093_HB3695 LRB093 08539 BDD 11549 b 1 AN ACT in relation to mental health. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 1. Short title. This Act may be cited as the MI 5 Olmstead Initiative of 2003. 6 Section 5. Purposes. 7 (a) The General Assembly recognizes that the United 8 States Supreme Court in Olmstead v. L.C. ex Rel. Zimring, 119 9 S. Ct. 2176 (1999), affirmed that the unjustifiable 10 institutionalization of a person with a disability who could 11 live in the community with proper support, and wishes to do 12 so, is unlawful discrimination in violation of the Americans 13 with Disabilities Act (ADA). The State of Illinois, along 14 with all other states, is required to provide appropriate 15 residential and community-based support services to persons 16 with disabilities who wish to live in less restrictive 17 settings. 18 (b) It is the purpose of this Act to implement the MI 19 Olmstead Initiative in response to the U.S. Supreme Court's 20 decision in Olmstead v. L.C. in order (1) to enable 1,000 21 persons with mental illness or a co-occurring disorder of 22 mental illness and substance abuse who currently reside in 23 nursing facilities, to move, within the next 5 years, to the 24 most integrated residential settings in the community as 25 possible and (2) to provide cost effective community 26 residential environments and supports to enable these persons 27 to live successfully in the community. 28 (c) It is the further purpose of this Act to create a 29 continuum of residential and supportive services in community 30 settings for persons with mental illness or a co-occurring 31 disorder of mental illness and substance abuse, while -2- LRB093 08539 BDD 11549 b 1 increasing federal and client financial participation through 2 the Medicaid and Social Security programs, wherever possible. 3 (d) The MI Olmstead Initiative is not intended to 4 substitute for or replace the obligation of the State of 5 Illinois to develop and implement a comprehensive, 6 effectively working plan for placing persons with 7 disabilities in less restrictive settings, under the Supreme 8 Court decision in Olmstead v. L.C. 9 Section 10. Definitions. For purposes of this Act: 10 "Department" means the Department of Human Services. 11 "Institution for mental diseases" (IMD) means a nursing 12 facility licensed by the Illinois Department of Public Health 13 under the Nursing Home Care Act as defined, consistent with 14 federal regulations, by the Illinois Department of Public Aid 15 where services to residents are ineligible for federal 16 financial participation under the Medicaid program because 17 mental illness is the specific reason for being in the 18 facility for more than 50% of the residents over 21 and under 19 65 years of age. 20 "Qualified individual" means an adult who is over 21 21 years and under 65 years of age who agrees to participate in 22 the MI Olmstead Initiative and meets one of the following 23 criteria: 24 (1) the person is substantially impaired in 2 or 25 more major life activities as a consequence of a mental 26 illness or a co-occurring mental illness and substance 27 abuse disorder; or 28 (2) the person has a record of having been 29 substantially impaired in 2 or more major life activities 30 as a consequence of a mental illness or a co-occurring 31 mental illness and substance abuse disorder. 32 Section 15. Programs and services of the MI Olmstead -3- LRB093 08539 BDD 11549 b 1 Initiative. 2 (a) The Department shall identify 200 qualified 3 individuals during each of the 5 years following the 4 implementation date of this Act or 1,000 persons in total, 5 who agree to and are able to be transitioned to alternative 6 residential settings within the community. In order to 7 appropriately select persons for the MI Olmstead Initiative, 8 the Department, by working in conjunction with an owner or 9 operator of a nursing facility or an IMD, and with the 10 guardian of the qualified individual, if any, shall assure 11 that: 12 (1) a comprehensive evaluation and diagnosis of the 13 qualified individual has been administered by a qualified 14 examiner, including an assessment of skills, abilities, 15 and potential for residential and work placement, adapted 16 to the person's primary language, cultural background, 17 and ethnic origin; 18 (2) an individual program plan or individual 19 treatment plan, or both, has been completed for the 20 qualified individual, outlining a range of services to be 21 provided as outlined in subsection (b) of this Section; 22 (3) the qualified individual is advised of 23 available and appropriate community-based alternatives 24 for his or her care before a decision on placement is 25 made; and 26 (4) a planning specialist or case manager assists 27 the individual in making the move from an institution to 28 a community setting. 29 (b) The MI Olmstead Initiative shall be designed with a 30 capacity for 1,000 qualified individuals over 5 years and 31 shall offer, or create as necessary, services and supports 32 for these individuals to live in the most integrated 33 community-based setting possible. The services and supports 34 in community-based settings shall include, but not be limited -4- LRB093 08539 BDD 11549 b 1 to: 2 (1) residence in the most integrated setting 3 possible, whether independent living in a private 4 residence, a supported residential program, a supervised 5 residential program, or supportive housing, as 6 appropriate; 7 (2) rehabilitation and support services, including 8 assertive community treatment, case management, 9 supportive and supervised day treatment, and psychosocial 10 rehabilitation; 11 (3) vocational training, as appropriate, that 12 contributes to the person's independence and employment 13 potential; 14 (4) employment, as appropriate, free from 15 discrimination pursuant to the Constitution and laws of 16 this State; 17 (5) periodic reevaluation and review of the 18 individual program plan or the individual treatment plan, 19 or both, at least twice each year, in order to measure 20 progress, to modify or change objectives if necessary, 21 and to provide guidance and remediation techniques. The 22 qualified individual and his or her guardian, if any, 23 shall have the right (i) to participate in the planning 24 and decision-making process regarding the plan and (ii) 25 to be informed in writing, or in that individual's mode 26 of communication, of progress at reasonable time 27 intervals; 28 (6) due process so that any individual aggrieved by 29 a decision of the Department regarding services provided 30 under this Act is given an opportunity to present 31 complaints at a due process hearing before a hearing 32 officer designated by the Director of the Department, in 33 addition to any other rights under federal, State, or 34 local laws. -5- LRB093 08539 BDD 11549 b 1 (c) The Department shall implement, coordinate, monitor, 2 and evaluate the MI Olmstead Initiative in cooperation with 3 the Department of Public Aid, the Department of Public 4 Health, the Bureau of the Budget, and other State agencies as 5 appropriate, as well as organizations or service providers 6 whose mission includes advocacy for or the provision of 7 quality services to persons with mental illness or a 8 co-occurring disorder of mental illness and substance abuse. 9 Section 20. Report to the General Assembly. The 10 Department, in cooperation with the Department of Public Aid 11 and the Department of Public Health, shall report to the 12 General Assembly on the status of the MI Olmstead Initiative 13 by October 1 each year of the 5-year initiative, and shall 14 include in the report an analysis of the costs and benefits 15 of the Initiative, a review of the State's continued use of 16 IMD's and a plan for consolidation and conversion of those 17 facilities to non-IMD nursing facilities for the purpose of 18 maximizing federal financial participation under the Medicaid 19 program. 20 Section 25. Implementation Dates. The Department shall 21 promulgate rules to govern all aspects of this Act by April 22 1, 2004. Subject to available appropriations, the Department 23 shall begin implementation of the MI Olmstead initiative by 24 July 1, 2004. 25 Section 99. Effective date. This Act takes effect upon 26 becoming law.