SB0437 94TH GENERAL ASSEMBLY

LRB094 10560 DRJ 40856 b

94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB0437

Introduced 2/16/2005, by Sen. Wendell E. Jones

SYNOPSIS AS INTRODUCED:

New Act

Creates the MI Olmstead Initiative Act to establish a 5-year program to provide individuals with mental illness or a co-occurring disorder of mental illness and substance abuse with appropriate residential and community-based support services. Requires the Department of Human Services to identify potential participants for the program. Sets forth the services and supports that constitute the program. Requires that implementation of the program begin by July 1, 2006. Requires the Department to annually report to the General Assembly concerning the program. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT in relation to mental health.

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 MI Olmstead Initiative Act.

Section 5. Purposes.

(a) The General Assembly recognizes that the United States Supreme Court in Olmstead v. L.C. ex rel. Zimring, 119 S. Ct. 2176 (1999), affirmed that the unjustifiable institutionalization of a person with a disability who could live in the community with proper support, and wishes to do so, is unlawful discrimination in violation of the Americans with Disabilities Act (ADA). The State of Illinois, along with all other states, is required to provide appropriate residential and community-based support services to persons with disabilities who wish to live in less restrictive settings and are able to do so.

(b) It is the purpose of this Act to implement the MI Olmstead Initiative in response to the U.S. Supreme Court's decision in Olmstead v. L.C. in order (1) to enable 1,000 persons with mental illness or a co-occurring disorder of mental illness and substance abuse, who currently reside in nursing facilities, who choose to move, and who are able to do so, to move within the next 5 years to the most integrated residential settings possible in the community and (2) to provide cost-effective community residential environments and supports to enable these persons to live successfully in the community.

(c) It is the further purpose of this Act to create a continuum of residential and supportive services in community settings for persons with mental illness or a co-occurring disorder of mental illness and substance abuse, while increasing federal and client financial participation through the Medicaid and Social Security programs, wherever possible.

(d) The MI Olmstead Initiative is not intended to substitute for or replace the obligation of the State of Illinois to develop and implement a comprehensive, effectively working plan for placing persons with disabilities in less restrictive settings, under the Supreme Court decision in Olmstead v. L.C.

Section 10. Definitions. For purposes of this Act:

"Department" means the Department of Human Services.

"Institution for mental diseases" (IMD) means a nursing facility licensed by the Illinois Department of Public Health under the Nursing Home Care Act as defined, consistent with federal regulations, by the Illinois Department of Public Aid where services to residents are ineligible for federal financial participation under the Medicaid program because mental illness is the specific reason for being in the facility for more than 50% of the residents over 21 and under 65 years of age.

"Qualified individual" means an adult who is 19 years of age or older and under 65 years of age who agrees to participate in the MI Olmstead Initiative, is assessed by an appropriate professional and found to be able to move to a less restrictive setting, and meets one of the following criteria:

(1) the person is substantially impaired in 2 or more major life activities as a consequence of a mental illness or a co-occurring mental illness and substance abuse disorder; or

(2) the person has a record of having been substantially impaired in 2 or more major life activities as a consequence of a mental illness or a co-occurring mental illness and substance abuse disorder.

Section 15. Programs and services of the MI Olmstead Initiative.

(a) The Department shall identify 200 qualified individuals during each of the 5 years following the implementation date of this Act, or 1,000 persons in total, who agree to and are able to be transitioned to alternative residential settings within the community. In order to appropriately select persons for the MI Olmstead Initiative, the Department, by working in conjunction with an owner or operator of a nursing facility or an IMD, and with the guardian of the qualified individual, if any, shall ensure that:

(1) a comprehensive evaluation and diagnosis of the qualified individual has been administered by a qualified examiner, including an assessment of skills, abilities, and potential for residential and work placement, adapted to the person's primary language, cultural background, and ethnic origin;

(2) an individual program plan or individual treatment plan, or both, has been completed for the qualified individual, outlining a range of services to be provided as described in subsection (b) of this Section;

(3) the qualified individual is advised of available and appropriate community-based alternatives for his or her care before a decision on placement is made; and

(4) a planning specialist or case manager assists the individual in making the move from an institution to a community setting.

(b) The MI Olmstead Initiative shall be designed with a capacity for 1,000 qualified individuals over 5 years and shall offer, or create as necessary, services and supports for these individuals to live in the most integrated community-based setting possible. The services and supports in community-based settings shall include, but not be limited to:

(1) Residence in the most integrated setting possible, whether independent living in a private residence, a supported residential program, a supervised residential program, or supportive housing, as appropriate.

(2) Rehabilitation and support services, including assertive community treatment, case management, supportive and supervised day treatment, and psychosocial rehabilitation.

(3) Vocational training, as appropriate, that contributes to the person's independence and employment potential.

(4) Employment, as appropriate, free from discrimination pursuant to the Constitution and laws of this State.

(5) Periodic reevaluation and review of the individual program plan or the individual treatment plan, or both, at least twice each year, in order to measure progress, to modify or change objectives if necessary, and to provide guidance and remediation techniques. The qualified individual and his or her guardian, if any, shall have the right (i) to participate in the planning and decision-making process regarding the plan and (ii) to be informed in writing, or in that individual's mode of communication, of progress at reasonable time intervals.

(6) Due process so that any individual aggrieved by a decision of the Department regarding services provided under this Act is given an opportunity to present complaints at a due process hearing before a hearing officer designated by the Director of the Department, in addition to any other rights under federal, State, or local laws.

(c) The Department shall implement, coordinate, monitor, and evaluate the MI Olmstead Initiative in cooperation with the Department of Public Aid, the Department of Public Health, the Governor's Office of Management and Budget, and other State agencies as appropriate, as well as organizations or service providers whose mission includes advocacy for or the provision of quality services to persons with mental illness or a co-occurring disorder of mental illness and substance abuse.

Section 20. Prospective savings. Any monetary savings to the State derived from transitioning qualified individuals to alternative residential settings shall first be used to ensure that all necessary services and supports are available to the individual within the community.

Section 25. Report to the General Assembly. The Department, in cooperation with the Department of Public Aid and the Department of Public Health, shall report to the General Assembly on the status of the MI Olmstead Initiative by October 1 in each year of the 5-year initiative, and shall include in the report an analysis of the costs and benefits of the Initiative, a review of the State's use of nursing facilities, including IMD's, for the care of persons with severe mental illness, and a plan for adjusting State policy, including the further consolidation or conversion of IMD facilities to non-IMD nursing facilities for the purpose of maximizing federal financial participation under the Medicaid program.

Section 30. Implementation dates. The Department shall adopt rules to govern all aspects of this Act by April 1, 2006. Subject to available appropriations, the Department shall begin implementation of the MI Olmstead Initiative by July 1, 2006.

Section 99. Effective date. This Act takes effect upon becoming law.