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.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning persons with disabilities.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Illinois Disability Integration Act.
 
6    Section 5. Findings. The General Assembly finds that:
7    (1) The Americans with Disabilities Act of 1990 and the
8holdings of the Supreme Court in Olmstead v. L.C., 527 U.S. 581
9(1999), have clearly articulated that individuals with
10disabilities have a civil right to participate in society as
11equal citizens. The right to live and work in the community is
12necessary for the exercise of the civil rights that have
13already been secured for all individuals with disabilities.
14However, the State of Illinois still does not provide
15sufficient community-based services and supports to
16individuals with disabilities in order to end segregation in
17institutions.
18    (2) Illinois continues to approach decisions regarding
19long-term services and supports from social welfare and
20budgetary perspectives, but has not considered these decisions
21from a civil rights perspective.
22    (3) The State of Illinois has not consistently planned to
23ensure sufficient supports and services for individuals with

 

 

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1disabilities, including those with the most significant
2disabilities, to enable individuals with disabilities to live
3in the most integrated setting. As a result, many individuals
4with disabilities who reside in institutions are prevented from
5living in the community. Additionally, individuals with
6disabilities who are not in institutions find themselves at
7risk of institutional placement.
8    (4) Illinois institutionalizes more people with
9disabilities than any other state in the union, with the
10exception of one other state: Texas.
11    (5) Fully 32 states meet the 80/80 Home and Community
12Standard, which requires that 80% of all individuals with
13disabilities are served in the community and 80% of all
14resources spent are for home and community support. Illinois
15does not meet this basic standard.
16    (6) The continuing existence of unfair and unnecessary
17institutionalization denies individuals with disabilities the
18opportunity to live and participate on an equal basis in the
19community.
20    (7) Every individual who is eligible for long-term services
21and supports has a federally protected right to be meaningfully
22integrated into their community and to receive community-based
23long-term services and supports.
24    (8) It is the intent of this Act to (i) provide long-term
25services and supports to individuals with disabilities in a
26manner that allows such individuals to live in the most

 

 

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1integrated setting (including the individual's own home) and
2have maximum control over their services and supports, and (ii)
3ensure that long-term services and supports are provided in a
4manner which allows individuals with disabilities to lead an
5independent life.
 
6    Section 10. Definitions. As used in this Act:
7    "Assistance" as used with respect to instrumental
8activities of daily living, includes support provided to an
9individual by another person due to confusion, dementia,
10behavioral symptoms, or cognitive, intellectual, mental, or
11emotional disabilities, including support to: (i) help the
12individual identify and set goals, overcome fears, and manage
13transitions; (ii) help the individual with executive
14functioning, decision-making, supported decision-making, and
15problem solving; (iii) provide reassurance to the individual;
16and (iv) help the individual with orientation, memory, and
17other activities related to independent living.
18    "Community-based", when used in reference to services or
19supports, means services or supports that are provided to an
20individual with an LTSS disability to enable that individual to
21live in the community and lead an independent life, and that
22are delivered in settings that have the following qualities:
23        (1) are integrated into the greater community and
24    supports in terms of infrastructure, environment,
25    amenities, location, services, and features;

 

 

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1        (2) provide full access to the greater community
2    (including access to opportunities to seek employment and
3    work in competitive integrated settings, engage in
4    community life, control personal resources, and receive
5    services in the community);
6        (3) give access to the greater community to the same
7    extent as access to the community is enjoyed by an
8    individual who is not receiving long-term services or
9    supports;
10        (4) represent a meaningful choice from among
11    nonresidential setting options, including
12    nondisability-specific settings;
13        (5) ensure the individual has rights to privacy,
14    dignity, and respect, and freedom from coercion and
15    restraint;
16        (6) optimize, but do not regiment, individual
17    initiative, autonomy, and independence in making life
18    choices, including choices about daily activities,
19    physical environment, and persons with whom the individual
20    interacts;
21        (7) facilitate individual choice regarding the
22    provision of services and supports, and who provides those
23    services and supports;
24        (8) allow ownership by an individual with an LTSS
25    disability or the individual's family member;
26        (9) permit an individual with an LTSS disability to

 

 

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1    possess an individual lease of a dwelling that has lockable
2    access and egress and that includes living, sleeping,
3    bathing, and cooking areas over which the individual with
4    an LTSS disability or the individual's family member has
5    domain and control;
6        (10) permit no more than 4 unrelated individuals with
7    an LTSS disability to reside together in a dwelling that is
8    a group or shared residence;
9        (11) give privacy in the individual's sleeping unit,
10    including a lockable entrance door controlled by the
11    individual;
12        (12) cause an individual to share a sleeping unit only
13    if such an arrangement is consensual and if having a choice
14    of roommates within the residence is possible;
15        (13) provide the individual with the freedom to furnish
16    and decorate the individual's sleeping or living unit as
17    permitted under the lease or other agreement;
18        (14) guarantee the individual the freedom and support
19    to control his or her own schedules and activities;
20        (15) give the individual the right to have visitors of
21    the individual's choosing at any time; and
22        (16) are physically accessible to the individual with
23    an LTSS disability living at the residence.
24    "Dwelling" has the meaning ascribed to that term in Section
25802 of the Fair Housing Act (42 U.S.C. 3602).
26    "Health-related tasks" means specific nonacute tasks,

 

 

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1typically regulated by states as medical or nursing tasks that
2an individual with a disability may require to live in the
3community, including administration of medication; assistance
4with use, operation, and maintenance of a ventilator; and
5maintenance and use of a gastrostomy tube, a catheter, or a
6stable ostomy.
7    "Individual with a disability" means an individual who is a
8person with a disability, as defined in Section 3 of the
9Americans with Disabilities Act of 1990 (42 U.S.C. 12102).
10    "Individual with an LTSS disability" means an individual
11with a disability who, in order to live in the community and
12lead an independent life, requires assistance in accomplishing
13activities of daily living; instrumental activities of daily
14living; health-related tasks; or other functions, tasks, or
15activities related to an activity or task previously described;
16and is currently in an institutional placement or at risk of
17institutionalization if the individual does not receive
18community-based long-term services and supports.
19    "Instrumental activities of daily living" means one or more
20activities related to living independently in the community,
21including activities related to: (i) nutrition, such as
22preparing meals or special diets, monitoring to prevent choking
23or aspiration, or assisting with special utensils; (ii)
24household chores and environmental maintenance tasks; (iii)
25communication and interpersonal skills, such as using the
26telephone or other communications devices, forming and

 

 

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1maintaining interpersonal relationships, or securing
2opportunities to participate in group support or peer-to-peer
3support arrangements; (iv) travel and community participation,
4such as shopping, arranging appointments, or moving around the
5community; (v) care of others, such as raising children, taking
6care of pets, or selecting caregivers; or (vi) management of
7personal property and personal safety, such as taking
8medication, handling or managing money, or responding to
9emergent situations or unscheduled needs requiring an
10immediate response.
11    "Long-term service or support" or "LTSS" means the
12assistance provided to an individual with a disability in
13accomplishing, acquiring the means or ability to accomplish,
14maintaining, or enhancing: (i) activities of daily living; (ii)
15instrumental activities of daily living; (iii) health-related
16tasks; or(iv) other functions, tasks, or activities related to
17an activity or task previously described in (i), (ii) or (iii).
18    "LTSS insurance provider" means a public or private entity
19that (i) provides funds for long-term services and supports and
20(ii) is engaged in commerce or in an industry or activity
21affecting commerce.
 
22    Section 15. Discrimination.
23    (a) In General. No public entity or LTSS insurance provider
24shall deny an individual with an LTSS disability who is
25eligible for institutional placement, or otherwise

 

 

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1discriminate against that individual in the provision of,
2community-based long-term services and supports that enable
3the individual to live in the community and lead an independent
4life.
5    (b) Specific Prohibitions. For purposes of this Act,
6discrimination by a public entity or LTSS insurance provider
7includes:
8        (1) imposition or application of eligibility criteria
9    or another policy that prevents or tends to prevent an
10    individual with an LTSS disability, or any class of
11    individuals with LTSS disabilities, from receiving a
12    community-based long-term service or support;
13        (2) imposition or application of a policy or other
14    mechanism, such as a service or cost cap, that prevent or
15    tends to prevent an individual with an LTSS disability, or
16    any class of individuals with LTSS disabilities, from
17    receiving a community-based long-term service or support;
18        (3) failure to provide a specific community-based
19    long-term service or support or a type of community-based
20    long-term service or support needed for an individual with
21    an LTSS disability, or any class of individuals with LTSS
22    disabilities;
23        (4) imposition or application of a policy, rule,
24    regulation, or restriction that interferes with the
25    opportunity for an individual with an LTSS disability, or
26    any class of individuals with LTSS disabilities, to live in

 

 

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1    the community and lead an independent life, which may
2    include a requirement that an individual with an LTSS
3    disability receive a service or support (such as day
4    services or employment services) in a congregate or
5    disability-specific setting;
6        (5) imposition or application of a waiting list or
7    other mechanism that delays or restricts access of an
8    individual with an LTSS disability to a community-based
9    long-term service or support;
10        (6) failure to establish an adequate rate or other
11    payment structure that is necessary to ensure the
12    availability of a workforce sufficient to support an
13    individual with an LTSS disability in living in the
14    community and leading an independent life;
15        (7) failure to provide community-based services and
16    supports, on an intermittent, short-term, or emergent
17    basis, that assist an individual with an LTSS disability to
18    live in the community and lead an independent life;
19        (8) imposition or application of a policy, such as a
20    requirement that an individual utilize informal support,
21    that restricts, limits, or delays the ability of an
22    individual with an LTSS disability to secure a
23    community-based long-term service or support to live in the
24    community or lead an independent life;
25        (9) failure to implement a formal procedure and a
26    mechanism to ensure that (i) individuals with LTSS

 

 

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1    disabilities are offered the alternative of
2    community-based long-term services and supports prior to
3    institutionalization; and (ii) if selected by an
4    individual with an LTSS disability, the community-based
5    long-term services and supports previously described are
6    provided;
7        (10) failure to ensure that each institutionalized
8    individual with an LTSS disability is regularly notified of
9    the alternative of community-based long-term services and
10    supports and that those community-based long-term services
11    and supports are provided if the individual with an LTSS
12    disability selects such services and supports; and
13        (11) failure to make a reasonable modification in a
14    policy, practice, or procedure, when such modification is
15    necessary to allow an individual with an LTSS disability to
16    receive a community-based long-term service or support.
17    (c) Additional Prohibition. For purposes of this Act,
18discrimination by a public entity also includes a failure to
19ensure that there is sufficient availability of affordable,
20accessible, and integrated housing to allow an individual with
21an LTSS disability to choose to live in the community and lead
22an independent life, including the availability of an option to
23live in housing where the receipt of LTSS is not tied to
24tenancy.
25    (d) Construction. Nothing in this Section shall be
26construed to prevent a public entity or LTSS insurance provider

 

 

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1from providing community-based long-term services and supports
2at a level that is greater than the level that is required by
3this Section; or to limit the rights of an individual with a
4disability under any provision of law other than this Section;
5or shall be construed to prohibit a public entity or LTSS
6insurance provider from using managed care techniques, as long
7as the use of such techniques does not have the effect of
8discriminating against an individual in the provision of
9community-based long-term services and supports, as prohibited
10by this Act.