Due to implementation of the Illinois Medical Assistance Program Illinois Medicaid Program Advanced Cloud Technology (IMPACT), there is a period of time during which no applications that require HFS enrollment, will be processed. This period begins May 29, 2015.
Please visit the IMPACT webpage for more information.
Please complete the applications below and follow the corresponding process. Allow 6-8 weeks for processing in order for the stated CANTS and criminal background checks to be completed and received.
- EI Credential Application EI Credential Application * Writable but needs to be printed and sent in.
- View EI Credential Application Podcast
- View New Credential Flowchart
- View New Associate Provider Flowchart
- CBO Enrollment Application(does not apply to Associate Level applicants).
- View CBO Instructional Podcast
- W-9 Questions Re: LLC
TO LEARN IF YOU ARE ENROLLED TO BILL FOR SERVICES, CALL THE CENTRAL BILLING OFFICE AT (800) 634-8540.
The Department of Human Services, Bureau of Early Intervention requires the following checks for all providers applying for or renewing an EI credential:
- CANTS (Child Abuse & Neglect Tracking System)
- Criminal background fingerprint vendors
- Illinois Sex Offender Registry (SOR)
No Provider shall be credentialed to provide early intervention services without the clearance results from all checks being documented by Provider Connections.
All new EI credential applicants are required to document:
- Specific educational/licensure requirements
- Completion of EI System Overview Training. System Overview training is now available online at www.illinoiseitraining.org and consists of an online component and 1 day face-to-face follow-up training. Provider Connections will process credential applications only if all educational/licensure requirements and a minimum of the online portion of EI System Overview training are documented as complete.
- Service Coordinators and Parent Liaisons will be allowed 3 months from the date their temporary credentials are issued to verify completion of System Overview training and their respective training requirements.
- Background check results.
- Completion of System Overview Training.
- Agreement to participate in Ongoing Professional Development Meetings.
Temporary Credential Requirements
In addition to the above mentioned educational and training requirements, all new providers will:
- Have 18 months from the date their temporary credentials are issued to complete the required 240 hours of consultation verification (Form)consultation verification (Form). DT-Hearing, DT-Vision, and DT-O&M and providers credentialed under the EI service categories of Clinical Assessment, Counseling and other Therapeutic Services, Nursing, Nutrition, and Social Services, as defined in Appendix C, need only document 120 hours.
- Documentation of this requirement must show that the individual participated in consultation with an appropriately experienced individual of the same discipline/Early Intervention service group who has experience working with children ages birth to three with special needs and their families. The consultation shall be in compliance with the professional standards of the individual seeking the credential, as determined and documented by the consultant.
- All new unlicensed providers (except DTs) must complete the four core knowledge areas during the 18-month temporary period. DTs are required to document the completed four core knowledge area requirements upon application.
The four core knowledge area requirements have been eliminated for all licensed providers.
A credential extension of up to 6 months for credentialed Specialist and Associate Level providers & 90 days for credentialed Service Coordinators and Parent Liaisons may be granted due to non-compliance with Supervised Professional Experience and/or completion of training requirements established due to extreme hardship or extenuating circumstances. Such requests will be evaluated on an individual case basis and must follow the prescribed procedures.
Credential Extension Request Form
What is the Ongoing Professional Development Plan (OPDP)?
All new/renewing EI credentialed providers must agree to participate in OPDP activities by using the Ongoing Professional Development Plan Form. OPDP activities are a once a month, non-billable, meeting held either face-to-face or over the telephone with an individual specialist-level credentialed provider or group, of which at least one member is a specialist-level credentialed provider. A Credentialed Provider, now including providers with a temporary credential, must document a minimum of 75% of their Ongoing Professional Development Plan (OPDP) meetings completed.
These meetings are intended to be used for professional development through discussion of client/family concerns, needs, strengths, resources, priorities, outcomes, strategies, and service plans in order to support best practices.