Sen. Julie A. Morrison

Filed: 3/18/2022

 

 


 

 


 
10200HB4242sam001LRB102 19896 KTG 37715 a

1
AMENDMENT TO HOUSE BILL 4242

2    AMENDMENT NO. ______. Amend House Bill 4242 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Children and Family Services Act is
5amended by changing Section 5a as follows:
 
6    (20 ILCS 505/5a)  (from Ch. 23, par. 5005a)
7    Sec. 5a. Reimbursable services for which the Department of
8Children and Family Services shall pay 100% of the reasonable
9cost pursuant to a written contract negotiated between the
10Department and the agency furnishing the services (which shall
11include but not be limited to the determination of reasonable
12cost, the services being purchased and the duration of the
13agreement) include, but are not limited to:
 
14SERVICE ACTIVITIES
15    Adjunctive Therapy;

 

 

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1    Child Care Service, including day care;
2    Clinical Therapy;
3    Custodial Service;
4    Field Work Students;
5    Food Service;
6    Normal Education;
7    In-Service Training;
8    Intake or Evaluation, or both;
9    Medical Services;
10    Recreation;
11    Social Work or Counselling, or both;
12    Supportive Staff;
13    Volunteers.
 
14OBJECT EXPENSES
15    Professional Fees and Contract Service Payments;
16    Supplies;
17    Telephone and Telegram;
18    Occupancy;
19    Local Transportation;
20    Equipment and Other Fixed Assets, including amortization
21        of same;
22    Miscellaneous.
 
23ADMINISTRATIVE COSTS
24    Program Administration;

 

 

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1    Supervision and Consultation;
2    Inspection and Monitoring for purposes of issuing
3        licenses;
4    Determination of Children who are eligible
5    for federal or other reimbursement;
6    Postage and Shipping;
7    Outside Printing, Artwork, etc.;
8    Subscriptions and Reference Publications;
9    Management and General Expense.
10Reimbursement of administrative costs other than inspection
11and monitoring for purposes of issuing licenses may not exceed
1220% of the costs for other services.
13    The Department may offer services to any child or family
14with respect to whom a report of suspected child abuse or
15neglect has been called in to the hotline after completion of a
16family assessment as provided under subsection (a-5) of
17Section 7.4 of the Abused and Neglected Child Reporting Act
18and the Department has determined that services are needed to
19address the safety of the child and other family members and
20the risk of subsequent maltreatment. Acceptance of such
21services shall be voluntary.
22    All Object Expenses, Service Activities and Administrative
23Costs are allowable.
24    If a survey instrument is used in the rate setting
25process:
26        (a) with respect to any day care centers, it shall be

 

 

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1    limited to those agencies which receive reimbursement from
2    the State;
3        (b) the cost survey instrument shall be promulgated by
4    rule;
5        (c) any requirements of the respondents shall be
6    promulgated by rule;
7        (d) all screens, limits or other tests of
8    reasonableness, allowability and reimbursability shall be
9    promulgated by rule;
10        (e) adjustments may be made by the Department to rates
11    when it determines that reported wage and salary levels
12    are insufficient to attract capable caregivers in
13    sufficient numbers.
14    The Department of Children and Family Services may pay
15100% of the reasonable costs of research and valuation focused
16exclusively on services to youth in care. Such research
17projects must be approved, in advance, by the Director of the
18Department.
19    In addition to reimbursements otherwise provided for in
20this Section, the Department of Human Services shall, in
21accordance with annual written agreements, make advance
22quarterly disbursements to local public agencies for child day
23care services with funds appropriated from the Local Effort
24Day Care Fund.
25    Neither the Department of Children and Family Services nor
26the Department of Human Services shall pay or approve

 

 

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1reimbursement for day care in a facility which is operating
2without a valid license or permit, except in the case of day
3care homes or day care centers which are exempt from the
4licensing requirements of the "Child Care Act of 1969".
5    The rates paid to day care providers by the Department of
6Children and Family Services shall match the rates paid to
7child care providers by the Department of Human Services under
8the child care assistance program, including base rates and
9any relevant rate enhancements.
10(Source: P.A. 100-159, eff. 8-18-17.)
 
11    Section 10. The Illinois Public Aid Code is amended by
12changing Section 9A-11 as follows:
 
13    (305 ILCS 5/9A-11)  (from Ch. 23, par. 9A-11)
14    Sec. 9A-11. Child care.
15    (a) The General Assembly recognizes that families with
16children need child care in order to work. Child care is
17expensive and families with low incomes, including those who
18are transitioning from welfare to work, often struggle to pay
19the costs of day care. The General Assembly understands the
20importance of helping low-income working families become and
21remain self-sufficient. The General Assembly also believes
22that it is the responsibility of families to share in the costs
23of child care. It is also the preference of the General
24Assembly that all working poor families should be treated

 

 

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1equally, regardless of their welfare status.
2    (b) To the extent resources permit, the Illinois
3Department shall provide child care services to parents or
4other relatives as defined by rule who are working or
5participating in employment or Department approved education
6or training programs. At a minimum, the Illinois Department
7shall cover the following categories of families:
8        (1) recipients of TANF under Article IV participating
9    in work and training activities as specified in the
10    personal plan for employment and self-sufficiency;
11        (2) families transitioning from TANF to work;
12        (3) families at risk of becoming recipients of TANF;
13        (4) families with special needs as defined by rule;
14        (5) working families with very low incomes as defined
15    by rule;
16        (6) families that are not recipients of TANF and that
17    need child care assistance to participate in education and
18    training activities; and
19        (7) youth in care, as defined in Section 4d of the
20    Children and Family Services Act, who are parents,
21    regardless of income or whether they are working or
22    participating in Department-approved employment or
23    education or training programs. Any family that receives
24    child care assistance in accordance with this paragraph
25    shall receive one additional 12-month child care
26    eligibility period after the parenting youth in care's

 

 

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1    case with the Department of Children and Family Services
2    is closed, regardless of income or whether the parenting
3    youth in care is working or participating in
4    Department-approved employment or education or training
5    programs;
6        (8) families receiving Extended Family Support Program
7    services from the Department of Children and Family
8    Services, regardless of income or whether they are working
9    or participating in Department-approved employment or
10    education or training programs; and
11        (9) (7) families with children under the age of 5 who
12    have an open intact family services case with the
13    Department of Children and Family Services. Any family
14    that receives child care assistance in accordance with
15    this paragraph shall remain eligible for child care
16    assistance 6 months after the child's intact family
17    services case is closed, regardless of whether the child's
18    parents or other relatives as defined by rule are working
19    or participating in Department approved employment or
20    education or training programs. The Department of Human
21    Services, in consultation with the Department of Children
22    and Family Services, shall adopt rules to protect the
23    privacy of families who are the subject of an open intact
24    family services case when such families enroll in child
25    care services. Additional rules shall be adopted to offer
26    children who have an open intact family services case the

 

 

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1    opportunity to receive an Early Intervention screening and
2    other services that their families may be eligible for as
3    provided by the Department of Human Services.
4    Beginning October 1, 2023, and every October 1 thereafter,
5the Department of Children and Family Services shall report to
6the General Assembly on the number of children who received
7child care via vouchers paid for by the Department of Children
8and Family Services during the preceding fiscal year. The
9report shall include the ages of children who received child
10care, the type of child care they received, and the number of
11months they received child care.
12    The Department shall specify by rule the conditions of
13eligibility, the application process, and the types, amounts,
14and duration of services. Eligibility for child care benefits
15and the amount of child care provided may vary based on family
16size, income, and other factors as specified by rule.
17    The Department shall update the Child Care Assistance
18Program Eligibility Calculator posted on its website to
19include a question on whether a family is applying for child
20care assistance for the first time or is applying for a
21redetermination of eligibility.
22    A family's eligibility for child care services shall be
23redetermined no sooner than 12 months following the initial
24determination or most recent redetermination. During the
2512-month periods, the family shall remain eligible for child
26care services regardless of (i) a change in family income,

 

 

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1unless family income exceeds 85% of State median income, or
2(ii) a temporary change in the ongoing status of the parents or
3other relatives, as defined by rule, as working or attending a
4job training or educational program.
5    In determining income eligibility for child care benefits,
6the Department annually, at the beginning of each fiscal year,
7shall establish, by rule, one income threshold for each family
8size, in relation to percentage of State median income for a
9family of that size, that makes families with incomes below
10the specified threshold eligible for assistance and families
11with incomes above the specified threshold ineligible for
12assistance. Through and including fiscal year 2007, the
13specified threshold must be no less than 50% of the
14then-current State median income for each family size.
15Beginning in fiscal year 2008, the specified threshold must be
16no less than 185% of the then-current federal poverty level
17for each family size. Notwithstanding any other provision of
18law or administrative rule to the contrary, beginning in
19fiscal year 2019, the specified threshold for working families
20with very low incomes as defined by rule must be no less than
21185% of the then-current federal poverty level for each family
22size. Notwithstanding any other provision of law or
23administrative rule to the contrary, beginning in State fiscal
24year 2022, the specified income threshold shall be no less
25than 200% of the then-current federal poverty level for each
26family size.

 

 

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1    In determining eligibility for assistance, the Department
2shall not give preference to any category of recipients or
3give preference to individuals based on their receipt of
4benefits under this Code.
5    Nothing in this Section shall be construed as conferring
6entitlement status to eligible families.
7    The Illinois Department is authorized to lower income
8eligibility ceilings, raise parent co-payments, create waiting
9lists, or take such other actions during a fiscal year as are
10necessary to ensure that child care benefits paid under this
11Article do not exceed the amounts appropriated for those child
12care benefits. These changes may be accomplished by emergency
13rule under Section 5-45 of the Illinois Administrative
14Procedure Act, except that the limitation on the number of
15emergency rules that may be adopted in a 24-month period shall
16not apply.
17    The Illinois Department may contract with other State
18agencies or child care organizations for the administration of
19child care services.
20    (c) Payment shall be made for child care that otherwise
21meets the requirements of this Section and applicable
22standards of State and local law and regulation, including any
23requirements the Illinois Department promulgates by rule in
24addition to the licensure requirements promulgated by the
25Department of Children and Family Services and Fire Prevention
26and Safety requirements promulgated by the Office of the State

 

 

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1Fire Marshal, and is provided in any of the following:
2        (1) a child care center which is licensed or exempt
3    from licensure pursuant to Section 2.09 of the Child Care
4    Act of 1969;
5        (2) a licensed child care home or home exempt from
6    licensing;
7        (3) a licensed group child care home;
8        (4) other types of child care, including child care
9    provided by relatives or persons living in the same home
10    as the child, as determined by the Illinois Department by
11    rule.
12    (c-5) Solely for the purposes of coverage under the
13Illinois Public Labor Relations Act, child and day care home
14providers, including licensed and license exempt,
15participating in the Department's child care assistance
16program shall be considered to be public employees and the
17State of Illinois shall be considered to be their employer as
18of January 1, 2006 (the effective date of Public Act 94-320),
19but not before. The State shall engage in collective
20bargaining with an exclusive representative of child and day
21care home providers participating in the child care assistance
22program concerning their terms and conditions of employment
23that are within the State's control. Nothing in this
24subsection shall be understood to limit the right of families
25receiving services defined in this Section to select child and
26day care home providers or supervise them within the limits of

 

 

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1this Section. The State shall not be considered to be the
2employer of child and day care home providers for any purposes
3not specifically provided in Public Act 94-320, including, but
4not limited to, purposes of vicarious liability in tort and
5purposes of statutory retirement or health insurance benefits.
6Child and day care home providers shall not be covered by the
7State Employees Group Insurance Act of 1971.
8    In according child and day care home providers and their
9selected representative rights under the Illinois Public Labor
10Relations Act, the State intends that the State action
11exemption to application of federal and State antitrust laws
12be fully available to the extent that their activities are
13authorized by Public Act 94-320.
14    (d) The Illinois Department shall establish, by rule, a
15co-payment scale that provides for cost sharing by families
16that receive child care services, including parents whose only
17income is from assistance under this Code. The co-payment
18shall be based on family income and family size and may be
19based on other factors as appropriate. Co-payments may be
20waived for families whose incomes are at or below the federal
21poverty level.
22    (d-5) The Illinois Department, in consultation with its
23Child Care and Development Advisory Council, shall develop a
24plan to revise the child care assistance program's co-payment
25scale. The plan shall be completed no later than February 1,
262008, and shall include:

 

 

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1        (1) findings as to the percentage of income that the
2    average American family spends on child care and the
3    relative amounts that low-income families and the average
4    American family spend on other necessities of life;
5        (2) recommendations for revising the child care
6    co-payment scale to assure that families receiving child
7    care services from the Department are paying no more than
8    they can reasonably afford;
9        (3) recommendations for revising the child care
10    co-payment scale to provide at-risk children with complete
11    access to Preschool for All and Head Start; and
12        (4) recommendations for changes in child care program
13    policies that affect the affordability of child care.
14    (e) (Blank).
15    (f) The Illinois Department shall, by rule, set rates to
16be paid for the various types of child care. Child care may be
17provided through one of the following methods:
18        (1) arranging the child care through eligible
19    providers by use of purchase of service contracts or
20    vouchers;
21        (2) arranging with other agencies and community
22    volunteer groups for non-reimbursed child care;
23        (3) (blank); or
24        (4) adopting such other arrangements as the Department
25    determines appropriate.
26    (f-1) Within 30 days after June 4, 2018 (the effective

 

 

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1date of Public Act 100-587), the Department of Human Services
2shall establish rates for child care providers that are no
3less than the rates in effect on January 1, 2018 increased by
44.26%.
5    (f-5) (Blank).
6    (g) Families eligible for assistance under this Section
7shall be given the following options:
8        (1) receiving a child care certificate issued by the
9    Department or a subcontractor of the Department that may
10    be used by the parents as payment for child care and
11    development services only; or
12        (2) if space is available, enrolling the child with a
13    child care provider that has a purchase of service
14    contract with the Department or a subcontractor of the
15    Department for the provision of child care and development
16    services. The Department may identify particular priority
17    populations for whom they may request special
18    consideration by a provider with purchase of service
19    contracts, provided that the providers shall be permitted
20    to maintain a balance of clients in terms of household
21    incomes and families and children with special needs, as
22    defined by rule.
23(Source: P.A. 101-81, eff. 7-12-19; 101-657, eff. 3-23-21;
24102-491, eff. 8-20-21; revised 11-8-21.)
 
25    Section 15. The Early Intervention Services System Act is

 

 

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1amended by changing Section 3 as follows:
 
2    (325 ILCS 20/3)  (from Ch. 23, par. 4153)
3    Sec. 3. Definitions. As used in this Act:
4    (a) "Eligible infants and toddlers" means infants and
5toddlers under 36 months of age with any of the following
6conditions:
7        (1) Developmental delays.
8        (2) A physical or mental condition which typically
9    results in developmental delay.
10        (3) Being at risk of having substantial developmental
11    delays based on informed clinical opinion.
12        (4) Either (A) having entered the program under any of
13    the circumstances listed in paragraphs (1) through (3) of
14    this subsection but no longer meeting the current
15    eligibility criteria under those paragraphs, and
16    continuing to have any measurable delay, or (B) not having
17    attained a level of development in each area, including
18    (i) cognitive, (ii) physical (including vision and
19    hearing), (iii) language, speech, and communication, (iv)
20    social or emotional, or (v) adaptive, that is at least at
21    the mean of the child's age equivalent peers; and, in
22    addition to either item (A) or item (B), (C) having been
23    determined by the multidisciplinary individualized family
24    service plan team to require the continuation of early
25    intervention services in order to support continuing

 

 

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1    developmental progress, pursuant to the child's needs and
2    provided in an appropriate developmental manner. The type,
3    frequency, and intensity of services shall differ from the
4    initial individualized family services plan because of the
5    child's developmental progress, and may consist of only
6    service coordination, evaluation, and assessments.
7    "Eligible infants and toddlers" includes any child under
8the age of 3 who is the subject of a substantiated case of
9child abuse or neglect as defined in the federal Child Abuse
10Prevention and Treatment Act.
11    (b) "Developmental delay" means a delay in one or more of
12the following areas of childhood development as measured by
13appropriate diagnostic instruments and standard procedures:
14cognitive; physical, including vision and hearing; language,
15speech and communication; social or emotional; or adaptive.
16The term means a delay of 30% or more below the mean in
17function in one or more of those areas.
18    (c) "Physical or mental condition which typically results
19in developmental delay" means:
20        (1) a diagnosed medical disorder or exposure to a
21    toxic substance bearing a relatively well known expectancy
22    for developmental outcomes within varying ranges of
23    developmental disabilities; or
24        (2) a history of prenatal, perinatal, neonatal or
25    early developmental events suggestive of biological
26    insults to the developing central nervous system and which

 

 

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1    either singly or collectively increase the probability of
2    developing a disability or delay based on a medical
3    history.
4    (d) "Informed clinical opinion" means both clinical
5observations and parental participation to determine
6eligibility by a consensus of a multidisciplinary team of 2 or
7more members based on their professional experience and
8expertise.
9    (e) "Early intervention services" means services which:
10        (1) are designed to meet the developmental needs of
11    each child eligible under this Act and the needs of his or
12    her family;
13        (2) are selected in collaboration with the child's
14    family;
15        (3) are provided under public supervision;
16        (4) are provided at no cost except where a schedule of
17    sliding scale fees or other system of payments by families
18    has been adopted in accordance with State and federal law;
19        (5) are designed to meet an infant's or toddler's
20    developmental needs in any of the following areas:
21            (A) physical development, including vision and
22        hearing,
23            (B) cognitive development,
24            (C) communication development,
25            (D) social or emotional development, or
26            (E) adaptive development;

 

 

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1        (6) meet the standards of the State, including the
2    requirements of this Act;
3        (7) include one or more of the following:
4            (A) family training,
5            (B) social work services, including counseling,
6        and home visits,
7            (C) special instruction,
8            (D) speech, language pathology and audiology,
9            (E) occupational therapy,
10            (F) physical therapy,
11            (G) psychological services,
12            (H) service coordination services,
13            (I) medical services only for diagnostic or
14        evaluation purposes,
15            (J) early identification, screening, and
16        assessment services,
17            (K) health services specified by the lead agency
18        as necessary to enable the infant or toddler to
19        benefit from the other early intervention services,
20            (L) vision services,
21            (M) transportation,
22            (N) assistive technology devices and services,
23            (O) nursing services,
24            (P) nutrition services, and
25            (Q) sign language and cued language services;
26        (8) are provided by qualified personnel, including but

 

 

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1    not limited to:
2            (A) child development specialists or special
3        educators, including teachers of children with hearing
4        impairments (including deafness) and teachers of
5        children with vision impairments (including
6        blindness),
7            (B) speech and language pathologists and
8        audiologists,
9            (C) occupational therapists,
10            (D) physical therapists,
11            (E) social workers,
12            (F) nurses,
13            (G) dietitian nutritionists,
14            (H) vision specialists, including ophthalmologists
15        and optometrists,
16            (I) psychologists, and
17            (J) physicians;
18        (9) are provided in conformity with an Individualized
19    Family Service Plan;
20        (10) are provided throughout the year; and
21        (11) are provided in natural environments, to the
22    maximum extent appropriate, which may include the home and
23    community settings, unless justification is provided
24    consistent with federal regulations adopted under Sections
25    1431 through 1444 of Title 20 of the United States Code.
26    (f) "Individualized Family Service Plan" or "Plan" means a

 

 

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1written plan for providing early intervention services to a
2child eligible under this Act and the child's family, as set
3forth in Section 11.
4    (g) "Local interagency agreement" means an agreement
5entered into by local community and State and regional
6agencies receiving early intervention funds directly from the
7State and made in accordance with State interagency agreements
8providing for the delivery of early intervention services
9within a local community area.
10    (h) "Council" means the Illinois Interagency Council on
11Early Intervention established under Section 4.
12    (i) "Lead agency" means the State agency responsible for
13administering this Act and receiving and disbursing public
14funds received in accordance with State and federal law and
15rules.
16    (i-5) "Central billing office" means the central billing
17office created by the lead agency under Section 13.
18    (j) "Child find" means a service which identifies eligible
19infants and toddlers.
20    (k) "Regional intake entity" means the lead agency's
21designated entity responsible for implementation of the Early
22Intervention Services System within its designated geographic
23area.
24    (l) "Early intervention provider" means an individual who
25is qualified, as defined by the lead agency, to provide one or
26more types of early intervention services, and who has

 

 

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1enrolled as a provider in the early intervention program.
2    (m) "Fully credentialed early intervention provider" means
3an individual who has met the standards in the State
4applicable to the relevant profession, and has met such other
5qualifications as the lead agency has determined are suitable
6for personnel providing early intervention services, including
7pediatric experience, education, and continuing education. The
8lead agency shall establish these qualifications by rule filed
9no later than 180 days after the effective date of this
10amendatory Act of the 92nd General Assembly.
11    (n) "Telehealth" has the meaning given to that term in
12Section 5 of the Telehealth Act.
13(Source: P.A. 101-10, eff. 6-5-19; 102-104, eff. 7-22-21.)
 
14    Section 99. Effective date. This Act takes effect upon
15becoming law, except that Section 5 takes effect on July 1,
162023.".