HB2600 101ST GENERAL ASSEMBLY

LRB101 09991 KTG 55093 b

101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB2600

Introduced , by Rep. Bob Morgan

SYNOPSIS AS INTRODUCED:

New Act

Creates the Illinois Disability Integration Act. Provides that no public entity or long-term service or support (LTSS) insurance provider shall deny an individual with an LTSS disability who is eligible for institutional placement community-based long-term services and supports that enable the individual to live in the community and lead an independent life. Sets forth specific acts of discrimination by a public entity or LTSS insurance provider that are prohibited under the Act, including: (i) imposition or application of eligibility criteria or another policy that prevents or tends to prevent an individual with an LTSS disability from receiving a community-based long-term service or support; (ii) failure to establish an adequate rate or other payment structure that is necessary to ensure the availability of a workforce sufficient to support an individual with an LTSS disability in living in the community and leading an independent life; and (iii) failure to ensure that each institutionalized individual with an LTSS disability is regularly notified of the alternative of community-based long-term services and supports and that those community-based long-term services and supports are provided if the individual with an LTSS disability selects such services and supports. Provides that the Act shall not be construed to: (1) prevent a public entity or LTSS insurance provider from providing community-based long-term services and supports at a level that is greater than the level that is required under the Act; or (2) prohibit a public entity or LTSS insurance provider from using managed care techniques, as long as the use of such techniques does not have the effect of discriminating against an individual as prohibited under the Act. Defines terms.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning persons with disabilities.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Illinois Disability Integration Act.

Section 5. Findings. The General Assembly finds that:

(1) The Americans with Disabilities Act of 1990 and the holdings of the Supreme Court in Olmstead v. L.C., 527 U.S. 581 (1999), have clearly articulated that individuals with disabilities have a civil right to participate in society as equal citizens. The right to live and work in the community is necessary for the exercise of the civil rights that have already been secured for all individuals with disabilities. However, the State of Illinois still does not provide sufficient community-based services and supports to individuals with disabilities in order to end segregation in institutions.

(2) Illinois continues to approach decisions regarding long-term services and supports from social welfare and budgetary perspectives, but has not considered these decisions from a civil rights perspective.

(3) The State of Illinois has not consistently planned to ensure sufficient supports and services for individuals with disabilities, including those with the most significant disabilities, to enable individuals with disabilities to live in the most integrated setting. As a result, many individuals with disabilities who reside in institutions are prevented from living in the community. Additionally, individuals with disabilities who are not in institutions find themselves at risk of institutional placement.

(4) Illinois institutionalizes more people with disabilities than any other state in the union, with the exception of one other state: Texas.

(5) Fully 32 states meet the 80/80 Home and Community Standard, which requires that 80% of all individuals with disabilities are served in the community and 80% of all resources spent are for home and community support. Illinois does not meet this basic standard.

(6) The continuing existence of unfair and unnecessary institutionalization denies individuals with disabilities the opportunity to live and participate on an equal basis in the community.

(7) Every individual who is eligible for long-term services and supports has a federally protected right to be meaningfully integrated into their community and to receive community-based long-term services and supports.

(8) It is the intent of this Act to (i) provide long-term services and supports to individuals with disabilities in a manner that allows such individuals to live in the most integrated setting (including the individual's own home) and have maximum control over their services and supports, and (ii) ensure that long-term services and supports are provided in a manner which allows individuals with disabilities to lead an independent life.

Section 10. Definitions. As used in this Act:

"Assistance" as used with respect to instrumental activities of daily living, includes support provided to an individual by another person due to confusion, dementia, behavioral symptoms, or cognitive, intellectual, mental, or emotional disabilities, including support to: (i) help the individual identify and set goals, overcome fears, and manage transitions; (ii) help the individual with executive functioning, decision-making, supported decision-making, and problem solving; (iii) provide reassurance to the individual; and (iv) help the individual with orientation, memory, and other activities related to independent living.

"Community-based", when used in reference to services or supports, means services or supports that are provided to an individual with an LTSS disability to enable that individual to live in the community and lead an independent life, and that are delivered in settings that have the following qualities:

(1) are integrated into the greater community and supports in terms of infrastructure, environment, amenities, location, services, and features;

(2) provide full access to the greater community (including access to opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community);

(3) give access to the greater community to the same extent as access to the community is enjoyed by an individual who is not receiving long-term services or supports;

(4) represent a meaningful choice from among nonresidential setting options, including nondisability-specific settings;

(5) ensure the individual has rights to privacy, dignity, and respect, and freedom from coercion and restraint;

(6) optimize, but do not regiment, individual initiative, autonomy, and independence in making life choices, including choices about daily activities, physical environment, and persons with whom the individual interacts;

(7) facilitate individual choice regarding the provision of services and supports, and who provides those services and supports;

(8) allow ownership by an individual with an LTSS disability or the individual's family member;

(9) permit an individual with an LTSS disability to possess an individual lease of a dwelling that has lockable access and egress and that includes living, sleeping, bathing, and cooking areas over which the individual with an LTSS disability or the individual's family member has domain and control;

(10) permit no more than 4 unrelated individuals with an LTSS disability to reside together in a dwelling that is a group or shared residence;

(11) give privacy in the individual's sleeping unit, including a lockable entrance door controlled by the individual;

(12) cause an individual to share a sleeping unit only if such an arrangement is consensual and if having a choice of roommates within the residence is possible;

(13) provide the individual with the freedom to furnish and decorate the individual's sleeping or living unit as permitted under the lease or other agreement;

(14) guarantee the individual the freedom and support to control his or her own schedules and activities;

(15) give the individual the right to have visitors of the individual's choosing at any time; and

(16) are physically accessible to the individual with an LTSS disability living at the residence.

"Dwelling" has the meaning ascribed to that term in Section 802 of the Fair Housing Act (42 U.S.C. 3602).

"Health-related tasks" means specific nonacute tasks, typically regulated by states as medical or nursing tasks that an individual with a disability may require to live in the community, including administration of medication; assistance with use, operation, and maintenance of a ventilator; and maintenance and use of a gastrostomy tube, a catheter, or a stable ostomy.

"Individual with a disability" means an individual who is a person with a disability, as defined in Section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102).

"Individual with an LTSS disability" means an individual with a disability who, in order to live in the community and lead an independent life, requires assistance in accomplishing activities of daily living; instrumental activities of daily living; health-related tasks; or other functions, tasks, or activities related to an activity or task previously described; and is currently in an institutional placement or at risk of institutionalization if the individual does not receive community-based long-term services and supports.

"Instrumental activities of daily living" means one or more activities related to living independently in the community, including activities related to: (i) nutrition, such as preparing meals or special diets, monitoring to prevent choking or aspiration, or assisting with special utensils; (ii) household chores and environmental maintenance tasks; (iii) communication and interpersonal skills, such as using the telephone or other communications devices, forming and maintaining interpersonal relationships, or securing opportunities to participate in group support or peer-to-peer support arrangements; (iv) travel and community participation, such as shopping, arranging appointments, or moving around the community; (v) care of others, such as raising children, taking care of pets, or selecting caregivers; or (vi) management of personal property and personal safety, such as taking medication, handling or managing money, or responding to emergent situations or unscheduled needs requiring an immediate response.

"Long-term service or support" or "LTSS" means the assistance provided to an individual with a disability in accomplishing, acquiring the means or ability to accomplish, maintaining, or enhancing: (i) activities of daily living; (ii) instrumental activities of daily living; (iii) health-related tasks; or(iv) other functions, tasks, or activities related to an activity or task previously described in (i), (ii) or (iii).

"LTSS insurance provider" means a public or private entity that (i) provides funds for long-term services and supports and (ii) is engaged in commerce or in an industry or activity affecting commerce.

Section 15. Discrimination.

(a) In General. No public entity or LTSS insurance provider shall deny an individual with an LTSS disability who is eligible for institutional placement, or otherwise discriminate against that individual in the provision of, community-based long-term services and supports that enable the individual to live in the community and lead an independent life.

(b) Specific Prohibitions. For purposes of this Act, discrimination by a public entity or LTSS insurance provider includes:

(1) imposition or application of eligibility criteria or another policy that prevents or tends to prevent an individual with an LTSS disability, or any class of individuals with LTSS disabilities, from receiving a community-based long-term service or support;

(2) imposition or application of a policy or other mechanism, such as a service or cost cap, that prevent or tends to prevent an individual with an LTSS disability, or any class of individuals with LTSS disabilities, from receiving a community-based long-term service or support;

(3) failure to provide a specific community-based long-term service or support or a type of community-based long-term service or support needed for an individual with an LTSS disability, or any class of individuals with LTSS disabilities;

(4) imposition or application of a policy, rule, regulation, or restriction that interferes with the opportunity for an individual with an LTSS disability, or any class of individuals with LTSS disabilities, to live in the community and lead an independent life, which may include a requirement that an individual with an LTSS disability receive a service or support (such as day services or employment services) in a congregate or disability-specific setting;

(5) imposition or application of a waiting list or other mechanism that delays or restricts access of an individual with an LTSS disability to a community-based long-term service or support;

(6) failure to establish an adequate rate or other payment structure that is necessary to ensure the availability of a workforce sufficient to support an individual with an LTSS disability in living in the community and leading an independent life;

(7) failure to provide community-based services and supports, on an intermittent, short-term, or emergent basis, that assist an individual with an LTSS disability to live in the community and lead an independent life;

(8) imposition or application of a policy, such as a requirement that an individual utilize informal support, that restricts, limits, or delays the ability of an individual with an LTSS disability to secure a community-based long-term service or support to live in the community or lead an independent life;

(9) failure to implement a formal procedure and a mechanism to ensure that (i) individuals with LTSS disabilities are offered the alternative of community-based long-term services and supports prior to institutionalization; and (ii) if selected by an individual with an LTSS disability, the community-based long-term services and supports previously described are provided;

(10) failure to ensure that each institutionalized individual with an LTSS disability is regularly notified of the alternative of community-based long-term services and supports and that those community-based long-term services and supports are provided if the individual with an LTSS disability selects such services and supports; and

(11) failure to make a reasonable modification in a policy, practice, or procedure, when such modification is necessary to allow an individual with an LTSS disability to receive a community-based long-term service or support.

(c) Additional Prohibition. For purposes of this Act, discrimination by a public entity also includes a failure to ensure that there is sufficient availability of affordable, accessible, and integrated housing to allow an individual with an LTSS disability to choose to live in the community and lead an independent life, including the availability of an option to live in housing where the receipt of LTSS is not tied to tenancy.

(d) Construction. Nothing in this Section shall be construed to prevent a public entity or LTSS insurance provider from providing community-based long-term services and supports at a level that is greater than the level that is required by this Section; or to limit the rights of an individual with a disability under any provision of law other than this Section; or shall be construed to prohibit a public entity or LTSS insurance provider from using managed care techniques, as long as the use of such techniques does not have the effect of discriminating against an individual in the provision of community-based long-term services and supports, as prohibited by this Act.