Illinois General Assembly - Full Text of HB5196
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Full Text of HB5196  102nd General Assembly

HB5196eng 102ND GENERAL ASSEMBLY

  
  
  

 


 
HB5196 EngrossedLRB102 24844 RJT 34091 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Identification Card Act is amended
5by changing Section 4A as follows:
 
6    (15 ILCS 335/4A)  (from Ch. 124, par. 24A)
7    Sec. 4A. (a) "Person with a disability" as used in this Act
8means any person who is, and who is expected to indefinitely
9continue to be, subject to any of the following five types of
10disabilities:
11    Type One: Physical disability. A physical disability is a
12physical impairment, disease, or loss, which is of a permanent
13nature, and which substantially limits physical ability or
14motor skills. The Secretary of State shall establish standards
15not inconsistent with this provision necessary to determine
16the presence of a physical disability.
17    Type Two: Developmental disability. Developmental
18disability means "developmental disability" as defined in
19Section 1-106 of the Mental Health and Developmental
20Disabilities Code a disability that is attributable to: (i) an
21intellectual disability, cerebral palsy, epilepsy, or autism
22or (ii) any other condition that results in impairment similar
23to that caused by an intellectual disability and requires

 

 

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1services similar to those required by persons with
2intellectual disabilities. Such a disability must originate
3before the age of 18 years, be expected to continue
4indefinitely, and constitute a substantial disability. The
5Secretary of State shall establish standards not inconsistent
6with this provision necessary to determine the presence of a
7developmental disability.
8    Type Three: Visual disability. A visual disability is
9blindness, and the term "blindness" means central vision
10acuity of 20/200 or less in the better eye with the use of a
11correcting lens. An eye that is accompanied by a limitation in
12the fields of vision so that the widest diameter of the visual
13field subtends an angle no greater than 20 degrees shall be
14considered as having a central vision acuity of 20/200 or
15less. The Secretary of State shall establish standards not
16inconsistent with this Section necessary to determine the
17presence of a visual disability.
18    Type Four: Hearing disability. A hearing disability is a
19disability resulting in complete absence of hearing, or
20hearing that with sound enhancing or magnifying equipment is
21so impaired as to require the use of sensory input other than
22hearing as the principal means of receiving spoken language.
23The Secretary of State shall establish standards not
24inconsistent with this Section necessary to determine the
25presence of a hearing disability.
26    Type Five: Mental Disability. A mental disability is a

 

 

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1significant impairment of an individual's cognitive,
2affective, or relational abilities that may require
3intervention and may be a recognized, medically diagnosable
4illness or disorder. The Secretary of State shall establish
5standards not inconsistent with this provision necessary to
6determine the presence of a mental disability.
7    (b) For purposes of this Act, a disability shall be
8classified as follows: Class 1 disability: A Class 1
9disability is any type disability which does not render a
10person unable to engage in any substantial gainful activity or
11which does not impair his ability to live independently or to
12perform labor or services for which he is qualified. The
13Secretary of State shall establish standards not inconsistent
14with this Section necessary to determine the presence of a
15Class 1 disability. Class 1A disability: A Class 1A disability
16is a Class 1 disability which renders a person unable to walk
17200 feet or more unassisted by another person or without the
18aid of a walker, crutches, braces, prosthetic device or a
19wheelchair or without great difficulty or discomfort due to
20the following impairments: neurologic, orthopedic,
21oncological, respiratory, cardiac, arthritic disorder,
22blindness, or the loss of function or absence of a limb or
23limbs. The Secretary of State shall establish standards not
24inconsistent with this Section necessary to determine the
25presence of a Class 1A disability. Class 2 disability: A Class
262 disability is any type disability which renders a person

 

 

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1unable to engage in any substantial gainful activity, which
2substantially impairs his ability to live independently
3without supervision or in-home support services, or which
4substantially impairs his ability to perform labor or services
5for which he is qualified or significantly restricts the labor
6or services which he is able to perform. The Secretary of State
7shall establish standards not inconsistent with this Section
8necessary to determine the presence of a Class 2 disability.
9Class 2A disability: A Class 2A disability is a Class 2
10disability which renders a person unable to walk 200 feet or
11more unassisted by another person or without the aid of a
12walker, crutches, braces, prosthetic device or a wheelchair or
13without great difficulty or discomfort due to the following
14impairments: neurologic, orthopedic, oncological,
15respiratory, cardiac, arthritic disorder, blindness, or the
16loss of function or absence of a limb or limbs. The Secretary
17of State shall establish standards not inconsistent with this
18Section necessary to determine the presence of a Class 2A
19disability.
20(Source: P.A. 98-726, eff. 1-1-15; 99-143, eff. 7-27-15.)
 
21    Section 10. The Mental Health and Developmental
22Disabilities Administrative Act is amended by changing Section
232 as follows:
 
24    (20 ILCS 1705/2)  (from Ch. 91 1/2, par. 100-2)

 

 

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1    Sec. 2. Definitions; administrative subdivisions.
2    (a) For the purposes of this Act, unless the context
3otherwise requires:
4    "Department" means the Department of Human Services,
5successor to the former Department of Mental Health and
6Developmental Disabilities.
7    "Developmental disability" means "developmental
8disability" as defined in Section 1-106 of the Mental Health
9and Developmental Disabilities Code.
10    "Intellectual disability" means the "intellectual
11disability" as defined in Section 1-116 of the Mental Health
12and Developmental Disabilities Code.
13    "Secretary" means the Secretary of Human Services.
14    (b) Unless the context otherwise requires:
15        (1) References in this Act to the programs or
16    facilities of the Department shall be construed to refer
17    only to those programs or facilities of the Department
18    that pertain to mental health or developmental
19    disabilities.
20        (2) References in this Act to the Department's service
21    providers or service recipients shall be construed to
22    refer only to providers or recipients of services that
23    pertain to the Department's mental health and
24    developmental disabilities functions.
25        (3) References in this Act to employees of the
26    Department shall be construed to refer only to employees

 

 

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1    whose duties pertain to the Department's mental health and
2    developmental disabilities functions.
3    (c) The Secretary shall establish such subdivisions of the
4Department as shall be desirable and shall assign to the
5various subdivisions the responsibilities and duties placed
6upon the Department by the Laws of the State of Illinois.
7    (d) There is established a coordinator of services to deaf
8and hearing impaired persons with mental disabilities. In
9hiring this coordinator, every consideration shall be given to
10qualified deaf or hearing impaired individuals.
11    (e) Whenever the administrative director of the
12subdivision for mental health services is not a
13board-certified psychiatrist, the Secretary shall appoint a
14Chief for Clinical Services who shall be a board-certified
15psychiatrist with both clinical and administrative experience.
16The Chief for Clinical Services shall be responsible for all
17clinical and medical decisions for mental health services.
18(Source: P.A. 99-143, eff. 7-27-15.)
 
19    Section 15. The Disabilities Services Act of 2003 is
20amended by changing Section 10 as follows:
 
21    (20 ILCS 2407/10)
22    Sec. 10. Application of Act; definitions.
23    (a) This Act applies to persons with disabilities. The
24disabilities included are defined for purposes of this Act as

 

 

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1follows:
2    "Disability" means a disability as defined by the
3Americans with Disabilities Act of 1990 that is attributable
4to a developmental disability, a mental illness, or a physical
5disability, or combination of those.
6    "Developmental disability" means "developmental
7disability" as defined in Section 1-106 of the Mental Health
8and Developmental Disabilities Code. a disability that is
9attributable to an intellectual disability or a related
10condition. A related condition must meet all of the following
11conditions:
12        (1) It must be attributable to cerebral palsy,
13    epilepsy, or any other condition (other than mental
14    illness) found to be closely related to an intellectual
15    disability because that condition results in impairment of
16    general intellectual functioning or adaptive behavior
17    similar to that of individuals with an intellectual
18    disability, and requires treatment or services similar to
19    those required for those individuals. For purposes of this
20    Section, autism is considered a related condition.
21        (2) It must be manifested before the individual
22    reaches age 22.
23        (3) It must be likely to continue indefinitely.
24        (4) It must result in substantial functional
25    limitations in 3 or more of the following areas of major
26    life activity: self-care, language, learning, mobility,

 

 

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1    self-direction, and capacity for independent living.
2    "Mental Illness" means a mental or emotional disorder
3verified by a diagnosis contained in the Diagnostic and
4Statistical Manual of Mental Disorders-Fourth Edition,
5published by the American Psychiatric Association (DSM-IV), or
6its successor, or International Classification of Diseases,
79th Revision, Clinical Modification (ICD-9-CM), or its
8successor, that substantially impairs a person's cognitive,
9emotional, or behavioral functioning, or any combination of
10those, excluding (i) conditions that may be the focus of
11clinical attention but are not of sufficient duration or
12severity to be categorized as a mental illness, such as
13parent-child relational problems, partner-relational
14problems, sexual abuse of a child, bereavement, academic
15problems, phase-of-life problems, and occupational problems
16(collectively, "V codes"), (ii) organic disorders such as
17substance intoxication dementia, substance withdrawal
18dementia, Alzheimer's disease, vascular dementia, dementia due
19to HIV infection, and dementia due to Creutzfeldt-Jakob
20disease and disorders associated with known or unknown
21physical conditions such as hallucinosis, amnestic disorders
22and delirium, and psychoactive substance-induced organic
23disorders, and (iii) an intellectual disability or
24psychoactive substance use disorders.
25    "Intellectual disability" means "intellectual disability"
26as defined in Section 1-116 of the Mental Health and

 

 

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1Developmental Disabilities Code significantly sub-average
2general intellectual functioning existing concurrently with
3deficits in adaptive behavior and manifested before the age of
422 years.
5    "Physical disability" means a disability as defined by the
6Americans with Disabilities Act of 1990 that meets the
7following criteria:
8        (1) It is attributable to a physical impairment.
9        (2) It results in a substantial functional limitation
10    in any of the following areas of major life activity: (i)
11    self-care, (ii) receptive and expressive language, (iii)
12    learning, (iv) mobility, (v) self-direction, (vi) capacity
13    for independent living, and (vii) economic sufficiency.
14        (3) It reflects the person's need for a combination
15    and sequence of special, interdisciplinary, or general
16    care, treatment, or other services that are of lifelong or
17    of extended duration and must be individually planned and
18    coordinated.
19    (b) In this Act:
20    "Chronological age-appropriate services" means services,
21activities, and strategies for persons with disabilities that
22are representative of the lifestyle activities of nondisabled
23peers of similar age in the community.
24    "Comprehensive evaluation" means procedures used by
25qualified professionals selectively with an individual to
26determine whether a person has a disability and the nature and

 

 

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1extent of the services that the person with a disability
2needs.
3    "Department" means the Department on Aging, the Department
4of Human Services, the Department of Public Health, the
5Department of Public Aid (now Department Healthcare and Family
6Services), the University of Illinois Division of Specialized
7Care for Children, the Department of Children and Family
8Services, and the Illinois State Board of Education, where
9appropriate, as designated in the implementation plan
10developed under Section 20.
11    "Family" means a natural, adoptive, or foster parent or
12parents or other person or persons responsible for the care of
13an individual with a disability in a family setting.
14    "Family or individual support" means those resources and
15services that are necessary to maintain an individual with a
16disability within the family home or his or her own home. These
17services may include, but are not limited to, cash subsidy,
18respite care, and counseling services.
19    "Independent service coordination" means a social service
20that enables persons with developmental disabilities and their
21families to locate, use, and coordinate resources and
22opportunities in their communities on the basis of individual
23need. Independent service coordination is independent of
24providers of services and funding sources and is designed to
25ensure accessibility, continuity of care, and accountability
26and to maximize the potential of persons with developmental

 

 

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1disabilities for independence, productivity, and integration
2into the community. Independent service coordination includes,
3at a minimum: (i) outreach to identify eligible individuals;
4(ii) assessment and periodic reassessment to determine each
5individual's strengths, functional limitations, and need for
6specific services; (iii) participation in the development of a
7comprehensive individual service or treatment plan; (iv)
8referral to and linkage with needed services and supports; (v)
9monitoring to ensure the delivery of appropriate services and
10to determine individual progress in meeting goals and
11objectives; and (vi) advocacy to assist the person in
12obtaining all services for which he or she is eligible or
13entitled.
14    "Individual service or treatment plan" means a recorded
15assessment of the needs of a person with a disability, a
16description of the services recommended, the goals of each
17type of element of service, an anticipated timetable for the
18accomplishment of the goals, and a designation of the
19qualified professionals responsible for the implementation of
20the plan.
21    "Least restrictive environment" means an environment that
22represents the least departure from the normal patterns of
23living and that effectively meets the needs of the person
24receiving the service.
25(Source: P.A. 97-227, eff. 1-1-12; 98-756, eff. 7-16-14.)
 

 

 

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1    Section 25. The School Code is amended by changing Section
22-3.83 as follows:
 
3    (105 ILCS 5/2-3.83)  (from Ch. 122, par. 2-3.83)
4    Sec. 2-3.83. Individual transition plan model pilot
5program.
6    (a) The General Assembly finds that transition services
7for special education students in secondary schools are needed
8for the increasing numbers of students exiting school
9programs. Therefore, to ensure coordinated and timely delivery
10of services, the State shall establish a model pilot program
11to provide such services. Local school districts, using joint
12agreements and regional service delivery systems for special
13and vocational education selected by the Governor's Planning
14Council on Developmental Disabilities, shall have the primary
15responsibility to convene transition planning meetings for
16these students who will require post-school adult services.
17    (b) For purposes of this Section:
18        (1) "Post-secondary Service Provider" means a provider
19    of services for adults who have any developmental
20    disability as defined in Section 1-106 of the Mental
21    Health and Developmental Disabilities Code or who are
22    persons with one or more disabilities as defined in the
23    Rehabilitation of Persons with Disabilities Act.
24        (2) "Individual Education Plan" means a written
25    statement for an exceptional child that provides at least

 

 

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1    a statement of: the child's present levels of educational
2    performance, annual goals and short-term instructional
3    objectives; specific special education and related
4    services; the extent of participation in the regular
5    education program; the projected dates for initiation of
6    services; anticipated duration of services; appropriate
7    objective criteria and evaluation procedures; and a
8    schedule for annual determination of short-term
9    objectives.
10        (3) "Individual Transition Plan" (ITP) means a
11    multi-agency informal assessment of a student's needs for
12    post-secondary adult services including but not limited to
13    employment, post-secondary education or training and
14    residential independent living.
15        (4) "Developmental Disability" means "developmental
16    disability" as defined in Section 1-106 of the Mental
17    Health and Developmental Disabilities Code a disability
18    which is attributable to: (a) an intellectual disability,
19    cerebral palsy, epilepsy or autism; or to (b) any other
20    condition which results in impairment similar to that
21    caused by an intellectual disability and which requires
22    services similar to those required by persons with an
23    intellectual disability. Such disability must originate
24    before the age of 18 years, be expected to continue
25    indefinitely, and constitute a substantial disability.
26        (5) "Exceptional Characteristic" means any disabling

 

 

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1    or exceptional characteristic which interferes with a
2    student's education including, but not limited to, a
3    determination that the student has a severe or profound
4    mental disability, has mental disability but is trainable,
5    is deaf-blind, or has some other health impairment.
6    (c) The model pilot program required by this Section shall
7be established and administered by the Governor's Planning
8Council on Developmental Disabilities in conjunction with the
9case coordination pilot projects established by the Department
10of Human Services pursuant to Section 4.1 of the Community
11Services Act, as amended.
12    (d) The model pilot program shall include the following
13features:
14        (1) Written notice shall be sent to the student and,
15    when appropriate, his or her parent or guardian giving the
16    opportunity to consent to having the student's name and
17    relevant information shared with the local case
18    coordination unit and other appropriate State or local
19    agencies for purposes of inviting participants to the
20    individual transition plan meeting.
21        (2) Meetings to develop and modify, as needed, an
22    Individual Transition Plan shall be conducted annually for
23    all students with a developmental disability in the pilot
24    program area who are age 16 or older and who are receiving
25    special education services for 50% or more of their public
26    school program. These meetings shall be convened by the

 

 

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1    local school district and conducted in conjunction with
2    any other regularly scheduled meetings such as the
3    student's annual individual educational plan meeting. The
4    Governor's Planning Council on Developmental Disabilities
5    shall cooperate with and may enter into any necessary
6    written agreements with the Department of Human Services
7    and the State Board of Education to identify the target
8    group of students for transition planning and the
9    appropriate case coordination unit to serve these
10    individuals.
11        (3) The ITP meetings shall be co-chaired by the
12    individual education plan coordinator and the case
13    coordinator. The ITP meeting shall include but not be
14    limited to discussion of the following: the student's
15    projected date of exit from the public schools; his
16    projected post-school goals in the areas of employment,
17    residential living arrangement and post-secondary
18    education or training; specific school or post-school
19    services needed during the following year to achieve the
20    student's goals, including but not limited to vocational
21    evaluation, vocational education, work experience or
22    vocational training, placement assistance, independent
23    living skills training, recreational or leisure training,
24    income support, medical needs and transportation; and
25    referrals and linkage to needed services, including a
26    proposed time frame for services and the responsible

 

 

HB5196 Engrossed- 16 -LRB102 24844 RJT 34091 b

1    agency or provider. The individual transition plan shall
2    be signed by participants in the ITP discussion, including
3    but not limited to the student's parents or guardian, the
4    student (where appropriate), multi-disciplinary team
5    representatives from the public schools, the case
6    coordinator and any other individuals who have
7    participated in the ITP meeting at the discretion of the
8    individual education plan coordinator, the developmental
9    disability case coordinator or the parents or guardian.
10        (4) At least 10 days prior to the ITP meeting, the
11    parents or guardian of the student shall be notified in
12    writing of the time and place of the meeting by the local
13    school district. The ITP discussion shall be documented by
14    the assigned case coordinator, and an individual student
15    file shall be maintained by each case coordination unit.
16    One year following a student's exit from public school the
17    case coordinator shall conduct a follow up interview with
18    the student.
19        (5) Determinations with respect to individual
20    transition plans made under this Section shall not be
21    subject to any due process requirements prescribed in
22    Section 14-8.02 of this Code.
23    (e) (Blank).
24(Source: P.A. 99-143, eff. 7-27-15.)
 
25    Section 30. The MC/DD Act is amended by changing Section

 

 

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13-801.1 as follows:
 
2    (210 ILCS 46/3-801.1)
3    Sec. 3-801.1. Access to records of resident with
4developmental disabilities. Notwithstanding the other
5provisions of this Act to the contrary, the agency designated
6by the Governor under Section 1 of "An Act in relation to the
7protection and advocacy of the rights of persons with
8developmental disabilities, and amending Acts therein named",
9enacted by the 84th General Assembly, shall have access to the
10records of a person with developmental disabilities who
11resides in a facility, subject to the limitations of this Act.
12The agency shall also have access for the purpose of
13inspection and copying, to the records of a person with
14developmental disabilities who resides in any such facility if
15(1) a complaint is received by such agency from or on behalf of
16the person with a developmental disability, and (2) such
17person does not have a guardian or the State or the designee of
18the State is the guardian of such person. The designated
19agency shall provide written notice to the person with
20developmental disabilities and the State guardian of the
21nature of the complaint based upon which the designated agency
22has gained access to the records. No record or the contents of
23any record shall be redisclosed by the designated agency
24unless the person with developmental disabilities and the
25State guardian are provided 7 days' advance written notice,

 

 

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1except in emergency situations, of the designated agency's
2intent to redisclose such record, during which time the person
3with developmental disabilities or the State guardian may seek
4to judicially enjoin the designated agency's redisclosure of
5such record on the grounds that such redisclosure is contrary
6to the interests of the person with developmental
7disabilities. If a person with developmental disabilities
8resides in such a facility and has a guardian other than the
9State or the designee of the State, the facility director
10shall disclose the guardian's name, address, and telephone
11number to the designated agency at the agency's request.
12    Upon request, the designated agency shall be entitled to
13inspect and copy any records or other materials which may
14further the agency's investigation of problems affecting
15numbers of persons with developmental disabilities. When
16required by law any personally identifiable information of
17persons with a developmental disability shall be removed from
18the records. However, the designated agency may not inspect or
19copy any records or other materials when the removal of
20personally identifiable information imposes an unreasonable
21burden on the facility. For the purposes of this Section,
22"developmental disability" means "developmental disability" as
23defined in Section 1-106 of the Mental Health and
24Developmental Disabilities Code. a severe, chronic disability
25of a person which:
26        (A) is attributable to a mental or physical impairment

 

 

HB5196 Engrossed- 19 -LRB102 24844 RJT 34091 b

1    or combination of mental and physical impairments;
2        (B) is manifested before the person attains age 22;
3        (C) is likely to continue indefinitely;
4        (D) results in substantial functional limitations in 3
5    or more of the following areas of major life activity: (i)
6    self care, (ii) receptive and expressive language, (iii)
7    learning, (iv) mobility, (v) self direction, (vi) capacity
8    for independent living, and (vii) economic self
9    sufficiency; and
10        (E) reflects the person's need for combination and
11    sequence of special, interdisciplinary or generic care,
12    treatment or other services which are of lifelong or
13    extended duration and are individually planned and
14    coordinated.
15(Source: P.A. 99-180, eff. 7-29-15.)
 
16    Section 35. The ID/DD Community Care Act is amended by
17changing Section 3-801.1 as follows:
 
18    (210 ILCS 47/3-801.1)
19    Sec. 3-801.1. Access to records of resident with
20developmental disabilities. Notwithstanding the other
21provisions of this Act to the contrary, the agency designated
22by the Governor under Section 1 of "An Act in relation to the
23protection and advocacy of the rights of persons with
24developmental disabilities, and amending Acts therein named",

 

 

HB5196 Engrossed- 20 -LRB102 24844 RJT 34091 b

1enacted by the 84th General Assembly, shall have access to the
2records of a person with developmental disabilities who
3resides in a facility, subject to the limitations of this Act.
4The agency shall also have access for the purpose of
5inspection and copying, to the records of a person with
6developmental disabilities who resides in any such facility if
7(1) a complaint is received by such agency from or on behalf of
8the person with a developmental disability, and (2) such
9person does not have a guardian or the State or the designee of
10the State is the guardian of such person. The designated
11agency shall provide written notice to the person with
12developmental disabilities and the State guardian of the
13nature of the complaint based upon which the designated agency
14has gained access to the records. No record or the contents of
15any record shall be redisclosed by the designated agency
16unless the person with developmental disabilities and the
17State guardian are provided 7 days' advance written notice,
18except in emergency situations, of the designated agency's
19intent to redisclose such record, during which time the person
20with developmental disabilities or the State guardian may seek
21to judicially enjoin the designated agency's redisclosure of
22such record on the grounds that such redisclosure is contrary
23to the interests of the person with developmental
24disabilities. If a person with developmental disabilities
25resides in such a facility and has a guardian other than the
26State or the designee of the State, the facility director

 

 

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1shall disclose the guardian's name, address, and telephone
2number to the designated agency at the agency's request.
3    Upon request, the designated agency shall be entitled to
4inspect and copy any records or other materials which may
5further the agency's investigation of problems affecting
6numbers of persons with developmental disabilities. When
7required by law any personally identifiable information of
8persons with a developmental disability shall be removed from
9the records. However, the designated agency may not inspect or
10copy any records or other materials when the removal of
11personally identifiable information imposes an unreasonable
12burden on the facility. For the purposes of this Section,
13"developmental disability" means "developmental disability" as
14defined in Section 1-106 of the Mental Health and
15Developmental Disabilities Code. a severe, chronic disability
16of a person which:
17        (A) is attributable to a mental or physical impairment
18    or combination of mental and physical impairments;
19        (B) is manifested before the person attains age 22;
20        (C) is likely to continue indefinitely;
21        (D) results in substantial functional limitations in 3
22    or more of the following areas of major life activity: (i)
23    self care, (ii) receptive and expressive language, (iii)
24    learning, (iv) mobility, (v) self direction, (vi) capacity
25    for independent living, and (vii) economic self
26    sufficiency; and

 

 

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1        (E) reflects the person's need for combination and
2    sequence of special, interdisciplinary or generic care,
3    treatment or other services which are of lifelong or
4    extended duration and are individually planned and
5    coordinated.
6(Source: P.A. 96-339, eff. 7-1-10.)
 
7    Section 40. The Illinois Insurance Code is amended by
8changing Section 356z.2 as follows:
 
9    (215 ILCS 5/356z.2)
10    Sec. 356z.2. Coverage for adjunctive services in dental
11care.
12    (a) An individual or group policy of accident and health
13insurance amended, delivered, issued, or renewed after January
141, 2003 (the effective date of Public Act 92-764) shall cover
15charges incurred, and anesthetics provided, in conjunction
16with dental care that is provided to a covered individual in a
17hospital or an ambulatory surgical treatment center if any of
18the following applies:
19        (1) the individual is a child age 6 or under;
20        (2) the individual has a medical condition that
21    requires hospitalization or general anesthesia for dental
22    care; or
23        (3) the individual is a person with a disability.
24    (a-5) An individual or group policy of accident and health

 

 

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1insurance amended, delivered, issued, or renewed after January
21, 2016 (the effective date of Public Act 99-141) shall cover
3charges incurred, and anesthetics provided by a dentist with a
4permit provided under Section 8.1 of the Illinois Dental
5Practice Act, in conjunction with dental care that is provided
6to a covered individual in a dental office, oral surgeon's
7office, hospital, or ambulatory surgical treatment center if
8the individual is under age 26 and has been diagnosed with an
9autism spectrum disorder as defined in Section 10 of the
10Autism Spectrum Disorders Reporting Act or a developmental
11disability. A covered individual shall be required to make 2
12visits to the dental care provider prior to accessing other
13coverage under this subsection.
14    For purposes of this subsection, "developmental
15disability" means "developmental disability" as defined in
16Section 1-106 of the Mental Health and Developmental
17Disabilities Code a disability that is attributable to an
18intellectual disability or a related condition, if the related
19condition meets all of the following conditions:
20        (1) it is attributable to cerebral palsy, epilepsy, or
21    any other condition, other than mental illness, found to
22    be closely related to an intellectual disability because
23    that condition results in impairment of general
24    intellectual functioning or adaptive behavior similar to
25    that of individuals with an intellectual disability and
26    requires treatment or services similar to those required

 

 

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1    for those individuals; for purposes of this definition,
2    autism is considered a related condition;
3        (2) it is manifested before the individual reaches age
4    22;
5        (3) it is likely to continue indefinitely; and
6        (4) it results in substantial functional limitations
7    in 3 or more of the following areas of major life activity:
8    self-care, language, learning, mobility, self-direction,
9    and capacity for independent living.
10    (b) For purposes of this Section, "ambulatory surgical
11treatment center" has the meaning given to that term in
12Section 3 of the Ambulatory Surgical Treatment Center Act.
13    For purposes of this Section, "person with a disability"
14means a person, regardless of age, with a chronic disability
15if the chronic disability meets all of the following
16conditions:
17        (1) It is attributable to a mental or physical
18    impairment or combination of mental and physical
19    impairments.
20        (2) It is likely to continue.
21        (3) It results in substantial functional limitations
22    in one or more of the following areas of major life
23    activity:
24            (A) self-care;
25            (B) receptive and expressive language;
26            (C) learning;

 

 

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1            (D) mobility;
2            (E) capacity for independent living; or
3            (F) economic self-sufficiency.
4    (c) The coverage required under this Section may be
5subject to any limitations, exclusions, or cost-sharing
6provisions that apply generally under the insurance policy.
7    (d) This Section does not apply to a policy that covers
8only dental care.
9    (e) Nothing in this Section requires that the dental
10services be covered.
11    (f) The provisions of this Section do not apply to
12short-term travel, accident-only, limited, or specified
13disease policies, nor to policies or contracts designed for
14issuance to persons eligible for coverage under Title XVIII of
15the Social Security Act, known as Medicare, or any other
16similar coverage under State or federal governmental plans.
17(Source: P.A. 101-525, eff. 1-1-20.)
 
18    Section 45. The Mental Health and Developmental
19Disabilities Code is amended by changing Sections 1-106 and
201-116 as follows:
 
21    (405 ILCS 5/1-106)  (from Ch. 91 1/2, par. 1-106)
22    Sec. 1-106. "Developmental disability" means a severe,
23chronic disability, other than mental illness, found to be
24closely related to an intellectual disability because this

 

 

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1condition results in impairment of general intellectual
2functioning or adaptive behavior similar to that of persons
3with ID, and requires services similar to those required for a
4person with an intellectual disability. In addition, a
5developmental disability: (1) is manifested before the
6individual reaches 22 years of age; (2) is likely to continue
7indefinitely; (3) results in substantial functional
8limitations in three or more of the following areas of major
9life activity: self-care, receptive and expressive language,
10learning, mobility, self-direction, capacity for independent
11living, or economic self-sufficiency; and (4) reflects the
12individual's need for a combination and sequence of special
13interdisciplinary or generic services, individualized
14supports, or other forms of assistance that are of lifelong or
15extended duration and are individually planned and coordinated
16a disability which is attributable to: (a) an intellectual
17disability, cerebral palsy, epilepsy or autism; or (b) any
18other condition which results in impairment similar to that
19caused by an intellectual disability and which requires
20services similar to those required by persons with an
21intellectual disability. Such disability must originate before
22the age of 18 years, be expected to continue indefinitely, and
23constitute a substantial disability.
24(Source: P.A. 99-143, eff. 7-27-15.)
 
25    (405 ILCS 5/1-116)  (from Ch. 91 1/2, par. 1-116)

 

 

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1    Sec. 1-116. Intellectual disability. "Intellectual
2disability" means a disorder with onset during the
3developmental period (before the individual reaches age 22),
4that includes both intellectual and adaptive deficits in
5conceptual, social and practical domains. The following 3
6criteria must be met: (1) deficits in intellectual functions
7such as reasoning, problem solving, planning, abstract
8thinking, judgment, academic learning, and learning from
9experience confirmed by both clinical assessment and
10individualized, standardized intelligence testing (generally
11indicated with an IQ score of about 70 or below), (2) deficits
12in adaptive functioning that result in failure to meet
13developmental and sociocultural standards for personal
14independence and social responsibility. Without ongoing
15support, the adaptive deficits limit functioning in one or
16more activities of daily life, such as communication, social
17participation, and independent living, across multiple
18environments, such as home, school, work, and community, and
19(3) onset of intellectual and adaptive deficits during the
20developmental period significantly subaverage general
21intellectual functioning which exists concurrently with
22impairment in adaptive behavior and which originates before
23the age of 18 years.
24(Source: P.A. 97-227, eff. 1-1-12.)
 
25    Section 50. The Specialized Living Centers Act is amended

 

 

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1by changing Section 2.03 as follows:
 
2    (405 ILCS 25/2.03)  (from Ch. 91 1/2, par. 602.03)
3    Sec. 2.03. "Person with a developmental disability" means
4a person with a "developmental disability" as defined in
5Section 1-116 of the Mental Health and Developmental
6Disabilities Code individuals whose disability is attributable
7to an intellectual disability, cerebral palsy, epilepsy or
8other neurological condition which generally originates before
9such individuals attain age 18 which had continued or can be
10expected to continue indefinitely and which constitutes a
11substantial disability to such individuals.
12(Source: P.A. 99-143, eff. 7-27-15.)
 
13    Section 55. The Developmental Disability and Mental
14Disability Services Act is amended by changing Section 2-3 as
15follows:
 
16    (405 ILCS 80/2-3)  (from Ch. 91 1/2, par. 1802-3)
17    Sec. 2-3. As used in this Article, unless the context
18requires otherwise:
19    (a) "Agency" means an agency or entity licensed by the
20Department pursuant to this Article or pursuant to the
21Community Residential Alternatives Licensing Act.
22    (b) "Department" means the Department of Human Services,
23as successor to the Department of Mental Health and

 

 

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1Developmental Disabilities.
2    (c) "Home-based services" means services provided to an
3adult with a mental disability who lives in his or her own
4home. These services include but are not limited to:
5        (1) home health services;
6        (2) case management;
7        (3) crisis management;
8        (4) training and assistance in self-care;
9        (5) personal care services;
10        (6) habilitation and rehabilitation services;
11        (7) employment-related services;
12        (8) respite care; and
13        (9) other skill training that enables a person to
14    become self-supporting.
15    (d) "Legal guardian" means a person appointed by a court
16of competent jurisdiction to exercise certain powers on behalf
17of an adult with a mental disability.
18    (e) "Adult with a mental disability" means a person over
19the age of 18 years who lives in his or her own home; who needs
20home-based services, but does not require 24-hour-a-day
21supervision; and who has one of the following conditions:
22severe autism, severe mental illness, a severe or profound
23intellectual disability, or severe and multiple impairments.
24    (f) In one's "own home" means that an adult with a mental
25disability lives alone; or that an adult with a mental
26disability is in full-time residence with his or her parents,

 

 

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1legal guardian, or other relatives; or that an adult with a
2mental disability is in full-time residence in a setting not
3subject to licensure under the Nursing Home Care Act, the
4Specialized Mental Health Rehabilitation Act of 2013, the
5ID/DD Community Care Act, the MC/DD Act, or the Child Care Act
6of 1969, as now or hereafter amended, with 3 or fewer other
7adults unrelated to the adult with a mental disability who do
8not provide home-based services to the adult with a mental
9disability.
10    (g) "Parent" means the biological or adoptive parent of an
11adult with a mental disability, or a person licensed as a
12foster parent under the laws of this State who acts as a foster
13parent to an adult with a mental disability.
14    (h) "Relative" means any of the following relationships by
15blood, marriage or adoption: parent, son, daughter, brother,
16sister, grandparent, uncle, aunt, nephew, niece, great
17grandparent, great uncle, great aunt, stepbrother, stepsister,
18stepson, stepdaughter, stepparent or first cousin.
19    (i) "Severe autism" means a lifelong developmental
20disability which is typically manifested before 30 months of
21age and is characterized by severe disturbances in reciprocal
22social interactions; verbal and nonverbal communication and
23imaginative activity; and repertoire of activities and
24interests. A person shall be determined severely autistic, for
25purposes of this Article, if both of the following are
26present:

 

 

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1        (1) Diagnosis consistent with the criteria for
2    autistic disorder in the current edition of the Diagnostic
3    and Statistical Manual of Mental Disorders.
4        (2) Severe disturbances in reciprocal social
5    interactions; verbal and nonverbal communication and
6    imaginative activity; repertoire of activities and
7    interests. A determination of severe autism shall be based
8    upon a comprehensive, documented assessment with an
9    evaluation by a licensed clinical psychologist or
10    psychiatrist. A determination of severe autism shall not
11    be based solely on behaviors relating to environmental,
12    cultural or economic differences.
13    (j) "Severe mental illness" means the manifestation of all
14of the following characteristics:
15        (1) A primary diagnosis of one of the major mental
16    disorders in the current edition of the Diagnostic and
17    Statistical Manual of Mental Disorders listed below:
18            (A) Schizophrenia disorder.
19            (B) Delusional disorder.
20            (C) Schizo-affective disorder.
21            (D) Bipolar affective disorder.
22            (E) Atypical psychosis.
23            (F) Major depression, recurrent.
24        (2) The individual's mental illness must substantially
25    impair his or her functioning in at least 2 of the
26    following areas:

 

 

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1            (A) Self-maintenance.
2            (B) Social functioning.
3            (C) Activities of community living.
4            (D) Work skills.
5        (3) Disability must be present or expected to be
6    present for at least one year.
7    A determination of severe mental illness shall be based
8upon a comprehensive, documented assessment with an evaluation
9by a licensed clinical psychologist or psychiatrist, and shall
10not be based solely on behaviors relating to environmental,
11cultural or economic differences.
12    (k) "Severe or profound intellectual disability" means a
13manifestation of all of the following characteristics:
14        (1) A diagnosis which meets Classification in Mental
15    Retardation or criteria in the current edition of the
16    Diagnostic and Statistical Manual of Mental Disorders for
17    severe or profound mental retardation (an IQ of 40 or
18    below). This must be measured by a standardized instrument
19    for general intellectual functioning.
20        (2) A severe or profound level of disturbed adaptive
21    behavior. This must be measured by a standardized adaptive
22    behavior scale or informal appraisal by the professional
23    in keeping with illustrations in Classification in Mental
24    Retardation, 1983.
25        (3) Disability diagnosed before age of 18.
26    A determination of a severe or profound intellectual

 

 

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1disability shall be based upon a comprehensive, documented
2assessment with an evaluation by a licensed clinical
3psychologist or certified school psychologist or a
4psychiatrist, and shall not be based solely on behaviors
5relating to environmental, cultural or economic differences.
6    (l) "Severe and multiple impairments" means the
7manifestation of all of the following characteristics:
8        (1) The evaluation determines the presence of a
9    developmental disability which is expected to continue
10    indefinitely, constitutes a substantial disability and is
11    attributable to any of the following:
12            (A) Intellectual disability as defined in Section
13        1-116 of the Mental Health and Developmental
14        Disabilities Code , which is defined as general
15        intellectual functioning that is 2 or more standard
16        deviations below the mean concurrent with impairment
17        of adaptive behavior which is 2 or more standard
18        deviations below the mean. Assessment of the
19        individual's intellectual functioning must be measured
20        by a standardized instrument for general intellectual
21        functioning.
22            (B) Cerebral palsy.
23            (C) Epilepsy.
24            (D) Autism.
25            (E) Any other condition which results in
26        impairment similar to that caused by an intellectual

 

 

HB5196 Engrossed- 34 -LRB102 24844 RJT 34091 b

1        disability and which requires services similar to
2        those required by persons with intellectual
3        disabilities.
4        (2) The evaluation determines multiple disabilities in
5    physical, sensory, behavioral or cognitive functioning
6    which constitute a severe or profound impairment
7    attributable to one or more of the following:
8            (A) Physical functioning, which severely impairs
9        the individual's motor performance that may be due to:
10                (i) Neurological, psychological or physical
11            involvement resulting in a variety of disabling
12            conditions such as hemiplegia, quadriplegia or
13            ataxia,
14                (ii) Severe organ systems involvement such as
15            congenital heart defect,
16                (iii) Physical abnormalities resulting in the
17            individual being non-mobile and non-ambulatory or
18            confined to bed and receiving assistance in
19            transferring, or
20                (iv) The need for regular medical or nursing
21            supervision such as gastrostomy care and feeding.
22            Assessment of physical functioning must be based
23        on clinical medical assessment by a physician licensed
24        to practice medicine in all its branches, using the
25        appropriate instruments, techniques and standards of
26        measurement required by the professional.

 

 

HB5196 Engrossed- 35 -LRB102 24844 RJT 34091 b

1            (B) Sensory, which involves severe restriction due
2        to hearing or visual impairment limiting the
3        individual's movement and creating dependence in
4        completing most daily activities. Hearing impairment
5        is defined as a loss of 70 decibels aided or speech
6        discrimination of less than 50% aided. Visual
7        impairment is defined as 20/200 corrected in the
8        better eye or a visual field of 20 degrees or less.
9        Sensory functioning must be based on clinical medical
10        assessment by a physician licensed to practice
11        medicine in all its branches using the appropriate
12        instruments, techniques and standards of measurement
13        required by the professional.
14            (C) Behavioral, which involves behavior that is
15        maladaptive and presents a danger to self or others,
16        is destructive to property by deliberately breaking,
17        destroying or defacing objects, is disruptive by
18        fighting, or has other socially offensive behaviors in
19        sufficient frequency or severity to seriously limit
20        social integration. Assessment of behavioral
21        functioning may be measured by a standardized scale or
22        informal appraisal by a clinical psychologist or
23        psychiatrist.
24            (D) Cognitive, which involves intellectual
25        functioning at a measured IQ of 70 or below.
26        Assessment of cognitive functioning must be measured

 

 

HB5196 Engrossed- 36 -LRB102 24844 RJT 34091 b

1        by a standardized instrument for general intelligence.
2        (3) The evaluation determines that development is
3    substantially less than expected for the age in cognitive,
4    affective or psychomotor behavior as follows:
5            (A) Cognitive, which involves intellectual
6        functioning at a measured IQ of 70 or below.
7        Assessment of cognitive functioning must be measured
8        by a standardized instrument for general intelligence.
9            (B) Affective behavior, which involves over and
10        under responding to stimuli in the environment and may
11        be observed in mood, attention to awareness, or in
12        behaviors such as euphoria, anger or sadness that
13        seriously limit integration into society. Affective
14        behavior must be based on clinical assessment using
15        the appropriate instruments, techniques and standards
16        of measurement required by the professional.
17            (C) Psychomotor, which includes a severe
18        developmental delay in fine or gross motor skills so
19        that development in self-care, social interaction,
20        communication or physical activity will be greatly
21        delayed or restricted.
22        (4) A determination that the disability originated
23    before the age of 18 years.
24    A determination of severe and multiple impairments shall
25be based upon a comprehensive, documented assessment with an
26evaluation by a licensed clinical psychologist or

 

 

HB5196 Engrossed- 37 -LRB102 24844 RJT 34091 b

1psychiatrist.
2    If the examiner is a licensed clinical psychologist,
3ancillary evaluation of physical impairment, cerebral palsy or
4epilepsy must be made by a physician licensed to practice
5medicine in all its branches.
6    Regardless of the discipline of the examiner, ancillary
7evaluation of visual impairment must be made by an
8ophthalmologist or a licensed optometrist.
9    Regardless of the discipline of the examiner, ancillary
10evaluation of hearing impairment must be made by an
11otolaryngologist or an audiologist with a certificate of
12clinical competency.
13    The only exception to the above is in the case of a person
14with cerebral palsy or epilepsy who, according to the
15eligibility criteria listed below, has multiple impairments
16which are only physical and sensory. In such a case, a
17physician licensed to practice medicine in all its branches
18may serve as the examiner.
19    (m) "Twenty-four-hour-a-day supervision" means
2024-hour-a-day care by a trained mental health or developmental
21disability professional on an ongoing basis.
22(Source: P.A. 98-104, eff. 7-22-13; 99-143, eff. 7-27-15;
2399-180, eff. 7-29-15; 99-642, eff. 7-28-16.)
 
24    Section 60. The Developmental Disability Prevention Act is
25amended by changing Section 2 as follows:
 

 

 

HB5196 Engrossed- 38 -LRB102 24844 RJT 34091 b

1    (410 ILCS 250/2)  (from Ch. 111 1/2, par. 2102)
2    Sec. 2. As used in this Act:
3    (a) "perinatal" means the period of time between the
4conception of an infant and the end of the first month of life;
5    (b) "congenital" means those intrauterine factors which
6influence the growth, development and function of the fetus;
7    (c) "environmental" means those extrauterine factors which
8influence the adaptation, well being or life of the newborn
9and may lead to disability;
10    (d) "high risk" means an increased level of risk of harm or
11mortality to the woman of childbearing age, fetus or newborn
12from congenital and/or environmental factors;
13    (e) "perinatal center" means a referral facility intended
14to care for the high risk patient before, during, or after
15labor and delivery and characterized by sophistication and
16availability of personnel, equipment, laboratory,
17transportation techniques, consultation and other support
18services;
19    (f) "developmental disability" means "developmental
20disability" as defined in Section 1-106 of the Mental Health
21and Developmental Disabilities Code an intellectual
22disability, cerebral palsy, epilepsy, or other neurological
23disabling conditions of an individual found to be closely
24related to an intellectual disability or to require treatment
25similar to that required by individuals with an intellectual

 

 

HB5196 Engrossed- 39 -LRB102 24844 RJT 34091 b

1disability, and the disability originates before such
2individual attains age 18, and has continued, or can be
3expected to continue indefinitely, and constitutes a
4substantial disability of such individuals;
5    (g) "disability" means a condition characterized by
6temporary or permanent, partial or complete impairment of
7physical, mental or physiological function;
8    (h) "Department" means the Department of Public Health.
9(Source: P.A. 99-143, eff. 7-27-15.)
 
10    Section 70. The Probate Act of 1975 is amended by changing
11Section 11a-1 as follows:
 
12    (755 ILCS 5/11a-1)  (from Ch. 110 1/2, par. 11a-1)
13    Sec. 11a-1. "Developmental disability", "intellectual
14disability", and "related condition" defined.
15    "Developmental disability" means "developmental
16disability" as defined in Section 1-116 of the Mental Health
17and Developmental Disabilities Code a disability that is
18attributable to an intellectual disability or a related
19condition.
20    "Intellectual disability" means "intellectual disability"
21as defined in Section 1-116 of the Mental Health and
22Developmental Disabilities Code significantly subaverage
23general intellectual functioning existing concurrently with
24deficits in adaptive behavior and manifested before the age of

 

 

HB5196 Engrossed- 40 -LRB102 24844 RJT 34091 b

122 years.
2    "Related condition" means a condition that:
3        (1) is attributable to cerebral palsy, epilepsy, or
4    any other condition, other than mental illness, found to
5    be closely related to an intellectual disability because
6    that condition results in impairment of general
7    intellectual functioning or adaptive behavior similar to
8    that of individuals with an intellectual disability, and
9    requires treatment or services similar to those required
10    for those individuals. For purposes of this Act, autism is
11    considered a related condition;
12        (2) is manifested before the individual reaches age
13    22;
14        (3) is likely to continue indefinitely; and
15        (4) results in substantial functional limitation in 3
16    or more of the following areas of major life activity:
17    self-care, language, learning, mobility, self-direction,
18    and capacity for independent living.
19(Source: P.A. 102-72, eff. 1-1-22; 102-109, eff. 1-1-22.)