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1    AN ACT concerning children.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5.23 as follows:
 
6    (305 ILCS 5/5-5.23)
7    (Text of Section after amendment by P.A. 101-461)
8    Sec. 5-5.23. Children's mental health services.
9    (a) The Department of Healthcare and Family Services, by
10rule, shall require the screening and assessment of a child
11prior to any Medicaid-funded admission to an inpatient hospital
12for psychiatric services to be funded by Medicaid. The
13screening and assessment shall include a determination of the
14appropriateness and availability of out-patient support
15services for necessary treatment. The Department, by rule,
16shall establish methods and standards of payment for the
17screening, assessment, and necessary alternative support
18services.
19    (b) The Department of Healthcare and Family Services, to
20the extent allowable under federal law, shall secure federal
21financial participation for Individual Care Grant expenditures
22made by the Department of Healthcare and Family Services for
23the Medicaid optional service authorized under Section 1905(h)

 

 

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1of the federal Social Security Act, pursuant to the provisions
2of Section 7.1 of the Mental Health and Developmental
3Disabilities Administrative Act. The Department of Healthcare
4and Family Services may exercise the authority under this
5Section as is necessary to administer Individual Care Grants as
6authorized under Section 7.1 of the Mental Health and
7Developmental Disabilities Administrative Act.
8    (c) The Department of Healthcare and Family Services shall
9work collaboratively with the Department of Children and Family
10Services and the Division of Mental Health of the Department of
11Human Services to implement subsections (a) and (b).
12    (d) On and after July 1, 2012, the Department shall reduce
13any rate of reimbursement for services or other payments or
14alter any methodologies authorized by this Code to reduce any
15rate of reimbursement for services or other payments in
16accordance with Section 5-5e.
17    (e) All rights, powers, duties, and responsibilities
18currently exercised by the Department of Human Services related
19to the Individual Care Grant program are transferred to the
20Department of Healthcare and Family Services with the transfer
21and transition of the Individual Care Grant program to the
22Department of Healthcare and Family Services to be completed
23and implemented within 6 months after the effective date of
24this amendatory Act of the 99th General Assembly. For the
25purposes of the Successor Agency Act, the Department of
26Healthcare and Family Services is declared to be the successor

 

 

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1agency of the Department of Human Services, but only with
2respect to the functions of the Department of Human Services
3that are transferred to the Department of Healthcare and Family
4Services under this amendatory Act of the 99th General
5Assembly.
6        (1) Each act done by the Department of Healthcare and
7    Family Services in exercise of the transferred powers,
8    duties, rights, and responsibilities shall have the same
9    legal effect as if done by the Department of Human Services
10    or its offices.
11        (2) Any rules of the Department of Human Services that
12    relate to the functions and programs transferred by this
13    amendatory Act of the 99th General Assembly that are in
14    full force on the effective date of this amendatory Act of
15    the 99th General Assembly shall become the rules of the
16    Department of Healthcare and Family Services. All rules
17    transferred under this amendatory Act of the 99th General
18    Assembly are hereby amended such that the term "Department"
19    shall be defined as the Department of Healthcare and Family
20    Services and all references to the "Secretary" shall be
21    changed to the "Director of Healthcare and Family Services
22    or his or her designee". As soon as practicable hereafter,
23    the Department of Healthcare and Family Services shall
24    revise and clarify the rules to reflect the transfer of
25    rights, powers, duties, and responsibilities affected by
26    this amendatory Act of the 99th General Assembly, using the

 

 

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1    procedures for recodification of rules available under the
2    Illinois Administrative Procedure Act, except that
3    existing title, part, and section numbering for the
4    affected rules may be retained. The Department of
5    Healthcare and Family Services, consistent with its
6    authority to do so as granted by this amendatory Act of the
7    99th General Assembly, shall propose and adopt any other
8    rules under the Illinois Administrative Procedure Act as
9    necessary to administer the Individual Care Grant program.
10    These rules may include, but are not limited to, the
11    application process and eligibility requirements for
12    recipients.
13        (3) All unexpended appropriations and balances and
14    other funds available for use in connection with any
15    functions of the Individual Care Grant program shall be
16    transferred for the use of the Department of Healthcare and
17    Family Services to operate the Individual Care Grant
18    program. Unexpended balances shall be expended only for the
19    purpose for which the appropriation was originally made.
20    The Department of Healthcare and Family Services shall
21    exercise all rights, powers, duties, and responsibilities
22    for operation of the Individual Care Grant program.
23        (4) Existing personnel and positions of the Department
24    of Human Services pertaining to the administration of the
25    Individual Care Grant program shall be transferred to the
26    Department of Healthcare and Family Services with the

 

 

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1    transfer and transition of the Individual Care Grant
2    program to the Department of Healthcare and Family
3    Services. The status and rights of Department of Human
4    Services employees engaged in the performance of the
5    functions of the Individual Care Grant program shall not be
6    affected by this amendatory Act of the 99th General
7    Assembly. The rights of the employees, the State of
8    Illinois, and its agencies under the Personnel Code and
9    applicable collective bargaining agreements or under any
10    pension, retirement, or annuity plan shall not be affected
11    by this amendatory Act of the 99th General Assembly. All
12    transferred employees who are members of collective
13    bargaining units shall retain their seniority, continuous
14    service, salary, and accrued benefits.
15        (5) All books, records, papers, documents, property
16    (real and personal), contracts, and pending business
17    pertaining to the powers, duties, rights, and
18    responsibilities related to the functions of the
19    Individual Care Grant program, including, but not limited
20    to, material in electronic or magnetic format and necessary
21    computer hardware and software, shall be delivered to the
22    Department of Healthcare and Family Services; provided,
23    however, that the delivery of this information shall not
24    violate any applicable confidentiality constraints.
25        (6) Whenever reports or notices are now required to be
26    made or given or papers or documents furnished or served by

 

 

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1    any person to or upon the Department of Human Services in
2    connection with any of the functions transferred by this
3    amendatory Act of the 99th General Assembly, the same shall
4    be made, given, furnished, or served in the same manner to
5    or upon the Department of Healthcare and Family Services.
6        (7) This amendatory Act of the 99th General Assembly
7    shall not affect any act done, ratified, or canceled or any
8    right occurring or established or any action or proceeding
9    had or commenced in an administrative, civil, or criminal
10    cause regarding the Department of Human Services before the
11    effective date of this amendatory Act of the 99th General
12    Assembly; and those actions or proceedings may be defended,
13    prosecuted, and continued by the Department of Human
14    Services.
15    (f) (Blank).
16    (g) Family Support Program. The Department of Healthcare
17and Family Services shall restructure the Family Support
18Program, formerly known as the Individual Care Grant program,
19to enable early treatment of youth, emerging adults, and
20transition-age adults with a serious mental illness or serious
21emotional disturbance.
22        (1) As used in this subsection and in subsections (h)
23    through (s):
24            (A) "Youth" means a person under the age of 18.
25            (B) "Emerging adult" means a person who is 18
26        through 20 years of age.

 

 

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1            (C) "Transition-age adult" means a person who is 21
2        through 25 years of age.
3        (2) The Department shall amend 89 Ill. Adm. Code 139 in
4    accordance with this Section and consistent with the
5    timelines outlined in this Section.
6        (3) Implementation of any amended requirements shall
7    be completed within 8 months of the adoption of any
8    amendment to 89 Ill. Adm. Code 139 that is consistent with
9    the provisions of this Section.
10        (4) To align the Family Support Program with the
11    Medicaid system of care, the services available to a youth,
12    emerging adult, or transition-age adult through the Family
13    Support Program shall include all Medicaid community-based
14    mental health treatment services and all Family Support
15    Program services included under 89 Ill. Adm. Code 139. No
16    person receiving services through the Family Support
17    Program or the Specialized Family Support Program shall
18    become a Medicaid enrollee unless Medicaid eligibility
19    criteria are met and the person is enrolled in Medicaid. No
20    part of this Section creates an entitlement to services
21    through the Family Support Program, the Specialized Family
22    Support Program, or the Medicaid program.
23        (5) The Family Support Program shall align with the
24    following system of care principles:
25            (A) Treatment and support services shall be based
26        on the results of an integrated behavioral health

 

 

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1        assessment and treatment plan using an instrument
2        approved by the Department of Healthcare and Family
3        Services.
4            (B) Strong interagency collaboration between all
5        State agencies the parent or legal guardian is involved
6        with for services, including the Department of
7        Healthcare and Family Services, the Department of
8        Human Services, the Department of Children and Family
9        Services, the Department of Juvenile Justice, and the
10        Illinois State Board of Education.
11            (C) Individualized, strengths-based practices and
12        trauma-informed treatment approaches.
13            (D) For a youth, full participation of the parent
14        or legal guardian at all levels of treatment through a
15        process that is family-centered and youth-focused. The
16        process shall include consideration of the services
17        and supports the parent, legal guardian, or caregiver
18        requires for family stabilization, and shall connect
19        such person or persons to services based on available
20        insurance coverage.
21    (h) Eligibility for the Family Support Program.
22Eligibility criteria established under 89 Ill. Adm. Code 139
23for the Family Support Program shall include the following:
24        (1) Individuals applying to the program must be under
25    the age of 26.
26        (2) Requirements for parental or legal guardian

 

 

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1    involvement are applicable to youth and to emerging adults
2    or transition-age adults who have a guardian appointed
3    under Article XIa of the Probate Act.
4        (3) Youth, emerging adults, and transition-age adults
5    are eligible for services under the Family Support Program
6    upon their third inpatient admission to a hospital or
7    similar treatment facility for the primary purpose of
8    psychiatric treatment within the most recent 12 months and
9    are hospitalized for the purpose of psychiatric treatment.
10        (4) School participation for emerging adults applying
11    for services under the Family Support Program may be waived
12    by request of the individual at the sole discretion of the
13    Department of Healthcare and Family Services.
14        (5) School participation is not applicable to
15    transition-age adults.
16    (i) Notification of Family Support Program and Specialized
17Family Support Program services.
18        (1) Within 12 months after the effective date of this
19    amendatory Act of the 101st General Assembly, the
20    Department of Healthcare and Family Services, with
21    meaningful stakeholder input through a working group of
22    psychiatric hospitals, Family Support Program providers,
23    family support organizations, the Community and
24    Residential Services Authority, a statewide association
25    representing a majority of hospitals, a statewide
26    association representing physicians, and foster care

 

 

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1    alumni advocates, shall establish a clear process by which
2    a youth's or emerging adult's parents, guardian, or
3    caregiver, or the emerging adult or transition-age adult,
4    is identified, notified, and educated about the Family
5    Support Program and the Specialized Family Support Program
6    upon a first psychiatric inpatient hospital admission, and
7    any following psychiatric inpatient admissions.
8    Notification and education may take place through a Family
9    Support Program coordinator, a mobile crisis response
10    provider, a Comprehensive Community Based Youth Services
11    provider, the Community and Residential Services
12    Authority, or any other designated provider or coordinator
13    identified by the Department of Healthcare and Family
14    Services. In developing this process, the Department of
15    Healthcare and Family Services and the working group shall
16    take into account the unique needs of emerging adults and
17    transition-age adults without parental involvement who are
18    eligible for services under the Family Support Program. The
19    Department of Healthcare and Family Services and the
20    working group shall ensure the appropriate provider or
21    coordinator is required to assist individuals and their
22    parents, guardians, or caregivers, as applicable, in the
23    completion of the application or referral process for the
24    Family Support Program or the Specialized Family Support
25    Program.
26        (2) Upon a youth's, emerging adult's or transition-age

 

 

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1    adult's second psychiatric inpatient hospital admission,
2    prior to hospital discharge, the hospital must, if it is
3    aware of the patient's prior psychiatric inpatient
4    hospital admission, ensure that the youth's parents,
5    guardian, or caregiver, or the emerging adult or
6    transition-age adult, has have been notified of the Family
7    Support Program and the Specialized Family Support Program
8    prior to hospital discharge.
9        (3) Psychiatric lockout as last resort.
10            (A) Prior to referring any youth to the Department
11        of Children and Family Services for the filing of a
12        petition in accordance with subparagraph (c) of
13        paragraph (1) of Section 2-4 of the Juvenile Court Act
14        of 1987 alleging that the youth is dependent because
15        the youth was left in a psychiatric hospital beyond
16        medical necessity, the hospital shall attempt to
17        contact educate the youth and the youth's parents,
18        guardian, or caregiver about the Family Support
19        Program and the Specialized Family Support Program and
20        shall assist with connections to the designated Family
21        Support Program coordinator in the service area by
22        providing educational materials developed by the
23        Department of Healthcare and Family Services. Once
24        this process has begun, any such youth shall be
25        considered a youth for whom an application for the
26        Family Support Program is pending with the Department

 

 

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1        of Healthcare and Family Services or an active
2        application for the Family Support Program was being
3        reviewed by the Department for the purposes of
4        subsection (a) of Section 2-4b subparagraph (b) of
5        paragraph (1) of Section 2-4 of the Juvenile Court Act
6        of 1987, or for the purposes of subsection (a) of
7        Section 5-711 of the Juvenile Court Act of 1987.
8            (B) No state agency or hospital shall coach a
9        parent or guardian of a youth in a psychiatric hospital
10        inpatient unit to lock out or otherwise relinquish
11        custody of a youth to the Department of Children and
12        Family Services for the sole purpose of obtaining
13        necessary mental health treatment for the youth. In the
14        absence of abuse or neglect, a psychiatric lockout or
15        custody relinquishment to the Department of Children
16        and Family Services shall only be considered as the
17        option of last resort. Nothing in this Section shall
18        prohibit discussion of medical treatment options or a
19        referral to legal counsel.
20        (4) Development of new Family Support Program
21    services.
22            (A) Development of specialized therapeutic
23        residential treatment for youth and emerging adults
24        with high-acuity mental health conditions. Through a
25        working group led by the Department of Healthcare and
26        Family Services that includes the Department of

 

 

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1        Children and Family Services and residential treatment
2        providers for youth and emerging adults, the
3        Department of Healthcare and Family Services, within
4        12 months after the effective date of this amendatory
5        Act of the 101st General Assembly, shall develop a plan
6        for the development of specialized therapeutic
7        residential treatment beds similar to a qualified
8        residential treatment program, as defined in the
9        federal Family First Prevention Services Act, for
10        youth in the Family Support Program with high-acuity
11        mental health needs. The Department of Healthcare and
12        Family Services and the Department of Children and
13        Family Services shall work together to maximize
14        federal funding through Medicaid and Title IV-E of the
15        Social Security Act in the development and
16        implementation of this plan.
17            (B) Using the Department of Children and Family
18        Services' beyond medical necessity data over the last 5
19        years and any other relevant, available data, the
20        Department of Healthcare and Family Services shall
21        assess the estimated number of these specialized
22        high-acuity residential treatment beds that are needed
23        in each region of the State based on the number of
24        youth remaining in psychiatric hospitals beyond
25        medical necessity and the number of youth placed
26        out-of-state who need this level of care. The

 

 

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1        Department of Healthcare and Family Services shall
2        report the results of this assessment to the General
3        Assembly by no later than December 31, 2020.
4            (C) Development of an age-appropriate therapeutic
5        residential treatment model for emerging adults and
6        transition-age adults. Within 30 months after the
7        effective date of this amendatory Act of the 101st
8        General Assembly, the Department of Healthcare and
9        Family Services, in partnership with the Department of
10        Human Services' Division of Mental Health and with
11        significant and meaningful stakeholder input through a
12        working group of providers and other stakeholders,
13        shall develop a supportive housing model for emerging
14        adults and transition-age adults receiving services
15        through the Family Support Program who need
16        residential treatment and support to enable recovery.
17        Such a model shall be age-appropriate and shall allow
18        the residential component of the model to be in a
19        community-based setting combined with intensive
20        community-based mental health services.
21    (j) Workgroup to develop a plan for improving access to
22substance use treatment. The Department of Healthcare and
23Family Services and the Department of Human Services' Division
24of Substance Use Prevention and Recovery shall co-lead a
25working group that includes Family Support Program providers,
26family support organizations, and other stakeholders over a

 

 

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112-month period beginning in the first quarter of calendar year
22020 to develop a plan for increasing access to substance use
3treatment services for youth, emerging adults, and
4transition-age adults who are eligible for Family Support
5Program services.
6    (k) Appropriation. Implementation of this Section shall be
7limited by the State's annual appropriation to the Family
8Support Program. Spending within the Family Support Program
9appropriation shall be further limited for the new Family
10Support Program services to be developed accordingly:
11        (1) Targeted use of specialized therapeutic
12    residential treatment for youth and emerging adults with
13    high-acuity mental health conditions through appropriation
14    limitation. No more than 12% of all annual Family Support
15    Program funds shall be spent on this level of care in any
16    given state fiscal year.
17        (2) Targeted use of residential treatment model
18    established for emerging adults and transition-age adults
19    through appropriation limitation. No more than one-quarter
20    of all annual Family Support Program funds shall be spent
21    on this level of care in any given state fiscal year.
22    (l) Exhausting third party insurance coverage first.
23        (A) A parent, legal guardian, emerging adult, or
24    transition-age adult with private insurance coverage shall
25    work with the Department of Healthcare and Family Services,
26    or its designee, to identify insurance coverage for any and

 

 

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1    all benefits covered by their plan. If insurance
2    cost-sharing by any method for treatment is
3    cost-prohibitive for the parent, legal guardian, emerging
4    adult, or transition-age adult, Family Support Program
5    funds may be applied as a payer of last resort toward
6    insurance cost-sharing for purposes of using private
7    insurance coverage to the fullest extent for the
8    recommended treatment. If the Department, or its agent, has
9    a concern relating to the parent's, legal guardian's,
10    emerging adult's, or transition-age adult's insurer's
11    compliance with Illinois or federal insurance requirements
12    relating to the coverage of mental health or substance use
13    disorders, it shall refer all relevant information to the
14    applicable regulatory authority.
15        (B) The Department of Healthcare and Family Services
16    shall use Medicaid funds first for an individual who has
17    Medicaid coverage if the treatment or service recommended
18    using an integrated behavioral health assessment and
19    treatment plan (using the instrument approved by the
20    Department of Healthcare and Family Services) is covered by
21    Medicaid.
22        (C) If private or public insurance coverage does not
23    cover the needed treatment or service, Family Support
24    Program funds shall be used to cover the services offered
25    through the Family Support Program.
26    (m) Service authorization. A youth, emerging adult, or

 

 

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1transition-age adult enrolled in the Family Support Program or
2the Specialized Family Support Program shall be eligible to
3receive a mental health treatment service covered by the
4applicable program if the medical necessity criteria
5established by the Department of Healthcare and Family Services
6are met.
7    (n) Streamlined application. The Department of Healthcare
8and Family Services shall revise the Family Support Program
9applications and the application process to reflect the changes
10made to this Section by this amendatory Act of the 101st
11General Assembly within 8 months after the adoption of any
12amendments to 89 Ill. Adm. Code 139.
13    (o) Study of reimbursement policies during planned and
14unplanned absences of youth and emerging adults in Family
15Support Program residential treatment settings. The Department
16of Healthcare and Family Services shall undertake a study of
17those standards of the Department of Children and Family
18Services and other states for reimbursement of residential
19treatment during planned and unplanned absences to determine if
20reimbursing residential providers for such unplanned absences
21positively impacts the availability of residential treatment
22for youth and emerging adults. The Department of Healthcare and
23Family Services shall begin the study on July 1, 2019 and shall
24report its findings and the results of the study to the General
25Assembly, along with any recommendations for or against
26adopting a similar policy, by December 31, 2020.

 

 

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1    (p) Public awareness and educational campaign for all
2relevant providers. The Department of Healthcare and Family
3Services shall engage in a public awareness campaign to educate
4hospitals with psychiatric units, crisis response providers
5such as Screening, Assessment and Support Services providers
6and Comprehensive Community Based Youth Services agencies,
7schools, and other community institutions and providers across
8Illinois on the changes made by this amendatory Act of the
9101st General Assembly to the Family Support Program. The
10Department of Healthcare and Family Services shall produce
11written materials geared for the appropriate target audience,
12develop webinars, and conduct outreach visits over a 12-month
13period beginning after implementation of the changes made to
14this Section by this amendatory Act of the 101st General
15Assembly.
16    (q) Maximizing federal matching funds for the Family
17Support Program and the Specialized Family Support Program. The
18Department of Healthcare and Family Services, as the sole
19Medicaid State agency, shall seek approval from the federal
20Centers for Medicare and Medicaid Services within 12 months
21after the effective date of this amendatory Act of the 101st
22General Assembly to draw additional federal Medicaid matching
23funds for individuals served under the Family Support Program
24or the Specialized Family Support Program who are not covered
25by the Department's medical assistance programs. The
26Department of Children and Family Services, as the State agency

 

 

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1responsible for administering federal funds pursuant to Title
2IV-E of the Social Security Act, shall submit a State Plan to
3the federal government within 12 months after the effective
4date of this amendatory Act of the 101st General Assembly to
5maximize the use of federal Title IV-E prevention funds through
6the federal Family First Prevention Services Act, to provide
7mental health and substance use disorder treatment services and
8supports, including, but not limited to, the provision of
9short-term crisis and transition beds post-hospitalization for
10youth who are at imminent risk of entering Illinois' youth
11welfare system solely due to the inability to access mental
12health or substance use treatment services.
13    (r) Outcomes and data reported annually to the General
14Assembly. Beginning in 2021, the Department of Healthcare and
15Family Services shall submit an annual report to the General
16Assembly that includes the following information with respect
17to the time period covered by the report:
18        (1) The number and ages of youth, emerging adults, and
19    transition-age adults who requested services under the
20    Family Support Program and the Specialized Family Support
21    Program and the services received.
22        (2) The number and ages of youth, emerging adults, and
23    transition-age adults who requested services under the
24    Specialized Family Support Program who were eligible for
25    services based on the number of hospitalizations.
26        (3) The number and ages of youth, emerging adults, and

 

 

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1    transition-age adults who applied for Family Support
2    Program or Specialized Family Support Program services but
3    did not receive any services.
4    (s) Rulemaking authority. Unless a timeline is otherwise
5specified in a subsection, if amendments to 89 Ill. Adm. Code
6139 are needed for implementation of this Section, such
7amendments shall be filed by the Department of Healthcare and
8Family Services within one year after the effective date of
9this amendatory Act of the 101st General Assembly.
10(Source: P.A. 101-461, eff. 1-1-20.)
 
11    Section 99. Effective date. This Act takes effect upon
12becoming law.