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1 | AN ACT concerning health.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Developmental Disability and Mental | ||||||||||||||||||||||||
5 | Disability Services Act is amended by changing Section 2-3 as | ||||||||||||||||||||||||
6 | follows:
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7 | (405 ILCS 80/2-3) (from Ch. 91 1/2, par. 1802-3)
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8 | Sec. 2-3. As used in this Article, unless the context | ||||||||||||||||||||||||
9 | requires otherwise:
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10 | (a) "Agency" means an agency or entity licensed by the | ||||||||||||||||||||||||
11 | Department
pursuant to this Article or pursuant to the | ||||||||||||||||||||||||
12 | Community Residential
Alternatives Licensing Act.
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13 | (b) "Department" means the Department of Human Services, as | ||||||||||||||||||||||||
14 | successor to
the Department of Mental Health and Developmental | ||||||||||||||||||||||||
15 | Disabilities.
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16 | (c) "Home-based services" means services provided to an | ||||||||||||||||||||||||
17 | adult with a mental disability who lives in his or her own | ||||||||||||||||||||||||
18 | home. These services include but are
not limited to:
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19 | (1) home health services;
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20 | (2) case management;
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21 | (3) crisis management;
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22 | (4) training and assistance in self-care;
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23 | (5) personal care services;
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1 | (6) habilitation and rehabilitation services;
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2 | (7) employment-related services;
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3 | (8) respite care; and
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4 | (9) other skill training that enables a person to | ||||||
5 | become self-supporting.
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6 | (d) "Legal guardian" means a person appointed by a court of | ||||||
7 | competent
jurisdiction to exercise certain powers on behalf of | ||||||
8 | an adult with a mental disability.
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9 | (e) "Adult with a mental disability" means a person over | ||||||
10 | the age of 18 years
who lives in his or her own home; who needs | ||||||
11 | home-based services,
but does not require 24-hour-a-day | ||||||
12 | supervision; and who has one of the
following conditions: | ||||||
13 | severe autism, severe mental illness, a severe or
profound | ||||||
14 | intellectual disability, or severe and multiple impairments.
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15 | (f) In one's "own home" means that an adult with a mental | ||||||
16 | disability lives
alone; or that an adult with a mental | ||||||
17 | disability is in full-time residence with his
or her parents, | ||||||
18 | legal guardian, or other relatives; or that an adult with a | ||||||
19 | mental disability is in full-time residence in a setting not | ||||||
20 | subject to
licensure under the Nursing Home Care Act, the | ||||||
21 | Specialized Mental Health Rehabilitation Act of 2013, the ID/DD | ||||||
22 | Community Care Act, the MC/DD Act, or the Child Care Act of | ||||||
23 | 1969, as now or hereafter amended, with 3 or fewer other adults | ||||||
24 | unrelated to the
adult with a mental disability who do not | ||||||
25 | provide home-based services to the
adult with a mental | ||||||
26 | disability , or a facility licensed by a unit of local |
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1 | government authority with 4 or 5 other adults unrelated to the | ||||||
2 | adult with a mental disability who do not provide home-based | ||||||
3 | services to the adult with a mental disability .
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4 | (g) "Parent" means the biological or adoptive parent
of an | ||||||
5 | adult with a mental disability, or a person licensed as a
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6 | foster parent under the laws of this State who acts as a foster | ||||||
7 | parent to an adult with a mental disability.
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8 | (h) "Relative" means any of the following relationships
by | ||||||
9 | blood, marriage or adoption: parent, son, daughter, brother, | ||||||
10 | sister,
grandparent, uncle, aunt, nephew, niece, great | ||||||
11 | grandparent, great uncle,
great aunt, stepbrother, stepsister, | ||||||
12 | stepson, stepdaughter, stepparent or
first cousin.
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13 | (i) "Severe autism" means a lifelong developmental | ||||||
14 | disability which is
typically manifested before 30 months of | ||||||
15 | age and is characterized by
severe disturbances in reciprocal | ||||||
16 | social interactions; verbal and
nonverbal communication and | ||||||
17 | imaginative activity; and repertoire of
activities and | ||||||
18 | interests. A person shall be determined severely
autistic, for | ||||||
19 | purposes of this Article, if both of the following are present:
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20 | (1) Diagnosis consistent with the criteria for | ||||||
21 | autistic disorder in
the current edition of the Diagnostic | ||||||
22 | and Statistical Manual of Mental
Disorders.
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23 | (2) Severe disturbances in reciprocal social | ||||||
24 | interactions; verbal and
nonverbal communication and | ||||||
25 | imaginative activity; repertoire of activities
and | ||||||
26 | interests. A determination of severe autism shall be based |
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1 | upon a
comprehensive, documented assessment with an | ||||||
2 | evaluation by a licensed
clinical psychologist or | ||||||
3 | psychiatrist. A determination of severe autism
shall not be | ||||||
4 | based solely on behaviors relating to environmental, | ||||||
5 | cultural
or economic differences.
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6 | (j) "Severe mental illness" means the manifestation of all | ||||||
7 | of the
following characteristics:
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8 | (1) A primary diagnosis of one of the major mental | ||||||
9 | disorders
in the current edition of the Diagnostic and | ||||||
10 | Statistical Manual of Mental
Disorders listed below:
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11 | (A) Schizophrenia disorder.
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12 | (B) Delusional disorder.
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13 | (C) Schizo-affective disorder.
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14 | (D) Bipolar affective disorder.
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15 | (E) Atypical psychosis.
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16 | (F) Major depression, recurrent.
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17 | (2) The individual's mental illness must substantially | ||||||
18 | impair his
or her functioning in at least 2 of the | ||||||
19 | following areas:
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20 | (A) Self-maintenance.
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21 | (B) Social functioning.
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22 | (C) Activities of community living.
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23 | (D) Work skills.
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24 | (3) Disability must be present or expected to be | ||||||
25 | present for at least
one year.
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26 | A determination of severe mental illness shall be based |
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1 | upon a
comprehensive, documented assessment with an evaluation | ||||||
2 | by a licensed
clinical psychologist or psychiatrist, and shall | ||||||
3 | not be based solely on
behaviors relating to environmental, | ||||||
4 | cultural or economic differences.
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5 | (k) "Severe or profound intellectual disability" means a | ||||||
6 | manifestation of all
of the following characteristics:
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7 | (1) A diagnosis which meets Classification in Mental | ||||||
8 | Retardation or
criteria in the current edition of the | ||||||
9 | Diagnostic and Statistical Manual of
Mental Disorders for | ||||||
10 | severe or profound mental retardation (an IQ of 40 or
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11 | below). This must be measured by a standardized instrument | ||||||
12 | for general
intellectual functioning.
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13 | (2) A severe or profound level of disturbed adaptive | ||||||
14 | behavior. This
must be measured by a standardized adaptive | ||||||
15 | behavior scale or informal
appraisal by the professional in | ||||||
16 | keeping with illustrations in
Classification in Mental | ||||||
17 | Retardation, 1983.
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18 | (3) Disability diagnosed before age of 18.
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19 | A determination of a severe or profound intellectual | ||||||
20 | disability shall be based
upon a comprehensive, documented | ||||||
21 | assessment with an evaluation by a
licensed clinical | ||||||
22 | psychologist or certified school psychologist or a
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23 | psychiatrist, and shall not be based solely on behaviors | ||||||
24 | relating to
environmental, cultural or economic differences.
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25 | (l) "Severe and multiple impairments" means the | ||||||
26 | manifestation of all of
the following characteristics:
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1 | (1) The evaluation determines the presence of a | ||||||
2 | developmental
disability which is expected to continue | ||||||
3 | indefinitely, constitutes a
substantial disability and is | ||||||
4 | attributable to any of the following:
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5 | (A) Intellectual disability, which is defined as | ||||||
6 | general intellectual
functioning that is 2 or more | ||||||
7 | standard deviations below the mean
concurrent with | ||||||
8 | impairment of adaptive behavior which is 2 or more | ||||||
9 | standard
deviations below the mean. Assessment of the | ||||||
10 | individual's intellectual
functioning must be measured | ||||||
11 | by a standardized instrument for general
intellectual | ||||||
12 | functioning.
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13 | (B) Cerebral palsy.
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14 | (C) Epilepsy.
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15 | (D) Autism.
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16 | (E) Any other condition which results in | ||||||
17 | impairment similar to that
caused by an intellectual | ||||||
18 | disability and which requires services similar to | ||||||
19 | those
required by persons with intellectual | ||||||
20 | disabilities.
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21 | (2) The evaluation determines multiple disabilities in | ||||||
22 | physical, sensory,
behavioral or cognitive functioning | ||||||
23 | which constitute a severe or profound
impairment | ||||||
24 | attributable to one or more of the following:
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25 | (A) Physical functioning, which severely impairs | ||||||
26 | the individual's motor
performance that may be due to:
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1 | (i) Neurological, psychological or physical | ||||||
2 | involvement resulting in a
variety of disabling | ||||||
3 | conditions such as hemiplegia, quadriplegia or | ||||||
4 | ataxia,
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5 | (ii) Severe organ systems involvement such as | ||||||
6 | congenital heart defect,
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7 | (iii) Physical abnormalities resulting in the | ||||||
8 | individual being
non-mobile and non-ambulatory or | ||||||
9 | confined to bed and receiving assistance
in | ||||||
10 | transferring, or
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11 | (iv) The need for regular medical or nursing | ||||||
12 | supervision such as
gastrostomy care and feeding.
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13 | Assessment of physical functioning must be based | ||||||
14 | on clinical medical
assessment by a physician licensed | ||||||
15 | to practice medicine in all its branches,
using the | ||||||
16 | appropriate instruments, techniques and standards of | ||||||
17 | measurement
required by the professional.
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18 | (B) Sensory, which involves severe restriction due | ||||||
19 | to hearing or
visual impairment limiting the | ||||||
20 | individual's movement and creating
dependence in | ||||||
21 | completing most daily activities. Hearing impairment | ||||||
22 | is
defined as a loss of 70 decibels aided or speech | ||||||
23 | discrimination of less
than 50% aided. Visual | ||||||
24 | impairment is defined as 20/200 corrected in the
better | ||||||
25 | eye or a visual field of 20 degrees or less.
Sensory | ||||||
26 | functioning must be based on clinical medical |
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1 | assessment by a
physician licensed to practice | ||||||
2 | medicine in all its branches using the
appropriate | ||||||
3 | instruments, techniques and standards of measurement | ||||||
4 | required
by the professional.
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5 | (C) Behavioral, which involves behavior that is | ||||||
6 | maladaptive and presents
a danger to self or others, is | ||||||
7 | destructive to property by deliberately
breaking, | ||||||
8 | destroying or defacing objects, is disruptive by | ||||||
9 | fighting, or has
other socially offensive behaviors in | ||||||
10 | sufficient frequency or severity to
seriously limit | ||||||
11 | social integration. Assessment of behavioral | ||||||
12 | functioning
may be measured by a standardized scale or | ||||||
13 | informal appraisal by a clinical
psychologist or | ||||||
14 | psychiatrist.
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15 | (D) Cognitive, which involves intellectual | ||||||
16 | functioning at a measured IQ
of 70 or below. Assessment | ||||||
17 | of cognitive functioning must be measured by a
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18 | standardized instrument for general intelligence.
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19 | (3) The evaluation determines that development is | ||||||
20 | substantially less
than expected for the age in cognitive, | ||||||
21 | affective or psychomotor behavior
as follows:
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22 | (A) Cognitive, which involves intellectual | ||||||
23 | functioning at a measured IQ
of 70 or below. Assessment | ||||||
24 | of cognitive functioning must be measured by a
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25 | standardized instrument for general intelligence.
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26 | (B) Affective behavior, which involves over and |
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1 | under responding to
stimuli in the environment and may | ||||||
2 | be observed in mood, attention to
awareness, or in | ||||||
3 | behaviors such as euphoria, anger or sadness that
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4 | seriously limit integration into society. Affective | ||||||
5 | behavior must be based
on clinical assessment using the | ||||||
6 | appropriate instruments, techniques and
standards of | ||||||
7 | measurement required by the professional.
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8 | (C) Psychomotor, which includes a severe | ||||||
9 | developmental delay in fine or
gross motor skills so | ||||||
10 | that development in self-care, social interaction,
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11 | communication or physical activity will be greatly | ||||||
12 | delayed or restricted.
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13 | (4) A determination that the disability originated | ||||||
14 | before the age of
18 years.
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15 | A determination of severe and multiple impairments shall be | ||||||
16 | based upon a
comprehensive, documented assessment with an | ||||||
17 | evaluation by a licensed
clinical psychologist or | ||||||
18 | psychiatrist.
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19 | If the examiner is a licensed clinical psychologist, | ||||||
20 | ancillary evaluation
of physical impairment, cerebral palsy or | ||||||
21 | epilepsy must be made by a
physician licensed to practice | ||||||
22 | medicine in all its branches.
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23 | Regardless of the discipline of the examiner, ancillary | ||||||
24 | evaluation of
visual impairment must be made by an | ||||||
25 | ophthalmologist or a licensed optometrist.
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26 | Regardless of the discipline of the examiner, ancillary |
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1 | evaluation of
hearing impairment must be made by an | ||||||
2 | otolaryngologist or an audiologist
with a certificate of | ||||||
3 | clinical competency.
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4 | The only exception to the above is in the case of a person | ||||||
5 | with cerebral
palsy or epilepsy who, according to the | ||||||
6 | eligibility criteria listed below,
has multiple impairments | ||||||
7 | which are only physical and sensory. In such a
case, a | ||||||
8 | physician licensed to practice medicine in all its branches may
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9 | serve as the examiner.
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10 | (m) "Twenty-four-hour-a-day supervision" means | ||||||
11 | 24-hour-a-day care by a
trained mental health or developmental | ||||||
12 | disability professional on an ongoing
basis.
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13 | (Source: P.A. 98-104, eff. 7-22-13; 99-143, eff. 7-27-15; | ||||||
14 | 99-180, eff. 7-29-15; 99-642, eff. 7-28-16.)
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