Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 500 - EARLY INTERVENTION PROGRAM › Subpart D - FINANCIAL MATTERS › Section 500.130 - Family Fee/Insurance

Current through Register Vol. 48, No. 28, July 12, 2024
a) A
				statewide sliding fee schedule shall be established by the Department and
				updated annually for direct EI services and assistive technology devices set
				forth in Section
				500.55,
				except for those services that are required to be provided at no cost to
				families, including evaluation and assessment, service coordination, IFSP
				development and review, and procedural safeguards. (See Appendix A.)
b) Each family's fee obligation shall be
				established annually. Family participation fees will be billed and collected in
				installments through the centralized billing system. Families that fail to
				provide requisite income information will be charged the maximum amount on the
				sliding scale. Families shall not be required to pay more in annual fees than
				the cost of EI services and assistive technology devices received during the
				year and paid by the EI system. At the written request of the family, the fee
				obligation shall be adjusted prospectively at any point during the year upon
				proof of change in family income or family size.
c) With parental consent, families shall have
				their private insurance billed for services and devices set forth in Section
				500.55, except for those services and devices that are required to be provided
				at no cost to the families.
d)
				Recipients of medical assistance under Article V of the Illinois Public Aid
				Code or the Children's Health Insurance Program Act and WIC Program recipients
				shall not be charged an EI family participation fee. Parents of children
				eligible for Medicaid shall be encouraged but not mandated to enroll their
				children with Medicaid so Medicaid funds can be accessed for EI services and
				devices.
e) DHS' definition of
				ability to pay compares a family's household size and income to the sliding
				scale found in Appendix A and considers excessive out-of-pocket
				medical/disaster expenses. A family meets the definition of ability to pay if
				the family falls within the scale and does not have excessive, proven
				out-of-pocket medical expenses. Medical expenses must be expenses identified by
				the Internal Revenue Service as allowable deductions, and disaster expenses
				must be directly related to fire, flood or other act of nature. A family meets
				the definition of inability to pay if the family does not fall within the scale
				or does fall within the scale but has excessive proven out-of-pocket
				medical/disaster expenses exceeding 15% of income.
f) Exemptions:
1) A family may request exemption through the
				regional intake entity from the family participation fee due to documentation
				of catastrophic circumstances or extraordinary expense, by showing either:
A) current (within 12 calendar months)
				out-of-pocket medical expense in excess of 15% of gross income; or
B) current (within 12 calendar months)
				out-of-pocket losses in excess of 15% of gross income caused by disaster, such
				as fire, flood or tornado.