Current through Register Vol. 48, No. 38, September 20, 2024
a)
Requirements Related to the Provision of FAPE
1) A school district is responsible for
developing students' IEPs and remains responsible for ensuring that children
receive all the services described in their IEPs in a timely fashion,
regardless of whether another agency will ultimately pay for the
services.
2) A school district may
look to non-educational entities such as insurance companies and the Medicaid
program, to pay for services for which these entities are otherwise
responsible. The district must have written consent from parents in order to
use their private insurance.
3)
Services required by an IEP must be provided at no cost to the child's parents,
whether they have public or private insurance. Parents shall be notified that
the use of their private insurance proceeds to pay for services is voluntary.
In the case of a child who is dually insured (through private insurance and
Medicaid), a family shall not be required to draw upon private insurance whose
use is a prerequisite to billing Medicaid if that use of insurance will result
in financial costs to the family.
4) "Financial costs to the family" include:
A) Out-of-pocket expenses incurred in filing
a claim, such as the payment of a deductible or required co-payment, but not
including incidental costs such as the time needed to file an insurance claim
or the postage needed to mail the claim;
B) A decrease in available lifetime coverage
or any other benefit under an insurance policy;
C) Payment by the family for services that
would otherwise be covered by Medicaid and that are required for the child
outside of the time the child is in school;
D) An increase in premiums or the
discontinuation of a policy; and
E)
A risk in terms of loss of eligibility for home- and community-based waivers,
based on aggregate health-related expenditures.
b) The federal regulations implementing the
Individuals with Disabilities Education Act (see
34 CFR
300) establish detailed requirements for the
use of federal funds in connection with service to students who are eligible
under this Part. School districts and cooperative entities are required to
comply with those federal requirements.
c) School districts and cooperative entities
shall use federal matching funds received under Medicaid or the All Kids
program only to supplement special education programs and services.
d) Computation of Reimbursement Under Section
14-7.03 of the School Code
The amount of reimbursement for which a district shall be
eligible under Section 14-7.03 of the School Code shall be computed by
determining the actual cost of maintaining the program in accordance with the
State Board's rules for Determining Special Education Per Capita Tuition Charge
(23 Ill. Adm. Code 130). The total reimbursement for a child who is living in a
residential care facility and who has been placed in a nonpublic special
education program by the responsible district shall not exceed the amount
authorized under Section 14-7.02 of the School Code.
e) Eligibility of Students for Funding Under
Section 14-7.03 of the School Code
1) A
student who meets the requirements of Section 14-1.11a(5) of the School Code is
eligible for reimbursement under Section 14-7.03 of the School Code if that
student:
A) is a resident of one of the
residential care facilities described in Section
226.320;
B) would not be a resident of that school
district except by virtue of placement in one of the residential care
facilities described in Section
226.320(a);
and
C) has been declared eligible
for special education and related services pursuant to this Part.
2) A student who has been declared
eligible for special education and related services pursuant to this Part and
is living in a State residential unit or county-operated detention center is
eligible for reimbursement under Section 14-7.03 of the School Code.
