HB4836ham002 100TH GENERAL ASSEMBLY

Rep. Jeanne M Ives

Filed: 4/20/2018

 

 


 

 


 
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AMENDMENT TO HOUSE BILL 4836

2    AMENDMENT NO. ______. Amend House Bill 4836 by replacing
3everything after the enacting clause with the following:
 
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

 

 

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1adult with a mental disability who lives in his or her own
2home. These services include but are not limited to:
3        (1) home health services;
4        (2) case management;
5        (3) crisis management;
6        (4) training and assistance in self-care;
7        (5) personal care services;
8        (6) habilitation and rehabilitation services;
9        (7) employment-related services;
10        (8) respite care; and
11        (9) other skill training that enables a person to
12    become self-supporting.
13    (d) "Legal guardian" means a person appointed by a court of
14competent jurisdiction to exercise certain powers on behalf of
15an adult with a mental disability.
16    (e) "Adult with a mental disability" means a person over
17the age of 18 years who lives in his or her own home; who needs
18home-based services, but does not require 24-hour-a-day
19supervision; and who has one of the following conditions:
20severe autism, severe mental illness, a severe or profound
21intellectual disability, or severe and multiple impairments.
22    (f) In one's "own home" means that an adult with a mental
23disability lives alone; or that an adult with a mental
24disability is in full-time residence with his or her parents,
25legal guardian, or other relatives; or that an adult with a
26mental disability is in full-time residence in a setting not

 

 

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1subject to licensure under the Nursing Home Care Act, the
2Specialized Mental Health Rehabilitation Act of 2013, the ID/DD
3Community Care Act, the MC/DD Act, or the Child Care Act of
41969, as now or hereafter amended, with 3 or fewer other adults
5unrelated to the adult with a mental disability who do not
6provide home-based services to the adult with a mental
7disability, or a facility licensed by a unit of local
8government authority with 4 or 5 other adults unrelated to the
9adult with a mental disability who do not provide home-based
10services to the adult with a mental disability.
11    (g) "Parent" means the biological or adoptive parent of an
12adult with a mental disability, or a person licensed as a
13foster parent under the laws of this State who acts as a foster
14parent to an adult with a mental disability.
15    (h) "Relative" means any of the following relationships by
16blood, marriage or adoption: parent, son, daughter, brother,
17sister, grandparent, uncle, aunt, nephew, niece, great
18grandparent, great uncle, great aunt, stepbrother, stepsister,
19stepson, stepdaughter, stepparent or first cousin.
20    (i) "Severe autism" means a lifelong developmental
21disability which is typically manifested before 30 months of
22age and is characterized by severe disturbances in reciprocal
23social interactions; verbal and nonverbal communication and
24imaginative activity; and repertoire of activities and
25interests. A person shall be determined severely autistic, for
26purposes of this Article, if both of the following are present:

 

 

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

 

 

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

 

 

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1disability shall be based upon a comprehensive, documented
2assessment with an evaluation by a licensed clinical
3psychologist or certified school psychologist or a
4psychiatrist, and shall not be based solely on behaviors
5relating to environmental, cultural or economic differences.
6    (l) "Severe and multiple impairments" means the
7manifestation of all of the following characteristics:
8        (1) The evaluation determines the presence of a
9    developmental disability which is expected to continue
10    indefinitely, constitutes a substantial disability and is
11    attributable to any of the following:
12            (A) Intellectual disability, which is defined as
13        general intellectual functioning that is 2 or more
14        standard deviations below the mean concurrent with
15        impairment of adaptive behavior which is 2 or more
16        standard deviations below the mean. Assessment of the
17        individual's intellectual functioning must be measured
18        by a standardized instrument for general intellectual
19        functioning.
20            (B) Cerebral palsy.
21            (C) Epilepsy.
22            (D) Autism.
23            (E) Any other condition which results in
24        impairment similar to that caused by an intellectual
25        disability and which requires services similar to
26        those required by persons with intellectual

 

 

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1        disabilities.
2        (2) The evaluation determines multiple disabilities in
3    physical, sensory, behavioral or cognitive functioning
4    which constitute a severe or profound impairment
5    attributable to one or more of the following:
6            (A) Physical functioning, which severely impairs
7        the individual's motor performance that may be due to:
8                (i) Neurological, psychological or physical
9            involvement resulting in a variety of disabling
10            conditions such as hemiplegia, quadriplegia or
11            ataxia,
12                (ii) Severe organ systems involvement such as
13            congenital heart defect,
14                (iii) Physical abnormalities resulting in the
15            individual being non-mobile and non-ambulatory or
16            confined to bed and receiving assistance in
17            transferring, or
18                (iv) The need for regular medical or nursing
19            supervision such as gastrostomy care and feeding.
20            Assessment of physical functioning must be based
21        on clinical medical assessment by a physician licensed
22        to practice medicine in all its branches, using the
23        appropriate instruments, techniques and standards of
24        measurement required by the professional.
25            (B) Sensory, which involves severe restriction due
26        to hearing or visual impairment limiting the

 

 

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1        individual's movement and creating dependence in
2        completing most daily activities. Hearing impairment
3        is defined as a loss of 70 decibels aided or speech
4        discrimination of less than 50% aided. Visual
5        impairment is defined as 20/200 corrected in the better
6        eye or a visual field of 20 degrees or less. Sensory
7        functioning must be based on clinical medical
8        assessment by a physician licensed to practice
9        medicine in all its branches using the appropriate
10        instruments, techniques and standards of measurement
11        required by the professional.
12            (C) Behavioral, which involves behavior that is
13        maladaptive and presents a danger to self or others, is
14        destructive to property by deliberately breaking,
15        destroying or defacing objects, is disruptive by
16        fighting, or has other socially offensive behaviors in
17        sufficient frequency or severity to seriously limit
18        social integration. Assessment of behavioral
19        functioning may be measured by a standardized scale or
20        informal appraisal by a clinical psychologist or
21        psychiatrist.
22            (D) 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        (3) The evaluation determines that development is

 

 

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1    substantially less than expected for the age in cognitive,
2    affective or psychomotor behavior as follows:
3            (A) Cognitive, which involves intellectual
4        functioning at a measured IQ of 70 or below. Assessment
5        of cognitive functioning must be measured by a
6        standardized instrument for general intelligence.
7            (B) Affective behavior, which involves over and
8        under responding to stimuli in the environment and may
9        be observed in mood, attention to awareness, or in
10        behaviors such as euphoria, anger or sadness that
11        seriously limit integration into society. Affective
12        behavior must be based on clinical assessment using the
13        appropriate instruments, techniques and standards of
14        measurement required by the professional.
15            (C) Psychomotor, which includes a severe
16        developmental delay in fine or gross motor skills so
17        that development in self-care, social interaction,
18        communication or physical activity will be greatly
19        delayed or restricted.
20        (4) A determination that the disability originated
21    before the age of 18 years.
22    A determination of severe and multiple impairments shall be
23based upon a comprehensive, documented assessment with an
24evaluation by a licensed clinical psychologist or
25psychiatrist.
26    If the examiner is a licensed clinical psychologist,

 

 

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1ancillary evaluation of physical impairment, cerebral palsy or
2epilepsy must be made by a physician licensed to practice
3medicine in all its branches.
4    Regardless of the discipline of the examiner, ancillary
5evaluation of visual impairment must be made by an
6ophthalmologist or a licensed optometrist.
7    Regardless of the discipline of the examiner, ancillary
8evaluation of hearing impairment must be made by an
9otolaryngologist or an audiologist with a certificate of
10clinical competency.
11    The only exception to the above is in the case of a person
12with cerebral palsy or epilepsy who, according to the
13eligibility criteria listed below, has multiple impairments
14which are only physical and sensory. In such a case, a
15physician licensed to practice medicine in all its branches may
16serve as the examiner.
17    (m) "Twenty-four-hour-a-day supervision" means
1824-hour-a-day care by a trained mental health or developmental
19disability professional on an ongoing basis.
20(Source: P.A. 98-104, eff. 7-22-13; 99-143, eff. 7-27-15;
2199-180, eff. 7-29-15; 99-642, eff. 7-28-16.)".