Written consent of the child's parents is obtained, in accordance with s. DHS 90.12 (2) (a)
, before the initial evaluation and assessment are conducted;
Other early intervention services as identified in s. DHS 90.11 (4)
are provided in accordance with the IFSP. County administrative agencies shall determine the parental cost share of early intervention services costs not met by third party payers in accordance with par. (i)
. Parental cost share for early intervention services shall begin with services designated in IFSPs developed or reviewed on or after March 1, 2002.
Parental cost shares are determined. The county administrative
agency shall have billing, revenue collection and revenue tracking responsibility for the parental cost share unless the county administrative agency delegates these responsibilities to a service provider by written agreement specifying the conditions of the delegation. A county administrative agency shall make an assessment of the parental cost share for services to an eligible child in the following manner:
Determine the annual income of the parents. When the legally responsible parents live in separate households and the child eligible for the birth to 3 program resides in both households, the family size is determined for each household. There is a separate parental cost share determined for each household.
Determine the federal poverty guidelines for the annual income after disability deduction and family size.
Determine the percent above or below the federal poverty guidelines determined in subd. 1. c.
, the family's annual income after disability deduction determined in subd. 1. b.
, and assign the parental cost share according to Table DHS 90.06.
The maximum parental cost share is $1,800 per year without regard to the number of children in the birth to 3 program in the family. When the legally responsible parents live in separate households and the child eligible for the birth to 3 program resides in both households, combined cost shares may not exceed $1,800. The cost shares shall be divided between the parents based on the parents' relative income.
Table DHS 90.06
Assignment of Parental Cost Share
- See PDF for table
DHS 90.06 Note
Note: The Federal Poverty Guidelines are adjusted yearly and are published annually in the Federal Register. The Department will distribute the applicable Federal Poverty Guidelines information that is effective each year. To receive the current Federal Poverty Guidelines, contact the Birth to 3 Program Coordinator at the Division of Disability and Elder Services, P.O. Box 7851, Madison, WI 53707, or call 608-266-8276, or fax 608-261-6752.
A parent who is informed of his or her rights and who knowingly refuses to provide full financial information is held liable for the maximum parental cost share.
A parental cost share for early intervention services is assessed unless the parents have financial liability for other services subject to the uniform fee system that are provided to the eligible child.
Parents are informed of their right to request a waiver of the parental cost share in part or in whole if the request is based on unique circumstances of the child or family.
Parents are informed as early as is administratively feasible of the parents' rights and responsibilities under the cost share system. The department shall provide sample brochures to county administrative agencies to assist the agencies in informing parents.
Revenue received from payments of the parental cost share is used only for early intervention services within the county and do not supplant county funds required under s. 51.44 (3) (c)
Written consent of the child's parent is obtained, in accordance with s. DHS 90.12 (2) (b)
, for provision of early intervention services for the child and family to implement the IFSP;
Interagency agreements are entered into with other local agencies to identify respective roles and responsibilities in the delivery of early intervention services, coordinate service delivery, ensure the timely delivery of services and identify how disputes will be resolved when there is disagreement about the agency responsible for provision of a particular service;
The confidentiality of personally identifiable information about a child, a parent of the child or other member of the child's family, in accordance with s. DHS 90.12 (3)
, is maintained;
The need of a child for a surrogate parent is determined, and a surrogate parent is appointed in accordance with s. DHS 90.13
if the child needs one;
An early intervention record is maintained for each child which includes the individualized family service plan for the child, all records of core services and other early intervention services received by the child, parental consent documents and other records pertaining to the child or the child's family required by this chapter, and these are made available for inspection by the child's parents and representatives of the department;
The early intervention record is kept separate from other records on the child maintained by the agency unless the parent specifically agrees in writing that another record and the early intervention record be kept together. Other records that might be kept with the early intervention record are the family support assessment and plan under s. 46.985, Stats., and ch. DHS 65
, and the community options program assessment under s. 46.27 (6)
DHS 90.06 Note
Note: Section 46.985, Stats., was repealed by 2015 Wis. Act 55 rendering Chapter DHS 65 unenforceable and without effect. Chapter DHS 65 will be repealed in future rulemaking.
Local birth to 3 program records are maintained, including interagency agreements, records of how funds were budgeted and expended, records of personnel qualifications, records related to state training plan implementation and copies of contracts and agreements with service providers, and these are made available for inspection by representatives of the department; and
The department is provided, on request, with information on use of funds, system development, number of children needing and receiving early intervention services, types of services needed, types of services provided and such other information the department requires to describe and assess the operation of the local program.
DHS 90.06 History
Cr. Register, June, 1992, No. 438
, eff. 7-1-92; emerg. am. (1), (2) (c), (g) and (n), renum. (2) (m) to be (2) (m) 1., cr. (2) (m) 2., eff. 1-1-93; am. (1), (2) (c), (g) and (n), renum. (2) (m) to be (2) (m) 1., cr. (2) (m) 2., Register, June, 1993, No. 450
, eff. 7-1-93;
am. (2) (g), renum. (2) (h) to (o) to be (2) (i) to (p), cr. (2) (h), Register, April, 1997, No. 496
, eff. 5-1-97; corrections in (2) (h) and (n) made under s. 13.93 (2m) (b) 7., Register, September, 1999, No. 525
; emerg. renum. (1) to be (1m) and (2) (i) to (p) to be (2) (j) to (q), cr. (1) and (2) (i), am. (2) (h), eff. 10-1-01. CR 01-106
: renum. (1) to be (1m) and (2) (i) to (p) to be (2) (j) to (q), cr. (1) and (2) (i), am. (2) (h), Register February 2002 No. 554
, eff. 3-1-02; CR 03-033
: r. (2) (m) Register December 2003 No. 576
, eff. 1-1-04; corrections in (1) (a) and (2) (o) 2. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635
DHS 90.07 Identification and referral. DHS 90.07(1)
Establishment of child find system.
Each county administrative agency shall establish a comprehensive child find system to ensure that all children who may be eligible for the birth to 3 program are identified and referred for screening or for evaluation to determine eligibility for the birth to 3 program. The system shall include public awareness activities and an informed referral network.
A county administrative agency shall establish a formal system of communication and coordination among agencies and others within the community serving young children. This referral network shall identify and include local providers of services related to early intervention, enhance each provider's knowledge of eligibility criteria under this chapter and coordinate referrals to the local birth to 3 program.
The informed referral network shall be made up of all primary referral sources. Primary referral sources include but are not limited to:
All agencies which receive funds directly or through a subcontract under relevant federal programs;
Health care providers such as neonatal intensive care units, perinatal follow-through clinics, hospitals, physicians, public health agencies and facilities, and rehabilitation agencies and facilities;
Other qualified personnel and local providers of services to young children and their families.
If the primary referral source suspects that an infant or toddler has a developmental delay, the primary referral source shall conduct or request a formal screening to determine if there is reason to refer the child for an evaluation.
If the primary referral source has reasonable cause to believe that a child has a diagnosed physical or mental condition which has a high probability of resulting in a developmental delay or has a developmental delay, the primary referral source shall refer the child for an evaluation. The primary referral source shall ensure that referral for evaluation is made no more than 2 working days after a child has been identified.
DHS 90.07 Note
Note: Referral sources should differentiate between a request or need for a formal screening and referral for an evaluation. For example, a child diagnosed as having Down syndrome, which has a high probability of resulting in a developmental delay, should be referred for an evaluation rather than a formal screening, whereas a child who seems slow in speech or motor development may first be formally screened to determine if there is need for an evaluation.
A service provider may do informal or formal screening of a child as part of the service provider's routine observations or intake procedures.
Following either a formal or informal screening, the primary referral source or the service provider shall inform the parent of the reason, procedures and results of the screening.
DHS 90.07 Note
Note: While parental consent is not required to screen a child, the service provider is encouraged to give the parent information about the screening process before conducting the screening.
DHS 90.07 History
Cr. Register, June, 1992, No. 438
, eff. 7-1-92;
am. (1), (3) (b) 2., Register, April, 1997, No. 496
, eff. 5-1-97; am (1), r. and recr. (3), Register, September, 1999, No. 525
, eff. 10-1-99.
Designation of service coordinator.
When a child is referred to the birth to 3 program for evaluation and possible early intervention services, the county administrative agency shall as soon as possible designate a service coordinator for that child and the child's family.
(2) Determination of eligibility.
A referred child shall be evaluated in accordance with the criteria under sub. (4)
to determine the child's eligibility for early intervention services under the program.
In consultation with the parent and based on the child's suspected needs, the service coordinator shall select at least 2 qualified personnel from those under par. (b)
who, with the parent and service coordinator, will make up the EI team to perform the evaluation and make the determination of eligibility. Qualified personnel may be from different agencies and shall be from at least 2 different disciplines in areas of suspected need. The service coordinator may be one of the qualified personnel if the service coordinator is qualified as required under par. (b)
. At least one of the qualified personnel shall have expertise in the assessment of both typical and atypical development and expertise in child development and program planning.
Qualified personnel who are qualified to serve on the EI team are the following:
Audiologists with at least a master's degree in audiology from an accredited institution of higher education who are registered or licensed under ch. 459, Stats.
Nutritionists registered as dietitians by or eligible for registration as dietitians by the American dietetic association;
Rehabilitation counselors employed by the department's division of vocational rehabilitation as coordinators of hearing impaired services who have at least a master's degree in rehabilitation counseling or a related field;
Registered nurses with at least a bachelor's degree in nursing from an accredited institution of higher education and licensed under s. 441.06
Special education teachers, including early childhood special education needs teachers, vision teachers and hearing teachers, licensed through the department of public instruction;
Speech and language pathologists with at least a master's degree in speech and language pathology from an accredited institution of higher education and who are registered under ch. 459, Stats.
, or licensed under ch. 115, Stats.
, and ch. PI 34
Other persons qualified by professional training and experience to perform the evaluation and determine eligibility.
A child is eligible for early intervention services under the birth to 3 program if the EI team determines under sub. (5)
that the child is developmentally delayed or under sub. (6)
that the child has a diagnosed physical or mental condition which will likely result in developmental delay.
A determination of developmental delay shall be based upon the EI team's clinical opinion supported by:
A developmental history of the child and other pertinent information about the child obtained from parents and other caregivers;
Observations made of the child in his or her daily settings identified by the parent, including how the child interacts with people and familiar toys and other objects in the child's environment; and
Except as provided under par. (b)
, a determination of at least 25% delay in one or more areas of development as measured by a criterion referenced instrument, or a score of 1.3 or more standard deviation below the mean in one or more areas of development as measured by a norm-referenced instrument, and interpreted by a qualified professional based on informed clinical opinion. In this subdivision, “areas of development" mean:
If the results of the formal testing under par. (a) 3.
closely approach but do not equal the standard in par. (a) 3.
for a developmental delay but observation by qualified personnel or parents indicates that some aspect of the child's development is atypical and is adversely affecting the child's overall development, the EI team may use alternative procedures or instruments that meet acceptable professional standards to document the atypical development and to conclude, based on informed clinical opinion, that the child should be considered developmentally delayed.
DHS 90.08 Note
Note: Examples of atypical developments are asymmetrical movement, variant speech and language patterns, delay in achieving significant interactive milestones such as exhibiting a pleasurable response to a caregiver's attention, and presence of an unusual pattern of development such as a sleep disturbance or eating difficulties.
(6) Determination of diagnosed condition.
A determination of high probability that a child's diagnosed physical or mental condition will result in a developmental delay shall be based upon the EI team's informed clinical opinion supported by a physician's report documenting the condition. High probability implies that a clearly established case has been made for a developmental delay.
DHS 90.08 Note
Note: Examples of these diagnosed conditions are chromosomal disorders such as Down syndrome, birth defects such as spina bifida, significant or progressive vision or hearing impairment, neuromotor disorders such as cerebral palsy, postnatal traumatic events such as severe head injuries, severe emotional disturbances, dysmorphic syndromes such as fetal alcohol syndrome, addiction at birth, a maternal infection transmitted to the fetus such as AIDS, neurological impairments of unknown etiology such as autism, untreated metabolic disorders such as PKU and certain chronic or progressive conditions.
The service coordinator shall ensure that the parents of the child are involved and consulted throughout the entire evaluation process.
The EI team shall examine all relevant available data concerning the child, including the following:
Medical records and other health records concerning the child's medical history and health status, including physical examination reports, results of vision and hearing screenings, hospital discharge records and specialty clinic reports;
Any records and screening results of the child's developmental functioning in the following areas: