Rep. Sara Feigenholtz

Filed: 4/20/2015

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 4096

2    AMENDMENT NO. ______. Amend House Bill 4096 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Administrative Procedure Act is
5amended by changing Section 5-45 as follows:
 
6    (5 ILCS 100/5-45)  (from Ch. 127, par. 1005-45)
7    Sec. 5-45. Emergency rulemaking.
8    (a) "Emergency" means the existence of any situation that
9any agency finds reasonably constitutes a threat to the public
10interest, safety, or welfare.
11    (b) If any agency finds that an emergency exists that
12requires adoption of a rule upon fewer days than is required by
13Section 5-40 and states in writing its reasons for that
14finding, the agency may adopt an emergency rule without prior
15notice or hearing upon filing a notice of emergency rulemaking
16with the Secretary of State under Section 5-70. The notice

 

 

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1shall include the text of the emergency rule and shall be
2published in the Illinois Register. Consent orders or other
3court orders adopting settlements negotiated by an agency may
4be adopted under this Section. Subject to applicable
5constitutional or statutory provisions, an emergency rule
6becomes effective immediately upon filing under Section 5-65 or
7at a stated date less than 10 days thereafter. The agency's
8finding and a statement of the specific reasons for the finding
9shall be filed with the rule. The agency shall take reasonable
10and appropriate measures to make emergency rules known to the
11persons who may be affected by them.
12    (c) An emergency rule may be effective for a period of not
13longer than 150 days, but the agency's authority to adopt an
14identical rule under Section 5-40 is not precluded. No
15emergency rule may be adopted more than once in any 24 month
16period, except that this limitation on the number of emergency
17rules that may be adopted in a 24 month period does not apply
18to (i) emergency rules that make additions to and deletions
19from the Drug Manual under Section 5-5.16 of the Illinois
20Public Aid Code or the generic drug formulary under Section
213.14 of the Illinois Food, Drug and Cosmetic Act, (ii)
22emergency rules adopted by the Pollution Control Board before
23July 1, 1997 to implement portions of the Livestock Management
24Facilities Act, (iii) emergency rules adopted by the Illinois
25Department of Public Health under subsections (a) through (i)
26of Section 2 of the Department of Public Health Act when

 

 

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1necessary to protect the public's health, (iv) emergency rules
2adopted pursuant to subsection (n) of this Section, (v)
3emergency rules adopted pursuant to subsection (o) of this
4Section, or (vi) emergency rules adopted pursuant to subsection
5(c-5) of this Section. Two or more emergency rules having
6substantially the same purpose and effect shall be deemed to be
7a single rule for purposes of this Section.
8    (c-5) To facilitate the maintenance of the program of group
9health benefits provided to annuitants, survivors, and retired
10employees under the State Employees Group Insurance Act of
111971, rules to alter the contributions to be paid by the State,
12annuitants, survivors, retired employees, or any combination
13of those entities, for that program of group health benefits,
14shall be adopted as emergency rules. The adoption of those
15rules shall be considered an emergency and necessary for the
16public interest, safety, and welfare.
17    (d) In order to provide for the expeditious and timely
18implementation of the State's fiscal year 1999 budget,
19emergency rules to implement any provision of Public Act 90-587
20or 90-588 or any other budget initiative for fiscal year 1999
21may be adopted in accordance with this Section by the agency
22charged with administering that provision or initiative,
23except that the 24-month limitation on the adoption of
24emergency rules and the provisions of Sections 5-115 and 5-125
25do not apply to rules adopted under this subsection (d). The
26adoption of emergency rules authorized by this subsection (d)

 

 

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1shall be deemed to be necessary for the public interest,
2safety, and welfare.
3    (e) In order to provide for the expeditious and timely
4implementation of the State's fiscal year 2000 budget,
5emergency rules to implement any provision of this amendatory
6Act of the 91st General Assembly or any other budget initiative
7for fiscal year 2000 may be adopted in accordance with this
8Section by the agency charged with administering that provision
9or initiative, except that the 24-month limitation on the
10adoption of emergency rules and the provisions of Sections
115-115 and 5-125 do not apply to rules adopted under this
12subsection (e). The adoption of emergency rules authorized by
13this subsection (e) shall be deemed to be necessary for the
14public interest, safety, and welfare.
15    (f) In order to provide for the expeditious and timely
16implementation of the State's fiscal year 2001 budget,
17emergency rules to implement any provision of this amendatory
18Act of the 91st General Assembly or any other budget initiative
19for fiscal year 2001 may be adopted in accordance with this
20Section by the agency charged with administering that provision
21or initiative, except that the 24-month limitation on the
22adoption of emergency rules and the provisions of Sections
235-115 and 5-125 do not apply to rules adopted under this
24subsection (f). The adoption of emergency rules authorized by
25this subsection (f) shall be deemed to be necessary for the
26public interest, safety, and welfare.

 

 

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1    (g) In order to provide for the expeditious and timely
2implementation of the State's fiscal year 2002 budget,
3emergency rules to implement any provision of this amendatory
4Act of the 92nd General Assembly or any other budget initiative
5for fiscal year 2002 may be adopted in accordance with this
6Section by the agency charged with administering that provision
7or initiative, except that the 24-month limitation on the
8adoption of emergency rules and the provisions of Sections
95-115 and 5-125 do not apply to rules adopted under this
10subsection (g). The adoption of emergency rules authorized by
11this subsection (g) shall be deemed to be necessary for the
12public interest, safety, and welfare.
13    (h) In order to provide for the expeditious and timely
14implementation of the State's fiscal year 2003 budget,
15emergency rules to implement any provision of this amendatory
16Act of the 92nd General Assembly or any other budget initiative
17for fiscal year 2003 may be adopted in accordance with this
18Section by the agency charged with administering that provision
19or initiative, except that the 24-month limitation on the
20adoption of emergency rules and the provisions of Sections
215-115 and 5-125 do not apply to rules adopted under this
22subsection (h). The adoption of emergency rules authorized by
23this subsection (h) shall be deemed to be necessary for the
24public interest, safety, and welfare.
25    (i) In order to provide for the expeditious and timely
26implementation of the State's fiscal year 2004 budget,

 

 

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1emergency rules to implement any provision of this amendatory
2Act of the 93rd General Assembly or any other budget initiative
3for fiscal year 2004 may be adopted in accordance with this
4Section by the agency charged with administering that provision
5or initiative, except that the 24-month limitation on the
6adoption of emergency rules and the provisions of Sections
75-115 and 5-125 do not apply to rules adopted under this
8subsection (i). The adoption of emergency rules authorized by
9this subsection (i) shall be deemed to be necessary for the
10public interest, safety, and welfare.
11    (j) In order to provide for the expeditious and timely
12implementation of the provisions of the State's fiscal year
132005 budget as provided under the Fiscal Year 2005 Budget
14Implementation (Human Services) Act, emergency rules to
15implement any provision of the Fiscal Year 2005 Budget
16Implementation (Human Services) Act may be adopted in
17accordance with this Section by the agency charged with
18administering that provision, except that the 24-month
19limitation on the adoption of emergency rules and the
20provisions of Sections 5-115 and 5-125 do not apply to rules
21adopted under this subsection (j). The Department of Public Aid
22may also adopt rules under this subsection (j) necessary to
23administer the Illinois Public Aid Code and the Children's
24Health Insurance Program Act. The adoption of emergency rules
25authorized by this subsection (j) shall be deemed to be
26necessary for the public interest, safety, and welfare.

 

 

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1    (k) In order to provide for the expeditious and timely
2implementation of the provisions of the State's fiscal year
32006 budget, emergency rules to implement any provision of this
4amendatory Act of the 94th General Assembly or any other budget
5initiative for fiscal year 2006 may be adopted in accordance
6with this Section by the agency charged with administering that
7provision or initiative, except that the 24-month limitation on
8the adoption of emergency rules and the provisions of Sections
95-115 and 5-125 do not apply to rules adopted under this
10subsection (k). The Department of Healthcare and Family
11Services may also adopt rules under this subsection (k)
12necessary to administer the Illinois Public Aid Code, the
13Senior Citizens and Disabled Persons Property Tax Relief Act,
14the Senior Citizens and Disabled Persons Prescription Drug
15Discount Program Act (now the Illinois Prescription Drug
16Discount Program Act), and the Children's Health Insurance
17Program Act. The adoption of emergency rules authorized by this
18subsection (k) shall be deemed to be necessary for the public
19interest, safety, and welfare.
20    (l) In order to provide for the expeditious and timely
21implementation of the provisions of the State's fiscal year
222007 budget, the Department of Healthcare and Family Services
23may adopt emergency rules during fiscal year 2007, including
24rules effective July 1, 2007, in accordance with this
25subsection to the extent necessary to administer the
26Department's responsibilities with respect to amendments to

 

 

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1the State plans and Illinois waivers approved by the federal
2Centers for Medicare and Medicaid Services necessitated by the
3requirements of Title XIX and Title XXI of the federal Social
4Security Act. The adoption of emergency rules authorized by
5this subsection (l) shall be deemed to be necessary for the
6public interest, safety, and welfare.
7    (m) In order to provide for the expeditious and timely
8implementation of the provisions of the State's fiscal year
92008 budget, the Department of Healthcare and Family Services
10may adopt emergency rules during fiscal year 2008, including
11rules effective July 1, 2008, in accordance with this
12subsection to the extent necessary to administer the
13Department's responsibilities with respect to amendments to
14the State plans and Illinois waivers approved by the federal
15Centers for Medicare and Medicaid Services necessitated by the
16requirements of Title XIX and Title XXI of the federal Social
17Security Act. The adoption of emergency rules authorized by
18this subsection (m) shall be deemed to be necessary for the
19public interest, safety, and welfare.
20    (n) In order to provide for the expeditious and timely
21implementation of the provisions of the State's fiscal year
222010 budget, emergency rules to implement any provision of this
23amendatory Act of the 96th General Assembly or any other budget
24initiative authorized by the 96th General Assembly for fiscal
25year 2010 may be adopted in accordance with this Section by the
26agency charged with administering that provision or

 

 

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1initiative. The adoption of emergency rules authorized by this
2subsection (n) shall be deemed to be necessary for the public
3interest, safety, and welfare. The rulemaking authority
4granted in this subsection (n) shall apply only to rules
5promulgated during Fiscal Year 2010.
6    (o) In order to provide for the expeditious and timely
7implementation of the provisions of the State's fiscal year
82011 budget, emergency rules to implement any provision of this
9amendatory Act of the 96th General Assembly or any other budget
10initiative authorized by the 96th General Assembly for fiscal
11year 2011 may be adopted in accordance with this Section by the
12agency charged with administering that provision or
13initiative. The adoption of emergency rules authorized by this
14subsection (o) is deemed to be necessary for the public
15interest, safety, and welfare. The rulemaking authority
16granted in this subsection (o) applies only to rules
17promulgated on or after the effective date of this amendatory
18Act of the 96th General Assembly through June 30, 2011.
19    (p) In order to provide for the expeditious and timely
20implementation of the provisions of Public Act 97-689,
21emergency rules to implement any provision of Public Act 97-689
22may be adopted in accordance with this subsection (p) by the
23agency charged with administering that provision or
24initiative. The 150-day limitation of the effective period of
25emergency rules does not apply to rules adopted under this
26subsection (p), and the effective period may continue through

 

 

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1June 30, 2013. The 24-month limitation on the adoption of
2emergency rules does not apply to rules adopted under this
3subsection (p). The adoption of emergency rules authorized by
4this subsection (p) is deemed to be necessary for the public
5interest, safety, and welfare.
6    (q) In order to provide for the expeditious and timely
7implementation of the provisions of Articles 7, 8, 9, 11, and
812 of this amendatory Act of the 98th General Assembly,
9emergency rules to implement any provision of Articles 7, 8, 9,
1011, and 12 of this amendatory Act of the 98th General Assembly
11may be adopted in accordance with this subsection (q) by the
12agency charged with administering that provision or
13initiative. The 24-month limitation on the adoption of
14emergency rules does not apply to rules adopted under this
15subsection (q). The adoption of emergency rules authorized by
16this subsection (q) is deemed to be necessary for the public
17interest, safety, and welfare.
18    (r) In order to provide for the expeditious and timely
19implementation of the provisions of this amendatory Act of the
2098th General Assembly, emergency rules to implement this
21amendatory Act of the 98th General Assembly may be adopted in
22accordance with this subsection (r) by the Department of
23Healthcare and Family Services. The 24-month limitation on the
24adoption of emergency rules does not apply to rules adopted
25under this subsection (r). The adoption of emergency rules
26authorized by this subsection (r) is deemed to be necessary for

 

 

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1the public interest, safety, and welfare.
2    (s) In order to provide for the expeditious and timely
3implementation of the provisions of Sections 5-5b.1 and 5A-2 of
4the Illinois Public Aid Code, emergency rules to implement any
5provision of Section 5-5b.1 or Section 5A-2 of the Illinois
6Public Aid Code may be adopted in accordance with this
7subsection (s) by the Department of Healthcare and Family
8Services. The rulemaking authority granted in this subsection
9(s) shall apply only to those rules adopted prior to July 1,
102015. Notwithstanding any other provision of this Section, any
11emergency rule adopted under this subsection (s) shall only
12apply to payments made for State fiscal year 2015. The adoption
13of emergency rules authorized by this subsection (s) is deemed
14to be necessary for the public interest, safety, and welfare.
15    (t) In order to provide for the expeditious and timely
16implementation of the provisions of this amendatory Act of the
1799th General Assembly, emergency rules to implement this
18amendatory Act of the 99th General Assembly may be adopted in
19accordance with this subsection (t) by the Department of
20Healthcare and Family Services. The 24-month limitation on the
21adoption of emergency rules does not apply to rules adopted
22under this subsection (t). The adoption of emergency rules
23authorized by this subsection (t) is deemed to be necessary for
24the public interest, safety, and welfare.
25(Source: P.A. 98-104, eff. 7-22-13; 98-463, eff. 8-16-13;
2698-651, eff. 6-16-14; 99-2, eff. 3-26-15.)
 

 

 

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1    Section 10. The Mental Health and Developmental
2Disabilities Administrative Act is amended by changing Section
37.1 and by adding Sections 75, 75.01, 75.02, 75.03, 75.04,
475.05, 75.06, 75.07, 75.08, 75.09, 75.10, 75.11, 75.12, 75.13,
575.14, 75.15, 75.16, and 75.17 as follows:
 
6    (20 ILCS 1705/7.1)  (from Ch. 91 1/2, par. 100-7.1)
7    Sec. 7.1. To assist families to place children with mental
8illness, for whom no appropriate care is available in
9Department facilities, in licensed private facilities, the
10Department shall supplement the amount a family is able to pay,
11as determined by the Department and the amount available from
12other sources, provided the Department's share shall not exceed
13a uniform maximum rate to be determined from time to time by
14the Department. The Department of Healthcare and Family
15Services may exercise such authority under this Section as is
16necessary to implement the provisions of Section 5.23 of the
17Illinois Public Aid Code and to administer Individual Care
18Grants.
19(Source: P.A. 88-380.)
 
20    (20 ILCS 1705/75 new)
21    Sec. 75. Purpose; transfer of certain rights, powers,
22duties, and functions; application of Sections 75.01 through
2375.17.

 

 

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1    (a) It is the purpose of this Part to transfer to the
2Department of Healthcare and Family Services certain rights,
3powers, and duties currently exercised by the Department of
4Human Services related to Individual Care Grants for children
5with complex behavioral health needs. This transfer is intended
6to make possible the more effective and efficient operation of
7Individual Care Grant services.
8    (b) Certain rights, powers, and duties currently exercised
9by the Department of Human Services related to Individual Care
10Grants for children with complex behavioral health needs are
11transferred to the Department of Healthcare and Family Services
12with the transfer and transition of the Individual Care Grant
13program to the Department of Healthcare and Family Services to
14be completed and implemented within 6 months after the
15effective date of this amendatory Act of the 99th General
16Assembly, as provided in Section 7.1 of this Act and Section 15
17of this amendatory Act of the 99th General Assembly. For the
18purposes of the Successor Agency Act, the Department of
19Healthcare and Family Services is declared to be the successor
20agency of the Department of Human Services, but only with
21respect to the functions of the Department of Human Services
22that are transferred to the Department of Healthcare and Family
23Services under this amendatory Act of the 99th General
24Assembly.
25    (c) Sections 75.01 through 75.17 (this Part) shall
26supersede any rules of the Department of Human Services

 

 

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1regarding which children are eligible to receive funds for an
2Individual Care Grant hereinafter referred to as "ICG" due to
3their mental illness, including intensive community services
4or residential placement, when clinically appropriate.
5Comprehensive services are to be funded to assist in reducing
6the child's severity of symptoms and illness to maintain the
7individual in the least restrictive setting that is clinically
8appropriate. With the goal of keeping families unified, funds
9shall be provided to assist parents or guardians in obtaining
10necessary services and support for children with complex
11behavioral health needs, not just children with psychosis.
12    (d) In addition to the other statutory provisions regarding
13Individual Care Grants, this Part is intended to supplement and
14provide procedures for Individual Care Grants. However, if
15there is a conflict between anything contained in the other
16statutory provisions, those other statutory provisions shall
17prevail.
18    (e) This Part establishes the Children's Behavioral Health
19Cabinet. The Office of the Governor shall establish and chair a
20Children's Behavioral Health Cabinet that shall include the
21Directors of Healthcare and Family Services, Children and
22Family Services, and Juvenile Justice or their designees, the
23Secretary of Human Services or his or her designee, the State
24Superintendent of Education or his or her designee, family
25representatives, provider representatives, and other necessary
26stakeholders, as determined by the Office of the Governor, to

 

 

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1inform the design and management of children's behavioral
2health services. The Children's Behavioral Health Cabinet
3shall meet at least quarterly. The Children's Behavioral Health
4Cabinet shall prepare an annual report to the General Assembly
5on or before January 30th of each year related to the
6implementation of any remedies in response to litigation
7against the Department of Healthcare and Family Services
8related to children's behavioral health and the general status
9of children's behavioral health in this State.
 
10    (20 ILCS 1705/75.01 new)
11    Sec. 75.01. Definitions.
12    For the purposes of this Part, unless the context otherwise
13requires:
14    "Children" means individuals under 18 years of age.
15    "Days" means calendar days.
16    "Department" means the Department of Healthcare and Family
17Services.
18    "Director" means the Director of the Department of
19Healthcare and Family Services.
20    "Division of Mental Health" or "DMH" means the Department
21of Human Services, Division of Mental Health.
22    "ICG Coordinator" means staff employed by an Illinois
23screening, assessment and support services program to provide
24support, information and recommendations regarding available
25services, case coordination, and supports to youth applying for

 

 

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1or with an Illinois ICG.
2    "Individual Services Plan" or "ISP" means the plan that
3identifies the child's goals and selects the level of care and
4associated services required to meet the goals.
5    "Licensed private facilities" means residential treatment
6facilities licensed by the Department of Children and Family
7Services under 89 Ill. Adm. Code 404, or, for out-of-state
8facilities, in accordance with Section 15.1 of the Mental
9Health and Developmental Disabilities Administrative Act,
10which have been accredited by the Joint Commission on the
11Accreditation of Healthcare Organizations hereinafter
12preferred to as "JCAHO" as a psychiatric facility serving
13children and adolescents or which have been surveyed and
14approved by the Department as meeting standards equivalent to
15standards for psychiatric facilities serving children and
16adolescents found in the 1997 Standards for Behavioral Health
17Care released by JCAHO.
18    "Parent or guardian" means a parent, biological, or
19adoptive, or an individual appointed as legal guardian by the
20court under the Probate Act of 1975. A parent or guardian does
21not include a governmental agency or social service agency, or
22any employee thereof, appointed by a court as guardian or
23custodian.
24    "Residential facility" means a facility providing 24-hour
25supervised out-of-home therapeutic care, including, but not
26limited to: single or multiple site program sites or apartments

 

 

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1that provide a 24-hour supervised environment.
2    "SASS" or "Screening, Assessment and Support Services"
3means short-term, crisis intervention mental health services
4that are provided to children who are at risk or who actually
5experience hospitalization due to psychiatric reasons.
6    "Staff" means employees or persons under contract with the
7Department.
8    "Young adults" means individuals 18 through 21 years of
9age.
10    "Young adult support services" means time-limited funding
11for young adults to cover costs of services and supports, not
12included under other programs for which the person may be
13eligible, to aid the young adult in his or her transition to
14community living and funding that can be applied to the costs
15of a supported living arrangement or other appropriate
16transitional services that help to integrate the young adult
17into his or her adult roles in the community.
 
18    (20 ILCS 1705/75.02 new)
19    Sec. 75.02. Stakeholder Committee.
20    (a) The Department of Healthcare and Family Services shall
21establish an ICG Stakeholder Committee comprised of parents,
22youth, provider representatives, representation from the
23Department of Children and Family Services, representation
24from the Department of Human Services, representation from the
25Department of Juvenile Justice, representation from the CCBYS

 

 

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1program and other stakeholders as determined by the Department.
2    (b) The ICG Stakeholder Committee shall meet on a quarterly
3basis.
4    (c) All potential program changes shall be presented to the
5ICG Stakeholder Committee for discussion and input prior to
6implementation.
 
7    (20 ILCS 1705/75.03 new)
8    Sec. 75.03. Eligibility criteria for an individual care
9grant. In order to be eligible for ICG funding, the following
10criteria must be met:
11    (1) The parent or guardian must be a resident of this
12State, as defined in Section 2-10 of the Illinois Public Aid
13Code.
14    (2) The child must:
15        (A) have a diagnosis, which the current symptoms do not
16    represent a single acute episode from which rapid and
17    substantial remission is likely, of: schizophrenia
18    spectrum and other psychotic disorders; bipolar and
19    related disorders; depressive disorders; anxiety
20    disorders; obsessive-compulsive and related disorders;
21    trauma-related and stressor-related disorders;
22    dissociative disorders; or somatic symptom disorders;
23        (B) must not be older than 17 1/2 years of age at the
24    time of prior authorization;
25        (C) must meet medical necessity standards as

 

 

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1    established in Section 75.04 by the Department; and
2    (3) The child must not be under the guardianship of another
3State agency that has financial and legal responsibility for
4the youth.
 
5    (20 ILCS 1705/75.04 new)
6    Sec. 75.04. Medical necessity.
7    (a) The Department of Healthcare and Family Services shall,
8in collaboration with the Department of Human Services and the
9Department of Children and Family Services, establish the
10appropriate clinical standards for Community ICG Services and
11Residential ICG Services, using the Child and Adolescent Needs
12and Strengths (CANS) Assessment, within 6 months of the
13effective date of this Part. The Department of Healthcare and
14Family Services shall review the clinical threshold with the
15Department of Human Services and the Department of Children and
16Family Services, annually.
17    (b) Through the use of the CANS Assessment, a child's needs
18shall be stratified across tiers of service intensity. ICG
19community services shall have a different clinical threshold
20than ICG residential services.
21    (c) Families shall be notified of the intensity of services
22for which their child qualifies: ICG community or ICG
23residential. A family may always select to substitute lower
24intensity services for higher intensity services.
25    (d) The Department of Healthcare and Family Services shall

 

 

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1continue to use the existing methods of determining clinical
2appropriateness until it transitions to the utilization of the
3CANS Assessment, as detailed in this Section.
4    (e) Children placed in a residential setting shall undergo
5a continued stay review, as established by the Department of
6Healthcare and Family Services. A child placed in ICG community
7services shall undergo a clinical review every 6 months.
 
8    (20 ILCS 1705/75.05 new)
9    Sec. 75.05. Emergency individual care grants.
10    (a) To be eligible for an emergency temporary individual
11care grant:
12        (1) the child and family must meet the eligibility
13    requirements in Section 75.03;
14        (2) a child receiving inpatient psychiatric care (for
15    example at a psychiatric hospital or similar facility) who
16    is ready for discharge and who is not able to return home
17    due to the safety of the child, family, or individual may
18    be awarded a temporary emergency grant for a period of 90
19    days; and
20        (3) the attending child and adolescent psychiatrist
21    must recommend that the child is in need of on-going 24
22    hour supervision, such as residential placement.
23    (b) During the 90-day period complete the ICG prior
24authorization process in accordance with this Part.
25    (c) Section 75.11 applies to decisions under this Section.
 

 

 

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1    (20 ILCS 1705/75.06 new)
2    Sec. 75.06. ICG application reform, prior authorization
3process, re-authorization process.
4     (a) The Department of Healthcare and Family Services shall
5replace the existing ICG application process with a simplified
6service prior authorization process on or before 6 months after
7the effective date of this amendatory Act of the 99th General
8Assembly.
9    (b) The Department's simplified service prior
10authorization process shall include the following:
11        (1) demographic details regarding the child;
12        (2) clinical diagnosis verified by an LPHA within the
13    last 6 months;
14        (3) completed CANS scores;
15        (4) history of inpatient and residential care;
16        (5) history of SASS services;
17        (6) history of behavioral health services;
18        (7) signed authorization detailing need for
19    residential care by a LPHA;
20        (8) family details, including a signed statement of
21    engagement indicating that the family will participate in
22    treatment and that the child will have a place of residency
23    upon discharge from treatment.
24    (c) The Department of Healthcare and Family Services shall
25establish a process for reviewing and authorizing prior

 

 

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1authorization requests within 5 days of submission.
2    (d) The Department of Healthcare and Family Services shall
3re-authorize grants every 6 months, so long as the child is
4under the age of 21.
5    (e) The parent or guardian, child (if appropriate), and
6provider shall be notified in writing, 6 weeks prior to the
7anniversary date of the Department of Healthcare and Family
8Services decision to re-authorize or terminate funding.
 
9    (20 ILCS 1705/75.07 new)
10    Sec. 75.07. Parent or guardian responsibilities;
11resources.
12    (a) The parent or guardian of a child receiving an ICG must
13participate in the child's care, treatment, and is willing to
14accept the child home upon discharge to the community.
15    (b) When a youth is placed in residential care, the
16residential provider shall apply for all public sources of
17financial support available to or for the child, including but
18not limited to Social Security Administration ("SSA") benefits
19and supplemental security income ("SSI") authorized under 42
20U.S.C. 1381, and these funds must be applied to the costs of
21residential care, to the extent provided by law.
22    (c) Upon placement in residential care, if the child is not
23already receiving benefits from SSA, the parent or guardian
24shall authorize the residential placement staff to initiate an
25application for SSI immediately after placement or on the 90th

 

 

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1day, depending on family income levels. If the child is
2receiving benefits from SSA upon admission into residential
3care, the parent or guardian shall authorize the residential
4placement staff to initiate an application on behalf of the
5residential agency to become payee for SSA benefits.
6    (d) The parent or guardian must notify the Department of
7Healthcare and Family Services of any changes in the level of
8financial support from public sources. Declaration of
9ineligibility, reduction of benefits, or loss of benefits
10through the actions of another governmental agency shall not
11affect the Department's continued funding, unless these
12actions are the consequence of the parent or guardian's failure
13to pursue benefits or comply with this Section.
14    (e) All financial assets of the child exceeding an exempt
15amount established by the Department of Healthcare and Family
16Services must be applied to the costs of residential care. The
17determination that certain assets may be exempt is subject to
18the Department's review and approval.
19    (f) If the child is covered by private medical insurance,
20it is primary coverage for community or residential services.
21The ICG shall be considered secondary coverage.
22    (g) The parent or guardian must notify the Department of
23Healthcare and Family Services of any changes of address for
24the parent or guardian.
25    (h) The parent or guardian must notify the Department of
26Healthcare and Family Services of any changes of guardianship

 

 

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1or custody.
 
2    (20 ILCS 1705/75.08 new)
3    Sec. 75.08. ICG service appeals, denials, and complaints.
4The Department of Healthcare and Family Services shall adopt
5rules for addressing service appeals, grant denials (including
6re-authorization determinations) and complaints related to the
7ICG program. The appeals and denial process shall include a
8Director's Level Review process and funding of a child's ICG
9shall continue through all appeals processes.
 
10    (20 ILCS 1705/75.09 new)
11    Sec. 75.09. Individual Services Plan Development.
12    (a) When the individual has been determined eligible for
13community or residential ICG, the ICG Program Office shall
14refer the parent or guardian to the appropriate SASS agency for
15the purpose of developing an individual services plan.
16    (b) The ICG Coordinator/SASS Coordinator shall provide
17support, information, and recommendations regarding available
18services and help the family determine the right services to
19meet the needs of the child and stabilize the family.
20    (c) The individual service plan shall be developed with the
21parent or guardian and appropriate service providers and must
22be reviewed and re-authorized every 6 months. The individual
23service plan shall include:
24        (1) identifying specific problems to be addressed;

 

 

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1        (2) integrating all of the services to be provided;
2        (3) defining specific goals and objectives and the
3    projected duration and costs of services;
4        (4) the parent or guardian's approval of the identified
5    service providers; and
6        (5) identifying the licensed physician, clinical
7    psychologist, clinical social worker, or clinical
8    professional counselor under whose clinical direction the
9    services will be provided and obtain, by signature, his or
10    approval of the plan.
11    (d) The development or implementation of an individual
12services plan may be deferred for one or more of the following
13conditions:
14        (1) continuing hospitalization is required;
15        (2) extended absence from the family due to the child
16    running away or a court-ordered transfer of custody or
17    guardianship to a governmental agency; or
18        (3) the parent or guardian does not wish to initiate
19    any services with ICG funding or fails to participate in
20    the individual services planning.
21    (e) If the individual services plan is not developed or
22implemented within 6 months of the ICG award, the parent or
23guardian must re-authorize the awarded ICG grant.
24    (f) A recommendation to move a child to a lower level of
25care must include a minimum of 30 days of preparation for this
26transition.
 

 

 

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1    (20 ILCS 1705/75.10 new)
2    Sec. 75.10. Alternative In-home services.
3    (a) The Department of Healthcare and Family Services or its
4representative shall review individual services plans as well
5as discharge plans and may approve funding for alternative
6in-home services as described in this Section.
7    (b) Alternative in-home services include, but are not
8limited to, care coordination, community support, crisis
9stabilization services, mentoring, respite support services,
10and young adult support services.
11    (c) ICG funding shall not be used to replace services
12authorized under 59 Ill. Adm. Code, Part 132 or other services
13for which the child and family may be eligible through federal,
14State, or local funding.
15    (d) Limits of hours and costs shall be authorized on a case
16by case basis by the Department.
 
17    (20 ILCS 1705/75.11 new)
18    Sec. 75.11. Residential placement.
19    (a) SASS staff shall discuss with the parent or guardian
20the potentially appropriate facilities based on factors such as
21the child's age, sex, and mental health condition, as well as
22locations and programs of facilities, and the requirements for
23placement and parental involvement, and shall, at the parent's
24or guardian's direction and with appropriately executed

 

 

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1consents, prepare clinical referral packets to be sent to the
2facilities.
3    (b) The list of facilities appropriate for placement
4through the ICG program is comprised of facilities which:
5        (1) meet the standards for licensed private facilities
6    as defined in administrative rules;
7        (2) have an educational program approved by the
8    Illinois State Board of Education;
9        (3) have a per diem rate that includes residential
10    services, such as room and board, but does not include
11    tuition as established for purchased care services under
12    the rules of the Illinois Purchased Care Review Board in 89
13    Ill. Adm. Code 900, the Department of Children and Family
14    Services in 89 Ill. Adm. Code 356, or the Department in
15    Section 54 of the Mental Health and Developmental
16    Disabilities Administrative Act; and
17        (4) have entered into a contract with the Department
18    for these services during the current fiscal period.
19    (c) If appropriate placement for a child cannot be obtained
20from a contracted provider, the Department may contract with
21other private facilities meeting the standards provided in
22paragraphs (1) and (2) of subsection (b) of this Section.
23    (d) The Department may negotiate for additional services
24from facilities to augment existing services or to develop a
25specialized resource for a child.
26    (e) An individual service plan shall be developed within 30

 

 

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

 

 

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1        (4) notifying the local education agency that the child
2    has been placed in a residential facility and requesting
3    their participation in educational planning. The local
4    education agency is responsible for the tuition costs of
5    residential placement under State law.
6    (g) Prior to residential placement, if the youth has not
7yet been identified as eligible for special education services,
8the parent or guardian should initiate a case study evaluation
9through their local school district.
 
10    (20 ILCS 1705/75.12 new)
11    Sec. 75.12. Discharge from residential services.
12     (a) An Individual Service Plan must follow the discharge
13protocol established by the Division of Mental Health in order
14to ensure that community services are in place before
15discharge. The parent or guardian with support from an ICG
16Coordinator shall identify and procure appropriate community
17services.
18    (b) If the child is leaving the ICG program upon discharge,
19appropriate child and adolescent or adult services must be
20engaged.
 
21    (20 ILCS 1705/75.13 new)
22    Sec. 75.13. Termination of funding or services.
23ICG funding shall be terminated in any of the following
24circumstances:

 

 

09900HB4096ham001- 30 -LRB099 07770 RLC 34365 a

1    (1) failure of the parent or guardian to meet prior
2authorization, re-authorization, or eligibility requirements;
3    (2) the child is no longer enrolled in an approved
4educational program at the elementary or high school level, or
5attainment of age 21, whichever occurs first;
6    (3) completion of residential treatment or alternative
7in-home or community services;
8    (4) the parent or guardian is no longer an Illinois
9resident; however, funding and placement for the child may
10continue until completion of the school year;
11    (5) guardianship of the child is ordered by the court to a
12State agency;
13    (6) the child's resources, private or public, are
14sufficient to pay the costs of care;
15    (7) any 12-month period without receiving residential,
16community, or alternative in-home; or
17    (8) Upon the completion of the annual ICG renewal process,
18it is determined that the child no longer would clinically
19benefit from the services being provided.
 
20    (20 ILCS 1705/75.14 new)
21    Sec. 75.14. Monitoring. The Department shall establish
22policies and procedures related to the monitoring of
23residential, community, and alternative in-home services
24providers.
 

 

 

09900HB4096ham001- 31 -LRB099 07770 RLC 34365 a

1    (20 ILCS 1705/75.15 new)
2    Sec. 75.15. Bed holds.
3    (a) The Department shall adopt rules regarding bed holds
4and may not reimburse a provider for more than 40 bed nights
5per State fiscal year per individual.
6    (b) An agency shall not be reimbursed for an individual's
7absence after the date of discharge or when his or her
8treatment plan includes removal from the agency program or
9after the date of the agency's knowledge of the individual's
10pending termination.
 
11    (20 ILCS 1705/75.16 new)
12    Sec. 75.16. Children's Behavioral Health Reform.
13    (a) The Department of Healthcare and Family Services shall
14seek to maximize federal financial participation for all
15services covered under this Part and to fully integrate the ICG
16program into the Children's Behavioral Health Reform efforts
17established by the Department. To the extent that full
18integration of the ICG program into the Department of
19Healthcare and Family Services behavioral health care
20coordination entity creates a conflict with any Part of this
21Act, the Department shall establish provisional policies that
22shall be in effect for the term of the agreement between the
23Department of Healthcare and Family Services and any such care
24coordination entity.
25    (b) The Department shall establish an updated ICG Program

 

 

09900HB4096ham001- 32 -LRB099 07770 RLC 34365 a

1design. The Department shall work collaboratively with the
2Division of Mental Health and the Department of Children and
3Family Services as it establishes an implementation plan for
4Children's Behavioral Health Reform and adopt new rules
5detailing the operation of an updated ICG Program that
6coordinates service delivery and design before December 31,
72016.
 
8    (20 ILCS 1705/75.17 new)
9    Sec. 75.17. Repeal. Sections 75 through 75.17 are repealed
10on January 1, 2018.
 
11    Section 15. The Illinois Public Aid Code is amended by
12changing Section 5-5.23 as follows:
 
13    (305 ILCS 5/5-5.23)
14    Sec. 5-5.23. Children's mental health services.
15    (a) The Department of Healthcare and Family Services, by
16rule, shall require the screening and assessment of a child
17prior to any Medicaid-funded admission to an inpatient hospital
18for psychiatric services to be funded by Medicaid. The
19screening and assessment shall include a determination of the
20appropriateness and availability of out-patient support
21services for necessary treatment. The Department, by rule,
22shall establish methods and standards of payment for the
23screening, assessment, and necessary alternative support

 

 

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1services.
2    (b) The Department of Healthcare and Family Services, to
3the extent allowable under federal law, shall secure federal
4financial participation for Individual Care Grant expenditures
5made by the Department of Healthcare and Family Services of
6Human Services for the Medicaid optional service authorized
7under Section 1905(h) of the federal Social Security Act,
8pursuant to the provisions of Section 7.1 of the Mental Health
9and Developmental Disabilities Administrative Act. The
10Department of Healthcare and Family Services may exercise such
11authority under this Section as is necessary to administer
12Individual Care Grants as authorized under Section 7.1 of the
13Mental Health and Developmental Disabilities Administrative
14Act.
15    (c) The Department of Healthcare and Family Services shall
16work collaboratively with the Department of Children and Family
17Services and the Division of Mental Health of jointly with the
18Department of Human Services to implement subsections (a) and
19(b).
20    (d) On and after July 1, 2012, the Department shall reduce
21any rate of reimbursement for services or other payments or
22alter any methodologies authorized by this Code to reduce any
23rate of reimbursement for services or other payments in
24accordance with Section 5-5e.
25(Source: P.A. 97-689, eff. 6-14-12.)
 

 

 

09900HB4096ham001- 34 -LRB099 07770 RLC 34365 a

1    Section 99. Effective date. This Act takes effect upon
2becoming law.".