered under the policy. An



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1individual or group policy of accident or health insurance may
2provide reimbursement to a facility that serves as the
3originating site at the time a telehealth service is rendered.
4provides coverage for telehealth services, then it must comply
5with the following:
6    (c) To ensure telehealth service, e-visit, and virtual
7check-in access is equitable for all patients in receipt of
8health care services under this Section and health care
9professionals and facilities are able to deliver medically
10necessary services that can be appropriately delivered via
11telehealth within the scope of their licensure or
12certification, coverage required under this Section shall
13comply with all of the following:
14        (1) An individual or group policy of accident or
15    health insurance shall providing telehealth services may
16    not:
17            (A) require that in-person contact occur between a
18        health care professional provider and a patient before
19        the provision of a telehealth service;
20            (B) require patients, the health care
21        professionals, or facilities provider to prove or
22        document a hardship or access barrier to an in-person
23        consultation for coverage and reimbursement of
24        telehealth services, e-visits, or virtual check-ins to
25        be provided through telehealth;
26            (C) require the use of telehealth services,



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1        e-visits, or virtual check-ins when the health care
2        professional provider has determined that it is not
3        appropriate; or
4            (D) require the use of telehealth services when a
5        patient chooses an in-person consultation; .
6            (E) require a health care professional to be
7        physically present in the same room as the patient at
8        the originating site, unless deemed medically
9        necessary by the health care professional providing
10        the telehealth service;
11            (F) create geographic or facility restrictions or
12        requirements for telehealth services, e-visits, or
13        virtual check-ins;
14            (G) require health care professionals or
15        facilities to offer or provide telehealth services,
16        e-visits, or virtual check-ins;
17            (H) require patients to use telehealth services,
18        e-visits, or virtual check-ins, or require patients to
19        use a separate panel of health care professionals or
20        facilities to receive telehealth service, e-visit, or
21        virtual check-in coverage and reimbursement; or
22            (I) impose upon telehealth services, e-visits, or
23        virtual check-ins utilization review requirements that
24        are unnecessary, duplicative, or unwarranted or impose
25        any treatment limitations, prior authorization,
26        documentation, or recordkeeping requirements that are



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1        more stringent than the requirements applicable to the
2        same health care service when rendered in-person,
3        except procedure code modifiers may be required to
4        document telehealth.
5        (2) Deductibles, copayments, or coinsurance, or any
6    other cost-sharing applicable to services provided through
7    telehealth shall not exceed the deductibles, copayments,
8    or coinsurance, or any other cost-sharing required by the
9    individual or group policy of accident or health insurance
10    for the same services provided through in-person
11    consultation.
12        (3) An individual or group policy of accident or
13    health insurance shall notify health care professionals
14    and facilities of any instructions necessary to facilitate
15    billing for telehealth services, e-visits, and virtual
16    check-ins.
17    (d) For purposes of reimbursement, an individual or group
18policy of accident or health insurance that is amended,
19delivered, issued, or renewed on or after the effective date
20of this amendatory Act of the 102nd General Assembly shall
21reimburse an in-network health care professional or facility,
22including a health care professional or facility in a tiered
23network, for telehealth services provided through an
24interactive telecommunications system on the same basis, in
25the same manner, and at the same reimbursement rate that would
26apply to the services if the services had been delivered via an



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1in-person encounter by an in-network or tiered network health
2care professional or facility. This subsection applies only to
3those services provided by telehealth that may otherwise be
4billed as an in-person service. This subsection is inoperative
5on and after January 1, 2028, except that this subsection is
6operative after that date with respect to mental health and
7substance use disorder telehealth services.
8    (e) The Department and the Department of Public Health
9shall commission a report to the General Assembly administered
10by an established medical college in this State wherein
11supervised clinical training takes place at an affiliated
12institution that uses telehealth services, subject to
13appropriation. The report shall study the telehealth coverage
14and reimbursement policies established in subsections (b) and
15(d) of this Section, to determine if the policies improve
16access to care, reduce health disparities, promote health
17equity, have an impact on utilization and cost-avoidance,
18including direct or indirect cost savings to the patient, and
19to provide any recommendations for telehealth access expansion
20in the future. An individual or group policy of accident or
21health insurance shall provide data necessary to carry out the
22requirements of this subsection upon request of the
23Department. The Department and the Department of Public Health
24shall submit the report by December 31, 2026. The established
25medical college may utilize subject matter expertise to
26complete any necessary actuarial analysis.



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1    (f) Nothing in this Section is intended to limit the
2ability of an individual or group policy of accident or health
3insurance and a health care professional or facility to
4voluntarily negotiate alternate reimbursement rates for
5telehealth services. Such voluntary negotiations shall take
6into consideration the ongoing investment necessary to ensure
7these telehealth platforms may be continuously maintained,
8seamlessly updated, and integrated with a patient's electronic
9medical records.
10    (g) An (b-5) If an individual or group policy of accident
11or health insurance that is amended, delivered, issued, or
12renewed on or after the effective date of this amendatory Act
13of the 102nd General Assembly shall provide provides coverage
14for telehealth services, it must provide coverage for licensed
15dietitian nutritionists and certified diabetes educators who
16counsel senior diabetes patients in the senior diabetes
17patients' homes to remove the hurdle of transportation for
18senior diabetes patients to receive treatment, in accordance
19with the Dietitian Nutritionist Practice Act.
20    (h) Any policy, contract, or certificate of health
21insurance coverage that does not distinguish between
22in-network and out-of-network health care professionals and
23facilities shall be subject to this Section as though all
24health care professionals and facilities were in-network.
25    (i) Health care professionals and facilities shall
26determine the appropriateness of specific sites, technology



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1platforms, and technology vendors for a telehealth service, as
2long as delivered services adhere to all federal and State
3privacy, security, and confidentiality laws, rules, or
4regulations, including, but not limited to, the Health
5Insurance Portability and Accountability Act of 1996 and the
6Mental Health and Developmental Disabilities Confidentiality
8    (j) (c) Nothing in this Section shall be deemed as
9precluding a health insurer from providing benefits for other
10telehealth services, including, but not limited to, services
11not required for coverage provided through an asynchronous
12store and forward system, remote patient monitoring services,
13remote monitoring services, other monitoring services, or oral
14communications otherwise covered under the policy.
15    (k) There shall be no restrictions on originating site
16requirements for telehealth coverage or reimbursement to the
17distant site under this Section other than requiring the
18telehealth services to be medically necessary and clinically
20    (l) The Department may adopt rules, including emergency
21rules subject to the provisions of Section 5-45 of the
22Illinois Administrative Procedure Act, to implement the
23provisions of this Section.
24(Source: P.A. 100-1009, eff. 1-1-19.)
25    Section 15. The Telehealth Act is amended by changing



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1Sections 5, 10, and 15 as follows:
2    (225 ILCS 150/5)
3    Sec. 5. Definitions. As used in this Act:
4    "Asynchronous store and forward system" means the
5transmission of a patient's medical information through an
6electronic communications system at an originating site to a
7health care professional or facility at a distant site that
8does not require real-time or synchronous interaction between
9the health care professional and the patient.
10    "Distant site" means the location at which the health care
11professional rendering the telehealth service is located.
12    "Established patient" means a patient with a relationship
13with a health care professional in which there has been an
14exchange of an individual's protected health information for
15the purpose of providing patient care, treatment, or services.
16    "E-visit" means a patient-initiated non-face-to-face
17communication through an online patient portal between an
18established patient and a health care professional.
19    "Facility" includes a facility that is owned or operated
20by a hospital under the Hospital Licensing Act or University
21of Illinois Hospital Act, a facility under the Nursing Home
22Care Act, a rural health clinic, a federally qualified health
23center, a local health department, a community mental health
24center, a behavioral health clinic as defined in 89 Ill. Adm.
25Code 140.453, an encounter rate clinic, a skilled nursing



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1facility, a substance use treatment program licensed by the
2Division of Substance Use Prevention and Recovery of the
3Department of Human Services, a school-based health center as
4defined in 77 Ill. Adm. Code 641.10, a physician's office, a
5podiatrist's office, a supportive living program provider, a
6hospice provider, home health agency, or home nursing agency
7under the Home Health, Home Services, and Home Nursing Agency
8Licensing Act, a facility under the ID/DD Community Care Act,
9community-integrated living arrangements as defined in the
10Community-Integrated Living Arrangements Licensure and
11Certification Act, and a provider who receives reimbursement
12for a patient's room and board.
13    "Health care professional" includes, but is not limited
14to, physicians, physician assistants, optometrists, advanced
15practice registered nurses, clinical psychologists licensed in
16Illinois, prescribing psychologists licensed in Illinois,
17dentists, occupational therapists, pharmacists, physical
18therapists, clinical social workers, speech-language
19pathologists, audiologists, hearing instrument dispensers,
20licensed certified substance use disorder treatment providers
21and clinicians, and mental health professionals and clinicians
22authorized by Illinois law to provide mental health services,
23and qualified providers listed under paragraph (8) of
24subsection (e) of Section 3 of the Early Intervention Services
25System Act, dietitian nutritionists licensed in Illinois, and
26health care professionals associated with a facility.



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1    "Interactive telecommunications system" means an audio and
2video system, an audio-only telephone system (landline or
3cellular), or any other telecommunications system permitting
42-way, synchronous interactive communication between a patient
5at an originating site and a health care professional or
6facility at a distant site. "Interactive telecommunications
7system" does not include a facsimile machine, electronic mail
8messaging, or text messaging.
9    "Originating site" means the location at which the patient
10is located at the time telehealth services are provided to the
11patient via telehealth.
12    "Remote patient monitoring" means the use of connected
13digital technologies or mobile medical devices to collect
14medical and other health data from a patient at one location
15and electronically transmit that data to a health care
16professional or facility at a different location for
17collection and interpretation.
18    "Telehealth services" means the evaluation, diagnosis, or
19interpretation of electronically transmitted patient-specific
20data between a remote location and a licensed health care
21professional that generates interaction or treatment
22recommendations. "Telehealth services" includes telemedicine
23and the delivery of health care services, including mental
24health treatment and substance use disorder treatment and
25services to a patient, regardless of patient location,
26provided by way of an interactive telecommunications system,



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1asynchronous store and forward system, remote patient
2monitoring technologies, e-visits, or virtual check-ins as
3defined in subsection (a) of Section 356z.22 of the Illinois
4Insurance Code.
5    "Virtual check-in" means a brief patient-initiated
6communication using a technology-based service, excluding
7facsimile, between an established patient and a health care
8professional. "Virtual check-in" does not include
9communications from a related office visit provided within the
10previous 7 days, nor communications that lead to an office
11visit or procedure within the next 24 hours or soonest
12available appointment.
13(Source: P.A. 100-317, eff. 1-1-18; 100-644, eff. 1-1-19;
14100-930, eff. 1-1-19; 101-81, eff. 7-12-19; 101-84, eff.
16    (225 ILCS 150/10)
17    Sec. 10. Practice authority. A health care professional
18treating a patient located in this State through telehealth
19services must be licensed or authorized to practice in
21(Source: P.A. 100-317, eff. 1-1-18.)
22    (225 ILCS 150/15)
23    Sec. 15. Use of telehealth services.
24    (a) A health care professional may engage in the practice



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1of telehealth services in Illinois to the extent of his or her
2scope of practice as established in his or her respective
3licensing Act consistent with the standards of care for
4in-person services. This Act shall not be construed to alter
5the scope of practice of any health care professional or
6authorize the delivery of health care services in a setting or
7in a manner not otherwise authorized by the laws of this State.
8    (b) Telehealth services provided pursuant to this Section
9shall be consistent with all federal and State privacy,
10security, and confidentiality laws, rules, or regulations.
11(Source: P.A. 100-317, eff. 1-1-18.)
12    Section 20. The Early Intervention Services System Act is
13amended by changing Sections 3 and 11 and by adding Section 3b
14as follows:
15    (325 ILCS 20/3)  (from Ch. 23, par. 4153)
16    Sec. 3. Definitions. As used in this Act:
17    (a) "Eligible infants and toddlers" means infants and
18toddlers under 36 months of age with any of the following
20        (1) Developmental delays.
21        (2) A physical or mental condition which typically
22    results in developmental delay.
23        (3) Being at risk of having substantial developmental
24    delays based on informed clinical opinion.



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1        (4) Either (A) having entered the program under any of
2    the circumstances listed in paragraphs (1) through (3) of
3    this subsection but no longer meeting the current
4    eligibility criteria under those paragraphs, and
5    continuing to have any measurable delay, or (B) not having
6    attained a level of development in each area, including
7    (i) cognitive, (ii) physical (including vision and
8    hearing), (iii) language, speech, and communication, (iv)
9    social or emotional, or (v) adaptive, that is at least at
10    the mean of the child's age equivalent peers; and, in
11    addition to either item (A) or item (B), (C) having been
12    determined by the multidisciplinary individualized family
13    service plan team to require the continuation of early
14    intervention services in order to support continuing
15    developmental progress, pursuant to the child's needs and
16    provided in an appropriate developmental manner. The type,
17    frequency, and intensity of services shall differ from the
18    initial individualized family services plan because of the
19    child's developmental progress, and may consist of only
20    service coordination, evaluation, and assessments.
21    (b) "Developmental delay" means a delay in one or more of
22the following areas of childhood development as measured by
23appropriate diagnostic instruments and standard procedures:
24cognitive; physical, including vision and hearing; language,
25speech and communication; social or emotional; or adaptive.
26The term means a delay of 30% or more below the mean in



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1function in one or more of those areas.
2    (c) "Physical or mental condition which typically results
3in developmental delay" means:
4        (1) a diagnosed medical disorder or exposure to a
5    toxic substance bearing a relatively well known expectancy
6    for developmental outcomes within varying ranges of
7    developmental disabilities; or
8        (2) a history of prenatal, perinatal, neonatal or
9    early developmental events suggestive of biological
10    insults to the developing central nervous system and which
11    either singly or collectively increase the probability of
12    developing a disability or delay based on a medical
13    history.
14    (d) "Informed clinical opinion" means both clinical
15observations and parental participation to determine
16eligibility by a consensus of a multidisciplinary team of 2 or
17more members based on their professional experience and
19    (e) "Early intervention services" means services which:
20        (1) are designed to meet the developmental needs of
21    each child eligible under this Act and the needs of his or
22    her family;
23        (2) are selected in collaboration with the child's
24    family;
25        (3) are provided under public supervision;
26        (4) are provided at no cost except where a schedule of



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1    sliding scale fees or other system of payments by families
2    has been adopted in accordance with State and federal law;
3        (5) are designed to meet an infant's or toddler's
4    developmental needs in any of the following areas:
5            (A) physical development, including vision and
6        hearing,
7            (B) cognitive development,
8            (C) communication development,
9            (D) social or emotional development, or
10            (E) adaptive development;
11        (6) meet the standards of the State, including the
12    requirements of this Act;
13        (7) include one or more of the following:
14            (A) family training,
15            (B) social work services, including counseling,
16        and home visits,
17            (C) special instruction,
18            (D) speech, language pathology and audiology,
19            (E) occupational therapy,
20            (F) physical therapy,
21            (G) psychological services,
22            (H) service coordination services,
23            (I) medical services only for diagnostic or
24        evaluation purposes,
25            (J) early identification, screening, and
26        assessment services,



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1            (K) health services specified by the lead agency
2        as necessary to enable the infant or toddler to
3        benefit from the other early intervention services,
4            (L) vision services,
5            (M) transportation,
6            (N) assistive technology devices and services,
7            (O) nursing services,
8            (P) nutrition services, and
9            (Q) sign language and cued language services;
10        (8) are provided by qualified personnel, including but
11    not limited to:
12            (A) child development specialists or special
13        educators, including teachers of children with hearing
14        impairments (including deafness) and teachers of
15        children with vision impairments (including
16        blindness),
17            (B) speech and language pathologists and
18        audiologists,
19            (C) occupational therapists,
20            (D) physical therapists,
21            (E) social workers,
22            (F) nurses,
23            (G) dietitian nutritionists,
24            (H) vision specialists, including ophthalmologists
25        and optometrists,
26            (I) psychologists, and



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1            (J) physicians;
2        (9) are provided in conformity with an Individualized
3    Family Service Plan;
4        (10) are provided throughout the year; and
5        (11) are provided in natural environments, to the
6    maximum extent appropriate, which may include the home and
7    community settings, unless justification is provided
8    consistent with federal regulations adopted under Sections
9    1431 through 1444 of Title 20 of the United States Code.
10    (f) "Individualized Family Service Plan" or "Plan" means a
11written plan for providing early intervention services to a
12child eligible under this Act and the child's family, as set
13forth in Section 11.
14    (g) "Local interagency agreement" means an agreement
15entered into by local community and State and regional
16agencies receiving early intervention funds directly from the
17State and made in accordance with State interagency agreements
18providing for the delivery of early intervention services
19within a local community area.
20    (h) "Council" means the Illinois Interagency Council on
21Early Intervention established under Section 4.
22    (i) "Lead agency" means the State agency responsible for
23administering this Act and receiving and disbursing public
24funds received in accordance with State and federal law and
26    (i-5) "Central billing office" means the central billing



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1office created by the lead agency under Section 13.
2    (j) "Child find" means a service which identifies eligible
3infants and toddlers.
4    (k) "Regional intake entity" means the lead agency's
5designated entity responsible for implementation of the Early
6Intervention Services System within its designated geographic
8    (l) "Early intervention provider" means an individual who
9is qualified, as defined by the lead agency, to provide one or
10more types of early intervention services, and who has
11enrolled as a provider in the early intervention program.
12    (m) "Fully credentialed early intervention provider" means
13an individual who has met the standards in the State
14applicable to the relevant profession, and has met such other
15qualifications as the lead agency has determined are suitable
16for personnel providing early intervention services, including
17pediatric experience, education, and continuing education. The
18lead agency shall establish these qualifications by rule filed
19no later than 180 days after the effective date of this
20amendatory Act of the 92nd General Assembly.
21    (n) "Telehealth" has the meaning given to that term in
22Section 5 of the Telehealth Act.
23(Source: P.A. 101-10, eff. 6-5-19.)
24    (325 ILCS 20/3b new)
25    Sec. 3b. Services delivered by telehealth. An early



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1intervention provider may deliver via telehealth any type of
2early intervention service outlined in subsection (e) of
3Section 3 to the extent of the early intervention provider's
4scope of practice as established in the provider's respective
5licensing Act consistent with the standards of care for
6in-person services. This Section shall not be construed to
7alter the scope of practice of any early intervention provider
8or authorize the delivery of early intervention services in a
9setting or in a manner not otherwise authorized by the laws of
10this State.
11    (325 ILCS 20/11)  (from Ch. 23, par. 4161)
12    Sec. 11. Individualized Family Service Plans.
13    (a) Each eligible infant or toddler and that infant's or
14toddler's family shall receive:
15        (1) timely, comprehensive, multidisciplinary
16    assessment of the unique strengths and needs of each
17    eligible infant and toddler, and assessment of the
18    concerns and priorities of the families to appropriately
19    assist them in meeting their needs and identify supports
20    and services to meet those needs; and
21        (2) a written Individualized Family Service Plan
22    developed by a multidisciplinary team which includes the
23    parent or guardian. The individualized family service plan
24    shall be based on the multidisciplinary team's assessment
25    of the resources, priorities, and concerns of the family



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1    and its identification of the supports and services
2    necessary to enhance the family's capacity to meet the
3    developmental needs of the infant or toddler, and shall
4    include the identification of services appropriate to meet
5    those needs, including the frequency, intensity, and
6    method of delivering services. During and as part of the
7    initial development of the individualized family services
8    plan, and any periodic reviews of the plan, the
9    multidisciplinary team may seek consultation from the lead
10    agency's designated experts, if any, to help determine
11    appropriate services and the frequency and intensity of
12    those services. All services in the individualized family
13    services plan must be justified by the multidisciplinary
14    assessment of the unique strengths and needs of the infant
15    or toddler and must be appropriate to meet those needs. At
16    the periodic reviews, the team shall determine whether
17    modification or revision of the outcomes or services is
18    necessary.
19    (b) The Individualized Family Service Plan shall be
20evaluated once a year and the family shall be provided a review
21of the Plan at 6 month intervals or more often where
22appropriate based on infant or toddler and family needs. The
23lead agency shall create a quality review process regarding
24Individualized Family Service Plan development and changes
25thereto, to monitor and help assure that resources are being
26used to provide appropriate early intervention services.



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1    (c) The initial evaluation and initial assessment and
2initial Plan meeting must be held within 45 days after the
3initial contact with the early intervention services system.
4The 45-day timeline does not apply for any period when the
5child or parent is unavailable to complete the initial
6evaluation, the initial assessments of the child and family,
7or the initial Plan meeting, due to exceptional family
8circumstances that are documented in the child's early
9intervention records, or when the parent has not provided
10consent for the initial evaluation or the initial assessment
11of the child despite documented, repeated attempts to obtain
12parental consent. As soon as exceptional family circumstances
13no longer exist or parental consent has been obtained, the
14initial evaluation, the initial assessment, and the initial
15Plan meeting must be completed as soon as possible. With
16parental consent, early intervention services may commence
17before the completion of the comprehensive assessment and
18development of the Plan.
19    (d) Parents must be informed that early intervention
20services shall be provided to each eligible infant and
21toddler, to the maximum extent appropriate, in the natural
22environment, which may include the home or other community
23settings. Parents must also be informed of the availability of
24early intervention services provided through telehealth
25services. Parents shall make the final decision to accept or
26decline early intervention services, including whether



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1accepted services are delivered in person or via telehealth
2services. A decision to decline such services shall not be a
3basis for administrative determination of parental fitness, or
4other findings or sanctions against the parents. Parameters of
5the Plan shall be set forth in rules.
6    (e) The regional intake offices shall explain to each
7family, orally and in writing, all of the following:
8        (1) That the early intervention program will pay for
9    all early intervention services set forth in the
10    individualized family service plan that are not covered or
11    paid under the family's public or private insurance plan
12    or policy and not eligible for payment through any other
13    third party payor.
14        (2) That services will not be delayed due to any rules
15    or restrictions under the family's insurance plan or
16    policy.
17        (3) That the family may request, with appropriate
18    documentation supporting the request, a determination of
19    an exemption from private insurance use under Section
20    13.25.
21        (4) That responsibility for co-payments or
22    co-insurance under a family's private insurance plan or
23    policy will be transferred to the lead agency's central
24    billing office.
25        (5) That families will be responsible for payments of
26    family fees, which will be based on a sliding scale



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1    according to the State's definition of ability to pay
2    which is comparing household size and income to the
3    sliding scale and considering out-of-pocket medical or
4    disaster expenses, and that these fees are payable to the
5    central billing office. Families who fail to provide
6    income information shall be charged the maximum amount on
7    the sliding scale.
8    (f) The individualized family service plan must state
9whether the family has private insurance coverage and, if the
10family has such coverage, must have attached to it a copy of
11the family's insurance identification card or otherwise
12include all of the following information:
13        (1) The name, address, and telephone number of the
14    insurance carrier.
15        (2) The contract number and policy number of the
16    insurance plan.
17        (3) The name, address, and social security number of
18    the primary insured.
19        (4) The beginning date of the insurance benefit year.
20    (g) A copy of the individualized family service plan must
21be provided to each enrolled provider who is providing early
22intervention services to the child who is the subject of that
24    (h) Children receiving services under this Act shall
25receive a smooth and effective transition by their third
26birthday consistent with federal regulations adopted pursuant



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1to Sections 1431 through 1444 of Title 20 of the United States
2Code. Beginning July 1, 2022, children who receive early
3intervention services prior to their third birthday and are
4found eligible for an individualized education program under
5the Individuals with Disabilities Education Act, 20 U.S.C.
61414(d)(1)(A), and under Section 14-8.02 of the School Code
7and whose birthday falls between May 1 and August 31 may
8continue to receive early intervention services until the
9beginning of the school year following their third birthday in
10order to minimize gaps in services, ensure better continuity
11of care, and align practices for the enrollment of preschool
12children with special needs to the enrollment practices of
13typically developing preschool children.
14(Source: P.A. 101-654, eff. 3-8-21.)
15    Section 99. Effective date. This Act takes effect upon
16becoming law.".