99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB4096

 

Introduced , by Rep. Sara Feigenholtz

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 1705/75 new
20 ILCS 1705/75.01 new
20 ILCS 1705/75.02 new
20 ILCS 1705/75.03 new
20 ILCS 1705/75.04 new
20 ILCS 1705/75.05 new
20 ILCS 1705/75.06 new
20 ILCS 1705/75.07 new
20 ILCS 1705/75.08 new
20 ILCS 1705/75.09 new
20 ILCS 1705/75.10 new
20 ILCS 1705/75.11 new
20 ILCS 1705/75.12 new
20 ILCS 1705/75.13 new
20 ILCS 1705/75.14 new

    Amends the Mental Health and Developmental Disabilities Administrative Act. Defines the terms and provides procedures under which children are eligible to receive funds for an Individual Care Grant (ICG) for residential placement due to their mental illness, including alternative in-home or community services in lieu of residential placement, when clinically appropriate. Supersedes Department of Human Services rules.


LRB099 07770 RLC 27903 b

 

 

A BILL FOR

 

HB4096LRB099 07770 RLC 27903 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Mental Health and Developmental
5Disabilities Administrative Act is amended by adding Sections
675, 75.01, 75.02, 75.03, 75.04, 75.05, 75.06, 75.07, 75.08,
775.09, 75.10, 75.11, 75.12, 75.13, and 75.14 as follows:
 
8    (20 ILCS 1705/75 new)
9    Sec. 75. Application of Sections 75.01 through 75.14;
10purpose.
11    (a) Sections 75.01 through 75.14 (this Part) shall
12supersede any rules of the Department regarding which children
13are eligible to receive funds for an Individual Care Grant
14hereinafter referred to as "ICG" for residential placement due
15to their mental illness, including alternative in-home or
16community services in lieu of residential placement, when
17clinically appropriate. Comprehensive services are to be
18funded to assist in reducing the child's severe symptoms of the
19illness and to maintain this reduction. Funds shall be provided
20to assist parents or guardians in obtaining these services at
21the appropriate level of care.
22    (b) This Part shall be in addition to the other statutory
23provisions regarding Individual Care Grants. This Part is

 

 

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1intended to supplement and provide procedures for Individual
2Care Grants. However, if there is a conflict between anything
3contained in the other statutory provisions, those other
4statutory provisions shall prevail.
 
5    (20 ILCS 1705/75.01 new)
6    Sec. 75.01. Definitions.
7    For the purposes of this Part, unless the context otherwise
8requires:
9    "Children" means individuals under 18 years of age.
10    "Days" means calendar days.
11    "Department" means the Department of Human Services.
12    "Division of Mental Health" or "DMH" means the Department
13of Human Services, Division of Mental Health.
14    "Child support services" means time-limited funding to
15cover costs that would otherwise be prohibitive to the parents
16for the child to participate in community activities when those
17activities are related to objectives in the child's current
18individual services plan.
19    "ICG Coordinator" means staff employed by an Illinois
20screening, assessment and support services program to provide
21support, information and recommendations regarding available
22services, case coordination, and supports to youth applying for
23or with an Illinois ICG.
24    "Individual Services Plan" or "ISP" means the plan that
25identifies the child's goals and selects the level of care and

 

 

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1associated services required to meet the goals.
2    "Individual Services Planning Team" means the team
3composed of family members, significant people in the lives of
4the child and family, representatives of the community's human
5service agencies and the youth's school system, who provide
6needed support to an identified child and family and which is
7responsible for the development, implementation, and
8monitoring of a unified Child and Family Plan that engages and
9involves the family and closely coordinates needed services and
10support.
11    "Licensed private facilities" means residential treatment
12facilities licensed by the Department of Children and Family
13Services under 89 Ill. Adm. Code 404, or, for out-of-state
14facilities, in accordance with Section 15.1 of the Mental
15Health and Developmental Disabilities Administrative Act,
16which have been accredited by the Joint Commission on the
17Accreditation of Healthcare Organizations hereinafter
18preferred to as "JCAHO" as a psychiatric facility serving
19children and adolescents or which have been surveyed and
20approved by the Department as meeting standards equivalent to
21standards for psychiatric facilities serving children and
22adolescents found in the 1997 Standards for Behavioral Health
23Care released by JCAHO.
24    "Parent or guardian" means a parent, biological, or
25adoptive, or an individual appointed as legal guardian by the
26court under the Probate Act of 1975. A parent or guardian does

 

 

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1not include a governmental agency or social service agency, or
2any employee thereof, appointed by a court as guardian or
3custodian for application purposes.
4    "Residential facility" means a facility providing 24-hour
5supervised out-of-home therapeutic care, including, but not
6limited to: single or multiple site program sites or apartments
7that provide a 24-hour supervised environment.
8    "SASS" or "screening, assessment and support services"
9means intensive community-based mental health services that
10are provided to children who are at risk or who actually
11experience hospitalization due to psychiatric reasons.
12    "Secretary" means the Secretary of Human Services.
13    "Serious emotional disturbance" means an emotional
14disturbance affecting children and adolescents between the
15ages of one and 20 years of age. In order to qualify as a
16serious emotional disturbance, the disturbance must meet the
17following diagnostic and functional criteria:
18        (1) Diagnostic criteria: The focus of treatment
19    provided to the child must be based on one of the following
20    diagnoses in the most current version of the Diagnostic and
21    Statistical Manual ("DSM"):
22            (A) schizophrenia spectrum and other psychotic
23        disorders;
24            (B) bipolar and related disorders;
25            (C) depressive disorders;
26            (D) anxiety disorders;

 

 

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1            (E) obsessive-compulsive and related disorders;
2            (F) trauma- and stressor-related disorders;
3            (G) dissociative disorders; and
4            (H) somatic symptom disorders.
5        (2) Functional Criteria: The functional impairment
6    must be:
7            (A) the result of mental health problems for which
8        the child is or will be receiving care;
9            (B) expected to persist in the absence of
10        treatment;
11            (C) The functional impairment cannot be solely
12        attributed to an intellectual, sensory, or health
13        factor; and
14            (D) In order for the disturbance to be classified
15        as a serious emotional disturbance, the youth must also
16        meet criteria for functional impairment in at least 2
17        of the following areas:
18                (i) Functioning in self-care, or impairment in
19            developmentally appropriate self-care skills,
20            which is manifested by a person's consistent
21            inability to take care of personal grooming,
22            hygiene, clothes and meeting of nutritional needs,
23            or medication non-compliance.
24                (ii) Functioning in community, or impairment
25            in community functioning, which is manifested by a
26            consistent lack of developmentally appropriate

 

 

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1            behavioral controls, decision-making, and judgment
2            and value systems which results in involvement
3            with police, juvenile justice, or the criminal
4            justice system, or repeated psychiatric
5            hospitalizations due to risk of harm to self or
6            others or because he or she is a chronic runaway.
7                (iii) Functioning in social relationships, or
8            impairment of social relationships, which is
9            manifested by the consistent inability to develop
10            and maintain satisfactory relationships with peers
11            and adults.
12                (iv) Functioning in the family, or impairment
13            in family functioning, which is manifested by a
14            pattern of: (aa) disregard for safety and welfare
15            of self or others, which includes, but is not
16            limited to, self-harm, fire setting, and serious
17            and chronic destructiveness which may lead to
18            repeated psychiatric hospitalizations; (bb)
19            significantly disruptive behavior exemplified by
20            repeated or unprovoked violence to siblings or
21            parents; or (cc) the inability to conform to
22            reasonable limitations and expectations. The
23            degree of impairment must be significant enough
24            that it requires intensive supervision, beyond
25            what is developmentally appropriate, by a parent
26            or caregiver and may result in removal from the

 

 

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1            family or its equivalent.
2                (v) Functioning at school, or impairment in
3            functioning at school, which is manifested by the
4            inability to pursue educational goals in a normal
5            time frame for example, consistently failing
6            grades, repeated truancy, expulsion, property
7            damage or violence towards others that cannot be
8            remediated by a classroom setting, either
9            traditional or specialized.
10    "Staff" means employees or persons under contract with the
11Department.
12    "Young adults" means individuals 18 through 21 years of
13age.
14    "Young adult support services" means time-limited funding
15for young adults to cover costs of services and supports, not
16included under other programs for which the person may be
17eligible, to aid the young adult in his or her transition to
18community living and funding that can be applied to the costs
19of a supported living arrangement or other appropriate
20transitional services that help to integrate the young adult
21into his or her adult roles in the community.
 
22    (20 ILCS 1705/75.02 new)
23    Sec. 75.02. Eligibility criteria for an individual care
24grant. In order to be eligible for ICG funding, the following
25criteria must be met:

 

 

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1    (1) The parent or guardian must be a resident of this
2State, as defined in Section 2-10 of the Illinois Public Aid
3Code.
4    (2) The child must have a severe emotional disturbance and
5must not be older than 17 1/2 years of age at the time of
6application. The course of the illness should indicate that the
7symptoms do not represent an acute episode from which rapid and
8substantial remission is likely.
9    (3) The child must not be under the guardianship of another
10State agency that has financial and legal responsibility for
11the youth. However, a child that becomes a ward of the State
12solely for purposes of obtaining residential treatment for a
13serious emotional disturbance, and when there is no evidence of
14abuse or neglect of the child, shall be eligible for an ICG if
15all other criteria are satisfied.
16    (4) The child must be enrolled in a public, private, or
17parochial school that satisfies the compulsory school
18attendance requirements set forth in Section 26-1 of the School
19Code.
 
20    (20 ILCS 1705/75.03 new)
21    Sec. 75.03. Emergency Individual Care Grants.
22    (a) To be eligible for an emergency temporary individual
23care grant;
24        (1) the child and family must meet the eligibility
25    requirements in Section 75.02.

 

 

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1        (2) A child in institutional care (psychiatric
2    hospital, juvenile detention center, or similar facility)
3    who is ready for discharge and who is not able to return
4    home due to the safety of the child, family, or individual
5    may be awarded a temporary emergency grant for a period of
6    90 days.
7        (3) The attending child and adolescent psychiatrist
8    must recommend that the child is in need of on-going 24
9    hour supervision, such as residential placement.
10    (b) For purposes of this Section, paragraph (3) of Section
1175.02 of this Act shall not apply if custody will end at
12discharge.
13    (c) During the 90-day period a complete application must be
14prepared and submitted in accordance with this Part.
15    (d) Section 75.08 applies to decisions under this Section.
 
16    (20 ILCS 1705/75.04 new)
17    Sec. 75.04. Parent or guardian responsibilities;
18resources.
19    (a) The parent or guardian of a child receiving an ICG must
20participate in the child's care, treatment, and discharge to
21family and community.
22    (b) When a youth is placed in residential care, the
23residential provider shall apply for all public sources of
24financial support available to or for the child, including but
25not limited to Social Security Administration ("SSA") benefits

 

 

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1and supplemental security income ("SSI") authorized under
2Section 1381 of Title 42 of the United States Code, and these
3funds must be applied to the costs of residential care, to the
4extent provided by law.
5    (c) Upon placement in residential care, if the child is not
6already receiving benefits from SSA, the parent or guardian
7shall authorize the residential placement staff to initiate an
8application for SSI immediately after placement or on the 90th
9day, depending on family income levels. If the child is
10receiving benefits from SSA upon admission into residential
11care, the parent or guardian shall authorize the residential
12placement staff to initiate an application on behalf of the
13residential agency to become payee for SSA benefits.
14    (d) The parent or guardian must notify the Department of
15any changes in the level of financial support from public
16sources. Declaration of ineligibility, reduction of benefits,
17or loss of benefits through the actions of another governmental
18agency shall not affect the Department's continued funding,
19unless these actions are the consequence of the parent or
20guardian's failure to pursue benefits or comply with this
21Section.
22    (e) All financial assets of the child exceeding an exempt
23amount established by the Department must be applied to the
24costs of residential care. The determination that certain
25assets may be exempt is subject to the Department's review and
26approval.

 

 

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1    (f) If the child is covered by private medical insurance,
2it is primary coverage for community or residential services.
3The ICG shall be considered secondary coverage.
4    (g) The parent or guardian must notify the Department of
5any changes of address for the parent or guardian.
6    (h) The parent or guardian must notify the Department of
7any changes of guardianship or custody.
 
8    (20 ILCS 1705/75.05 new)
9    Sec. 75.05. Secretary's level appeal for ICG denial.
10    (a) The parent or guardian may appeal the denial of
11eligibility for an ICG to the Secretary in writing. The appeal
12must be received by the Department from the parent or guardian
13within 40 days after the date of the denial correspondence from
14the ICG Program Office. The written appeal must provide in
15detail each basis on which the appeal is being made,
16specifically stating each reason that the denial of eligibility
17is alleged to be improper. Additional information may be
18provided and shall be considered as part of the review process.
19This information shall be provided with the appeal letter.
20    (b) A Secretary's level review shall be performed within 30
21days after the receipt of the parent or guardian's appeal.
22    (c) A Secretary's level review shall be made by one
23reviewer selected by the Secretary. The reviewer shall be a
24licensed physician who is board eligible in child psychiatry
25from the American Board of Psychiatry and Neurology and shall

 

 

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1have had no professional or personal relationship with the
2child and family to be reviewed. The reviewer shall not be the
3original reviewer of the ICG.
4    (d) Following a Secretary's level review of the original
5application package, of the original determination, and of the
6parent or guardian's appeal, the reviewer shall make a
7recommendation to the Secretary as to whether the child is
8eligible for an ICG or is not eligible for an ICG.
9    (e) The Secretary shall make the final administrative
10decision as to whether the child is eligible for an ICG or is
11not eligible for an ICG. The final administrative decision
12shall be sent in writing to the parent or guardian within 40
13days after the receipt of the parent or guardian's written
14appeal. The Secretary shall further indicate the basis for the
15final administrative decision.
16    (f) The Secretary's decision shall constitute the
17Department's final administrative decision and no application
18for a re-hearing shall be accepted. The decision is then
19reviewable in accordance with the Administrative Review Law.
 
20    (20 ILCS 1705/75.06 new)
21    Sec. 75.06. Individual Services Plan Development.
22    (a) When the individual has been determined eligible for an
23ICG, the ICG Program Office shall refer the parent or guardian
24to the appropriate SASS agency for the purpose of developing an
25individual services plan.

 

 

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1    (b) The parent or guardian shall determine whether to use
2the ICG for community services, if available, or residential
3placement. The ICG Coordinator/SASS Coordinator shall provide
4support, information, and recommendations regarding available
5services.
6    (c) The development or implementation of an individual
7services plan may be deferred for one or more of the following
8conditions:
9        (1) continuing hospitalization is required;
10        (2) extended absence from the family due to the child
11    running away or a court-ordered transfer of custody or
12    guardianship to a governmental agency; or
13        (3) the parent or guardian does not wish to initiate
14    any services with ICG funding or fails to participate in
15    the individual services planning.
16    (d) If the individual services plan is not developed or
17implemented within one year after the date of approval for
18eligibility, the parent or guardian must reapply to obtain ICG
19funding.
20    (e) On an ongoing basis, but at least annually, the ISP
21shall be updated. In keeping with family-driven, youth-guided
22principles established for systems of care by the American
23Academy of Child and Adolescent Psychiatry, the parent or
24guardian shall form an individual services planning team to
25make recommendations. The parent or guardian shall determine
26whether to use the ICG for community services, if available, or

 

 

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1for residential placement. At the individual services planning
2meeting, the parent or guardian shall receive information and
3recommendations for appropriate services. This may include
4data from assessment tools. The planning team must recommend
5services that currently exist, or that can be obtained or
6created.
7    (f) The ISP team may be reconvened at any time upon request
8of the parent or guardian or other members.
9    (g) A recommendation to move a child to a lower level of
10care must include a minimum of 90 days of preparation for this
11transition. Whenever possible, changes should occur at natural
12school transitions such as the beginning of the school year, or
13the beginning or end of a semester, in order to cause as little
14disruption as possible for the child.
 
15    (20 ILCS 1705/75.07 new)
16    Sec. 75.07. Alternative In-home or Community Services.
17    (a) DMH or its representative shall review individual
18services plans as well as discharge plans and may approve
19funding for alternative in-home or community services as
20described in this Section. The plan shall be reviewed and
21revised every 6 months by the parent or guardian and
22appropriate service providers and must:
23        (1) identify specific problems to be addressed;
24        (2) integrate all of the services to be provided;
25        (3) define specific goals and objectives and the

 

 

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1    projected duration and costs of services;
2        (4) reflect the parent or guardian's approval of the
3    identified service providers; and
4        (5) identify the licensed physician, clinical
5    psychologist, clinical social worker, or clinical
6    professional counselor under whose clinical direction the
7    services will be provided and obtain, by signature, his or
8    her approval of the plan.
9    (b) In-home or community services include, but are not
10limited to, case management, community support, crisis
11intervention, mentoring, respite and young adult support
12services. The complete list of ICG community services shall be
13included in the current version of the ICG Parent Handbook and
14the ICG Provider Handbook.
15    (c) ICG funding shall not be used to replace grant-in-aid
16funded services or other services for which the child and
17family may be eligible through federal, State, or local
18funding.
19    (d) Limits of hours and costs shall be authorized on a case
20by case basis by the Department.
 
21    (20 ILCS 1705/75.08 new)
22    Sec. 75.08. Residential Placement.
23    (a) At the individual services planning meeting, SASS staff
24will discuss with the parent or guardian the potentially
25appropriate facilities based on such factors as the child's

 

 

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1age, sex, and mental health condition, as well as locations and
2programs of facilities, and the requirements for placement and
3parental involvement, and shall, at the parent's or guardian's
4direction and with appropriately executed consents, prepare
5clinical referral packets to be sent to the facilities.
6    (b) The list of facilities appropriate for placement
7through the ICG program is comprised of facilities which:
8        (1) meet the standards for licensed private facilities
9    as defined in administrative rules;
10        (2) have an educational program approved by the
11    Illinois State Board of Education;
12        (3) have a per diem rate that includes residential
13    services, such as room and board, but does not include
14    tuition as established for purchased care services under
15    the rules of the Illinois Purchased Care Review Board in 89
16    Ill. Adm. Code 900, the Department of Children and Family
17    Services in 89 Ill. Adm. Code 356, or the Department in
18    Section 54 of the Mental Health and Developmental
19    Disabilities Administrative Act; and
20        (4) have entered into a contract with the Department
21    for these services during the current fiscal period.
22    (c) If appropriate placement for a child cannot be obtained
23from a contracted provider, the Department may contract with
24other private facilities meeting the standards provided in
25subsections (b)(1) and (2) of this Section.
26    (d) The Department may negotiate for additional services

 

 

HB4096- 17 -LRB099 07770 RLC 27903 b

1from facilities to augment existing services or to develop a
2specialized resource for a child.
3    (e) An individual service plan shall be developed within 30
4days after placement, including expected duration and
5outcomes, by facility staff in consultation with the parent or
6guardian and the child. This individual service plan shall be
7reviewed and updated quarterly, including documentation of
8parental participation and consideration of discharge to
9in-home or community services. These updated plans and progress
10reports shall be provided quarterly to the Department or its
11designee. Together with the goals as stated in the case record
12summary, these documents shall be the basis for the
13Department's review and approval for continuing funding for
14placement, including alternative in-home or community service
15which are part of the discharge plan.
16    (f) Parent or guardian responsibilities during placement
17include the following:
18        (1) participation in and cooperation with the
19    facility's requirements for the child's care, treatment,
20    and discharge to the family and community;
21        (2) completion and submission of any forms and
22    documents as may be required by the Department;
23        (3) the usual and customary costs of parenthood or
24    guardianship, including:
25            (A) clothing;
26            (B) medical and dental costs;

 

 

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1            (C) personal allowance and incidentals; and
2            (D) transportation costs, to and from the
3        facility; and
4        (4) notifying the local education agency that the child
5    has been placed in a residential facility and requesting
6    their participation in educational planning. The local
7    education agency is responsible for the tuition costs of
8    residential placement under State law.
9    (g) Prior to residential placement, if the youth has not
10yet been identified as eligible for special education services,
11the parent or guardian should initiate a case study evaluation
12through their local school district.
 
13    (20 ILCS 1705/75.09 new)
14    Sec. 75.09. Discharge from residential services.
15    (a) When discharge from residential services is
16anticipated, a discharge plan must be developed by the child's
17ISP team. This Individual Service Plan must follow the
18discharge protocol established by DMH in order to ensure that
19community services are in place before discharge. The parent or
20guardian with support from an ICG Coordinator shall identify
21and procure appropriate community services.
22    (b) If the child is leaving the ICG program upon discharge,
23appropriate child and adolescent or adult services must be
24engaged.
 

 

 

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1    (20 ILCS 1705/75.10 new)
2    Sec. 75.10. Service appeals.
3    (a) Service decisions may be appealed. Service decisions
4include the level of care, for example (residential versus
5community and other levels established in this Section) and
6denial of individual services within the levels. The following
7persons may appeal:
8        (1) the parent of a youth with an ICG;
9        (2) the legal guardian of a youth with an ICG; or
10        (3) an 18 to 21 year old with an ICG who are their own
11    legal guardian.
12    (b) The reviewer of the appeal must be a licensed physician
13who is board certified or board eligible in child and
14adolescent psychiatry from the American Board of Psychiatry and
15Neurology and has been instructed by Section 7.1 of the Mental
16Health and Developmental Disabilities Administrative Act and
17shall have had no professional or personal relationship, or
18financial interest with the child and family to be reviewed.
19The reviewer must conduct an in-person assessment of the child,
20using a validated assessment tool. The reviewer must state the
21clinical basis for his or her decision. If the reviewer
22disagrees with the service recommendations of the treating
23clinician, school district, or parent or guardian, the reviewer
24must state:
25        (1) why he or she disagrees;
26        (2) specify an alternative plan based on available

 

 

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1    services;
2        (3) and state why the alternative plan is clinically
3    preferable and appropriate for the child.
4    The alternative plan shall be reviewed after the Level of
5Care ("LOC") group makes recommendations.
6    (c) The following is the process for the Appeal Review:
7        (1) the documentation for the level of care appeal
8    shall be mailed by the Child and Adolescent Office via
9    United States Postal Service mail with tracking and
10    delivery confirmation to the psychiatrist selected by the
11    Secretary of Human Services to review change in level of
12    care appeals;
13        (2) the appeal must be reviewed and a decision returned
14    within 5 business weeks; and
15        (3) The reviewer must use the quarterly reports, the
16    identified tool, and a statement of need from the ISP team
17    in making the review and additional documents may be
18    reviewed to determine whether to uphold or deny the appeal;
19    and
20    (d) The following shall be the service status during
21appeal:
22        (1) When a reduction in service level is being appealed
23    the higher level service shall remain in place during the
24    appeal.
25        (2) When an increase in service level is being
26    appealed, the higher level may be put in place if the

 

 

HB4096- 21 -LRB099 07770 RLC 27903 b

1    attending psychiatrist certifies that child or family
2    safety is at risk at the existing level of service.
 
3    (20 ILCS 1705/75.11 new)
4    Sec. 75.11. Termination of funding or services.
5    (a) ICG funding shall be terminated in any of the following
6circumstances:
7        (1) failure of the parent or guardian to meet annual
8    reporting and eligibility requirements;
9        (2) the child is no longer enrolled in an approved
10    educational program at the elementary or high school level,
11    or attainment of age 21, whichever occurs first;
12        (3) completion of residential treatment or alternative
13    in-home or community services;
14        (4) the parent or guardian is no longer an Illinois
15    resident; however, funding and placement for the child may
16    continue until completion of the school year;
17        (5) guardianship of the child is ordered by the court
18    to a State agency;
19        (6) the child's resources, private or public, are
20    sufficient to pay the costs of care; or
21        (7) any 12-month period without receiving residential
22    or alternative in-home or community services.
23    (b) The parent or guardian's objection to termination may
24be addressed under the Secretary's level appeal process in
25accordance with this Part. ICG funding shall continue during

 

 

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1the appeal process.
 
2    (20 ILCS 1705/75.12 new)
3    Sec. 75.12. Monitoring.
4    (a) Pursuant to the ICG program, the Department retains the
5right for on-site inspection to monitor the care, treatment,
6and progress of children funded through the ICG program.
7    (b) Subsequent to any of these monitoring activities, the
8Department may require termination of placement and the
9development and implementation of a discharge plan, including
10alternative residential or in-home or community services.
11    (c) If the Department terminates placement, the parent or
12guardian may appeal that determination under Section 75.08 of
13this Part. ICG funding shall continue during the appeal
14process.
 
15    (20 ILCS 1705/75.13 new)
16    Sec. 75.13. Grant renewal process.
17    (a) The ICG is a grant that shall be reviewed annually up
18to age 21 of the child and may be renewed with documentation of
19continuing clinical need at the appropriate level of care as
20well as proof of enrollment in an approved education program at
21the elementary or high school level, and documentation of the
22parent or guardian's participation in the child's care,
23treatment, and discharge to family and community. For purposes
24of this Section, clinical need is defined as continued severe

 

 

HB4096- 23 -LRB099 07770 RLC 27903 b

1symptoms, maintenance of reduced symptoms, and development of
2appropriate life skills.
3    (b) The ICG Program Office staff shall commence a review of
4the child's care, his or her current educational status and
5parent or guardian's participation 3 months prior to the
6anniversary date of the child's entry to the ICG program. The
7ICG Program Office shall rely on the current individual
8services plan of the provider serving the child, the provider's
9quarterly reports, proof of enrollment in an approved
10educational program at the elementary or high school level, and
11the parent or guardian's report.
12    (c) The parent or guardian shall be notified by the ICG
13Program Office of the review and shall be invited to provide
14information as to the child's needs, level of care, and parent
15or guardian participation.
16    (d) The parent or guardian, child (if appropriate), and
17provider shall be notified 6 weeks prior to the anniversary
18date of the Department's decision to renew or terminate
19funding.
20    (e) If ICG funding is terminated under the grant renewal
21process, the parent or guardian may appeal that determination
22under Section 75.08 of this Part. ICG funding will continue
23during the appeal process.
 
24    (20 ILCS 1705/75.14 new)
25    Sec. 75.14. Bed holds.

 

 

HB4096- 24 -LRB099 07770 RLC 27903 b

1    (a) The Department may reimburse a community agency for up
2to 120 consecutive or non-consecutive nights per State fiscal
3year for an individual on a programmatically approved absence
4from the residential facility.
5    (b) An agency shall not be reimbursed for an individual's
6absence after the date of discharge or when his or her
7treatment plan includes removal from the agency program or
8after the date of the agency's knowledge of the individual's
9pending termination.
10    (c) A bed hold billing request by an agency that falls
11within a 60 day cumulative limit per State fiscal year shall be
12authorized if it is consistent with the Department's policies
13and procedures.
14    (d) Any absence that would exceed 60 cumulative days per
15State fiscal year must be communicated to and approved by the
16Individual Care Grant Program staff.