Chapter DHS 90

DHS 90.06(1)(e) (e) “Full financial information” means information about parental income, expenses, and assets that the county administrative agency requests to determine the parental cost share.

DHS 90.06(1)(f) (f) “Parent” means a child’s adoptive or biological mother or father who has legal responsibility for the child.

DHS 90.06(1)(g) (g) “Parental cost share” means an annual amount of money the county administrative agency determines to be due and payable currently from the parents.

DHS 90.06(1m) (1m) Designation by county board. The county board of each county shall designate a county department under s. 46.21, 46.22, 46.23, 51.42 or 51.437, Stats., a local public health agency or any other county agency or enter into a contract or agreement with any other public agency to be the administrative agency in the county for the birth to 3 program. That designation or notice of other arrangement shall be made by letter to the department.

DHS 90.06(2) (2) Responsibilities. A county administrative agency shall ensure that all of the following are done:

DHS 90.06(2)(a) (a) Parents, representatives of agencies that refer, evaluate or provide services to young children and their families in the community and other interested persons are involved in planning, development and operation of the early intervention service system;

DHS 90.06(2)(b) (b) A comprehensive child find system is established in accordance with s. DHS 90.07, including activities to make the public aware of the local birth to 3 program and development of a formal system of communication and coordination among pertinent agencies operating in the county that may have contact with eligible children and their families;

DHS 90.06(2)(c) (c) A service coordinator is designated for every child referred for evaluation. The service coordinator need not be an employee of the county administrative agency but shall be accountable to the county administrative agency;

DHS 90.06(2)(d) (d) The parents are informed orally and in writing about the purposes of the birth to 3 program, the process and the procedural safeguards;

DHS 90.06(2)(e) (e) The parents are collaborators in the IFSP planning process;

DHS 90.06(2)(f) (f) 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;

DHS 90.06(2)(g) (g) Core services are provided at no cost to the parent;

DHS 90.06(2)(h) (h) 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.

DHS 90.06(2)(i) (i)

DHS 90.06(2)(i)1. 1. 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:

DHS 90.06(2)(i)1.a. a. 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.

DHS 90.06(2)(i)1.b. b. Determine the annual income after disability deduction.

DHS 90.06(2)(i)1.c. c. Determine the federal poverty guidelines for the annual income after disability deduction and family size.

DHS 90.06(2)(i)1.d. d. 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.

DHS 90.06(2)(i)1.e. e. 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

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.

DHS 90.06(2)(i)2. 2. 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.

DHS 90.06(2)(i)3. 3. 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.

DHS 90.06(2)(i)4. 4. 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.

DHS 90.06(2)(i)5. 5. 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.

DHS 90.06(2)(i)6. 6. 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), Stats.

DHS 90.06(2)(j) (j) 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;

DHS 90.06(2)(k) (k) 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;

DHS 90.06(2)(L) (L) 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;

DHS 90.06(2)(n) (n) 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;

DHS 90.06(2)(o) (o)

DHS 90.06(2)(o)1. 1. 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;

DHS 90.06(2)(o)2. 2. 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. Records that might be kept with the early intervention record include an individual service plan under the programs established in ss. 46.011 (1g) and 46.272, Stats.

DHS 90.06(2)(p) (p) 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

DHS 90.06(2)(q) (q) 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 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; CR 20-039: am. (1) (a), (2) (o) 2. Register October 2021 No. 790, eff. 11-1-21.

DHS 90.07 DHS 90.07 Identification and referral.

DHS 90.07(1) (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.

DHS 90.07(2) (2) Informed referral network.

DHS 90.07(2)(a) (a) 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.

DHS 90.07(2)(b) (b) The informed referral network shall be made up of all primary referral sources. Primary referral sources include but are not limited to:

DHS 90.07(2)(b)1. 1. Parents;

DHS 90.07(2)(b)2. 2. All agencies which receive funds directly or through a subcontract under relevant federal programs;

DHS 90.07(2)(b)3. 3. 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;

DHS 90.07(2)(b)4. 4. Day care providers;

DHS 90.07(2)(b)5. 5. Schools; and

DHS 90.07(2)(b)6. 6. Other qualified personnel and local providers of services to young children and their families.

DHS 90.07(3) (3) Screening and referral for evaluation.

DHS 90.07(3)(a) (a) 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.

DHS 90.07(3)(b) (b) 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.

DHS 90.07(3)(c) (c)

DHS 90.07(3)(c)1. 1. A service provider may do informal or formal screening of a child as part of the service provider’s routine observations or intake procedures.

DHS 90.07(3)(c)2. 2. 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 History 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.

DHS 90.08 DHS 90.08 Evaluation.

DHS 90.08(1) (1) 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.

DHS 90.08(2) (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.

DHS 90.08(3) (3) EI team.

DHS 90.08(3)(a) (a) 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.

DHS 90.08(3)(b) (b) Qualified personnel who are qualified to serve on the EI team are the following:

DHS 90.08(3)(b)1. 1. 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.;

DHS 90.08(3)(b)2. 2. Nutritionists registered as dietitians by or eligible for registration as dietitians by the American dietetic association;

DHS 90.08(3)(b)3. 3. Occupational therapists licensed under ch. 448, Stats.;

DHS 90.08(3)(b)4. 4. Physical therapists licensed under ch. 448, Stats.;

DHS 90.08(3)(b)5. 5. Physicians licensed under ch. 448, Stats.;

DHS 90.08(3)(b)6. 6. Psychologists licensed under ch. 455, Stats.;

DHS 90.08(3)(b)7. 7. 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;

DHS 90.08(3)(b)8. 8. Registered nurses with at least a bachelor’s degree in nursing from an accredited institution of higher education and licensed under s. 441.06, Stats.;

DHS 90.08(3)(b)9. 9. School psychologists licensed under ch. 115, Stats., and ch. PI 34;

DHS 90.08(3)(b)10. 10. Social workers certified under ch. 457, Stats.;

DHS 90.08(3)(b)11. 11. Special education teachers, including early childhood special education needs teachers, vision teachers and hearing teachers, licensed through the department of public instruction;

DHS 90.08(3)(b)12. 12. 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; and

DHS 90.08(3)(b)13. 13. Other persons qualified by professional training and experience to perform the evaluation and determine eligibility.

DHS 90.08(4) (4) 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.

DHS 90.08(5) (5) Determination of developmental delay.

DHS 90.08(5)(a) (a) A determination of developmental delay shall be based upon the EI team’s clinical opinion supported by:

DHS 90.08(5)(a)1. 1. A developmental history of the child and other pertinent information about the child obtained from parents and other caregivers;

DHS 90.08(5)(a)2. 2. 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

DHS 90.08(5)(a)3. 3. 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:

DHS 90.08(5)(a)3.a. a. Cognitive development;

DHS 90.08(5)(a)3.b. b. Physical development, including vision and hearing;

DHS 90.08(5)(a)3.c. c. Communication development;

DHS 90.08(5)(a)3.d. d. Social and emotional development; and

DHS 90.08(5)(a)3.e. e. Adaptive development which includes self-help skills.

DHS 90.08(5)(b) (b) 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.