093_SB1621ham001

 










                                     LRB093 03226 MKM 16624 a

 1                    AMENDMENT TO SENATE BILL 1621

 2        AMENDMENT NO.     .  Amend Senate Bill 1621 by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  1.  Short  title.  This Act may be cited as the
 5    Disabilities Services Act of 2003.

 6        Section 5.  Purpose.  It is the purpose of  this  Act  to
 7    create  an  advisory  committee  to  develop  and implement a
 8    disabilities services  implementation  plan  as  provided  in
 9    Section 20 to ensure compliance by the State of Illinois with
10    the  Americans  with  Disabilities  Act  and  the decision in
11    Olmstead v. L.C., 119 S.Ct. 2176 (1999).

12        Section 10. Application of Act; definitions.
13        (a)  This Act applies to persons with  disabilities.  The
14    disabilities included are defined for purposes of this Act as
15    follows:
16        "Disability"   means  a  disability  as  defined  by  the
17    Americans with Disabilities Act of 1990 that is  attributable
18    to  a  developmental  disability,  a  mental  illness,  or  a
19    physical disability, or combination of those.
20        "Developmental  disability"  means  a  disability that is
21    attributable to mental retardation or a related condition.  A
 
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 1    related condition must meet all of the following conditions:
 2             (1)  It  must  be  attributable  to  cerebral palsy,
 3        epilepsy, or  any  other  condition  (other  than  mental
 4        illness)   found   to   be   closely  related  to  mental
 5        retardation because that condition results in  impairment
 6        of  general intellectual functioning or adaptive behavior
 7        similar to that of individuals with  mental  retardation,
 8        and  requires  treatment  or  services  similar  to those
 9        required for those  individuals.  For  purposes  of  this
10        Section autism shall be considered a related condition.
11             (2)  It  must  be  manifested  before the individual
12        reaches age 22.
13             (3)  It must be likely to continue indefinitely.
14             (4)  It  must  result  in   substantial   functional
15        limitations  in 3 or more of the following areas of major
16        life activity: self-care, language,  learning,  mobility,
17        self-direction, and capacity for independent living.
18        "Mental  Illness"  means  a  mental or emotional disorder
19    verified by a  diagnosis  contained  in  the  Diagnostic  and
20    Statistical   Manual   of  Mental  Disorders-Fourth  Edition,
21    published by the American Psychiatric Association (DSM-IV) or
22    International  Classification  of  Diseases,  9th   Revision,
23    Clinical   Modification  (ICD-9-CM)  or  its  successor  that
24    substantially impairs a  person's  cognitive,  emotional,  or
25    behavioral   functioning,   or   any  combination  of  those,
26    excluding (i) conditions that may be the  focus  of  clinical
27    attention  but  are not of sufficient duration or severity to
28    be categorized as a  mental  illness,  such  as  parent-child
29    relational   problems,  partner-relational  problems,  sexual
30    abuse   of   a   child,   bereavement,   academic   problems,
31    phase-of-life    problems,    and    occupational    problems
32    (collectively, "V codes"), (ii)  organic  disorders  such  as
33    substance   intoxication   dementia,   substance   withdrawal
34    dementia,  Alzheimer's  disease,  vascular dementia, dementia
 
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 1    due to HIV infection, and dementia  due  to  Creutzfeld-Jakob
 2    disease  and  disorders  associated  with  known  or  unknown
 3    physical  conditions such as hallucinasis, amnestic disorders
 4    and  delirium,  and  psychoactive  substance-induced  organic
 5    disorders, and (iii) a developmental disability, a  substance
 6    abuse disorder, or an abnormality manifested only by repeated
 7    criminal or otherwise anti-social conduct.
 8        "Mental   retardation"  means  significantly  sub-average
 9    general intellectual functioning existing  concurrently  with
10    deficits  in  adaptive behavior and manifested before the age
11    of 22 years.
12        "Physical disability" means a disability  as  defined  by
13    the  Americans  with  Disabilities Act of 1990 that meets the
14    following criteria:
15             (1)  It is attributable to a physical impairment.
16             (2)  It  results   in   a   substantial   functional
17        limitation  in  any  of the following areas of major life
18        activity: (i) self-care, (ii)  receptive  and  expressive
19        language,    (iii)    learning,    (iv)   mobility,   (v)
20        self-direction, (vi) capacity for independent living, and
21        (vii) economic sufficiency.
22             (3)  It reflects the person's need for a combination
23        and sequence of special,  interdisciplinary,  or  general
24        care,  treatment,  or other services that are of lifelong
25        or of extended duration and must be individually  planned
26        and coordinated.
27        (b)  In this Act:
28        "Chronological  age-appropriate services" means services,
29    activities, and strategies for persons with disabilities that
30    are representative of the lifestyle activities of nondisabled
31    peers of similar age in the community.
32        "Comprehensive  evaluation"  means  procedures  used   by
33    qualified  professionals  selectively  with  an individual to
34    determine whether a person has a disability  and  the  nature
 
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 1    and  extent of the services that the person with a disability
 2    needs.
 3        "Department"  means  the   Department   on   Aging,   the
 4    Department  of  Human  Services,  the  Department  of  Public
 5    Health,  the  Department  of  Public  Aid,  the University of
 6    Illinois Division  of  Specialized  Care  for  Children,  the
 7    Department  of Children and Family Services, and the Illinois
 8    State Board of Education, where appropriate, as designated in
 9    the implementation plan developed under Section 20.
10        "Family" means a natural, adoptive, or foster  parent  or
11    parents  or  other person or persons responsible for the care
12    of an individual with a disability in a family setting.
13        "Family or individual support" means those resources  and
14    services  that are necessary to maintain an individual with a
15    disability within the family home or his  or  her  own  home.
16    These  services  may  include,  but  are not limited to, cash
17    subsidy, respite care, and counseling services.
18        "Independent service coordination" means a social service
19    that enables  persons  with  developmental  disabilities  and
20    their  families  to locate, use, and coordinate resources and
21    opportunities in their communities on the basis of individual
22    need. Independent  service  coordination  is  independent  of
23    providers  of services and funding sources and is designed to
24    ensure accessibility, continuity of care, and  accountability
25    and  to  maximize the potential of persons with developmental
26    disabilities for independence, productivity, and  integration
27    into   the   community.   Independent   service  coordination
28    includes, at a minimum: (i)  outreach  to  identify  eligible
29    individuals;  (ii)  assessment  and  periodic reassessment to
30    determine    each    individual's    strengths,    functional
31    limitations,  and   need   for   specific   services;   (iii)
32    participation   in   the   development   of  a  comprehensive
33    individual service or treatment plan; (iv)  referral  to  and
34    linkage  with needed services and supports; (v) monitoring to
 
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 1    ensure the delivery of appropriate services and to  determine
 2    individual progress in meeting goals and objectives; and (vi)
 3    advocacy  to  assist the person in obtaining all services for
 4    which he or she is eligible or entitled.
 5        "Individual service or treatment plan" means  a  recorded
 6    assessment  of  the  needs  of  a person with a disability, a
 7    description of the services recommended, the  goals  of  each
 8    type  of element of service, an anticipated timetable for the
 9    accomplishment  of  the  goals,  and  a  designation  of  the
10    qualified professionals responsible for the implementation of
11    the plan.
12        "Least restrictive environment" means an environment that
13    represents the least departure from the  normal  patterns  of
14    living  and  that  effectively  meets the needs of the person
15    receiving the service.

16        Section 15.  Services.  Services  shall  be  provided  in
17    accordance  with  the  individual  service  or treatment plan
18    developed  for  an  individual  under   this   Section.   The
19    individual   shall   initially   be  screened  for  potential
20    eligibility by the  appropriate  State  agency  and,  if  the
21    individual  is  deemed  probably  eligible  for  a disability
22    service  or  program,  a  comprehensive  evaluation  of   the
23    individual  shall  be conducted to determine the services and
24    programs  appropriate  for  that  individual.  The  array  of
25    available services shall be  described  in  the  Disabilities
26    Services  Implementation Plan required under this Act and may
27    include, but need not be limited to:
28             (1)  Comprehensive  evaluation  and  diagnosis.    A
29        person  with  a  suspected disability who is applying for
30        Department-authorized disability services  must  receive,
31        after   an  initial  screening  and  a  determination  of
32        probable eligibility for a disability service or program,
33        a comprehensive diagnosis and  evaluation,  including  an
 
                            -6-      LRB093 03226 MKM 16624 a
 1        assessment   of  skills,  abilities,  and  potential  for
 2        residential and work placement, adapted  to  his  or  her
 3        primary language, cultural background, and ethnic origin.
 4        All  components  of  a  comprehensive  evaluation must be
 5        administered by a qualified professional, as  defined  by
 6        rule.
 7             (2)  Individual service or treatment plan.  A person
 8        with  a  disability  shall receive services in accordance
 9        with a current individual service or treatment  plan.   A
10        person  with a disability who is receiving services shall
11        be provided  periodic  reevaluation  and  review  of  the
12        individual  service or treatment plan, at least annually,
13        in  order  to  measure  progress,  to  modify  or  change
14        objectives if necessary,  and  to  provide  guidance  and
15        remediation techniques.
16             A  person  with a disability and his or her guardian
17        have  the  right  to  participate  in  the  planning  and
18        decision-making process regarding the person's individual
19        service or treatment plan and to be informed in  writing,
20        or in that person's mode of communication, of progress at
21        reasonable time intervals.  Each person must be given the
22        opportunity   to  make  decisions  and  exercise  options
23        regarding  the  plan,  consistent   with   the   person's
24        capabilities. Family members and other representatives of
25        the person with a disability must be allowed, encouraged,
26        and  supported to participate as well, if the person with
27        a disability consents to that participation.
28             (3)  Nondiscriminatory access to services.  A person
29        with a disability may  not  be  denied  program  services
30        because of sex, ethnic origin, marital status, ability to
31        pay  (except  where contrary to law), or criminal record.
32        Specific program eligibility requirements with regard  to
33        disability,  level of need, age, and other matters may be
34        established by the Department by  rule.   The  Department
 
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 1        may  set priorities for the provision of services and for
 2        determining the need  and  eligibility  for  services  in
 3        accordance with available funding.
 4             (4)  Family  or individual support.  A person with a
 5        disability must be provided family or individual  support
 6        services,  or both, whenever possible and appropriate, to
 7        prevent unnecessary out-of-home placement and  to  foster
 8        independent   living  skills  when  authorized  for  such
 9        services.
10             (5)  Residential choices and options.  A person with
11        a disability who  requires  residential  placement  in  a
12        supervised  or supported setting must be provided choices
13        among various residential  options  when  authorized  for
14        those  services.   The  placement  must be offered in the
15        least  restrictive   environment   appropriate   to   the
16        individual.
17             (6)  Education.   A person with a disability has the
18        right to a free, appropriate public education as provided
19        in both State and federal law.   Each  local  educational
20        agency  must  prepare persons with disabilities for adult
21        living.  In anticipation of adulthood, each person with a
22        disability has the right to a transition  plan  developed
23        and  ready for implementation before the person's exit by
24        no later than the school year in which the person reaches
25        age 14, consistent with the requirements of  the  federal
26        Individuals  with  Disabilities Education Act and Article
27        XIV of the School Code.
28             (7)  Vocational   training.    A   person   with   a
29        disability must be  provided  vocational  training,  when
30        appropriate,    that    contributes   to   the   person's
31        independence and  employment  potential.   This  training
32        should include strategies and activities in programs that
33        lead   to   employment  and  reemployment  in  the  least
34        restrictive environment appropriate to the individual.
 
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 1             (8)  Employment.  A person with a disability has the
 2        right to be employed free from  discrimination,  pursuant
 3        to the Constitution and laws of this State.
 4             (9)  Independent service coordination. A person with
 5        a   developmental  disability  who  is  receiving  direct
 6        services from the Department must be provided independent
 7        service coordination when needed.
 8             (10)  Mental health  supports.  Individuals  with  a
 9        disability must be provided needed mental health supports
10        such  as  psychological  rehabilitation,  psychiatric and
11        medication coverage, day treatment, care management,  and
12        crisis services.
13             (11)  Due   process.  A  person  with  a  disability
14        retains the rights of citizenship. Any  person  aggrieved
15        by   a   decision  of  a  department  regarding  services
16        provided under this Act must be given an  opportunity  to
17        present  complaints  at  a  due process hearing before an
18        impartial hearing officer designated by the  director  of
19        that   department.   Any  person  aggrieved  by  a  final
20        administrative  decision  rendered  following   the   due
21        process hearing may seek judicial review of that decision
22        pursuant  to  the  Administrative  Review  Law.  The term
23        "administrative decision" is defined as in Section  3-101
24        of the Code of Civil Procedure. Attorney's fees and costs
25        may  be  awarded  to  a prevailing complainant in any due
26        process hearing or action for judicial review under  this
27        Act.
28             The  right  to  a hearing under this item (11) is in
29        addition to any other rights  under  federal,  State,  or
30        local  laws,  however  nothing  in  this Section shall be
31        construed as requiring the establishment  of  a  new  due
32        process  hearing  procedure  if  one already exists for a
33        particular service or program.
 
                            -9-      LRB093 03226 MKM 16624 a
 1        Section 20.  Implementation.
 2        (a)   The Governor shall appoint an advisory committee to
 3    assist  in  the   development   and   implementation   of   a
 4    Disabilities  Services  Implementation  Plan that will ensure
 5    compliance by the State of Illinois with the  Americans  with
 6    Disabilities  Act  and  the decision in Olmstead v. L.C., 119
 7    S.Ct. 2176 (1999). The advisory committee shall be  known  as
 8    the  Illinois  Disabilities  Services  Advisory Committee and
 9    shall be composed of no  more  than  33  members,  including:
10    persons  who  have  a  physical  disability,  a developmental
11    disability, or a mental illness; senior  citizens;  advocates
12    for  persons  with  physical  disabilities;  advocates    for
13    persons  with  developmental  disabilities;    advocates  for
14    persons  with  mental illness; advocates for senior citizens;
15    representatives of providers  of  services  to  persons  with
16    physical disabilities, developmental disabilities, and mental
17    illness;  representatives  of providers of services to senior
18    citizens; and representatives of organized labor.
19        In addition, the following State officials shall serve on
20    the committee as ex-officio non-voting members: the Secretary
21    of  Human  Services  or  his  or  her  designee;  the   State
22    Superintendent  of  Education  or  his  or  her designee; the
23    Director of Aging or  his  or  her  designee;  the  Executive
24    Director of the Illinois Housing Development Authority or his
25    or  her  designee;  the  Director of Public Aid or his or her
26    designee; and the Director of Employment Security or  his  or
27    her designee.
28        The advisory committee shall select officers, including a
29    chair and a vice-chair.
30        The  advisory committee shall meet at least quarterly and
31    shall keep official meeting minutes. Committee members  shall
32    not  be  compensated  but  shall  be  paid for their expenses
33    related to attendance at meetings.
34        (b)  The implementation plan must include, but  need  not
 
                            -10-     LRB093 03226 MKM 16624 a
 1    be limited to, the following:
 2             (1)  Establishing    procedures    for    completing
 3        comprehensive   evaluations,   including  provisions  for
 4        Department review and approval  of  need  determinations.
 5        The  Department  may  utilize  independent evaluators and
 6        targeted  or  sample  reviews  during  this  review   and
 7        approval process, as it deems appropriate.
 8             (2)  Establishing  procedures for the development of
 9        an individual service or treatment plan for  each  person
10        with  a  disability,  including provisions for Department
11        review and authorization.
12             (3)  Identifying core services  to  be  provided  by
13        agencies of the State of Illinois or other agencies.
14             (4)  Establishing      minimum     standards     for
15        individualized services.
16             (5)  Establishing minimum standards for  residential
17        services in the least restrictive environment.
18             (6)  Establishing  minimum  standards for vocational
19        services.
20             (7)  Establishing due process hearing procedures.
21             (8)  Establishing  minimum  standards   for   family
22        support services.
23             (9)  Securing   financial   resources  necessary  to
24        fulfill  the  purposes  and  requirements  of  this  Act,
25        including but  not  limited  to  obtaining  approval  and
26        implementing  waivers  or demonstrations authorized under
27        federal law.
28        (c)  The Governor, with the assistance  of  the  Illinois
29    Disabilities Services Advisory Committee and the Secretary of
30    Human  Services,  is  responsible  for  the completion of the
31    implementation plan. The Governor must submit a report to the
32    General Assembly by November 1, 2004, which must include  the
33    following:
34             (1)  The implementation plan.
 
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 1             (2)  A  description  of current and planned programs
 2        and services necessary to meet the  requirements  of  the
 3        individual  service  or  treatment plans required by this
 4        Act, together with the actions to be taken by  the  State
 5        of   Illinois   to   ensure  that  those  plans  will  be
 6        implemented. This description shall include a  report  of
 7        related  program  and  service improvements or expansions
 8        implemented by the Department since the effective date of
 9        this Act.
10             (3)  The estimated  costs  of  current  and  planned
11        programs   and   services   to   be  provided  under  the
12        implementation plan.
13             (4)  A  report  on  the  number  of   persons   with
14        disabilities  who  may  be  eligible  to receive services
15        under this Act, together with a report on the  number  of
16        persons who are currently receiving those services.
17             (5)  Any  proposed  changes in State policies, laws,
18        or regulations necessary  to  fulfill  the  purposes  and
19        requirements of this Act.
20        (d)  The  Governor,  with the assistance of the Secretary
21    of Human Services, shall annually update  the  implementation
22    plan  and report changes to the General Assembly by July 1 of
23    each year. Initial implementation of the plan is required  by
24    July  1, 2005.  The requirement of annual updates and reports
25    expires in 2008, unless otherwise  extended  by  the  General
26    Assembly.

27        Section  25.  Appropriations.  Services shall be provided
28    under this Act to the extent  that  appropriations  are  made
29    available  by  the  General  Assembly  for  the  programs and
30    services indicated in the implementation plan.

31        Section 30.  Entitlements. This Act does not  create  any
32    new  entitlement to a service, program, or benefit, but shall
 
                            -12-     LRB093 03226 MKM 16624 a
 1    not be construed to affect  any  entitlement  to  a  service,
 2    program, or benefit created by any other law.

 3        Section  75.  The  Illinois Public Aid Code is amended by
 4    changing Section 5-2 as follows:

 5        (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
 6        Sec.  5-2.  Classes   of   Persons   Eligible.    Medical
 7    assistance  under  this  Article shall be available to any of
 8    the following classes of persons in respect to  whom  a  plan
 9    for  coverage  has  been  submitted  to  the  Governor by the
10    Illinois Department and approved by him:
11        1.  Recipients of basic maintenance grants under Articles
12    III and IV.
13        2.  Persons  otherwise  eligible  for  basic  maintenance
14    under Articles III and IV but who fail to qualify  thereunder
15    on  the  basis  of need, and who have insufficient income and
16    resources to  meet  the  costs  of  necessary  medical  care,
17    including but not limited to the following:
18             (a)  All   persons   otherwise  eligible  for  basic
19        maintenance under Article III but  who  fail  to  qualify
20        under  that  Article  on  the  basis of need and who meet
21        either of the following requirements:
22                  (i)  their  income,  as   determined   by   the
23             Illinois  Department  in accordance with any federal
24             requirements, is equal to or less than 70% in fiscal
25             year 2001, equal to or less than 85% in fiscal  year
26             2002  and  until  a  date  to  be  determined by the
27             Department by rule, and equal to or less  than  100%
28             beginning  on  the date determined by the Department
29             by rule, of  the  nonfarm  income  official  poverty
30             line, as defined by the federal Office of Management
31             and  Budget  and revised annually in accordance with
32             Section 673(2) of the Omnibus Budget  Reconciliation
 
                            -13-     LRB093 03226 MKM 16624 a
 1             Act  of  1981,  applicable  to  families of the same
 2             size; or
 3                  (ii)  their  income,  after  the  deduction  of
 4             costs incurred for medical care and for other  types
 5             of  remedial  care,  is equal to or less than 70% in
 6             fiscal year 2001, equal  to  or  less  than  85%  in
 7             fiscal  year  2002 and until a date to be determined
 8             by the Department by rule, and equal to or less than
 9             100%  beginning  on  the  date  determined  by   the
10             Department  by  rule, of the nonfarm income official
11             poverty  line,  as  defined  in  item  (i)  of  this
12             subparagraph (a).
13             (b)  All persons who would  be  determined  eligible
14        for   such   basic   maintenance   under  Article  IV  by
15        disregarding  the  maximum  earned  income  permitted  by
16        federal law.
17        3.  Persons who would otherwise qualify for  Aid  to  the
18    Medically Indigent under Article VII.
19        4.  Persons  not  eligible  under  any  of  the preceding
20    paragraphs who fall sick, are injured,  or  die,  not  having
21    sufficient  money,  property  or  other resources to meet the
22    costs  of  necessary  medical  care  or  funeral  and  burial
23    expenses.
24        5. (a)  Women  during  pregnancy,  after  the   fact   of
25        pregnancy  has  been determined by medical diagnosis, and
26        during the 60-day period beginning on the last day of the
27        pregnancy, together with their infants and children  born
28        after  September 30, 1983, whose income and resources are
29        insufficient to meet the costs of necessary medical  care
30        to  the  maximum  extent  possible under Title XIX of the
31        Federal Social Security Act.
32             (b)  The Illinois Department and the Governor  shall
33        provide a plan for coverage of the persons eligible under
34        paragraph 5(a) by April 1, 1990.  Such plan shall provide
 
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 1        ambulatory  prenatal  care  to  pregnant  women  during a
 2        presumptive eligibility period and  establish  an  income
 3        eligibility standard that is equal to 133% of the nonfarm
 4        income  official  poverty line, as defined by the federal
 5        Office of Management and Budget and revised  annually  in
 6        accordance  with  Section  673(2)  of  the Omnibus Budget
 7        Reconciliation Act of 1981, applicable to families of the
 8        same size, provided that costs incurred for medical  care
 9        are  not  taken  into  account in determining such income
10        eligibility.
11             (c)  The   Illinois   Department   may   conduct   a
12        demonstration in at least one county  that  will  provide
13        medical assistance to pregnant women, together with their
14        infants  and  children  up  to one year of age, where the
15        income eligibility standard is set  up  to  185%  of  the
16        nonfarm  income  official poverty line, as defined by the
17        federal Office of Management  and  Budget.  The  Illinois
18        Department  shall seek and obtain necessary authorization
19        provided  under  federal  law   to   implement   such   a
20        demonstration.  Such demonstration may establish resource
21        standards  that  are  not  more  restrictive  than  those
22        established under Article IV of this Code.
23        6.  Persons  under  the  age of 18 who fail to qualify as
24    dependent under Article IV and who have  insufficient  income
25    and  resources to meet the costs of necessary medical care to
26    the maximum extent permitted under Title XIX of  the  Federal
27    Social Security Act.
28        7.  Persons  who are 18 years of age or younger and would
29    qualify as disabled as defined under the Federal Supplemental
30    Security Income Program, provided medical  service  for  such
31    persons    would    be   eligible   for   Federal   Financial
32    Participation,   and   provided   the   Illinois   Department
33    determines that:
34             (a)  the person requires a level of care provided by
 
                            -15-     LRB093 03226 MKM 16624 a
 1        a hospital, skilled  nursing  facility,  or  intermediate
 2        care  facility,  as determined by a physician licensed to
 3        practice medicine in all its branches;
 4             (b)  it is appropriate to provide such care  outside
 5        of  an institution, as determined by a physician licensed
 6        to practice medicine in all its branches;
 7             (c)  the estimated amount which  would  be  expended
 8        for  care outside the institution is not greater than the
 9        estimated  amount  which  would   be   expended   in   an
10        institution.
11        Persons  who  are  16  years  of  age  or  older who have
12    received benefits under this  subsection  shall  be  reviewed
13    annually  to  determine  appropriate ways to prepare them and
14    their families to transition from the  technology  dependent,
15    medically  fragile,  home-based  and community-based services
16    waiver to the home-based and community-based services  waiver
17    authorized under Title XIX of the federal Social Security Act
18    and  administered by the Office of Rehabilitation Services of
19    the Illinois Department of  Human  Services.  The  transition
20    shall include:
21             (1)  Assessing the person's medical needs, including
22        consultation by a physician licensed to practice medicine
23        in  all  its  branches,  and  providing  information  and
24        opportunities   to   transition   from   services   using
25        registered   nurses   or  licensed  practical  nurses  to
26        services using certified nursing assistants  or  personal
27        assistants  in  order to assist the person and his or her
28        family in adjusting  to  services  provided  through  the
29        adult home-based and community-based services waiver.
30             (2)  Assessing  the  person's  needs for educational
31        and vocational planning and linking the person and his or
32        her family to support services that assist the person  to
33        transition  successfully  from  the technology dependent,
34        medically fragile model of care to an  adult  independent
 
                            -16-     LRB093 03226 MKM 16624 a
 1        living model administered by the Office of Rehabilitation
 2        Services.
 3             (3)  Development  of  a  service plan with timelines
 4        for implementation by the person's 21st birthday based on
 5        the level of care required for that person.  The  service
 6        plan  shall provide services comparable to coverage under
 7        this paragraph under  a  home-based  and  community-based
 8        waiver adult independent living model administered by the
 9        Illinois  Department of Human Services when the person is
10        no longer eligible for coverage under this paragraph. The
11        service plan may include services at a  cost  no  greater
12        than   the   Department  of  Public  Aid  rate  paid  for
13        exceptional care services provided in a  skilled  nursing
14        facility pursuant to Section 5-5.8a.
15        8.  Persons  who  become ineligible for basic maintenance
16    assistance  under  Article  IV  of  this  Code  in   programs
17    administered  by  the  Illinois  Department due to employment
18    earnings and persons in assistance units comprised of  adults
19    and  children  who  become  ineligible  for basic maintenance
20    assistance under Article VI of this Code  due  to  employment
21    earnings.   The  plan  for coverage for this class of persons
22    shall:
23             (a)  extend the medical assistance coverage  for  up
24        to  12  months following termination of basic maintenance
25        assistance; and
26             (b)  offer persons who  have  initially  received  6
27        months  of  the coverage provided in paragraph (a) above,
28        the  option  of  receiving  an  additional  6  months  of
29        coverage, subject to the following:
30                  (i)  such  coverage  shall   be   pursuant   to
31             provisions of the federal Social Security Act;
32                  (ii)  such  coverage shall include all services
33             covered while the  person  was  eligible  for  basic
34             maintenance assistance;
 
                            -17-     LRB093 03226 MKM 16624 a
 1                  (iii)  no  premium  shall  be  charged for such
 2             coverage; and
 3                  (iv)  such coverage shall be suspended  in  the
 4             event  of  a  person's failure without good cause to
 5             file in a timely fashion reports required  for  this
 6             coverage  under the Social Security Act and coverage
 7             shall be reinstated upon the filing of such  reports
 8             if the person remains otherwise eligible.
 9        9.  Persons   with   acquired  immunodeficiency  syndrome
10    (AIDS) or with AIDS-related conditions with respect  to  whom
11    there   has  been  a  determination  that  but  for  home  or
12    community-based services such individuals would  require  the
13    level  of  care  provided  in  an inpatient hospital, skilled
14    nursing facility or intermediate care facility  the  cost  of
15    which  is reimbursed under this Article.  Assistance shall be
16    provided to such persons  to  the  maximum  extent  permitted
17    under Title XIX of the Federal Social Security Act.
18        10.  Participants   in   the   long-term  care  insurance
19    partnership program established  under  the  Partnership  for
20    Long-Term Care Act who meet the qualifications for protection
21    of resources described in Section 25 of that Act.
22        11.  Persons  with  disabilities  who  are  employed  and
23    eligible     for     Medicaid,     pursuant     to    Section
24    1902(a)(10)(A)(ii)(xv)  of  the  Social  Security   Act,   as
25    provided by the Illinois Department by rule.
26        12.  Subject   to   federal  approval,  persons  who  are
27    eligible for medical  assistance  coverage  under  applicable
28    provisions of the federal Social Security Act and the federal
29    Breast  and  Cervical  Cancer Prevention and Treatment Act of
30    2000.  Those eligible persons are defined to include, but not
31    be limited to, the following persons:
32             (1)  persons who have been screened  for  breast  or
33        cervical  cancer  under  the  U.S.  Centers  for  Disease
34        Control and Prevention Breast and Cervical Cancer Program
 
                            -18-     LRB093 03226 MKM 16624 a
 1        established  under  Title XV of the federal Public Health
 2        Services Act  in  accordance  with  the  requirements  of
 3        Section  1504 of that Act as administered by the Illinois
 4        Department of Public Health; and
 5             (2)  persons  whose  screenings  under   the   above
 6        program  were  funded  in  whole  or  in  part  by  funds
 7        appropriated  to the Illinois Department of Public Health
 8        for breast or cervical cancer screening.
 9    "Medical  assistance"  under  this  paragraph  12  shall   be
10    identical to the benefits provided under the State's approved
11    plan  under  Title  XIX  of  the  Social  Security  Act.  The
12    Department must request  federal  approval  of  the  coverage
13    under  this  paragraph  12 within 30 days after the effective
14    date of this amendatory Act of the 92nd General Assembly.
15        The Illinois Department and the Governor shall provide  a
16    plan  for  coverage of the persons eligible under paragraph 7
17    as soon as possible after July 1, 1984.
18        The eligibility of any such person for medical assistance
19    under this Article is not affected  by  the  payment  of  any
20    grant under the Senior Citizens and Disabled Persons Property
21    Tax   Relief   and   Pharmaceutical  Assistance  Act  or  any
22    distributions or items of income described under subparagraph
23    (X) of paragraph (2) of subsection (a) of Section 203 of  the
24    Illinois  Income  Tax  Act.   The  Department  shall  by rule
25    establish  the  amounts  of  assets  to  be  disregarded   in
26    determining  eligibility  for medical assistance, which shall
27    at a minimum equal the amounts to be  disregarded  under  the
28    Federal  Supplemental Security Income Program.  The amount of
29    assets of a single person to be disregarded shall not be less
30    than $2,000, and the amount of assets of a married couple  to
31    be disregarded shall not be less than $3,000.
32        To  the  extent  permitted  under federal law, any person
33    found guilty of a second violation of Article VIIIA shall  be
34    ineligible  for  medical  assistance  under  this Article, as
 
                            -19-     LRB093 03226 MKM 16624 a
 1    provided in Section 8A-8.
 2        The eligibility of  any  person  for  medical  assistance
 3    under  this  Article  shall not be affected by the receipt by
 4    the person of donations or benefits from fundraisers held for
 5    the person in cases of serious illness, as  long  as  neither
 6    the  person  nor  members  of the person's family have actual
 7    control over the donations or benefits or the disbursement of
 8    the donations or benefits.
 9    (Source: P.A. 91-676, eff.  12-23-99;  91-699,  eff.  7-1-00;
10    91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff. 7-3-01;
11    92-597, eff. 6-28-02.)

12        (405 ILCS 80/1-1 rep.)
13        (405 ILCS 80/1-2 rep.)
14        (405 ILCS 80/1-3 rep.)
15        (405 ILCS 80/1-4 rep.)
16        (405 ILCS 80/1-5 rep.)
17        Section  90.  The  Developmental  Disability  and  Mental
18    Disability Services Act is amended by repealing Sections 1-1,
19    1-2,  1-3,  1-4,  and  1-5  (the  Developmental  Disabilities
20    Services Law).

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