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A<+~? > F`8~x?>㇀`@????˃`@ ????ˁ#o???d g Cw??  g?!hAsR}h?1>4u??p}@}A>"y@|OG>~?͟~?"  ?~>" OOc|?-@ 8}|0?#A`? ?~=|?- ~߀?$ !߀G??,~-{ A@~&;W?Aÿ|~&x~?;/|xA|,~~ ^93$_`|7  g ? ,?2?z C ?++?x ߃ 6|?  +6x? 9=@p|?9?|1?|9<9O?9?9?2<@ ǀ9 &  ?=?9 A?@ ?~|?``}&` @~# ~O}C? i0KX p~ P8??8>  < | ~> x?~?> ?0SAs~>x ?? ~> '!~~ ?13'  w~~ `#@'>@~~?~> P '~~~`1~??87} ??<+|?~? ~~7?||?Ϗ `}|? { ?@{N 8 >@w8'y?>`?`08?x/0x$?8?xb~ ?8;- x08~!/! }p- @?~!? c4p &`~~??%`p>  |~o&`? ?>~~y ?~8D|~ ??ux  8>~ ?  8~  #  # ?@ AH/Ͽ#`@ ǃ|/@ "|/ a1 aC~F CC~ 0~ ?~ ~ }?~@@#~8~?䀏@~" 8?x> |!,/{~ Cp??y @ @?OO p@`?8 @8a?08 aܟ? 8p08 Dvhx'?q,x0p4|0 -8 ?x  0?r|_0 ??1?v|&w  t?1  _8???  ???   ??o%?@ >P ?铂oO~/ O g/_ 7^ 翯 <?h >   k  ? ~ = LJ ?O3? G<g  O~3 '<  ?. g<? A'} g<  g<?   g<?  C G~?a A O~?? _! >4 ? ! > ? ?0@~o ? ?8 !/ ?_?(xĀ?? ?>x??? >_|? |" :??h< ?? ?8 / p?   #N? #>H?? L<A~Z? (@xz? )/@? ? ?<   ? ρp c ?#IA  ?0  ?q>  ? <\ ?~ ~ 8D?? ?p  `Ȃ      ? ? ???  ??~ h ! `  p  ?? p ??? ?  ??   ?     ??    `     ?  ?  ?  0?? ?0 8 x? ><        ??q   | ?? ? ?     ? ?  ?  |     ? ~ ? |? { <?  p0 ? 8 ?  ? ?? ?  ? `?   ~?A <??? ?? ??? ?  ?  ??>? ~| x ? s ?s ?q??p?pp?      ?    89+\  `&Times New Roman A /)  NXHXXNXXHXXNXH     XHXXXH     e  600INDEPENDENCEAVE.,S.W.,WASHINGTON,DC20202 e Ԍ X Ќ  XHXXXH    sXXH OurmissionistoensureequalaccesstoeducationandtopromoteeducationalexcellencethroughouttheNationXHXs (e2$ L!  NXHXXNXXHXXNXH   1 Q %'  NXHXXNXXHXXNXH  Q(XQ! X(#X! HonorableHowardPetersIII ! !E(#PageXH    2  %XHX   X A +1!AE.` hp x (#X(#E ($      L!  NXHXXNXXHXXNXH  E1X` hp x (#XE    1    #aaddԀ#bbaaThefindingscontainedinthisreportarebasedontheregulatoryrequirementsofPartHofIDEA X thatwereineffectatthetimeofOSEPsmonitoringvisit.#aabbԀ#ddaa dTable_A d1 d  X  X   %'  ;1X` hp x (#;   (#  XXXS\  `&Times New RomanS8.` hp x (#8XXXS\  `&Times New RomanS  /)  ;1X` hp x (#;     (#  XXXS\  `&Times New RomanS  %'  ) p x (#)=(= (#XXXS\  `&Times New RomanS EnclosureA..Page US S\  `&Times New RomanS        XXXS\  `&Times New RomanS - -8.` hp x (#8  /)  ) p x (#)XXXS\  `&Times New RomanS2% %d>>>>'dxd  L!  8.` hp x (#8!  ! , 8.` hp x (#8        XXXS\  `&Times New RomanS..An enrolledproviderisaserviceproviderwhohasbeenenrolledbyDHSintheparticipatingprovidernetworkandisapprovedtoreceivereimbursementforcostsofprovidingearlyinterventionservicestoeligiblechildrenandtheirfamilies,consistentwithPartCrequirements.$35;?CGKOS3A.1111111  L!  8.` hp x (#8 , 8.` hp x (#8      XXXS\  `&Times New RomanS..Similarly,OSEPdidnotfindevidenceofchildfindactivitiesdesignedtoeffectivelyreachouttoHispanicfamilieslivinginruralareasofIllinois.AservicecoordinatorfromProviderAreaCstatedthatshewasunawareofanymaterials(e.g.,childfind)inSpanishthatcouldbeusedwithfamiliesinhercatchmentarea.  X  X   %'  8.4` hp x (#8   (#  XXXS\  `&Times New RomanS8.` hp x (#8XXXS\  `&Times New RomanS  %'  8.4` hp x (#8=(= (#XXXS\  `&Times New RomanS EnclosureB..Page US S\  `&Times New RomanS        XXXS\  `&Times New RomanS - -8.` hp x (#8 Table_B$35;?CGKOS41.1111111$35=AEIMQU5(a)1111111(z2$ L!  NXHXXNXXHXXNXH    0  #|x(J$  NXXXNXXXXNX0&d9 Z6Times New Roman RegularNXs'{s':i+00U L!  NXHXXNXXHXXNXH        XX$.B  ԍ̎0   (#X  E1X` hp x (#(#EC  _݌̌ XXXXHXXXH  HonorableHowardPetersIII   h SEPTEMBER23,1998  SecretaryE1X` hp x (#XEXHXXXHXHXXXH    k  DepartmentofHumanServicesk Ԍ   Ќ XXXXHXXXHXHXXXH  623E.Adams   POBox19429Springfield,Illinois627949429DearSecretaryPeters:DuringtheweekofMarch2,1998,theOfficeofSpecialEducationPrograms(OSEP)oftheU.S.DepartmentofEducationconductedatargetedonsitereviewoftheIllinoisDepartmentofHumanServices(DHS)implementationofPartC,formerlyPartH,oftheIndividualswithDisabilitiesEducationAct(PartC)3 2  1      .ThepurposeofthereviewwastodeterminewhetherDHSismeetingits X  responsibilitytoensurethatearlyinterventionservicesforinfantsandtoddlerswithdisabilitiesandtheirfamiliesareadministeredinamannerconsistentwiththerequirementsofPartC.OSEPfocuseditsinquiryonspecificaspectsofimplementationofPartCinIllinois,particularlychildfindandpublicawarenessactivities,provisionofearlyinterventionservicestoeligiblechildrenandtheirfamiliesinnaturalenvironments,transitionfromPartCtopreschoolorotherappropriateservicesatagethree,andDHSadministrativeresponsibilitiesforimplementationofthestatewideearlyinterventionsystem.B.` hp x (#XBTheissueofwhetheralleligiblechildrenintheStatearebeingserved,whichwasthefocusoflitigationagainsttheStateandofIllinois highriskgranteestatusforfiscalyears(FYs)1996and1997,wasnotinvestigatedonthistrip.However,wewillbereturningforafollowupvisitandwillexaminethatandotherissuesatthetime.Inaddition,wedidnotincludeinthisreportissuesidentifiedduringthevisitrelatingtotheStatesuseoffamiliesprivateinsurancetofundPartCservices,becauseOSEPiscurrentlyconductingrulemakingproceedingsonthattopic.Afterafinaldecisionismadeontheissues,OSEPwillreviewIllinoispoliciesandpracticesregardingtheuseofinsurance.E1X` hp x (#XEWerecognizethattheleadagencyresponsibilityforPartCinIllinoischangedtoDHSjusttwomonthspriortoOSEPsvisitandthatsomeoftheproblemscitedinthisreportmaywellhavebegunduringIllinoisStateBoardofEducations(ISBEs)tenureasleadagency.OSEPdecidedthatitwasimportanttoconductaprogramreviewearlyoninDHStenureastheleadagencyforPartCtofacilitateanongoingworkingrelationshipbetweenDHSandOSEP.OneareaofparticularconcernandinneedofimmediateattentionisthenumberofinconsistencieswithFederallaw(34CFRPart303)foundinthe EarlyInterventionServicesSystemProcedureManual.OSEPwastoldbyallChildandFamilyConnections(CFC)managersandinitialservicecoordinatorsvisitedthattheManual )"$% 0 01$ 0  istheirprimaryguidancedocumenttoimplementPartC.DHSmusttakeimmediateactiontocorrecttheinconsistentprocedures.TheseissuesareaddressedinEnclosureAtothisletter,sectionIII.D.2.OnJuly7,1998,thisOfficereceivedacopyofrevisionsofselectedformsintheManual.ThisOfficewillworkwithyourstafftoidentifyotherareasoftheManualfoundtobeinconsistentwithPartCrequirementsandinneedofcorrection.OSEP'smonitoringplacesstrongemphasisonthoserequirementsmostcloselyassociatedwithpositiveresultsforchildrenwithdisabilitiesandtheirfamilies.DuringtheexitbriefingattheconclusionofOSEP'sonsitevisit,membersoftheOSEPmonitoringteam(Dr.BobbiStettnerEaton,Dr.GreggCorr,Ms.TereseLilly,Ms.SarahWillis)discussedthepreliminaryfindingswithyou,membersofyourstaff(i.e.,AssociateSecretaryAnnPatla,DeputyDivisionDirectorConnieBrooks,andBureauChief/PartCCoordinatorMaryMiller)andMs.SueWalter,therepresentativeoftheIllinoisInteragencyCouncilforEarlyIntervention(IICEI).Atthetimeofthebriefing,wehighlightedbothareasthatOSEPconsidersstrengthsofIllinoisearlyinterventionsystem,aswellasareasthatcontinuetobeachallenge.EnclosureAofthislettersetsforthOSEP'sfindingsofnoncompliancewithFederalrequirements.EnclosureBaddressessomeoftheoverarchingsystemicconcernsrelatedtotheimplementationofIllinoisstatewideearlyinterventionsystem,andisofferedfortechnicalssistancepurposesonly.    &    OSEP'sMonitoringMethodology'  PresiteDocumentReview AsinallStates,OSEPusedamultifacetedprocesstoreviewtheimplementationofPartCinIllinois.Inadditiontoonsitevisits,thisprocessincluded:reviewandapprovaloftheState'sPartCapplicationwhichsetsouttheState'sstatute,policiesandprocedures,reviewoftheStatesannualperformancereport,andothercorrespondence,andtelephonecallsthatOSEPreceivedregardingtheState'simplementationfromavarietyofsources,includingparentsandadvocates.Priortoitsvisit,OSEPalsorequestedandreviewedadditionaldocumentationrelatedtotheState'simplementationofrequirementsfordueprocesshearings,complaintresolution,andmonitoringprocedures,aswellasthechildcountandservicereportsfromthetwentyfourChildandFamilyConnectionssites.Duringtheinitialplanningconversations,Ms.MillerexplainedthatChildandFamilyConnectionsisastatewideendeavorwithregionalpointsofentryintotheearlyinterventionsystem,thatisresponsibleforthecomprehensive,multidisciplinaryevaluationofeachchild,birththroughtwo,todetermineeligibility,neededassessmentactivitiesrelatedtothechildandthechildsfamily,anddevelopmentandimplementationoftheIndividualizedFamilyServicePlan(IFSP)withinthe45daytimeframe.    &    SelectionofMonitoringIssuesandProviderstoVisitOSEPreviewedStatedocumentsregardingtheprovisionofearlyinterventionservicesindeterminingtheissuesthatitwouldreviewintheonsitevisit.Inconjunctionwith'  Ms.Millerandherstaff,OSEPidentifiedfiveChildandFamilyConnectionssitestovisitasasampleofthestatewideimplementation,includingoneofthesitespreviouslydeemeda demonstrationsite.    &    OnsiteDataCollectionandFindingsThefiveChildandFamilyConnectionsmanagersalsoinvitedserviceprovidersandotherChildandFamilyConnectionsmanagersinproximitytotheirgeographicareatobepartoftheOSEPinterviews.Forpurposesofthisreport,providerareasareidentifiedalphabeticallyasA,B,C,D,orE,andincludeboththeoriginalfiveChildandFamilyConnectionsSitesandthesubsequentlyparticipatingsitesfromthesurroundingareas.OSEPusesthesedesignationsratherthanthenameofanyoftheChildandFamilyConnectionsorprovidersinEnclosureAbecausethefindingsinEnclosureAfocusontheeffectivenessofDHS'systemforensuringcompliance,ratherthancompliancebyanyparticularprovider.'  *56 d,( I0,( @0,( @I+  7777&"d7 ! B$!  >4X` hp x (#> INTERVIEWLOCATION *77&d*  ! B$!  ;1X` hp x (#;CHILDANDFAMILYCONNECTIONSSITES *777&d*  ! B$!  DESIGNATION '7'  ! B$!  >4X` hp x (#> EastSt.Louis  ! B$!;1X` hp x (#;    ! B$!  ChildandFamilyConnections#21,22,24 7   ! B$!  ProviderAreaA '7'  ! B$!  >4X` hp x (#>Effingham    ! B$!  ;1X` hp x (#;ChildandFamilyConnections#19,20,23 7   ! B$!  ProviderAreaB '7'  ! B$!  >4X` hp x (#>Springfield    ! B$!  ;1X` hp x (#;ChildandFamilyConnections#17&18 7   ! B$!  ProviderAreaC '7'  ! B$!  >4X` hp x (#>Chicagoland    ! B$!  ;1X` hp x (#;ChildandFamilyConnections#712 7   ! B$!  ProviderAreaD )77)  ! B$!  >4X` hp x (#>Bloomington 7   ! B$!  ;1X` hp x (#;ChildandFamilyConnections#1316 77   ! B$!  ProviderAreaE DuringtheentranceconferenceonMarch2,1998,Dr.StettnerEaton,theOSEPPartCcontact,andDr.Corr,theOSEPAssociateDivisionDirector,interviewedMs.Patla,Ms.Miller,Ms.Brooks,andyou.Twoadditionalinterviewswerealsoheldonthatdate;onewithrepresentativemembersoftheExecutiveCommitteeoftheIllinoisInteragencyCouncilforEarlyInterventionandtheotherwithmembersoftheEarlyInterventionTransitionTeam,whichfacilitatedthetransitionofleadagencyresponsibilityfortheimplementationofthestatewidesystemofearlyinterventionservicesfromISBEtoDHS.Inaddition,relevantdocumentationwasalsoreviewed.Drs.StettnerEatonandCorralsovisitedinformallywithDr.VincentAlloccoandseveralofhisstaffatElValortoobtaininformationaboutservicestopredominantlySpanishspeakingfamiliesservedintheimmediateChicagoarea.OnMarch3,Drs.StettnerEatonandCorrconductedgroupinterviewsatChildandFamilyConnectionssite#7inChicagowithparentsofchildrenservedbythePartCsystem,servicecoordinators,serviceproviders,andChildandFamilyConnectionsmanagersfromsites#7through#12.OnMarch4,asimilarprocessofgroupinterviews,asidentifiedabove,wasconductedattheChildandFamilyConnectionssite#16inBloomington,includingChildandFamilyConnectionsmanagersfromsites#13through#16.TheotherOSEPteam,Ms.LillyandMs.Willis,visitedandcollectedimplementationdataatChildandFamilyConnectionssitesinEastSt.Louis(ChildandFamilyConnectionssites#21,22,24),Effingham(ChildandFamilyConnectionssites#19,20,23),andSpringfield(ChildandFamilyConnectionssites#17and18).Again,asimilarpatternofgroupinterviewswasfollowedasdescribedabove.Whereappropriate,OSEPhasincludeddatainEnclosureAthatitcollectedfromthosesitesthatsupportorclarifyitsfindingsregardingthesufficiencyandeffectivenessoftheearlyinterventionsystemforensuringcompliancewiththerequirementsofPartC. InvolvementofParentsandAdvocates: OSEPiscommittedtoactivelyinvolvingparentsandadvocatesasintegralpartnersinthemonitoringprocess.Therefore,everyeffortismadetoincludetheirinputbysolicitingtheirperceptionsregardingvariousaspectsofimplementationofthestatewideearlyinterventionsystem.Aspreviouslystated,OSEPconductedsmallgroupparentinterviewsateachofthefiveChildandFamilyConnectionssiteswhereinterviewswereconducted.ThesemeetingsprovidedOSEPwithparents'viewsoftheeffectivenessoftheearlyinterventionservicesprovidedforinfants,toddlersandtheirfamilies,aswellasthechallenges.ParentsandadvocateswerealsoinvolvedinastakeholdersmeetingthatwasconvenedbyDHSattheconclusionofOSEPsmonitoringvisit.Priortotheonsitevisit,OSEPworkedcloselywithDHStoidentifytherepresentativeconstituenciesneededatthestakeholdersmeeting.Stakeholderrepresentationincludedindividualsfromtwodifferentparenttrainingandinformationcenters,advocates,parents,includingaparentrepresentativefromtheIllinoisInteragencyCouncilonEarlyIntervention,membersoftheStateEarlyInterventionTransitionTeam,alegislativestaffrepresentative,arepresentativefromISBE,andDHSstaff.Ms.JoSchackleford,fromtheNationalEarlyChildhoodTechnicalAssistanceSystem(NEC*TAS),whichisFederallyfundedbyOSEPtoprovidetechnicalassistancetoStatesintheimplementationofPartCandthePreschoolProgram,facilitatedthestakeholdersmeeting.Duringthestakeholdersmeeting,OSEPpresenteditsinitialfindingsfromthemonitoringvisitandDHSprovideditsobservations,reactions,andresponsestotheissuesraisedbyOSEP.Inmanycases,DHSconfirmedOSEPsinitialimpressions.Thesediscussionswerefollowedbybreakoutsessionsinwhichthestakeholdersidentifiedstrategiesandactivitiesthatcouldbeutilizedtoaddresstheidentifiedareasofdeficiencies,includingapproximatetimelines,resources,andtentativeidentificationofresponsiblepersons.Theoutcomeofthestakeholdersmeetingwasthedevelopmentofadraftimprovementactionplan,whichDHSwillreviseforcompletenessafterreviewingthefindingsidentifiedinEnclosureA.Inordertosupportthedevelopmentofamutuallyagreeableimprovementactionplanthatwillcorrectthefindingsandimproveresultsforyoungchildrenwithdisabilitiesandtheirfamilies,wewouldliketoschedule,atyourconvenience,aconferencecallwithDHS,theChairoftheIllinoisInteragencyCouncilonEarlyIntervention,andanyotherappropriaterepresentativesfromthestakeholdersmeetingtosolidifytheimprovementactionplan.ThefinalimprovementactionplanmustbedevelopedandsubmittedtothisOfficewithin45daysofreceiptofthisletter.   (#  ;1X` hp x (#;&  S\  `&Times New RomanS FollowupProceduresXXXS\  `&Times New RomanS EnclosureAoutlinesthefindingsDHSmustaddressinitsimprovementactionplan.Thefindingsinthisletterarefinal,unlesswithin15daysfromthedateonwhichDHSreceivesthisletter,DHSconcludesthatevidenceofnoncomplianceissignificantlyinaccurateorthatoneormorefindingsisincorrectandrequestsreconsiderationofsuchfinding(s).Anyrequestforreconsiderationmustspecifythefinding(s)forwhichDHSrequestsreconsideration,thefactualand/orlegalbasisfortherequest,andmustincludedocumentationtosupporttherequest.OSEPwillreviewanyDHSrequestforreconsiderationand,ifappropriate,issuealetterofresponseinformingDHSofanyrevisiontothefindings.Requestsforreconsiderationofafindingwillnotdelaythedevelopmentoftheimprovementactionplanandimplementationtimelinesforfindingsnotpartofthereconsiderationrequest.OurstaffisavailabletoprovidetechnicalassistanceduringanyphaseofthedevelopmentandimplementationofDHSimprovementplan.Pleaseletmeknowifwecanbeoffurtherassistance.'  IwouldliketothankyouandtheDHSstaff,particularlyMs.MillerandtheChildandFamilyConnectionsmanagers,fortheircooperationandassistanceduringourreview.Throughoutthemonitoringprocess,DHSstaffwasveryresponsiveinprovidinginformationthatenabledOSEPstafftoacquireabetterunderstandingoftheimplementationofPartCinIllinois.TheCommitteeReportthataccompaniedthereauthorizationoftheIDEA,Pub.L.10517,recognizedtheimportanceofearlyinterventionservicesforinfantsandtoddlerswithdisabilitiesandreconfirmedourbeliefthatitisinthebestinterestofthesechildren,theirfamilies,schools,andsocietyingeneralthatservicescontinuetobeprovided.WethankyouforyoureffortstoimproveearlyinterventionservicesandresultsfortheyoungestofchildrenwithdisabilitiesinIllinois. < ;1X` hp x (#;Sincerely,  ?8(?&    ThomasHehir- -Director'  OfficeofSpecialEducationPrograms  ;1X` hp x (#;Enclosurescc:..Ms.MaryMiller..BureauChief/PartCCoordinator9  :;) p x (#)S\  `&Times New RomanS <=ENCLOSUREA=?(=;1X` hp x (#;S\  `&Times New RomanSFINDINGSANDREQUIREDFOLLOWUPACTIONS - -XXXS\  `&Times New RomanSInordertobeginimmediatecorrectionofthefindingssetforthinthefollowingtable,DHSmusttakethefollowinggeneralcorrectiveactions: , 8.` hp x (#8  1...DHSmustdistributeOSEPsletteroffindingstoallpublicagenciesandearlyinterventionprovidersinvolvedinthePartCprogram,togetherwithamemorandumdirectingthemtodeterminewhethertheyhavecompliedwithPartCrequirements,asclarifiedbyOSEP'sLetterofFindings.ThememorandummustfurtherdirecttheseagenciesandproviderstodiscontinueanynoncompliantpracticesandimplementproceduresthatareconsistentwithPartC,andsubmitdocumentationtoDHSthattheyhaveimplementedrevisedproceduresthatcorrecttheciteddeficiencies.DHSmustsubmitthismemorandumtoOSEPwithin30daysofthedateonwhichDHSreceivesthisletter.Within15daysofOSEP'sapprovalofthememorandum,DHSmustdisseminateittoallappropriateagenciesandearlyinterventionprovidersthroughoutIllinois.FortheProviderAreaswhereOSEPidentifieddeficiencies,DHSmustsubmitdocumentationtoOSEPverifyingthatthenoteddeficiencieshavebeencorrected.    !  !    2...DHSmustdevelopanimprovementplan,inconjunctionwithOSEP,theIllinoisInteragencyCouncilonEarlyIntervention,andotherappropriatepartners,toaddressthedeficienciesdetailedinthisletteroffindings.ThefinalimprovementactionplanmustbedevelopedandsubmittedtothisOfficewithin45daysofDHSreceiptofthisletter,andmustbedisseminatedwidelytoinformthepublicoftheactionsbeingtakentoaddressthefindings.Inaddition,DHSmustsendtoOSEPverificationthatthedeficiencieshavebeencorrected.  X ;1X` hp x (#;    8.` hp x (#8OSEPidentifiedfindingsinthreeareas:servicecoordination,provisionofearlyinterventionservices,andgeneraladministrationandsupervision.Adiscussionofeachfollows.??7(?S\  `&Times New RomanS I.SERVICECOORDINATION- -XXXS\  `&Times New RomanS  Background: Consistentwith34CFR303.22,eachStatemustensurethatservicecoordinationisavailableforeacheligiblechildandthechildsfamilyuponreferraltothepublicagencyandthroughoutthechildseligibilityforservices.Servicecoordinationisanactiveongoingprocessthatinvolvesassistingparentsofeligiblechildreningainingaccesstoearlyinterventionservicesandotherservicesidentifiedintheindividualizedfamilyserviceplan(IFSP),facilitatingthetimelydeliveryofavailableservicesandcontinuouslyseekingtheappropriateservicesandsituationsnecessarytobenefitthedevelopmentofeachchildbeingservedforthedurationofthechildseligibility.Itistheservicecoordinatorwhoisthesinglepointofcontactbetweenthefamilyandtheearlyinterventionsystem,andprovidessupportinnegotiatingtheidentificationandevaluationprocess,developmentandimplementationoftheIFSP,andfacilitatinglinkageswithotherservices,includingmedicalservices,outsidetheimmediatepurviewoftheearlyinterventionsystem. Finding1: OSEPfindsthatIllinoisisnotensuringthatservicecoordinationthatmeetstherequirementsofPartCisprovidedtoalleligiblechildrenandtheirfamilies.Ingeneral,servicecoordinatorsarenotassistingparentsinobtainingallneededservicesforeligiblechildrenandfamilies.Servicecoordinatorsmustassistparentsofeligiblechildreningainingaccesstoearlyinterventionservicesandserveasthesinglepointofcontactinhelpingthefamilyobtaintheservicesandassistanceneeded.34CFR303.22.However,ChildandFamilyConnectionsmanagers,servicecoordinators,serviceproviders,andparentsacrosstheStatetoldOSEPthatparentstypicallywerenotgivendirectassistanceinobtainingservices,butratherwereprovidedwithalistofproviderphonenumbers.Thelistcontainsthenamesandtelephonenumbersofserviceproviderswhoareenrolled @   ׀intheIllinoisearlyinterventionsystem.Informationprovidedtoparentsaboutservicecoordinationdidnotappeartobesufficienttoinformparentsabouttheservicecoordinationfunction.Parentsoftendidnotknowtocalltheirservicecoordinatoriftheyhadaconcern;infact,manyoftheparentsstatedthattheydidnotknowwhotheirservicecoordinatorwas.WithouttheassistanceoftheirservicecoordinatororotherIFSPteammembers,parentsmustresearchprovideravailability,schedules,methodofprovidingservices,andlocationofservicesinordertoobtaintheearlyinterventionservicesneededfortheirchild.Servicecoordinatorsarethereforenotcoordinatingservicesfromdifferentprovidersnorservingasthesinglepointofcontactforfamilies.Therequiredpurposeandveryintentofservicecoordination,toassistparentsingainingaccesstotheappropriateearlyinterventionservicesidentifiedontheirchildsIFSP,isnotoccurring.Duringthestakeholdersmeeting,Ms.MillerconfirmedthispracticeandstatedthatservicecoordinationinIllinoisisnotbeingprovidedasrequired.Anotherresponsibilityoftheservicecoordinatoristoidentifyneededresourcesandtocoordinateservicesacrossagencylinesforaneligiblechildandthechildsfamily.34CFR303.22(a)(2).However,servicecoordinatorsandprovidersinProviderAreasB,CandEreportedthatiftheservicesneededbyachildwerenotavailablewithintheirownprovideragency,thechildandfamilydidnotgetthatparticularservice.Further,servicecoordinatorsinProviderAreasDandE,andaChildandFamilyConnectionsmanagerfromProviderAreaB,statedthattheydidnotknowwheretolocateotherserviceproviderswhomightbeavailabletoprovideservicesbecausethereisadelayinreceivingupdatedlistsofnewlyenrolledprovidersintheIllinoisearlyinterventionsystem,orbecauseofashortageofavailableserviceproviders.ServicecoordinatorsinProviderAreasA,B,D,andEreportedthattheyonlycoordinatedservicesfromtheirownprovideragency,evenifneededserviceswerenotavailablefromtheagency.Asanexample,aparentfromProviderareaBtoldOSEPthatsheherselfmadenumeroustelephonecallstoobtainrespitecareforherchildthatwasnotavailablefromtheagencywhereherchildreceivedamajorityofherservices.Shealsostatedthattheservicecoordinatoronlycoordinatedservicesfromheremployingagency,notoutsideoracrossagencylines,asrequiredbyPartC.Anotherparent,fromProviderAreaA,statedthatthephysicaltherapyserviceslistedonherchildsIFSPwerenotprovidedbecausetheservicecoordinatorsaidtherewerenoavailableenrolledproviders.However,theparentthenlocatedaphysicaltherapistoutsidetheprovidernetworkwhowaswillingtoprovidetheneededservicesforherchild.WhenOSEPinterviewedservicecoordinators,theyrespondedthattheydidnotknowtheywererequiredtoperformmanyoftheservicecoordinationfunctionscontainedin303.22.IneverysiteOSEPvisited,theChildandFamilyConnectionsmanagersandservicecoordinatorsexpressedtheneedfortrainingrelatedtotheirpositions.Thisisparticularlycriticalforservicecoordinatorswhoarerequiredtoassistfamiliesinmanywaysandfacilitatethetimelydeliveryofservices.Theinitialservicecoordinators,whotypicallyperformintakefunctionsandinitialcontactwithfamilies,reportedthattheyhadcompletedthebriefStatetrainingactivitytargetedforthem.However,ineverysitevisit,ongoingservicecoordinatorsreportedthat,althoughtheyhadnotyetreceivedtraining,theywereworkingwithfamiliestothebestoftheirabilities.ChildandFamilyConnectionsmanagersandongoingservicecoordinatorsreportedthattrainingwasscheduledforthenearfuture.Atthestakeholdersmeeting,Ms.MillerconfirmedthatatthetimeofOSEPsvisit,manyoftheongoingservicecoordinatorshadnotreceivedanytrainingfortheirjobs,butthattrainingwasscheduled.TheMay26,1998quarterlyreport,submittedasaconditionoftheStateshighriskgranteestatus,containedinformationthattrainingof525ongoingservicecoordinatorshadbeencompletedfromFebruary1throughApril30,1998.Areviewof20IFSPsacrossthesitesvisitedrevealedthatservicecoordinationwaslistedontheIFSPsasanearlyinterventionservice,withaspecifiedamountoftimeandfrequencyforservicecoordinationforeachchild.However,alleligiblechildrenandtheirfamiliesareentitledtoongoingservicecoordinationtoensuretheprovisionofappropriateearlyinterventionservicesandtheidentificationandlinkagetomedicalandotherservices,asneeded.Congressrecognizedthatservicecoordination,byitsverynature,isanongoingprocess,anditthatwouldbedifficult,ifnotimpossible,topredeterminetheamountofservicecoordinationtimeneededduetotheindividualneedsofchildrenandfamiliesatvarioustimesthroughoutaneligiblechildsenrollmentinPartC.Servicecoordinationis,therefore,notaspecificearlyinterventionserviceforwhichfrequencyandintensityisidentifiedonachildsIFSP.AnIFSPwhichspecifiesaparticularamountandfrequencyofservicecoordinationmaynotallowforthefullrangeofservicecoordinationactivitiesneededtoprovidesupportstoaparticularchildandthechildsfamily.Specifiedtimeallocationsconflictwiththerequirementforongoingservicecoordinationandmayrestrictthemajorbenefitsofservicecoordinationtoafamily.OfthetwentyIFSPsexamined,twelveindicated30minutesorlessofservicecoordinationpermonth,withsevenoftheselistingoneservicecoordinationeventpermonthfor15minutes.OftheremainingeightIFSPs,twoindicatedfourhoursofservicecoordinationpermonth,andthreestatedtwohours,resultinginanaverageacrossall20IFSPsreviewedof50minutesperchildpermonth.Inthese20IFSPs,theredidnotappeartobearelationshipbetweenthefrequencyandintensityofservicecoordinationlistedontheIFSPsandtheparticularneedsofthechildandthechildsfamily.Inaddition,servicecoordinatorsinProviderAreaEstatedthatfamiliesintheircatchmentareadidnotreceivesufficientamountsofservicecoordinationorongoingcontact.Recentstudiesofhomevisitingandservicecoordinationindicatethatthetimeneededtoprovidethearrayofactivitiesforactive,ongoingservicecoordinationcouldnotbeaccomplishedwithinthetimeconstraintsindicatedonmanyoftheseIFSPs(Roberts,R.,Akers,A.L.,andBehl,D.D.,1996;Roberts,R.N.,Behl,D.D.,&Akers,A.L.,1996).OSEPnotedthatonepossiblefactorcontributingtotheselimitationsonthefrequencyandintensityofservicecoordinationisthattheChildandFamilyConnectionssiteswereonlyreceiving$61permonthfortwohoursofbillableservicecoordinationpereligiblechildfromDHS.(Inaddition,DHSinformedOSEPthatDHSismovingtoafeeforservicesystemforallservicesinthefuture.Thischangemayhaveafurtherimpact.)??7(?8.` hp x (#8S\  `&Times New RomanS II.PROVISIONOFEARLYINTERVENTIONSERVICES- -&  XXXS\  `&Times New RomanS  Background:'  EachStatemustdeveloppoliciesandprocedurestoensurethatIFSPsareindividuallydevelopedandimplementedforeacheligiblechildandthechildsfamily.TheStatemustensurethatallappropriateearlyinterventionservicesareidentifiedandprovidedconsistentwith34CFR303.344. Finding2: OSEPfindsthatDHShasnotensuredthatearlyinterventionservicesareindividuallydeterminedandthatneededservicesareincludedontheIFSPandprovided.ThelawrequiresthateachIFSPmustincludeastatementofspecificearlyinterventionservicesnecessarytomeettheuniqueneedsofthechildandthechildsfamilytoachievetheoutcomesidentified,includingthefrequency,intensity,andmethodofdeliveringservices;thenaturalenvironmentsinwhichearlyinterventionserviceswillbeprovided;thelocationoftheservices;andpaymentarrangements,ifany(303.344(d)). ( A $( , ;1` hp x (#;  23  ..LackofindividualizeddecisionsbytheIFSPteam!   8.` hp x (#8 DecisionsrelatedtotheprovisionofearlyinterventionservicesmustbemadeinanIFSPmeeting,byamultidisciplinaryteamthatincludestheparent.OSEPwastoldbyChildandFamilyConnectionsmanagers,servicecoordinators,andprovidersineachoftheProviderAreasvisitedthatenrolledserviceproviderspredeterminethelocationandintensityoftheservicestheyprovideregardlessofthechildsneedsortheresultsoftheevaluationandassessments,andthatthesedecisionsarenotmadebytheIFSPteam.ServicecoordinatorsinProviderAreaDreportedthatthemethodofservicedeliverywasbasedonthephilosophyofaparticularprogram/providerandoftenthenumberofavailablestaff.Forexample,inProviderAreaC,aChildandFamilyConnectionsmanagerreportedthatallphysicaltherapyservicesareprovidedinacenterandallspecialinstructionisprovidedonlyinthechildshomewithoutindividualizeddecisionmakingbytheIFSPteam.InProviderAreaB,speechservicesareonlyprovidedingroupsettingsinacenterbasedprogram.InProviderareasAandB,alltherapyservicesareprovidedonlyinacentersetting.Servicestoachildandthechildsfamilyaremostoftenbasedontheavailabilityoftheexistingservicesandtheconfigurationoftheservicedeliverysystem(e.g.,servicesonlyavailableonacertaindayfromonlyoneavailableprovider).AcrosstheState,OSEPwastoldbyongoingservicecoordinatorsandprovidersthattheearlyinterventionservicesidentifiedonachildsIFSPwerethoseservicesavailablewithintheirownagencyortheDHS participatingprovidernetwork.OSEPwasalsotoldthatunlessapaymentsourcecouldbereadilyidentifiedforaspecificneededearlyinterventionservice,itwastypicallynotincludedinachildsIFSP.OSEPwastoldthatthetypeandlocationofservices,andparticularlytheidentificationofaserviceproviderwasbasedon familychoice.ChildandFamilyConnectionsmanagersexplainedtoOSEPthattheexpresseddesiresofthefamilyrelatedtothechoiceoftheproviderofearlyinterventionserviceswerehonoredinanefforttobe familyfriendly.ManydecisionsaboutserviceproviderswerenotmadebythemultidisciplinaryteaminanIFSPmeetingwithparentalinput,butratherunilaterallybyoneteammember,theparent.FamiliesandserviceprovidersintheruralareasservedbyProviderAreasBandCreportedthatoftentheonlyoptionsforfamilieswereasingleavailableproviderornoserviceatall.  , ;1` hp x (#;  23  ..Lackofpersonnel!   8.` hp x (#8 DuringtheinitialandexitinterviewswithDHSstaffandothers,allacknowledgedthecriticalneedtogreatlyexpandtheparticipatingprovidernetworkinordertoensurethatsufficientnumbersofserviceprovidersareavailableandtoensurethatnochildwaitforservices.Theleadagency,initsapplication,assuredthatitwouldfullyimplementthestatewidesystemofearlyinterventionservices.Inordertodoso,itmusthaveadequatenumbersofappropriatelycertifiedandtrainedpersonnel.34CFR303.360303.361.OSEPfoundthisnottobethecase.Statewide,ChildandFamilyConnectionsmanagers,servicecoordinators,serviceproviders,andparentsidentifiedspecificpersonnelshortageswithineachoftheirserviceareas.Theresultoftheseshortageswasevidencedinoneoftwoways:eitherspecificearlyinterventionserviceswerenotlistedonachildsIFSPalthoughtherewasadocumentedneed,ortheservicewasidentifiedontheIFSPandthechildwasplacedonawaitinglistuntilaserviceproviderbecameavailablewithinthe participatingprovidernetwork.Asexamples:theChildandFamilyConnectionsmanagersinProviderAreaAreportedthattherewerenotenoughprovidersofoccupationalandphysicaltherapyservices;aserviceproviderfromthatsameareaconfirmedthatmanychildrenwerenotreceivingtheservicesontheirIFSPsbecauseofthelackofproviders.ServicecoordinatorsfromProviderAreasBandCstatedthataneededearlyinterventionservicewasnotlistedonachildsIFSPiftherewerenotavailableproviders.AserviceproviderfromProviderAreaCtoldOSEPthatvisionserviceswerenotcurrentlyavailabletochildrenwithdocumentedneedsforthisserviceontheirIFSP,becausetheenrolledvisionprovider wasswamped.ChildandFamilyConnectionsmanagersandserviceprovidersfromProviderAreaEtoldOSEPthattherewerewaitinglistsforsometherapyservices(e.g.,speechservices)dueto programcapacityissues.BothinmeetingswithOSEPandatthestakeholdersmeetingDHSstaffacknowledgedtheneedforadditionalserviceprovidersacrosstheState.  , ;1` hp x (#;  23  ..Lackofsufficientfundsorotherresources!   8.` hp x (#8 TheIFSPisdesignedasacomprehensivedocumentusedtoidentifythespecificearlyinterventionservicesneededtomeettheuniqueneedsofthechildandthechildsfamily,aswellasmedicalandotherservicesneededthatarenotthedirectresponsibilityoftheearlyinterventionsystem.ChildandFamilyConnectionsmanagers,ongoingservicecoordinators,andfamiliesacrosstheStatetoldOSEPthattransportation,assistivetechnology,andrespitecarearenottypicallyidentifiedservicesonachildsIFSP,eventhoughtheneedwasdocumented.ChildandFamilyConnectionsmanagersreportedthatthesethreeserviceswerenotincludedinagencycontractsfromDHSandtherewasnootherfiscalmechanismtosupporttheseservices.Forexample,ChildandFamilyConnectionmanagersandservicecoordinatorsinProviderAreaCreportedthattheydidnotknowhowtoaccessreimbursementofanycostsassociatedwithparenttravelforearlyinterventionservices,thereforeneededtransportationserviceswerenotincludedonIFSPs.ThesemanagersalsoreportedthattheycouldnotobtainlanguageinterpretersforIFSPmeetingsbecausetherewasnomethodforfinancialsupport(e.g.,forparentswhoaredeaforhavelimitedEnglishproficiency).ThisviolatesPartCrequirements thatIFSPmeetingsmustbeconducted...inthenativelanguageofthefamilyorothermodeofcommunicationusedbythefamily,unlessitisclearlynotfeasibletodoso.34CFR303.342(d)and(e).AChildandFamilyConnectionsmanagerfromProviderAreaBalsostatedthatthelackoftransportationservicespreventedsomeofthechildrentheyservedfromreceivingotherneededearlyinterventionservicesidentifiedontheirIFSP.AservicecoordinatorfromProviderAreaCtoldOSEPthatachildwithanauditoryimpairmentinneedofahearingaidwasreferredbacktothechildsownphysicianforassistanceinobtainingahearingaidbecauseofthelackoffundingresourceswithintheearlyinterventionsystem.Thepracticedetailedabovehasresultedinchildrenbeingdeniedappropriateearlyinterventionservicesthathavebeendocumentedasaneedbasedonevaluationsandassessments.??7(?S\  `&Times New RomanS III.GENERALADMINISTRATIONANDSUPERVISION- -XXXS\  `&Times New RomanS  Background: Under303.501,eachStatemustensurethatallprogramsandactivitiesusedtoimplementthestatewideearlyinterventionsystemareconsistentwith34CFRPart303.TheStateisrequiredtoadoptandusepropermethodsofadministeringtheprogram,including:monitoringagencies,institutionsandorganizationsusedbytheState,enforcingobligationsimposedonthoseentitiesasaresultoftheseregulations,providingtechnicalassistanceifnecessary,andcorrectingdeficienciesthatareidentifiedthroughmonitoring.EachStatesapplicationmustcontaininformationandprocedurestoensuretheabove.IllinoisFY19961998PartCapplicationcontainstherequiredproceduresanddocuments. Finding3: OSEPfindsthattheleadagencyhasnotfulfilleditsobligationforthegeneraladministration,supervisionandmonitoringofprogramsandactivitiesusedbytheState,whetherornottheyreceiveassistanceunderPartC,toimplementthestatewidesystemofearlyinterventionservicesinthefollowingareas: ( A $( , ;1` hp x (#;  23  ..Confidentiality(34CFR303.460)󀀄   8.` hp x (#8 EachStatemustestablishoradoptproceduralsafeguardstoensurethattherightsofchildrenandtheirfamiliesareprotected,includingprotectionoffamilyprivacy.Theprotectionofanypersonallyidentifiableinformationcollected,used,ormaintainedmustmeettherequirementsin34CFR300.560through300.576,withappropriatemodificationsforPartC.34CFR303.460.IllinoisprovidedassurancesinitsFY19961998applicationthatitadoptedpoliciesandproceduresgoverningconfidentialityofpersonallyidentifiableinformationthatareconsistentwith300.560300.576.Asexplainedbelow,OSEPfoundanumberofwaysinwhichDHSisnotmeetingtheconfidentialityrequirementsofIDEA,particularlythoserelatedtothestorageandmaintenanceofrecords.Section300.563oftheIDEAregulationsprovidesforprotectioninthedisclosureofpersonallyidentifiableinformation.Consistentwith34CFR300.563,theIllinoisEarlyInterventionServicesSystemProcedureManual,at02.20.00and02.60.20,statesthateachparticipatingagencymustmaintainarecordofindividualswhoobtainaccesstoachildsrecords,includingthenameoftheindividual,dateofaccess,andthepurposeforwhichthatindividualisauthorizedtoexaminetherecords.However,noneofthechildrensrecordsthatOSEPreviewedhadtherequiredaccessforms.Inaddition,recordsatProviderAreaCwerenotstoredinasecurelocation,butrathermaintainedinopenshelvinginanareawheretherewasgeneralaccessbyallagencystaff,manyofwhomwerenotassociatedwiththeinfantsandtoddlersprogram.See300.572.Inaddition,Illinoismonitoringprotocoldoesnotaddressimplementationoftherequirementsregardingtheprotectedaccessofpersonallyidentifiableinformationandotherconfidentialitymatters.Page20ofthe ChildRecordReview,FY1995onlyrequiresdocumentationofreleaseofinformationforms,notverificationoftheexistenceofaccesslogs,asrequiredby34CFR300.563.Page16ofthe LocalSystemDevelopmentReview,FY1995requiresdocumentationthat TheLSAhasproceduresinplacetoensuretheconfidentialityofallpersonallyidentifiableinformationaboutachildandthechildsfamily,and, Thereisevidenceinthechildsrecordthatinformationisnotreleasedtootheragenciesunlesstheparentgiveswrittenconsent.However,basedonOSEPsmonitoringvisit,theleadagencyneedstomodifyitsmonitoringprocedurestoaddressconfidentiality.  , ;1` hp x (#;  23  ..ProceduralSafeguards:PriorNotice;NativeLanguage󀄀(34CFR303.403(c))!   8.` hp x (#8 InorderforparentstoexercisetheirrightsundertheIDEA,theymusthaveaccesstoandunderstandalloftheproceduralsafeguards,includingconfidentialityprovisions.IDEAprovidesthatinformationcommunicatedtoparentsbeintheirnativelanguage,unlessnotfeasibletodoso,inaccordancewith34CFR303.403(c)and300.561(a)(1).Procedure01.00.00ofIllinoisEarlyInterventionServicesSystemProcedureManual(page2)confirmsthatfamilydueprocessrightsandotherproceduralsafeguardsaretobeprovidedinthefamilysprimarylanguageorothermodeofcommunication.However,acrosstheStateOSEPwastoldbyChildandFamilyConnectionsmanagersandservicecoordinatorsthattheParentsRightsbooklet,whichisusedaspartofnoticetoinformparentsaboutproceduralsafeguards,isonlyavailableinEnglish.ServiceprovidersfromProviderAreasDandEstatedthattherewerefamiliesintheircatchmentareawhoneededaSpanishversionoftheParentsRightsbookletbecausetheyweremonolingual,buttherewerenosuchtranslationsavailable B   .AChildandFamilyConnectionsmanagerfromProviderAreaDreportedthattheysoughtoutlocalassistanceinordertoprovidetheParentsRightsbookletinSpanishtoaSpanishspeakingfamily. C.PoliciesRelatedtoPaymentforServicesandFees(34CFR303.520303.521) EachleadagencyisresponsibleforestablishingStatepoliciesrelatedtohowservicestoeligiblechildrenandtheirfamilieswillbepaidforunderPartC.Thesepoliciesmustspecify,amongotheritems,whichfunctionsorservices,ifany,willbesubjecttoasystemofpayments,includinginformationaboutthepaymentsystemandscheduleofslidingfees,ifany,thatwillbeused.Thesepolicieswouldalsoaddressuseofthirdpartyprivateinsurance,asappropriateintheState.OSEPwastoldbymanyparentsandserviceprovidersthatthereisgreatconfusionacrosstheStateaboutthecollectionoffeesandthereisconsiderableinconsistencyrelatedtowhetherofnotfeeswillbecollected,andifso,whowillcollectthem.SeveralserviceprovidersstatedthattheyarenotcollectingtherequiredfeesbecausetheyhavereceivedconflictinginstructionsfromtheStateandhaddecidednottofurtherconfusefamiliesuntiltheStatemakesadefinitivedecisiononimplementationoffees.DuringthesixmonthspriortoOSEPsvisit,providersreportedthattheyweretoldbyISBE(leadagencyatthetime)thatthesystemoffeeswastobeimplemented,thentoldbyISBEtosuspendcollection,andthenjustpriortoourvisit,providersreportedthattheywereinformedbyDHStoreinstitutethefeecollection.MorethanoneproviderstatedthatshewasgoingtowaituntilDHSwascertainaboutthepermanencyofthefeeproceduresbeforeimposingitonfamilieswhoreceivedearlyinterventionservices.ParentsfromProviderAreasA,C,andD,toldOSEPthatfamiliespaidafeeforservicesbasedontheincomeinformationprovidedontheFamilyResourceInventory,eventhoughtheirprivateinsurancehadalreadypaidonehundredpercentofthecostoftheearlyinterventionservicesforwhichtheywerebeingbilled.TheStateisnotconsistentlyapplyingitspoliciesonfeesassetforthinitsFY19961998PartCapplication.  &    ( A $( , ;1` hp x (#;  23  ..Supervisionandmonitoringofprograms(303.501)!   8.` hp x (#8DHS,asleadagencyforPartC,isresponsibleforthegeneraladministrationandsupervisionofprogramsandactivitiesusedtoimplementPartCstatewide.Theleadagencyisrequiredtoadoptandusepropermethodsofadministeringeachprogramincluding:(1)monitoringagencies,institutions,organizationsusedbytheStatetocarryoutPartC;(2)enforcinganyobligationsimposedonthoseagenciesunderPartC;(3)providingtechnicalassistance,ifnecessary,tothoseagencies,institutions,organizations;and(4)correctingdeficienciesthatareidentifiedthroughmonitoring.'  AspartofDHSresponsibilityforgeneraladministration,DHSmustensurethatallpolicies(e.g.,Statestatutes,regulations,Governorsorder,directives,otherwrittendocumentsthatrepresenttheStatespositiononthisprogramsee34CFR303.19)relatedtotheimplementationofPartCareconsistentwith34CFRPart303. , 8.` hp x (#8  1...Monitoring󀄀  AppendixOofIllinoisFY19961998PartCapplicationcontainsinformationandproceduresabouttheComprehensiveQualityReviewSystem(FY1995)thattheleadagencyfollowstoconductitsmonitoringefforts.Thissystem,asdescribedinAppendixOoftheFY19961998application,includesaselfassessmentprocess,anannualplanupdate,aconsumersatisfactionsurvey,onsitequalityreviewvisits,andtechnicalassistance.TheComprehensiveQualityReviewSystemoftheIllinoisEarlyInterventionServicesSystem(e.g.,localsystemdevelopmentreviewandchildrecordreview)doesincludeelementsthatwouldenabletheleadagencytoidentifyimplementationproblems.However,areviewofthesedocumentsindicatesinaccuraciesinthefollowingareas:       (#   8.` hp x (#8"  " X 5+ ` hp x (#5    *..LocalSystemDevelopmentReview(FY1995)Pages16and17:Themonitoringsectiononconfidentialitydoesnotcontainalltherequiredelements,consistentwith34CFR300.560300.573.Illinoisdocumentismissingthefollowing:300.562,300.564300.573.  X    *..ChildRecordReview(FY1995)Page3(item1.2,3)incorrectlyincludeschildrenatriskofdevelopmentaldelayasaneligiblepopulationforPartCinIllinois,whichisinconsistentwithIllinoisFY19961998application.   8.` hp x (#8 , 8.` hp x (#8  2...Guidance󀄀  EachoftheChildandFamilyConnectionsmanagerstoldOSEPthattheEarlyInterventionServicesSystemProcedureManualistheirprimarysourceofguidanceforimplementationofPartC.ThisdocumentwasdevelopedandimplementedstatewidepriortoJanuary1,1998,whenDHSbecametheleadagencyforPartC.TheEarlyInterventionServicesSystemProcedureManual,whichwasdistributedtoallChildandFamilyConnectionssites,containsanumberofproceduresthatareinconsistentwith34CFRPart303,including:   8.` hp x (#8"  " X 5+ ` hp x (#5    1...ThroughouttheManual,referenceismadetosubmittinginformationtoISBEandISBEsresponsibilitiesfortheearlyinterventionsysteminIllinois.   5+4 4` hp x (#5  *..ThedocumentneedstoberevisedtorefertoDHSresponsibilityasleadagency.  X 8.` hp x (#8    2...P.4statesthat, Eitherpartymayrequestadelayinconveningahearingand/ortheprehearingconference.     5+4 4` hp x (#5  *..IntheStatesFY19961998application,theStateincludeddueprocessproceduresthatmettherequirementsof303.421303.425(PartCdueprocessprocedures).  8.44` hp x (#8    *..PartCdoesnotpermitextensionoftimelines.Thedocumentmustberevisedtoensurethattimelinesfordueprocesshearingdecisionsarenotextended,consistentwith34CFR303.423;and   8.` hp x (#8"  " X 5+ ` hp x (#5    3...ThroughoutthedocumentIllinoisresidencyandcitizenshiparerequiredasaconditionofreceivingearlyinterventionservices(see02.50.00,02.50.20,02.50.30,02.50.40,item2.0).  8.` hp x (#8  5+4 4` hp x (#5  *..ThedocumentmustbeamendedtoensurethatappropriateearlyinterventionservicesareavailabletoallchildrenintheStatewhoareeligibleandtheirfamilies.PartCdoesnotpermittheexclusionofeligiblechildrenwhodonothavecitizenship.   8.4` hp x (#8C  DS\  `&Times New RomanSEENCLOSUREB    ;1X` hp x (#;&    =?(=8.` hp x (#8OVERARCHINGSYSTEMCONCERNS - -XXXS\  `&Times New RomanS'  *FG d,x}}+  7777&"d7       d B$!OVERARCHINGCONCERNSRELATEDTOSYSTEMSDEVELOPMENT +77+    (#   d B$!;1` hp x (#; Duringthevisit,OSEPidentifiedseveralissuesofconcernwhichareraisedastechnicalassistancetotheleadagencyasfurtherrefinementsofthestatewidesystemofearlyinterventionservicedeliveryoccur: +77+    d B$!>4` hp x (#>  1...ThereisconfusionabouttheresponsibilitiesofandrelationshipbetweentheLocalInteragencyCouncilsandtheChildandFamilyConnectionsoffices,particularlywithrespecttowhichentityhasresponsibilityforchildfind,publicawareness,andthecompilationoflocaldirectoryinformation.ChildandFamilyConnectionsmanagersalsostatedtheirconfusionaroundwho,ifanyone,wasresponsibleforsupervisingtheLocalInteragencyCouncildirector,whosesalaryisincludedineachChildandFamilyConnectionsbudget.Insomecases,theLocalInteragencyCouncildirectorissupervisedbytheChildandFamilyConnectionsmanager,whileinotherareastheLocalInteragencyConnectionsdirectorisindependentoftheChildandFamilyConnections,regardlessofthefunctionsthateachentityperforms. +77+     d B$!>4` hp x (#>( H $(  A7` hp x (#A  23  ..TherewereavarietyofconcernsrelatedtothecommunicationlinkageswithintheStatesystem!     d B$!;1` hp x (#;( I $(>4` hp x (#>  23  ..TheredidnotappeartobeamechanismforcommunicationbetweentheLocalInteragencyCouncilsandtheStateInteragencyCoordinatingCouncilwhichcouldfacilitatebettercommunicationwithintheState;    d B$!;1` hp x (#;>4` hp x (#>  23  ..Inaddition,communicationlinksbetweentheChildandFamilyConnectionofficesandtheLocalInteragencyCoordinatingCouncilswereinconsistent;    d B$!>4` hp x (#>A7` hp x (#A  23  ..ChildandFamilyConnectionsmanagersconsistentlystatedthattheyhadlittleaccesstolocallygenerateddatathatwassenttoDHSanddidntknowwhichproviderswerenewlyregisteredwiththeCentralBillingOfficeintheState.Thisoftencausedconfusionorinabilitytoidentifyavailableserviceproviders.TheLeadAgencyalsoexpressedasimilarconcernthatatthetimeofOSEPsvisit,ChildandFamilyConnectionsofficescouldnotaccessstatewidedata;and        (#   d B$!>4` hp x (#>A7` hp x (#A  23  ..ThereappearstobenodirectcommunicationamongtheStateInteragencyCoordinatingCouncil,theLocalInteragencyCoordinatingCouncils,andDHS.OSEPwastoldthatthisoftenresultsinthelackofvaluableinformationfortheLeadAgencyandtheStateInteragencyCoordinatingCounciltoformulatestrategiesforsystemimprovement. +77+    2  d B$!>4` hp x >  3...TheinteragencylinkagesatboththeStateandlocallevelscontinuetobeachallenge.TheOSEPteamfoundnoevidencethatearlyinterventionservicecoordinatorswereworkingwithothercasemanagementorservicecoordinationprogramsinwhichachildmayalreadyreceivingservices,suchasMaternalandChildHealth(TitleV)orMedicaid(TitleXIX).Therealsoappearstobenomechanismforaservicecoordinatoralreadyworkingwithachildandhis/herfamily,butemployedbyanotherpublicagency,toalsoserveasthechildsearlyinterventionservicecoordinatorunderPartC.Thismayresultinduplicationofservicecoordinationforsomechildrenandtheirfamilies. +777+       8.` hp x (#8      d B$!>4` hp x (#>4...Inadditiontotheinconsistentimplementationofthesystemofpaymentsnotedinthereportabove,thereisevidencethattheStatemaynotbedetermining,onaconsistentbasis,afamilys abilitytopay.ParentsfromProviderAreasB,C,andE,serviceprovidersandChildandFamilyConnectionsmanagersfromProviderAreasAandBstatedthattheyknewoffamilieswhohadbeenpreviouslyenrolledintheearlyinterventionsystem,buthadwithdrawntheirchildrenfromserviceswhenfeeswereimplemented.ThisstatementwasrepeatedbyfamiliesacrosstheState,particularlyforchildrenwhosefamiliesincurredhighmedicalcostsfortheircare.AfamilyfromProviderAreaBtoldOSEPthattheywererequiredtopaytheslidingfeeseventhoughtheyowedlargesumsofmoneyforexpensivemedicalinterventionsandwereconsideringbankruptcybecauseofthedebt.AnotherfamilyfromProviderAreaEstatedthatoveraneighteenmonthperiodtheyhadgonethrough$1.5millionofprivateinsuranceexpenditures,another$40,000outofpocketformedicaltreatmentfortheirdaughter,andtheywerealsobeingassessedforearlyinterventionservicesonthePartCslidingfeescale.   XXXS\  `&Times New RomanS     (#    d B$!8.` hp x (#8OSEPwasalsotoldbyseveralChildandFamilyConnectionsmanagersthattheyknewoffamilieswhodecidednottoavailthemselvesofearlyinterventionservicesbecausetheydidnotwanttocompletetheFamilyResourceInventoryasaconditiontoreceiveearlyinterventionservices.Basedonthisinformation,theStateneedstoexaminewhetheritisuniformlyimplementingtherequirementin303.520(b)(3)(ii)that theinabilityoftheparentsofaneligiblechildtopayforserviceswillnotresultinthedenialofservicestothechildorthechildsfamily.   8.` hp x (#8