Section 111.20  Services to individuals who are deaf, hard-of-hearing, deaf-blind, deafened and/or use manual/visual communication

All individuals receiving services shall be provided with adequate and humane care and services pursuant to an individualized service (treatment or habilitation) plan in accordance with Sections 2-102(a), 3-209, and 4-309 of the Code.  Individuals who are deaf, hard of hearing, deaf-blind, or deafened (i.e., experiencing hearing loss and/or using manual or visual communication) shall not be excluded from facility participation, be denied facility benefits, or be subjected to any form of discrimination [405 ILCS 5/2-102(a), 3-204, 3-205, and 4-205].

a)         Definitions

For the purposes of this Section, the following terms are defined:

"Auxiliary Aids and Services."  See definition for auxiliary aids and services in the Code of Federal Regulations (28 CFR 36.303) and the Americans with Disabilities Act (42 U.S.C. 12103(1)).

"CART (Computer Aided Realtime Translation) reporting services."  The verbatim translation of the spoken word into a visually enhanced format from a stenotype machine to a computer.

"CART reporter."  A certified shorthand reporter licensed by the Department of Financial and Professional Regulation under the Illinois Certified Shorthand Reporters Act of 1984 [225 ILCS 415] or a registered professional reporter licensed by the National Court Reporters Association.

"Code."  The Mental Health and Developmental Disabilities Code [405 ILCS 5].

"Communication facilitation."  The means provided to overcome a barrier in communication created because an individual has a hearing loss and/or uses manual or visual communication, e.g., interpreter services, CART reporting services, or mental health or developmental disability services, and deafness professional services.

"Deaf."  Any person with hearing loss as described in 225 ILCS 443/10.

"Deaf-blind."  Any person with hearing loss as described in 225 ILCS 443/10 and a visual impairment with best corrected visual acuity of 20/70 or poorer in the better eye or a contraction of the visual field of 20 degrees or less in the better eye.

"Deafened."  Any loss of hearing, occurring at any age after spoken language was acquired, that precludes processing of linguistic information through audition, with or without a hearing aid.

"Department."  The Illinois Department of Human Services (DHS).

"Facility."  Any mental health or developmental disability facility, as defined by Sections 1-107 and 1-114 of the Code.

"Hard-of-hearing."  Any person with hearing loss as defined by 225 ILCS 443/10.

"Individual."  A recipient of mental health or developmental disabilities services, as defined by Sections 1-111 and 1-128 of the Code.

"Interpreter."  A sign language interpreter for the deaf or any person defined as an interpreter by Section 10 of the Interpreter for the Deaf Licensure Act of 2007 [225 ILCS 443].

"Manual or visual communication."  Using the hands, body, or facial expressions as the primary modalities for communication, which may include and not be limited to American Sign Language, signed English, fingerspelling, pantomime, gestures, lip or speech reading, tactile fingerspelling or signs, reading, or writing.

"Mental health or developmental disability and deafness professionals." Mental health or developmental disability professionals, e.g., psychiatrists, psychologists, social workers, psychiatric nurses, speech and language pathologists, and other mental health or developmental disability professionals with intermediate or advanced expertise in manual or visual communication modes and languages and knowledge of culture and psychosocial aspects of individuals who have hearing loss.

"Preferred mode of communication."  Any mode of visual or auditory communication used by an individual with hearing loss to express themselves or comprehend others' communication, such as American Sign Language or writing.

"Statewide Accessibility and Accommodation Coordinator."  The Department's Statewide Accessibility and Accommodation Coordinator of Services for People who are Deaf, Hard of Hearing, or Deaf-Blind.

b)         Services for individuals with hearing loss

1)         Intake and admission

A)        The intake staff shall conduct an initial assessment to ascertain whether an individual presenting for admission has a hearing loss.  This assessment shall include identifying the type and degree of hearing loss based on the available information at the time and whether the individual requires manual or visual communication.  This information shall be documented on the "Clinical Record Face Sheet" or the facility's intake form.

B)        Each facility shall maintain a list of interpreters, CART reporters, and mental health or developmental disability deafness professionals employed by, or under contract to, the facility.  The list shall have each interpreter's licensure level.  The facility director shall be responsible for distributing the list to the appropriate facility staff and updating it at least annually.  These lists shall be submitted to the Statewide Accessibility and Accommodation Coordinator.

C)        Facility staff, with the assistance, if necessary, of family members or friends of the individual who use the individual's preferred mode of communication, shall inform the individual that an interpreter, CART reporters (to facilitate communication), and/or mental health or developmental disability and deafness professionals (to consult) have been contacted and the expected time of arrival. Facility staff (unless licensed under the Interpreter for the Deaf Licensure Act of 2007), family members, or friends of the individual shall not interpret.  A qualified licensed interpreter or CART reporter shall be used during the individual's intake, assessment, and evaluation, when information is being conveyed to the individual regarding admission, discharge, transfer, or the right to object thereto, the explanation of the individual's rights, when being examined for involuntary admission or certification, while being interviewed or tested by a psychologist, psychiatrist, or physician, during therapy, or whenever necessary to provide effective treatment or habilitation services to the individual.  Unless preferred by the individual, writing is not an acceptable substitute for an interpreter or CART reporter.

D)        If communication facilitation is necessary in order to determine whether the individual meets the admission criteria, or to complete the admission, discharge, or transfer process, it shall be obtained preferably within 12 hours, but not later than the time limits prescribed by Sections 3-503, 3-504(f), 3-604, 3-607, 3-610, 3-704(a), 4-300, 4-402(a), and 4-405 of the Code.  The services of an interpreter or CART reporter shall be available to the facility 24 hours per day, seven days per week.  This requirement may be met by contracting with a person or agency for services, as needed.  The facility shall pay for the cost of the interpreter or CART reporter.

E)        The Statewide Accessibility and Accommodation Coordinator shall assist any facility, on request, in obtaining the services of an interpreter or a CART reporter.

2)         Treatment or habilitation services

A)        Interpreter services, CART reporting services, and/or the services of mental health or developmental disability and deafness professionals as determined by the interdisciplinary team, shall be made available to individuals or staff who have hearing loss and/or use manual or visual communication such as signed English or American Sign Language.

B)        Facilities shall provide appropriate services and/or treatment to individuals who have hearing loss and/or use manual or visual communication and the appropriate auxiliary aids and services to allow such individuals to benefit from the services and/or treatment.  The Statewide Accessibility and Accommodation Coordinator shall be contacted to provide assistance to facilities to develop and provide appropriate services for these individuals.  Treatment or habilitation programs for individuals who have hearing loss and/or use manual or visual communication may include arrangements made by the facility with other facilities, private clinicians, or other community providers (e.g., hospitals, clinics, Department-funded agencies) that can meet the individual's treatment or habilitation needs.

C)        Individuals who have hearing loss and/or use manual or visual communication shall be provided with, for example, video phones, captioned phones, phone amplifiers, and/or telebraille devices, whichever is appropriate, to ensure their right to private telephone communication as provided by Section 2-103 of the Code. Visual and tactile life-safety alerting devices including, but not limited to, wake-up alarms (lights and/or vibrators) and fire alarms (lights and/or vibrators) shall be installed or made available, where necessary.

D)        As a part of the quality assessment and improvement program, facilities shall have a written compliance plan for individuals who have hearing loss and/or use manual or visual communication.  This plan shall include, but not be limited to:

i)          Designated staff responsible for implementing, monitoring, and evaluating the plan;

ii)         A list of interpreters, CART reporters, and mental health or developmental disability and deafness professionals employed by, or contracted to, the facility, their skill level in American Sign Language, and any licenses or certifications they hold; and

iii)        Training for staff on the unique aspects of providing services to individuals who have hearing loss and/or use manual or visual communication and procedures to assist the individual in filling out a complaint form.

3)         Clinical records documentation.  Provision of interpreters, CART reporters, mental health or developmental disability and deafness professionals, special equipment, and other support services shall be documented in the intake and treatment summaries.

(Source:  Amended at 49 Ill. Reg. 8228, effective May 30, 2025)