Wis. Admin. Code Department of Health Services DHS 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.
DHS
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.
DHS 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.
DHS 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.
DHS 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.
DHS 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.
(o)
Vision services. Vision services, to include:
1. Evaluation and assessment of visual
functioning, including the diagnosis and appraisal of specific visual
disorders, delays and abilities;
2.
Referral for medical and other professional services necessary for habilitation
or rehabilitation of visual functioning disorders, or both;
3. Communication skills training for all
environments, visual training, independent living skills training and
additional training to activate visual motor abilities; and
4. Provision of consultation to and training
of parents, other service providers and community agencies in regard to vision
services.
(5)
SERVICE DELIVERY.
(a)
Location of
services. To the maximum extent appropriate to the needs of the child,
early intervention services shall be provided in the child's natural
environments, including home and community settings where children without
disabilities participate. A setting other than a natural environment may be
used only when early intervention outcomes cannot be satisfactorily achieved
for the child in a natural environment. If reasons exist for providing services
in settings other than the child's natural environments, those reasons shall be
documented in the child's IFSP.
(b)
Method of service delivery. Early intervention services shall
be provided in ways that are most appropriate for meeting the needs of eligible
children and their families. These may include parent and child activities,
group activities, one-to-one sessions, and provision of a resource such as
staff time.
(6)
QUALIFIED PERSONNEL.
(a) Early intervention
services for eligible children and their families may only be provided by
qualified personnel listed in this subsection who meet Wisconsin requirements
for practice of their profession or discipline or other professionally
recognized requirements, as follows:
1.
Audiologists shall have at least a master's degree in audiology from an
accredited institution of higher education and be registered or licensed under
ch. 459, Stats.;
2. Early
intervention program assistants shall be at least 18 years of age and meet one
of the following requirements:
a. Have at
least 3 years of experience in supervising structured youth
activities;
b. Have completed at
least 3 years of college education;
c. Have a combination of education and
experience under subds. 1. and 2. totaling 3 years; or
d. Have completed a 2-year program in child
care and development approved by the Wisconsin department of public
instruction.
2m.
Marriage and family therapists shall be licensed [certified] under ch. 457,
Stats.;
3. Nutritionists shall be
registered or be eligible for registration as dietitians by the American
dietetic association, and dietitian technicians shall have at least an
associate degree from an accredited institution of higher education and be
registered as dietitian technicians by the American dietetic
association;
4. Occupational
therapists shall be licensed under ch. 448, Stats.; and occupational therapy
assistants shall be licensed under ch. 448, Stats.;
5. Orientation and mobility specialists shall
have completed an orientation and mobility program approved by the association
for education and rehabilitation of the blind and visually impaired;
6. Parent facilitators shall be parents of
children with disabilities who are hired by county administrative agencies or
service providers on the basis of their demonstrated skills in planning,
communicating and providing support to the parents of eligible
children;
7. Pediatricians and
other physicians shall be licensed under ch. 448, Stats., and physician
assistants shall be certified under s.
448.05(5),
Stats.;
8. Physical therapists
shall be licensed under ch. 448, Stats., and physical therapist assistants
shall have graduated from a 2-year college level program approved by the
American physical therapy association;
9. Psychologists shall be licensed under ch.
455, Stats.;
10. Registered nurses
shall be licensed under s.
441.06, Stats., and licensed
practical nurses shall be licensed under s.
441.10, Stats.;
11. Rehabilitation counselors shall have at
least a master's degree in rehabilitation counseling or a related
field;
12. School psychologists
shall be licensed under ch. 115, Stats., and ch. PI 34;
13. Social workers shall be certified under
ch. 457, Stats.;
14. Special
education teachers, including early childhood special education teachers,
vision teachers and hearing teachers, shall be licensed through the department
of public instruction; and
15.
Speech and language pathologists shall have at least a master's degree in
speech and language pathology from an accredited institution of higher
education and be registered or licensed under ch. 459, Stats., or shall be
licensed under ch. 115, Stats., and ch. PI 34.
(b) Early intervention personnel under par.
(a) 2., 3., 4., 6., 7., 8. and 10. who are paraprofessionals shall work under
supervision as defined by standards of the profession or standards developed by
the department.
Notes
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