Page 423
HFS 90.03
DEPARTMENT OF HEALTH
& FAMILY SERVICES
Unofficial Text
(See Printed Volume). Current through date and Register shown on Title Page.
Register, December,
2004, No. 588
Chapter HFS 90
EARLY INTERVENTION
SERVICES FOR CHILDREN FROM BIRTH TO AGE 3 WITH DEVELOPMENTAL NEEDS
HFS 90.01 Authority
and purpose.
HFS 90.02 Applicability.
HFS 90.03 Definitions.
HFS 90.04 Eligibility.
HFS 90.05 Department responsibilities.
HFS 90.06 County administrative agency designation and responsibilities.
HFS 90.07 Identification and referral.
HFS 90.08 Evaluation.
HFS 90.09 Assessment.
HFS 90.10 Development of service plan.
HFS 90.11 Service provision.
HFS 90.12 Procedural safeguards for parents.
HFS 90.13 Surrogate parent.
Note: Chapter
HSS 90 was created as an emergency rule effective October 1, 1991. Chapter HSS
90 was renumbered Chapter HFS 90 under s. 13.93 (2m) (b) 1., Stats., and corrections
made under s. 13.93 (2m) (b) 6. and 7., Stats., Register, April, 1997, No. 496.
HFS 90.01 Authority
and purpose. This chapter is promulgated under the authority of s. 51.44
(5) (a), Stats., to implement a statewide program of services for children in
the age group birth to 3 who are significantly delayed developmentally insofar
as their cognitive development, physical development, including vision and hearing,
communication development, social and emotional development or development of
adaptive behavior and self-help skills is concerned, or are diagnosed as having
a physical or mental condition which is likely to result in significantly delayed
development.
History: Cr. Register, June, 1992, No. 438, eff. 7-1-92.
HFS 90.02 Applicability.
This chapter applies to the department, to county agencies administering the
early intervention services program, to other county agencies providing services
under that program, and to all providers of early intervention services who
are under contract to or have entered into agreement with county agencies to
provide those services.
History: Cr. Register, June, 1992, No. 438, eff. 7-1-92.
HFS 90.03 Definitions.
In this chapter:
(1) “Assessment”
means the initial and ongoing procedures used by qualified personnel and family
members, following determination of eligibility, to determine an eligible child’s
unique strengths and needs and the nature and extent of early intervention services
required by the child and the child’s family to meet those needs.
(2) “Assistive
technology device” means an item, piece of equipment or product system, whether
acquired commercially off the shelf, modified or customized, that is used to
increase, maintain or improve the functional capability of an eligible child.
(2m) “Assistive
technology service” means a service that directly assists a child with a disability
in the selection, acquisition or use of an assistive technology device.
(3) “Atypical
development” means development that is unusual in its pattern, is not within
normal developmental milestones, and adversely affects the child’s overall development.
(4) “Birth
to 3” means from birth up to but not including age 3.
(5) “Birth
to 3 program” means the effort in Wisconsin under s. 51.44, Stats., and this
chapter that is directed at meeting the developmental needs of eligible children
and meeting the needs of their families as these needs relate to the child’s
individual development.
(6) “Child”
means a person in the age group birth to 3 with a developmental delay or disability
as determined in accordance with criteria under s. HFS 90.08 (5) or (6).
(7) “Child
find” means identifying, locating and evaluating children who may be eligible
for the birth to 3 program.
(8) “Consent”
means, in reference to a parent, that the parent:
- (a) Has been fully
informed of all information relevant to an activity for which consent is sought,
in the parent’s language or other mode of communication;
- (b) Understands
that information;
- (c) Agrees in writing
to the activity for which consent is sought and the written consent describes
that activity and lists the records, if any, that will be released in this
connection, and to whom the records will be released; and
- (d) Understands
that the granting of consent is voluntary and may be revoked at any time.
(9) “Core
services” means the interdisciplinary evaluation of a child to determine eligibility,
the identification of a service coordinator, provision of service coordination,
development of an individualized family service plan, and the protection of
rights under procedural safeguards. (10) “County administrative agency”
means the s. 46.21, 46.22, 46.23, 51.42 or 51.437, Stats., department, the local
public health agency or any other public agency either designated by a county
board of supervisors or acting under contract or agreement with the county board
of supervisors to operate the birth to 3 program in the county and provide or
contract for early intervention services for eligible children in that county.
(11) “Department”
means the Wisconsin department of health and family services.
(12) “Developmental
delay” means development that lags behind established developmental milestones
as determined in accordance with the criteria under s. HFS 90.08 (5).
(13) “Developmental
status” means the current functioning of a child in the areas of cognition,
communication, vision and hearing, social interaction, emotional response, adaptive
behavior and self-help skills, and the current physical condition and health
of the child.
(14) “Diagnosed
condition” means a physical or mental condition for which the probability is
high, based on a physician’s diagnosis and documenting report, that the condition
will result in a developmental delay.
(15) “Early
intervention record” means information recorded in any way by the county administrative
agency or service provider regarding a child’s screening, evaluation, assessment
or eligibility determination, development and implementation of the IFSP, individual
complaints dealing with the child or family and any other matter related to
early intervention services provided to the child and the child’s family.
(16) “Early
intervention services” means services provided under public supervision that
are designed to meet the special developmental needs of an eligible child and
the needs of the child’s family related to the child’s development and selected
in collaboration with the parent.
(17) “EI team”
or “early intervention team” means the interdisciplinary team consisting of
the parent, service coordinator and 424 HFS 90.03 WISCONSIN ADMINISTRATIVE
CODE Unofficial Text (See Printed Volume). Current through date and Register
shown on Title Page. Register, December, 2004, No. 588 appropriate qualified
personnel that conducts the evaluation or assessment of a child.
(18) “Eligible
child” means a child eligible for the birth to 3 program.
(19) “Evaluation”
means the process used by qualified professionals to determine a child’s initial
and continuing eligibility for early intervention services under s. 51.44, Stats.,
and this chapter.
(20) “Family-directed
assessment” means the ongoing process by which the parent and service providers
work together in partnership to identify and understand the family’s strengths,
resources, concerns and priorities including relevant cultural factors, beliefs
and values, in order to provide support and services to increase the family’s
capacity to meet the developmental needs of the child.
(21) “IFSP”
or “individualized family service plan” means a written plan for providing early
intervention services to an eligible child and the child’s family.
(22) “IFSP
planning process” means the process to develop the IFSP which begins with the
family’s first contacts with the birth to 3 program, includes the evaluation
of the child’s abilities to determine eligibility; identification and assessment
of the eligible child’s unique needs; at a family’s option, family-directed
assessment of the family’s strengths, resources, concerns and priorities; development
of the written IFSP; implementation of the plan; planning for transition to
other programs or services; and ongoing review and revision of the written plan.
(23) “IFSP
team” means the team that develops and implements the IFSP consisting of the
parent, service coordinator, service providers, at least one professional who
served on the EI team and any other person identified by the parent.
(24) “Interdisciplinary”
means drawing from different disciplines, specialties and perspectives, including
perspectives of parents, and using formal channels of communication that encourage
members or contributors to share information and discuss results.
(24m) “Native
language” means the language or other mode of communication normally used by
the parent.
(25) “Natural
environment” means settings that are natural or normal for the child’s age peers
who have no disability.
(26) “Parent”
means the biological parents with parental rights or, if there is only one,
the biological parent with parental rights; the parents by adoption or, if there
is only one, the parent by adoption; a person acting as a parent such as a grandparent
or stepparent with whom the child lives; a guardian; or a surrogate parent.
Note: The term “parent” is being used in the singular throughout this chapter
for reasons of convenience of expression.
(27) “Parent
facilitator” means the parent of a child with a disability, who is hired by
the county administrative agency or a service provider on the basis of demonstrated
skills in planning and communicating and in providing support to other parents.
(28) “Part
C” means the federal grant program to help states establish statewide comprehensive
systems of early intervention services for children in the age group birth to
3 and their families, 20 USC 1471-1485, which was added to the Individuals with
Disabilities Education Act, 20 USC ch. 33, by PL 99-457 and amended by PL 102-119
and PL 105-17.
(28m) “Personally
identifiable information” means the name of the child or the child’s parent
or other family member, the address of the child or the child’s parent or other
family member, any personal identifier such as the child’s or parent’s social
security number, or a list of personal characteristics or other information
that would make it possible to identify the child with reasonable certainty.
(29) “Procedural
safeguards” means the requirements under ss. HFS 90.12 and 90.13 designed to
protect the rights of children and families receiving services through the birth
to 3 program.
(30) “Public
health agency” means a health department, board or officer under ch. 251, Stats.
(31) “Qualified
personnel” means persons who have met Wisconsin approved or recognized certification,
licensing, registration or other comparable requirements set out in s. HFS 90.11
(6) for providing an early intervention service.
(32) “Screening”
means the process for identifying children who need further evaluation because
they may have a developmental delay or a diagnosed condition.
(33) “Service
coordinator” means the person designated by a county administrative agency and
responsible to that agency for coordinating the evaluation of a child, the assessment
of the child and family and the development of an individualized family service
plan, and for assisting and enabling the eligible child and the child’s family
to receive early intervention and other services and procedural safeguards under
this chapter. A “service coordinator” is called a “case manager” for purposes
of reimbursement for services under chs. HFS 101 to 108.
(34) “Service
provider” means a public or private agency which by contract or agreement with
a county administrative agency provides early intervention services under s.
51.44, Stats., and this chapter.
(35) “Surrogate
parent” means a person who has been appointed in accordance with s. HFS 90.13
to act as a child’s parent in all matters relating to s. 51.44, Stats., and
this chapter.
History: Cr.
Register, June, 1992, No. 438, eff. 7-1-92; emerg. am. (1), (2), (6), (10),
(16), (19), (28) and (33), cr. (2g), (8) (b), (24g) and (28g), renum. (8) (b)
to (d) to be (8) (c) to (e), r. and recr. (25), eff. 1-1-93; am. (1), (2), (6),
(10), (16), (19), (28) and (33), cr. (2m), (24m) and (28m), renum. (8) (c) and
(d) to be (8) (d) and (c) and am., r. and recr. (25), Register, June, 1993,
No. 450, eff. 7-1-93; am. (15), Register, April, 1997, No. 496, eff. 5-1-97;
am. (28), Register, September, 1999, No. 525, eff. 10-1-99.
HFS 90.04 Eligibility.
A child shall be eligible for early intervention services under this chapter
if the child is either:
(1) Determined by
the EI team under s. HFS 90.08 to be developmentally delayed; or
(2) Determined by
the EI team under s. HFS 90.08 to have a physician-diagnosed and documented
physical or mental condition which has a high probability of resulting in a
developmental delay.
History: Cr. Register, June, 1992, No. 438, eff. 7-1-92.
HFS 90.05 Department
responsibilities.
(1) GENERAL.
The department is responsible for developing and supporting a statewide comprehensive
system of services for children with disabilities in the age group birth to
3 and their families, and for supervising and monitoring local birth to 3 programs
to ensure that they comply with 20 USC 1471-1485, 34 CFR Pt. 303, s. 51.44,
Stats., and this chapter.
(2) DEVELOPMENT
AND SUPPORT. In developing and supporting the statewide system, the department
shall:
- (a) Provide technical
assistance to county administrative agencies on operation of a local birth
to 3 program;
- (b) Enter into
an interagency agreement with the Wisconsin department of public instruction
related to operation of the birth to 3 program, including operation of child
find and facilitating the transition at age 3 of a child with a disability
from the birth to 3 program to the program for children with exceptional educational
needs under ch. 115, Stats., and ch. PI 11, and such other state- level interagency
and intra-agency agreements as are necessary to facilitate and coordinate
the operation of birth to 3 programs. The interagency and intra-agency agreements
shall cover assignment of financial responsibility and the resolution of disputes;
- (c) Undertake public
awareness and other child find activities that focus on identification, location
or evaluation of children who are eligible to receive early intervention services.
The department shall endeavor to make the public aware of the rationale for
early intervention services, the availability of those services, how to make
referrals and how a family might obtain the services, through various means
such as public service announcements and the distribution of brochures and
other printed materials. Before undertaking any statewide child find activity
that focuses on the identification, location or evaluation of children, the
department shall ensure that adequate notice is published in newspapers or
other media with circulation adequate to notify parents throughout the state
of the activity;
- (d) Operate or
arrange for operation of a central directory of services to provide information
on request by mail or telephone about public and private early intervention
resources, research and demonstration projects in the state and various professional
and other groups providing assistance to children in the birth to 3 age group
and their families; and
- (e) Develop a comprehensive
system of personnel development, including a plan for the provision of both
preservice and inservice training, conducted as appropriate on an interdisciplinary
basis, for the many different kinds of personnel needed to provide early intervention
services, including personnel from public and private providers, primary referral
sources, paraprofessionals and service coordinators. The training shall be
directed specifically at:
- 1. Understanding
the basic components of early intervention services available in the state;
- 2. Meeting
the interrelated social, emotional, health, developmental and educational
needs of eligible children; and
- 3. Assisting
parents of eligible children in furthering the development of their children
and in participating fully in the development and implementation of the
IFSP.
(3) SUPERVISION
AND MONITORING. In supervising and monitoring local birth to 3 programs, the department
shall:
- (a) Collect from
county administrative agencies information on use of funds, system development,
number of children needing and receiving early intervention services, types
of services needed, types of services provided and such other information
the department requires to describe and assess the operation of local programs;
- (b) Have ready
access to county administrative agency files and staff, and the files and
staff of service providers under contract or agreement with the county administrative
agency;
- (c) Make an independent
on-site investigation if the department determines it is necessary;
- (d) Ensure that
deficiencies identified through monitoring are corrected by means that may
include technical assistance, negotiations, corrective action plans and the
threat or imposition of sanctions as allowed by law to achieve compliance
including withholding of funds under s. 46.031 (2r), Stats.; and
- (e) Resolve disputes
between local agencies that cannot be resolved locally. One or both parties
may ask the department, in writing, to resolve a dispute or, if the department
determines that a dispute between local agencies adversely affects or threatens
to adversely affect the delivery of services to families, the department may,
on its own initiative, act to resolve the dispute.
(4) PROCEDURES
FOR RECEIVING AND RESOLVING COMPLAINTS ABOUT OPERATION OF THE PROGRAM.
(a)
- 1. Any individual
or organization having reason to believe that one or more requirements of
this chapter or Part C and its implementing regulations, 34 CFR Pt. 303,
are not being met by the department or a county administrative agency or
by any other public agency or private provider involved in the early intervention
system under agreement with the county administrative agency may complain
to the department. The complaint shall be in writing and be signed and shall
consist of a statement setting forth the complaint and the facts upon which
the complaint is based. The department shall develop procedures to inform
parents and other interested individuals and organizations about their right
to file a complaint and how to file a complaint.
- 2. Complaints
under subd. 1. shall not concern events that occurred more than one year
before the complaint is made, except if the complainant could not have reasonably
known about the event any earlier.
Note: A complaint under this subsection should be sent to the Birth to 3
Program, Division of Disability and Elder Services, P.O. Box 7851, Madison,
WI 53707.
Note: Processes for resolution of disputes between parents and county administrative
agencies are described in s. HFS 90.12 (5) and (6).
- (b) The department
in response to a complaint filed under par. (a) shall appoint a complaint
investigator who shall do the following:
- 1. Find out
the facts related to the complaint;
- 2. Interview
the complainant or the complainant’s representative as part of fact-finding
if that seems useful;
- 3. Conduct
an independent on-site investigation at the county administrative agency
or of a service provider if the department considers that necessary;
- 4. Consider
the merits of the complaint; and
- 5. Recommend
resolution of the complaint.
- (c)
- 1. Except as
provided under subd. 2., within 60 days after receiving a complaint under
this subsection the department shall prepare a written decision stating
the reasons for the decision and forward the decision to the affected
agency or agencies with a copy to the complainant.
- 2. The department
may extend the time limit for resolving a complaint by an additional 60
days if it determines that exceptional circumstances exist with respect
to a particular complaint.
History: Cr. Register, June, 1992, No. 438, eff. 7-1-92; emerg.
am. (2) (c) and (4) (a), renum. (2) (e) 1. and 2. and (3) (c) to be (2)
(e) 2. and 3. and (3) (d) and am. (3) (d), cr. (2) (e) 1. and (3) (c),
eff. 1-1-93; am. (2) (c), (3) (b) and (4) (a), renum. (2) (e) 1. and 2.
and (3) (c) to be (2) (e) 2. and 3. and (3) (d) and am. (3) (d), cr. (2)
(e) 1., (3) (c) and (e), Register, June, 1993, No. 450, eff. 7-1-93; am.
(4) (a), Register, April, 1997, No. 496, eff. 5-1-97; am. (4) (a), Register,
September, 1999, No. 525, eff. 10-1-99; CR 03-033: am. (4) (a) and (c)
1. Register December 2003 No. 576, eff. 1-1-04.
HFS 90.06 County
administrative agency designation and responsibilities.
(1) DEFINITIONS.
In this section:
- (a) “Annual income
after disability deductions” means the annual parental income less a deduction
of $3,300 for each member of the family participating in the birth to 3 program
and each child under 19 years of age with a disability as defined in s. HFS
65.02 (5).
- (b) “Annual parental
income” means total income of the legally responsible parent or parents as
reported on the parent’s most recent federal individual tax return.
- (c) “Family” means
people who share a residence and are any of the following:
- 1. A child
eligible for the Birth to 3 Program.
- 2. A parent
of a person in subd. 1.
- 3. Any minor
in the residence for whom a person in subd. 2. is legally responsible.
- (d) “Federal poverty
guidelines” means the administrative version of the federal poverty measure,
adjusted for families of different size, that are issued annually by the U.S.
Department of Health & Human Services.
- (e) “Full financial
information” means information about parental income, expenses, and assets
that the county administrative agency requests to determine the parental cost
share.
- (f) “Parent” means
a child’s adoptive or biological mother or father who has legal responsibility
for the child.
- (g) “Parental cost
share” means an annual amount of money the county administrative agency determines
to be due and payable currently from the parents.
(1m) DESIGNATION
BY COUNTY BOARD. The county board of each county shall designate a county
department under s. 46.21, 46.22, 46.23, 51.42 or 51.437, Stats., a local
public health agency or any other county agency or enter into a contract
or agreement with any other public agency to be the administrative agency
in the county for the birth to 3 program. That designation or notice of
other arrangement shall be made by letter to the department.
Note: The letter identifying the county administrative agency should be
sent to Birth to 3 Program Coordinator, Division of Disability and Elder
Services, P.O. Box 7851, Madison, WI 53707.
(2) RESPONSIBILITIES.
A county administrative agency shall ensure that all of the following are
done:
- (a) Parents,
representatives of agencies that refer, evaluate or provide services to
young children and their families in the community and other interested
persons are involved in planning, development and operation of the early
intervention service system;
- (b) A comprehensive
child find system is established in accordance with s. HFS 90.07, including
activities to make the public aware of the local birth to 3 program and
development of a formal system of communication and coordination among
pertinent agencies operating in the county that may have contact with
eligible children and their families;
- (c) A service
coordinator is designated for every child referred for evaluation. The
service coordinator need not be an employee of the county administrative
agency but shall be accountable to the county administrative agency;
- (d) The parents
are informed orally and in writing about the purposes of the birth to
3 program, the process and the procedural safeguards;
- (e) The parents
are collaborators in the IFSP planning process;
- (f) Written
consent of the child’s parents is obtained, in accordance with s. HFS
90.12 (2) (a), before the initial evaluation and assessment are conducted;
- (g) Core services
are provided at no cost to the parent;
- (h) Other early
intervention services as identified in s. HFS 90.11 (4) are provided in
accordance with the IFSP. County administrative agencies shall determine
the parental cost share of early intervention services costs not met by
third party payers in accordance with par. (i). Parental cost share for
early intervention services shall begin with services designated in IFSPs
developed or reviewed on or after March 1, 2002.
- (i)
- 1. Parental
cost shares are determined. The county administrative agency shall
have billing, revenue collection and revenue tracking responsibility
for the parental cost share unless the county administrative agency
delegates these responsibilities to a service provider by written
agreement specifying the conditions of the delegation. A county administrative
agency shall make an assessment of the parental cost share for services
to an eligible child in the following manner:
- a.
Determine the annual income of the parents. When the legally responsible
parents live in separate households and the child eligible for
the birth to 3 program resides in both households, the family
size is determined for each household. There is a separate parental
cost share determined for each household.
- b.
Determine the annual income after disability deduction.
- c.
Determine the federal poverty guidelines for the annual income
after disability deduction and family size.
- d.
Determine the percent above or below the federal poverty guidelines
determined in subd. 1. c., the family’s annual income after disability
deduction determined in subd. 1. b., and assign the parental cost
share according to Table HFS 90.06.
- e.
The maximum parental cost share is $1,800 per year without regard
to the number of children in the birth to 3 program in the family.
When the legally responsible parents live in separate households
and the child eligible for the birth to 3 program resides in both
households, combined cost shares may not exceed $1,800. The cost
shares shall be divided between the parents based on the parents’
relative income.
Table
HFS 90.06
Assignment of Parental Cost Share
| Annual
Income After Disability Deduction |
Annual
Cost Share |
Monthly
Cost Share Payment |
| At
or below 250% of the Federal Poverty Guideline (FPG) |
None |
None
| |
| Over
250% of the FPG and at or below 300% of the FPG |
$300 |
$25
per month |
| Over
300% and at or below 350% of the FPG |
$420 |
$35 per month |
| Over
350% of the FPG and at or below 400% of the FPG |
$600 |
$50
per month |
| Over
400% of the FPG and at or below 500% of the FPG |
$900 |
$75
per month |
| Over
500% of the FPG and at or below 600% of the FPG |
$1200 |
$100
per month |
| Over
600% of the FPG and at or below 700% of the FPG |
$1500 |
$125
per month |
| Over
700% of the FPG |
$1800 |
$150
per month |
Note: The
Federal Poverty Guidelines are adjusted yearly and are published annually
in the Federal Register. The Department will distribute the applicable
Federal Poverty Guidelines information that is effective each year.
To receive the current Federal Poverty Guidelines, contact the Birth
to 3 Program Coordinator at the Division of Disability and Elder Services,
P.O. Box 7851, Madison, WI 53707, or call 608-266-8276, or fax 608-261-6752.
- 2. A parent
who is informed of his or her rights and who knowingly refuses to
provide full financial information is held liable for the maximum
parental cost share.
- 3. A parental
cost share for early intervention services is assessed unless the
parents have financial liability for other services subject to the
uniform fee system that are provided to the eligible child.
- 4. Parents
are informed of their right to request a waiver of the parental cost
share in part or in whole if the request is based on unique circumstances
of the child or family.
- 5. Parents
are informed as early as is administratively feasible of the parents’
rights and responsibilities under the cost share system. The department
shall provide sample brochures to county administrative agencies to
assist the agencies in informing parents.
- 6. Revenue
received from payments of the parental cost share is used only for
early intervention services within the county and do not supplant
county funds required under s. 51.44 (3) (c), Stats.
- (j) Written
consent of the child’s parent is obtained, in accordance with s. HFS 90.12
(2) (b), for provision of early intervention services for the child and
family to implement the IFSP;
- (k) Interagency
agreements are entered into with other local agencies to identify respective
roles and responsibilities in the delivery of early intervention services,
coordinate service delivery, ensure the timely delivery of services and
identify how disputes will be resolved when there is disagreement about
the agency responsible for provision of a particular service;
- (L) The confidentiality
of personally identifiable information about a child, a parent of the child
or other member of the child’s family, in accordance with s. HFS 90.12 (3),
is maintained;
- (n) The need of
a child for a surrogate parent is determined, and a surrogate parent is appointed
in accordance with s. HFS 90.13 if the child needs one;
- (o)
- 1. An early
intervention record is maintained for each child which includes the individualized
family service plan for the child, all records of core services and other
early intervention services received by the child, parental consent documents
and other records pertaining to the child or the child’s family required
by this chapter, and these are made available for inspection by the child’s
parents and representatives of the department;
- 2. The early
intervention record is kept separate from other records on the child maintained
by the agency unless the parent specifically agrees in writing that another
record and the early intervention record be kept together. Other records
that might be kept with the early intervention record are the family support
assessment and plan under s. 46.985, Stats., and ch. HFS 65, and the community
options program assessment under s. 46.27 (6), Stats.
- (p) Local birth
to 3 program records are maintained, including interagency agreements, records
of how funds were budgeted and expended, records of personnel qualifications,
records related to state training plan implementation and copies of contracts
and agreements with service providers, and these are made available for inspection
by representatives of the department; and
- (q) The department
is provided, on request, with information on use of funds, system development,
number of children needing and receiving early intervention services, types
of services needed, types of services provided and such other information
the department requires to describe and assess the operation of the local
program.
History: Cr.
Register, June, 1992, No. 438, eff. 7-1-92; emerg. am. (1), (2) (c), (g) and
(n), renum. (2) (m) to be (2) (m) 1., cr. (2) (m) 2., eff. 1-1-93; am. (1),
(2) (c), (g) and (n), renum. (2) (m) to be (2) (m) 1., cr. (2) (m) 2., Register,
June, 1993, No. 450, eff. 7-1-93; am. (2) (g), renum. (2) (h) to (o) to be (2)
(i) to (p), cr. (2) (h), Register, April, 1997, No. 496, eff. 5-1-97; corrections
in (2) (h) and (n) made under s. 13.93 (2m) (b) 7., Register, September, 1999,
No. 525; emerg. renum. (1) to be (1m) and (2) (i) to (p) to be (2) (j) to (q),
cr. (1) and (2) (i), am. (2) (h), eff. 10-1-01. CR 01-106: renum. (1) to be
(1m) and (2) (i) to (p) to be (2) (j) to (q), cr. (1) and (2) (i), am. (2) (h),
Register February 2002 No. 554, eff. 3-1-02; CR 03-033: r. (2) (m) Register
December 2003 No. 576, eff. 1-1-04.
HFS 90.07 Identification
and referral.
(1) ESTABLISHMENT
OF CHILD FIND SYSTEM. Each county administrative agency shall establish a comprehensive
child find system to ensure that all children who may be eligible for the birth
to 3 program are identified and referred for screening or for evaluation to
determine eligibility for the birth to 3 program. The system shall include public
awareness activities and an informed referral network.
(2) INFORMED
REFERRAL NETWORK.
- (a) A county administrative
agency shall establish a formal system of communication and coordination among
agencies and others within the community serving young children. This referral
network shall identify and include local providers of services related to
early intervention, enhance each provider’s knowledge of eligibility criteria
under this chapter and coordinate referrals to the local birth to 3 program.
- (b) The informed
referral network shall be made up of all primary referral sources. Primary
referral sources include but are not limited to:
- 1. Parents;
- 2. All agencies
which receive funds directly or through a subcontract under relevant federal
programs;
- 3. Health care
providers such as neonatal intensive care units, perinatal follow-through
clinics, hospitals, physicians, public health agencies and facilities,
and rehabilitation agencies and facilities;
- 4. Day care
providers;
- 5. Schools;
and
- 6. Other qualified
personnel and local providers of services to young children and their
families.
(3) SCREENING
AND REFERRAL FOR EVALUATION.
- (a) If the primary
referral source suspects that an infant or toddler has a developmental delay,
the primary referral source shall conduct or request a formal screening to
determine if there is reason to refer the child for an evaluation.
- (b) If the primary
referral source has reasonable cause to believe that a child has a diagnosed
physical or mental condition which has a high probability of resulting in
a developmental delay or has a developmental delay, the primary referral source
shall refer the child for an evaluation. The primary referral source shall
ensure that referral for evaluation is made no more than 2 working days after
a child has been identified.
Note: Referral sources should differentiate between a request or need for
a formal screening and referral for an evaluation. For example, a child diagnosed
as having Down syndrome, which has a high probability of resulting in a developmental
delay, should be referred for an evaluation rather than a formal screening,
whereas a child who seems slow in speech or motor development may first be
formally screened to determine if there is need for an evaluation.
- (c)
- 1. A service
provider may do informal or formal screening of a child as part of the
service provider’s routine observations or intake procedures.
- 2. Following
either a formal or informal screening, the primary referral source or
the service provider shall inform the parent of the reason, procedures
and results of the screening.
Note: While parental consent is not required to screen a child, the service
provider is encouraged to give the parent information about the screening
process before conducting the screening.
History: Cr.
Register, June, 1992, No. 438, eff. 7-1-92; am. (1), (3) (b) 2., Register, April,
1997, No. 496, eff. 5-1-97; am (1), r. and recr. (3), Register, September, 1999,
No. 525, eff. 10-1-99.
HFS 90.08 Evaluation.
(1) DESIGNATION
OF SERVICE COORDINATOR. When a child is referred to the birth to 3 program for
evaluation and possible early intervention services, the county administrative
agency shall as soon as possible designate a service coordinator for that child
and the child’s family.
(2) DETERMINATION
OF ELIGIBILITY. A referred child shall be evaluated in accordance with the criteria
under sub. (4) to determine the child’s eligibility for early intervention services
under the program.
(3) EI TEAM.
- (a) In consultation
with the parent and based on the child’s suspected needs, the service coordinator
shall select at least 2 qualified personnel from those under par. (b) who,
with the parent and service coordinator, will make up the EI team to perform
the evaluation and make the determination of eligibility. Qualified personnel
may be from different agencies and shall be from at least 2 different disciplines
in areas of suspected need. The service coordinator may be one of the qualified
personnel if the service coordinator is qualified as required under par. (b).
At least one of the qualified personnel shall have expertise in the assessment
of both typical and atypical development and expertise in child development
and program planning.
- (b) Qualified personnel
who are qualified to serve on the EI team are the following:
- 1. Audiologists
with at least a master’s degree in audiology from an accredited institution
of higher education who are registered or licensed under ch. 459, Stats.;
- 2. Nutritionists
registered as dietitians by or eligible for registration as dietitians
by the American dietetic association;
- 3. Occupational
therapists licensed under ch. 448, Stats.;
- 4. Physical
therapists licensed under ch. 448, Stats.;
- 5. Physicians
licensed under ch. 448, Stats.;
- 6. Psychologists
licensed under ch. 455, Stats.;
- 7. Rehabilitation
counselors employed by the department’s division of vocational rehabilitation
as coordinators of hearing impaired services who have at least a master’s
degree in rehabilitation counseling or a related field;
- 8. Registered
nurses with at least a bachelor’s degree in nursing from an accredited
institution of higher education and licensed under s. 441.06, Stats.;
- 9. School psychologists
licensed under ch. 115, Stats., and ch. PI 34;
- 10. Social
workers certified under ch. 457, Stats.;
- 11. Special
education teachers, including early childhood special education needs
teachers, vision teachers and hearing teachers, licensed through the department
of public instruction;
- 12. Speech
and language pathologists with at least a master’s degree in speech and
language pathology from an accredited institution of higher education
and who are registered under ch. 459, Stats., or licensed under ch. 115,
Stats., and ch. PI 34; and
- 13. Other persons
qualified by professional training and experience to perform the evaluation
and determine eligibility.
(4) ELIGIBILITY.
A child is eligible for early intervention services under the birth to 3 program
if the EI team determines under sub. (5) that the child is developmentally delayed
or under sub. (6) that the child has a diagnosed physical or mental condition
which will likely result in developmental delay.
(5) DETERMINATION
OF DEVELOPMENTAL DELAY.
- (a) A determination
of developmental delay shall be based upon the EI team’s clinical opinion
supported by:
- 1. A developmental
history of the child and other pertinent information about the child obtained
from parents and other caregivers;
- 2. Observations
made of the child in his or her daily settings identified by the parent, including
how the child interacts with people and familiar toys and other objects in
the child’s environment; and
- 3. Except as provided
under par. (b), a determination of at least 25% delay in one or more areas
of development as measured by a criterion referenced instrument, or a score
of 1.3 or more standard deviation below the mean in one or more areas of development
as measured by a norm-referenced instrument, and interpreted by a qualified
professional based on informed clinical opinion. In this subdivision, “areas
of development” mean:
- a. Cognitive
development;
- b. Physical
development, including vision and hearing;
- c. Communication
development;
- d. Social and
emotional development; and
- e. Adaptive
development which includes self-help skills.
(b) If the results
of the formal testing under par. (a) 3. closely approach but do not equal the
standard in par. (a) 3. for a developmental delay but observation by qualified
personnel or parents indicates that some aspect of the child’s development is
atypical and is adversely affecting the child’s overall development, the EI
team may use alternative procedures or instruments that meet acceptable professional
standards to document the atypical development and to conclude, based on informed
clinical opinion, that the child should be considered developmentally delayed.
Note: Examples of atypical developments are asymmetrical movement, variant speech
and language patterns, delay in achieving significant interactive milestones
such as exhibiting a pleasurable response to a caregiver’s attention, and presence
of an unusual pattern of development such as a sleep disturbance or eating difficulties.
(6) DETERMINATION
OF DIAGNOSED CONDITION. A determination of high probability that a child’s
diagnosed physical or mental condition will result in a developmental delay
shall be based upon the EI team’s informed clinical opinion supported by a
physician’s report documenting the condition. High probability implies that
a clearly established case has been made for a developmental delay.
Note: Examples of these diagnosed conditions are chromosomal disorders such
as Down syndrome, birth defects such as spina bifida, significant or progressive
vision or hearing impairment, neuromotor disorders such as cerebral palsy,
postnatal traumatic events such as severe head injuries, severe emotional
disturbances, dysmorphic syndromes such as fetal alcohol syndrome, addiction
at birth, a maternal infection transmitted to the fetus such as AIDS, neurological
impairments of unknown etiology such as autism, untreated metabolic disorders
such as PKU and certain chronic or progressive conditions.
(7) EI TEAM
PROCEDURE.
- (a) The service
coordinator shall ensure that the parents of the child are involved and
consulted throughout the entire evaluation process.
- (b) The EI team
shall examine all relevant available data concerning the child, including
the following:
- 1. Medical
records and other health records concerning the child’s medical history
and health status, including physical examination reports, results of
vision and hearing screenings, hospital discharge records and specialty
clinic reports;
- 2. Any records
and screening results of the child’s developmental functioning in the
following areas:
- a. Cognitive
development;
- b. Physical
development, including vision and hearing;
- c. Communication
development;
- d. Social
and emotional development; and
- e. Adaptive
development which includes self-help skills; and
- 3. Records
of any previous interventions provided to the child, including therapy
reports, treatment records and service plans.
- (c) The EI team
shall use additional observation, screening results and other testing instruments
and procedures as needed, to determine the child’s level of functioning
in each of the following areas of development:
- 1. Cognitive
development, as evidenced by play skills, manipulation of toys, sensorimotor
schemes, attention, perceptual skills, memory, problem solving and reasoning;
- 2. Physical
development, including hearing and vision, as evidenced by gross motor
and fine motor coordination, tactility, health and growth. If there
has not been a physical examination of the child in the past 2 months,
one shall be requested if appropriate;
- 3. Communication
development, as evidenced by understanding, expression, quantity and
quality of speech sounds or words, and communicative intent through
gestures. Communication development includes the acquisition of communications
skills during pre-verbal and verbal phases of development; receptive
and expressive language, including spoken, non-spoken and sign language
means of expression; oral-motor development; auditory awareness skills
and processing; the use of augmentative communication devices; and speech
production and awareness.
- 4. Social
and emotional development, as evidenced by temperament, mood attachment,
self-soothing behaviors, adaptability, activity level, awareness of
others and interpersonal relationships; and
- 5. Adaptive
development which includes self-help skills, to include drinking, eating,
eliminating, dressing and bathing.
- (d) Testing instruments
and other materials and procedures employed by the EI team shall meet the
following requirements:
- 1. They shall
be administered or provided in the child’s or family’s primary language
or other mode of communication. When this is clearly not possible, the
circumstances preventing it shall be documented in the child’s early
intervention record;
- 2. They may
not be racially or culturally discriminatory;
- 3. They shall
be validated for the specific purpose and age group for which they are
used;
- 4. They shall
be administered by trained personnel in accordance with instructions
of the developer;
- 5. They shall
be tailored to assess the specific area of development and not simply
provide a single general intelligence quotient; and
- 6. In regard
to tests, they shall be selected to ensure that when they are administered
to a child with impaired sensory, manual or speaking skills, the test
results accurately reflect what the tests purport to measure.
- (e) No single
procedure may be used as the sole criterion for determining eligibility.
- (f) With the
parent’s consent, members of the EI team may consult with persons not on
the EI team to help the EI team members determine if the child needs early
intervention services.
- (g) Following
the evaluation, all members of the EI team shall jointly discuss their findings
and conclusions and determine if there is documentation, data or other evidence
that the child is developmentally delayed or has a condition which has a
high probability of resulting in delayed development. If a member cannot
be present, that member shall be involved through other means, such as participating
in a conference call, or be represented by someone who is knowledgeable
about the child and about the member’s findings and conclusions.
- (h) At the conclusion
of the joint discussion under par. (g), the EI team shall prepare a report
which shall include each member’s findings and conclusions and be signed
by all members of the team. If a member participated through a conference
call, the signature may be by proxy. The report shall include:
- 1. Results
of the evaluation, including levels of functioning in the areas of development
under sub. (5) (a) 3.; and
- 2. A determination
of either eligibility or non-eligibility, with a determination of eligibility
accompanied by documentation of the child’s developmental delay or diagnosed
condition.
- (i) The service
coordinator shall provide the child’s parent with a copy of the EI team’s
report.
- (j) If the EI
team finds that the child is not eligible, the EI team report shall in addition
include:
- 1. An offer
to re-screen the child within 6 months;
- 2. Information
about community services that may benefit the child and family, such
as day care, parent support groups or parenting classes; and
- 3. A statement
that, if the parent requests it and consents to it, referral will be
made to other programs from which the child and family may benefit and
that the service coordinator will assist the parent in locating and
gaining access to other services.
- (k) If the parent
chooses not to take part in the evaluation process or development of the
report, the service coordinator shall meet with the parent upon completion
of the evaluation to discuss the findings and conclusions of the EI team.
The service coordinator shall document in the child’s early intervention
record why the parent was not involved and the steps taken to share the
findings and conclusions of the EI team with the parent.
(8)
EFFECT OF RELOCATION OF ELIGIBLE CHILD. When the family of a child who
has been determined eligible for early intervention services based on
an EI team evaluation moves to another county, the child shall remain
eligible for services in the new county of residence on the basis of the
original determination of eligibility. The services identified in the
IFSP in effect on the date that the family moves to the new county shall
be provided until a new IFSP is developed.
History: Cr. Register, June, 1992, No. 438, eff. 7-1-92; emerg.
am. (3) (b) 11., 12. and (8), cr. (3) (b) 13., r. (7) (h) 2., eff. 1-1-93;
am. (3) (b) 11., 12. and (8), cr. (3) (b) 13., renum. (7) (h) 1. (intro.)
to be (7) (h) (intro.), r. (7) (h) 2., Register, June, 1993, No. 450,
eff. 7-1-93; am. (1), (3) (a), (b) 10., (5) (a) 3., (7) (b) 1., (g), (h)
(intro.), Register, April, 1997, No. 496, eff. 5-1-97; am. (7) (k), Register,
September, 1999, No. 525, eff. 10-1-99; CR 03-033: am. (3) (b) 3. and
11. Register December 2003 No. 576, eff. 1-1-04; corrections in (3) (b)
9. and 12. made under s. 13.93 (2m) (b) 7., Stats., Register December
2004 No. 588.
HFS 90.09
Assessment.
(1)
ASSESSMENT OF CHILD.
- (a)Initial
assessment.
- 1. Once
a child is determined under s. HFS 90.08 to be eligible for early
intervention services, the EI team shall, as needed, carry out additional
observations, procedures and testing to assess and determine the
child’s unique developmental needs. All assessment tests and other
materials and procedures shall comply with s. HFS 90.08 (7) (d).
- 2. Following
the assessment under subd. 1., the EI team shall prepare a report.
This report need not be a separate document but may be made part
of the EI team’s report under s. HFS 90.08 (7) (h) or the IFSP under
s. HFS 90.10. The report shall include:
- a.
A summary of the assessment, including the child’s strengths
and needs; and
- b.
A list of potential services needed.
- 3. The
service coordinator shall provide the child’s parent with a copy
of the assessment report.
- (b) Ongoing
assessment. Ongoing assessments shall be carried on as needed by
either the EI team or the IFSP team. All ongoing assessments shall meet
the requirements in par. (a).
- (c) Discussion
with nonparticipating parent. If the parent chooses not to take
part in the assessment or development of the report, the service coordinator
shall meet with the parent upon completion of the assessment to discuss
the findings and recommendations. The service coordinator shall document
in the child’s early intervention record why the parent was not involved
and the steps taken to share the findings and recommendations of the
assessment report with the parents.
(2)
FAMILY-DIRECTED ASSESSMENT.
- (a) Any assessment
of the child’s family shall be with the family’s permission. The assessment
shall be directed by the family and shall focus on the family’s strengths,
resources, concerns and priorities related to enhancing development of the
child.
- (b) An assessment
of the family shall:
- 1. Be completed
by the family alone with a choice of assessment tools offered to the
family, or be completed by the family in collaboration with other personnel
trained to make use of appropriate formal or informal methods and procedures;
- 2. Be based
on information provided by family members through personal interviews;
and
- 3. Incorporate
the family members’ description of the family’s strengths, resources,
concerns and priorities as these are related to enhancing the child’s
development.
History: Cr. Register, June, 1992, No. 438, eff. 7-1-92; am.
(2) (a), Register, June, 1993, No. 450, eff. 7-1-93; am. (1) (a), 2.,
Register, April, 1997, No. 496, eff. 7-1-97.
HFS 90.10
Development of service plan.
(1)TIME
LIMIT. Except as provided in sub. (2) (a), within 45 days after receiving
a referral for initial evaluation of a child, the county administrative
agency shall complete the evaluation under s. HFS 90.08 and the assessment
under s. HFS 90.09 and the service coordinator shall convene a meeting
to develop the initial IFSP.
(2)
INTERIM IFSP.
- (a) Delay
in completing evaluation and assessment. If exceptional circumstances
directly affecting the child or the child’s family, such as illness
of the child or a parent or the parent’s refusal to consent to a procedure,
make it impossible to complete the evaluation and assessment within
45 days, the county administrative agency shall:
- 1. Document
the exceptional circumstances in the child’s early intervention
record;
- 2. Ensure
that the service coordinator, the parent, at least one of the qualified
personnel directly involved in the child’s evaluation and assessment
and, as appropriate, persons who will be providing services for
the child and family develop and implement an interim IFSP which
includes the service coordinator’s name, the early intervention
services that are needed immediately and the circumstances and reasons
for development of the interim IFSP;
- 3. Obtain
the parent’s written consent to the services, and to a revised deadline
for completion of the evaluation and assessment; and
- 4. Complete
the evaluation within the extended period agreed upon by the family
and EI team.
- (b) Provision
of services before completing evaluation and assessment. Provision
of early intervention services to a child and the child’s family may
be started before the evaluation and assessment are completed if there
is a clear and obvious need that can be addressed without waiting for
completion of the formal evaluation and assessment and if the following
conditions are met:
- 1. The
parent gives written consent for the services;
- 2. An
interim IFSP is developed and implemented by the service coordinator,
parent, at least one of the qualified personnel directly involved
in the child’s evaluation and assessment and, as appropriate, persons
who will be providing services for the child and family, which includes
the service coordinator’s name, the early intervention services
that are needed immediately and the circumstances and reasons for
development of the interim IFSP; and
- 3. The
evaluation and assessment are completed within the time period prescribed
in sub. (1).
(3)
IFSP TEAM. The IFSP team shall consist of the parent, other family members
requested by the parent, the service coordinator, an advocate if requested
by the parent, at least one of the qualified personnel who took part in
the evaluation and assessment of the child, at least one professional
who has expertise in assessment of both typical and atypical development
and expertise in child development and program planning, and appropriate
service providers. If a professional who took part in the evaluation and
assessment cannot be present at a meeting to develop the IFSP, the service
coordinator shall ensure that the professional is involved through some
other means.
(4)
MEETING TO DEVELOP IFSP. The IFSP shall be developed on the basis of the
evaluation and assessment by the IFSP team and with attention to the concerns
and priorities of the parent. All meetings shall be conducted in settings
and at times that are convenient to families, and the service coordinator
shall ensure that written notice of a meeting is provided to all participants
early enough before the meeting date so that they will be able to attend.
If the parent wishes to attend but cannot attend at the scheduled time,
the meeting shall be rescheduled.
(5)
CONTENT. The IFSP may have several different sections that are completed
at various times throughout the process. All sections of the IFSP shall
be maintained in one file or binder. The parents shall be given a copy,
the contents of which shall be fully explained to the parents and kept
current. The IFSP shall contain:
- (a) Information
about the child’s developmental status, including statements concerning
the child’s present levels of cognitive development, physical development,
to include vision, hearing and health status, communication development,
social and emotional development and adaptive development such as self-help
skills, based on professionally acceptable objective criteria. This
information shall be assembled from the initial evaluation and assessment
reports and the results of any ongoing assessments.
- (b) With
the concurrence of the parent, a summary of the family’s strengths,
resources, concerns and priorities related to enhancing the development
of the child;
- (c) A statement
of the outcomes expected to be achieved for the child and family, as
identified by the IFSP team, and the criteria, procedures and timelines
used to determine:
- 1. Progress
being made toward achieving the outcomes; and
- 2. Whether
modification of the outcomes or services is necessary;
- (d) Identification
of the specific early intervention services necessary to achieve the
outcomes identified in par. (e), including:
- 1. The
frequency and intensity of a service, to include the number of days
or sessions it will be provided, the length of time the service
will be provided during a session and whether the service will be
provided on an individual or group basis;
- 2. The
locations where early intervention services will be provided. This
list shall be accompanied by a statement that describes the environments
in which early intervention services are provided, with justification
if a specific early intervention service will not be provided in
a natural environment.
- 3. How
a service will be provided;
- 4. Payment
arrangements, if any;
- 5. If
appropriate, medical and other services that the child needs that
are not required under the birth to 3 program and the steps that
will be taken to secure those services from public or private sources.
This does not apply to routine medical services such as immunizations
and well baby care unless a child needs those services and they
are not otherwise available or being provided; and
- 6. The
projected dates for initiating the services and the expected duration
of the services;
- (e) The name
of the service coordinator who will be responsible for the implementation
of the IFSP and coordination with other agencies and individuals. This
may be the same service coordinator who was originally designated at
the time the child was initially referred for evaluation or a new service
coordinator;
- (f) A written
plan for the steps to be taken to support the child and family through
transitions, including the transition upon reaching the age of 3 to
a preschool program under subch. V of ch. 115, Stats., or to other appropriate
services for children who may not be eligible for a preschool program
under subch. V of ch. 115, Stats. These steps shall include:
- 1. Discussing
a prospective transition in advance with the parents and giving
them information about the new setting and other matters related
to the child’s transition including the role of the family;
- 2. Implementing
procedures to prepare the child for changes in service delivery,
including helping with adjustment to and functioning in the new
setting;
- 3. With
parental consent, forwarding of information about the child to the
local educational agency or other service agency to assure continuity
of services; and
- 4. In
the case of a child who may be eligible for a preschool program
under subch. V of ch. 115, Stats., convening, with the approval
of the family, a conference involving the family, the county administrative
agency and the local educational agency responsible for preschool
programs under subch. V of ch. 115, Stats., at least 90 days before
the child reaches the age of 3, in order to:
- a.
Prepare a written transition plan to reflect decisions made
at the conference and the roles of sending and receiving agencies;
and
- b.
Review the child’s program options for the period from the child’s
third birthday through the remainder of the school year.
Note:
A child with exceptional educational needs, as defined in s. 115.76
(3), Stats., on reaching age 3 is entitled to a free appropriate
public education in accordance with ch. PI 11.
- 5. In
the case of a child who may not be eligible for preschool programs
under subch. V of ch. 115, Stats., making reasonable efforts to
convene, with the approval of the family, a conference involving
the family, the county administrative agency and other agencies
providing services for children not eligible for preschool programs
assisted under subch. V of ch. 115, Stats., in order to:
- a.
Discuss the appropriate services the child may receive; and
- b.
Prepare a written transition plan to reflect decisions made
at the conference and the role of sending and receiving agencies.
Note: While subds. 4. and 5. require a conference for a child’s
transition at age 3 from the Birth to 3 program to a preschool
program under subch. V of ch. 115, Stats., or to other appropriate
services, the county administrative agency is encouraged, whenever
there is a change in an agency providing services to the child
and the child’s family, to convene a conference with the family
and the sending and receiving agencies to develop a plan to
support the child and family and define the role of the agencies.
- (g) Provision
in accordance with sub. (7) for ongoing review, evaluation and, as necessary,
revision of the plan.
- (h) The projected
dates for the periodic review and annual evaluation of the plan in accordance
with sub. (7).
(6)
CONSOLIDATED PLAN. If an eligible child is required to have both an IFSP
and an individualized service plan under another federal or state program,
the county administrative agency may develop a single consolidated document
provided that the document contains all of the information required for
the contents of the IFSP under sub. (5) and is developed in accordance
with the requirements of this chapter.
(7)
REVIEW AND EVALUATION.
- (a) Periodic
review. A review of an IFSP shall take place every 6 months or more
frequently if warranted or a parent requests it. The review shall be
carried out at a meeting or by other means acceptable to the parent
and other participants and shall involve at least the parent or parents
and the service coordinator, other family members if requested by a
parent, and an advocate or other person from outside the family if requested
by a parent. If conditions warrant, provision shall be made to include
persons directly involved in conducting the evaluation and assessment
and, as appropriate, persons providing services to the child or family.
The purpose of the review is to determine:
- 1. The
progress being made toward achieving the planned outcomes; and
- 2. Whether
modification or revision of the planned outcomes or services is
necessary.
- (b) Annual
meeting.
- 1. At
least annually the service coordinator shall convene a meeting at
which the IFSP shall be evaluated and, as appropriate, revised.
To the extent possible, participants shall be those persons who
participated in the development of the IFSP or reviews under par.
(a) and, in addition, a person or persons directly involved in conducting
the evaluation and assessment and, as appropriate, persons providing
services to the child or family. If a professional who was directly
involved in the evaluation and assessment cannot be present at the
annual meeting to evaluate the IFSP, the service coordinator shall
ensure that the professional is involved through other means such
as participating in a conference call, having a knowledgeable representative
attend the meeting or making pertinent records available for the
meeting.
- 2. The
meeting shall be conducted in a setting and at a time that is convenient
to families, and written notice of a meeting shall be provided to
all participants early enough before the meeting date to ensure
that they will be able to attend.
- 3. To
ensure that parents fully understand and are active participants
in the IFSP process, all meetings shall be conducted with someone
present who can interpret for the family if the family’s native
language is different from the language at the meeting, unless this
is not feasible.
History:
Cr. Register, June, 1992, No. 438, eff. 7-1-92; emerg. r. and recr. (2)
(a) 2. and (5) (h), am. (2) (b) 2., (3), (5) (intro.), (g), (7) (a) (intro.)
and (b) 1., cr. (7) (b) 3., eff. 1-1-93; r. and recr. (2) (a) 2. and (5)
(h), am. (2) (b) 2., (3), (5) (intro.), (g), (7) (a) (intro.) and (b)
1., cr. (7) (b) 3., Register, June, 1993, No. 450, eff. 7-1-93; am. (5)
(a) and (7) (a) (intro.), r. (5) (b), (c) and (h), renum. (5) (d) to (g)
to be (5) (b) to (e) and (5) (i) to be (5) (g), cr. (5) (f) and (h), Register,
April, 1997, No. 496, eff. 5-1-97; r. and recr. (5) (d) 2., am. (5) (f)
(intro.) and 4. (intro.), cr. (5) (f) 5., Register, September, 1999, No.
525, eff. 10-1-99; CR 03-033: am. (2) (b) (intro.) Register December 2003
No. 576, eff. 1-1-04.
HFS 90.11 Service
provision. (1) COORDINATION.
- (a) Role
of the service coordinator. The service coordinator shall coordinate
the delivery of all services across agency lines and serve as the single
point of contact in helping a family obtain the services the child and
family need as described in the IFSP.
- (b) Functions
of the service coordinator. Service coordination activities include:
- 1. Coordinating
the performance of evaluation and assessments as described in ss.
HFS 90.08 and 90.09;
- 2. Facilitating
and participating in development, review and evaluation of the IFSP;
- 3. Assisting
parents in identifying available service providers;
- 4. Facilitating
access to services and coordinating and monitoring the timely provision
of services;
- 5. Informing
parents of the availability of advocacy services;
- 6. Coordinating
with medical and other health care providers; and
- 7. Facilitating
the development of transition plans under s. HFS 90.10 (5) (f).
- (c) Qualifications
of the service coordinator. 1. A service coordinator shall have at least
one year of supervised experience working with families with special
needs, and have demonstrated knowledge and understanding about:
- a. Children
in the age group birth to 3 who are eligible for the program;
- b. Part
C and the federal implementing regulations, 34 CFR Pt. 303, and
this chapter; and
- c. The
nature and scope of services available under the birth to 3 program
and how these are financed.
- 2. The service
coordinator may be a person from the list of qualified personnel in
s. HFS 90.08 (3) (b), another person with experience and training indicated
under subd. 1. or a parent facilitator.
(2) EARLY
INTERVENTION SERVICES—GENERAL CONDITIONS AND GENERAL ROLE OF PROVIDERS.
(a) General conditions
for early intervention services.
- 1. Appropriate
early intervention services for an eligible child and the child’s family,
provided to the maximum extent appropriate to the needs of the child in
natural environments, including the home and community settings in which
children without disabilities participate, shall be based on the developmental
needs of the child and shall be provided with the written consent of the
parent. Services shall be provided in collaboration with the parent, by
qualified personnel, and in compliance with this chapter and Part C requirements.
- 2. The county
administrative agency shall provide or arrange for the provision of early
intervention core services at no cost to the child’s parent and shall provide
or arrange for the provision of other early intervention services identified
in the child’s IFSP. The county administrative agency shall determine the
parental cost share of early intervention services costs not met by third
party payers in accordance with s. HFS 90.06 (2) (i).
- 3. Funds allocated
for the birth to 3 program may not be used to satisfy a financial commitment
for services that would have been paid for from another public or private
source if it were not for the establishment of the program. Funds allocated
for the birth to 3 program may only be used for early intervention services
that an eligible child needs but is not currently entitled to under any
other federal, state, local government or private funding source.
Note: Federal law at 20 USC 1479 permits the use of birth to 3 program funds
to provide a free and appropriate public education, in accordance with the
requirements of 20 USC 1411 to 1420, to children with disabilities from
their third birthday to the beginning of the following school year.
(b)General role
of early intervention service providers.
- 1. A provider
of early intervention services shall do all of the following:
- a. Follow
the requirements of this chapter;
- b. Consult
with parents, other service providers and community agencies to ensure
that the service is effective;
- c. Educate
parents, other service providers and community agencies in regard to
the provision of that type of service;
- d. When a
member of the team, participate in the EI team’s assessment of a child,
any family-directed assessment of the family and development of integrated
goals and outcomes for the IFSP;
- e. When a
member of the team, train other team members to implement aspects of
his or her discipline according to standards of practice of the discipline;
and
- f. Make a
good faith effort to assist each eligible child in achieving the outcomes
of the child’s IFSP.
- 2. Service providers,
including service coordinators, shall attend or otherwise avail themselves
of 5 hours of training each year related to early intervention. For service
providers without previous experience with Wisconsin’s early intervention
program, the 5-hour training requirement in the first year of service provision
shall include a basic orientation to the program. Training may be inservice
training, conferences, workshops, earning of continuing education credits
or earning of higher education credits.
- 3. A service
provider is not liable if an eligible child does not achieve the growths
projected in the child’s IFSP.
(3) EARLY
INTERVENTION CORE SERVICES.
- (a) County administrative
agencies shall make the following core services available at no cost to
all families that have a child who is eligible or may be eligible for the
birth to 3 program:
- 1. Identification
and referral;
- 2. Screening;
- 3. Evaluation;
- 4. Assessment
for an eligible child;
- 5. Development
of the IFSP for an eligible child and family;
- 6. Service
coordination for an eligible child and family; and
- 7. Protection
of parent and child rights by means of the procedural safeguards.
- (b) With parent
consent a third party may be billed for evaluation and assessment activities.
The service coordinator shall ensure that the parent, prior to giving consent,
is informed and understands that because of third party billing the parent
may incur financial loss, including but not limited to a decrease in benefits
or increase in premiums or discontinuation of the policy.
(4) OTHER EARLY
INTERVENTION SERVICES.
A county administrative agency shall provide or arrange for the provision of
other early intervention services. The county administrative agency shall determine
the parental cost share of early intervention services costs not met by third
party payers in accordance with s. HFS 90.06 (2) (i). Parental cost share for
early intervention services shall begin with services designated in IFSPs developed
or reviewed on or after March 1, 2002. Types of other early intervention services
include the following:
- (a) Assistive
technology services and devices. Assistive technology services and devices,
to include:
- 1. Evaluating
the needs of a child with a disability for an assistive technology device,
including a functional evaluation of the child in the child’s customary
environment;
- 2. Purchasing,
leasing or otherwise providing for the acquisition of assistive technology
devices for children with disabilities;
- 3. Selecting,
designing, fitting, customizing, adapting, applying, maintaining, repairing
or replacing assistive technology devices;
- 4. Coordinating
and using other therapies, interventions or services with assistive
technology devices, such as those associated with existing education
and rehabilitation plans and programs;
- 5. Training
or technical assistance for a child with disabilities or, if appropriate,
the family of a child with disabilities, in the use of an assistive
technology device; and
- 6. Training
or technical assistance for professionals, including individuals providing
education or rehabilitation services, employers and other individuals
who provide services to or are otherwise substantially involved in the
major life functions of children with disabilities.
- (b) Audiology
services. Audiology services, to include:
- 1. Identification
of children with audiological impairment, using risk criteria and appropriate
audiological screening techniques;
- 2. Determination
of the range, nature and degree of hearing loss and communication functions
by use of audiological evaluation procedures;
- 3. Referral
for medical and other services necessary for habilitation or rehabilitation;
- 4. Provision
of auditory training, aural rehabilitation, speech reading and listening
device orientation and training;
- 5. Provision
of services for prevention of hearing loss;
- 6. Determination
of the child’s need for individual amplification, including selecting,
fitting and dispensing appropriate listening and vibrotactile devices,
and evaluating the effectiveness of those devices; and
- 7. Provision
of consultation to and training of parents, other service providers
and community agencies in regard to audiology services.
- (c) Communication
services. Communication services, also called speech and language services,
to include:
- 1. Identification,
diagnosis and assessment of children with communicative or oral pharyngeal
disorders or delays in development of communication skills, which include
delays in the acquisition of communication skills during preverbal and
verbal phases of development; in the development of receptive and expressive
language, including spoken and non-spoken means of expression; in oral-motor
development; and in auditory awareness and processing. This also includes
identification of the need for the acquisition of sign language and
augmentative communication devices or systems;
- 2. Referral
for and coordination with medical or other professional services necessary
for the habilitation or rehabilitation of children with communicative
or oral pharyngeal disorders and delays in development of communication
skills;
- 3. Services
for the habilitation, rehabilitation or prevention of communicative
or oropharyngeal disorders and delays in development of communication
skills, including services directed at the acquisition of sign language,
the development of auditory awareness skills and speech production and
the use of augmentative communication devices;
- 4. Development
of augmentation devices or systems, including communication boards and
sign language; and
- 5. Provision
of consultation to and training of parents, other service providers
and community agencies in regard to communication services.
- (d) Family education
and counseling services. Family education and counseling services, to include:
1. Services provided
by qualified personnel to assist the family or caregiver in caring for the child,
understanding the special needs of the child, enhancing the child’s development,
modeling appropriate parent-child interactions and providing information on
child development; and
2. Providing informal
support and connecting parents with other parents. This may include parent to
parent match programs and parent support groups.
(e) Health care services.
- 1. Health care
services necessary to enable a child to benefit from other early intervention
services under this subsection while receiving those other early intervention
services. These include:
- a. Clean
and intermittent catheterization; tracheotomy care; tube feeding, changing
a dressing or colostomy collection bag and other health care services;
and
- b. Consultation
provided by physicians to other service providers concerning the special
health care needs of eligible children that have to be addressed in
the course of providing early intervention services.
- 2. “Health care
services” does not include:
a. Services that
are surgical in nature such as cleft palate surgery or surgery for club foot;
b. Services that
are purely medical in nature such as hospitalization for management of a congenital
heart ailment or the prescribing of medicine or drugs for any purpose;
c. Devices necessary
to control or treat a medical condition; or
d. Medical health
services such as immunizations and “well baby” care that are routinely recommended
for all children.
(f) Medical services.
Medical services only for diagnostic or evaluation purposes. These are services
provided by a licensed physician to determine a child’s developmental status
and need for early intervention services.
(g) Nursing services.
Nursing services, to include:
- 1. The assessment
of health status for the purpose of providing nursing care, including identification
of patterns of human response to actual or potential health problems, and
the assessment of home environment and parent-child interactions for the
purpose of providing interventions and referrals to support parents and
enhance the child’s development;
- 2. Provision
of nursing care to prevent health problems, restore or improve functioning
and promote optimal health and development. This includes identification
of family concerns and coordination of available resources to meet those
concerns;
- 3. Administration
of medications, treatments and regimens prescribed by a physician licensed
under ch. 448, Stats.; and
- 4. Provision
of consultation to and training of parents, other service providers and
community agencies in regard to nursing services.
(h) Nutrition services.
- 1. Nutrition
services, to include:
- a. Identifying
dietary and nutritional needs;
- b. Developing
and monitoring appropriate nutritional plans based on assessment results;
- c. Conducting
individual assessments in nutritional history and dietary intake: anthropometric,
biochemical and clinical variables; feeding skills and feeding problems;
and food habits and food preferences;
- d. Providing
nutritional treatment and intervention and counseling parents and caregivers
on appropriate nutritional intake, based on assessment results; and
- e. Making
referrals to appropriate community resources to carry out nutritional
goals.
- 2. “Nutrition
services” does not include coverage of the cost of food supplements, vitamins
or prescription formulations designed to improve or maintain a child’s nutritional
status.
(i) Occupational
therapy services. Occupational therapy services that address the functional
needs of a child related to the performance of self-help skills or to adaptive
development, and to adaptive behavior and play, and sensory, motor and postural
development. These services are designed to improve the child’s functional ability
in home and community settings and include:
1. Identification,
assessment and intervention;
2. Adaptation of
the environment, and selection, design and fabrication of assistive and orthotic
devices to facilitate development and promote the acquisition of functional
skills;
3. Prevention or
minimization of the impact of initial or future impairment, delay in development
or loss of functional ability; and
4. Provision of consultation
to and training of parents, other service providers and community agencies in
regard to occupational therapy services.
(j) Physical therapy.
Physical therapy services to promote sensorimotor functions through the enhancement
of musculoskeletal status, neurobehavioral organization, perceptual and motor
development, cardiopulmonary status and effective environmental adaption. These
services include:
- 1. Screening,
evaluation and assessment of infants and toddlers to identify movement dysfunction;
- 2. Obtaining,
interpreting and integrating information appropriate to program planning,
to prevent, alleviate or compensate for movement dysfunctions and related
functional problems;
- 3. Providing
individual and group services and treatment to prevent, alleviate or compensate
for movement dysfunction and related functional problems; and
- 4. Provision
of consultation to and training of parents, other service providers and
community agencies in regard to physical therapy services.
(k) Psychological
services. Psychological services, to include:
- 1. Administering
psychological and developmental tests and other assessment procedures, interpreting
results, and obtaining, integrating and interpreting information about child
behavior and child and family conditions related to learning, mental health
and development;
- 2. Planning and
managing a program of psychological services, including psychological counseling
for children and parents, family counseling, consultation on child development,
and parent education; and
- 3. Provision
of consultation to and training of parents, other service providers and
community agencies in regard to psychological services.
(L) Social work
services. Social work services, to include:
- 1. Making home
visits to evaluate a child’s living conditions and patterns of parent-child
interactions;
- 2. Preparing
a social and emotional developmental assessment of the child within the
family context;
- 3. Providing
individual and family group counseling with parents and other family members,
and appropriate social skill- building within the family context;
- 4. Working with
problems in a child’s and family’s living situation, at home, in the community
and at any center where early intervention services are provided, that affect
the child’s maximum utilization of early intervention services; and
- 5. Identifying,
mobilizing and coordinating community resources and services to enable the
child and family to receive maximum benefit from early intervention services;
and
- 6. Provision
of consultation to and training of parents, other service providers and
community agencies in regard to social work services.
(m) Special instruction.
Special instruction, to include:
- 1. Evaluation
and assessment in all areas of development;
- 2. Designing
learning environments and activities that promote the child’s acquisition
of skills in a variety of developmental areas including cognitive processes,
communication, motor skills and social interaction;
- 3. Curriculum
planning, including the planned interaction of personnel, materials and
time and space, that leads to achieving the outcomes in the child’s individualized
family service plan;
- 4. Providing
families with information, skills and support related to enhancing the skill
development of the child;
- 5. Working with
a child to enhance the child’s development;
- 6. Working with
other providers to develop an understanding of the child’s disability and
the impact of that disability on the child’s development;
- 7. Providing
support and consultation to child care providers and others in integrated
child care settings; and
- 8. Provision
of consultation to and training of parents, other service providers and
community agencies in regard to special instruction services.
(n) Transportation
and related costs of travel. Transportation and related costs of travel,
whether mileage or by taxi, common carrier or other means, and including tolls
and parking, necessary to enable an eligible child and the child’s family to
receive early intervention services.