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| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 HB1255 Introduced 02/08/11, by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED: | | 410 ILCS 535/17 | from Ch. 111 1/2, par. 73-17 | 750 ILCS 50/18.06 | | 750 ILCS 50/18.1 | from Ch. 40, par. 1522.1 | 750 ILCS 50/18.1a | | 750 ILCS 50/18.1b | | 750 ILCS 50/18.2 | from Ch. 40, par. 1522.2 | 750 ILCS 50/18.3a | from Ch. 40, par. 1522.3a | 750 ILCS 50/18.6 | from Ch. 40, par. 1522.6 |
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Amends the Vital Records Act. Provides that if a new birth certificate is issued subsequent to an adoption, the original certificate is not subject to inspection until the adopted person has reached the age of 21; but thereafter, the original certificate is available as provided by the Adoption Act. Amends the Adoption Act. Provides that for purposes of the Act, a "surviving spouse" of an adopted or surrendered person must be age 21 or over. Provides that the Registry may not release identity information when a birth parent is deceased and when the deceased birth parent's Birth Preference Form indicates that the birth parent did not allow the release of identifying information and did not want to be contacted by the birth child after the child attains the age of 21. Provides that the Medical Information Exchange Questionnaire shall include a comprehensive check-list of medical conditions, including those of genetic origin. Makes other changes. Effective immediately. |
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| | A BILL FOR |
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1 | | AN ACT concerning families.
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2 | | Be it enacted by the People of the State of Illinois, |
3 | | represented in the General Assembly:
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4 | | Section 5. The Vital Records Act is amended by changing |
5 | | Section 17 as follows:
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6 | | (410 ILCS 535/17) (from Ch. 111 1/2, par. 73-17)
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7 | | Sec. 17. (1) For a person born in this State, the State |
8 | | Registrar of Vital
Records shall establish a new certificate of |
9 | | birth when he receives any of
the following:
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10 | | (a) A certificate of adoption as provided in Section 16 |
11 | | or a certified
copy of the order of adoption together with |
12 | | the information necessary to
identify the original |
13 | | certificate of birth and to establish the new
certificate |
14 | | of birth; except that a new certificate of birth shall not |
15 | | be
established if so requested by the court ordering the |
16 | | adoption, the
adoptive parents, or the adopted person.
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17 | | (b) A certificate of adoption or a certified copy of |
18 | | the order of
adoption entered in a court of competent |
19 | | jurisdiction of any other state or
country declaring |
20 | | adopted a child born in the State of Illinois, together
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21 | | with the information necessary to identify the original |
22 | | certificate of
birth and to establish the new certificate |
23 | | of birth; except that a new
certificate of birth shall not |
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1 | | be established if so requested by the court
ordering the |
2 | | adoption, the adoptive parents, or the adopted person.
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3 | | (c) A request that a new certificate be established and |
4 | | such evidence as
required by regulation proving that such |
5 | | person has been legitimatized, or
that the circuit court, |
6 | | the Department of Healthcare and Family Services (formerly
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7 | | Illinois Department of Public Aid), or
a court or |
8 | | administrative agency of any other state
has established
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9 | | the paternity of such a person
by judicial or |
10 | | administrative processes or by voluntary acknowledgment,
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11 | | which is accompanied by the social security
numbers of all |
12 | | persons determined and presumed to be the parents.
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13 | | (d) An affidavit by a physician that he has performed |
14 | | an operation on a
person, and that by reason of the |
15 | | operation the sex designation on such
person's birth record |
16 | | should be changed. The State Registrar of Vital
Records may |
17 | | make any investigation or require any further information |
18 | | he
deems necessary.
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19 | | Each request for a new certificate of birth shall be |
20 | | accompanied by a fee
of $15 and entitles the applicant to one |
21 | | certification or certified copy
of the new certificate. If the |
22 | | request is for additional copies, it shall
be accompanied by a |
23 | | fee of $2 for each additional certification or certified
copy.
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24 | | (2) When a new certificate of birth is established, the |
25 | | actual place and
date of birth shall be shown; provided, in the |
26 | | case of adoption of a person
born in this State by parents who |
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1 | | were residents of this State at the time
of the birth of the |
2 | | adopted person, the place of birth may be shown as the
place of |
3 | | residence of the adoptive parents at the time of such person's
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4 | | birth, if specifically requested by them, and any new |
5 | | certificate of birth
established prior to the effective date of |
6 | | this amendatory Act may be
corrected accordingly if so |
7 | | requested by the adoptive parents or the
adopted person when of |
8 | | legal age. The social security numbers of the
parents shall not |
9 | | be recorded on the certificate of birth. The social
security |
10 | | numbers may only be used for purposes allowed under federal |
11 | | law.
The new certificate shall be substituted for the original |
12 | | certificate of birth:
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13 | | (a) Thereafter, the original certificate and the |
14 | | evidence of adoption,
paternity, legitimation, or sex |
15 | | change shall not be subject to inspection
or certification |
16 | | except upon order of the circuit court or
as provided by |
17 | | regulation. If the new certificate was issued subsequent to |
18 | | an adoption, the original certificate shall not be subject |
19 | | to inspection until the adopted person has reached the age |
20 | | of 21; thereafter, the original certificate shall be made |
21 | | available as provided by Section 18.1b of the Adoption Act.
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22 | | (b) Upon receipt of notice of annulment of adoption, |
23 | | the original
certificate of birth shall be restored to its |
24 | | place in the files, and the
new certificate and evidence |
25 | | shall not be subject to inspection or
certification except |
26 | | upon order of the circuit court.
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1 | | (3) If no certificate of birth is on file for the person |
2 | | for whom a new
certificate is to be established under this |
3 | | Section, a delayed record of
birth shall be filed with the |
4 | | State Registrar of Vital Records as provided
in Section 14 or |
5 | | Section 15 of this Act before a new certificate of birth
is |
6 | | established, except that when the date and place of birth and |
7 | | parentage
have been established in the adoption proceedings, a |
8 | | delayed record shall
not be required.
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9 | | (4) When a new certificate of birth is established by the |
10 | | State
Registrar of Vital Records, all copies of the original |
11 | | certificate of birth
in the custody of any custodian of |
12 | | permanent local records in this State
shall be transmitted to |
13 | | the State Registrar of Vital Records as directed,
and shall be |
14 | | sealed from inspection except as provided by Section 18.1b of |
15 | | the Adoption Act .
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16 | | (5) Nothing in this Section shall be construed to prohibit |
17 | | the amendment
of a birth certificate in accordance with |
18 | | subsection (6) of Section 22.
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19 | | (Source: P.A. 95-331, eff. 8-21-07.)
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20 | | Section 10. The Adoption Act is amended by changing |
21 | | Sections 18.06, 18.1, 18.1a, 18.1b, 18.2, 18.3a, and 18.6 as |
22 | | follows:
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23 | | (750 ILCS 50/18.06)
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24 | | Sec. 18.06. Definitions. When used in Sections
18.05 |
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1 | | through Section 18.6, for the purposes of the Registry:
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2 | | "Adopted person" means a person who was adopted
pursuant to |
3 | | the laws in effect at the time of the adoption.
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4 | | "Adoptive parent" means a person who has become a parent |
5 | | through the legal
process of adoption.
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6 | | "Adult child" means the biological child 21 years of age or |
7 | | over of a deceased adopted or surrendered person.
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8 | | "Adult Adopted or Surrendered Person" means an adopted or |
9 | | surrendered person 21 years of age or over. |
10 | | "Agency" means a public child welfare agency or a licensed |
11 | | child welfare
agency.
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12 | | "Birth aunt" means the adult full or half sister of a |
13 | | deceased birth parent.
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14 | | "Birth father" means the biological father of an adopted or |
15 | | surrendered
person who is named on the original certificate of |
16 | | live birth or on a consent
or surrender document, or a |
17 | | biological father whose paternity has been
established by a |
18 | | judgment or order of the court, pursuant to the Illinois
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19 | | Parentage Act of 1984.
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20 | | "Birth mother" means the biological mother of an adopted or |
21 | | surrendered
person.
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22 | | "Birth parent" means a birth mother or birth father of an |
23 | | adopted or
surrendered person.
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24 | | "Birth Parent Preference Form" means the form prepared by |
25 | | the Department of Public Health pursuant to Section 18.2 |
26 | | completed by a birth parent registrant and filed with the |
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1 | | Registry that indicates the birth parent's preferences |
2 | | regarding contact and , if applicable, the release of his or her |
3 | | identifying information on the non-certified copy of the |
4 | | original birth certificate released to an adult adopted or |
5 | | surrendered person or to the surviving adult child or surviving |
6 | | spouse of a deceased adopted or surrendered person who has |
7 | | filed a Request for a Non-Certified Copy of an Original Birth |
8 | | Certificate. |
9 | | "Birth relative" means a birth mother, birth father, birth |
10 | | sibling, birth aunt, or birth uncle.
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11 | | "Birth sibling" means the adult full or half sibling
of an |
12 | | adopted or
surrendered person.
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13 | | "Birth uncle" means the adult full or half brother of a |
14 | | deceased birth parent.
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15 | | "Confidential intermediary" means an individual certified |
16 | | by the Department of Children and Family Services pursuant to |
17 | | Section 18.3a(e). |
18 | | "Denial of Information Exchange" means an affidavit |
19 | | completed by a
registrant with the Illinois Adoption Registry |
20 | | and Medical Information Exchange
denying the release of |
21 | | identifying information which has been filed with the Registry.
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22 | | "Information Exchange Authorization" means
an affidavit |
23 | | completed by a registrant with the Illinois Adoption Registry |
24 | | and
Medical Information Exchange authorizing the release of |
25 | | identifying
information which has been filed with the Registry.
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26 | | "Medical Information Exchange Questionnaire" means the |
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1 | | medical
history
questionnaire completed by a registrant of the |
2 | | Illinois Adoption Registry and
Medical Information Exchange.
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3 | | "Non-certified Copy of the Original Birth Certificate" |
4 | | means a non-certified copy of the original certificate of live |
5 | | birth of an adult adopted or surrendered person who was born in |
6 | | Illinois. |
7 | | "Proof of death" means a death certificate.
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8 | | "Registrant" or "Registered Party" means a birth parent, |
9 | | birth sibling,
birth aunt, birth uncle, adopted or surrendered |
10 | | person 21 years of age or over, adoptive parent or legal
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11 | | guardian of an adopted or surrendered person under the age of |
12 | | 21, or adoptive parent, surviving spouse, or adult child of a |
13 | | deceased adopted or surrendered person who has filed
an |
14 | | Illinois Adoption Registry Application or Registration |
15 | | Identification Form
with the Registry.
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16 | | "Registry" means the Illinois Adoption Registry and |
17 | | Medical Information Exchange. |
18 | | "Request for a Non-Certified Copy of an Original Birth |
19 | | Certificate" means an affidavit completed by an adult adopted |
20 | | or surrendered person or by the surviving adult child or |
21 | | surviving spouse of a deceased adopted or surrendered person |
22 | | and filed with the Registry requesting a non-certified copy of |
23 | | an adult adopted or surrendered person's original certificate |
24 | | of live birth in Illinois. |
25 | | "Surrendered person" means a person whose parents' rights |
26 | | have been
surrendered or terminated but who has not been |
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1 | | adopted.
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2 | | "Surviving spouse" means the wife or husband , 21 years of |
3 | | age or older, of a deceased adopted or surrendered person who |
4 | | would be 21 years of age or older if still alive and who has one |
5 | | or more surviving biological children who are under the age of |
6 | | 21.
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7 | | "18.3 Statement" means a statement regarding the |
8 | | disclosure of identifying information signed by a birth parent |
9 | | under Section 18.3 of this Act as it existed immediately prior |
10 | | to the effective date of this amendatory Act of the 96th |
11 | | General Assembly. |
12 | | (Source: P.A. 96-895, eff. 5-21-10.)
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13 | | (750 ILCS 50/18.1) (from Ch. 40, par. 1522.1)
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14 | | Sec. 18.1. Disclosure of identifying information.
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15 | | (a) The Department of Public Health shall establish and |
16 | | maintain a
Registry for the purpose of allowing mutually
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17 | | consenting members of birth and adoptive families to exchange |
18 | | identifying and medical information. Identifying information |
19 | | for
the purpose of this Act shall mean any one or more of the |
20 | | following:
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21 | | (1) The name and last known address of the consenting |
22 | | person or persons.
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23 | | (2) A copy of the Illinois Adoption Registry |
24 | | Application of the
consenting person or persons.
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25 | | (3) A non-certified copy of the original birth |
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1 | | certificate of an adult adopted
or surrendered person.
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2 | | (b) Written authorization from all parties identified must |
3 | | be received prior
to disclosure of any identifying information, |
4 | | with the exception of non-certified copies of original birth |
5 | | certificates released to adult adopted or surrendered persons |
6 | | or to surviving adult children and surviving spouses of |
7 | | deceased adopted or surrendered persons pursuant to the |
8 | | procedures outlined in Section 18.1b(e).
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9 | | (c) At any time after a child is surrendered for adoption, |
10 | | or at any
time during the adoption proceedings or at any time |
11 | | thereafter, either
birth parent or both of them may file with |
12 | | the Registry a Birth
Parent Registration Identification Form |
13 | | and an Information Exchange
Authorization or a Denial of |
14 | | Information Exchange .
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15 | | (d) A birth sibling 21 years of age or over who was not |
16 | | surrendered for
adoption and who has submitted a copy of his or |
17 | | her birth certificate as well as proof of death for a deceased |
18 | | birth parent
and such birth parent did not file a Denial of |
19 | | Information Exchange or a Birth Parent Preference Form on which |
20 | | Option E was selected with the
Registry prior to his or her |
21 | | death may file a Registration Identification Form
and an |
22 | | Information Exchange Authorization or a Denial of Information |
23 | | Exchange.
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24 | | (e) A birth aunt or birth uncle who has submitted birth |
25 | | certificates for himself or herself and for a deceased birth |
26 | | parent naming at least one common biological parent as well as |
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1 | | proof of death for the deceased birth parent and such birth |
2 | | parent did not file a Denial of Information Exchange or a Birth |
3 | | Parent Preference Form on which Option E was selected with the |
4 | | Registry prior to his or her death may file a Registration |
5 | | Identification Form and an Information Exchange Authorization |
6 | | or a Denial of Information Exchange.
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7 | | (f) Any adopted person 21 years of age or over, any |
8 | | surrendered person
21 years of age or over, or any adoptive |
9 | | parent or legal guardian of an
adopted or surrendered person |
10 | | under the age of 21 may file with the Registry
a Registration |
11 | | Identification Form and an Information Exchange Authorization
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12 | | or a Denial of Information Exchange.
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13 | | (g) Any adult child 21 years of age or over of a deceased |
14 | | adopted or surrendered person who has submitted a copy of his |
15 | | or her birth certificate naming an adopted or surrendered |
16 | | person as his or her biological parent as well as proof of |
17 | | death for the deceased adopted or surrendered person and such |
18 | | adopted or surrendered person did not file a Denial of |
19 | | Information Exchange with the Registry prior to his or her |
20 | | death may file a Registration Identification Form and an |
21 | | Information Exchange Authorization or a Denial of Information |
22 | | Exchange.
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23 | | (h) Any surviving spouse of a deceased adopted or |
24 | | surrendered person 21 years of age or over who has submitted |
25 | | proof of death for the deceased adopted or surrendered person |
26 | | and such adopted or surrendered person did not file a Denial of |
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1 | | Information Exchange with the Registry prior to his or her |
2 | | death as well as a birth certificate naming themselves and the |
3 | | adopted or surrendered person as the parents of a minor child |
4 | | under the age of 21 may file a Registration Identification Form |
5 | | and an Information Exchange Authorization or a Denial of |
6 | | Information Exchange.
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7 | | (i) Any adoptive parent or legal guardian of a deceased |
8 | | adopted or surrendered person who is 21 years of age or over |
9 | | who has submitted proof of death as well as proof of parentage |
10 | | or guardianship for the deceased adopted or surrendered person |
11 | | and such adopted or surrendered person did not file a Denial of |
12 | | Information Exchange with the Registry prior to his or her |
13 | | death may file a Registration Identification Form and an |
14 | | Information Exchange Authorization or a Denial of Information |
15 | | Exchange.
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16 | | (j) The Department of Public Health shall supply to the |
17 | | adopted or
surrendered person or his or her adoptive parents, |
18 | | legal guardians, adult children or surviving spouse, and
to the |
19 | | birth parents identifying information only if both the adopted |
20 | | or
surrendered person, or one of his or her adoptive parents, |
21 | | legal guardians, adult children or his or her surviving spouse, |
22 | | and
the birth parents have filed with the Registry an |
23 | | Information Exchange
Authorization or a Birth Parent |
24 | | Preference Form on which Option A, B, or C was selected and the |
25 | | information at the Registry indicates that the
consenting |
26 | | adopted or surrendered person, the child of the consenting
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1 | | adoptive parents or legal guardians, the parent of the |
2 | | consenting adult child of the adopted or surrendered person, or |
3 | | the deceased wife or husband of the consenting surviving spouse
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4 | | is the child of the consenting birth
parents, except |
5 | | identifying information that appears on a non-certified copy of |
6 | | an original birth certificate may be provided to an adult |
7 | | adopted or surrendered person or to the surviving adult child |
8 | | or surviving spouse of a deceased adopted or surrendered person |
9 | | pursuant to the procedures outlined in Section 18.1b(e) of this |
10 | | Act.
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11 | | The Department of Public Health shall supply to adopted or |
12 | | surrendered
persons who are birth siblings identifying |
13 | | information only if both siblings
have filed with the Registry |
14 | | an Information Exchange Authorization and the
information at |
15 | | the Registry indicates that the consenting siblings have one
or |
16 | | both birth parents in common. Identifying information shall be |
17 | | supplied to
consenting birth siblings who were adopted or |
18 | | surrendered if any such sibling
is 21 years of age or over. |
19 | | Identifying information shall be supplied to
consenting birth |
20 | | siblings who were not adopted or surrendered if any such
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21 | | sibling is 21 years of age or over and has proof of death of the |
22 | | common birth
parent and such birth parent did not file a Denial |
23 | | of Information Exchange or a Birth Parent Preference Form on |
24 | | which Option E was selected
with the Registry prior to his or |
25 | | her death.
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26 | | (k) The Department of Public Health shall supply to the |
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1 | | adopted or surrendered person or his or her adoptive parents, |
2 | | legal guardians, adult children or surviving spouse, and to a |
3 | | birth aunt identifying information only if both the adopted or |
4 | | surrendered person or one of his or her adoptive parents, legal |
5 | | guardians, adult children or his or her surviving spouse, and |
6 | | the birth aunt have filed with the Registry an Information |
7 | | Exchange Authorization and the information at the Registry |
8 | | indicates that the consenting adopted or surrendered person, or |
9 | | the child of the consenting adoptive parents or legal |
10 | | guardians, or the parent of the consenting adult child, or the |
11 | | deceased wife or husband of the consenting surviving spouse of |
12 | | the adopted or surrendered person is or was the child of the |
13 | | brother or sister of the consenting birth aunt.
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14 | | (l) The Department of Public Health shall supply to the |
15 | | adopted or surrendered person or his or her adoptive parents, |
16 | | legal guardians, adult children or surviving spouse, and to a |
17 | | birth uncle identifying information only if both the adopted or |
18 | | surrendered person or one of his or her adoptive parents, legal |
19 | | guardians, adult children or his or her surviving spouse, and |
20 | | the birth uncle have filed with the Registry an Information |
21 | | Exchange Authorization and the information at the Registry |
22 | | indicates that the consenting adopted or surrendered person, or |
23 | | the child of the consenting adoptive parents or legal |
24 | | guardians, or the parent of the consenting adult child, or the |
25 | | deceased wife or husband of the consenting surviving spouse of |
26 | | the adopted or surrendered person is or was the child of the |
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1 | | brother or sister of the consenting birth uncle.
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2 | | (m) A registrant
may notify the Registry of his or her
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3 | | desire not to have identifying information revealed or may |
4 | | revoke any previously
filed Information Exchange Authorization |
5 | | by completing and filing with the
Registry a Registry |
6 | | Identification Form along with a Denial of Information
Exchange |
7 | | or, if applicable, a Birth Parent Preference Form . Any |
8 | | registrant, except a birth parent, may revoke his or her Denial |
9 | | of Information Exchange by filing
an Information Exchange |
10 | | Authorization. A birth parent may revoke a Denial of |
11 | | Information Exchange by filing a Birth Parent Preference Form. |
12 | | Any birth parent who has previously filed a Birth Parent |
13 | | Preference Form where Option E was selected may revoke such |
14 | | preference by filing a subsequent Birth Parent Preference Form |
15 | | and selecting Option A, B, C, or D. The Department of Public |
16 | | Health shall
act in accordance with the most recently filed |
17 | | affidavit.
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18 | | (n) Identifying information ascertained from the Registry |
19 | | shall be
confidential and may be disclosed only (1) upon a |
20 | | Court Order, which order
shall name the person or persons |
21 | | entitled to the information, or (2) to a registrant who is the |
22 | | subject of an Information Exchange
Authorization or, if |
23 | | applicable, a Birth Parent Preference Form that was completed |
24 | | by another registrant and filed with the Illinois Adoption |
25 | | Registry and Medical Information Exchange, or (3) as authorized |
26 | | under subsection (h) of Section 18.3 of
this Act, or (4) |
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1 | | pursuant to the procedures outlined in Section 18.1b(e) of this |
2 | | Act. Any person who willfully provides unauthorized
disclosure |
3 | | of any information filed with the Registry or who knowingly or
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4 | | intentionally files false information with the Registry shall |
5 | | be guilty of
a Class A misdemeanor and shall be liable for |
6 | | damages.
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7 | | (o) If information is disclosed pursuant to this Act, the |
8 | | Department shall
redact it to remove any identifying |
9 | | information about any party who has not
consented to the |
10 | | disclosure of such identifying information, or, in the case of |
11 | | identifying information on the original birth certificate, |
12 | | pursuant to Section 18.1b(e) of this Act.
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13 | | (Source: P.A. 96-895, eff. 5-21-10.)
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14 | | (750 ILCS 50/18.1a)
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15 | | Sec. 18.1a. Registry matches.
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16 | | (a) The Registry shall release identifying information, as |
17 | | specified on
the applicant's Information Exchange |
18 | | Authorization or, if applicable, a Birth Parent Preference |
19 | | Form , to the following
mutually consenting registered parties
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20 | | and provide them with any photographs or correspondence which |
21 | | have been placed in the
Adoption/Surrender Records File and
are |
22 | | specifically intended for the registered parties:
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23 | | (i) an adult adopted or surrendered person and one of |
24 | | his or her birth
relatives who have both filed an |
25 | | applicable Information
Exchange Authorization or, if |
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1 | | applicable, a Birth Parent Preference Form specifying the |
2 | | other consenting party with the Registry,
if
information |
3 | | available to the Registry
confirms that the consenting |
4 | | adopted or surrendered person is biologically related to |
5 | | the consenting birth relative;
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6 | | (ii) the adoptive parent or legal guardian of an |
7 | | adopted or surrendered
person under the age of 21
and one |
8 | | of the adopted or surrendered person's birth relatives who
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9 | | have both filed an Information Exchange Authorization |
10 | | specifying the other
consenting party with the Registry , |
11 | | or, if applicable, a Birth Parent Preference Form, with the |
12 | | Registry, if
information available to the Registry |
13 | | confirms that the child of the consenting
adoptive parent |
14 | | or legal guardian is biologically related to the
consenting
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15 | | birth relative; and
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16 | | (iii) the adoptive parent, adult child or surviving |
17 | | spouse of a deceased adopted or surrendered person, and one |
18 | | of the adopted or surrendered person's birth relatives who |
19 | | have both filed an applicable Information Exchange |
20 | | Authorization specifying the other consenting party with |
21 | | the Registry, or, if applicable, a Birth Parent Preference |
22 | | Form, with the Registry, if information available to the |
23 | | Registry confirms that the child of the consenting adoptive |
24 | | parent, the parent of the consenting adult child or the |
25 | | deceased wife or husband of the consenting surviving spouse |
26 | | of the adopted or surrendered person was biologically |
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1 | | related to the consenting birth relative.
|
2 | | (b) If a registrant is the subject of a Denial of
|
3 | | Information Exchange filed by another registered party or is an |
4 | | adopted or surrendered person, or the surviving relative of a |
5 | | deceased adopted or surrendered person, and a birth parent of |
6 | | the adopted or surrendered person completed a Birth Parent |
7 | | Preference Form and selected Option E , the Registry shall
not |
8 | | release identifying information to either registrant or, if |
9 | | applicable, to an adopted person who has requested a copy of |
10 | | his or her original birth certificate, with the exception of |
11 | | non-certified copies of the original birth certificate |
12 | | released under Section 18.1b(e), and as to a birth parent who |
13 | | has prohibited release of identifying information on the |
14 | | original birth certificate to the adult adopted or surrendered |
15 | | person, upon the death of said birth parent.
|
16 | | (c) If a registrant has completed a Medical Information |
17 | | Exchange
Questionnaire and has consented to its disclosure, |
18 | | that Questionnaire shall be
released to any registered party |
19 | | who has indicated their desire to receive such
information on |
20 | | his or her Illinois Adoption Registry Application, if
|
21 | | information available to the Registry
confirms that the |
22 | | consenting parties are biologically related, that the |
23 | | consenting
birth relative and the child of the consenting |
24 | | adoptive parents or legal
guardians are birth relatives, or |
25 | | that the consenting birth relative and the deceased wife or |
26 | | husband of the consenting surviving spouse are birth relatives.
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| | HB1255 | - 18 - | LRB097 07482 RPM 47592 b |
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1 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
2 | | (750 ILCS 50/18.1b)
|
3 | | Sec. 18.1b. The Illinois Adoption Registry Application. |
4 | | The Illinois
Adoption Registry Application shall substantially |
5 | | include the following:
|
6 | | (a) General Information. The Illinois Adoption Registry
|
7 | | Application shall include the space to provide Information |
8 | | about the registrant
including his or her
surname, given name |
9 | | or names, social security number (optional), mailing
address, |
10 | | home telephone number, gender, date and place of birth, and the |
11 | | date
of registration. If applicable and known
to the |
12 | | registrant, he or she may include the maiden surname of the
|
13 | | birth mother, any subsequent surnames of the birth mother, the |
14 | | surname of the
birth father, the given name or names of the |
15 | | birth parents, the dates and
places of birth of the birth |
16 | | parents, the surname and given name or names of
the adopted |
17 | | person prior to adoption, the gender and date and place of |
18 | | birth of
the adopted or surrendered person, the name of the |
19 | | adopted person following
his or her adoption and the state and |
20 | | county where the judgment of adoption was
finalized.
|
21 | | (b) Medical Information Exchange Questionnaire. In |
22 | | recognition of
the importance of medical information and of |
23 | | recent discoveries regarding the
genetic origin of many medical |
24 | | conditions and diseases all registrants shall be
asked to |
25 | | voluntarily complete a Medical
Information Exchange |
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| | HB1255 | - 19 - | LRB097 07482 RPM 47592 b |
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1 | | Questionnaire. The Medical Information Exchange Questionnaire |
2 | | shall include a comprehensive check-list of medical conditions |
3 | | and diseases including those of genetic origin.
|
4 | | (1) For birth relatives, the Medical Information |
5 | | Exchange
Questionnaire
shall
include a comprehensive |
6 | | check-list of medical
conditions and diseases including |
7 | | those of genetic origin. Birth relatives shall be asked to |
8 | | indicate all genetically-inherited diseases
and
conditions |
9 | | on this
list which are known to exist in the adopted or |
10 | | surrendered person's birth
family at the time of |
11 | | registration.
In addition, all birth relatives
shall be |
12 | | apprised of the Registry's provisions for voluntarily |
13 | | submitting
information about their and their family's |
14 | | medical
histories on a confidential, ongoing basis.
|
15 | | (2) Adopted and surrendered persons and their adoptive |
16 | | parents, legal
guardians, adult children, and surviving |
17 | | spouses shall be asked to indicate all
|
18 | | genetically-inherited diseases and medical conditions with |
19 | | which the adopted or
surrendered person or, if applicable, |
20 | | his or her children have been diagnosed
since birth.
|
21 | | (3) The Medical Information Exchange Questionnaire
|
22 | | shall include a space where the registrant may authorize |
23 | | the release of the
Medical Information Exchange |
24 | | Questionnaire to specified registered parties and a
|
25 | | disclaimer
informing registrants that the Department of |
26 | | Public Health cannot guarantee the
accuracy of medical |
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| | HB1255 | - 20 - | LRB097 07482 RPM 47592 b |
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1 | | information exchanged through the Registry.
|
2 | | (c) Written statement. All registrants shall be given the
|
3 | | opportunity to voluntarily file a written statement with the |
4 | | Registry. This
statement
shall be submitted in the space |
5 | | provided.
No written statement submitted to the Registry
shall |
6 | | include identifying information pertaining to any person other |
7 | | than the
registrant who submitted it.
Any such identifying |
8 | | information shall be redacted by the Department or
returned for |
9 | | removal of identifying information.
|
10 | | (d) Exchange of information. All registrants except birth |
11 | | parents may indicate their
wishes regarding contact and the |
12 | | exchange of identifying and/or medical information with any |
13 | | other registrant by completing an
Information Exchange |
14 | | Authorization or a Denial of Information Exchange. Birth |
15 | | parents may indicate their wishes regarding contact by filing a |
16 | | Birth Parent Preference Form pursuant to the procedures |
17 | | outlined in this Section.
|
18 | | (1) Information Exchange Authorization. Adopted or |
19 | | surrendered persons 21
years of age or over who are |
20 | | interested in exchanging identifying and/or medical |
21 | | information or would welcome contact with one or more of |
22 | | their
birth relatives; birth parents
who are interested in |
23 | | exchanging identifying and/or medical information or would |
24 | | welcome contact with an adopted or surrendered
person 21 |
25 | | years of age or over, or one or more of his or her adoptive |
26 | | parents, legal guardians, adult children, or a surviving |
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1 | | spouse;
birth siblings 21 years of age or over who were |
2 | | adopted or surrendered and who
are interested in exchanging |
3 | | identifying and/or medical information or would welcome |
4 | | contact with an adopted or surrendered person, or one or |
5 | | more of
his or her adoptive parents, legal guardians, adult |
6 | | children, or a surviving spouse; birth siblings 21 years of |
7 | | age
or
over who were not surrendered and who have submitted |
8 | | proof of death for any
common
birth parent
who did not file |
9 | | a Denial of Information Exchange or a Birth Parent |
10 | | Preference Form on which Option E was selected prior to his |
11 | | or her death,
and who are interested in exchanging |
12 | | identifying and/or medical information or would welcome |
13 | | contact with an adopted or surrendered person, or one or
|
14 | | more of his or her adoptive parents,
legal guardians, adult |
15 | | children, or a surviving spouse; birth aunts and birth |
16 | | uncles 21 years of age or over who have submitted birth |
17 | | certificates for themselves and a deceased birth parent |
18 | | naming at least one common biological parent as well as |
19 | | proof of death for a deceased birth parent and who are |
20 | | interested in exchanging identifying and/or medical |
21 | | information or would welcome contact with an adopted or |
22 | | surrendered person 21 years of age or over, or one or more |
23 | | of his or her adoptive parents, legal guardians, adult |
24 | | children or a surviving spouse;
adoptive parents or
legal |
25 | | guardians of
adopted or surrendered persons under the age |
26 | | of 21 who are interested in exchanging identifying and/or |
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1 | | medical information or would welcome
contact with one or |
2 | | more of the adopted or surrendered person's birth |
3 | | relatives; adoptive parents and legal guardians of |
4 | | deceased adopted or surrendered persons 21 years of age or |
5 | | over who have submitted proof of death for a deceased |
6 | | adopted or surrendered person who did not file a Denial of |
7 | | Information Exchange prior to his or her death and who are |
8 | | interested in exchanging identifying and/or medical |
9 | | information or would welcome contact with one or more of |
10 | | the adopted or surrendered person's birth relatives; adult |
11 | | children of deceased adopted or surrendered persons who |
12 | | have submitted a birth certificate naming the adopted or |
13 | | surrendered person as their biological parent and proof of |
14 | | death for an adopted or surrendered person who did not file |
15 | | a Denial of Information Exchange prior to his or her death; |
16 | | and surviving spouses of deceased adopted or surrendered |
17 | | persons who have submitted a marriage certificate naming an |
18 | | adopted or surrendered person as their deceased wife or |
19 | | husband and proof of death for an adopted or surrendered |
20 | | person who did not file a Denial of Information Exchange |
21 | | prior to his or her death and who are interested in |
22 | | exchanging identifying and/or medical information or would |
23 | | welcome contact with one or more of the adopted or |
24 | | surrendered person's birth relatives may specify with whom |
25 | | they
wish to exchange identifying information by
filing an |
26 | | Information Exchange Authorization.
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1 | | (2) Denial of Information Exchange. Adopted or |
2 | | surrendered persons 21
years of age or over who do not wish |
3 | | to exchange identifying information or establish contact |
4 | | with one or
more of their birth relatives may specify
with |
5 | | whom they do not wish to exchange
identifying information |
6 | | or do not wish to establish contact by filing a Denial of
|
7 | | Information Exchange. Birth relatives other than birth |
8 | | parents who do not wish to
establish contact with an
|
9 | | adopted or surrendered person or one or more of his or her |
10 | | adoptive parents,
legal guardians, or adult children may |
11 | | specify with whom they do not wish to exchange identifying
|
12 | | information or do not wish to establish contact by filing a |
13 | | Denial of Information Exchange. Birth parents who wish to |
14 | | prohibit the release of their identifying information on |
15 | | the original birth certificate released to an adult adopted |
16 | | or surrendered person who was born after January 1, 1946, |
17 | | or to the surviving adult child or surviving spouse of a |
18 | | deceased adopted or surrendered person who was born after |
19 | | January 1, 1946, may do so by filing a Denial with the |
20 | | Registry on or before December 31, 2010. As of January 1, |
21 | | 2011, birth parents who wish to prohibit the release of |
22 | | identifying information on the non-certified copy of the |
23 | | original birth certificate released to an adult adopted |
24 | | surrendered person or to the surviving adult child or |
25 | | surviving spouse of a deceased adopted or surrendered |
26 | | person may do so by selecting Option E on a Birth Parent |
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1 | | Preference Form and filing the Form with the Registry. |
2 | | Adoptive parents or
legal guardians of adopted or |
3 | | surrendered persons under the age of 21 who do
not wish to |
4 | | establish contact with one or more of the adopted or
|
5 | | surrendered person's birth relatives may specify with whom |
6 | | they
do not wish to exchange identifying
information by |
7 | | filing a Denial of Information Exchange. Adoptive parents, |
8 | | adult children, and surviving spouses of deceased adoptees |
9 | | who do not wish to exchange identifying information or |
10 | | establish contact with one or more of the adopted or |
11 | | surrendered person's birth relatives may specify with whom |
12 | | they do not wish to exchange identifying information or do |
13 | | not wish to establish contact by filing a Denial of |
14 | | Information Exchange.
|
15 | | (3) Birth Parent Preference Form. Beginning January 1, |
16 | | 2011, birth parents who are eligible to register with the |
17 | | Illinois Adoption Registry and Medical Information |
18 | | Exchange and whose birth child was born on or after January |
19 | | 1, 1946 may who wish to communicate their wishes regarding |
20 | | contact or may prohibit and/or the release of their |
21 | | identifying information on the non-certified copy of the |
22 | | original birth certificate released under subsection (e) |
23 | | of this Section by filing to an adult adopted or |
24 | | surrendered person or the surviving adult child or |
25 | | surviving spouse of a deceased adopted or surrendered |
26 | | person who has requested a copy of the adopted or |
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1 | | surrendered person's original birth certificate by filing |
2 | | a Request for a Non-Certified Copy of an Original Birth |
3 | | Certificate pursuant to subsection (e) of this Section, may |
4 | | file a Birth Parent Preference Form with the Registry. |
5 | | Birth parents whose birth child was born before January 1, |
6 | | 1946, may communicate their wishes regarding contact by |
7 | | completing a Birth Parent Preference Form, selecting |
8 | | Option A, B, C, or D, and filing the form with the |
9 | | Registry, but may not prohibit the release of identifying |
10 | | information. All Birth Parent Preference Forms on file with |
11 | | the Registry at the time of receipt of a Request for a |
12 | | Non-Certified Copy of an Original Birth Certificate from an |
13 | | adult adopted or surrendered person or the surviving adult |
14 | | child or surviving spouse of a deceased adopted or |
15 | | surrendered person shall be forwarded to the relevant |
16 | | adopted or surrendered person or surviving adult child or |
17 | | surviving spouse of a deceased adopted or surrendered |
18 | | person along with a non-certified copy of the adopted or |
19 | | surrendered person's original birth certificate as |
20 | | outlined in subsection (e) of this Section. |
21 | | (e) Procedures for requesting a non-certified copy of an |
22 | | original birth certificate by an adult adopted or surrendered |
23 | | person or by a surviving adult child or surviving spouse of a |
24 | | deceased adopted or surrendered person: |
25 | | (1) On or after the effective date of this amendatory |
26 | | Act of the 96th General Assembly, any adult adopted or |
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1 | | surrendered person who was born in Illinois prior to |
2 | | January 1, 1946, may complete and file with the Registry a |
3 | | Request for a Non-Certified Copy of an Original Birth |
4 | | Certificate. The Registry shall provide such adult adopted |
5 | | or surrendered person with an unaltered, non-certified |
6 | | copy of his or her original birth certificate upon receipt |
7 | | of the Request for a Non-Certified Copy of an Original |
8 | | Birth Certificate. Additionally, in cases where an adopted |
9 | | or surrendered person born in Illinois prior to January 1, |
10 | | 1946, is deceased, and one of his or her surviving adult |
11 | | children or his or her surviving spouse has registered with |
12 | | the Registry, he or she may complete and file with the |
13 | | Registry a Request for a Non-Certified Copy of an Original |
14 | | Birth Certificate. The Registry shall provide such |
15 | | surviving adult child or surviving spouse with an |
16 | | unaltered, non-certified copy of the adopted or |
17 | | surrendered person's original birth certificate upon |
18 | | receipt of the Request for a Non-Certified Copy of an |
19 | | Original Birth Certificate. |
20 | | (2) Beginning November 15, 2011, any adult adopted or |
21 | | surrendered person who was born in Illinois on or after |
22 | | January 1, 1946, may complete and file with the Registry a |
23 | | Request for a Non-certified Copy of an Original Birth |
24 | | Certificate. Additionally, in cases where the adopted or |
25 | | surrendered person is deceased and one of his or her |
26 | | surviving adult children or his or her surviving spouse has |
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1 | | registered with the Registry, he or she may complete and |
2 | | file with the Registry a Request for a Non-Certified Copy |
3 | | of an Original Birth Certificate.
Upon receipt of such |
4 | | request from an adult adopted or surrendered person or from |
5 | | one of his or her surviving adult children or his or her |
6 | | surviving spouse, the Registry shall: |
7 | | (i) Determine if there is a Denial of Information |
8 | | Exchange which was filed by a birth parent named on the |
9 | | original birth certificate prior to January 1, 2011. If |
10 | | a Denial was filed by a birth parent named on the |
11 | | original birth certificate prior to January 1, 2011, |
12 | | and there is no proof of death in the Registry file for |
13 | | the birth parent who filed said Denial, the Registry |
14 | | shall inform the requesting adult adopted or |
15 | | surrendered person or the requesting surviving adult |
16 | | child or surviving spouse of a deceased adopted or |
17 | | surrendered person that they may receive a |
18 | | non-certified copy of the original birth certificate |
19 | | from which all identifying information pertaining to |
20 | | the birth parent who filed the Denial has been |
21 | | redacted. A requesting adult adopted or surrendered |
22 | | person shall also be informed in writing of his or her |
23 | | right to petition the court for the appointment of a |
24 | | confidential intermediary pursuant to Section 18.3a of |
25 | | this Act and, if applicable, to conduct a search |
26 | | through an agency post-adoption search program once 5 |
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1 | | years have elapsed since the birth parent filed the |
2 | | Denial of Information Exchange with the Registry. |
3 | | (ii) Determine if a birth parent named on the |
4 | | original birth certificate has filed a Birth Parent |
5 | | Preference Form. If one of the birth parents named on |
6 | | the original birth certificate filed a Birth Parent |
7 | | Preference Form and selected Option A, B, C, or D, the |
8 | | Registry shall forward to the adult adopted or |
9 | | surrendered person or to the surviving adult child or |
10 | | surviving spouse of a deceased adopted or surrendered |
11 | | person a copy of the Birth Parent Preference Form along |
12 | | with an unaltered non-certified copy of his or her |
13 | | original birth certificate .
If one of the birth parents |
14 | | named on the original birth certificate filed a Birth |
15 | | Parent Preference Form and selected Option E, and there |
16 | | is no proof of death in the Registry file for the birth |
17 | | parent who filed said Birth Parent Preference Form, the |
18 | | Registry shall inform the requesting adult adopted or |
19 | | surrendered person or the requesting surviving adult |
20 | | child or surviving spouse of a deceased adopted or |
21 | | surrendered person that he or she may receive a |
22 | | non-certified copy of the original birth certificate |
23 | | from which identifying information pertaining to the |
24 | | birth parent who completed the Birth Parent Preference |
25 | | Form has been redacted per the birth parent's |
26 | | specifications on the Form. The Registry shall forward |
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1 | | to the adult adopted or surrendered person or to the |
2 | | surviving adult child or surviving spouse of a deceased |
3 | | adopted or surrendered person a copy of the Birth |
4 | | Parent Preference Form filed by the birth parent from |
5 | | which identifying information has been redacted per |
6 | | the birth parent's specifications on the Form. The |
7 | | requesting adult adopted or surrendered person shall |
8 | | also be informed in writing of his or her right to |
9 | | petition the court for the appointment of a |
10 | | confidential intermediary pursuant to Section 18.3a of |
11 | | this Act, and, if applicable, to conduct a search |
12 | | through an agency post-adoption search program once 5 |
13 | | years have elapsed since the birth parent filed the |
14 | | Birth Parent Preference Form, on which Option E was |
15 | | selected, with the Registry. |
16 | | (iii) Determine if a birth parent named on the |
17 | | original birth certificate has filed an Information |
18 | | Exchange Authorization. |
19 | | (iv) If the Registry has confirmed that a |
20 | | requesting adult adopted or surrendered person or the |
21 | | parent of a requesting adult child of a deceased |
22 | | adopted or surrendered person or the husband or wife of |
23 | | a requesting surviving spouse was not the object of a |
24 | | Denial of Information Exchange filed by a birth parent |
25 | | on or before December 31, 2010, and that no birth |
26 | | parent named on the original birth certificate has |
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1 | | filed a Birth Parent Preference Form where Option E was |
2 | | selected prior to the receipt of a Request for a |
3 | | Non-Certified Copy of an Original Birth Certificate, |
4 | | the Registry shall provide the adult adopted or |
5 | | surrendered person or his or her surviving adult child |
6 | | or surviving spouse with an unaltered non-certified |
7 | | copy of the adopted or surrendered person's original |
8 | | birth certificate. |
9 | | (3) In cases where the Registry receives a Birth Parent |
10 | | Preference Form from a birth parent subsequent to the |
11 | | release of the non-certified copy of the original birth |
12 | | certificate to an adult adopted or surrendered person or to |
13 | | the surviving adult child or surviving spouse of a deceased |
14 | | adopted or surrendered person, the Birth Parent Preference |
15 | | Form shall be immediately forwarded to the adult adopted or |
16 | | surrendered person or to the surviving adult child or |
17 | | surviving spouse of the deceased adopted or surrendered |
18 | | person and the birth parent who filed the form shall be |
19 | | informed that the relevant original birth certificate has |
20 | | already been released. |
21 | | (4) A copy of the original birth certificate shall only |
22 | | be released to adopted or surrendered persons who were born |
23 | | in Illinois; to surviving adult children or surviving |
24 | | spouses of deceased adopted or surrendered persons who were |
25 | | born in Illinois; or to 2 registered parties who have both |
26 | | consented to the release of a non-certified copy of the |
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1 | | original birth certificate to one another through the |
2 | | Registry when the birth of the relevant adopted or |
3 | | surrendered person took place in Illinois. |
4 | | (5) In cases where the Registry receives a Request for |
5 | | a Non-Certified Copy of an Original Birth Certificate from |
6 | | an adult adopted or surrendered person who has not |
7 | | completed a Registry application and the file of that |
8 | | adopted or surrendered person includes an Information |
9 | | Exchange Authorization , Birth Parent Preference Form, or |
10 | | Medical Information Exchange Questionnaire from one or |
11 | | more of his or her birth relatives, the Registry shall so |
12 | | inform the adult adopted or surrendered person and forward |
13 | | Registry application forms to him or her along with a |
14 | | non-certified copy of the original birth certificate |
15 | | consistent with the procedures outlined in this subsection |
16 | | (e). |
17 | | (6) In cases where a birth parent registered with the |
18 | | Registry and filed a Medical Information Exchange |
19 | | Questionnaire prior to the effective date of this |
20 | | amendatory Act of the 96th General Assembly but gave no |
21 | | indication as to his or her wishes regarding contact or the |
22 | | sharing of identifying information, the Registry shall |
23 | | contact the birth parent by written letter prior to January |
24 | | 1, 2011, and provide him or her with the opportunity to |
25 | | indicate his or her preference regarding contact and the |
26 | | sharing of identifying information by submitting a Birth |
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1 | | Parent Preference Form to the Registry prior to November 1, |
2 | | 2011. |
3 | | (7) In cases where the Registry cannot locate a copy of |
4 | | the original birth certificate in the Registry file, they |
5 | | shall be authorized to request a copy of the original birth |
6 | | certificate from the Illinois county where the birth took |
7 | | place for placement in the Registry file. |
8 | | (8) Adopted and surrendered persons who wish to have |
9 | | their names placed with the Illinois Adoption Registry and |
10 | | Medical Information Exchange may do so by completing a |
11 | | Registry application at any time, but completing a Registry |
12 | | application shall not be required for adopted and |
13 | | surrendered persons who seek only to obtain a copy of their |
14 | | original birth certificate or any relevant Birth Parent |
15 | | Preference Forms through the Registry. |
16 | | (9) In cases where a birth parent filed a Denial of |
17 | | Information Exchange with the Registry prior to January 1, |
18 | | 2011, or filed a Birth Parent Preference Form with the |
19 | | Registry and selected Option E after January 1, 2011, and a |
20 | | proof of death for the birth parent who filed the Denial or |
21 | | the Birth Parent Preference Form has been filed with the |
22 | | Registry by either a confidential intermediary , or a |
23 | | surviving relative of the deceased birth parent, or a birth |
24 | | child of the deceased birth parent, the Registry shall be |
25 | | authorized to release an unaltered non-certified copy of |
26 | | the original birth certificate to an adult adopted or |
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1 | | surrendered person or to the surviving adult child or |
2 | | surviving spouse of a deceased adopted or surrendered |
3 | | person who has filed a Request for a Non-Certified Copy of |
4 | | the Original Birth Certificate with the Registry. |
5 | | (10) On and after the effective date of this amendatory |
6 | | Act of the 96th General Assembly, in cases where all birth |
7 | | parents named on the original birth certificate of an |
8 | | adopted or surrendered person born after January 1, 1946, |
9 | | are deceased and copies of death certificates for all birth |
10 | | parents named on the original birth certificate have been |
11 | | filed with the Registry by either a confidential |
12 | | intermediary , or a surviving relative of the deceased birth |
13 | | parent, or a birth child of the deceased birth parent, the |
14 | | Registry shall be authorized to release a non-certified |
15 | | copy of the original birth certificate to the adopted or |
16 | | surrendered person upon receipt of his or her Request for a |
17 | | Non-Certified Copy of an Original Birth Certificate. |
18 | | (f) A registrant may complete all or any part of the |
19 | | Illinois Adoption
Registry Application. All Illinois Adoption |
20 | | Registry Applications, Information
Exchange
Authorizations, |
21 | | Denials of Information Exchange, requests to revoke an
|
22 | | Information
Exchange Authorization or Denial of Information |
23 | | Exchange, Birth Parent Preference Forms, and affidavits
|
24 | | submitted
to the Registry shall be
accompanied by proof of |
25 | | identification.
|
26 | | (Source: P.A. 96-895, eff. 5-21-10; revised 9-2-10.)
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| | HB1255 | - 34 - | LRB097 07482 RPM 47592 b |
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1 | | (750 ILCS 50/18.2) (from Ch. 40, par. 1522.2)
|
2 | | Sec. 18.2. Forms.
|
3 | | (a) The Department shall develop the Illinois Adoption |
4 | | Registry forms as provided in this Section. The General |
5 | | Assembly shall reexamine the content of the form as requested |
6 | | by the Department, in consultation with the Registry Advisory |
7 | | Council. The form of the Birth Parent Registration
|
8 | | Identification Form shall be substantially as follows:
|
9 | | BIRTH PARENT REGISTRATION IDENTIFICATION
|
10 | | (Insert all known information)
|
11 | | I, ....., state that I am the ...... (mother or father) of the
|
12 | | following child:
|
13 | | Child's original name: ..... (first) ..... (middle) ..... |
14 | | (last),
..... (hour of birth), ..... (date of birth), |
15 | | ..... (city and state of
birth), ..... (name of |
16 | | hospital).
|
17 | | Father's full name: ...... (first) ...... (middle) ..... |
18 | | (last),
..... (date of birth), ..... (city and state of |
19 | | birth).
|
20 | | Name of mother inserted on birth certificate: ..... (first) |
21 | | .....
(middle) ..... (last), ..... (race), ..... (date |
22 | | of birth), ......
(city and state of birth).
|
23 | | That I surrendered my child to: ............. (name of agency), |
24 | | .....
(city and state of agency), ..... (approximate date |
25 | | child surrendered).
|
|
| | HB1255 | - 35 - | LRB097 07482 RPM 47592 b |
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|
1 | | That I placed my child by private adoption: ..... (date),
|
2 | | ...... (city
and state).
|
3 | | Name of adoptive parents, if known: ......
|
4 | | Other identifying information: .....
|
5 | | ........................
|
6 | | (Signature of parent)
|
7 | | ............ ........................
|
8 | | (date) (printed name of parent)
|
9 | | (b) The form of the Adopted Person
Registration |
10 | | Identification shall be substantially
as follows:
|
11 | | ADOPTED PERSON
|
12 | | REGISTRATION IDENTIFICATION
|
13 | | (Insert all known information)
|
14 | | I, ....., state the following:
|
15 | | Adopted Person's present name: ..... (first) ..... |
16 | | (middle)
..... (last).
|
17 | | Adopted Person's name at birth (if known): ..... (first)
|
18 | | ..... (middle) .....
(last), ..... (birth date), ..... |
19 | | (city and state of birth), ......
(sex), ..... (race).
|
20 | | Name of adoptive father: ..... (first) ..... (middle) ..... |
21 | | (last), .....
(race).
|
22 | | Maiden name of adoptive mother: ..... (first) ..... |
23 | | (middle) .....
(last), ..... (race).
|
24 | | Name of birth mother (if known): ..... (first) .....
|
25 | | (middle)
..... (last), ..... (race).
|
|
| | HB1255 | - 36 - | LRB097 07482 RPM 47592 b |
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|
1 | | Name of birth father (if known): ..... (first) .....
|
2 | | (middle)
..... (last), ..... (race).
|
3 | | Name(s) at birth of sibling(s) having a common birth
parent |
4 | | with adoptee
(if known): ..... (first) ..... (middle) |
5 | | ..... (last), ..... (race), and name
of common birth |
6 | | parent: ..... (first) ..... (middle) .....
(last),
|
7 | | ..... (race).
|
8 | | I was adopted through: ..... (name of agency).
|
9 | | I was adopted privately: ..... (state "yes" if known).
|
10 | | I was adopted in ..... (city and state), ..... (approximate |
11 | | date).
|
12 | | Other identifying information: .............
|
13 | | ......................
|
14 | | (signature of adoptee)
|
15 | | ........... .........................
|
16 | | (date) (printed name of adoptee)
|
17 | | (c) The form of the Surrendered Person Registration |
18 | | Identification shall be
substantially as follows:
|
19 | | SURRENDERED PERSON REGISTRATION
|
20 | | IDENTIFICATION
|
21 | | (Insert all known information)
|
22 | | I, ....., state the following:
|
23 | | Surrendered Person's present name: ..... (first) .....
|
24 | | (middle) ..... (last).
|
25 | | Surrendered Person's name at birth (if known): ..... |
|
| | HB1255 | - 37 - | LRB097 07482 RPM 47592 b |
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|
1 | | (first)
.....
(middle) ..... (last), .....(birth |
2 | | date), ..... (city and state of
birth), ...... (sex), |
3 | | ..... (race).
|
4 | | Name of guardian father: ..... (first) ..... (middle) ..... |
5 | | (last), .....
(race).
|
6 | | Maiden name of guardian mother: ..... (first) ..... |
7 | | (middle) .....
(last), ..... (race).
|
8 | | Name of birth mother (if known): ..... (first) .....
|
9 | | (middle) .....
(last) ..... (race).
|
10 | | Name of birth father (if known): ..... (first) .....
|
11 | | (middle) .....
(last), .....(race).
|
12 | | Name(s) at birth of sibling(s) having a common birth
parent |
13 | | with surrendered person
(if known): ..... (first) |
14 | | ..... (middle) ..... (last), ..... (race), and name
of |
15 | | common birth parent: ..... (first) ..... (middle) |
16 | | .....
(last),
..... (race).
|
17 | | I was surrendered for adoption to: ..... (name of agency).
|
18 | | I was surrendered for adoption in ..... (city and state), ..... |
19 | | (approximate
date).
|
20 | | Other identifying information: ............
|
21 | | ................................
|
22 | | (signature of surrendered person)
|
23 | | ............ ......................
|
24 | | (date) (printed name of person
|
25 | | surrendered for adoption)
|
|
| | HB1255 | - 38 - | LRB097 07482 RPM 47592 b |
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|
1 | | (c-3) The form of the Registration Identification Form for |
2 | | Surviving Relatives of Deceased Birth Parents shall be |
3 | | substantially as follows:
|
4 | | REGISTRATION IDENTIFICATION FORM
|
5 | | FOR SURVIVING RELATIVES OF DECEASED BIRTH PARENTS
|
6 | | (Insert all known information)
|
7 | | I, ....., state the following:
|
8 | | Name of deceased birth parent at time of surrender:
|
9 | | Deceased birth parent's date of birth:
|
10 | | Deceased birth parent's date of death:
|
11 | | Adopted or surrendered person's name at birth (if known): |
12 | | .....(first) ..... (middle) ..... (last), .....(birth |
13 | | date), ..... (city and state of birth), ...... (sex), |
14 | | ..... (race).
|
15 | | My relationship to the adopted or surrendered person (check |
16 | | one): (birth parent's non-surrendered child) (birth parent's |
17 | | sister) (birth parent's brother).
|
18 | | If you are a non-surrendered child of the birth parent, provide |
19 | | name(s) at birth and age(s) of non-surrendered siblings having |
20 | | a common parent with the birth parent. If more than one |
21 | | sibling, please give information requested below on reverse |
22 | | side of this form. If you are a sibling or parent of the birth |
23 | | parent, provide name(s) at birth and age(s) of the sibling(s) |
24 | | of the birth parent. If more than one sibling, please give |
25 | | information requested below on reverse side of this form.
|
|
| | HB1255 | - 39 - | LRB097 07482 RPM 47592 b |
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|
1 | | Name (First) ..... (middle) ..... (last), .....(birth |
2 | | date), ..... (city and state of birth), ...... (sex), |
3 | | ..... (race).
|
4 | | Name(s) of common parent(s) (first) ..... (middle) ..... |
5 | | (last), .....(race), (first) ..... (middle) ..... |
6 | | (last), .....(race).
|
7 | | My birth sibling/child of my brother/child of my sister/ was |
8 | | surrendered for adoption to ..... (name of agency) City and |
9 | | state of agency ..... Date .....(approximate) Other |
10 | | identifying information ..... (Please note that you must: (i) |
11 | | be at least 21 years of age to register; (ii) submit with your |
12 | | registration a certified copy of the birth parent's birth |
13 | | certificate; (iii) submit a certified copy of the birth |
14 | | parent's death certificate; and (iv) if you are a |
15 | | non-surrendered birth sibling or a sibling of the deceased |
16 | | birth parent, also submit a certified copy of your birth |
17 | | certificate with this registration. No application from a |
18 | | surviving relative of a deceased birth parent can be accepted |
19 | | if the birth parent filed a Denial of Information Exchange |
20 | | prior to his or her death.)
|
21 | | ................................
|
22 | | (signature of birth parent's surviving relative)
|
23 | | ............ ............ |
24 | | (date) (printed name of birth |
25 | | parent's surviving relative) |
|
| | HB1255 | - 40 - | LRB097 07482 RPM 47592 b |
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|
1 | | (c-5) The form of the Registration Identification Form for |
2 | | Surviving Relatives of Deceased Adopted or Surrendered Persons |
3 | | shall be substantially as follows:
|
4 | | REGISTRATION IDENTIFICATION FORM FOR
|
5 | | SURVIVING RELATIVES OF DECEASED ADOPTED OR SURRENDERED PERSONS
|
6 | | (Insert all known information)
|
7 | | I, ....., state the following:
|
8 | | Adopted or surrendered person's name at birth (if known): |
9 | | (first) ..... (middle) ..... (last), .....(birth |
10 | | date), ..... (city and state of birth), ...... (sex), |
11 | | ..... (race). |
12 | | Adopted or surrendered person's date of death:
|
13 | | My relationship to the deceased adopted or surrendered |
14 | | person(check one): (adoptive mother) (adoptive father) (adult |
15 | | child) (surviving spouse).
|
16 | | If you are an adult child or surviving spouse of the adopted or |
17 | | surrendered person, provide name(s) at birth and age(s) of the |
18 | | children of the adopted or surrendered person. If the adopted |
19 | | or surrendered person had more than one child, please give |
20 | | information requested below on reverse side of this form. |
21 | | Name (first) ..... (middle) ..... (last), .....(birth |
22 | | date), ..... (city and state of birth), ...... (sex), |
23 | | ..... (race). |
24 | | Name(s) of common parent(s) (first) ..... (middle) ..... |
25 | | (last), .....(race), (first) ..... (middle) ..... |
|
| | HB1255 | - 41 - | LRB097 07482 RPM 47592 b |
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|
1 | | (last), .....(race).
|
2 | | My child/parent/deceased spouse was surrendered for |
3 | | adoption to .....(name of agency) City and state of agency |
4 | | ..... Date ..... (approximate) Other identifying |
5 | | information ..... (Please note that you must: (i) be at |
6 | | least 21 years of age to register; (ii) submit with your |
7 | | registration a certified copy of the adopted or surrendered |
8 | | person's death certificate; (iii) if you are the child of a |
9 | | deceased adopted or surrendered person, also submit a |
10 | | certified copy of your birth certificate with this |
11 | | registration; and (iv) if you are the surviving wife or |
12 | | husband of a deceased adopted or surrendered person, also |
13 | | submit a copy of your marriage certificate with this |
14 | | registration. No application from a surviving relative of a |
15 | | deceased adopted or surrendered person can be accepted if |
16 | | the adopted or surrendered person filed a Denial of |
17 | | Information Exchange prior to his or her death.)
|
18 | | ................................
|
19 | | (signature of adopted or surrendered person's surviving
|
20 | | relative)
|
21 | | ............ ............ |
22 | | (date) (printed name of adopted
|
23 | | person's surviving relative)
|
|
| | HB1255 | - 42 - | LRB097 07482 RPM 47592 b |
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|
1 | | (d) The form of the Information Exchange Authorization |
2 | | shall be
substantially
as follows:
|
3 | | INFORMATION EXCHANGE AUTHORIZATION
|
4 | | I, ....., state that I am the person who completed the |
5 | | Registration
Identification; that I am of the age of ..... |
6 | | years; that I hereby
authorize the Department of Public Health |
7 | | to give to the following person(s)
(birth mother
)
(birth |
8 | | father) (birth sibling) (adopted or surrendered person
) |
9 | | (adoptive mother) (adoptive father) (legal guardian of an |
10 | | adopted or surrendered person) (birth aunt) (birth uncle) |
11 | | (adult child of a deceased adopted or surrendered person) |
12 | | (surviving spouse of a deceased adopted or surrendered person) |
13 | | (all eligible relatives) the following
(please check the
|
14 | | information
authorized for exchange):
|
15 | | [ ] 1. Only my name and last known address.
|
16 | | [ ] 2. A copy of my Illinois Adoption Registry |
17 | | Application.
|
18 | | [ ] 3. A non-certified copy of the adopted or |
19 | | surrendered person's original certificate of live birth |
20 | | (check only if you are an adopted or surrendered person or |
21 | | the surviving adult child or surviving spouse of a deceased |
22 | | adopted or surrendered person).
|
23 | | [ ] 4. A copy of my completed medical questionnaire.
|
24 | | I am fully aware that I can only be supplied with
|
25 | | information about an individual or individuals who have
duly
|
26 | | executed an Information Exchange Authorization that
has
not |
|
| | HB1255 | - 43 - | LRB097 07482 RPM 47592 b |
|
|
1 | | been revoked or, if I am an adopted or surrendered person, from |
2 | | a birth parent who completed a Birth Parent Preference Form and |
3 | | did not prohibit the release of his or her identity to me; that |
4 | | I can be contacted by writing to: ..... (own name or
name of |
5 | | person to contact) (address) (phone number).
|
6 | | NOTE: New IARMIE registrants who do not complete a Medical |
7 | | Information Exchange Questionnaire and release a copy of their |
8 | | questionnaire to at least one Registry applicant must pay a $15 |
9 | | registration fee. |
10 | | Dated (insert date).
|
11 | | .............. |
12 | | (signature)
|
13 | | (e) The form of the Denial of Information Exchange shall be
|
14 | | substantially as follows:
|
15 | | DENIAL OF INFORMATION EXCHANGE
|
16 | | I, ....., state that I am the person who completed the |
17 | | Registration
Identification; that I am of the age of ..... |
18 | | years; that I hereby
instruct the Department of Public Health |
19 | | not to give any identifying
information about me to the |
20 | | following person(s)
(birth mother) (birth father) (birth |
21 | | sibling)(adopted or surrendered person)(adoptive mother) |
22 | | (adoptive father)(legal guardian of an adopted or surrendered |
23 | | person)(birth aunt)(birth uncle)(adult child of a deceased |
24 | | adopted or surrendered person) (surviving spouse of a deceased |
25 | | adopted or surrendered person) (all eligible relatives). |
|
| | HB1255 | - 44 - | LRB097 07482 RPM 47592 b |
|
|
1 | | IMPORTANT NOTE: A DENIAL FILED BY A BIRTH PARENT ON OR AFTER |
2 | | JANUARY 1, 2011, SHALL NOT PROHIBIT THE RELEASE OF THE BIRTH |
3 | | PARENT'S IDENTIFYING INFORMATION ON THE ORIGINAL BIRTH |
4 | | CERTIFICATE OF AN ADULT ADOPTED OR SURRENDERED PERSON. BIRTH |
5 | | PARENTS WHO WISH TO PROHIBIT THE RELEASE OF THEIR IDENTIFYING |
6 | | INFORMATION ON THE ORIGINAL BIRTH CERTIFICATE OF AN ADULT |
7 | | ADOPTED OR SURRENDERED PERSON SHALL FILE A BIRTH PARENT |
8 | | PREFERENCE FORM ON OR AFTER JANUARY 1, 2011. DENIALS FILED BY A |
9 | | BIRTH PARENT BEFORE JANUARY 1, 2011, WILL EXPIRE UPON THE DEATH |
10 | | OF THE BIRTH PARENT WITH RESPECT TO ACCESS TO IDENTIFYING |
11 | | INFORMATION ON THE ORIGINAL BIRTH CERTIFICATE RELEASED TO AN |
12 | | ADULT ADOPTED OR SURRENDERED PERSON OR TO A SURVIVING ADULT |
13 | | CHILD OR SURVIVING SPOUSE OF A DECEASED ADOPTED OR SURRENDERED |
14 | | PERSON.
|
15 | | I do/do not (circle appropriate response) authorize the |
16 | | Registry to release a copy of my completed Medical Information |
17 | | Exchange Questionnaire to qualified Registry applicants.
NOTE: |
18 | | New IARMIE registrants who do not complete a Medical |
19 | | Information Exchange Questionnaire and release a copy of their |
20 | | questionnaire to at least one Registry applicant must pay a $15 |
21 | | registration fee.
Birth parents filing a Denial of Information |
22 | | Exchange are advised that, under Illinois law, an adult adopted |
23 | | person may initiate a search for a birth parent who has filed a |
24 | | Denial of Information Exchange or Birth Parent Preference Form |
25 | | on which Option E was selected through the State confidential |
26 | | intermediary program once 5 years have elapsed since the filing |
|
| | HB1255 | - 45 - | LRB097 07482 RPM 47592 b |
|
|
1 | | of the Denial of Information Exchange or Birth Parent |
2 | | Preference Form .
|
3 | | Dated (insert date).
|
4 | | ............... |
5 | | (signature)
|
6 | | (f) The form of the Birth Parent Preference Form shall be |
7 | | substantially as follows: |
8 | | In recognition of the basic right of all persons to access |
9 | | their birth records, Illinois law now provides for the release |
10 | | of original birth certificates to adopted and surrendered |
11 | | persons 21 years of age or older upon request. While many birth |
12 | | parents are comfortable sharing their identities or initiating |
13 | | contact with their birth sons and daughters once they have |
14 | | reached adulthood, Illinois law also recognizes that there may |
15 | | be unique situations where a birth parent might have a |
16 | | compelling reason for not wishing to establish contact with a |
17 | | birth son or birth daughter or for not wishing to release |
18 | | identifying information that appears on the original birth |
19 | | certificate of a birth son or birth daughter who has reached |
20 | | adulthood. The Illinois Adoption Registry and Medical |
21 | | Information Exchange (IARMIE) has therefore established the |
22 | | attached this form to allow birth parents whose birth son or |
23 | | daughter was born on or after January 1, 1946, to express their |
24 | | preferences wishes regarding contact ; and , if their birth child |
25 | | was born on or after January 1, 1946, to express their wishes |
|
| | HB1255 | - 46 - | LRB097 07482 RPM 47592 b |
|
|
1 | | regarding the sharing of identifying information listed on the |
2 | | original birth certificate with an adult adopted or surrendered |
3 | | person who has reached the age of 21 or his or her surviving |
4 | | relatives . |
5 | | In selecting one of the 5 options below, birth parents |
6 | | should keep in mind that the decision to deny an adult adopted |
7 | | or surrendered person access to identifying information on his |
8 | | or her original birth record and/or information about |
9 | | genetically-transmitted diseases is an important decision one |
10 | | that may can impact the adopted or surrendered person's life in |
11 | | many ways. A request for anonymity on this form only pertains |
12 | | to information that is provided to an adult adopted or |
13 | | surrendered person or his or her surviving relatives through |
14 | | the Registry . This will and does not prevent the disclosure of |
15 | | identifying information that may be available to the adoptee |
16 | | through his or her adoptive parents and/or other means |
17 | | available to him or her. Birth parents who would prefer not to |
18 | | be contacted by their surrendered son or daughter are strongly |
19 | | urged to complete both the Non-Identifying Information Section |
20 | | included on the final page of the attached form this document |
21 | | and the Medical Questionnaire in order to provide their |
22 | | surrendered son or daughter with the background information he |
23 | | or she their surrendered son or daughter may need to better |
24 | | understand himself or herself and his or her origins. Birth |
25 | | parents whose birth son or birth daughter is under 21 years of |
26 | | age at the time of the completion of this form are reminded |
|
| | HB1255 | - 47 - | LRB097 07482 RPM 47592 b |
|
|
1 | | that no original birth certificate will be released by the |
2 | | IARMIE before an adoptee has reached the age of 21. |
3 | | Furthermore, birth parents whose surrendered son or daughter is |
4 | | under 21 years of age at the time of completion of this form |
5 | | are reminded that, since no original birth certificates are |
6 | | released by the IARMIE before an adoptee has reached the age of |
7 | | 21, and birth parents are encouraged to take as much time as |
8 | | they need to weigh the options available to them before |
9 | | completing this form. Should you need additional assistance in |
10 | | completing this form, please contact the agency that handled |
11 | | the adoption, if applicable, or the Illinois Adoption Registry |
12 | | and Medical Information Exchange at 877-323-5299 217-557-5159 . |
13 | | After careful consideration, I , (insert your name) ......, |
14 | | have made the following decision regarding contact with my |
15 | | birth son/birth daughter, (insert birth son's/birth daughter's |
16 | | name at birth, if applicable) ......, who was born in (insert |
17 | | city/town of birth) ...... on (insert date of birth)...... and |
18 | | the release of my identifying information as it appears on |
19 | | his/her original birth certificate when he/she reaches the age |
20 | | of 21, and I have chosen Option ...... (insert A, B, C, D, or E, |
21 | | as applicable). I realize that this form must be accompanied by |
22 | | a completed IARMIE application form as well as a Medical |
23 | | Information Exchange Questionnaire or the $15 registration |
24 | | fee. I am also aware that I may revoke this decision at any |
25 | | time by completing a new Birth Parent Preference Form and |
26 | | filing it with the IARMIE. I understand that it is my |
|
| | HB1255 | - 48 - | LRB097 07482 RPM 47592 b |
|
|
1 | | responsibility to update the IARMIE with any changes to contact |
2 | | information provided below. I also understand that, while |
3 | | preferences regarding the release of identifying information |
4 | | through the Registry are binding unless the law should change |
5 | | in the future, any selection I have made regarding my preferred |
6 | | method of contact is not. |
7 | | .................................... |
8 | | (Signature/Date) |
9 | | (Please insert your signature and today's date above, as well |
10 | | as under your chosen option, A, B, C, D, or E below.) |
11 | | Option A. My birth son or birth daughter was born on or after |
12 | | January 1, 1946, and I agree to the release of my identifying |
13 | | information as it appears on my birth son's/birth daughter's |
14 | | original birth certificate, OR my birth son or birth daughter |
15 | | was born prior to January 1, 1946. I would welcome direct |
16 | | contact with my birth son/birth daughter when he or she has |
17 | | reached the age of 21 . In addition, before my birth son or |
18 | | birth daughter has reached the age of 21 or in the event of his |
19 | | or her death, I would welcome contact with the following |
20 | | relatives of my birth child (circle all that apply): adoptive |
21 | | mother, adoptive father, surviving spouse, surviving adult |
22 | | child. and I wish to be contacted at the following mailing |
23 | | address, email address or phone number: |
24 | | ..................... |
|
| | HB1255 | - 49 - | LRB097 07482 RPM 47592 b |
|
|
1 | | ............................................................. |
2 | | ............................................................. |
3 | | ............................................................. |
4 | | (Signature/Date) |
5 | | Option B. My birth son or birth daughter was born on or after |
6 | | January 1, 1946, and I agree to the release of my identifying |
7 | | information as it appears on my birth son's/birth daughter's |
8 | | original birth certificate, OR my birth son or birth daughter |
9 | | was born prior to January 1, 1946. I would welcome contact with |
10 | | my birth son/birth daughter when he or she has reached the age |
11 | | of 21 . In addition, before my birth son or birth daughter has |
12 | | reached the age of 21 or in the event of his or her death, I |
13 | | would welcome contact with the following relatives of my birth |
14 | | child (circle all that apply): adoptive mother, adoptive |
15 | | father, surviving spouse, surviving adult child. , but I would |
16 | | prefer to be contacted through the following person. (Insert |
17 | | name and mailing address, email address or phone number of |
18 | | chosen contact person.) |
19 | | ..................................... |
20 | | ............................................................. |
21 | | (Signature/Date) |
22 | | Option C. My birth son or birth daughter was born on or after |
23 | | January 1, 1946, and I agree to the release of my identifying |
24 | | information name as it appears on my birth son's/birth |
|
| | HB1255 | - 50 - | LRB097 07482 RPM 47592 b |
|
|
1 | | daughter's original birth certificate, OR my birth son or birth |
2 | | daughter was born prior to January 1, 1946. I would welcome |
3 | | contact with my birth son/birth daughter when he or she has |
4 | | reached the age of 21 . In addition, before my birth son or |
5 | | birth daughter has reached the age of 21 or in the event of his |
6 | | or her death, I would welcome contact with the following |
7 | | relatives of my birth child (circle all that apply): adoptive |
8 | | mother, adoptive father, surviving spouse, surviving adult |
9 | | child. , but I would prefer to be contacted through the Illinois |
10 | | Confidential Intermediary Program confidential intermediary |
11 | | program (please call 800-526-9022 for additional information) |
12 | | or through the agency that handled the adoption. (Insert agency |
13 | | name, address and phone number, if applicable.) |
14 | | ............. |
15 | | ............................................................. |
16 | | (Signature/Date) |
17 | | Option D. My birth son or birth daughter was born on or after |
18 | | January 1, 1946, and I agree to the release of my identifying |
19 | | information name as it appears on my birth son's/birth |
20 | | daughter's original birth certificate when he or she has |
21 | | reached the age of 21 , OR my birth son or birth daughter was |
22 | | born prior to January 1, 1946. but I would prefer not to be |
23 | | contacted by my birth son/birth daughter or his or her adoptive |
24 | | parents or surviving relatives when he or she has reached the |
25 | | age of 21 . |
|
| | HB1255 | - 51 - | LRB097 07482 RPM 47592 b |
|
|
1 | | ................... |
2 | | (Signature/Date) |
3 | | Option E. My birth son or birth daughter was born on or after |
4 | | January 1, 1946, and I wish to prohibit the release of my |
5 | | (circle ALL applicable options) first name, last name, last |
6 | | known address, birth son/birth daughter's last name (if last |
7 | | name listed is same as mine), as they appear on my birth |
8 | | son's/birth daughter's original birth certificate and do not |
9 | | wish to be contacted by my birth son/birth daughter when he or |
10 | | she has reached the age of 21. If there were any special |
11 | | circumstances that played a role in your decision to remain |
12 | | anonymous which you would like to share with your birth |
13 | | son/birth daughter, please list them in the space provided |
14 | | below (optional). |
15 | | ........................................... |
16 | | ............................................................. |
17 | | I understand that, although I have chosen to prohibit the |
18 | | release of my identity on the non-certified copy of the |
19 | | original birth certificate released to my birth son/birth |
20 | | daughter, he or she may request that a court-appointed |
21 | | confidential intermediary contact me to request updated |
22 | | medical information and/or confirm my desire to remain |
23 | | anonymous once 5 years have elapsed since the signing of this |
24 | | form; at the time of this subsequent search, I wish to be |
25 | | contacted through the person named below. (Insert in blank area |
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1 | | below the name and phone number of the contact person, or leave |
2 | | it blank if you wish to be contacted directly.) I also |
3 | | understand that this request for anonymity shall expire upon my |
4 | | death. |
5 | | ...................................................... |
6 | | ............................................................. |
7 | | (Signature/Date) |
8 | | NOTE: A copy of this form will be forwarded to your birth son |
9 | | or birth daughter should he or she file a request for his or |
10 | | her original birth certificate with the IARMIE. However, if you |
11 | | have selected Option E, identifying information, per your |
12 | | specifications above, will be deleted from the copy of this |
13 | | form forwarded to your birth son or daughter during your |
14 | | lifetime. In the event that an adopted or surrendered person is |
15 | | deceased, his or her surviving adult children may request a |
16 | | copy of the adopted or surrendered person's original birth |
17 | | certificate providing they have registered with the IARMIE; the |
18 | | copy of this form and the non-certified copy of the original |
19 | | birth certificate forwarded to the surviving child of the |
20 | | adopted or surrendered person shall be redacted per your |
21 | | specifications on this form during your lifetime. |
22 | | Non-Identifying Information Section
|
23 | | I wish to voluntarily provide the following non-identifying |
24 | | information to my birth son or birth daughter surrendered son |
25 | | or daughter :
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1 | | My age at the time of my child's birth was .........
|
2 | | My race is best described as: .......................... |
3 | | My height is: ......... |
4 | | My body type is best described as (circle one): slim, average, |
5 | | muscular, a few extra pounds, or more than a few extra pounds.
|
6 | | My natural hair color is/was: .................. |
7 | | My eye color is: .................. |
8 | | My religion is best described as: ..................
|
9 | | My ethnic background is best described as: ..................
|
10 | | My educational level is closest to (circle applicable |
11 | | response): completed elementary school, graduated from |
12 | | high school, attended college, earned bachelor's degree, |
13 | | earned master's degree, earned doctoral degree.
|
14 | | My occupation is best described as .................. |
15 | | My hobbies include .................. |
16 | | My interests include .................. |
17 | | My talents include .................. |
18 | | In addition to my surrendered son or daughter, I also |
19 | | am the biological parent of (insert number) ....... boys and |
20 | | (insert number) ....... girls, of whom (insert number) ....... |
21 | | are still living.
|
22 | | The relationship between me and my child's birth mother/birth |
23 | | father would best be described as (circle appropriate |
24 | | response): husband and wife, ex-spouses, boyfriend and |
25 | | girlfriend, casual acquaintances, other (please specify) |
26 | | .............. |
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1 | | (g) The form of the Request for a Non-Certified Copy of an |
2 | | Original Birth Certificate shall be substantially as follows: |
3 | | REQUEST FOR A NON-CERTIFIED COPY OF AN ORIGINAL BIRTH |
4 | | CERTIFICATE |
5 | | I, (requesting party's full name) ....., hereby request a |
6 | | non-certified copy of (check appropriate option) ..... my |
7 | | original birth certificate ..... the original birth |
8 | | certificate of my deceased adopted or surrendered parent ..... |
9 | | the original birth certificate of my deceased adopted or |
10 | | surrendered spouse (insert deceased parent's/deceased spouse's |
11 | | name at adoption) ...... I/my deceased parent/my deceased |
12 | | spouse was born in (insert city and county of adopted or |
13 | | surrendered person's birth) ..... on ..... (insert adopted or |
14 | | surrendered person's date of birth). In the event that one or |
15 | | both of my/my deceased parent's/my deceased spouse's birth |
16 | | parents has requested that their identity not be released to |
17 | | me/to my deceased parent/to my deceased spouse, I wish to |
18 | | (check appropriate option) ..... a. receive a non-certified |
19 | | copy of the original birth certificate from which identifying |
20 | | information pertaining to the birth parent who requested |
21 | | anonymity has been deleted; or ..... b. I do not wish to |
22 | | received an altered copy of the original birth certificate. |
23 | | Dated (insert date). |
24 | | ................... |
25 | | (signature)
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1 | | (h) Any Information Exchange Authorization, Denial of |
2 | | Information
Exchange, or Birth Parent Preference Form filed |
3 | | with the Registry, or Request for a Non-Certified Copy of an |
4 | | Original Birth Certificate filed with the Registry by a |
5 | | surviving adult child or surviving spouse of a deceased adopted |
6 | | or surrendered person, shall be acknowledged by the person who |
7 | | filed it before a notary
public, in form
substantially as |
8 | | follows:
|
9 | | State of ..............
|
10 | | County of .............
|
11 | | I, a Notary Public, in and for the said County, in the |
12 | | State aforesaid,
do hereby certify that ............... |
13 | | personally known to me to be the
same person whose name is |
14 | | subscribed to the foregoing certificate of
acknowledgement, |
15 | | appeared before me in person and acknowledged that (he or
she) |
16 | | signed such certificate as (his or her) free and voluntary act |
17 | | and
that the statements in such certificate are true.
|
18 | | Given under my hand and notarial seal on (insert date).
|
19 | | .........................
|
20 | | (signature)
|
21 | | (i) When the execution of an Information Exchange
|
22 | | Authorization, Denial of Information Exchange, or Birth Parent |
23 | | Preference Form or Request for a Non-Certified Copy of an |
24 | | Original Birth Certificate completed by a surviving adult child |
25 | | or surviving spouse of a deceased adopted or surrendered person |
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1 | | is acknowledged before a
representative of an agency, such |
2 | | representative shall have his signature
on said Certificate |
3 | | acknowledged before a notary public, in form substantially
as |
4 | | follows:
|
5 | | State of..........
|
6 | | County of.........
|
7 | | I, a Notary Public, in and for the said County, in the |
8 | | State aforesaid,
do hereby certify that ..... personally known |
9 | | to me to be the same person
whose name is subscribed to the |
10 | | foregoing certificate of acknowledgement,
appeared before me |
11 | | in person and acknowledged that (he or she) signed such
|
12 | | certificate as (his or her) free and voluntary act and that the |
13 | | statements
in such certificate are true.
|
14 | | Given under my hand and notarial seal on (insert date).
|
15 | | .......................
|
16 | | (signature)
|
17 | | (j) When an Illinois Adoption Registry Application,
|
18 | | Information
Exchange Authorization, Denial of
Information |
19 | | Exchange, Birth Parent Preference Form, or Request for a |
20 | | Non-Certified Copy of an Original Birth Certificate completed |
21 | | by a surviving adult child or surviving spouse of a deceased |
22 | | adopted or surrendered person is executed in a foreign country, |
23 | | the
execution of such
document shall be acknowledged or |
24 | | affirmed before an officer of the United
States consular |
25 | | services.
|
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1 | | (k) If the person signing an Information Exchange
|
2 | | Authorization, Denial of Information, Birth Parent Preference |
3 | | Form, or Request for a Non-Certified Copy of an Original Birth |
4 | | Certificate completed by a surviving adult child or surviving |
5 | | spouse of a deceased adopted or surrendered person is in the |
6 | | military service of the
United States, the execution of such |
7 | | document may be acknowledged before a
commissioned officer and |
8 | | the signature of such officer on such certificate
shall be |
9 | | verified or acknowledged before a notary public or by such |
10 | | other
procedure as is then in effect for such division or |
11 | | branch of the armed forces.
|
12 | | (l) An adopted or surrendered person who completes a |
13 | | Request For a Non-Certified Copy of the Original Birth |
14 | | Certificate shall meet the same filing requirements and pay the |
15 | | same filing fees as a non-adopted person seeking to obtain a |
16 | | copy of his or her original birth certificate.
|
17 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
18 | | (750 ILCS 50/18.3a) (from Ch. 40, par. 1522.3a)
|
19 | | Sec. 18.3a. Confidential intermediary.
|
20 | | (a) General purposes.
Notwithstanding any other provision |
21 | | of
this Act, any
adopted or surrendered person 21 years of age |
22 | | or over, any adoptive parent or legal guardian
of
an adopted or |
23 | | surrendered person under the age of 21, or any birth parent of |
24 | | an adopted
or surrendered person who is 21 years of age or over |
25 | | may petition the court in any county in
the
State of Illinois |
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1 | | for appointment of a confidential intermediary as provided in
|
2 | | this Section for the purpose of exchanging medical information |
3 | | with one or
more mutually consenting biological relatives, |
4 | | obtaining identifying
information about one or more mutually |
5 | | consenting biological relatives, or
arranging contact with one |
6 | | or more mutually consenting biological relatives.
|
7 | | Additionally, in cases where an adopted or surrendered person |
8 | | is deceased,
an adult child of the adopted
or surrendered |
9 | | person or his or her adoptive parents or surviving spouse may |
10 | | file a petition under this Section and in cases
where the birth |
11 | | parent is deceased,
an adult birth sibling of the adopted or |
12 | | surrendered person or of the deceased birth parent
may
file a |
13 | | petition under this Section for the purpose of exchanging |
14 | | medical
information with one or more mutually consenting |
15 | | biological relatives of the adopted or surrendered person,
|
16 | | obtaining identifying information about one or more mutually |
17 | | consenting
biological relatives of the adopted or surrendered |
18 | | person, or arranging contact with one or more mutually
|
19 | | consenting biological relatives of the adopted or surrendered |
20 | | person. Beginning January 1, 2006, any adopted or surrendered |
21 | | person 21 years of age or over; any adoptive parent or legal |
22 | | guardian of an adopted or surrendered person under the age of |
23 | | 21; any birth parent, birth sibling, birth aunt, or birth uncle |
24 | | of an adopted or surrendered person over the age of 21; any |
25 | | surviving child, adoptive parent, or surviving spouse of a |
26 | | deceased adopted or surrendered person who wishes to petition |
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1 | | the court for the appointment of a confidential intermediary |
2 | | shall be required to accompany their petition with proof of |
3 | | registration with the Illinois Adoption Registry and Medical |
4 | | Information Exchange.
|
5 | | (b) Petition. Upon petition by an adopted or surrendered
|
6 | | person 21 years of age or over (an "adult adopted or |
7 | | surrendered person"), an
adoptive parent or legal guardian of |
8 | | an adopted or surrendered person under the age of 21,
or a |
9 | | birth parent of an adopted or surrendered person who is 21 |
10 | | years of age or over, the
court
shall appoint a confidential |
11 | | intermediary. Upon petition by
an adult child, adoptive parent |
12 | | or surviving spouse of an adopted or surrendered person who is |
13 | | deceased, by an adult birth sibling of an adopted or |
14 | | surrendered person
whose common birth parent is deceased
and |
15 | | whose adopted or surrendered birth sibling is 21 years of age |
16 | | or over, or by an adult sibling of a birth parent who is |
17 | | deceased,
and whose surrendered child is 21 years of age or |
18 | | over, the court may appoint a confidential
intermediary if the |
19 | | court finds that the disclosure is of greater benefit than
|
20 | | nondisclosure.
The petition shall state which biological |
21 | | relative
or
relatives are being sought and shall indicate if |
22 | | the petitioner wants to do any
one or more of the following: |
23 | | exchange medical information with the
biological relative or |
24 | | relatives, obtain identifying information from the
biological |
25 | | relative or relatives, or to arrange contact with the |
26 | | biological
relative.
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1 | | (c) Order. The order appointing the confidential |
2 | | intermediary shall allow
that
intermediary to conduct a search |
3 | | for the sought-after relative by accessing
those records |
4 | | described in subsection (g) of this Section.
|
5 | | (d) Fees and expenses. The court shall condition the |
6 | | appointment of the
confidential intermediary on the |
7 | | petitioner's payment of the intermediary's
fees and expenses in |
8 | | advance of the commencement of the work of the
confidential |
9 | | intermediary. However, no fee shall be charged if the |
10 | | petitioner is an adult adopted or surrendered person and the |
11 | | sought-after relative is a birth parent who filed a Denial with |
12 | | the Registry prior to January 1, 2011, or filed a Birth Parent |
13 | | Preference Form on which Option E was selected after January 1, |
14 | | 2011 and more than 5 years have transpired since the birth |
15 | | parent filed the Denial of Information Exchange or Birth Parent |
16 | | Preference Form on which Option E was selected.
|
17 | | (e) Eligibility of intermediary. The court may appoint as |
18 | | confidential
intermediary any
person certified by the |
19 | | Department of Children and Family Services as qualified to |
20 | | serve as a confidential
intermediary.
Certification shall be |
21 | | dependent upon the
confidential intermediary completing a |
22 | | course of training including, but not
limited to, applicable |
23 | | federal and State privacy laws.
|
24 | | (f) Confidential Intermediary Council. There shall be |
25 | | established under the
Department of Children and Family
|
26 | | Services a Confidential Intermediary Advisory Council. One |
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1 | | member shall be an
attorney representing the Attorney General's |
2 | | Office appointed by the Attorney
General. One member shall be a |
3 | | currently certified confidential intermediary
appointed by the |
4 | | Director of the Department of Children and Family Services.
The |
5 | | Director shall also appoint 5 additional members. When making |
6 | | those
appointments, the Director shall consider advocates for |
7 | | adopted persons,
adoptive parents, birth parents, lawyers who |
8 | | represent clients in private
adoptions, lawyers specializing |
9 | | in privacy law, and representatives of agencies
involved in |
10 | | adoptions. The Director shall appoint one of the 7 members as
|
11 | | the chairperson. An attorney from the Department of Children |
12 | | and Family
Services
and the person directly responsible for |
13 | | administering the confidential
intermediary program shall |
14 | | serve as ex-officio, non-voting advisors to the
Council. |
15 | | Council members shall serve at the discretion of the Director |
16 | | and
shall receive no compensation other than reasonable |
17 | | expenses approved by the
Director. The Council shall meet no |
18 | | less than twice yearly and shall meet at least once yearly with |
19 | | the Registry Advisory Council, and shall make
recommendations |
20 | | to the Director regarding the development of rules, procedures,
|
21 | | and forms that will ensure efficient and effective operation of |
22 | | the
confidential intermediary process, including:
|
23 | | (1) Standards for certification for confidential |
24 | | intermediaries.
|
25 | | (2) Oversight of methods used to verify that |
26 | | intermediaries are complying
with the appropriate laws.
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1 | | (3) Training for confidential intermediaries, |
2 | | including training with
respect to federal and State |
3 | | privacy laws.
|
4 | | (4) The relationship between confidential |
5 | | intermediaries and the court
system, including the |
6 | | development of sample orders defining the scope of the
|
7 | | intermediaries' access to information.
|
8 | | (5) Any recent violations of policy or procedures by |
9 | | confidential
intermediaries and remedial steps, including |
10 | | decertification, to prevent future
violations.
|
11 | | (g) Access. Subject to the limitations of subsection (i) |
12 | | of this
Section, the
confidential
intermediary shall have |
13 | | access to vital records or a comparable public entity that |
14 | | maintains vital records in another state in accordance with |
15 | | that state's laws, maintained by the Department of
Public |
16 | | Health and its local designees for the maintenance of vital |
17 | | records or a comparable public entity that maintains vital |
18 | | records in another state in accordance with that state's laws |
19 | | and
all records of the court or any adoption agency,
public
or |
20 | | private, as limited in this Section, which relate to the |
21 | | adoption or the identity and location of an
adopted or |
22 | | surrendered person, of an adult child or surviving spouse of a |
23 | | deceased adopted or surrendered person, or of a birth
parent, |
24 | | birth sibling, or the sibling of a deceased birth parent. The
|
25 | | confidential intermediary shall not have access to any personal |
26 | | health
information protected by the Standards for Privacy of |
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1 | | Individually
Identifiable Health Information adopted by the |
2 | | U.S. Department of Health and
Human Services under the Health |
3 | | Insurance Portability and Accountability Act of
1996 unless the |
4 | | confidential intermediary has obtained written consent from |
5 | | the
person whose information is being sought by an adult |
6 | | adopted or surrendered person or, if that person is a minor |
7 | | child,
that person's parent or guardian. Confidential
|
8 | | intermediaries shall be authorized to inspect confidential |
9 | | relinquishment and
adoption records. The confidential |
10 | | intermediary shall not be authorized to
access medical
records, |
11 | | financial records, credit records, banking records, home |
12 | | studies,
attorney file records, or other personal records.
In |
13 | | cases where a birth parent is being sought, an adoption agency |
14 | | shall inform
the confidential intermediary of any statement |
15 | | filed pursuant to Section 18.3, hereinafter referred to as "the |
16 | | 18.3 statement",
indicating a desire of the surrendering birth |
17 | | parent to have identifying
information shared or to not have |
18 | | identifying information shared. If there was
a clear statement |
19 | | of intent by the sought-after birth parent not to have
|
20 | | identifying information shared, the confidential intermediary |
21 | | shall discontinue
the search and inform the petitioning party |
22 | | of the sought-after relative's
intent unless the birth parent |
23 | | filed the 18.3 statement prior to the effective date of this |
24 | | amendatory Act of the 96th General Assembly and more than 5 |
25 | | years have elapsed since the filing of the 18.3 statement. If |
26 | | the adult adopted or surrendered person is the subject of an |
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1 | | 18.3 statement indicating a desire not to establish contact |
2 | | which was filed more than 5 years prior to the search request, |
3 | | the confidential intermediary shall confirm the petitioner's |
4 | | desire to continue the search. Information
provided to the |
5 | | confidential intermediary by an adoption agency shall be
|
6 | | restricted to the full name, date of birth, place of birth, |
7 | | last known address,
last known telephone number of the |
8 | | sought-after relative or, if applicable,
of the children or |
9 | | siblings of the sought-after relative, and the 18.3 statement.
|
10 | | (h) Adoption agency disclosure of medical information. If |
11 | | the petitioner is
an adult adopted or surrendered person or the |
12 | | adoptive parent of a
minor and if the petitioner has signed a |
13 | | written authorization to disclose
personal medical |
14 | | information, an adoption agency disclosing information to a
|
15 | | confidential intermediary shall disclose available medical |
16 | | information about
the adopted or surrendered person from birth |
17 | | through adoption.
|
18 | | (i) Duties of confidential intermediary in conducting a |
19 | | search. In
conducting
a search under this Section, the |
20 | | confidential intermediary shall first confirm
that there is no |
21 | | Denial of Information Exchange on file with the Illinois
|
22 | | Adoption Registry. If the petitioner is an adult child of an |
23 | | adopted or surrendered person
who is deceased, the
confidential |
24 | | intermediary shall additionally confirm that the adopted or |
25 | | surrendered person
did not file a Denial of Information |
26 | | Exchange or a Birth Parent Preference Form with Option E |
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1 | | selected with the Illinois Adoption
Registry during his or her |
2 | | life. If there is a Denial on file with the Registry, the |
3 | | confidential intermediary must discontinue the search unless |
4 | | the petitioner is an adult adopted or surrendered person and |
5 | | the sought-after birth relative filed the Denial 5 years or |
6 | | more prior to the search or the birth parent has not been the |
7 | | object of a search through the State confidential intermediary |
8 | | program for 10 or more years. If the petitioner is an adult |
9 | | adopted or surrendered person and there is a Birth Parent |
10 | | Preference Form on file with the Registry and the birth parent |
11 | | who completed the form selected Option E, the confidential |
12 | | intermediary must discontinue the search unless 5 years or more |
13 | | have elapsed since the filing of the Birth Parent Preference |
14 | | Form. If the petitioner is an adult birth sibling of
an
adopted
|
15 | | or surrendered person or an adult sibling of a birth parent who |
16 | | is deceased,
the confidential intermediary shall
additionally |
17 | | confirm that the birth parent did not file a Denial of |
18 | | Information
Exchange or a Birth Parent Preference Form with |
19 | | Option E selected with the Registry during his or her life. If |
20 | | the confidential
intermediary learns that a sought-after birth |
21 | | parent signed an 18.3 statement
indicating his or her intent |
22 | | not to have identifying information shared, and
did not later |
23 | | file an Information Exchange Authorization or a Birth Parent |
24 | | Preference Form with the
Registry, the confidential |
25 | | intermediary shall discontinue the search and inform
the |
26 | | petitioning party of the birth parent's intent, unless the |
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1 | | petitioner is an adult adopted or surrendered person and 5 |
2 | | years or more have elapsed since the birth parent signed the |
3 | | statement indicating his or her intent not to have identifying |
4 | | information shared. In cases where the birth parent filed a |
5 | | Denial of Information Exchange or Birth Parent Preference Form |
6 | | where Option E was selected, or statement indicating his or her |
7 | | intent not to have identifying information shared less than 5 |
8 | | years prior to the search request and the petitioner is an |
9 | | adult adopted or surrendered person, the confidential |
10 | | intermediary shall inform the petitioner of the need to |
11 | | discontinue the search until 5 years have elapsed since the |
12 | | Denial of Information Exchange or Birth Parent Preference Form |
13 | | where Option E was selected, or statement
was filed; in cases |
14 | | where a birth parent was previously the subject of a search |
15 | | through the State confidential intermediary program, the |
16 | | confidential intermediary shall inform the petitioner of the |
17 | | need to discontinue the search until 10 years or more have |
18 | | elapsed since the initial search was closed. In cases where a |
19 | | birth parent has been the object of 2 searches through the |
20 | | State confidential intermediary program, no subsequent search |
21 | | for the birth parent shall be authorized absent a court order |
22 | | to the contrary.
|
23 | | In conducting a search under this Section, the confidential |
24 | | intermediary
shall attempt to locate the relative or relatives |
25 | | from whom the petitioner has
requested information. If the |
26 | | sought-after relative is deceased
or cannot be located after a |
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1 | | diligent search, the
confidential intermediary may contact |
2 | | other adult relatives of the
sought-after relative.
|
3 | | The confidential intermediary shall contact a sought-after |
4 | | relative on
behalf of the petitioner in a manner that respects |
5 | | the sought-after relative's
privacy and shall inform the |
6 | | sought-after relative of the petitioner's request
for medical |
7 | | information, identifying information or contact as stated in |
8 | | the
petition. Based upon the terms of the petitioner's request, |
9 | | the confidential
intermediary shall contact a sought-after |
10 | | relative on behalf of the petitioner
and inform the |
11 | | sought-after relative of the following options:
|
12 | | (1) The sought-after relative may totally reject one or |
13 | | all of the
requests for medical information, identifying |
14 | | information or
contact. The sought-after relative shall be |
15 | | informed that they can
provide a medical questionnaire to |
16 | | be forwarded to the petitioner
without releasing any |
17 | | identifying information. The confidential
intermediary |
18 | | shall inform the petitioner of the sought-after
relative's |
19 | | decision to reject the sharing of information or contact.
|
20 | | (2) The sought-after relative may consent to |
21 | | completing a medical
questionnaire only. In this case, the |
22 | | confidential intermediary
shall provide the questionnaire |
23 | | and ask the sought-after relative to
complete it. The |
24 | | confidential intermediary shall forward the
completed |
25 | | questionnaire to the petitioner and inform the petitioner
|
26 | | of the sought-after relative's desire to not provide any |
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1 | | additional
information.
|
2 | | (3) The sought-after relative may communicate with the |
3 | | petitioner
without having his or her identity disclosed. In |
4 | | this case, the
confidential intermediary shall arrange the |
5 | | desired communication
in a manner that protects the |
6 | | identity of the sought-after relative.
The confidential |
7 | | intermediary shall inform the petitioner of the
|
8 | | sought-after relative's decision to communicate but not |
9 | | disclose
his or her identity.
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10 | | (4) The sought-after sought after relative may consent |
11 | | to initiate contact with the
petitioner. If both the |
12 | | petitioner and the sought-after relative or
relatives are |
13 | | eligible to register with the Illinois Adoption Registry,
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14 | | the confidential intermediary shall provide the necessary
|
15 | | application forms and request that the sought-after |
16 | | relative
register with the Illinois Adoption Registry. If |
17 | | either the petitioner
or the sought-after relative or |
18 | | relatives are ineligible to register
with the Illinois |
19 | | Adoption Registry, the confidential intermediary
shall |
20 | | obtain written consents from both parties that they wish to
|
21 | | disclose their identities to each other and to have contact |
22 | | with
each other.
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23 | | (j) Oath. The confidential intermediary shall sign an oath |
24 | | of
confidentiality substantially as follows: "I, .........., |
25 | | being duly sworn, on
oath depose and say: As a condition of |
26 | | appointment as a confidential
intermediary, I affirm that:
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1 | | (1) I will not disclose to the petitioner,
directly or |
2 | | indirectly, any confidential information
except in a |
3 | | manner consistent with the
law.
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4 | | (2) I recognize that violation of this oath subjects me |
5 | | to civil liability
and to a potential finding of contempt |
6 | | of court.
................................
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7 | | SUBSCRIBED AND SWORN to before me, a Notary Public, on (insert
|
8 | | date)
|
9 | | ................................."
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10 | | (k) Sanctions.
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11 | | (1) Any confidential intermediary who improperly |
12 | | discloses
confidential information identifying a |
13 | | sought-after relative shall be liable to
the sought-after |
14 | | relative for damages and may also be found in contempt of
|
15 | | court.
|
16 | | (2) Any person who learns a sought-after
relative's |
17 | | identity, directly or indirectly, through the use of |
18 | | procedures
provided in this Section and who improperly |
19 | | discloses information identifying
the sought-after |
20 | | relative shall be liable to the sought-after relative for
|
21 | | actual damages plus minimum punitive damages of $10,000.
|
22 | | (3) The Department shall fine any confidential |
23 | | intermediary who improperly
discloses
confidential |
24 | | information in violation of item (1) or (2) of this |
25 | | subsection (k)
an amount up to $2,000 per improper |
26 | | disclosure. This fine does not affect
civil liability under |
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1 | | item (2) of this subsection (k). The Department shall
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2 | | deposit all fines and penalties collected under this |
3 | | Section into the Illinois
Adoption Registry and Medical |
4 | | Information Fund.
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5 | | (l) Death of person being sought. Notwithstanding any other |
6 | | provision
of this Act, if the confidential intermediary |
7 | | discovers that the person
being sought has died, he or she |
8 | | shall report this fact to the court,
along with a copy of the |
9 | | death certificate. If the sought-after relative is a birth |
10 | | parent, the confidential intermediary shall also forward a copy |
11 | | of the birth parent's death certificate, if available, to the |
12 | | Registry for inclusion in the Registry file.
|
13 | | (m) Any confidential information obtained by the |
14 | | confidential intermediary
during the course of his or her |
15 | | search shall be kept strictly confidential
and shall be used |
16 | | for the purpose of arranging contact between the
petitioner and |
17 | | the sought-after birth relative. At the time the case is
|
18 | | closed, all identifying information shall be returned to the |
19 | | court for
inclusion in the impounded adoption file.
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20 | | (n) If the petitioner is an adopted or surrendered person |
21 | | 21 years of age or over or the
adoptive parent or legal |
22 | | guardian of an adopted or surrendered person under the age
of |
23 | | 21, any
non-identifying information, as defined in Section |
24 | | 18.4, that is
ascertained during the course of the search may |
25 | | be given in writing to
the petitioner at any time during the |
26 | | search before the case is closed.
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1 | | (o) Except as provided in subsection (k) of this Section, |
2 | | no liability shall
accrue to
the State, any State agency, any |
3 | | judge, any officer or employee of the
court, any certified |
4 | | confidential intermediary, or any agency designated
to oversee |
5 | | confidential intermediary services for acts, omissions, or
|
6 | | efforts made in good faith within the scope of this Section.
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7 | | (p) An adoption agency that has received a request from a |
8 | | confidential intermediary for the full name, date of birth, |
9 | | last known address, or last known telephone number of a |
10 | | sought-after relative pursuant to subsection (g) of Section |
11 | | 18.3a, or for medical information regarding a sought-after |
12 | | relative pursuant to subsection (h) of Section 18.3a, must |
13 | | satisfactorily comply with this court order within a period of |
14 | | 45 days. The court shall order the adoption agency to reimburse |
15 | | the petitioner in an amount equal to all payments made by the |
16 | | petitioner to the confidential intermediary, and the adoption |
17 | | agency shall be subject to a civil monetary penalty of $1,000 |
18 | | to be paid to the Department of Children and Family Services. |
19 | | Following the issuance of a court order finding that the |
20 | | adoption agency has not complied with Section 18.3, the |
21 | | adoption agency shall be subject to a monetary penalty of $500 |
22 | | per day for each subsequent day of non-compliance. Proceeds |
23 | | from such fines shall be utilized by the Department of Children |
24 | | and Family Services to subsidize the fees of petitioners as |
25 | | referenced in subsection (d) of this Section. |
26 | | (q) Provide information to eligible petitioner. The |
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1 | | confidential intermediary may provide to eligible petitioners |
2 | | as described in subsections (a) and (b) of this Section, the |
3 | | name of the child welfare agency which had legal custody of the |
4 | | surrendered person or responsibility for placing the |
5 | | surrendered person and any available contact information for |
6 | | such agency. In addition, the confidential intermediary may |
7 | | provide to such petitioners the name of the state in which the |
8 | | surrender occurred or in which the adoption was finalized. |
9 | | Any reimbursements and fines, notwithstanding any |
10 | | reimbursement directly to the petitioner, paid under this |
11 | | subsection are in addition to other remedies a court may |
12 | | otherwise impose by law. |
13 | | The Department of Children and Family Services shall submit |
14 | | reports to the Confidential Intermediary Advisory Council by |
15 | | July 1 and January 1 of each year in order to report the |
16 | | penalties assessed and collected under this subsection, the |
17 | | amounts of related deposits into the DCFS Children's Services |
18 | | Fund, and any expenditures from such deposits.
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19 | | (Source: P.A. 96-661, eff. 8-25-09; 96-895, eff. 5-21-10.)
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20 | | (750 ILCS 50/18.6) (from Ch. 40, par. 1522.6)
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21 | | Sec. 18.6. Registry fees. The Department of Public Health |
22 | | shall levy a
fee for each
registrant under Sections 18.05 |
23 | | through 18.5.
A $15 fee shall be charged for registering with |
24 | | the Illinois Adoption
Registry and Medical Information |
25 | | Exchange. However, this fee shall be
waived for all adopted or |
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1 | | surrendered persons, surviving children and spouses of |
2 | | deceased adopted persons, adoptive parents,
legal guardians, |
3 | | birth parents, birth aunts, birth uncles, and
birth siblings |
4 | | who complete a Medical Information Exchange Questionnaire at |
5 | | the
time of registration and authorize its release to specified |
6 | | registered parties,
and for adoptive parents
registering |
7 | | within 12 months of the finalization of the
adoption. All |
8 | | persons who were registered with the Illinois Adoption Registry
|
9 | | prior to the effective date of this amendatory Act of 1999
and |
10 | | who wish to
update their registration may do so without charge.
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11 | | No charge of any
kind shall be made for the withdrawal of any |
12 | | form provided in Section 18.2.
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13 | | (Source: P.A. 96-895, eff. 5-21-10.)
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14 | | Section 99. Effective date. This Act takes effect upon |
15 | | becoming law.
|