Full Text of HB4096 99th General Assembly
HB4096eng 99TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning State government.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Administrative Procedure Act is | 5 | | amended by changing Section 5-45 as follows: | 6 | | (5 ILCS 100/5-45) (from Ch. 127, par. 1005-45) | 7 | | Sec. 5-45. Emergency rulemaking. | 8 | | (a) "Emergency" means the existence of any situation that | 9 | | any agency
finds reasonably constitutes a threat to the public | 10 | | interest, safety, or
welfare. | 11 | | (b) If any agency finds that an
emergency exists that | 12 | | requires adoption of a rule upon fewer days than
is required by | 13 | | Section 5-40 and states in writing its reasons for that
| 14 | | finding, the agency may adopt an emergency rule without prior | 15 | | notice or
hearing upon filing a notice of emergency rulemaking | 16 | | with the Secretary of
State under Section 5-70. The notice | 17 | | shall include the text of the
emergency rule and shall be | 18 | | published in the Illinois Register. Consent
orders or other | 19 | | court orders adopting settlements negotiated by an agency
may | 20 | | be adopted under this Section. Subject to applicable | 21 | | constitutional or
statutory provisions, an emergency rule | 22 | | becomes effective immediately upon
filing under Section 5-65 or | 23 | | at a stated date less than 10 days
thereafter. The agency's |
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| 1 | | finding and a statement of the specific reasons
for the finding | 2 | | shall be filed with the rule. The agency shall take
reasonable | 3 | | and appropriate measures to make emergency rules known to the
| 4 | | persons who may be affected by them. | 5 | | (c) An emergency rule may be effective for a period of not | 6 | | longer than
150 days, but the agency's authority to adopt an | 7 | | identical rule under Section
5-40 is not precluded. No | 8 | | emergency rule may be adopted more
than once in any 24 month | 9 | | period, except that this limitation on the number
of emergency | 10 | | rules that may be adopted in a 24 month period does not apply
| 11 | | to (i) emergency rules that make additions to and deletions | 12 | | from the Drug
Manual under Section 5-5.16 of the Illinois | 13 | | Public Aid Code or the
generic drug formulary under Section | 14 | | 3.14 of the Illinois Food, Drug
and Cosmetic Act, (ii) | 15 | | emergency rules adopted by the Pollution Control
Board before | 16 | | July 1, 1997 to implement portions of the Livestock Management
| 17 | | Facilities Act, (iii) emergency rules adopted by the Illinois | 18 | | Department of Public Health under subsections (a) through (i) | 19 | | of Section 2 of the Department of Public Health Act when | 20 | | necessary to protect the public's health, (iv) emergency rules | 21 | | adopted pursuant to subsection (n) of this Section, (v) | 22 | | emergency rules adopted pursuant to subsection (o) of this | 23 | | Section, or (vi) emergency rules adopted pursuant to subsection | 24 | | (c-5) of this Section. Two or more emergency rules having | 25 | | substantially the same
purpose and effect shall be deemed to be | 26 | | a single rule for purposes of this
Section. |
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| 1 | | (c-5) To facilitate the maintenance of the program of group | 2 | | health benefits provided to annuitants, survivors, and retired | 3 | | employees under the State Employees Group Insurance Act of | 4 | | 1971, rules to alter the contributions to be paid by the State, | 5 | | annuitants, survivors, retired employees, or any combination | 6 | | of those entities, for that program of group health benefits, | 7 | | shall be adopted as emergency rules. The adoption of those | 8 | | rules shall be considered an emergency and necessary for the | 9 | | public interest, safety, and welfare. | 10 | | (d) In order to provide for the expeditious and timely | 11 | | implementation
of the State's fiscal year 1999 budget, | 12 | | emergency rules to implement any
provision of Public Act 90-587 | 13 | | or 90-588
or any other budget initiative for fiscal year 1999 | 14 | | may be adopted in
accordance with this Section by the agency | 15 | | charged with administering that
provision or initiative, | 16 | | except that the 24-month limitation on the adoption
of | 17 | | emergency rules and the provisions of Sections 5-115 and 5-125 | 18 | | do not apply
to rules adopted under this subsection (d). The | 19 | | adoption of emergency rules
authorized by this subsection (d) | 20 | | shall be deemed to be necessary for the
public interest, | 21 | | safety, and welfare. | 22 | | (e) In order to provide for the expeditious and timely | 23 | | implementation
of the State's fiscal year 2000 budget, | 24 | | emergency rules to implement any
provision of this amendatory | 25 | | Act of the 91st General Assembly
or any other budget initiative | 26 | | for fiscal year 2000 may be adopted in
accordance with this |
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| 1 | | Section by the agency charged with administering that
provision | 2 | | or initiative, except that the 24-month limitation on the | 3 | | adoption
of emergency rules and the provisions of Sections | 4 | | 5-115 and 5-125 do not apply
to rules adopted under this | 5 | | subsection (e). The adoption of emergency rules
authorized by | 6 | | this subsection (e) shall be deemed to be necessary for the
| 7 | | public interest, safety, and welfare. | 8 | | (f) In order to provide for the expeditious and timely | 9 | | implementation
of the State's fiscal year 2001 budget, | 10 | | emergency rules to implement any
provision of this amendatory | 11 | | Act of the 91st General Assembly
or any other budget initiative | 12 | | for fiscal year 2001 may be adopted in
accordance with this | 13 | | Section by the agency charged with administering that
provision | 14 | | or initiative, except that the 24-month limitation on the | 15 | | adoption
of emergency rules and the provisions of Sections | 16 | | 5-115 and 5-125 do not apply
to rules adopted under this | 17 | | subsection (f). The adoption of emergency rules
authorized by | 18 | | this subsection (f) shall be deemed to be necessary for the
| 19 | | public interest, safety, and welfare. | 20 | | (g) In order to provide for the expeditious and timely | 21 | | implementation
of the State's fiscal year 2002 budget, | 22 | | emergency rules to implement any
provision of this amendatory | 23 | | Act of the 92nd General Assembly
or any other budget initiative | 24 | | for fiscal year 2002 may be adopted in
accordance with this | 25 | | Section by the agency charged with administering that
provision | 26 | | or initiative, except that the 24-month limitation on the |
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| 1 | | adoption
of emergency rules and the provisions of Sections | 2 | | 5-115 and 5-125 do not apply
to rules adopted under this | 3 | | subsection (g). The adoption of emergency rules
authorized by | 4 | | this subsection (g) shall be deemed to be necessary for the
| 5 | | public interest, safety, and welfare. | 6 | | (h) In order to provide for the expeditious and timely | 7 | | implementation
of the State's fiscal year 2003 budget, | 8 | | emergency rules to implement any
provision of this amendatory | 9 | | Act of the 92nd General Assembly
or any other budget initiative | 10 | | for fiscal year 2003 may be adopted in
accordance with this | 11 | | Section by the agency charged with administering that
provision | 12 | | or initiative, except that the 24-month limitation on the | 13 | | adoption
of emergency rules and the provisions of Sections | 14 | | 5-115 and 5-125 do not apply
to rules adopted under this | 15 | | subsection (h). The adoption of emergency rules
authorized by | 16 | | this subsection (h) shall be deemed to be necessary for the
| 17 | | public interest, safety, and welfare. | 18 | | (i) In order to provide for the expeditious and timely | 19 | | implementation
of the State's fiscal year 2004 budget, | 20 | | emergency rules to implement any
provision of this amendatory | 21 | | Act of the 93rd General Assembly
or any other budget initiative | 22 | | for fiscal year 2004 may be adopted in
accordance with this | 23 | | Section by the agency charged with administering that
provision | 24 | | or initiative, except that the 24-month limitation on the | 25 | | adoption
of emergency rules and the provisions of Sections | 26 | | 5-115 and 5-125 do not apply
to rules adopted under this |
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| 1 | | subsection (i). The adoption of emergency rules
authorized by | 2 | | this subsection (i) shall be deemed to be necessary for the
| 3 | | public interest, safety, and welfare. | 4 | | (j) In order to provide for the expeditious and timely | 5 | | implementation of the provisions of the State's fiscal year | 6 | | 2005 budget as provided under the Fiscal Year 2005 Budget | 7 | | Implementation (Human Services) Act, emergency rules to | 8 | | implement any provision of the Fiscal Year 2005 Budget | 9 | | Implementation (Human Services) Act may be adopted in | 10 | | accordance with this Section by the agency charged with | 11 | | administering that provision, except that the 24-month | 12 | | limitation on the adoption of emergency rules and the | 13 | | provisions of Sections 5-115 and 5-125 do not apply to rules | 14 | | adopted under this subsection (j). The Department of Public Aid | 15 | | may also adopt rules under this subsection (j) necessary to | 16 | | administer the Illinois Public Aid Code and the Children's | 17 | | Health Insurance Program Act. The adoption of emergency rules | 18 | | authorized by this subsection (j) shall be deemed to be | 19 | | necessary for the public interest, safety, and welfare.
| 20 | | (k) In order to provide for the expeditious and timely | 21 | | implementation of the provisions of the State's fiscal year | 22 | | 2006 budget, emergency rules to implement any provision of this | 23 | | amendatory Act of the 94th General Assembly or any other budget | 24 | | initiative for fiscal year 2006 may be adopted in accordance | 25 | | with this Section by the agency charged with administering that | 26 | | provision or initiative, except that the 24-month limitation on |
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| 1 | | the adoption of emergency rules and the provisions of Sections | 2 | | 5-115 and 5-125 do not apply to rules adopted under this | 3 | | subsection (k). The Department of Healthcare and Family | 4 | | Services may also adopt rules under this subsection (k) | 5 | | necessary to administer the Illinois Public Aid Code, the | 6 | | Senior Citizens and Disabled Persons Property Tax Relief Act, | 7 | | the Senior Citizens and Disabled Persons Prescription Drug | 8 | | Discount Program Act (now the Illinois Prescription Drug | 9 | | Discount Program Act), and the Children's Health Insurance | 10 | | Program Act. The adoption of emergency rules authorized by this | 11 | | subsection (k) shall be deemed to be necessary for the public | 12 | | interest, safety, and welfare.
| 13 | | (l) In order to provide for the expeditious and timely | 14 | | implementation of the provisions of the
State's fiscal year | 15 | | 2007 budget, the Department of Healthcare and Family Services | 16 | | may adopt emergency rules during fiscal year 2007, including | 17 | | rules effective July 1, 2007, in
accordance with this | 18 | | subsection to the extent necessary to administer the | 19 | | Department's responsibilities with respect to amendments to | 20 | | the State plans and Illinois waivers approved by the federal | 21 | | Centers for Medicare and Medicaid Services necessitated by the | 22 | | requirements of Title XIX and Title XXI of the federal Social | 23 | | Security Act. The adoption of emergency rules
authorized by | 24 | | this subsection (l) shall be deemed to be necessary for the | 25 | | public interest,
safety, and welfare.
| 26 | | (m) In order to provide for the expeditious and timely |
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| 1 | | implementation of the provisions of the
State's fiscal year | 2 | | 2008 budget, the Department of Healthcare and Family Services | 3 | | may adopt emergency rules during fiscal year 2008, including | 4 | | rules effective July 1, 2008, in
accordance with this | 5 | | subsection to the extent necessary to administer the | 6 | | Department's responsibilities with respect to amendments to | 7 | | the State plans and Illinois waivers approved by the federal | 8 | | Centers for Medicare and Medicaid Services necessitated by the | 9 | | requirements of Title XIX and Title XXI of the federal Social | 10 | | Security Act. The adoption of emergency rules
authorized by | 11 | | this subsection (m) shall be deemed to be necessary for the | 12 | | public interest,
safety, and welfare.
| 13 | | (n) In order to provide for the expeditious and timely | 14 | | implementation of the provisions of the State's fiscal year | 15 | | 2010 budget, emergency rules to implement any provision of this | 16 | | amendatory Act of the 96th General Assembly or any other budget | 17 | | initiative authorized by the 96th General Assembly for fiscal | 18 | | year 2010 may be adopted in accordance with this Section by the | 19 | | agency charged with administering that provision or | 20 | | initiative. The adoption of emergency rules authorized by this | 21 | | subsection (n) shall be deemed to be necessary for the public | 22 | | interest, safety, and welfare. The rulemaking authority | 23 | | granted in this subsection (n) shall apply only to rules | 24 | | promulgated during Fiscal Year 2010. | 25 | | (o) In order to provide for the expeditious and timely | 26 | | implementation of the provisions of the State's fiscal year |
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| 1 | | 2011 budget, emergency rules to implement any provision of this | 2 | | amendatory Act of the 96th General Assembly or any other budget | 3 | | initiative authorized by the 96th General Assembly for fiscal | 4 | | year 2011 may be adopted in accordance with this Section by the | 5 | | agency charged with administering that provision or | 6 | | initiative. The adoption of emergency rules authorized by this | 7 | | subsection (o) is deemed to be necessary for the public | 8 | | interest, safety, and welfare. The rulemaking authority | 9 | | granted in this subsection (o) applies only to rules | 10 | | promulgated on or after the effective date of this amendatory | 11 | | Act of the 96th General Assembly through June 30, 2011. | 12 | | (p) In order to provide for the expeditious and timely | 13 | | implementation of the provisions of Public Act 97-689, | 14 | | emergency rules to implement any provision of Public Act 97-689 | 15 | | may be adopted in accordance with this subsection (p) by the | 16 | | agency charged with administering that provision or | 17 | | initiative. The 150-day limitation of the effective period of | 18 | | emergency rules does not apply to rules adopted under this | 19 | | subsection (p), and the effective period may continue through | 20 | | June 30, 2013. The 24-month limitation on the adoption of | 21 | | emergency rules does not apply to rules adopted under this | 22 | | subsection (p). The adoption of emergency rules authorized by | 23 | | this subsection (p) is deemed to be necessary for the public | 24 | | interest, safety, and welfare. | 25 | | (q) In order to provide for the expeditious and timely | 26 | | implementation of the provisions of Articles 7, 8, 9, 11, and |
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| 1 | | 12 of this amendatory Act of the 98th General Assembly, | 2 | | emergency rules to implement any provision of Articles 7, 8, 9, | 3 | | 11, and 12 of this amendatory Act of the 98th General Assembly | 4 | | may be adopted in accordance with this subsection (q) by the | 5 | | agency charged with administering that provision or | 6 | | initiative. The 24-month limitation on the adoption of | 7 | | emergency rules does not apply to rules adopted under this | 8 | | subsection (q). The adoption of emergency rules authorized by | 9 | | this subsection (q) is deemed to be necessary for the public | 10 | | interest, safety, and welfare. | 11 | | (r) In order to provide for the expeditious and timely | 12 | | implementation of the provisions of this amendatory Act of the | 13 | | 98th General Assembly, emergency rules to implement this | 14 | | amendatory Act of the 98th General Assembly may be adopted in | 15 | | accordance with this subsection (r) by the Department of | 16 | | Healthcare and Family Services. The 24-month limitation on the | 17 | | adoption of emergency rules does not apply to rules adopted | 18 | | under this subsection (r). The adoption of emergency rules | 19 | | authorized by this subsection (r) is deemed to be necessary for | 20 | | the public interest, safety, and welfare. | 21 | | (s) In order to provide for the expeditious and timely | 22 | | implementation of the provisions of Sections 5-5b.1 and 5A-2 of | 23 | | the Illinois Public Aid Code, emergency rules to implement any | 24 | | provision of Section 5-5b.1 or Section 5A-2 of the Illinois | 25 | | Public Aid Code may be adopted in accordance with this | 26 | | subsection (s) by the Department of Healthcare and Family |
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| 1 | | Services. The rulemaking authority granted in this subsection | 2 | | (s) shall apply only to those rules adopted prior to July 1, | 3 | | 2015. Notwithstanding any other provision of this Section, any | 4 | | emergency rule adopted under this subsection (s) shall only | 5 | | apply to payments made for State fiscal year 2015. The adoption | 6 | | of emergency rules authorized by this subsection (s) is deemed | 7 | | to be necessary for the public interest, safety, and welfare. | 8 | | (t) In order to provide for the expeditious and timely | 9 | | implementation of the provisions of this amendatory Act of the | 10 | | 99th General Assembly, emergency rules to implement this | 11 | | amendatory Act of the 99th General Assembly may be adopted in | 12 | | accordance with this subsection (t) by the Department of | 13 | | Healthcare and Family Services. The 24-month limitation on the | 14 | | adoption of emergency rules does not apply to rules adopted | 15 | | under this subsection (t). The adoption of emergency rules | 16 | | authorized by this subsection (t) is deemed to be necessary for | 17 | | the public interest, safety, and welfare. | 18 | | (Source: P.A. 98-104, eff. 7-22-13; 98-463, eff. 8-16-13; | 19 | | 98-651, eff. 6-16-14; 99-2, eff. 3-26-15.) | 20 | | Section 10. The Mental Health and Developmental | 21 | | Disabilities Administrative Act is amended by changing Section | 22 | | 7.1 and by adding Sections 75, 75.01, 75.02, 75.03, 75.04, | 23 | | 75.05, 75.06, 75.07, 75.08, 75.09, 75.10, 75.11, 75.12, 75.13, | 24 | | 75.14, 75.15, 75.16, and 75.17 as follows:
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| 1 | | (20 ILCS 1705/7.1) (from Ch. 91 1/2, par. 100-7.1)
| 2 | | Sec. 7.1.
To assist families to place children with mental | 3 | | illness, for whom
no appropriate care is available in | 4 | | Department facilities, in licensed private
facilities, the | 5 | | Department shall supplement the amount a family is able to pay,
| 6 | | as determined by the Department and the amount available from | 7 | | other sources,
provided the Department's share shall not exceed | 8 | | a uniform maximum rate to be
determined from time to time by | 9 | | the Department. The Department of Healthcare and Family | 10 | | Services may exercise such authority under this Section as is | 11 | | necessary to implement the provisions of Section 5.23 of the | 12 | | Illinois Public Aid Code and to administer Individual Care | 13 | | Grants.
| 14 | | (Source: P.A. 88-380.)
| 15 | | (20 ILCS 1705/75 new) | 16 | | Sec. 75. Purpose; transfer of certain rights, powers, | 17 | | duties, and functions; application of Sections 75.01 through | 18 | | 75.17. | 19 | | (a) It is the purpose of this Part to transfer to the | 20 | | Department of Healthcare and Family Services certain rights, | 21 | | powers, and duties currently exercised by the Department of | 22 | | Human Services related to Individual Care Grants for children | 23 | | with complex behavioral health needs. This transfer is intended | 24 | | to make possible the more effective and efficient operation of | 25 | | Individual Care Grant services. |
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| 1 | | (b) Certain rights, powers, and duties currently exercised | 2 | | by the Department of Human Services related to Individual Care | 3 | | Grants for children with complex behavioral health needs are | 4 | | transferred to the Department of Healthcare and Family Services | 5 | | with the transfer and transition of the Individual Care Grant | 6 | | program to the Department of Healthcare and Family Services to | 7 | | be completed and implemented within 6 months after the | 8 | | effective date of this amendatory Act of the 99th General | 9 | | Assembly, as provided in Section 7.1 of this Act and Section 15 | 10 | | of this amendatory Act of the 99th General Assembly. For the | 11 | | purposes of the Successor Agency Act, the Department of | 12 | | Healthcare and Family Services is declared to be the successor | 13 | | agency of the Department of Human Services, but only with | 14 | | respect to the functions of the Department of Human Services | 15 | | that are transferred to the Department of Healthcare and Family | 16 | | Services under this amendatory Act of the 99th General | 17 | | Assembly. | 18 | | (c) Sections 75.01 through 75.17 (this Part) shall | 19 | | supersede any rules of the Department of Human Services | 20 | | regarding which children are eligible to receive funds for an | 21 | | Individual Care Grant hereinafter referred to as "ICG" due to | 22 | | their mental illness, including intensive community services | 23 | | or residential placement, when clinically appropriate. | 24 | | Comprehensive services are to be funded to assist in reducing | 25 | | the child's severity of symptoms and illness to maintain the | 26 | | individual in the least restrictive setting that is clinically |
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| 1 | | appropriate. With the goal of keeping families unified, funds | 2 | | shall be provided to assist parents or guardians in obtaining | 3 | | necessary services and support for children with complex | 4 | | behavioral health needs, not just children with psychosis. | 5 | | (d) In addition to the other statutory provisions regarding | 6 | | Individual Care Grants, this Part is intended to supplement and | 7 | | provide procedures for Individual Care Grants. However, if | 8 | | there is a conflict between anything contained in the other | 9 | | statutory provisions, those other statutory provisions shall | 10 | | prevail. | 11 | | (e) This Part establishes the Children's Behavioral Health | 12 | | Cabinet. The Office of the Governor shall establish and chair a | 13 | | Children's Behavioral Health Cabinet that shall include the | 14 | | Directors of Healthcare and Family Services, Children and | 15 | | Family Services, and Juvenile Justice or their designees, the | 16 | | Secretary of Human Services or his or her designee, the State | 17 | | Superintendent of Education or his or her designee, family | 18 | | representatives, provider representatives, and other necessary | 19 | | stakeholders, as determined by the Office of the Governor, to | 20 | | inform the design and management of children's behavioral | 21 | | health services.
The Children's Behavioral Health Cabinet | 22 | | shall meet at least quarterly.
The Children's Behavioral Health | 23 | | Cabinet shall prepare an annual report to the General Assembly | 24 | | on or before January 30th of each year related to the | 25 | | implementation of any remedies in response to litigation | 26 | | against the Department of Healthcare and Family Services |
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| 1 | | related to children's behavioral health and the general status | 2 | | of children's behavioral health in this State. | 3 | | (20 ILCS 1705/75.01 new) | 4 | | Sec. 75.01. Definitions. | 5 | | For the purposes of this Part, unless the context otherwise | 6 | | requires: | 7 | | "Children" means individuals under 18 years of age. | 8 | | "Days" means calendar days. | 9 | | "Department" means the Department of Healthcare and Family | 10 | | Services. | 11 | | "Director" means the Director of the Department of | 12 | | Healthcare and Family Services. | 13 | | "Division of Mental Health" or "DMH" means the Department | 14 | | of Human Services, Division of Mental Health. | 15 | | "ICG Coordinator" means staff employed by an Illinois | 16 | | screening, assessment and support services program to provide | 17 | | support, information and recommendations regarding available | 18 | | services, case coordination, and supports to youth applying for | 19 | | or with an Illinois ICG. | 20 | | "Individual Services Plan" or "ISP" means the plan that | 21 | | identifies the child's goals and selects the level of care and | 22 | | associated services required to meet the goals. | 23 | | "Licensed private facilities" means residential treatment | 24 | | facilities licensed by the Department of Children and Family | 25 | | Services under 89 Ill. Adm. Code 404, or, for out-of-state |
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| 1 | | facilities, in accordance with Section 15.1 of the Mental | 2 | | Health and Developmental Disabilities Administrative Act, | 3 | | which have been accredited by the Joint Commission on the | 4 | | Accreditation of Healthcare Organizations hereinafter referred | 5 | | to as "JCAHO" as a psychiatric facility serving children and | 6 | | adolescents or which have been surveyed and approved by the | 7 | | Department as meeting standards equivalent to standards for | 8 | | psychiatric facilities serving children and adolescents found | 9 | | in the 1997 Standards for Behavioral Health Care released by | 10 | | JCAHO. | 11 | | "Parent or guardian" means a parent, biological, or | 12 | | adoptive, or an individual appointed as legal guardian by the | 13 | | court under the Probate Act of 1975. A parent or guardian does | 14 | | not include a governmental agency or social service agency, or | 15 | | any employee thereof, appointed by a court as guardian or | 16 | | custodian. | 17 | | "Residential facility" means a facility providing 24-hour | 18 | | supervised out-of-home therapeutic care, including, but not | 19 | | limited to: single or multiple site program sites or apartments | 20 | | that provide a 24-hour supervised environment. | 21 | | "SASS" or "Screening, Assessment and Support Services" | 22 | | means short-term, crisis intervention mental health services | 23 | | that are provided to children who are at risk or who actually | 24 | | experience
hospitalization due to psychiatric reasons. | 25 | | "Staff" means employees or persons under contract with the | 26 | | Department. |
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| 1 | | "Young adults" means individuals 18 through 21 years of | 2 | | age. | 3 | | "Young adult support services" means time-limited funding | 4 | | for young adults to cover costs of services and supports, not | 5 | | included under other programs for which the person may be | 6 | | eligible, to aid the young adult in his or her transition to | 7 | | community living and funding that can be applied to the costs | 8 | | of a supported living arrangement or other appropriate | 9 | | transitional services that help to integrate the young adult | 10 | | into his or her adult roles in the community. | 11 | | (20 ILCS 1705/75.02 new) | 12 | | Sec. 75.02. Stakeholder Committee. | 13 | | (a) The Department of Healthcare and Family Services shall | 14 | | establish an ICG Stakeholder Committee comprised of parents, | 15 | | youth, provider representatives, representation from the | 16 | | Department of Children and Family Services, representation | 17 | | from the Department of Human Services, representation from the | 18 | | Department of Juvenile Justice, representation from the CCBYS | 19 | | program and other stakeholders as determined by the Department. | 20 | | (b) The ICG Stakeholder Committee shall meet on a quarterly | 21 | | basis. | 22 | | (c) All potential program changes shall be presented to the | 23 | | ICG Stakeholder Committee for discussion and input prior to | 24 | | implementation. |
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| 1 | | (20 ILCS 1705/75.03 new) | 2 | | Sec. 75.03. Eligibility criteria for an individual care | 3 | | grant. In order to be eligible for ICG funding, the following | 4 | | criteria must be met: | 5 | | (1) The parent or guardian must be a resident of this | 6 | | State, as defined in Section 2-10 of the Illinois Public Aid | 7 | | Code. | 8 | | (2) The child must: | 9 | | (A) have a diagnosis, which the current symptoms do not | 10 | | represent a single acute episode from which rapid and | 11 | | substantial remission is likely, of: schizophrenia | 12 | | spectrum and other psychotic disorders; bipolar and | 13 | | related disorders; depressive disorders; anxiety | 14 | | disorders; obsessive-compulsive and related disorders; | 15 | | trauma-related and stressor-related disorders; | 16 | | dissociative disorders; or somatic symptom disorders; | 17 | | (B) must not be older than 17 1/2 years of age at the | 18 | | time of prior authorization; | 19 | | (C) must meet medical necessity standards as | 20 | | established in Section 75.04 by the Department; and | 21 | | (3) The child must not be under the guardianship of another | 22 | | State agency that has financial and legal responsibility for | 23 | | the youth. | 24 | | (20 ILCS 1705/75.04 new) | 25 | | Sec. 75.04. Medical necessity. |
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| 1 | | (a) The Department of Healthcare and Family Services shall, | 2 | | in collaboration with the Department of Human Services and the | 3 | | Department of Children and Family Services, establish the | 4 | | appropriate clinical standards for Community ICG Services and | 5 | | Residential ICG Services, using the Child and Adolescent Needs | 6 | | and Strengths (CANS) Assessment, within 6 months of the | 7 | | effective date of this Part. The Department of Healthcare and | 8 | | Family Services shall review the clinical threshold with the | 9 | | Department of Human Services and the Department of Children and | 10 | | Family Services, annually. | 11 | | (b) Through the use of the CANS Assessment, a child's needs | 12 | | shall be stratified across tiers of service intensity. ICG | 13 | | community services shall have a different clinical threshold | 14 | | than ICG residential services. | 15 | | (c) Families shall be notified of the intensity of services | 16 | | for which their child qualifies: ICG community or ICG | 17 | | residential. A family may always select to substitute lower | 18 | | intensity services for higher intensity services. | 19 | | (d) The Department of Healthcare and Family Services shall | 20 | | continue to use the existing methods of determining clinical | 21 | | appropriateness until it transitions to the utilization of the | 22 | | CANS Assessment, as detailed in this Section. | 23 | | (e) Children placed in a residential setting shall undergo | 24 | | a continued stay review, as established by the Department of | 25 | | Healthcare and Family Services. A child placed in ICG community | 26 | | services shall undergo a clinical review every 6 months. |
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| 1 | | (20 ILCS 1705/75.05 new) | 2 | | Sec. 75.05. Emergency individual care grants. | 3 | | (a) To be eligible for an emergency temporary individual | 4 | | care grant: | 5 | | (1) the child and family must meet the eligibility | 6 | | requirements in Section 75.03; | 7 | | (2) a child receiving inpatient psychiatric care (for | 8 | | example at a psychiatric hospital or similar facility) who | 9 | | is ready for discharge and who is not able to return home | 10 | | due to the safety of the child, family, or individual may | 11 | | be awarded a temporary emergency grant for a period of 90 | 12 | | days; and | 13 | | (3) the attending child and adolescent psychiatrist | 14 | | must recommend that the child is in need of on-going 24 | 15 | | hour supervision, such as residential placement. | 16 | | (b) During the 90-day period complete the ICG prior | 17 | | authorization process in accordance with this Part. | 18 | | (c) Section 75.11 applies to decisions under this Section. | 19 | | (20 ILCS 1705/75.06 new) | 20 | | Sec. 75.06. ICG application reform, prior authorization | 21 | | process, re-authorization process. | 22 | | (a) The Department of Healthcare and Family Services shall | 23 | | replace the existing ICG application process with a simplified | 24 | | service prior authorization process on or before 6 months after |
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| 1 | | the effective date of this amendatory Act of the 99th General | 2 | | Assembly. | 3 | | (b) The Department's simplified service prior | 4 | | authorization process shall include the following: | 5 | | (1) demographic details regarding the child; | 6 | | (2) clinical diagnosis verified by an LPHA within the | 7 | | last 6 months; | 8 | | (3) completed CANS scores; | 9 | | (4) history of inpatient and residential care; | 10 | | (5) history of SASS services; | 11 | | (6) history of behavioral health services; | 12 | | (7) signed authorization detailing need for | 13 | | residential care by a LPHA; | 14 | | (8) family details, including a signed statement of | 15 | | engagement indicating that the family will participate in | 16 | | treatment and that the child will have a place of residency | 17 | | upon discharge from treatment. | 18 | | (c) The Department of Healthcare and Family Services shall | 19 | | establish a process for reviewing and authorizing prior | 20 | | authorization requests within 5 days of submission. | 21 | | (d) The Department of Healthcare and Family Services shall | 22 | | re-authorize grants every 6 months, so long as the child is | 23 | | under the age of 21. | 24 | | (e) The parent or guardian, child (if appropriate), and | 25 | | provider shall be notified in writing, 6 weeks prior to the | 26 | | anniversary date of the Department of Healthcare and Family |
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| 1 | | Services decision to re-authorize or terminate funding. | 2 | | (20 ILCS 1705/75.07 new) | 3 | | Sec. 75.07. Parent or guardian responsibilities; | 4 | | resources. | 5 | | (a) The parent or guardian of a child receiving an ICG must | 6 | | participate in the child's care, treatment, and is willing to | 7 | | accept the child home upon discharge to the community. | 8 | | (b) When a youth is placed in residential care, the | 9 | | residential provider shall apply for all public sources of | 10 | | financial support available to or for the child, including but | 11 | | not limited to Social Security Administration ("SSA") benefits | 12 | | and supplemental security income ("SSI") authorized under 42 | 13 | | U.S.C. 1381, and these funds must be applied to the costs of | 14 | | residential care, to the extent provided by law. | 15 | | (c) Upon placement in residential care, if the child is not | 16 | | already receiving benefits from SSA, the parent or guardian | 17 | | shall authorize the residential placement staff to initiate an | 18 | | application for SSI immediately after placement or on the 90th | 19 | | day, depending on family income levels. If the child is | 20 | | receiving benefits from SSA upon admission into residential | 21 | | care, the parent or guardian shall authorize the residential | 22 | | placement staff to initiate an application on behalf of the | 23 | | residential agency to become payee for SSA benefits. | 24 | | (d) The parent or guardian must notify the Department of | 25 | | Healthcare and Family Services of any changes in the level of |
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| 1 | | financial support from public sources. Declaration of | 2 | | ineligibility, reduction of benefits, or loss of benefits | 3 | | through the actions of another governmental agency shall not | 4 | | affect the Department's continued funding, unless these | 5 | | actions are the consequence of the parent or guardian's failure | 6 | | to pursue benefits or comply with this Section. | 7 | | (e) All financial assets of the child exceeding an exempt | 8 | | amount established by the Department of Healthcare and Family | 9 | | Services must be applied to the costs of residential care. The | 10 | | determination that certain assets may be exempt is subject to | 11 | | the Department's review and approval. | 12 | | (f) If the child is covered by private medical insurance, | 13 | | it is primary coverage for community or residential services. | 14 | | The ICG shall be considered secondary coverage. | 15 | | (g) The parent or guardian must notify the Department of | 16 | | Healthcare and Family Services of any changes of address for | 17 | | the parent or guardian. | 18 | | (h) The parent or guardian must notify the Department of | 19 | | Healthcare and Family Services of any changes of guardianship | 20 | | or custody. | 21 | | (20 ILCS 1705/75.08 new) | 22 | | Sec. 75.08. ICG service appeals, denials, and complaints. | 23 | | The Department of Healthcare and Family Services shall adopt | 24 | | rules for addressing service appeals, grant denials (including | 25 | | re-authorization determinations) and complaints related to the |
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| 1 | | ICG program. The appeals and denial process shall include a | 2 | | Director's Level Review process and funding of a child's ICG | 3 | | shall continue through all appeals processes. | 4 | | (20 ILCS 1705/75.09 new) | 5 | | Sec. 75.09. Individual Services Plan Development. | 6 | | (a) When the individual has been determined eligible for | 7 | | community or residential ICG, the ICG Program Office shall | 8 | | refer the parent or guardian to the appropriate SASS agency for | 9 | | the purpose of developing an individual services plan. | 10 | | (b) The ICG Coordinator/SASS Coordinator shall provide | 11 | | support, information, and recommendations regarding available | 12 | | services and help the family determine the right services to | 13 | | meet the needs of the child and stabilize the family. | 14 | | (c) The individual service plan shall be developed with the | 15 | | parent or guardian and appropriate service providers and must | 16 | | be reviewed and re-authorized every 6 months. The individual | 17 | | service plan shall include: | 18 | | (1) identifying specific problems to be addressed; | 19 | | (2) integrating all of the services to be provided; | 20 | | (3) defining specific goals and objectives and the | 21 | | projected duration and costs of services; | 22 | | (4) the parent or guardian's approval of the identified | 23 | | service providers; and | 24 | | (5) identifying the licensed physician, clinical | 25 | | psychologist, clinical social worker, or clinical |
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| 1 | | professional counselor under whose clinical direction the | 2 | | services will be provided and obtain, by signature, his or | 3 | | approval of the plan. | 4 | | (d) The development or implementation of an individual | 5 | | services plan may be deferred for one or more of the following | 6 | | conditions: | 7 | | (1) continuing hospitalization is required; | 8 | | (2) extended absence from the family due to the child | 9 | | running away or a court-ordered transfer of custody or | 10 | | guardianship to a governmental agency; or | 11 | | (3) the parent or guardian does not wish to initiate | 12 | | any services with ICG funding or fails to participate in | 13 | | the individual services planning. | 14 | | (e) If the individual services plan is not developed or | 15 | | implemented within 6 months of the ICG award, the parent or | 16 | | guardian must re-authorize the awarded ICG grant. | 17 | | (f) A recommendation to move a child to a lower level of | 18 | | care must include a minimum of 30 days of preparation for this | 19 | | transition. | 20 | | (20 ILCS 1705/75.10 new) | 21 | | Sec. 75.10. Alternative In-home services. | 22 | | (a) The Department of Healthcare and Family Services or its | 23 | | representative shall review individual services plans as well | 24 | | as discharge plans and may approve funding for alternative | 25 | | in-home services as described in this Section. |
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| 1 | | (b) Alternative in-home services include, but are not | 2 | | limited to, care coordination, community support, crisis | 3 | | stabilization services, mentoring, respite support services, | 4 | | and young adult support services. | 5 | | (c) ICG funding shall not be used to replace services | 6 | | authorized under 59 Ill. Adm. Code, Part 132 or other services | 7 | | for which the child and family may be eligible through federal, | 8 | | State, or local funding. | 9 | | (d) Limits of hours and costs shall be authorized on a case | 10 | | by case basis by the Department. | 11 | | (20 ILCS 1705/75.11 new) | 12 | | Sec. 75.11. Residential placement. | 13 | | (a) SASS staff shall discuss with the parent or guardian | 14 | | the potentially appropriate facilities based on factors such as | 15 | | the child's age, sex, and mental health condition, as well as | 16 | | locations and programs of facilities, and the requirements for | 17 | | placement and parental involvement, and shall, at the parent's | 18 | | or guardian's direction and with appropriately executed | 19 | | consents, prepare clinical referral packets to be sent to the | 20 | | facilities. | 21 | | (b) The list of facilities appropriate for placement | 22 | | through the ICG program is comprised of facilities which: | 23 | | (1) meet the standards for licensed private facilities | 24 | | as defined in administrative rules; | 25 | | (2) have an educational program approved by the |
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| 1 | | Illinois State Board of Education; | 2 | | (3) have a per diem rate that includes residential | 3 | | services, such as room and board, but does not include | 4 | | tuition as established for purchased care services under | 5 | | the rules of the Illinois Purchased Care Review Board in 89 | 6 | | Ill. Adm. Code 900, the Department of Children and Family | 7 | | Services in 89 Ill. Adm. Code 356, or the Department in | 8 | | Section 54 of the Mental Health and Developmental | 9 | | Disabilities Administrative Act; and | 10 | | (4) have entered into a contract with the Department | 11 | | for these services during the current fiscal period. | 12 | | (c) If appropriate placement for a child cannot be obtained | 13 | | from a contracted provider, the Department may contract with | 14 | | other private facilities meeting the standards provided in | 15 | | paragraphs (1) and (2) of subsection (b) of this Section. | 16 | | (d) The Department may negotiate for additional services | 17 | | from facilities to augment existing services or to develop a | 18 | | specialized resource for a child. | 19 | | (e) An individual service plan shall be developed within 30 | 20 | | days after placement, including expected duration and | 21 | | outcomes, by facility staff in consultation with the parent or | 22 | | guardian and the child. This individual service plan shall be | 23 | | reviewed and updated quarterly, including documentation of | 24 | | parental participation and consideration of discharge to | 25 | | in-home or community services. These updated plans and progress | 26 | | reports shall be provided quarterly to the Department or its |
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| 1 | | designee. Together with the goals as stated in the case record | 2 | | summary, these documents shall be the basis for the | 3 | | Department's review and approval for continuing funding for | 4 | | placement, including alternative in-home or community service | 5 | | which are part of the discharge plan. | 6 | | (f) Parent or guardian responsibilities during placement | 7 | | include the following: | 8 | | (1) participation in and cooperation with the | 9 | | facility's requirements for the child's care, treatment, | 10 | | and discharge to the family and community; | 11 | | (2) completion and submission of any forms and | 12 | | documents as may be required by the Department; | 13 | | (3) the usual and customary costs of parenthood or | 14 | | guardianship, including: | 15 | | (A) clothing; | 16 | | (B) medical and dental costs; | 17 | | (C) personal allowance and incidentals; and | 18 | | (D) transportation costs, to and from the | 19 | | facility; and | 20 | | (4) notifying the local education agency that the child | 21 | | has been placed in a residential facility and requesting | 22 | | their participation in educational planning. The local | 23 | | education agency is responsible for the tuition costs of | 24 | | residential placement under State law. | 25 | | (g) Prior to residential placement, if the youth has not | 26 | | yet been identified as eligible for special education services, |
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| 1 | | the parent or guardian should initiate a case study evaluation | 2 | | through their local school district. | 3 | | (20 ILCS 1705/75.12 new) | 4 | | Sec. 75.12. Discharge from residential services. | 5 | | (a) An Individual Service Plan must follow the discharge | 6 | | protocol established by the Division of Mental Health in order | 7 | | to ensure that community services are in place before | 8 | | discharge. The parent or guardian with support from an ICG | 9 | | Coordinator shall identify and procure appropriate community | 10 | | services. | 11 | | (b) If the child is leaving the ICG program upon discharge, | 12 | | appropriate child and adolescent or adult services must be | 13 | | engaged. | 14 | | (20 ILCS 1705/75.13 new) | 15 | | Sec. 75.13. Termination of funding or services. | 16 | | ICG funding shall be terminated in any of the following | 17 | | circumstances: | 18 | | (1) failure of the parent or guardian to meet prior | 19 | | authorization, re-authorization, or eligibility requirements; | 20 | | (2) the child is no longer enrolled in an approved | 21 | | educational program at the elementary or high school level, or | 22 | | attainment of age 21, whichever occurs first; | 23 | | (3) completion of residential treatment or alternative | 24 | | in-home or community services; |
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| 1 | | (4) the parent or guardian is no longer an Illinois | 2 | | resident; however, funding and placement for the child may | 3 | | continue until completion of the school year; | 4 | | (5) guardianship of the child is ordered by the court to a | 5 | | State agency; | 6 | | (6) the child's resources, private or public, are | 7 | | sufficient to pay the costs of care; | 8 | | (7) any 12-month period without receiving residential, | 9 | | community, or alternative in-home; or | 10 | | (8) Upon the completion of the annual ICG renewal process, | 11 | | it is determined that the child no longer would clinically | 12 | | benefit from the services being provided. | 13 | | (20 ILCS 1705/75.14 new) | 14 | | Sec. 75.14. Monitoring. The Department shall establish | 15 | | policies and procedures related to the monitoring of | 16 | | residential, community, and alternative in-home services | 17 | | providers. | 18 | | (20 ILCS 1705/75.15 new) | 19 | | Sec. 75.15. Bed holds. | 20 | | (a) The Department shall adopt rules regarding bed holds | 21 | | and may not reimburse a provider for more than 40 bed nights | 22 | | per State fiscal year per individual. | 23 | | (b) An agency shall not be reimbursed for an individual's | 24 | | absence after the date of discharge or when his or her |
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| 1 | | treatment plan includes removal from the agency program or | 2 | | after the date of the agency's knowledge of the individual's | 3 | | pending termination. | 4 | | (20 ILCS 1705/75.16 new) | 5 | | Sec. 75.16. Children's Behavioral Health Reform. | 6 | | (a) The Department of Healthcare and Family Services shall | 7 | | seek to maximize federal financial participation for all | 8 | | services covered under this Part and to fully integrate the ICG | 9 | | program into the Children's Behavioral Health Reform efforts | 10 | | established by the Department. To the extent that full | 11 | | integration of the ICG program into the Department of | 12 | | Healthcare and Family Services behavioral health care | 13 | | coordination entity creates a conflict with any Part of this | 14 | | Act, the Department shall establish provisional policies that | 15 | | shall be in effect for the term of the agreement between the | 16 | | Department of Healthcare and Family Services and any such care | 17 | | coordination entity. | 18 | | (b) The Department shall establish an updated ICG Program | 19 | | design. The Department shall work collaboratively with the | 20 | | Division of Mental Health and the Department of Children and | 21 | | Family Services as it establishes an implementation plan for | 22 | | Children's Behavioral Health Reform and adopt new rules | 23 | | detailing the operation of an updated ICG Program that | 24 | | coordinates service delivery and design before December 31, | 25 | | 2016. |
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| 1 | | (20 ILCS 1705/75.17 new) | 2 | | Sec. 75.17. Repeal.
Sections 75 through 75.17 are repealed | 3 | | on January 1, 2018.
| 4 | | Section 15. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-5.23 as follows:
| 6 | | (305 ILCS 5/5-5.23)
| 7 | | Sec. 5-5.23. Children's mental health services.
| 8 | | (a) The Department of Healthcare and Family Services, by | 9 | | rule, shall require the screening and
assessment of
a child | 10 | | prior to any Medicaid-funded admission to an inpatient hospital | 11 | | for
psychiatric
services to be funded by Medicaid. The | 12 | | screening and assessment shall include a
determination of the | 13 | | appropriateness and availability of out-patient support
| 14 | | services
for necessary treatment. The Department, by rule, | 15 | | shall establish methods and
standards of payment for the | 16 | | screening, assessment, and necessary alternative
support
| 17 | | services.
| 18 | | (b) The Department of Healthcare and Family Services, to | 19 | | the extent allowable under federal law,
shall secure federal | 20 | | financial participation for Individual Care Grant
expenditures | 21 | | made
by the Department of Healthcare and Family Services of | 22 | | Human Services for the Medicaid optional service
authorized | 23 | | under
Section 1905(h) of the federal Social Security Act, |
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| 1 | | pursuant to the provisions
of Section
7.1 of the Mental Health | 2 | | and Developmental Disabilities Administrative Act. The | 3 | | Department of Healthcare and Family Services may exercise such | 4 | | authority under this Section as is necessary to administer | 5 | | Individual Care Grants as authorized under Section 7.1 of the | 6 | | Mental Health and Developmental Disabilities Administrative | 7 | | Act.
| 8 | | (c) The Department of Healthcare and Family Services shall | 9 | | work collaboratively with the Department of Children and Family | 10 | | Services and the Division of Mental Health of jointly with the | 11 | | Department of
Human Services to implement subsections (a) and | 12 | | (b).
| 13 | | (d) On and after July 1, 2012, the Department shall reduce | 14 | | any rate of reimbursement for services or other payments or | 15 | | alter any methodologies authorized by this Code to reduce any | 16 | | rate of reimbursement for services or other payments in | 17 | | accordance with Section 5-5e. | 18 | | (Source: P.A. 97-689, eff. 6-14-12.)
| 19 | | Section 99. Effective date. This Act takes effect upon | 20 | | becoming law. |
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