DHS 90.12(2)(b)2.a. a. The purpose of each service to be provided and the manner in which the service will be provided. The parent’s written consent shall specify each service the parent has authorized;

DHS 90.12(2)(b)2.b. b. The known cost to the parents of the services, if there are any costs, whether direct or indirect;

DHS 90.12(2)(b)2.c. c. Any likely effects on the parents of each service;

DHS 90.12(2)(b)2.d. d. The possible consequences of not consenting to each proposed service; and

DHS 90.12(2)(b)2.e. e. If consent is not given, the child will not receive the services.

DHS 90.12(2)(b)3. 3. A parent may consent to some services and reject others. If the parent objects to a proposed service, the program may not provide that service. The county administrative agency may not limit or deny the provision of a particular service because the parent has refused to consent to another service.

DHS 90.12(2)(c) (c) For billing a third party. With the parent’s consent, a third party may be billed for early intervention services. The service coordinator shall ensure that the parent, prior to giving consent, is informed of 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.

DHS 90.12(3) (3) Confidentiality.

DHS 90.12(3)(a) (a) Personally identifiable information about a child, a parent of the child or other member of the child’s family is confidential at all stages of record development and maintenance, including information collection, storage, disclosure and destruction.

DHS 90.12(3)(b) (b) The county administrative agency is responsible for maintaining the confidentiality of a child’s early intervention records wherever those records are located. Any interagency agreement or contract with a service provider shall set forth the service provider’s responsibility to keep early intervention records confidential. One staff member at each agency maintaining early identification records shall be designated to ensure that personally identifiable information is kept confidential. The county administrative agency shall provide training to staff concerning the policies of early intervention record maintenance and confidentiality.

DHS 90.12(3)(c) (c) Parents may review the early intervention records of their child.

DHS 90.12(3)(d) (d) A county administrative agency or service provider may disclose confidential information from early intervention records, without parental consent, only to those of its employees who have a legitimate need for the information in the performance of their duties and to representatives of the department who require the information for purposes of supervising and monitoring services provision and enforcing this chapter. Each county administrative agency shall maintain a list attached to the early intervention record which identifies by name the parents and by name and title those employees of the agency and service providers who are identified in the child’s IFSP as having a legitimate need for access to the early intervention record and who will have unrestricted access to that record. Each county administrative agency shall also maintain a log as part of an early intervention record, on which the name of any other employee or representative given access to the record or to whom information from the record was disclosed shall be recorded, along with the date of access or disclosure and the purpose of the access or disclosure.

DHS 90.12(3)(e) (e) The parent’s written consent consistent with s. 51.30 (2), Stats., is required to disclose confidential information except as authorized in par. (d). If a parent refuses consent to release confidential information and the refusal falls within the scope of s. 48.981, Stats., the county administrative agency or service provider may take action in accordance with s. 48.981, Stats.

DHS 90.12(3)(f) (f) The county administrative agency shall annually give notice to fully inform parents about the types of personally identifiable information that will be collected, maintained and distributed about participants in the early intervention system or information compiled during child find activities. This notice shall:

DHS 90.12(3)(f)1. 1. Be given in the native languages of the various population groups and list the languages in which the notice is available;

DHS 90.12(3)(f)2. 2. Contain a description of the children on whom personally identifiable information is maintained, the types of information sought, the methods the agency intends to use in gathering the information, including the sources from whom information is gathered, and the uses to be made of the information;

DHS 90.12(3)(f)3. 3. Contain information regarding storage, disclosure to third parties and retention and destruction of personally identifiable information; and

DHS 90.12(3)(f)4. 4. Contain a description of all the rights of parents and children regarding this information, including rights under 34 CFR 99.

DHS 90.12(3)(g) (g) The county administrative agency shall inform the parent when personally identifiable information contained in the early intervention record is no longer needed to provide early intervention services. The information shall be destroyed at the request of the parent except that a permanent record of the child’s name, date of birth, the parent’s address, the parent’s phone number, names of service coordinators and service providers, and exit data, including year and age upon exit and any programs entered into upon exiting, may be maintained. In this paragraph, “destruction” means physical destruction or removal of personally identifiable information from the early intervention record.

DHS 90.12 Note Note: For the information of interested persons, the confidentiality provisions of ch. DHS 90 meet the confidentiality requirements of Part B of the Individuals with Disabilities Education Act, 20 USC ch. 33, and 34 CFR 300.560 to 300.576 and the requirement of 34 CFR Pt. 99, with the following modifications:

DHS 90.12 Note (1) Any reference in those places to “state education agency” or “SEA” means the department;

DHS 90.12 Note (2) Any reference to “education of all children with disabilities” or“provision of free appropriate public education to all children” means provision of services to eligible children and families;

DHS 90.12 Note (3) Any reference to “local education agencies” or “LEAs” or to“intermediate education units” means county administrative agencies;

DHS 90.12 Note (4) Any reference to 34 CFR 300.128 on identification, location and evaluation of children with disabilities means 34 CFR 303.164 and 303.321, comprehensive child find system; and

DHS 90.12 Note (5) Any reference to 34 CFR 300.129 on confidentiality of personally identifiable information means 34 CFR 303.460, confidentiality of information.

DHS 90.12(4) (4) Opportunity to examine records.

DHS 90.12(4)(a) (a) The parent of a child may review all early intervention records concerning the child unless the county administrative agency has been provided documentation that the parent does not have the authority to review a record under state law governing such matters as custody, foster care, guardianship, separation and divorce.

DHS 90.12(4)(b) (b) When a child’s parent asks to review the child’s early intervention records, the county administrative agency or service provider shall:

DHS 90.12(4)(b)1. 1. Make the records available to the parent without unnecessary delay but not later than 10 days following the date of the request except that, if the request is in connection with a meeting on the individualized family service plan or a hearing to resolve a dispute or complaint involving the parent and the county agency or service provider, the records shall be made available at least 5 days before the meeting or hearing but in no case later than 10 days following the date of the request;