Current through Register Vol. 48, No. 38, September 20, 2024
a) Credentialing and enrollment, as set forth
in this Part, is only for the purpose of providing and being reimbursed for EI
services as set forth in this Part. It is not a license.
b) An individual shall meet the pertinent
licensing, degree, education and/or certification requirements for the service
to be provided, as set forth in Appendix C, as well as the requirements set
forth in this Section, in order to qualify for and maintain a credential to
provide EI services. Credentialed providers must also enroll in order to be
reimbursed for services.
c) To be
credentialed and maintain the credential the individual shall also:
1) not be delinquent in paying a child
support order as specified in Section 10-65 of the Illinois Administrative
Procedure Act [5 ILCS 100/10-65
];
2) not be in default of an
educational loan in accordance with Section 3 of the Education Loan Default Act
[5
ILCS 385/3] ;
3) not have served or completed a sentence
for a conviction of any of the felonies set forth in Section 25(a) and (b) of
the Health Care Worker Background Check Act [225 ILCS 46 ] within the preceding
five years (see Section 50-10 of the Illinois Procurement Code [30 ILCS 500
]);
4) not have been determined to
be a perpetrator of an indicated incident of child abuse or neglect in an
investigation by Illinois under the Abused and Neglected Child Reporting Act
[325 ILCS 5 ] or by another state under that state's laws for at least the
previous five years;
5) be in
compliance with pertinent laws, rules, and government directives regarding the
delivery of services for which they seek credentialing.
d) Applicants for a credential shall consent
to a background check as set forth in 89 Ill. Adm. Code
385.30(c)
through the Illinois Department of Children
and Family Services, consisting of review of CANTS/SACWIS, Illinois Sex
Offender Registry and criminal history.
e) Temporary Credential
An individual who is not currently credentialed and has
submitted an application to the Department's credentialing office, including an
acceptable plan for ongoing professional development as required in subsection
(k)(2), and has met the pertinent requirements provided in Appendix C, as well
as documentation of completion of EI systems training as defined in subsection
(f) and other requirements in this Part, will be issued a temporary credential
and may provide EI services.
f) EI Systems Training
1) In order to qualify for a credential, an
individual must document the completion of EI systems training as required and
provided by the Department. Parent Liaisons and Service Coordinators must
complete this training within 90 days after the receipt of the temporary
credential for such service. This training shall include at least:
A) Practice and procedures of private
insurance;
B) The role of the
regional intake entities, service coordination, program eligibility
determinations, family fees, All Kids, and the Division of Specialized Care for
Children (DSCC) applications, referrals and coordination with EI, and
procedural safeguards;
C)
Introduction to the EI Program, including provider enrollment and
credentialing, overview of EI Program policies and regulations, and billing
requirements; and
D) Evaluation and
assessment of birth-to-three children, individualized family service plan
development, monitoring and review, EI philosophy and best practices, and
quality assurance.
2) A
temporary credential may be issued to a Parent Liaison or Service Coordinator,
who shall document completion of training as required and approved by the
Department, within 90 days after the receipt of the temporary credential for
such service. This training shall include at least the EI systems training, set
forth in subsections (f)(1)(A) through (D), as well as:
A) Use of the management information
system;
B) Regional intake entity
operating philosophies and procedures; and
C) Transition.
Extensions of up to 90 days may be granted upon written
request setting forth facts concerning noncompliance with this requirement. The
Department's credentialing office will consider extreme hardship and other
extenuating circumstances and determine if an extension should be granted on an
individual basis.
g) Education
1) Individuals who hold a credential on July
1, 2007, other than individuals who hold a professional license in the State of
Illinois, as set forth in Appendix C, as part of the first subsequent
credential renewal application process, must provide documentation of the
completion of educational experiences, as approved by the Department, that
include at least two semester college hours or the equivalent (30 clock hours
or continuing education unit (CEU) credit hours) in each of the following EI
core knowledge content areas. Parent Liaisons are not required to provide this
documentation.
A) The Development of Young
Children: Typical and Atypical;
B)
Working with Families of Young Children with Disabilities;
C) Intervention Strategies for Young Children
with Special Needs; and
D)
Assessment of Young Children with Special Needs.
2) To qualify for a temporary credential,
developmental therapists must document completion of educational experiences,
as approved by the Department, that include at least two semester college hours
or the equivalent (30 clock hours or CEU credit hours) in each of the EI core
knowledge content areas listed in subsection (g)(1). As of July 1, 2007, all
other applicants for a temporary credential, other than individuals that hold a
professional license in the State of Illinois, as set forth in Appendix C,
shall document completion of these educational experiences within 18 months
after issuance of a temporary credential. Extensions of up to six months may be
allowed upon request in writing, received at least 30 days before the
expiration of the credential, setting forth the facts concerning noncompliance
with this requirement. The Department's credentialing office will consider
hardship and other extenuating circumstances and determine if an extension
should be granted on an individual basis.
h) Consultation Requirement Either Prior to
or During Temporary Credential
1) In order to
qualify for full credential, an individual must complete and document
consultation while providing 240 hours of direct services, for which they are
being credentialed, to children ages birth to three with special needs and
their families, except that Developmental Therapists/Vision, Orientation and
Mobility Developmental Therapists, Developmental Therapists/Hearing, and
providers credentialed under the EI service categories of Clinical Assessment,
Counseling and other Therapeutic Services, Nursing, Nutrition and Social
Services, as defined in Appendix C, need only document 120 hours. Documentation
must show that the individual participated in consultation with an
appropriately experienced individual of the same discipline/EI service group
who has experience working with children ages birth to three with special needs
and their families. The consultation shall be in compliance with the
professional standards of the individual seeking the credential, as determined
and documented by the consultant.
2) Individuals who do not meet the
consultation requirement in subsection (h)(1) shall complete and document such
experience within 18 months after issuance of their temporary credential.
Extensions of up to six months may be granted upon written request, received at
least 30 days before the expiration of the credential, setting forth the facts
concerning noncompliance with this requirement. The Department's credentialing
office will consider extreme hardship and other extenuating circumstances and
determine if an extension should be granted on an individual basis.
i) Full Credential
Once an individual with a temporary credential has documented
satisfactory completion of the requirements in subsections (g) and (h), as well
as the ongoing professional development requirement in subsection (k)(2),
he/she is eligible to be fully credentialed.
j) Evaluation and Assessment Services
Evaluation and assessment services for the purpose of
determining initial eligibility, participating in the development of an initial
comprehensive IFSP, and adding new types of services to existing IFSPs must be
provided by a provider with a credential for Evaluation/Assessment as set forth
in Appendix C in addition to an EI Specialist credential in the discipline
required by the service being evaluated.
k) Renewal of Credential
Full credentials are valid for three years. 60 to 90 days
before his/her credential expires, a provider shall submit a renewal
application to the Department in a form required by the Department. To qualify
for renewal, the provider must have met and provide documentation of the
following continuing professional education and development activities, as well
as documentation of maintenance of pertinent licensure/certification
requirements and compliance with this Part. Failure to receive a renewal notice
from the Department shall not excuse the submission of a renewal application
for one's credential.
1) Continuing
Professional Education
During the three years that the full credential is valid, a
credentialed provider shall receive a total of 30 hours of continuing
professional education as approved by the Department. Up to 20 of those hours
shall be provided by the Department, or its training designee. The provider
credential notification and renewal letters will define the number of hours
that shall be provided by the Department or its training designee. The
remaining training hours shall include one or more of the EI core knowledge
content areas set forth in subsections (g)(1)(A) through (D). Extensions of up
to three months may be granted upon written request, received at least 30 days
before the expiration of the credential, setting forth the facts concerning
noncompliance with this subsection (k)(1). The Department's credentialing
office will consider extreme hardship and other extenuating circumstances and
determine if an extension should be granted on an individual basis. The
extension shall not extend the time within which the subsequent year's training
requirements must be received.
2) Ongoing Professional Development
A) A credentialed provider (including
temporary) shall participate in a system of ongoing professional development
that includes a once a month non-billable meeting held either face-to-face or
over the telephone with either an individual specialist-level credentialed
provider or a group, of which at least one member is a specialist-level
credentialed provider in order to facilitate best practices through case
review. Each provider shall submit an ongoing professional development plan
with his/her initial and renewal credential application in a format provided by
the Department, and shall also report ongoing professional development
activities when moving from temporary to a full credential status and upon
credential renewal to the Department's credentialing office or upon request of
the Department or its designee in a format provided by the Department.
Documentation of ongoing professional development must demonstrate that a
credentialed provider participated in ongoing professional development meetings
in at least 75 percent of the months in his/her temporary or full credential
period.
B) Service Coordinators and
Parent Liaisons employed by regional intake entities shall participate in
ongoing professional development experience as defined and implemented through
a contractual agreement between the Department and the regional intake entity,
instead of the requirement of this subsection (k)(2).
l) Restoration of Lapsed
Credential
A credential that has lapsed for one year or less may be
restored upon application proving the receipt of 30 hours of continuing
professional education, as continuing professional education is defined in
subsection (k)(1), and documentation of ongoing professional development as
defined in subsection (k)(2).
m) Enrollment
Credentialed providers (including temporary) must enroll with
the Department in order to bill and receive payment for EI services. Enrollment
requires the payee entity to enter into a Service Provider Agreement with the
Department that establishes the duties, expectations, and relationships between
the Department and the Individual Provider or the Provider Agency. Providers
shall submit an enrollment application packet at the same time they submit an
application for a credential. Providers credentialed as an "associate", as
defined in Appendix C, are not required to enroll, but shall be supervised by a
specialist who is credentialed and enrolled in the same discipline, as set
forth in Appendix D. The payee entity will bill for the services provided by
the associate level provider under the name of the associate's supervisor. The
payee entity, supervisor and associate will comply with all directives and
policy and procedural changes. Failure to receive Department payments,
directives and policy and procedural changes, due to failure to comply with
this subsection, shall not excuse compliance with those directives and
changes.
n) Change of Name
or Address
Credentialed providers shall notify the Department's
credentialing office of any change of name or address within 30 days prior to
billing under the new name and/or address, or 30 days after such change,
whichever comes first. Correct information is required for a provider to
receive payment for services.
o) Providers shall also enroll with HFS to
become an All Kids provider, simultaneously with EI enrollment.
p) An individual applying for or renewing
enrollment shall state whether he or she is also enrolled as a DSCC
provider.
q) Termination of
Credential/Enrollment
1)
Credentialing/enrollment, as set forth in this Section, is not a license.
Rights of credential and enrollment are set forth in the Service Provider
Agreement. In addition to the provisions of this subsection (q), the Department
may exercise any rights it has under the Service Provider Agreement to
terminate the agreement.
2) The
following shall result in immediate automatic termination of a provider's
credential and enrollment:
A) Failure to
comply with the requirements of subsection (g) and/or (h) within the time
period or within a Department-granted extension not exceeding the maximum
extension time allowed.
B) Failure
to successfully enroll in, exclusion from or termination from participation in
All Kids and/or other programs of federal or State agencies.
C) Lapse of credential/enrollment for over 1
year without complying with subsection (l) or failure to bill for services for
more than 12 consecutive months.
D)
Suspension or termination of the license and/or certification required for the
service for which one is credentialed.
E) Failure to meet or maintain other
credential and enrollment requirements set forth in this Section.
3) The following shall also result
in termination of a provider's credential and enrollment:
A) Failure to comply with provisions of this
Part, or with EI Service Provider Agreements, or with other laws and
regulations relevant to the services for which there is a credential.
B) Unprofessional conduct.
C) Complaints the Department has determined
are founded and significant.
D)
Professional performance not consonant with recognized standard of care or
adverse action of a professional society or other professional
organization.
E) Lack of timely
cooperation regarding the submission of and adequacy of reports, the
development of appropriate goals and objectives and the development of
multidisciplinary treatment plans.
F) Inappropriate billing practices.
4) The provider shall be notified
of the date of termination and the reason, and shall help to transition clients
to new providers. The provider may request an informal hearing, but the request
shall not affect the termination date, which may proceed prior to the informal
hearing. The request must be made within 30 days after the notice of the
termination.
5) The provider may
present relevant information, witnesses and evidence to the Secretary or
his/her designee, in person or in writing. The Secretary or the designee will
review the information presented and any supplemental investigation performed
by the Department and issue a decision within 30 days after the
hearing.
6) The decision of the
Secretary or the designee shall be final.
r) The Department may deny an application for
credential and enrollment or a Service Provider Agreement if the applicant's
past conduct resulted in the termination of his or her credential and
enrollment or Service Provider Agreement. An applicant may appeal a denial for
a credential and enrollment or Service Provider Agreement based on a prior
termination pursuant to subsection (q).
