HB2572 101ST GENERAL ASSEMBLY

LRB101 08755 KTG 53842 b

101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB2572

Introduced , by Rep. Sara Feigenholtz

SYNOPSIS AS INTRODUCED:

See Index

Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance, or managed care plan, that is amended, delivered, issued, or renewed after June 30, 2020 to provide coverage for: (i) coordinated specialty care for first episode psychosis treatment and (ii) assertive community treatment and community support team treatment. Contains provisions concerning mental health professionals; service payments; and other matters. Makes conforming changes to other Acts. Amends the Substance Use Disorder Act. Requires the Department of Human Services to allow outpatient substance use treatment providers to keep a substance use treatment case open for 90 days when a person has not received a treatment service during such period. Amends the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to restructure the Family Support Program (Program) to: (i) enable early treatment of a child or young adult with serious mental health needs; (ii) align the program with system of care principles; and (iii) include both community-based and residential treatment services. Contains provisions on the new hallmarks of the Program; federal Medicaid matching dollars; an In-Home Therapy Pilot Program; and other matters. Amends the Adoption Act. Requires the Department of Children and Family Services to establish and maintain a toll-free number to respond to requests from the public about its post-placement and post-adoption support services; and to review and update its Post Adoption and Guardianship Services booklet. Requires the Department and the Department of Healthcare and Family Services to coordinate in the development of specified resources. Effective immediately.

FISCAL NOTE ACT MAY APPLY

STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. References to Act; intent; purposes. This Act may be referred to as the Children and Young Adult Mental Health Crisis Act. It is intended to fill in significant gaps in Illinois' mental health treatment system for children and young adults given that this is the age group that most mental health conditions begin to manifest. It also addresses barriers to access to substance use treatment for this age group because substance use is common for young people with mental health needs, often to manage untreated mental health symptoms.

Section 5. Findings. The General Assembly finds as follows:

(1) Over 850,000 children and young adults under age 25 in Illinois will experience a mental health condition, and between 40-50% of them will begin to use substances, including opioids, to self-medicate. Barely one-third will get treatment even though treatment can lead to recovery and wellness.

(2) Every year hundreds of Illinois children with treatable serious mental health conditions are forced to remain in psychiatric hospitals far beyond medical necessity because subsequent treatment options are not available.

(3) Custody relinquishment to the State of Illinois, often of adopted children with significant mental health needs, remains common as the only avenue for some children into mental health treatment.

(4) Community-based, wrap-around treatment models are not available early enough in Illinois to stabilize a child showing early signs of a serious mental health issue, and the State does not have enough residential treatment beds or the appropriate levels of care for children and young adults with high-acuity residential treatment needs.

(5) Children and young adults must have access to the level of mental health treatment they need at the first signs of a problem to prevent worsening of the condition and the use of substances for purposes of self-medication.

(6) The State's N.B. Consent Decree for children who are covered by the State's Medical Assistance Program and the State's 1115 waiver and related Medicaid State Plan amendments still leave many service gaps, and none of these efforts deal with challenges when private insurance does not cover proven treatment approaches covered by the public sector.

(7) Illinois' mental health system for children and young adults must align with system of care principles, which were developed by The Georgetown University Center for Child and Human Development and are the nationally recognized best practice for developing a strong treatment system. Such an approach evaluates what treatment and support the child or young adult, and the family, need in order to stabilize, recover, and achieve wellness based on a comprehensive assessment of the child's mental and behavioral health needs, rather than placing the young person in a program (because that is the only program the State has) that may not meet the needs of the child and family.

(8) This Act contains many of the crucial elements that Illinois requires for building an appropriate service delivery system consistent with system of care principles that will result in an enhanced delivery system and full continuum of care for children, youth, and young adults with mental health and substance use treatment needs, consistent with the federal requirements of Early and Periodic Screening, Diagnostic and Treatment, and for coverage of a comprehensive array of services through private insurance. Families should be able to draw from a full range of services to meet their child's and family's needs for optimal social emotional growth and development in the most integrated and clinically appropriate setting.

Section 10. The Illinois Administrative Procedure Act is amended by changing Section 5-45 as follows:

(5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)

Sec. 5-45. Emergency rulemaking.

(a) "Emergency" means the existence of any situation that any agency finds reasonably constitutes a threat to the public interest, safety, or welfare.

(b) If any agency finds that an emergency exists that requires adoption of a rule upon fewer days than is required by Section 5-40 and states in writing its reasons for that finding, the agency may adopt an emergency rule without prior notice or hearing upon filing a notice of emergency rulemaking with the Secretary of State under Section 5-70. The notice shall include the text of the emergency rule and shall be published in the Illinois Register. Consent orders or other court orders adopting settlements negotiated by an agency may be adopted under this Section. Subject to applicable constitutional or statutory provisions, an emergency rule becomes effective immediately upon filing under Section 5-65 or at a stated date less than 10 days thereafter. The agency's finding and a statement of the specific reasons for the finding shall be filed with the rule. The agency shall take reasonable and appropriate measures to make emergency rules known to the persons who may be affected by them.

(c) An emergency rule may be effective for a period of not longer than 150 days, but the agency's authority to adopt an identical rule under Section 5-40 is not precluded. No emergency rule may be adopted more than once in any 24-month period, except that this limitation on the number of emergency rules that may be adopted in a 24-month period does not apply to (i) emergency rules that make additions to and deletions from the Drug Manual under Section 5-5.16 of the Illinois Public Aid Code or the generic drug formulary under Section 3.14 of the Illinois Food, Drug and Cosmetic Act, (ii) emergency rules adopted by the Pollution Control Board before July 1, 1997 to implement portions of the Livestock Management Facilities Act, (iii) emergency rules adopted by the Illinois Department of Public Health under subsections (a) through (i) of Section 2 of the Department of Public Health Act when necessary to protect the public's health, (iv) emergency rules adopted pursuant to subsection (n) of this Section, (v) emergency rules adopted pursuant to subsection (o) of this Section, or (vi) emergency rules adopted pursuant to subsection (c-5) of this Section. Two or more emergency rules having substantially the same purpose and effect shall be deemed to be a single rule for purposes of this Section.

(c-5) To facilitate the maintenance of the program of group health benefits provided to annuitants, survivors, and retired employees under the State Employees Group Insurance Act of 1971, rules to alter the contributions to be paid by the State, annuitants, survivors, retired employees, or any combination of those entities, for that program of group health benefits, shall be adopted as emergency rules. The adoption of those rules shall be considered an emergency and necessary for the public interest, safety, and welfare.

(d) In order to provide for the expeditious and timely implementation of the State's fiscal year 1999 budget, emergency rules to implement any provision of Public Act 90-587 or 90-588 or any other budget initiative for fiscal year 1999 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (d). The adoption of emergency rules authorized by this subsection (d) shall be deemed to be necessary for the public interest, safety, and welfare.

(e) In order to provide for the expeditious and timely implementation of the State's fiscal year 2000 budget, emergency rules to implement any provision of Public Act 91-24 or any other budget initiative for fiscal year 2000 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (e). The adoption of emergency rules authorized by this subsection (e) shall be deemed to be necessary for the public interest, safety, and welfare.

(f) In order to provide for the expeditious and timely implementation of the State's fiscal year 2001 budget, emergency rules to implement any provision of Public Act 91-712 or any other budget initiative for fiscal year 2001 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (f). The adoption of emergency rules authorized by this subsection (f) shall be deemed to be necessary for the public interest, safety, and welfare.

(g) In order to provide for the expeditious and timely implementation of the State's fiscal year 2002 budget, emergency rules to implement any provision of Public Act 92-10 or any other budget initiative for fiscal year 2002 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (g). The adoption of emergency rules authorized by this subsection (g) shall be deemed to be necessary for the public interest, safety, and welfare.

(h) In order to provide for the expeditious and timely implementation of the State's fiscal year 2003 budget, emergency rules to implement any provision of Public Act 92-597 or any other budget initiative for fiscal year 2003 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (h). The adoption of emergency rules authorized by this subsection (h) shall be deemed to be necessary for the public interest, safety, and welfare.

(i) In order to provide for the expeditious and timely implementation of the State's fiscal year 2004 budget, emergency rules to implement any provision of Public Act 93-20 or any other budget initiative for fiscal year 2004 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (i). The adoption of emergency rules authorized by this subsection (i) shall be deemed to be necessary for the public interest, safety, and welfare.

(j) In order to provide for the expeditious and timely implementation of the provisions of the State's fiscal year 2005 budget as provided under the Fiscal Year 2005 Budget Implementation (Human Services) Act, emergency rules to implement any provision of the Fiscal Year 2005 Budget Implementation (Human Services) Act may be adopted in accordance with this Section by the agency charged with administering that provision, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (j). The Department of Public Aid may also adopt rules under this subsection (j) necessary to administer the Illinois Public Aid Code and the Children's Health Insurance Program Act. The adoption of emergency rules authorized by this subsection (j) shall be deemed to be necessary for the public interest, safety, and welfare.

(k) In order to provide for the expeditious and timely implementation of the provisions of the State's fiscal year 2006 budget, emergency rules to implement any provision of Public Act 94-48 or any other budget initiative for fiscal year 2006 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative, except that the 24-month limitation on the adoption of emergency rules and the provisions of Sections 5-115 and 5-125 do not apply to rules adopted under this subsection (k). The Department of Healthcare and Family Services may also adopt rules under this subsection (k) necessary to administer the Illinois Public Aid Code, the Senior Citizens and Persons with Disabilities Property Tax Relief Act, the Senior Citizens and Disabled Persons Prescription Drug Discount Program Act (now the Illinois Prescription Drug Discount Program Act), and the Children's Health Insurance Program Act. The adoption of emergency rules authorized by this subsection (k) shall be deemed to be necessary for the public interest, safety, and welfare.

(l) In order to provide for the expeditious and timely implementation of the provisions of the State's fiscal year 2007 budget, the Department of Healthcare and Family Services may adopt emergency rules during fiscal year 2007, including rules effective July 1, 2007, in accordance with this subsection to the extent necessary to administer the Department's responsibilities with respect to amendments to the State plans and Illinois waivers approved by the federal Centers for Medicare and Medicaid Services necessitated by the requirements of Title XIX and Title XXI of the federal Social Security Act. The adoption of emergency rules authorized by this subsection (l) shall be deemed to be necessary for the public interest, safety, and welfare.

(m) In order to provide for the expeditious and timely implementation of the provisions of the State's fiscal year 2008 budget, the Department of Healthcare and Family Services may adopt emergency rules during fiscal year 2008, including rules effective July 1, 2008, in accordance with this subsection to the extent necessary to administer the Department's responsibilities with respect to amendments to the State plans and Illinois waivers approved by the federal Centers for Medicare and Medicaid Services necessitated by the requirements of Title XIX and Title XXI of the federal Social Security Act. The adoption of emergency rules authorized by this subsection (m) shall be deemed to be necessary for the public interest, safety, and welfare.

(n) In order to provide for the expeditious and timely implementation of the provisions of the State's fiscal year 2010 budget, emergency rules to implement any provision of Public Act 96-45 or any other budget initiative authorized by the 96th General Assembly for fiscal year 2010 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative. The adoption of emergency rules authorized by this subsection (n) shall be deemed to be necessary for the public interest, safety, and welfare. The rulemaking authority granted in this subsection (n) shall apply only to rules promulgated during Fiscal Year 2010.

(o) In order to provide for the expeditious and timely implementation of the provisions of the State's fiscal year 2011 budget, emergency rules to implement any provision of Public Act 96-958 or any other budget initiative authorized by the 96th General Assembly for fiscal year 2011 may be adopted in accordance with this Section by the agency charged with administering that provision or initiative. The adoption of emergency rules authorized by this subsection (o) is deemed to be necessary for the public interest, safety, and welfare. The rulemaking authority granted in this subsection (o) applies only to rules promulgated on or after July 1, 2010 (the effective date of Public Act 96-958) through June 30, 2011.

(p) In order to provide for the expeditious and timely implementation of the provisions of Public Act 97-689, emergency rules to implement any provision of Public Act 97-689 may be adopted in accordance with this subsection (p) by the agency charged with administering that provision or initiative. The 150-day limitation of the effective period of emergency rules does not apply to rules adopted under this subsection (p), and the effective period may continue through June 30, 2013. The 24-month limitation on the adoption of emergency rules does not apply to rules adopted under this subsection (p). The adoption of emergency rules authorized by this subsection (p) is deemed to be necessary for the public interest, safety, and welfare.

(q) In order to provide for the expeditious and timely implementation of the provisions of Articles 7, 8, 9, 11, and 12 of Public Act 98-104, emergency rules to implement any provision of Articles 7, 8, 9, 11, and 12 of Public Act 98-104 may be adopted in accordance with this subsection (q) by the agency charged with administering that provision or initiative. The 24-month limitation on the adoption of emergency rules does not apply to rules adopted under this subsection (q). The adoption of emergency rules authorized by this subsection (q) is deemed to be necessary for the public interest, safety, and welfare.

(r) In order to provide for the expeditious and timely implementation of the provisions of Public Act 98-651, emergency rules to implement Public Act 98-651 may be adopted in accordance with this subsection (r) by the Department of Healthcare and Family Services. The 24-month limitation on the adoption of emergency rules does not apply to rules adopted under this subsection (r). The adoption of emergency rules authorized by this subsection (r) is deemed to be necessary for the public interest, safety, and welfare.

(s) In order to provide for the expeditious and timely implementation of the provisions of Sections 5-5b.1 and 5A-2 of the Illinois Public Aid Code, emergency rules to implement any provision of Section 5-5b.1 or Section 5A-2 of the Illinois Public Aid Code may be adopted in accordance with this subsection (s) by the Department of Healthcare and Family Services. The rulemaking authority granted in this subsection (s) shall apply only to those rules adopted prior to July 1, 2015. Notwithstanding any other provision of this Section, any emergency rule adopted under this subsection (s) shall only apply to payments made for State fiscal year 2015. The adoption of emergency rules authorized by this subsection (s) is deemed to be necessary for the public interest, safety, and welfare.

(t) In order to provide for the expeditious and timely implementation of the provisions of Article II of Public Act 99-6, emergency rules to implement the changes made by Article II of Public Act 99-6 to the Emergency Telephone System Act may be adopted in accordance with this subsection (t) by the Department of State Police. The rulemaking authority granted in this subsection (t) shall apply only to those rules adopted prior to July 1, 2016. The 24-month limitation on the adoption of emergency rules does not apply to rules adopted under this subsection (t). The adoption of emergency rules authorized by this subsection (t) is deemed to be necessary for the public interest, safety, and welfare.

(u) In order to provide for the expeditious and timely implementation of the provisions of the Burn Victims Relief Act, emergency rules to implement any provision of the Act may be adopted in accordance with this subsection (u) by the Department of Insurance. The rulemaking authority granted in this subsection (u) shall apply only to those rules adopted prior to December 31, 2015. The adoption of emergency rules authorized by this subsection (u) is deemed to be necessary for the public interest, safety, and welfare.

(v) In order to provide for the expeditious and timely implementation of the provisions of Public Act 99-516, emergency rules to implement Public Act 99-516 may be adopted in accordance with this subsection (v) by the Department of Healthcare and Family Services. The 24-month limitation on the adoption of emergency rules does not apply to rules adopted under this subsection (v). The adoption of emergency rules authorized by this subsection (v) is deemed to be necessary for the public interest, safety, and welfare.

(w) In order to provide for the expeditious and timely implementation of the provisions of Public Act 99-796, emergency rules to implement the changes made by Public Act 99-796 may be adopted in accordance with this subsection (w) by the Adjutant General. The adoption of emergency rules authorized by this subsection (w) is deemed to be necessary for the public interest, safety, and welfare.

(x) In order to provide for the expeditious and timely implementation of the provisions of Public Act 99-906, emergency rules to implement subsection (i) of Section 16-115D, subsection (g) of Section 16-128A, and subsection (a) of Section 16-128B of the Public Utilities Act may be adopted in accordance with this subsection (x) by the Illinois Commerce Commission. The rulemaking authority granted in this subsection (x) shall apply only to those rules adopted within 180 days after June 1, 2017 (the effective date of Public Act 99-906). The adoption of emergency rules authorized by this subsection (x) is deemed to be necessary for the public interest, safety, and welfare.

(y) In order to provide for the expeditious and timely implementation of the provisions of Public Act 100-23, emergency rules to implement the changes made by Public Act 100-23 to Section 4.02 of the Illinois Act on the Aging, Sections 5.5.4 and 5-5.4i of the Illinois Public Aid Code, Section 55-30 of the Alcoholism and Other Drug Abuse and Dependency Act, and Sections 74 and 75 of the Mental Health and Developmental Disabilities Administrative Act may be adopted in accordance with this subsection (y) by the respective Department. The adoption of emergency rules authorized by this subsection (y) is deemed to be necessary for the public interest, safety, and welfare.

(z) In order to provide for the expeditious and timely implementation of the provisions of Public Act 100-554, emergency rules to implement the changes made by Public Act 100-554 to Section 4.7 of the Lobbyist Registration Act may be adopted in accordance with this subsection (z) by the Secretary of State. The adoption of emergency rules authorized by this subsection (z) is deemed to be necessary for the public interest, safety, and welfare.

(aa) In order to provide for the expeditious and timely initial implementation of the changes made to Articles 5, 5A, 12, and 14 of the Illinois Public Aid Code under the provisions of Public Act 100-581, the Department of Healthcare and Family Services may adopt emergency rules in accordance with this subsection (aa). The 24-month limitation on the adoption of emergency rules does not apply to rules to initially implement the changes made to Articles 5, 5A, 12, and 14 of the Illinois Public Aid Code adopted under this subsection (aa). The adoption of emergency rules authorized by this subsection (aa) is deemed to be necessary for the public interest, safety, and welfare.

(bb) In order to provide for the expeditious and timely implementation of the provisions of Public Act 100-587, emergency rules to implement the changes made by Public Act 100-587 to Section 4.02 of the Illinois Act on the Aging, Sections 5.5.4 and 5-5.4i of the Illinois Public Aid Code, subsection (b) of Section 55-30 of the Alcoholism and Other Drug Abuse and Dependency Act, Section 5-104 of the Specialized Mental Health Rehabilitation Act of 2013, and Section 75 and subsection (b) of Section 74 of the Mental Health and Developmental Disabilities Administrative Act may be adopted in accordance with this subsection (bb) by the respective Department. The adoption of emergency rules authorized by this subsection (bb) is deemed to be necessary for the public interest, safety, and welfare.

(cc) In order to provide for the expeditious and timely implementation of the provisions of Public Act 100-587, emergency rules may be adopted in accordance with this subsection (cc) to implement the changes made by Public Act 100-587 to: Sections 14-147.5 and 14-147.6 of the Illinois Pension Code by the Board created under Article 14 of the Code; Sections 15-185.5 and 15-185.6 of the Illinois Pension Code by the Board created under Article 15 of the Code; and Sections 16-190.5 and 16-190.6 of the Illinois Pension Code by the Board created under Article 16 of the Code. The adoption of emergency rules authorized by this subsection (cc) is deemed to be necessary for the public interest, safety, and welfare.

(dd) In order to provide for the expeditious and timely implementation of the provisions of Public Act 100-864, emergency rules to implement the changes made by Public Act 100-864 to Section 3.35 of the Newborn Metabolic Screening Act may be adopted in accordance with this subsection (dd) by the Secretary of State. The adoption of emergency rules authorized by this subsection (dd) is deemed to be necessary for the public interest, safety, and welfare.

(ee) In order to provide for the expeditious and timely implementation of the provisions of this amendatory Act of the 100th General Assembly, emergency rules implementing the Illinois Underground Natural Gas Storage Safety Act may be adopted in accordance with this subsection by the Department of Natural Resources. The adoption of emergency rules authorized by this subsection is deemed to be necessary for the public interest, safety, and welfare.

(ff) In order to provide for the expeditious and timely implementation of Section 5-5.23 of the Illinois Public Aid Code, emergency rules to implement the changes made by this amendatory Act of the 101st General Assembly to Section 5-5.23 of the Illinois Public Aid Code may be adopted in accordance with this subsection (ff) by the Department of Healthcare and Family Services. The adoption of emergency rules authorized by this subsection (ff) is deemed to be necessary for the public interest, safety, and welfare.

(Source: P.A. 99-2, eff. 3-26-15; 99-6, eff. 1-1-16; 99-143, eff. 7-27-15; 99-455, eff. 1-1-16; 99-516, eff. 6-30-16; 99-642, eff. 7-28-16; 99-796, eff. 1-1-17; 99-906, eff. 6-1-17; 100-23, eff. 7-6-17; 100-554, eff. 11-16-17; 100-581, eff. 3-12-18; 100-587, Article 95, Section 95-5, eff. 6-4-18; 100-587, Article 110, Section 110-5, eff. 6-4-18; 100-864, eff. 8-14-18; 100-1172, eff. 1-4-19.)

Section 15. The State Employees Group Insurance Act of 1971 is amended by changing Section 6.11 as follows:

(5 ILCS 375/6.11)

(Text of Section before amendment by P.A. 100-1170)

Sec. 6.11. Required health benefits; Illinois Insurance Code requirements. The program of health benefits shall provide the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t of the Illinois Insurance Code. The program of health benefits shall provide the coverage required under Sections 356g, 356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, and 356z.26, and 356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code. The program of health benefits must comply with Sections 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 of the Illinois Insurance Code. The Department of Insurance shall enforce the requirements of this Section.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules; any purported rule not so adopted, for whatever reason, is unauthorized.

(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised 1-8-19.)

(Text of Section after amendment by P.A. 100-1170)

Sec. 6.11. Required health benefits; Illinois Insurance Code requirements. The program of health benefits shall provide the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t of the Illinois Insurance Code. The program of health benefits shall provide the coverage required under Sections 356g, 356g.5, 356g.5-1, 356m, 356u, 356w, 356x, 356z.2, 356z.4, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26, 356z.29, and 356z.32, and 356z.33 of the Illinois Insurance Code. The program of health benefits must comply with Sections 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 of the Illinois Insurance Code. The Department of Insurance shall enforce the requirements of this Section with respect to Sections 370c and 370c.1 of the Illinois Insurance Code; all other requirements of this Section shall be enforced by the Department of Central Management Services.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules; any purported rule not so adopted, for whatever reason, is unauthorized.

(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; 100-1170, eff. 6-1-19.)

Section 20. The Substance Use Disorder Act is amended by adding Section 55-36 as follows:

(20 ILCS 301/55-36 new)

Sec. 55-36. Fostering continued engagement in substance use outpatient treatment. The existing policy and practice of the Department of Human Services' Division of Substance Use Prevention and Recovery, as set forth in the Division's Automated Reporting and Tracking System (DARTS) User Manual, with respect to substance use disorder outpatient services, of requiring substance use treatment providers to close out a case if an individual does not receive an outpatient service for 30 days (the Division considers the person to have dropped out of treatment) is a barrier to reengaging in treatment and causes duplication of services upon reengagement. Beginning on the effective date of this amendatory Act of the 101st General Assembly, the Division of Substance Use Prevention and Recovery shall allow outpatient substance use treatment providers, if they choose to do so, keep a substance use treatment case open for at least 90 days when a person has not received a treatment service during such period to better foster reengaging in treatment. A person assessed to need Intensive Outpatient/Partial Hospitalization Level II care for substance use treatment shall be permitted to reach this level of care by the 6th week of treatment to enable them to gradually meet Level II service requirements. If anything in this Section causes a negative impact on Illinois' federal substance use block grant funding, this Section shall become inoperative.

Section 25. The Counties Code is amended by changing Section 5-1069.3 as follows:

(55 ILCS 5/5-1069.3)

Sec. 5-1069.3. Required health benefits. If a county, including a home rule county, is a self-insurer for purposes of providing health insurance coverage for its employees, the coverage shall include coverage for the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and 356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code. The coverage shall comply with Sections 155.22a, 355b, 356z.19, and 370c of the Illinois Insurance Code. The Department of Insurance shall enforce the requirements of this Section. The requirement that health benefits be covered as provided in this Section is an exclusive power and function of the State and is a denial and limitation under Article VII, Section 6, subsection (h) of the Illinois Constitution. A home rule county to which this Section applies must comply with every provision of this Section.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules; any purported rule not so adopted, for whatever reason, is unauthorized.

(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised 10-3-18.)

Section 30. The Illinois Municipal Code is amended by changing Section 10-4-2.3 as follows:

(65 ILCS 5/10-4-2.3)

Sec. 10-4-2.3. Required health benefits. If a municipality, including a home rule municipality, is a self-insurer for purposes of providing health insurance coverage for its employees, the coverage shall include coverage for the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and 356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code. The coverage shall comply with Sections 155.22a, 355b, 356z.19, and 370c of the Illinois Insurance Code. The Department of Insurance shall enforce the requirements of this Section. The requirement that health benefits be covered as provided in this is an exclusive power and function of the State and is a denial and limitation under Article VII, Section 6, subsection (h) of the Illinois Constitution. A home rule municipality to which this Section applies must comply with every provision of this Section.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules; any purported rule not so adopted, for whatever reason, is unauthorized.

(Source: P.A. 99-480, eff. 9-9-15; 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)

Section 35. The School Code is amended by changing Section 10-22.3f as follows:

(105 ILCS 5/10-22.3f)

Sec. 10-22.3f. Required health benefits. Insurance protection and benefits for employees shall provide the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, and 356z.26, and 356z.29, 356z.32, and 356z.33 of the Illinois Insurance Code. Insurance policies shall comply with Section 356z.19 of the Illinois Insurance Code. The coverage shall comply with Sections 155.22a, 355b, and 370c of the Illinois Insurance Code. The Department of Insurance shall enforce the requirements of this Section.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules; any purported rule not so adopted, for whatever reason, is unauthorized.

(Source: P.A. 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1024, eff. 1-1-19; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)

Section 40. The Illinois Insurance Code is amended by adding Section 356z.33 as follows:

(215 ILCS 5/356z.33 new)

Sec. 356z.33. Coverage of treatment models for early treatment of serious mental illnesses.

(a) For purposes of early treatment of a serious mental illness or serious emotional disturbance in a child or young adult under age 30, a group or individual policy of accident and health insurance, or managed care plan, that is amended, delivered, issued, or renewed after June 30, 2020 shall provide coverage of the following bundled, evidence-based treatment approaches for the purpose of early treatment of a serious mental illness or serious emotional disturbance:

(1) Coordinated specialty care for first episode psychosis treatment, covering the elements of the treatment model included in the most recent national research trials conducted by the National Institute of Mental Health in the Recovery After an Initial Schizophrenia Episode (RAISE) trials for psychosis or prodromal symptoms of psychosis resulting from a serious mental illness or serious emotional disturbance, but excluding the components of the treatment model related to education and employment support.

(2) Assertive community treatment (ACT) and community support team (CST) treatment, for purposes of early treatment of a serious mental illness or serious emotional disturbance. The elements of ACT and CST to be covered shall include those covered under Article V of the Illinois Public Aid Code, through 89 Ill. Adm. Code 140.453(d)(4).

(b) As used in this Section:

"Serious emotional disturbance" has the meaning as interpreted by the federal Substance Abuse and Mental Health Services Administration.

"Serious mental illness" has the meaning ascribed to that term in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.

(c) For purposes of credentialing the mental health professionals and other medical professionals that are part of a first episode psychosis treatment team, an ACT team, or a CST team the credentialing of the psychiatrist or the licensed clinical leader of the treatment team shall qualify all members of the treatment team to be credentialed with the insurer.

(d) Payment for the services performed under the treatment models listed in this Section shall be based on a bundled treatment model or payment, rather than payment for each separate service delivered by a treatment team member. By no later than 6 months after the effective date of this amendatory Act of the 101st General Assembly, the Department of Insurance shall convene a workgroup of Illinois insurance companies and Illinois mental health treatment providers that deliver the bundled treatment approaches listed in this Section to determine a coding solution that allows for these bundled treatment models to be coded and paid for as a bundle of services, similar to intensive outpatient treatment where multiple services are covered under one billing code or a bundled set of billing codes. The coding solution shall ensure that services delivered using first episode psychosis treatment, ACT, or CST are provided and billed as a bundled service, rather than for each individual service provided by a treatment team member, which would deconstruct the evidence-based practice. The coding solution shall be reached prior to coverage, which shall begin for plans amended, delivered, issued, or renewed after June 30, 2020, to ensure coverage of the treatment team approaches as intended by this Section.

(e) For purposes of determining medical necessity for the treatment approaches listed in this Section, neither disability nor functional impairment shall be a precondition to receive the treatment approach. The goal of coverage of these treatment approaches, as described in this Section, is early treatment to prevent the worsening of the serious mental illness or serious emotional disturbance. Medical necessity shall be presumed following a psychiatric hospitalization if one of the treatment approaches listed in this Section is recommended by a licensed physician, licensed clinical psychologist, licensed professional clinical counselor, or licensed clinical social worker.

(f) If, at any time, the Secretary of the United States Department of Health and Human Services, or its successor agency, adopts rules or regulations to be published in the Federal Register or publishes a comment in the Federal Register or issues an opinion, guidance, or other action that would require the State, under any provision of the Patient Protection and Affordable Care Act (P.L. 111-148), including, but not limited to, 42 U.S.C. 18031(d)(3)(b), or any successor provision, to defray the cost of any coverage for serious mental illnesses or serious emotional disturbances outlined in this Section, then the requirement that a group or individual policy of accident and health insurance or managed care plan cover the bundled treatment approaches listed in this Section is inoperative other than any such coverage authorized under Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and the State shall not assume any obligation for the cost of the coverage.

(g) After 5 years following full implementation of this Section, if requested by an insurer, the Department of Insurance shall contract with an independent third party with expertise in analyzing health insurance premiums and costs to perform an independent analysis of the impact coverage of the team-based treatment models listed in this Section has had on insurance premiums in Illinois. If premiums increased by more than 1% annually solely due to coverage of these treatment models, coverage of these models shall no longer be required.

Section 45. The Health Maintenance Organization Act is amended by changing Section 5-3 as follows:

(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)

Sec. 5-3. Insurance Code provisions.

(a) Health Maintenance Organizations shall be subject to the provisions of Sections 133, 134, 136, 137, 139, 140, 141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2, 355.3, 355b, 356g.5-1, 356m, 356v, 356w, 356x, 356y, 356z.2, 356z.4, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30, 356z.32, 356z.33, 364, 364.01, 367.2, 367.2-5, 367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1, paragraph (c) of subsection (2) of Section 367, and Articles IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.

(b) For purposes of the Illinois Insurance Code, except for Sections 444 and 444.1 and Articles XIII and XIII 1/2, Health Maintenance Organizations in the following categories are deemed to be "domestic companies":

(1) a corporation authorized under the Dental Service Plan Act or the Voluntary Health Services Plans Act;

(2) a corporation organized under the laws of this State; or

(3) a corporation organized under the laws of another state, 30% or more of the enrollees of which are residents of this State, except a corporation subject to substantially the same requirements in its state of organization as is a "domestic company" under Article VIII 1/2 of the Illinois Insurance Code.

(c) In considering the merger, consolidation, or other acquisition of control of a Health Maintenance Organization pursuant to Article VIII 1/2 of the Illinois Insurance Code,

(1) the Director shall give primary consideration to the continuation of benefits to enrollees and the financial conditions of the acquired Health Maintenance Organization after the merger, consolidation, or other acquisition of control takes effect;

(2)(i) the criteria specified in subsection (1)(b) of Section 131.8 of the Illinois Insurance Code shall not apply and (ii) the Director, in making his determination with respect to the merger, consolidation, or other acquisition of control, need not take into account the effect on competition of the merger, consolidation, or other acquisition of control;

(3) the Director shall have the power to require the following information:

(A) certification by an independent actuary of the adequacy of the reserves of the Health Maintenance Organization sought to be acquired;

(B) pro forma financial statements reflecting the combined balance sheets of the acquiring company and the Health Maintenance Organization sought to be acquired as of the end of the preceding year and as of a date 90 days prior to the acquisition, as well as pro forma financial statements reflecting projected combined operation for a period of 2 years;

(C) a pro forma business plan detailing an acquiring party's plans with respect to the operation of the Health Maintenance Organization sought to be acquired for a period of not less than 3 years; and

(D) such other information as the Director shall require.

(d) The provisions of Article VIII 1/2 of the Illinois Insurance Code and this Section 5-3 shall apply to the sale by any health maintenance organization of greater than 10% of its enrollee population (including without limitation the health maintenance organization's right, title, and interest in and to its health care certificates).

(e) In considering any management contract or service agreement subject to Section 141.1 of the Illinois Insurance Code, the Director (i) shall, in addition to the criteria specified in Section 141.2 of the Illinois Insurance Code, take into account the effect of the management contract or service agreement on the continuation of benefits to enrollees and the financial condition of the health maintenance organization to be managed or serviced, and (ii) need not take into account the effect of the management contract or service agreement on competition.

(f) Except for small employer groups as defined in the Small Employer Rating, Renewability and Portability Health Insurance Act and except for medicare supplement policies as defined in Section 363 of the Illinois Insurance Code, a Health Maintenance Organization may by contract agree with a group or other enrollment unit to effect refunds or charge additional premiums under the following terms and conditions:

(i) the amount of, and other terms and conditions with respect to, the refund or additional premium are set forth in the group or enrollment unit contract agreed in advance of the period for which a refund is to be paid or additional premium is to be charged (which period shall not be less than one year); and

(ii) the amount of the refund or additional premium shall not exceed 20% of the Health Maintenance Organization's profitable or unprofitable experience with respect to the group or other enrollment unit for the period (and, for purposes of a refund or additional premium, the profitable or unprofitable experience shall be calculated taking into account a pro rata share of the Health Maintenance Organization's administrative and marketing expenses, but shall not include any refund to be made or additional premium to be paid pursuant to this subsection (f)). The Health Maintenance Organization and the group or enrollment unit may agree that the profitable or unprofitable experience may be calculated taking into account the refund period and the immediately preceding 2 plan years.

The Health Maintenance Organization shall include a statement in the evidence of coverage issued to each enrollee describing the possibility of a refund or additional premium, and upon request of any group or enrollment unit, provide to the group or enrollment unit a description of the method used to calculate (1) the Health Maintenance Organization's profitable experience with respect to the group or enrollment unit and the resulting refund to the group or enrollment unit or (2) the Health Maintenance Organization's unprofitable experience with respect to the group or enrollment unit and the resulting additional premium to be paid by the group or enrollment unit.

In no event shall the Illinois Health Maintenance Organization Guaranty Association be liable to pay any contractual obligation of an insolvent organization to pay any refund authorized under this Section.

(g) Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules; any purported rule not so adopted, for whatever reason, is unauthorized.

(Source: P.A. 99-761, eff. 1-1-18; 100-24, eff. 7-18-17; 100-138, eff. 8-18-17; 100-863, eff. 8-14-18; 100-1026, eff. 8-22-18; 100-1057, eff. 1-1-19; 100-1102, eff. 1-1-19; revised 10-4-18.)

Section 50. The Illinois Public Aid Code is amended by changing Section 5-5.23 and by adding Sections 5-36, 5-37, 5-38, and 5-39 as follows:

(305 ILCS 5/5-5.23)

Sec. 5-5.23. Children's mental health services.

(a) The Department of Healthcare and Family Services, by rule, shall require the screening and assessment of a child prior to any Medicaid-funded admission to an inpatient hospital for psychiatric services to be funded by Medicaid. The screening and assessment shall include a determination of the appropriateness and availability of out-patient support services for necessary treatment. The Department, by rule, shall establish methods and standards of payment for the screening, assessment, and necessary alternative support services.

(b) The Department of Healthcare and Family Services, to the extent allowable under federal law, shall secure federal financial participation for Individual Care Grant expenditures made by the Department of Healthcare and Family Services for the Medicaid optional service authorized under Section 1905(h) of the federal Social Security Act, pursuant to the provisions of Section 7.1 of the Mental Health and Developmental Disabilities Administrative Act. The Department of Healthcare and Family Services may exercise the authority under this Section as is necessary to administer Individual Care Grants as authorized under Section 7.1 of the Mental Health and Developmental Disabilities Administrative Act.

(c) The Department of Healthcare and Family Services shall work collaboratively with the Department of Children and Family Services and the Division of Mental Health of the Department of Human Services to implement subsections (a) and (b).

(d) On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e.

(e) All rights, powers, duties, and responsibilities currently exercised by the Department of Human Services related to the Individual Care Grant program are transferred to the Department of Healthcare and Family Services with the transfer and transition of the Individual Care Grant program to the Department of Healthcare and Family Services to be completed and implemented within 6 months after the effective date of this amendatory Act of the 99th General Assembly. For the purposes of the Successor Agency Act, the Department of Healthcare and Family Services is declared to be the successor agency of the Department of Human Services, but only with respect to the functions of the Department of Human Services that are transferred to the Department of Healthcare and Family Services under this amendatory Act of the 99th General Assembly.

(1) Each act done by the Department of Healthcare and Family Services in exercise of the transferred powers, duties, rights, and responsibilities shall have the same legal effect as if done by the Department of Human Services or its offices.

(2) Any rules of the Department of Human Services that relate to the functions and programs transferred by this amendatory Act of the 99th General Assembly that are in full force on the effective date of this amendatory Act of the 99th General Assembly shall become the rules of the Department of Healthcare and Family Services. All rules transferred under this amendatory Act of the 99th General Assembly are hereby amended such that the term "Department" shall be defined as the Department of Healthcare and Family Services and all references to the "Secretary" shall be changed to the "Director of Healthcare and Family Services or his or her designee". As soon as practicable hereafter, the Department of Healthcare and Family Services shall revise and clarify the rules to reflect the transfer of rights, powers, duties, and responsibilities affected by this amendatory Act of the 99th General Assembly, using the procedures for recodification of rules available under the Illinois Administrative Procedure Act, except that existing title, part, and section numbering for the affected rules may be retained. The Department of Healthcare and Family Services, consistent with its authority to do so as granted by this amendatory Act of the 99th General Assembly, shall propose and adopt any other rules under the Illinois Administrative Procedure Act as necessary to administer the Individual Care Grant program. These rules may include, but are not limited to, the application process and eligibility requirements for recipients.

(3) All unexpended appropriations and balances and other funds available for use in connection with any functions of the Individual Care Grant program shall be transferred for the use of the Department of Healthcare and Family Services to operate the Individual Care Grant program. Unexpended balances shall be expended only for the purpose for which the appropriation was originally made. The Department of Healthcare and Family Services shall exercise all rights, powers, duties, and responsibilities for operation of the Individual Care Grant program.

(4) Existing personnel and positions of the Department of Human Services pertaining to the administration of the Individual Care Grant program shall be transferred to the Department of Healthcare and Family Services with the transfer and transition of the Individual Care Grant program to the Department of Healthcare and Family Services. The status and rights of Department of Human Services employees engaged in the performance of the functions of the Individual Care Grant program shall not be affected by this amendatory Act of the 99th General Assembly. The rights of the employees, the State of Illinois, and its agencies under the Personnel Code and applicable collective bargaining agreements or under any pension, retirement, or annuity plan shall not be affected by this amendatory Act of the 99th General Assembly. All transferred employees who are members of collective bargaining units shall retain their seniority, continuous service, salary, and accrued benefits.

(5) All books, records, papers, documents, property (real and personal), contracts, and pending business pertaining to the powers, duties, rights, and responsibilities related to the functions of the Individual Care Grant program, including, but not limited to, material in electronic or magnetic format and necessary computer hardware and software, shall be delivered to the Department of Healthcare and Family Services; provided, however, that the delivery of this information shall not violate any applicable confidentiality constraints.

(6) Whenever reports or notices are now required to be made or given or papers or documents furnished or served by any person to or upon the Department of Human Services in connection with any of the functions transferred by this amendatory Act of the 99th General Assembly, the same shall be made, given, furnished, or served in the same manner to or upon the Department of Healthcare and Family Services.

(7) This amendatory Act of the 99th General Assembly shall not affect any act done, ratified, or canceled or any right occurring or established or any action or proceeding had or commenced in an administrative, civil, or criminal cause regarding the Department of Human Services before the effective date of this amendatory Act of the 99th General Assembly; and those actions or proceedings may be defended, prosecuted, and continued by the Department of Human Services.

(f) (Blank). The Individual Care Grant program shall be inoperative during the calendar year in which implementation begins of any remedies in response to litigation against the Department of Healthcare and Family Services related to children's behavioral health and the general status of children's behavioral health in this State. Individual Care Grant recipients in the program the year it becomes inoperative shall continue to remain in the program until it is clinically appropriate for them to step down in level of care.

(g) Family Support Program. As Illinois' sole program for children and young adults with high mental health needs regardless of their source of health insurance (such as Medicaid or private insurance) the Department of Healthcare and Family Services shall restructure the Family Support Program, formerly known as the Individual Care Grant program, to: (i) enable early treatment of a child or young adult with serious mental health needs; (ii) align the program with system of care principles where a set of services, as outlined in this Section, are available to the child or young adult, and his or her family, to meet the needs of the child and the family; and (iii) include both community-based and residential treatment services. As part of a system of care approach, the following shall be hallmarks of the Family Support Program:

(1) The treatment and support services available to the child or young adult, and the family, shall be based on a comprehensive mental and behavioral health needs assessment, including substance use treatment needs, of the child or young adult.

(2) Community-based, wrap-around services, including team-based psychosocial treatment approaches, and substance use treatment, shall be available early on in the child or young adult's condition to enable early treatment and wellness.

(3) Strong interagency collaboration between all the State agencies the family is involved with for services, including the Department of Healthcare and Family Services, the Department of Human Services, the Department of Public Health, the Department of Children and Family Services, the Department of Juvenile Justice, and the Illinois State Board of Education, given that multiple treatment providers and public and private agencies are often involved with the child or young adult.

(4) Individualized, strengths-based practices and trauma-informed treatment approaches.

(5) Full participation of the family at all levels of treatment through a Child and Family Team using a process that is family-centered and child-focused as part of the wrap-around planning for determining services and supports necessary to stabilize the child or young adult, and the family, to enable wellness and recovery. This planning process must include consideration of the services and supports the parent or caregivers might need for family stabilization, and must assist in making connections to services based on the insurance coverage of the adult family members or caregivers.

(h) Maximizing federal Medicaid matching dollars for the Family Support Program. The Department of Healthcare and Family Services, as the sole Medicaid State agency, shall apply to the federal Centers for Medicare and Medicaid Services within 6 months after the effective date of this amendatory Act of the 101st General Assembly for an Illinois Title XIX State Plan amendment under Section 1915(i) of the Social Security Act or a Home and Community-Based Services Waiver to draw additional federal Medicaid matching funds for services provided through the Family Support Program for children and young adults who do not otherwise meet the eligibility criteria for Medicaid coverage. If federal approval is granted, the Department of Healthcare and Family Services shall file any rule necessary for implementation of this subsection within 3 months after receiving federal approval.

(i) Family Support Program; eligibility. A child or young adult under the age of 26 who (i) has a primary mental health diagnosis from the most current edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association or the International Statistical Classification of Diseases and Related Health Problems published by the World Health Organization, or (ii) has a serious emotional disturbance, excluding those with a primary diagnosis of an intellectual or a developmental disability or a learning disability shall be eligible for services under the Family Support Program, including community-based wrap-around services, if the child's or young adult's diagnosed condition prevents him or her from functioning in at least 2 of the following domains: age-appropriate self-care, family life, education or work, community living, or social/peer relationships. Psychosis shall not be required to be eligible for services under the Family Support Program.

(1) Presumptive eligibility. A child or young adult, including a former youth in care, under the age of 26 shall have presumptive eligibility under the Family Support Program following 3 psychiatric inpatient hospital admissions within a 12-month period regardless of whether there is a diagnosis of a serious mental illness or serious emotional disturbance, as it is not uncommon for children and young adults with serious mental health needs to not have a diagnosed condition, particularly for children that experienced trauma at an early age.

(2) Maximizing private and public insurance coverage. A family or young adult with private insurance coverage shall work with the Department of Healthcare and Family Services to maximize insurance coverage for any and all benefits covered by his or her health plan. If the Department of Healthcare and Family Services has a concern relating to the family's insurer's compliance with State or federal insurance requirements relating to the child's coverage of mental health or substance use disorders, the Department shall refer all relevant information to the applicable regulatory authority. A family or young adult with Medicaid coverage shall maximize the use of their Medicaid coverage for treatment services.

(3) Family involvement. While parental, guardian, or caregiver involvement shall be highly encouraged for children and young adults in the Family Support Program, for young adults age 18 up to age 26, parental, caregiver, or guardian involvement in their care shall be encouraged but not required to receive services through the Family Support Program.

(4) Notification of presumptive eligibility. By no later than 6 months after the effective date of this amendatory Act of the 101st General Assembly, the Department of Healthcare and Family Services, with meaningful stakeholder input from psychiatric hospitals, community providers, and advocates, shall be responsible for developing a process in which (i) the parents, guardian, or caregiver of a child or young adult, or a young adult age 18 or older directly, meeting the presumptive eligibility criteria are notified of presumptive eligibility for the Family Support Program; or (ii) the parents, guardian, or caregiver, or the young adult age 18 or older directly, is provided with information on the criteria for meeting presumptive eligibility, prior to hospital discharge to enable early connection to treatment following hospitalization. The Department of Healthcare and Family Services shall take into account that young adults without parental involvement are eligible for the Family Support Program and shall consider their needs and their ability (or inability) to apply in developing a process for entry into the Family Support Program through presumptive eligibility.

(5) Appropriation. This subsection shall be limited by the State's annual appropriation to the Family Support Program. Annual program expenditures shall not exceed the State's appropriation to the Family Support Program for that year.

(j) Family Support Program services. Services provided under the Family Support Program shall include the following irrespective of the type of insurance coverage of the child or young adult:

(1) All community-based mental health services covered under the Medical Assistance Program (whether in the Illinois Title XIX State Plan or covered through a waiver), including all team-based services and care and case management services, and all the services included in 89 Ill. Adm. Code 140.453 and 140.454.

(2) All community-based substance use treatment services covered under the Medical Assistance Program, whether covered by the Illinois Title XIX State Plan or by a federal waiver.

(3) Mental health residential treatment covered by the Family Support Program shall include treatment in a live-in therapeutic residential facility for children and young adults up to age 21. For youth and young adults 18 years of age or older (up to age 26) who need ongoing housing and treatment support to maintain recovery and gain independence, this level of treatment shall be provided using an age-appropriate supportive housing model through which the Family Support Program pays for housing support in the community mirroring the Division of Mental Health's Bridge Subsidy Program in existence on the effective date of this amendatory Act of the 101st General Assembly, combined with community-based mental health and substance use treatment services. The Department of Healthcare and Family Services, with meaningful stakeholder input from providers and advocates, shall file an amendment to 89 Ill. Adm. Code 139 for purposes of implementing an age-appropriate supportive housing model through the Family Support Program, consistent with subparagraphs (A) and (B) within 6 months after the effective date of this amendatory Act of the 101st General Assembly.

(A) For young adults receiving Family Support Program residential treatment services in a live-in, therapeutic residential treatment facility who reach age 21 but who continue to need residential and treatment support to maintain recovery and gain independence based on the recommendation of a licensed practitioner of the healing arts based on the results of the youths' comprehensive mental health needs assessment, these youth shall be transitioned into the community using an age-appropriate supportive housing model outlined in this Section. The transition period to supportive housing for these young adults shall begin no later than 6 months prior to transition to the community to enable sufficient time to locate appropriate, safe housing and make the transition without disrupting the treatment and care for the young adult. A young adult transitioning to a supportive housing model from a residential treatment facility through the Family Support Program shall not stay in the supportive housing model beyond 2 years. A young adult transitioning from a residential treatment facility or from supportive housing through the Family Support Program shall be eligible for community-based services through the Family Support Program to support his or her recovery and wellness up to age 26 based on his or her level of need using a comprehensive mental and behavioral health needs assessment.

(B) If a young adult age 21 or older comes into the Family Support Program for services and residential treatment and is recommended by a licensed practitioner of the healing arts based on the results of the comprehensive mental health needs assessment, that young adult shall be provided treatment using an age-appropriate supportive housing model outlined in this Section. For such youth, his or her length of stay in supportive housing through the Family Support Program shall not exceed 2 years in total. A young adult age 21, up to age 26, transitioning from supportive housing through the Family Support Program shall be eligible for community-based services through the Family Support Program to support the young adult's recovery and wellness up to age 26 based on his or her level of need using a comprehensive mental and behavioral health needs assessment. A young adult coming into the Family Support Program who is age 21 or older who needs only community-based mental health and substance use treatment services shall be eligible for the level of care the young adult needs based on his or her comprehensive mental and behavioral health needs assessment up to age 26.

(C) The amount of Family Support Program funding available for supportive housing services for young adults age 21 up to age 26 shall not exceed one-quarter of the annual appropriation made to the Family Support Program.

(D) The Department of Healthcare and Family Services shall develop a new level of therapeutic residential treatment for children or young adults under age 21 with high-acuity residential treatment needs but who are no longer appropriate for hospitalization. This level of care shall be equivalent to, and mirror, Medicaid psychiatric residential treatment facilities for children to ensure that when Illinois develops Medicaid-covered psychiatric residential treatment facilities, these facilities will qualify for federal Medicaid matching dollars as psychiatric residential treatment facilities for the Medicaid population. With meaningful input from stakeholders, including mental health residential treatment providers, the Department of Healthcare and Family Services shall determine the staffing needs of treatment providers to safely provide this level of care, and any infrastructure modifications needed to accommodate this level of care, and shall develop the reimbursement rate that covers the full cost to provide this level of care and shall provide for reimbursement for necessary infrastructure investments. This level of care shall be developed within 3 months after the effective date of this amendatory Act of the 101st General Assembly to alleviate the crisis of children remaining in psychiatric hospitals beyond medical necessity. The amount of the annual appropriation made to the Family Support Program that is spent on the high-acuity residential treatment outlined in this subparagraph shall not exceed 12% of that appropriation amount. Using Medicaid claims data over the last 5 years, the Department of Healthcare and Family Services shall assess the estimated number of these high-acuity residential treatment beds that are needed in each region of the State based on the number of children remaining in psychiatric hospitals beyond medical necessity and the number of children placed out-of-state who need this level of care. The Department of Healthcare and Family Services shall report the results of this assessment to the General Assembly by no later than June 30, 2020.

(4) Short-term, 90-day therapeutic crisis beds for children or young adults under age 21 who are at-risk of longer-term residential treatment shall be developed by the Department of Healthcare and Family Services. These crisis beds shall not diminish the existing residential treatment bed capacity in each region of the State. This level of care and the reimbursement rates shall be developed by the Department of Healthcare and Family Services within 3 months after the effective date of this amendatory Act of the 101st General Assembly to alleviate the crisis of children remaining in psychiatric hospitals beyond medical necessity.

(5) Supported education and employment services. To assist children or young adults in recovery, and to help them to remain in school or working so they can acquire the skills needed to become independent adults, Family Support Program services shall include supported education and employment services. The Department of Healthcare and Family Services shall adjust the Family Support Program rates upward to cover the cost of supported education and employment services. These services shall be available when recommended by a licensed practitioner of the healing arts based on the results of the comprehensive mental health needs assessment of the child or young adult.

(k) Consistent reimbursement rates. At a minimum, reimbursement rates in effect at the time of the service for community-based services shall be the rate paid to providers of Family Support Program services for the services covered by the Medical Assistance Program either under the Illinois Title XIX State Plan or through a federal waiver whether or not the child or young adult is covered under the Medical Assistance Program.

(l) Service eligibility. Consistent with system of care principles, a child or young adult in the Family Support Program shall be eligible to receive a mental health or substance use treatment service covered by the Family Support Program in accordance with this Section if it is recommended by a licensed practitioner of the healing arts based on the results of a comprehensive behavioral health needs assessment of the child or young adult whether or not the child or young adult is in a Medicaid managed care plan. Because children and young adults with serious mental health conditions typically need treatment for several months to stabilize their condition, the initial prior authorization for all team-based treatment (such as assertive community treatment or community support treatment) or residential treatment shall last for 6 months whether or not the child or young adult is in a Medicaid managed care plan. Following the first 6 months of team-based treatment or residential treatment, prior authorization shall not be required more frequently than quarterly, whether or not the child or young adult is in a Medicaid managed care plan. Mental and behavioral health assessments, treatment plans and treatment plan updates, and related reporting and documentation shall occur no more frequently than what is clinically appropriate. In determining the required frequency of assessments, treatment plans, and treatment plan updates, the Department of Healthcare and Family Services shall consider the frequency of such steps in the treatment process for other similar chronic medical conditions such as for diabetes.

(m) Streamlined application. The Department of Healthcare and Family Services shall revise the Family Support Program application and the application process to reflect the changes made to this Section by this amendatory Act of the 101st General Assembly consistent with the implementation timelines contained in this Section. For a child and young adult meeting the presumptive eligibility requirements, the Department of Healthcare and Family Services shall develop an application that is no longer than 2 pages that enables the family or young adult to demonstrate that they have met the presumptive eligibility standards set forth in this Section without undue burden or cost to ensure prompt access to treatment through the Family Support Program immediately following psychiatric hospitalization (services established or a treatment placement within 30 days following psychiatric hospital discharge).

(n) Services provided to Family Support Program youth during unplanned absences. Reimbursement for Family Support Program services, including transitional care services, intensive case management, and other services, delivered during unplanned absences from residential treatment (including under a supportive housing model) due to hospitalization, justice system involvement, or running away shall mirror the policies in place on January 1, 2018 for reimbursement of residential treatment provided through the Department of Children and Family Services, given the similarities between the 2 populations and the severity of the illnesses these children or youth have.

(o) Family Support Program public awareness and educational campaign for all relevant providers. To ensure widespread knowledge about the availability of the Family Support Program for families in need of treatment services for children with significant mental health needs, or for young adults who do not have an involved parent or caregiver, the Department of Healthcare and Family Services shall engage in a public awareness campaign to educate hospitals with psychiatric units, crisis response providers (such as SASS and CCBYS agencies), schools, and other community institutions and providers across Illinois on the changes to the Family Support Program made by this amendatory Act of the 101st General Assembly, how eligibility has changed, and how families and young adults in need of treatment can apply. The Department of Healthcare and Family Services shall produce written materials geared for the appropriate target audience, develop webinars, and conduct outreach visits over a one-year period beginning in September 2019.

(p) Notwithstanding any other provision of law, annual appropriations made to the Family Support Program, including unspent or lapsed Family Support Program funds, shall not be subject to fund sweeps, administrative charges or chargebacks, or any other fiscal or budgetary maneuver that would in any way transfer any funds appropriated for Family Support Program services into any other fund of the State.

(q) Outcomes and data on the Family Support Program. Beginning in 2021, the Department of Healthcare and Family Services shall submit an annual report to the General Assembly that includes the following information with respect to the time period covered by the report:

(1) The number and ages of the children and young adults who requested services under the Family Support Program, the services requested, and the services received.

(2) The number and ages of the children and young adults who requested services under the Family Support Program and were presumptively eligible for services in accordance with this Section.

(3) The length of time between application and assessment, and between assessment and the provision of Family Support Program services consistent with the assessed need, broken down by (i) the needed level of care, (ii) the age of the child or young adult, and (iii) whether or not the child or young adult had presumptive eligibility.

(4) The number and ages of the children or young adults who applied for Family Support Program services but did not receive any services, or did not receive the level of care identified as appropriate by the assessment, and the reason why services, or the appropriate services, were not provided.

(r) Rulemaking authority. Unless otherwise specified, this Section takes effect on the effective date of this amendatory Act of the 101st General Assembly. Unless a timeline is otherwise specified in a subsection, if amendments to 89 Ill. Adm. Code 139 are needed for implementation of this Section, such amendments shall be filed by the Department of Healthcare and Family Services within 6 months after the effective date of this amendatory Act of the 101st General Assembly. The Department may adopt rules necessary to implement this Section through the use of emergency rulemaking in accordance with Section 5-45 of the Illinois Administrative Procedure Act. For purposes of that Act, the General Assembly finds that the adoption of rules to implement this Section is deemed an emergency and necessary for the public interest, safety, and welfare.

(Source: P.A. 99-479, eff. 9-10-15.)

(305 ILCS 5/5-36 new)

Sec. 5-36. In-Home Therapy Pilot Program for children and youth.

(a) Within 6 months after the effective date of this amendatory Act of the 101st General Assembly, the Department of Healthcare and Family Services shall submit an application to the federal Centers for Medicare and Medicaid Services for Medicaid coverage through its existing 1115 waiver, or through a separate federal waiver or Illinois Title XIX State Plan amendment, for an In-Home Therapy Pilot Program for children or youth under age 21 to be provided in their parent's, guardian's, or caregiver's home, or at any other community or natural setting including school or child care. The purpose of the In-Home Therapy Pilot Program shall be to ameliorate the child or youth's mental health issues, and strengthen the family structures and supports. Hallmarks of in-home therapy, to be provided by a clinician, with the support of a paraprofessional, shall include or allow for each the following of the following:

(1) 24 hours a day, 7 days a week response capability by the provider.

(2) The frequency and duration of the visit will match the need and not be time-limited.

(3) Intensive family therapy that includes working with the child or family, including understanding the family dynamics, possible safety concerns, and seeking to teach strategies that address stressors that may arise in the process. Intensive family therapy may include sessions without the presence of the child in order to assist in strengthening parenting skills that are related to the child's mental health needs.

(4) Coaching in support of decision-making in both crisis and non-crisis situations.

(5) Skills training for the youth or the youth's parent, guardian, or caregiver.

The In-Home Therapy Pilot Program shall require a showing of medical necessity based on a comprehensive behavioral health assessment. Medical necessity shall not require a more stringent test than that the child or youth's clinical condition warrants in-home therapy in order to: (i) enhance problem-solving, limit-setting, risk management or safety planning, and communication; (ii) advance the therapeutic goals or improve ineffective patterns of interaction; and (iii) build skills to strengthen the parent's or caregiver's ability to sustain the child or youth in the home setting or to prevent the need for more intensive levels of service such as inpatient hospitalization or other out-of-home behavioral health treatment services.

(b) The Department of Healthcare and Family Services shall establish a rule for implementation of the In-Home Therapy Pilot Program within 6 months after receiving federal approval for Medicaid coverage for in-home therapy services. In-home therapy services shall not become a Medicaid-covered service unless federal financial participation is provided. Upon federal approval of Medicaid coverage for in-home therapy services and upon approval by the Joint Committee on Administrative Rules of a final rule for purposes of implementing the In-Home Therapy Pilot Program, in-home therapy services shall also be covered by the Family Support Program.

(305 ILCS 5/5-37 new)

Sec. 5-37. Education on mental health and substance use treatment services for children and young adults. The Department of Healthcare and Family Services shall contract with a third party with marketing and communications expertise to develop a layman's guide to the mental health and substance use treatment services available in Illinois through the Medical Assistance Program and through the Family Support Program, or other publicly funded programs, similar to what Massachusetts developed, to help families understand what services are available to them when they have a child in need of treatment or support. The guide shall be in easy-to-understand language, be prominently available the Department of Healthcare and Family Services' website, and be part of a statewide communications campaign to ensure families are aware of Family Support Program services. It shall briefly explain the service and whether it is covered by the Medical Assistance Program, the Family Support Program, or any other public funding source. Within one year after the effective date of this amendatory Act of the 101st General Assembly, the Department of Healthcare and Family Services shall complete this guide, have it available on its website, and launch the communications campaign. The Department of Healthcare and Family Services shall remove the requirement for family leadership councils under each Medicaid managed care organization and shall instead update this guide periodically as programs and services change or are added. Within 6 months after the effective date of this amendatory Act of the 101st General Assembly, the Department of Healthcare and Family Services shall develop and fund family leadership councils, or similar family-run organizations, regionally across Illinois, with a separate statewide Family Leadership Council made up of representatives from each regional council. These family leadership councils or similar family-run organizations shall help families gain the education and knowledge on available mental health and substance use treatment services available for children and young adults. The family leadership councils or similar family-run organizations established shall have input on the development of the layman's guide in accordance with this Section to ensure it is understandable for parents.

(305 ILCS 5/5-38 new)

Sec. 5-38. Billing mechanism for preventive mental health services delivered to children.

(a) The General Assembly finds:

(1) It is common for children to have mental health needs but to not have a full-blown diagnosis of a mental illness. Examples include, but are not limited to, children who have mild or emerging symptoms of a mental health condition (such as meeting some but not all the criteria for a diagnosis, including, but not limited to, symptoms of depression, attentional deficits, anxiety or prodromal symptoms of bipolar disorder or schizophrenia); cutting or engaging in other forms of self-harm; or experiencing violence or trauma).

(2) The federal requirement that Medicaid-covered children have access to Early and Periodic Screening, Diagnostic and Treatment services includes ensuring that Medicaid-covered children who have a mental health need but do not have a mental health diagnosis have access to treatment.

(3) The Department of Healthcare and Family Services' existing policy acknowledges this federal requirement by allowing for Medicaid billing for mental health services for children who have a need for services but who do not have a mental health diagnosis in Section 207.3.3 of the Community-Based Behavioral Services Provider Handbook. However, the current policy of the Department of Healthcare and Family Services requires clinicians to specify a diagnosis code and make a notation in the child's medical record that the service is preventive. This effectively requires the clinician to associate a diagnosis with the child and is a major barrier for services because many clinicians rightly are unwilling to document a mental health diagnosis in the medical record when a diagnosis is not medically appropriate.

(b) Consistent with the existing policy of the Department of Healthcare and Family Services and the federal Early and Periodic Screening, Diagnostic and Treatment requirement, within 6 months after the effective date of this amendatory Act of the 101st General Assembly, the Department of Healthcare and Family Services, with meaningful stakeholder input, shall develop and implement a medically appropriate and practical service coding solution that enables mental health providers and professionals to deliver and get paid for the appropriate level of mental health service to a child under age 21 who is enrolled in the Medical Assistance Program and has a mental health need but does not have a mental health diagnosis to prevent or preempt the development of a serious mental health condition. To ensure the solution makes sense in practice (and addresses the concern of inappropriately associating a diagnosis with a child, or exposing the provider to a federal Medicaid audit risk), the Department of Healthcare and Family Services shall convene a working group that includes children's mental health providers to receive input on recommendations for a solution prior to developing the service code to ensure the solution works in practice and does not deter clinicians from delivering prevention and early treatment to children with mental health needs but who do not have a diagnosed mental illness. The Department of Healthcare and Family Services shall meet with this working group at least 4 times prior to developing the service coding solution. The service coding solution developed in accordance with this Section shall enable and allow for mental health services for a child without a mental health diagnosis for purposes of prevention and early treatment when recommended by a licensed practitioner of the healing arts. For a low-intensity service, such as therapy, neither prior authorization nor a comprehensive mental health needs assessment shall be required to receive these services whether or not the child is enrolled in a Medicaid managed care plan. If the Department of Healthcare and Family Services determines that an Illinois Title XIX State Plan amendment is necessary to implement this Section, the State Plan amendment shall be filed with the federal Centers for Medicare and Medicaid Services by no later than 6 months after the effective date of this amendatory Act of the 101st General Assembly. If rulemaking is required to implement this Section, the rule shall be filed by the Department of Healthcare and Family Services with the Joint Committee on Administrative Rules by no later than 6 months after the effective date of this amendatory Act of the 101st General Assembly, and if federal approval is required, within 3 months after federal approval.

(305 ILCS 5/5-39 new)

Sec. 5-39. Alignment of children's mental health treatment systems. As Illinois begins to plan for implementation of the federal Family First Prevention Services Act, the establishment of psychiatric residential treatment facilities, and the implementation of the N.B. Consent Decree, the Governor's Office shall establish, convene, and lead a working group that includes the Director of Healthcare and Family Services, the Secretary of Human Services, the Director of Public Health, the Director of Children and Family Services, the Director of Juvenile Justice, the State Superintendent of Education, and the appropriate agency staff who will be responsible for implementation or oversight of these services. The working group shall meet at least quarterly to foster interagency collaboration and work toward aligning these services and programs, including provider requirements to deliver these services and the outcomes they must meet, in order to (i) create one children's mental health system that is consistent with system of care principles and that spans across State agencies, rather than separate siloed systems with different requirements, rates, and administrative processes and standards; and (ii) prevent out-of-home placements where possible.

Section 55. The Adoption Act is amended by changing Sections 1 and 18.9 as follows:

(750 ILCS 50/1) (from Ch. 40, par. 1501)

Sec. 1. Definitions. When used in this Act, unless the context otherwise requires:

A. "Child" means a person under legal age subject to adoption under this Act.

B. "Related child" means a child subject to adoption where either or both of the adopting parents stands in any of the following relationships to the child by blood, marriage, adoption, or civil union: parent, grand-parent, great-grandparent, brother, sister, step-parent, step-grandparent, step-brother, step-sister, uncle, aunt, great-uncle, great-aunt, first cousin, or second cousin. A person is related to the child as a first cousin or second cousin if they are both related to the same ancestor as either grandchild or great-grandchild. A child whose parent has executed a consent to adoption, a surrender, or a waiver pursuant to Section 10 of this Act or whose parent has signed a denial of paternity pursuant to Section 12 of the Vital Records Act or Section 12a of this Act, or whose parent has had his or her parental rights terminated, is not a related child to that person, unless (1) the consent is determined to be void or is void pursuant to subsection O of Section 10 of this Act; or (2) the parent of the child executed a consent to adoption by a specified person or persons pursuant to subsection A-1 of Section 10 of this Act and a court of competent jurisdiction finds that such consent is void; or (3) the order terminating the parental rights of the parent is vacated by a court of competent jurisdiction.

C. "Agency" for the purpose of this Act means a public child welfare agency or a licensed child welfare agency.

D. "Unfit person" means any person whom the court shall find to be unfit to have a child, without regard to the likelihood that the child will be placed for adoption. The grounds of unfitness are any one or more of the following, except that a person shall not be considered an unfit person for the sole reason that the person has relinquished a child in accordance with the Abandoned Newborn Infant Protection Act:

(a) Abandonment of the child.

(a-1) Abandonment of a newborn infant in a hospital.

(a-2) Abandonment of a newborn infant in any setting where the evidence suggests that the parent intended to relinquish his or her parental rights.

(b) Failure to maintain a reasonable degree of interest, concern or responsibility as to the child's welfare.

(c) Desertion of the child for more than 3 months next preceding the commencement of the Adoption proceeding.

(d) Substantial neglect of the child if continuous or repeated.

(d-1) Substantial neglect, if continuous or repeated, of any child residing in the household which resulted in the death of that child.

(e) Extreme or repeated cruelty to the child.

(f) There is a rebuttable presumption, which can be overcome only by clear and convincing evidence, that a parent is unfit if:

(1) Two or more findings of physical abuse have been entered regarding any children under Section 2-21 of the Juvenile Court Act of 1987, the most recent of which was determined by the juvenile court hearing the matter to be supported by clear and convincing evidence; or

(2) The parent has been convicted or found not guilty by reason of insanity and the conviction or finding resulted from the death of any child by physical abuse; or

(3) There is a finding of physical child abuse resulting from the death of any child under Section 2-21 of the Juvenile Court Act of 1987.

No conviction or finding of delinquency pursuant to Article V of the Juvenile Court Act of 1987 shall be considered a criminal conviction for the purpose of applying any presumption under this item (f).

(g) Failure to protect the child from conditions within his environment injurious to the child's welfare.

(h) Other neglect of, or misconduct toward the child; provided that in making a finding of unfitness the court hearing the adoption proceeding shall not be bound by any previous finding, order or judgment affecting or determining the rights of the parents toward the child sought to be adopted in any other proceeding except such proceedings terminating parental rights as shall be had under either this Act, the Juvenile Court Act or the Juvenile Court Act of 1987.

(i) Depravity. Conviction of any one of the following crimes shall create a presumption that a parent is depraved which can be overcome only by clear and convincing evidence: (1) first degree murder in violation of paragraph 1 or 2 of subsection (a) of Section 9-1 of the Criminal Code of 1961 or the Criminal Code of 2012 or conviction of second degree murder in violation of subsection (a) of Section 9-2 of the Criminal Code of 1961 or the Criminal Code of 2012 of a parent of the child to be adopted; (2) first degree murder or second degree murder of any child in violation of the Criminal Code of 1961 or the Criminal Code of 2012; (3) attempt or conspiracy to commit first degree murder or second degree murder of any child in violation of the Criminal Code of 1961 or the Criminal Code of 2012; (4) solicitation to commit murder of any child, solicitation to commit murder of any child for hire, or solicitation to commit second degree murder of any child in violation of the Criminal Code of 1961 or the Criminal Code of 2012; (5) predatory criminal sexual assault of a child in violation of Section 11-1.40 or 12-14.1 of the Criminal Code of 1961 or the Criminal Code of 2012; (6) heinous battery of any child in violation of the Criminal Code of 1961; or (7) aggravated battery of any child in violation of the Criminal Code of 1961 or the Criminal Code of 2012.

There is a rebuttable presumption that a parent is depraved if the parent has been criminally convicted of at least 3 felonies under the laws of this State or any other state, or under federal law, or the criminal laws of any United States territory; and at least one of these convictions took place within 5 years of the filing of the petition or motion seeking termination of parental rights.

There is a rebuttable presumption that a parent is depraved if that parent has been criminally convicted of either first or second degree murder of any person as defined in the Criminal Code of 1961 or the Criminal Code of 2012 within 10 years of the filing date of the petition or motion to terminate parental rights.

No conviction or finding of delinquency pursuant to Article 5 of the Juvenile Court Act of 1987 shall be considered a criminal conviction for the purpose of applying any presumption under this item (i).

(j) Open and notorious adultery or fornication.

(j-1) (Blank).

(k) Habitual drunkenness or addiction to drugs, other than those prescribed by a physician, for at least one year immediately prior to the commencement of the unfitness proceeding.

There is a rebuttable presumption that a parent is unfit under this subsection with respect to any child to which that parent gives birth where there is a confirmed test result that at birth the child's blood, urine, or meconium contained any amount of a controlled substance as defined in subsection (f) of Section 102 of the Illinois Controlled Substances Act or metabolites of such substances, the presence of which in the newborn infant was not the result of medical treatment administered to the mother or the newborn infant; and the biological mother of this child is the biological mother of at least one other child who was adjudicated a neglected minor under subsection (c) of Section 2-3 of the Juvenile Court Act of 1987.

(l) Failure to demonstrate a reasonable degree of interest, concern or responsibility as to the welfare of a new born child during the first 30 days after its birth.

(m) Failure by a parent (i) to make reasonable efforts to correct the conditions that were the basis for the removal of the child from the parent during any 9-month period following the adjudication of neglected or abused minor under Section 2-3 of the Juvenile Court Act of 1987 or dependent minor under Section 2-4 of that Act, or (ii) to make reasonable progress toward the return of the child to the parent during any 9-month period following the adjudication of neglected or abused minor under Section 2-3 of the Juvenile Court Act of 1987 or dependent minor under Section 2-4 of that Act. If a service plan has been established as required under Section 8.2 of the Abused and Neglected Child Reporting Act to correct the conditions that were the basis for the removal of the child from the parent and if those services were available, then, for purposes of this Act, "failure to make reasonable progress toward the return of the child to the parent" includes the parent's failure to substantially fulfill his or her obligations under the service plan and correct the conditions that brought the child into care during any 9-month period following the adjudication under Section 2-3 or 2-4 of the Juvenile Court Act of 1987. Notwithstanding any other provision, when a petition or motion seeks to terminate parental rights on the basis of item (ii) of this subsection (m), the petitioner shall file with the court and serve on the parties a pleading that specifies the 9-month period or periods relied on. The pleading shall be filed and served on the parties no later than 3 weeks before the date set by the court for closure of discovery, and the allegations in the pleading shall be treated as incorporated into the petition or motion. Failure of a respondent to file a written denial of the allegations in the pleading shall not be treated as an admission that the allegations are true.

(m-1) (Blank).

(n) Evidence of intent to forgo his or her parental rights, whether or not the child is a ward of the court, (1) as manifested by his or her failure for a period of 12 months: (i) to visit the child, (ii) to communicate with the child or agency, although able to do so and not prevented from doing so by an agency or by court order, or (iii) to maintain contact with or plan for the future of the child, although physically able to do so, or (2) as manifested by the father's failure, where he and the mother of the child were unmarried to each other at the time of the child's birth, (i) to commence legal proceedings to establish his paternity under the Illinois Parentage Act of 1984, the Illinois Parentage Act of 2015, or the law of the jurisdiction of the child's birth within 30 days of being informed, pursuant to Section 12a of this Act, that he is the father or the likely father of the child or, after being so informed where the child is not yet born, within 30 days of the child's birth, or (ii) to make a good faith effort to pay a reasonable amount of the expenses related to the birth of the child and to provide a reasonable amount for the financial support of the child, the court to consider in its determination all relevant circumstances, including the financial condition of both parents; provided that the ground for termination provided in this subparagraph (n)(2)(ii) shall only be available where the petition is brought by the mother or the husband of the mother.

Contact or communication by a parent with his or her child that does not demonstrate affection and concern does not constitute reasonable contact and planning under subdivision (n). In the absence of evidence to the contrary, the ability to visit, communicate, maintain contact, pay expenses and plan for the future shall be presumed. The subjective intent of the parent, whether expressed or otherwise, unsupported by evidence of the foregoing parental acts manifesting that intent, shall not preclude a determination that the parent has intended to forgo his or her parental rights. In making this determination, the court may consider but shall not require a showing of diligent efforts by an authorized agency to encourage the parent to perform the acts specified in subdivision (n).

It shall be an affirmative defense to any allegation under paragraph (2) of this subsection that the father's failure was due to circumstances beyond his control or to impediments created by the mother or any other person having legal custody. Proof of that fact need only be by a preponderance of the evidence.

(o) Repeated or continuous failure by the parents, although physically and financially able, to provide the child with adequate food, clothing, or shelter.

(p) Inability to discharge parental responsibilities supported by competent evidence from a psychiatrist, licensed clinical social worker, or clinical psychologist of mental impairment, mental illness or an intellectual disability as defined in Section 1-116 of the Mental Health and Developmental Disabilities Code, or developmental disability as defined in Section 1-106 of that Code, and there is sufficient justification to believe that the inability to discharge parental responsibilities shall extend beyond a reasonable time period. However, this subdivision (p) shall not be construed so as to permit a licensed clinical social worker to conduct any medical diagnosis to determine mental illness or mental impairment.

(q) (Blank).

(r) The child is in the temporary custody or guardianship of the Department of Children and Family Services, the parent is incarcerated as a result of criminal conviction at the time the petition or motion for termination of parental rights is filed, prior to incarceration the parent had little or no contact with the child or provided little or no support for the child, and the parent's incarceration will prevent the parent from discharging his or her parental responsibilities for the child for a period in excess of 2 years after the filing of the petition or motion for termination of parental rights.

(s) The child is in the temporary custody or guardianship of the Department of Children and Family Services, the parent is incarcerated at the time the petition or motion for termination of parental rights is filed, the parent has been repeatedly incarcerated as a result of criminal convictions, and the parent's repeated incarceration has prevented the parent from discharging his or her parental responsibilities for the child.

(t) A finding that at birth the child's blood, urine, or meconium contained any amount of a controlled substance as defined in subsection (f) of Section 102 of the Illinois Controlled Substances Act, or a metabolite of a controlled substance, with the exception of controlled substances or metabolites of such substances, the presence of which in the newborn infant was the result of medical treatment administered to the mother or the newborn infant, and that the biological mother of this child is the biological mother of at least one other child who was adjudicated a neglected minor under subsection (c) of Section 2-3 of the Juvenile Court Act of 1987, after which the biological mother had the opportunity to enroll in and participate in a clinically appropriate substance abuse counseling, treatment, and rehabilitation program.

E. "Parent" means a person who is the legal mother or legal father of the child as defined in subsection X or Y of this Section. For the purpose of this Act, a parent who has executed a consent to adoption, a surrender, or a waiver pursuant to Section 10 of this Act, who has signed a Denial of Paternity pursuant to Section 12 of the Vital Records Act or Section 12a of this Act, or whose parental rights have been terminated by a court, is not a parent of the child who was the subject of the consent, surrender, waiver, or denial unless (1) the consent is void pursuant to subsection O of Section 10 of this Act; or (2) the person executed a consent to adoption by a specified person or persons pursuant to subsection A-1 of Section 10 of this Act and a court of competent jurisdiction finds that the consent is void; or (3) the order terminating the parental rights of the person is vacated by a court of competent jurisdiction.

F. A person is available for adoption when the person is:

(a) a child who has been surrendered for adoption to an agency and to whose adoption the agency has thereafter consented;

(b) a child to whose adoption a person authorized by law, other than his parents, has consented, or to whose adoption no consent is required pursuant to Section 8 of this Act;

(c) a child who is in the custody of persons who intend to adopt him through placement made by his parents;

(c-1) a child for whom a parent has signed a specific consent pursuant to subsection O of Section 10;

(d) an adult who meets the conditions set forth in Section 3 of this Act; or

(e) a child who has been relinquished as defined in Section 10 of the Abandoned Newborn Infant Protection Act.

A person who would otherwise be available for adoption shall not be deemed unavailable for adoption solely by reason of his or her death.

G. The singular includes the plural and the plural includes the singular and the "male" includes the "female", as the context of this Act may require.

H. (Blank).

I. "Habitual residence" has the meaning ascribed to it in the federal Intercountry Adoption Act of 2000 and regulations promulgated thereunder.

J. "Immediate relatives" means the biological parents, the parents of the biological parents and siblings of the biological parents.

K. "Intercountry adoption" is a process by which a child from a country other than the United States is adopted by persons who are habitual residents of the United States, or the child is a habitual resident of the United States who is adopted by persons who are habitual residents of a country other than the United States.

L. (Blank).

M. "Interstate Compact on the Placement of Children" is a law enacted by all states and certain territories for the purpose of establishing uniform procedures for handling the interstate placement of children in foster homes, adoptive homes, or other child care facilities.

N. (Blank).

O. "Preadoption requirements" means any conditions or standards established by the laws or administrative rules of this State that must be met by a prospective adoptive parent prior to the placement of a child in an adoptive home.

P. "Abused child" means a child whose parent or immediate family member, or any person responsible for the child's welfare, or any individual residing in the same home as the child, or a paramour of the child's parent:

(a) inflicts, causes to be inflicted, or allows to be inflicted upon the child physical injury, by other than accidental means, that causes death, disfigurement, impairment of physical or emotional health, or loss or impairment of any bodily function;

(b) creates a substantial risk of physical injury to the child by other than accidental means which would be likely to cause death, disfigurement, impairment of physical or emotional health, or loss or impairment of any bodily function;

(c) commits or allows to be committed any sex offense against the child, as sex offenses are defined in the Criminal Code of 2012 and extending those definitions of sex offenses to include children under 18 years of age;

(d) commits or allows to be committed an act or acts of torture upon the child; or

(e) inflicts excessive corporal punishment.

Q. "Neglected child" means any child whose parent or other person responsible for the child's welfare withholds or denies nourishment or medically indicated treatment including food or care denied solely on the basis of the present or anticipated mental or physical impairment as determined by a physician acting alone or in consultation with other physicians or otherwise does not provide the proper or necessary support, education as required by law, or medical or other remedial care recognized under State law as necessary for a child's well-being, or other care necessary for his or her well-being, including adequate food, clothing and shelter; or who is abandoned by his or her parents or other person responsible for the child's welfare.

A child shall not be considered neglected or abused for the sole reason that the child's parent or other person responsible for his or her welfare depends upon spiritual means through prayer alone for the treatment or cure of disease or remedial care as provided under Section 4 of the Abused and Neglected Child Reporting Act. A child shall not be considered neglected or abused for the sole reason that the child's parent or other person responsible for the child's welfare failed to vaccinate, delayed vaccination, or refused vaccination for the child due to a waiver on religious or medical grounds as permitted by law.

R. "Putative father" means a man who may be a child's father, but who (1) is not married to the child's mother on or before the date that the child was or is to be born and (2) has not established paternity of the child in a court proceeding before the filing of a petition for the adoption of the child. The term includes a male who is less than 18 years of age. "Putative father" does not mean a man who is the child's father as a result of criminal sexual abuse or assault as defined under Article 11 of the Criminal Code of 2012.

S. "Standby adoption" means an adoption in which a parent consents to custody and termination of parental rights to become effective upon the occurrence of a future event, which is either the death of the parent or the request of the parent for the entry of a final judgment of adoption.

T. (Blank).

T-5. "Biological parent", "birth parent", or "natural parent" of a child are interchangeable terms that mean a person who is biologically or genetically related to that child as a parent.

U. "Interstate adoption" means the placement of a minor child with a prospective adoptive parent for the purpose of pursuing an adoption for that child that is subject to the provisions of the Interstate Compact on Placement of Children.

V. (Blank).

W. (Blank).

X. "Legal father" of a child means a man who is recognized as or presumed to be that child's father:

(1) because of his marriage to or civil union with the child's parent at the time of the child's birth or within 300 days prior to that child's birth, unless he signed a denial of paternity pursuant to Section 12 of the Vital Records Act or a waiver pursuant to Section 10 of this Act; or

(2) because his paternity of the child has been established pursuant to the Illinois Parentage Act, the Illinois Parentage Act of 1984, or the Gestational Surrogacy Act; or

(3) because he is listed as the child's father or parent on the child's birth certificate, unless he is otherwise determined by an administrative or judicial proceeding not to be the parent of the child or unless he rescinds his acknowledgment of paternity pursuant to the Illinois Parentage Act of 1984; or

(4) because his paternity or adoption of the child has been established by a court of competent jurisdiction.

The definition in this subsection X shall not be construed to provide greater or lesser rights as to the number of parents who can be named on a final judgment order of adoption or Illinois birth certificate that otherwise exist under Illinois law.

Y. "Legal mother" of a child means a woman who is recognized as or presumed to be that child's mother:

(1) because she gave birth to the child except as provided in the Gestational Surrogacy Act; or

(2) because her maternity of the child has been established pursuant to the Illinois Parentage Act of 1984 or the Gestational Surrogacy Act; or

(3) because her maternity or adoption of the child has been established by a court of competent jurisdiction; or

(4) because of her marriage to or civil union with the child's other parent at the time of the child's birth or within 300 days prior to the time of birth; or

(5) because she is listed as the child's mother or parent on the child's birth certificate unless she is otherwise determined by an administrative or judicial proceeding not to be the parent of the child.

The definition in this subsection Y shall not be construed to provide greater or lesser rights as to the number of parents who can be named on a final judgment order of adoption or Illinois birth certificate that otherwise exist under Illinois law.

Z. "Department" means the Illinois Department of Children and Family Services.

AA. "Placement disruption" means a circumstance where the child is removed from an adoptive placement before the adoption is finalized.

BB. "Secondary placement" means a placement, including but not limited to the placement of a youth in care as defined in Section 4d of the Children and Family Services Act, that occurs after a placement disruption or an adoption dissolution. "Secondary placement" does not mean secondary placements arising due to the death of the adoptive parent of the child.

CC. "Adoption dissolution" means a circumstance where the child is removed from an adoptive placement after the adoption is finalized.

DD. "Unregulated placement" means the secondary placement of a child that occurs without the oversight of the courts, the Department, or a licensed child welfare agency.

EE. "Post-placement and post-adoption support services" means support services for placed or adopted children and families that include, but are not limited to, mental health treatment, including counseling and other support services for emotional, behavioral, or developmental needs, and treatment for a substance use disorder.

(Source: P.A. 99-49, eff. 7-15-15; 99-85, eff. 1-1-16; 99-642, eff. 7-28-16; 99-836, eff. 1-1-17; 100-159, eff. 8-18-17.)

(750 ILCS 50/18.9)

Sec. 18.9. Post-placement and post-adoption support services.

(a) It is the public policy of this State to find permanency for children through adoption and to prevent placement disruption, adoption dissolution, and secondary placement. Public awareness and access Access to timely, effective post-placement and post-adoption support services to provide support and resources for children and youth in care as defined in Section 4d of the Children and Family Services Act, foster families, and adoptive families is essential to promote permanency. Public awareness of post-placement and post-adoption services and the ability of families to utilize effective services are essential to permanency.

(b) The Department shall establish and maintain accessible post-placement and post-adoption support services for all children adopted pursuant to this Act, all children residing in this State adopted pursuant to the Interstate Compact on the Placement of Children, all children residing in this State adopted pursuant to the Intercountry Adoption Act of 2000, and all former youth in care, as defined by the Children and Family Services Act, who have been placed in a guardianship.

(b-5) The Department shall establish and maintain a toll-free number to respond to requests from the public about its post-placement and post-adoption support services under subsection (b) and shall staff the toll-free number so that calls are answered on a timely basis, but in no event more than 24 hours from the receipt of a request.

(c) The Department shall publicize post information about the Department's post-placement and post-adoption support services pursuant to subsection (b) and the toll-free number pursuant to subsection (b-5) as follows:

(1) it shall post information on the Department's website; and

(2) it shall provide the information to every licensed child welfare agency, every out of State placement agency or entity approved under Section 4.1 of this Act, and any entity providing adoption support services in the Illinois courts; .

(3) it The Department's post-placement and post-adoption support services shall reference such information be referenced in the information regarding adoptive parents' rights and responsibilities document that the Department publishes and that is provided provides to adoptive parents under this Act and the Child Care Act.

(4) it shall provide the information, including the Post Adoption and Guardianship Services booklet, to prospective adoptive parents and guardians as part of its adoption and guardianship training and at the time they are presented with the Permanency Commitment form; and

(5) it shall include, in each annual notification letter mailed to adoptive parents and guardians, a short, easy-to-understand, 2-sided flier or news bulletin that describes access to post-placement and post-adoption services, how to access Medicaid and Individual Care Grant or Family Support Program services, the webpage address of the Post Adoption and Guardianship Services booklet, information on how to request that a copy of the booklet be mailed, and a sticker or magnet that includes the toll-free number to access the Department's post-placement and post-adoption support services. The Department shall establish and maintain a toll-free number to advise the public about its post-placement and post-adoption support services and post the number on its website.

(c-5) The Department shall review and update annually all information relating to its post-placement and post-adoption support services, including the Post Adoption and Guardianship Services booklet, to include updated information on Individual Care Group or Family Support Program services eligibility and the post-placement and post-adoption support services that are available through the State's Medical Assistance program established under Article V of the Illinois Public Aid Code or through any other State program for mental health services. The Department and the Department of Healthcare and Family Services shall coordinate their efforts in the development of resources described in this subsection.

(d) Every licensed child welfare agency, every entity approved under Section 4.1 of this Act, and any entity providing adoption support services in the Illinois courts shall provide the Department's website address and link to the Department's post-placement and post-adoption support services information set forth in subsection (c) of this Section, including the Department's toll-free number, to every adoptive parent, prospective adoptive parent, and guardian with whom they work in Illinois. This information shall be provided prior to placement.

(e) Beginning one year after the effective date of this amendatory Act of the 101st 99th General Assembly, the Department shall report annually to the General Assembly on January 15 the following information for the preceding year:

(1) a description of all post-placement and post-adoption support services the Department provides;

(2) without identifying the names of the recipients of the services, the number of guardians foster parents, prospective adoptive parents, and adoptive families in Illinois who have received the Department's post-placement and post-adoption support services and the type of services provided and, for each, the length of time between the initial contact to the Department to request post-placement and post-adoption support services and the first receipt of services, and the type of services received;

(3) the number of families who have contacted the Department about its post-placement and post-adoption support services due to a potential placement disruption, adoption dissolution, secondary placement, or unregulated placement, but for whom the Department declined to provide post-placement and post-adoption support services and the reasons that services were denied; and

(4) the number of placement disruptions, adoption dissolutions, unregulated placements, and secondary placements, and for each one:

(A) the type of placement or adoption, including whether the child who was the subject of the placement was a youth in care as defined in Section 4d of the Children and Family Services Act, and if the child was not a youth in care, whether the adoption was a private, agency, agency-assisted, interstate, or intercountry adoption;

(B) if the placement or adoption was intercountry, the country of birth of the child;

(C) whether the child who was the subject of the placement disruption, adoption dissolution, unregulated placement, or secondary placement entered State custody;

(D) the length of the placement prior to the placement disruption, adoption dissolution, unregulated placement, or secondary placement;

(E) the age of the child at the time of the placement disruption, adoption dissolution, unregulated placement, or secondary placement;

(F) the reason, if known, for the placement disruption, adoption dissolution, unregulated placement, or secondary placement; and

(G) if a licensed child welfare agency or any approved out of State placing entity participated in the initial placement, and, if applicable, the name of the agency or approved out of State placing entity; and .

(5) a description of the coordination between the Department and the Department of Healthcare and Family Services to develop resources under this subsection, including, but not limited to, a description of the goals of such coordination and whether the goals have been met.

(Source: P.A. 99-49, eff. 7-15-15; 100-159, eff. 8-18-17.)

Section 95. No acceleration or delay. Where this Act makes changes in a statute that is represented in this Act by text that is not yet or no longer in effect (for example, a Section represented by multiple versions), the use of that text does not accelerate or delay the taking effect of (i) the changes made by this Act or (ii) provisions derived from any other Public Act.

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