HB4836 EngrossedLRB100 16056 RLC 31175 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Developmental Disability and Mental
5Disability Services Act is amended by changing Section 2-3 as
6follows:
 
7    (405 ILCS 80/2-3)  (from Ch. 91 1/2, par. 1802-3)
8    Sec. 2-3. As used in this Article, unless the context
9requires otherwise:
10    (a) "Agency" means an agency or entity licensed by the
11Department pursuant to this Article or pursuant to the
12Community Residential Alternatives Licensing Act.
13    (b) "Department" means the Department of Human Services, as
14successor to the Department of Mental Health and Developmental
15Disabilities.
16    (c) "Home-based services" means services provided to an
17adult with a mental disability who lives in his or her own
18home. These services include but are not limited to:
19        (1) home health services;
20        (2) case management;
21        (3) crisis management;
22        (4) training and assistance in self-care;
23        (5) personal care services;

 

 

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1        (6) habilitation and rehabilitation services;
2        (7) employment-related services;
3        (8) respite care; and
4        (9) other skill training that enables a person to
5    become self-supporting.
6    (d) "Legal guardian" means a person appointed by a court of
7competent jurisdiction to exercise certain powers on behalf of
8an adult with a mental disability.
9    (e) "Adult with a mental disability" means a person over
10the age of 18 years who lives in his or her own home; who needs
11home-based services, but does not require 24-hour-a-day
12supervision; and who has one of the following conditions:
13severe autism, severe mental illness, a severe or profound
14intellectual disability, or severe and multiple impairments.
15    (f) In one's "own home" means that an adult with a mental
16disability lives alone; or that an adult with a mental
17disability is in full-time residence with his or her parents,
18legal guardian, or other relatives; or that an adult with a
19mental disability is in full-time residence in a setting not
20subject to licensure under the Nursing Home Care Act, the
21Specialized Mental Health Rehabilitation Act of 2013, the ID/DD
22Community Care Act, the MC/DD Act, or the Child Care Act of
231969, as now or hereafter amended, with 3 or fewer other adults
24unrelated to the adult with a mental disability who do not
25provide home-based services to the adult with a mental
26disability, or a facility licensed by a unit of local

 

 

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1government authority with 4 or 5 other adults unrelated to the
2adult with a mental disability who do not provide home-based
3services to the adult with a mental disability.
4    (g) "Parent" means the biological or adoptive parent of an
5adult with a mental disability, or a person licensed as a
6foster parent under the laws of this State who acts as a foster
7parent to an adult with a mental disability.
8    (h) "Relative" means any of the following relationships by
9blood, marriage or adoption: parent, son, daughter, brother,
10sister, grandparent, uncle, aunt, nephew, niece, great
11grandparent, great uncle, great aunt, stepbrother, stepsister,
12stepson, stepdaughter, stepparent or first cousin.
13    (i) "Severe autism" means a lifelong developmental
14disability which is typically manifested before 30 months of
15age and is characterized by severe disturbances in reciprocal
16social interactions; verbal and nonverbal communication and
17imaginative activity; and repertoire of activities and
18interests. A person shall be determined severely autistic, for
19purposes of this Article, if both of the following are present:
20        (1) Diagnosis consistent with the criteria for
21    autistic disorder in the current edition of the Diagnostic
22    and Statistical Manual of Mental Disorders.
23        (2) Severe disturbances in reciprocal social
24    interactions; verbal and nonverbal communication and
25    imaginative activity; repertoire of activities and
26    interests. A determination of severe autism shall be based

 

 

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1    upon a comprehensive, documented assessment with an
2    evaluation by a licensed clinical psychologist or
3    psychiatrist. A determination of severe autism shall not be
4    based solely on behaviors relating to environmental,
5    cultural or economic differences.
6    (j) "Severe mental illness" means the manifestation of all
7of the following characteristics:
8        (1) A primary diagnosis of one of the major mental
9    disorders in the current edition of the Diagnostic and
10    Statistical Manual of Mental Disorders listed below:
11            (A) Schizophrenia disorder.
12            (B) Delusional disorder.
13            (C) Schizo-affective disorder.
14            (D) Bipolar affective disorder.
15            (E) Atypical psychosis.
16            (F) Major depression, recurrent.
17        (2) The individual's mental illness must substantially
18    impair his or her functioning in at least 2 of the
19    following areas:
20            (A) Self-maintenance.
21            (B) Social functioning.
22            (C) Activities of community living.
23            (D) Work skills.
24        (3) Disability must be present or expected to be
25    present for at least one year.
26    A determination of severe mental illness shall be based

 

 

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1upon a comprehensive, documented assessment with an evaluation
2by a licensed clinical psychologist or psychiatrist, and shall
3not be based solely on behaviors relating to environmental,
4cultural or economic differences.
5    (k) "Severe or profound intellectual disability" means a
6manifestation of all of the following characteristics:
7        (1) A diagnosis which meets Classification in Mental
8    Retardation or criteria in the current edition of the
9    Diagnostic and Statistical Manual of Mental Disorders for
10    severe or profound mental retardation (an IQ of 40 or
11    below). This must be measured by a standardized instrument
12    for general intellectual functioning.
13        (2) A severe or profound level of disturbed adaptive
14    behavior. This must be measured by a standardized adaptive
15    behavior scale or informal appraisal by the professional in
16    keeping with illustrations in Classification in Mental
17    Retardation, 1983.
18        (3) Disability diagnosed before age of 18.
19    A determination of a severe or profound intellectual
20disability shall be based upon a comprehensive, documented
21assessment with an evaluation by a licensed clinical
22psychologist or certified school psychologist or a
23psychiatrist, and shall not be based solely on behaviors
24relating to environmental, cultural or economic differences.
25    (l) "Severe and multiple impairments" means the
26manifestation of all of the following characteristics:

 

 

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1        (1) The evaluation determines the presence of a
2    developmental disability which is expected to continue
3    indefinitely, constitutes a substantial disability and is
4    attributable to any of the following:
5            (A) Intellectual disability, which is defined as
6        general intellectual functioning that is 2 or more
7        standard deviations below the mean concurrent with
8        impairment of adaptive behavior which is 2 or more
9        standard deviations below the mean. Assessment of the
10        individual's intellectual functioning must be measured
11        by a standardized instrument for general intellectual
12        functioning.
13            (B) Cerebral palsy.
14            (C) Epilepsy.
15            (D) Autism.
16            (E) Any other condition which results in
17        impairment similar to that caused by an intellectual
18        disability and which requires services similar to
19        those required by persons with intellectual
20        disabilities.
21        (2) The evaluation determines multiple disabilities in
22    physical, sensory, behavioral or cognitive functioning
23    which constitute a severe or profound impairment
24    attributable to one or more of the following:
25            (A) Physical functioning, which severely impairs
26        the individual's motor performance that may be due to:

 

 

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1                (i) Neurological, psychological or physical
2            involvement resulting in a variety of disabling
3            conditions such as hemiplegia, quadriplegia or
4            ataxia,
5                (ii) Severe organ systems involvement such as
6            congenital heart defect,
7                (iii) Physical abnormalities resulting in the
8            individual being non-mobile and non-ambulatory or
9            confined to bed and receiving assistance in
10            transferring, or
11                (iv) The need for regular medical or nursing
12            supervision such as gastrostomy care and feeding.
13            Assessment of physical functioning must be based
14        on clinical medical assessment by a physician licensed
15        to practice medicine in all its branches, using the
16        appropriate instruments, techniques and standards of
17        measurement required by the professional.
18            (B) Sensory, which involves severe restriction due
19        to hearing or visual impairment limiting the
20        individual's movement and creating dependence in
21        completing most daily activities. Hearing impairment
22        is defined as a loss of 70 decibels aided or speech
23        discrimination of less than 50% aided. Visual
24        impairment is defined as 20/200 corrected in the better
25        eye or a visual field of 20 degrees or less. Sensory
26        functioning must be based on clinical medical

 

 

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1        assessment by a physician licensed to practice
2        medicine in all its branches using the appropriate
3        instruments, techniques and standards of measurement
4        required by the professional.
5            (C) Behavioral, which involves behavior that is
6        maladaptive and presents a danger to self or others, is
7        destructive to property by deliberately breaking,
8        destroying or defacing objects, is disruptive by
9        fighting, or has other socially offensive behaviors in
10        sufficient frequency or severity to seriously limit
11        social integration. Assessment of behavioral
12        functioning may be measured by a standardized scale or
13        informal appraisal by a clinical psychologist or
14        psychiatrist.
15            (D) Cognitive, which involves intellectual
16        functioning at a measured IQ of 70 or below. Assessment
17        of cognitive functioning must be measured by a
18        standardized instrument for general intelligence.
19        (3) The evaluation determines that development is
20    substantially less than expected for the age in cognitive,
21    affective or psychomotor behavior as follows:
22            (A) Cognitive, which involves intellectual
23        functioning at a measured IQ of 70 or below. Assessment
24        of cognitive functioning must be measured by a
25        standardized instrument for general intelligence.
26            (B) Affective behavior, which involves over and

 

 

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1        under responding to stimuli in the environment and may
2        be observed in mood, attention to awareness, or in
3        behaviors such as euphoria, anger or sadness that
4        seriously limit integration into society. Affective
5        behavior must be based on clinical assessment using the
6        appropriate instruments, techniques and standards of
7        measurement required by the professional.
8            (C) Psychomotor, which includes a severe
9        developmental delay in fine or gross motor skills so
10        that development in self-care, social interaction,
11        communication or physical activity will be greatly
12        delayed or restricted.
13        (4) A determination that the disability originated
14    before the age of 18 years.
15    A determination of severe and multiple impairments shall be
16based upon a comprehensive, documented assessment with an
17evaluation by a licensed clinical psychologist or
18psychiatrist.
19    If the examiner is a licensed clinical psychologist,
20ancillary evaluation of physical impairment, cerebral palsy or
21epilepsy must be made by a physician licensed to practice
22medicine in all its branches.
23    Regardless of the discipline of the examiner, ancillary
24evaluation of visual impairment must be made by an
25ophthalmologist or a licensed optometrist.
26    Regardless of the discipline of the examiner, ancillary

 

 

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1evaluation of hearing impairment must be made by an
2otolaryngologist or an audiologist with a certificate of
3clinical competency.
4    The only exception to the above is in the case of a person
5with cerebral palsy or epilepsy who, according to the
6eligibility criteria listed below, has multiple impairments
7which are only physical and sensory. In such a case, a
8physician licensed to practice medicine in all its branches may
9serve as the examiner.
10    (m) "Twenty-four-hour-a-day supervision" means
1124-hour-a-day care by a trained mental health or developmental
12disability professional on an ongoing basis.
13(Source: P.A. 98-104, eff. 7-22-13; 99-143, eff. 7-27-15;
1499-180, eff. 7-29-15; 99-642, eff. 7-28-16.)