Public Act 103-0546
SB0724 EnrolledLRB103 29722 SPS 56127 b SB0724 Enrolled LRB103 29722 SPS 56127 b
SB0724 Enrolled LRB103 29722 SPS 56127 b
AN ACT concerning health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
Interagency Children's Behavioral Health Services Act.
Section 5. Children's Behavioral Health Transformation
Initiative. This Act establishes a Children's Behavioral
Health Transformation Officer. The Officer shall lead the
State's comprehensive, interagency effort to ensure that youth
with significant and complex behavioral health needs receive
appropriate community and residential services and that the
State-supported system is transparent and easier for youth and
their families to navigate. The Officer shall serve as a
policymaker and spokesperson on children's behavioral health,
including coordinating the interagency effort through
legislation, rules, and budgets and communicating with the
General Assembly and federal and local leaders on these
critical issues.
An Interagency Children's Behavioral Health Services Team
is established to find appropriate services, residential
treatment, and support for children identified by each
participating agency as requiring enhanced agency
collaboration to identify and obtain treatment in a
SB0724 Enrolled LRB103 29722 SPS 56127 b
residential setting. Responsibilities of each participating
agency shall be outlined in an interagency agreement between
all the relevant State agencies.
Section 10. Interagency agreement. In order to establish
the Interagency Children's Behavioral Health Services Team,
within 90 days after the effective date of this Act, the
Department of Children of Family Services, the Department of
Human Services, the Department of Healthcare and Family
Services, the Illinois State Board of Education, the
Department of Juvenile Justice, and the Department of Public
Health shall enter into an interagency agreement for the
purpose of establishing the roles and responsibilities of each
participating agency.
The interagency agreement, among other things, shall
address all of the following:
(1) Require each participating agency to assign staff
to the Interagency Children's Behavioral Health Services
Team who have operational knowledge of and decision-making
authority over the agency's children's behavioral health
programs and services.
(2) Set criteria to identify children whose cases will
be presented to the Interagency Children's Behavioral
Health Services Team for prioritized review. Criteria
shall include, but not be limited to:
(A) the length of time the child has been
clinically approved for residential services through
existing funding streams but has not been admitted to
an appropriate program;
(B) the length of time the child has been in a
hospital emergency department or medical unit seeking
inpatient treatment for psychiatric or behavioral
health emergency;
(C) the length of time the child has been in a
psychiatric or general acute care hospital for
inpatient psychiatric treatment beyond medical
necessity;
(D) the risk of being taken into the custody of the
Department of Children and Family Services in the
absence of abuse or neglect as defined by the Abused
and Neglected Child Reporting Act or the Juvenile
Court Act of 1987 for the sole purpose of obtaining
behavioral health services or residential treatment;
(E) other circumstances that require enhanced
interagency collaboration to find appropriate services
for the child.
(3) Require each agency, or its designee, to present
each identified child's clinical case, to the extent
permitted by State and federal law, to the Interagency
Children's Behavioral Health Services Team during regular
team meetings to outline the child's needs and to
determine if any of the participating agencies have
residential or other supportive services that may be
available for the child to ensure that the child receives
appropriate treatment, including residential treatment if
necessary, as soon as possible.
(4) Require the Community and Residential Services
Authority to notify the Interagency Children's Behavioral
Health Services Team of any child that has been referred
for services who meet the criteria set forth in paragraph
(2) and to present the clinical cases for the child to the
interagency team to determine if any agency program can
assist the child.
(5) Require the participating agencies to develop a
quarterly analysis, to be submitted to the General
Assembly, the Governor's Office, and the Community and
Residential Services Authority including the following
information, to the extent permitted by State and federal
law:
(A) the number of children presented to the team;
(B) the children's clinical presentations that
required enhanced agency collaboration;
(C) the types of services including residential
treatment that were needed to appropriately support
the aggregate needs of children presented;
(D) the timeframe it took to find placement or
appropriate services; and
(E) any other data or information the Interagency
Children's Behavioral Health Services Team deems
appropriate.
All information collected, shared, or stored pursuant to
this Section shall be handled in accordance with all State and
federal privacy laws and accompanying regulations and rules,
including without limitation the federal Health Insurance
Portability and Accountability Act of 1996 (Public Law
104-191) and the Mental Health and Developmental Disabilities
Confidentiality Act.
Nothing in this Section shall be construed or applied in a
manner that would conflict with, diminish, or infringe upon,
any State agency's obligation to comply fully with
requirements imposed under a court order or State or federal
consent decree applicable to that agency.
Section 15. The Children and Family Services Act is
amended by changing Sections 5 and 17 as follows:
(20 ILCS 505/5) (from Ch. 23, par. 5005)
Sec. 5. Direct child welfare services; Department of
Children and Family Services. To provide direct child welfare
services when not available through other public or private
child care or program facilities.
(a) For purposes of this Section:
(1) "Children" means persons found within the State
who are under the age of 18 years. The term also includes
persons under age 21 who:
(A) were committed to the Department pursuant to
the Juvenile Court Act or the Juvenile Court Act of
1987 and who continue under the jurisdiction of the
court; or
(B) were accepted for care, service and training
by the Department prior to the age of 18 and whose best
interest in the discretion of the Department would be
served by continuing that care, service and training
because of severe emotional disturbances, physical
disability, social adjustment or any combination
thereof, or because of the need to complete an
educational or vocational training program.
(2) "Homeless youth" means persons found within the
State who are under the age of 19, are not in a safe and
stable living situation and cannot be reunited with their
families.
(3) "Child welfare services" means public social
services which are directed toward the accomplishment of
the following purposes:
(A) protecting and promoting the health, safety
and welfare of children, including homeless,
dependent, or neglected children;
(B) remedying, or assisting in the solution of
problems which may result in, the neglect, abuse,
exploitation, or delinquency of children;
(C) preventing the unnecessary separation of
children from their families by identifying family
problems, assisting families in resolving their
problems, and preventing the breakup of the family
where the prevention of child removal is desirable and
possible when the child can be cared for at home
without endangering the child's health and safety;
(D) restoring to their families children who have
been removed, by the provision of services to the
child and the families when the child can be cared for
at home without endangering the child's health and
safety;
(E) placing children in suitable adoptive homes,
in cases where restoration to the biological family is
not safe, possible, or appropriate;
(F) assuring safe and adequate care of children
away from their homes, in cases where the child cannot
be returned home or cannot be placed for adoption. At
the time of placement, the Department shall consider
concurrent planning, as described in subsection (l-1)
of this Section so that permanency may occur at the
earliest opportunity. Consideration should be given so
that if reunification fails or is delayed, the
placement made is the best available placement to
provide permanency for the child;
(G) (blank);
(H) (blank); and
(I) placing and maintaining children in facilities
that provide separate living quarters for children
under the age of 18 and for children 18 years of age
and older, unless a child 18 years of age is in the
last year of high school education or vocational
training, in an approved individual or group treatment
program, in a licensed shelter facility, or secure
child care facility. The Department is not required to
place or maintain children:
(i) who are in a foster home, or
(ii) who are persons with a developmental
disability, as defined in the Mental Health and
Developmental Disabilities Code, or
(iii) who are female children who are
pregnant, pregnant and parenting, or parenting, or
(iv) who are siblings, in facilities that
provide separate living quarters for children 18
years of age and older and for children under 18
years of age.
(b) (Blank).
(b-5) The Department shall adopt rules to establish a
process for all licensed residential providers in Illinois to
submit data as required by the Department, if they contract or
receive reimbursement for children's mental health, substance
use, and developmental disability services from the Department
of Human Services, the Department of Juvenile Justice, or the
Department of Healthcare and Family Services. The requested
data must include, but is not limited to, capacity, staffing,
and occupancy data for the purpose of establishing State need
and placement availability.
All information collected, shared, or stored pursuant to
this subsection shall be handled in accordance with all State
and federal privacy laws and accompanying regulations and
rules, including without limitation the federal Health
Insurance Portability and Accountability Act of 1996 (Public
Law 104-191) and the Mental Health and Developmental
Disabilities Confidentiality Act.
(c) The Department shall establish and maintain
tax-supported child welfare services and extend and seek to
improve voluntary services throughout the State, to the end
that services and care shall be available on an equal basis
throughout the State to children requiring such services.
(d) The Director may authorize advance disbursements for
any new program initiative to any agency contracting with the
Department. As a prerequisite for an advance disbursement, the
contractor must post a surety bond in the amount of the advance
disbursement and have a purchase of service contract approved
by the Department. The Department may pay up to 2 months
operational expenses in advance. The amount of the advance
disbursement shall be prorated over the life of the contract
or the remaining months of the fiscal year, whichever is less,
and the installment amount shall then be deducted from future
bills. Advance disbursement authorizations for new initiatives
shall not be made to any agency after that agency has operated
during 2 consecutive fiscal years. The requirements of this
Section concerning advance disbursements shall not apply with
respect to the following: payments to local public agencies
for child day care services as authorized by Section 5a of this
Act; and youth service programs receiving grant funds under
Section 17a-4.
(e) (Blank).
(f) (Blank).
(g) The Department shall establish rules and regulations
concerning its operation of programs designed to meet the
goals of child safety and protection, family preservation,
family reunification, and adoption, including, but not limited
to:
(1) adoption;
(2) foster care;
(3) family counseling;
(4) protective services;
(5) (blank);
(6) homemaker service;
(7) return of runaway children;
(8) (blank);
(9) placement under Section 5-7 of the Juvenile Court
Act or Section 2-27, 3-28, 4-25, or 5-740 of the Juvenile
Court Act of 1987 in accordance with the federal Adoption
Assistance and Child Welfare Act of 1980; and
(10) interstate services.
Rules and regulations established by the Department shall
include provisions for training Department staff and the staff
of Department grantees, through contracts with other agencies
or resources, in screening techniques to identify substance
use disorders, as defined in the Substance Use Disorder Act,
approved by the Department of Human Services, as a successor
to the Department of Alcoholism and Substance Abuse, for the
purpose of identifying children and adults who should be
referred for an assessment at an organization appropriately
licensed by the Department of Human Services for substance use
disorder treatment.
(h) If the Department finds that there is no appropriate
program or facility within or available to the Department for
a youth in care and that no licensed private facility has an
adequate and appropriate program or none agrees to accept the
youth in care, the Department shall create an appropriate
individualized, program-oriented plan for such youth in care.
The plan may be developed within the Department or through
purchase of services by the Department to the extent that it is
within its statutory authority to do.
(i) Service programs shall be available throughout the
State and shall include but not be limited to the following
services:
(1) case management;
(2) homemakers;
(3) counseling;
(4) parent education;
(5) day care; and
(6) emergency assistance and advocacy.
In addition, the following services may be made available
to assess and meet the needs of children and families:
(1) comprehensive family-based services;
(2) assessments;
(3) respite care; and
(4) in-home health services.
The Department shall provide transportation for any of the
services it makes available to children or families or for
which it refers children or families.
(j) The Department may provide categories of financial
assistance and education assistance grants, and shall
establish rules and regulations concerning the assistance and
grants, to persons who adopt children with physical or mental
disabilities, children who are older, or other hard-to-place
children who (i) immediately prior to their adoption were
youth in care or (ii) were determined eligible for financial
assistance with respect to a prior adoption and who become
available for adoption because the prior adoption has been
dissolved and the parental rights of the adoptive parents have
been terminated or because the child's adoptive parents have
died. The Department may continue to provide financial
assistance and education assistance grants for a child who was
determined eligible for financial assistance under this
subsection (j) in the interim period beginning when the
child's adoptive parents died and ending with the finalization
of the new adoption of the child by another adoptive parent or
parents. The Department may also provide categories of
financial assistance and education assistance grants, and
shall establish rules and regulations for the assistance and
grants, to persons appointed guardian of the person under
Section 5-7 of the Juvenile Court Act or Section 2-27, 3-28,
4-25, or 5-740 of the Juvenile Court Act of 1987 for children
who were youth in care for 12 months immediately prior to the
appointment of the guardian.
The amount of assistance may vary, depending upon the
needs of the child and the adoptive parents, as set forth in
the annual assistance agreement. Special purpose grants are
allowed where the child requires special service but such
costs may not exceed the amounts which similar services would
cost the Department if it were to provide or secure them as
guardian of the child.
Any financial assistance provided under this subsection is
inalienable by assignment, sale, execution, attachment,
garnishment, or any other remedy for recovery or collection of
a judgment or debt.
(j-5) The Department shall not deny or delay the placement
of a child for adoption if an approved family is available
either outside of the Department region handling the case, or
outside of the State of Illinois.
(k) The Department shall accept for care and training any
child who has been adjudicated neglected or abused, or
dependent committed to it pursuant to the Juvenile Court Act
or the Juvenile Court Act of 1987.
(l) The Department shall offer family preservation
services, as defined in Section 8.2 of the Abused and
Neglected Child Reporting Act, to help families, including
adoptive and extended families. Family preservation services
shall be offered (i) to prevent the placement of children in
substitute care when the children can be cared for at home or
in the custody of the person responsible for the children's
welfare, (ii) to reunite children with their families, or
(iii) to maintain an adoptive placement. Family preservation
services shall only be offered when doing so will not endanger
the children's health or safety. With respect to children who
are in substitute care pursuant to the Juvenile Court Act of
1987, family preservation services shall not be offered if a
goal other than those of subdivisions (A), (B), or (B-1) of
subsection (2) of Section 2-28 of that Act has been set, except
that reunification services may be offered as provided in
paragraph (F) of subsection (2) of Section 2-28 of that Act.
Nothing in this paragraph shall be construed to create a
private right of action or claim on the part of any individual
or child welfare agency, except that when a child is the
subject of an action under Article II of the Juvenile Court Act
of 1987 and the child's service plan calls for services to
facilitate achievement of the permanency goal, the court
hearing the action under Article II of the Juvenile Court Act
of 1987 may order the Department to provide the services set
out in the plan, if those services are not provided with
reasonable promptness and if those services are available.
The Department shall notify the child and his family of
the Department's responsibility to offer and provide family
preservation services as identified in the service plan. The
child and his family shall be eligible for services as soon as
the report is determined to be "indicated". The Department may
offer services to any child or family with respect to whom a
report of suspected child abuse or neglect has been filed,
prior to concluding its investigation under Section 7.12 of
the Abused and Neglected Child Reporting Act. However, the
child's or family's willingness to accept services shall not
be considered in the investigation. The Department may also
provide services to any child or family who is the subject of
any report of suspected child abuse or neglect or may refer
such child or family to services available from other agencies
in the community, even if the report is determined to be
unfounded, if the conditions in the child's or family's home
are reasonably likely to subject the child or family to future
reports of suspected child abuse or neglect. Acceptance of
such services shall be voluntary. The Department may also
provide services to any child or family after completion of a
family assessment, as an alternative to an investigation, as
provided under the "differential response program" provided
for in subsection (a-5) of Section 7.4 of the Abused and
Neglected Child Reporting Act.
The Department may, at its discretion except for those
children also adjudicated neglected or dependent, accept for
care and training any child who has been adjudicated addicted,
as a truant minor in need of supervision or as a minor
requiring authoritative intervention, under the Juvenile Court
Act or the Juvenile Court Act of 1987, but no such child shall
be committed to the Department by any court without the
approval of the Department. On and after January 1, 2015 (the
effective date of Public Act 98-803) and before January 1,
2017, a minor charged with a criminal offense under the
Criminal Code of 1961 or the Criminal Code of 2012 or
adjudicated delinquent shall not be placed in the custody of
or committed to the Department by any court, except (i) a minor
less than 16 years of age committed to the Department under
Section 5-710 of the Juvenile Court Act of 1987, (ii) a minor
for whom an independent basis of abuse, neglect, or dependency
exists, which must be defined by departmental rule, or (iii) a
minor for whom the court has granted a supplemental petition
to reinstate wardship pursuant to subsection (2) of Section
2-33 of the Juvenile Court Act of 1987. On and after January 1,
2017, a minor charged with a criminal offense under the
Criminal Code of 1961 or the Criminal Code of 2012 or
adjudicated delinquent shall not be placed in the custody of
or committed to the Department by any court, except (i) a minor
less than 15 years of age committed to the Department under
Section 5-710 of the Juvenile Court Act of 1987, ii) a minor
for whom an independent basis of abuse, neglect, or dependency
exists, which must be defined by departmental rule, or (iii) a
minor for whom the court has granted a supplemental petition
to reinstate wardship pursuant to subsection (2) of Section
2-33 of the Juvenile Court Act of 1987. An independent basis
exists when the allegations or adjudication of abuse, neglect,
or dependency do not arise from the same facts, incident, or
circumstances which give rise to a charge or adjudication of
delinquency. The Department shall assign a caseworker to
attend any hearing involving a youth in the care and custody of
the Department who is placed on aftercare release, including
hearings involving sanctions for violation of aftercare
release conditions and aftercare release revocation hearings.
As soon as is possible after August 7, 2009 (the effective
date of Public Act 96-134), the Department shall develop and
implement a special program of family preservation services to
support intact, foster, and adoptive families who are
experiencing extreme hardships due to the difficulty and
stress of caring for a child who has been diagnosed with a
pervasive developmental disorder if the Department determines
that those services are necessary to ensure the health and
safety of the child. The Department may offer services to any
family whether or not a report has been filed under the Abused
and Neglected Child Reporting Act. The Department may refer
the child or family to services available from other agencies
in the community if the conditions in the child's or family's
home are reasonably likely to subject the child or family to
future reports of suspected child abuse or neglect. Acceptance
of these services shall be voluntary. The Department shall
develop and implement a public information campaign to alert
health and social service providers and the general public
about these special family preservation services. The nature
and scope of the services offered and the number of families
served under the special program implemented under this
paragraph shall be determined by the level of funding that the
Department annually allocates for this purpose. The term
"pervasive developmental disorder" under this paragraph means
a neurological condition, including, but not limited to,
Asperger's Syndrome and autism, as defined in the most recent
edition of the Diagnostic and Statistical Manual of Mental
Disorders of the American Psychiatric Association.
(l-1) The legislature recognizes that the best interests
of the child require that the child be placed in the most
permanent living arrangement as soon as is practically
possible. To achieve this goal, the legislature directs the
Department of Children and Family Services to conduct
concurrent planning so that permanency may occur at the
earliest opportunity. Permanent living arrangements may
include prevention of placement of a child outside the home of
the family when the child can be cared for at home without
endangering the child's health or safety; reunification with
the family, when safe and appropriate, if temporary placement
is necessary; or movement of the child toward the most
permanent living arrangement and permanent legal status.
When determining reasonable efforts to be made with
respect to a child, as described in this subsection, and in
making such reasonable efforts, the child's health and safety
shall be the paramount concern.
When a child is placed in foster care, the Department
shall ensure and document that reasonable efforts were made to
prevent or eliminate the need to remove the child from the
child's home. The Department must make reasonable efforts to
reunify the family when temporary placement of the child
occurs unless otherwise required, pursuant to the Juvenile
Court Act of 1987. At any time after the dispositional hearing
where the Department believes that further reunification
services would be ineffective, it may request a finding from
the court that reasonable efforts are no longer appropriate.
The Department is not required to provide further
reunification services after such a finding.
A decision to place a child in substitute care shall be
made with considerations of the child's health, safety, and
best interests. At the time of placement, consideration should
also be given so that if reunification fails or is delayed, the
placement made is the best available placement to provide
permanency for the child.
The Department shall adopt rules addressing concurrent
planning for reunification and permanency. The Department
shall consider the following factors when determining
appropriateness of concurrent planning:
(1) the likelihood of prompt reunification;
(2) the past history of the family;
(3) the barriers to reunification being addressed by
the family;
(4) the level of cooperation of the family;
(5) the foster parents' willingness to work with the
family to reunite;
(6) the willingness and ability of the foster family
to provide an adoptive home or long-term placement;
(7) the age of the child;
(8) placement of siblings.
(m) The Department may assume temporary custody of any
child if:
(1) it has received a written consent to such
temporary custody signed by the parents of the child or by
the parent having custody of the child if the parents are
not living together or by the guardian or custodian of the
child if the child is not in the custody of either parent,
or
(2) the child is found in the State and neither a
parent, guardian nor custodian of the child can be
located.
If the child is found in his or her residence without a parent,
guardian, custodian, or responsible caretaker, the Department
may, instead of removing the child and assuming temporary
custody, place an authorized representative of the Department
in that residence until such time as a parent, guardian, or
custodian enters the home and expresses a willingness and
apparent ability to ensure the child's health and safety and
resume permanent charge of the child, or until a relative
enters the home and is willing and able to ensure the child's
health and safety and assume charge of the child until a
parent, guardian, or custodian enters the home and expresses
such willingness and ability to ensure the child's safety and
resume permanent charge. After a caretaker has remained in the
home for a period not to exceed 12 hours, the Department must
follow those procedures outlined in Section 2-9, 3-11, 4-8, or
5-415 of the Juvenile Court Act of 1987.
The Department shall have the authority, responsibilities
and duties that a legal custodian of the child would have
pursuant to subsection (9) of Section 1-3 of the Juvenile
Court Act of 1987. Whenever a child is taken into temporary
custody pursuant to an investigation under the Abused and
Neglected Child Reporting Act, or pursuant to a referral and
acceptance under the Juvenile Court Act of 1987 of a minor in
limited custody, the Department, during the period of
temporary custody and before the child is brought before a
judicial officer as required by Section 2-9, 3-11, 4-8, or
5-415 of the Juvenile Court Act of 1987, shall have the
authority, responsibilities and duties that a legal custodian
of the child would have under subsection (9) of Section 1-3 of
the Juvenile Court Act of 1987.
The Department shall ensure that any child taken into
custody is scheduled for an appointment for a medical
examination.
A parent, guardian, or custodian of a child in the
temporary custody of the Department who would have custody of
the child if he were not in the temporary custody of the
Department may deliver to the Department a signed request that
the Department surrender the temporary custody of the child.
The Department may retain temporary custody of the child for
10 days after the receipt of the request, during which period
the Department may cause to be filed a petition pursuant to the
Juvenile Court Act of 1987. If a petition is so filed, the
Department shall retain temporary custody of the child until
the court orders otherwise. If a petition is not filed within
the 10-day period, the child shall be surrendered to the
custody of the requesting parent, guardian, or custodian not
later than the expiration of the 10-day period, at which time
the authority and duties of the Department with respect to the
temporary custody of the child shall terminate.
(m-1) The Department may place children under 18 years of
age in a secure child care facility licensed by the Department
that cares for children who are in need of secure living
arrangements for their health, safety, and well-being after a
determination is made by the facility director and the
Director or the Director's designate prior to admission to the
facility subject to Section 2-27.1 of the Juvenile Court Act
of 1987. This subsection (m-1) does not apply to a child who is
subject to placement in a correctional facility operated
pursuant to Section 3-15-2 of the Unified Code of Corrections,
unless the child is a youth in care who was placed in the care
of the Department before being subject to placement in a
correctional facility and a court of competent jurisdiction
has ordered placement of the child in a secure care facility.
(n) The Department may place children under 18 years of
age in licensed child care facilities when in the opinion of
the Department, appropriate services aimed at family
preservation have been unsuccessful and cannot ensure the
child's health and safety or are unavailable and such
placement would be for their best interest. Payment for board,
clothing, care, training and supervision of any child placed
in a licensed child care facility may be made by the
Department, by the parents or guardians of the estates of
those children, or by both the Department and the parents or
guardians, except that no payments shall be made by the
Department for any child placed in a licensed child care
facility for board, clothing, care, training and supervision
of such a child that exceed the average per capita cost of
maintaining and of caring for a child in institutions for
dependent or neglected children operated by the Department.
However, such restriction on payments does not apply in cases
where children require specialized care and treatment for
problems of severe emotional disturbance, physical disability,
social adjustment, or any combination thereof and suitable
facilities for the placement of such children are not
available at payment rates within the limitations set forth in
this Section. All reimbursements for services delivered shall
be absolutely inalienable by assignment, sale, attachment, or
garnishment or otherwise.
(n-1) The Department shall provide or authorize child
welfare services, aimed at assisting minors to achieve
sustainable self-sufficiency as independent adults, for any
minor eligible for the reinstatement of wardship pursuant to
subsection (2) of Section 2-33 of the Juvenile Court Act of
1987, whether or not such reinstatement is sought or allowed,
provided that the minor consents to such services and has not
yet attained the age of 21. The Department shall have
responsibility for the development and delivery of services
under this Section. An eligible youth may access services
under this Section through the Department of Children and
Family Services or by referral from the Department of Human
Services. Youth participating in services under this Section
shall cooperate with the assigned case manager in developing
an agreement identifying the services to be provided and how
the youth will increase skills to achieve self-sufficiency. A
homeless shelter is not considered appropriate housing for any
youth receiving child welfare services under this Section. The
Department shall continue child welfare services under this
Section to any eligible minor until the minor becomes 21 years
of age, no longer consents to participate, or achieves
self-sufficiency as identified in the minor's service plan.
The Department of Children and Family Services shall create
clear, readable notice of the rights of former foster youth to
child welfare services under this Section and how such
services may be obtained. The Department of Children and
Family Services and the Department of Human Services shall
disseminate this information statewide. The Department shall
adopt regulations describing services intended to assist
minors in achieving sustainable self-sufficiency as
independent adults.
(o) The Department shall establish an administrative
review and appeal process for children and families who
request or receive child welfare services from the Department.
Youth in care who are placed by private child welfare
agencies, and foster families with whom those youth are
placed, shall be afforded the same procedural and appeal
rights as children and families in the case of placement by the
Department, including the right to an initial review of a
private agency decision by that agency. The Department shall
ensure that any private child welfare agency, which accepts
youth in care for placement, affords those rights to children
and foster families. The Department shall accept for
administrative review and an appeal hearing a complaint made
by (i) a child or foster family concerning a decision
following an initial review by a private child welfare agency
or (ii) a prospective adoptive parent who alleges a violation
of subsection (j-5) of this Section. An appeal of a decision
concerning a change in the placement of a child shall be
conducted in an expedited manner. A court determination that a
current foster home placement is necessary and appropriate
under Section 2-28 of the Juvenile Court Act of 1987 does not
constitute a judicial determination on the merits of an
administrative appeal, filed by a former foster parent,
involving a change of placement decision.
(p) (Blank).
(q) The Department may receive and use, in their entirety,
for the benefit of children any gift, donation, or bequest of
money or other property which is received on behalf of such
children, or any financial benefits to which such children are
or may become entitled while under the jurisdiction or care of
the Department, except that the benefits described in Section
5.46 must be used and conserved consistent with the provisions
under Section 5.46.
The Department shall set up and administer no-cost,
interest-bearing accounts in appropriate financial
institutions for children for whom the Department is legally
responsible and who have been determined eligible for
Veterans' Benefits, Social Security benefits, assistance
allotments from the armed forces, court ordered payments,
parental voluntary payments, Supplemental Security Income,
Railroad Retirement payments, Black Lung benefits, or other
miscellaneous payments. Interest earned by each account shall
be credited to the account, unless disbursed in accordance
with this subsection.
In disbursing funds from children's accounts, the
Department shall:
(1) Establish standards in accordance with State and
federal laws for disbursing money from children's
accounts. In all circumstances, the Department's
"Guardianship Administrator" or his or her designee must
approve disbursements from children's accounts. The
Department shall be responsible for keeping complete
records of all disbursements for each account for any
purpose.
(2) Calculate on a monthly basis the amounts paid from
State funds for the child's board and care, medical care
not covered under Medicaid, and social services; and
utilize funds from the child's account, as covered by
regulation, to reimburse those costs. Monthly,
disbursements from all children's accounts, up to 1/12 of
$13,000,000, shall be deposited by the Department into the
General Revenue Fund and the balance over 1/12 of
$13,000,000 into the DCFS Children's Services Fund.
(3) Maintain any balance remaining after reimbursing
for the child's costs of care, as specified in item (2).
The balance shall accumulate in accordance with relevant
State and federal laws and shall be disbursed to the child
or his or her guardian, or to the issuing agency.
(r) The Department shall promulgate regulations
encouraging all adoption agencies to voluntarily forward to
the Department or its agent names and addresses of all persons
who have applied for and have been approved for adoption of a
hard-to-place child or child with a disability and the names
of such children who have not been placed for adoption. A list
of such names and addresses shall be maintained by the
Department or its agent, and coded lists which maintain the
confidentiality of the person seeking to adopt the child and
of the child shall be made available, without charge, to every
adoption agency in the State to assist the agencies in placing
such children for adoption. The Department may delegate to an
agent its duty to maintain and make available such lists. The
Department shall ensure that such agent maintains the
confidentiality of the person seeking to adopt the child and
of the child.
(s) The Department of Children and Family Services may
establish and implement a program to reimburse Department and
private child welfare agency foster parents licensed by the
Department of Children and Family Services for damages
sustained by the foster parents as a result of the malicious or
negligent acts of foster children, as well as providing third
party coverage for such foster parents with regard to actions
of foster children to other individuals. Such coverage will be
secondary to the foster parent liability insurance policy, if
applicable. The program shall be funded through appropriations
from the General Revenue Fund, specifically designated for
such purposes.
(t) The Department shall perform home studies and
investigations and shall exercise supervision over visitation
as ordered by a court pursuant to the Illinois Marriage and
Dissolution of Marriage Act or the Adoption Act only if:
(1) an order entered by an Illinois court specifically
directs the Department to perform such services; and
(2) the court has ordered one or both of the parties to
the proceeding to reimburse the Department for its
reasonable costs for providing such services in accordance
with Department rules, or has determined that neither
party is financially able to pay.
The Department shall provide written notification to the
court of the specific arrangements for supervised visitation
and projected monthly costs within 60 days of the court order.
The Department shall send to the court information related to
the costs incurred except in cases where the court has
determined the parties are financially unable to pay. The
court may order additional periodic reports as appropriate.
(u) In addition to other information that must be
provided, whenever the Department places a child with a
prospective adoptive parent or parents, in a licensed foster
home, group home, or child care institution, or in a relative
home, the Department shall provide to the prospective adoptive
parent or parents or other caretaker:
(1) available detailed information concerning the
child's educational and health history, copies of
immunization records (including insurance and medical card
information), a history of the child's previous
placements, if any, and reasons for placement changes
excluding any information that identifies or reveals the
location of any previous caretaker;
(2) a copy of the child's portion of the client
service plan, including any visitation arrangement, and
all amendments or revisions to it as related to the child;
and
(3) information containing details of the child's
individualized educational plan when the child is
receiving special education services.
The caretaker shall be informed of any known social or
behavioral information (including, but not limited to,
criminal background, fire setting, perpetuation of sexual
abuse, destructive behavior, and substance abuse) necessary to
care for and safeguard the children to be placed or currently
in the home. The Department may prepare a written summary of
the information required by this paragraph, which may be
provided to the foster or prospective adoptive parent in
advance of a placement. The foster or prospective adoptive
parent may review the supporting documents in the child's file
in the presence of casework staff. In the case of an emergency
placement, casework staff shall at least provide known
information verbally, if necessary, and must subsequently
provide the information in writing as required by this
subsection.
The information described in this subsection shall be
provided in writing. In the case of emergency placements when
time does not allow prior review, preparation, and collection
of written information, the Department shall provide such
information as it becomes available. Within 10 business days
after placement, the Department shall obtain from the
prospective adoptive parent or parents or other caretaker a
signed verification of receipt of the information provided.
Within 10 business days after placement, the Department shall
provide to the child's guardian ad litem a copy of the
information provided to the prospective adoptive parent or
parents or other caretaker. The information provided to the
prospective adoptive parent or parents or other caretaker
shall be reviewed and approved regarding accuracy at the
supervisory level.
(u-5) Effective July 1, 1995, only foster care placements
licensed as foster family homes pursuant to the Child Care Act
of 1969 shall be eligible to receive foster care payments from
the Department. Relative caregivers who, as of July 1, 1995,
were approved pursuant to approved relative placement rules
previously promulgated by the Department at 89 Ill. Adm. Code
335 and had submitted an application for licensure as a foster
family home may continue to receive foster care payments only
until the Department determines that they may be licensed as a
foster family home or that their application for licensure is
denied or until September 30, 1995, whichever occurs first.
(v) The Department shall access criminal history record
information as defined in the Illinois Uniform Conviction
Information Act and information maintained in the adjudicatory
and dispositional record system as defined in Section 2605-355
of the Illinois State Police Law if the Department determines
the information is necessary to perform its duties under the
Abused and Neglected Child Reporting Act, the Child Care Act
of 1969, and the Children and Family Services Act. The
Department shall provide for interactive computerized
communication and processing equipment that permits direct
on-line communication with the Illinois State Police's central
criminal history data repository. The Department shall comply
with all certification requirements and provide certified
operators who have been trained by personnel from the Illinois
State Police. In addition, one Office of the Inspector General
investigator shall have training in the use of the criminal
history information access system and have access to the
terminal. The Department of Children and Family Services and
its employees shall abide by rules and regulations established
by the Illinois State Police relating to the access and
dissemination of this information.
(v-1) Prior to final approval for placement of a child,
the Department shall conduct a criminal records background
check of the prospective foster or adoptive parent, including
fingerprint-based checks of national crime information
databases. Final approval for placement shall not be granted
if the record check reveals a felony conviction for child
abuse or neglect, for spousal abuse, for a crime against
children, or for a crime involving violence, including rape,
sexual assault, or homicide, but not including other physical
assault or battery, or if there is a felony conviction for
physical assault, battery, or a drug-related offense committed
within the past 5 years.
(v-2) Prior to final approval for placement of a child,
the Department shall check its child abuse and neglect
registry for information concerning prospective foster and
adoptive parents, and any adult living in the home. If any
prospective foster or adoptive parent or other adult living in
the home has resided in another state in the preceding 5 years,
the Department shall request a check of that other state's
child abuse and neglect registry.
(w) Within 120 days of August 20, 1995 (the effective date
of Public Act 89-392), the Department shall prepare and submit
to the Governor and the General Assembly, a written plan for
the development of in-state licensed secure child care
facilities that care for children who are in need of secure
living arrangements for their health, safety, and well-being.
For purposes of this subsection, secure care facility shall
mean a facility that is designed and operated to ensure that
all entrances and exits from the facility, a building or a
distinct part of the building, are under the exclusive control
of the staff of the facility, whether or not the child has the
freedom of movement within the perimeter of the facility,
building, or distinct part of the building. The plan shall
include descriptions of the types of facilities that are
needed in Illinois; the cost of developing these secure care
facilities; the estimated number of placements; the potential
cost savings resulting from the movement of children currently
out-of-state who are projected to be returned to Illinois; the
necessary geographic distribution of these facilities in
Illinois; and a proposed timetable for development of such
facilities.
(x) The Department shall conduct annual credit history
checks to determine the financial history of children placed
under its guardianship pursuant to the Juvenile Court Act of
1987. The Department shall conduct such credit checks starting
when a youth in care turns 12 years old and each year
thereafter for the duration of the guardianship as terminated
pursuant to the Juvenile Court Act of 1987. The Department
shall determine if financial exploitation of the child's
personal information has occurred. If financial exploitation
appears to have taken place or is presently ongoing, the
Department shall notify the proper law enforcement agency, the
proper State's Attorney, or the Attorney General.
(y) Beginning on July 22, 2010 (the effective date of
Public Act 96-1189), a child with a disability who receives
residential and educational services from the Department shall
be eligible to receive transition services in accordance with
Article 14 of the School Code from the age of 14.5 through age
21, inclusive, notwithstanding the child's residential
services arrangement. For purposes of this subsection, "child
with a disability" means a child with a disability as defined
by the federal Individuals with Disabilities Education
Improvement Act of 2004.
(z) The Department shall access criminal history record
information as defined as "background information" in this
subsection and criminal history record information as defined
in the Illinois Uniform Conviction Information Act for each
Department employee or Department applicant. Each Department
employee or Department applicant shall submit his or her
fingerprints to the Illinois State Police in the form and
manner prescribed by the Illinois State Police. These
fingerprints shall be checked against the fingerprint records
now and hereafter filed in the Illinois State Police and the
Federal Bureau of Investigation criminal history records
databases. The Illinois State Police shall charge a fee for
conducting the criminal history record check, which shall be
deposited into the State Police Services Fund and shall not
exceed the actual cost of the record check. The Illinois State
Police shall furnish, pursuant to positive identification, all
Illinois conviction information to the Department of Children
and Family Services.
For purposes of this subsection:
"Background information" means all of the following:
(i) Upon the request of the Department of Children and
Family Services, conviction information obtained from the
Illinois State Police as a result of a fingerprint-based
criminal history records check of the Illinois criminal
history records database and the Federal Bureau of
Investigation criminal history records database concerning
a Department employee or Department applicant.
(ii) Information obtained by the Department of
Children and Family Services after performing a check of
the Illinois State Police's Sex Offender Database, as
authorized by Section 120 of the Sex Offender Community
Notification Law, concerning a Department employee or
Department applicant.
(iii) Information obtained by the Department of
Children and Family Services after performing a check of
the Child Abuse and Neglect Tracking System (CANTS)
operated and maintained by the Department.
"Department employee" means a full-time or temporary
employee coded or certified within the State of Illinois
Personnel System.
"Department applicant" means an individual who has
conditional Department full-time or part-time work, a
contractor, an individual used to replace or supplement staff,
an academic intern, a volunteer in Department offices or on
Department contracts, a work-study student, an individual or
entity licensed by the Department, or an unlicensed service
provider who works as a condition of a contract or an agreement
and whose work may bring the unlicensed service provider into
contact with Department clients or client records.
(Source: P.A. 101-13, eff. 6-12-19; 101-79, eff. 7-12-19;
101-81, eff. 7-12-19; 102-538, eff. 8-20-21; 102-558, eff.
8-20-21; 102-1014, eff. 5-27-22.)
(20 ILCS 505/17) (from Ch. 23, par. 5017)
Sec. 17. Youth and Community Services Program. The
Department of Human Services shall develop a State program for
youth and community services which will assure that youth who
come into contact or may come into contact with either the
child welfare system or the juvenile the child welfare and the
juvenile justice system systems will have access to needed
community, prevention, diversion, emergency and independent
living services. The term "youth" means a person under the age
of 19 years. The term "homeless youth" means a youth who cannot
be reunited with his or her family and is not in a safe and
stable living situation. This Section shall not be construed
to require the Department of Human Services to provide
services under this Section to any homeless youth who is at
least 18 years of age but is younger than 19 years of age;
however, the Department may, in its discretion, provide
services under this Section to any such homeless youth.
(a) The goals of the program shall be to:
(1) maintain children and youths in their own
community;
(2) eliminate unnecessary categorical funding of
programs by funding more comprehensive and integrated
programs;
(3) encourage local volunteers and voluntary
associations in developing programs aimed at preventing
and controlling juvenile delinquency;
(4) address voids in services and close service gaps;
(5) develop program models aimed at strengthening the
relationships between youth and their families and aimed
at developing healthy, independent lives for homeless
youth;
(6) contain costs by redirecting funding to more
comprehensive and integrated community-based services; and
(7) coordinate education, employment, training and
other programs for youths with other State agencies.
(b) The duties of the Department under the program shall
be to:
(1) design models for service delivery by local
communities;
(2) test alternative systems for delivering youth
services;
(3) develop standards necessary to achieve and
maintain, on a statewide basis, more comprehensive and
integrated community-based youth services;
(4) monitor and provide technical assistance to local
boards and local service systems;
(5) assist local organizations in developing programs
which address the problems of youths and their families
through direct services, advocacy with institutions, and
improvement of local conditions; and
(6) (blank); and develop a statewide adoption
awareness campaign aimed at pregnant teenagers.
(7) establish temporary emergency placements for youth
in crisis as defined by the Children's Behavioral Health
Transformation Team through comprehensive community-based
youth services provider grants.
(A) Temporary emergency placements:
(i) must be licensed through the Department of
Children and Family Services or, in the case of a
foster home or host home, by the supervising child
welfare agency;
(ii) must be strategically situated to meet
regional need and minimize geographic disruption
in consultation with the Children's Behavioral
Health Transformation Officer and the Children's
Behavioral Health Transformation Team; and
(iii) shall include Comprehensive
Community-Based Youth Services program host homes,
foster homes, homeless youth shelters, Department
of Children and Family Services youth shelters, or
other licensed placements for minor youth
compliant with the Child Care Act of 1969 provided
under the Comprehensive Community-Based Youth
Services program.
(B) Beginning on the effective date of this
amendatory Act of the 103rd General Assembly, once
sufficient capacity has been developed, temporary
emergency placements must also include temporary
emergency placement shelters provided under the
Comprehensive Community-Based Youth Services program.
Temporary emergency placement shelters shall be
managed by Comprehensive Community-Based Youth
Services provider organizations and shall be available
to house youth receiving interim 24/7 crisis
intervention services as defined by the Juvenile Court
Act of 1987 and the Comprehensive Community-Based
Youth Services program grant and the Department, and
shall provide access to clinical supports for youth
while staying at the shelter.
(C) Comprehensive Community-Based Youth Services
organizations shall retain the sole authority to place
youth in host homes and temporary emergency placement
shelters provided under the Comprehensive
Community-Based Youth Services program.
(D) Crisis youth, as defined by the Children's
Behavioral Health Transformation Team, shall be
prioritized in temporary emergency placements.
(E) Additional placement options may be authorized
for crisis and non-crisis program youth with the
permission of the youth's parent or legal guardian.
(F) While in a temporary emergency placement, the
organization shall work with the parent, guardian, or
custodian to effectuate the youth's return home or to
an alternative long-term living arrangement. As
necessary, the agency or association shall also work
with the youth's local school district, the
Department, the Department of Human Services, the
Department of Healthcare and Family Services, and the
Department of Juvenile Justice to identify immediate
and long-term services, treatment, or placement.
Nothing in this Section shall be construed or applied in a
manner that would conflict with, diminish, or infringe upon,
any State agency's obligation to comply fully with
requirements imposed under a court order or State or federal
consent decree applicable to that agency.
(Source: P.A. 89-507, eff. 7-1-97.)
Section 17. The Mental Health and Developmental
Disabilities Administrative Act is amended by adding Section
11.4 as follows:
(20 ILCS 1705/11.4 new)
Sec. 11.4. Care portal for families with children who have
complex behavioral health needs. The Department shall
establish and maintain a public-facing Care Portal to serve as
a centralized resource for families with children who have
significant and complex behavioral health needs. The Care
Portal shall streamline the process of directing families and
guardians to the appropriate level and type of care for their
children. In consultation with the Children's Behavioral
Health Transformation Officer, the Department shall develop
specifications for the Care Portal that ensure automatic
service eligibility matching, transparent data sharing,
regular reporting, and appropriate staffing, among other
items. The Department shall, in coordination with the
Departments of Children and Family Services, Healthcare and
Family Services, Juvenile Justice, and Public Health as well
as the State Board of Education, develop training and
communication for school districts, hospital social workers,
and system partners to demonstrate how individuals can assist
a family seeking youth behavioral health services and how to
access the Care Portal. Such training must include information
on the applicable federal and State law for the determination
of the need for residential placements for educational
purposes by individualized education program (IEP) teams.
Procedures for use of the Care Portal must not prohibit or
limit residential facilities from accepting students placed by
school districts for educational purposes as determined by the
IEP team.
Section 20. The School Code is amended by changing
Sections 2-3.163, 14-7.02, and 14-15.01 and by adding Section
2-3.196 as follows:
(105 ILCS 5/2-3.163)
Sec. 2-3.163. Prioritization of Urgency of Need for
Services database.
(a) The General Assembly makes all of the following
findings:
(1) The Department of Human Services maintains a
statewide database known as the Prioritization of Urgency
of Need for Services that records information about
individuals with developmental disabilities who are
potentially in need of services.
(2) The Department of Human Services uses the data on
Prioritization of Urgency of Need for Services to select
individuals for services as funding becomes available, to
develop proposals and materials for budgeting, and to plan
for future needs.
(3) Prioritization of Urgency of Need for Services is
available for children and adults with a developmental
disability who have an unmet service need anticipated in
the next 5 years.
(4) Prioritization of Urgency of Need for Services is
the first step toward getting developmental disabilities
services in this State. If individuals are not on the
Prioritization of Urgency of Need for Services waiting
list, they are not in queue for State developmental
disabilities services.
(5) Prioritization of Urgency of Need for Services may
be underutilized by children and their parents or
guardians due to lack of awareness or lack of information.
(b) The State Board of Education may work with school
districts to inform all students with developmental
disabilities and their parents or guardians about the
Prioritization of Urgency of Need for Services database.
(c) Subject to appropriation, the Department of Human
Services and State Board of Education shall develop and
implement an online, computer-based training program for at
least one designated employee in every public school in this
State to educate him or her about the Prioritization of
Urgency of Need for Services database and steps to be taken to
ensure children and adolescents are enrolled. The training
shall include instruction for at least one designated employee
in every public school in contacting the appropriate
developmental disabilities Independent Service Coordination
agency to enroll children and adolescents in the database. At
least one designated employee in every public school shall
ensure the opportunity to enroll in the Prioritization of
Urgency of Need for Services database is discussed during
annual individualized education program (IEP) meetings for all
children and adolescents believed to have a developmental
disability.
(d) The State Board of Education, in consultation with the
Department of Human Services, through school districts, shall
provide to parents and guardians of students a copy of the
Department of Human Services's guide titled "Understanding
PUNS: A Guide to Prioritization for Urgency of Need for
Services" each year at the annual review meeting for the
student's individualized education program, including the
consideration required in subsection (e) of this Section.
(e) The Department of Human Services shall consider the
length of time spent on the Prioritization of Urgency of Need
for Services waiting list, in addition to other factors
considered, when selecting individuals on the list for
services.
(f) Subject to appropriation, the Department of Human
Services shall expand its selection of individuals from the
Prioritization of Urgency of Need for Services database to
include individuals who receive services through the Children
and Young Adults with Developmental Disabilities - Support
Waiver.
(Source: P.A. 102-57, eff. 7-9-21.)
(105 ILCS 5/2-3.196 new)
Sec. 2-3.196. Mental health screenings. On or before
December 15, 2023, the State Board of Education, in
consultation with the Children's Behavioral Health
Transformation Officer, Children's Behavioral Health
Transformation Team, and the Office of the Governor, shall
file a report with the Governor and the General Assembly that
includes recommendations for implementation of mental health
screenings in schools for students enrolled in kindergarten
through grade 12. This report must include a landscape scan of
current district-wide screenings, recommendations for
screening tools, training for staff, and linkage and referral
for identified students.
(105 ILCS 5/14-7.02) (from Ch. 122, par. 14-7.02)
Sec. 14-7.02. Children attending private schools, public
out-of-state schools, public school residential facilities or
private special education facilities.
(a) The General Assembly recognizes that non-public
schools or special education facilities provide an important
service in the educational system in Illinois.
(b) If a student's individualized education program (IEP)
team determines that because of his or her disability the
special education program of a district is unable to meet the
needs of the child and the child attends a non-public school or
special education facility, a public out-of-state school or a
special education facility owned and operated by a county
government unit that provides special educational services
required by the child and is in compliance with the
appropriate rules and regulations of the State Superintendent
of Education, the school district in which the child is a
resident shall pay the actual cost of tuition for special
education and related services provided during the regular
school term and during the summer school term if the child's
educational needs so require, excluding room, board and
transportation costs charged the child by that non-public
school or special education facility, public out-of-state
school or county special education facility, or $4,500 per
year, whichever is less, and shall provide him any necessary
transportation. "Nonpublic special education facility" shall
include a residential facility, within or without the State of
Illinois, which provides special education and related
services to meet the needs of the child by utilizing private
schools or public schools, whether located on the site or off
the site of the residential facility. Resident district
financial responsibility and reimbursement applies for both
nonpublic special education facilities that are approved by
the State Board of Education pursuant to 23 Ill. Adm. Code 401
or other applicable laws or rules and for emergency placements
in nonpublic special education facilities that are not
approved by the State Board of Education pursuant to 23 Ill.
Adm. Code 401 or other applicable laws or rules, subject to the
requirements of this Section.
(c) Prior to the placement of a child in an out-of-state
special education residential facility, the school district
must refer to the child or the child's parent or guardian the
option to place the child in a special education residential
facility located within this State, if any, that provides
treatment and services comparable to those provided by the
out-of-state special education residential facility. The
school district must review annually the placement of a child
in an out-of-state special education residential facility. As
a part of the review, the school district must refer to the
child or the child's parent or guardian the option to place the
child in a comparable special education residential facility
located within this State, if any.
(c-5) Before a provider that operates a nonpublic special
education facility terminates a student's placement in that
facility, the provider must request an IEP meeting from the
contracting school district. If the provider elects to
terminate the student's placement following the IEP meeting,
the provider must give written notice to this effect to the
parent or guardian, the contracting public school district,
and the State Board of Education no later than 20 business days
before the date of termination, unless the health and safety
of any student are endangered. The notice must include the
detailed reasons for the termination and any actions taken to
address the reason for the termination.
(d) Payments shall be made by the resident school district
to the entity providing the educational services, whether the
entity is the nonpublic special education facility or the
school district wherein the facility is located, no less than
once per quarter, unless otherwise agreed to in writing by the
parties.
(e) A school district may place a student in a nonpublic
special education facility providing educational services, but
not approved by the State Board of Education pursuant to 23
Ill. Adm. Code 401 or other applicable laws or rules, provided
that the State Board of Education provides an emergency and
student-specific approval for placement. The State Board of
Education shall promptly, within 10 days after the request,
approve a request for emergency and student-specific approval
for placement if the following have been demonstrated to the
State Board of Education:
(1) the facility demonstrates appropriate licensure of
teachers for the student population;
(2) the facility demonstrates age-appropriate
curriculum;
(3) the facility provides enrollment and attendance
data;
(4) the facility demonstrates the ability to implement
the child's IEP; and
(5) the school district demonstrates that it made good
faith efforts to place the student in an approved
facility, but no approved facility has accepted the
student or has availability for immediate placement of the
student.
A resident school district may also submit such proof to the
State Board of Education as may be required for its student.
The State Board of Education may not unreasonably withhold
approval once satisfactory proof is provided to the State
Board.
(f) If an impartial due process hearing officer who is
contracted by the State Board of Education pursuant to this
Article orders placement of a student with a disability in a
residential facility that is not approved by the State Board
of Education, then, for purposes of this Section, the facility
shall be deemed approved for placement and school district
payments and State reimbursements shall be made accordingly.
(g) Emergency placement in a facility approved pursuant to
subsection (e) or (f) may continue to be utilized so long as
(i) the student's IEP team determines annually that such
placement continues to be appropriate to meet the student's
needs and (ii) at least every 3 years following the student's
placement, the IEP team reviews appropriate placements
approved by the State Board of Education pursuant to 23 Ill.
Adm. Code 401 or other applicable laws or rules to determine
whether there are any approved placements that can meet the
student's needs, have accepted the student, and have
availability for placement of the student.
(h) The State Board of Education shall promulgate rules
and regulations for determining when placement in a private
special education facility is appropriate. Such rules and
regulations shall take into account the various types of
services needed by a child and the availability of such
services to the particular child in the public school. In
developing these rules and regulations the State Board of
Education shall consult with the Advisory Council on Education
of Children with Disabilities and hold public hearings to
secure recommendations from parents, school personnel, and
others concerned about this matter.
The State Board of Education shall also promulgate rules
and regulations for transportation to and from a residential
school. Transportation to and from home to a residential
school more than once each school term shall be subject to
prior approval by the State Superintendent in accordance with
the rules and regulations of the State Board.
(i) A school district making tuition payments pursuant to
this Section is eligible for reimbursement from the State for
the amount of such payments actually made in excess of the
district per capita tuition charge for students not receiving
special education services. Such reimbursement shall be
approved in accordance with Section 14-12.01 and each district
shall file its claims, computed in accordance with rules
prescribed by the State Board of Education, on forms
prescribed by the State Superintendent of Education. Data used
as a basis of reimbursement claims shall be for the preceding
regular school term and summer school term. Each school
district shall transmit its claims to the State Board of
Education on or before August 15. The State Board of
Education, before approving any such claims, shall determine
their accuracy and whether they are based upon services and
facilities provided under approved programs. Upon approval the
State Board shall cause vouchers to be prepared showing the
amount due for payment of reimbursement claims to school
districts, for transmittal to the State Comptroller on the
30th day of September, December, and March, respectively, and
the final voucher, no later than June 20. If the money
appropriated by the General Assembly for such purpose for any
year is insufficient, it shall be apportioned on the basis of
the claims approved.
(j) No child shall be placed in a special education
program pursuant to this Section if the tuition cost for
special education and related services increases more than 10
percent over the tuition cost for the previous school year or
exceeds $4,500 per year unless such costs have been approved
by the Illinois Purchased Care Review Board. The Illinois
Purchased Care Review Board shall consist of the following
persons, or their designees: the Directors of Children and
Family Services, Public Health, Public Aid, and the Governor's
Office of Management and Budget; the Secretary of Human
Services; the State Superintendent of Education; and such
other persons as the Governor may designate. The Review Board
shall also consist of one non-voting member who is an
administrator of a private, nonpublic, special education
school. The Review Board shall establish rules and regulations
for its determination of allowable costs and payments made by
local school districts for special education, room and board,
and other related services provided by non-public schools or
special education facilities and shall establish uniform
standards and criteria which it shall follow. The Review Board
shall approve the usual and customary rate or rates of a
special education program that (i) is offered by an
out-of-state, non-public provider of integrated autism
specific educational and autism specific residential services,
(ii) offers 2 or more levels of residential care, including at
least one locked facility, and (iii) serves 12 or fewer
Illinois students.
(k) In determining rates based on allowable costs, the
Review Board shall consider any wage increases awarded by the
General Assembly to front line personnel defined as direct
support persons, aides, front-line supervisors, qualified
intellectual disabilities professionals, nurses, and
non-administrative support staff working in service settings
in community-based settings within the State and adjust
customary rates or rates of a special education program to be
equitable to the wage increase awarded to similar staff
positions in a community residential setting. Any wage
increase awarded by the General Assembly to front line
personnel defined as direct support persons, aides, front-line
supervisors, qualified intellectual disabilities
professionals, nurses, and non-administrative support staff
working in community-based settings within the State,
including the $0.75 per hour increase contained in Public Act
100-23 and the $0.50 per hour increase included in Public Act
100-23, shall also be a basis for any facility covered by this
Section to appeal its rate before the Review Board under the
process defined in Title 89, Part 900, Section 340 of the
Illinois Administrative Code. Illinois Administrative Code
Title 89, Part 900, Section 342 shall be updated to recognize
wage increases awarded to community-based settings to be a
basis for appeal. However, any wage increase that is captured
upon appeal from a previous year shall not be counted by the
Review Board as revenue for the purpose of calculating a
facility's future rate.
(l) Any definition used by the Review Board in
administrative rule or policy to define "related
organizations" shall include any and all exceptions contained
in federal law or regulation as it pertains to the federal
definition of "related organizations".
(m) The Review Board shall establish uniform definitions
and criteria for accounting separately by special education,
room and board and other related services costs. The Board
shall also establish guidelines for the coordination of
services and financial assistance provided by all State
agencies to assure that no otherwise qualified child with a
disability receiving services under Article 14 shall be
excluded from participation in, be denied the benefits of or
be subjected to discrimination under any program or activity
provided by any State agency.
(n) The Review Board shall review the costs for special
education and related services provided by non-public schools
or special education facilities and shall approve or
disapprove such facilities in accordance with the rules and
regulations established by it with respect to allowable costs.
(o) The State Board of Education shall provide
administrative and staff support for the Review Board as
deemed reasonable by the State Superintendent of Education.
This support shall not include travel expenses or other
compensation for any Review Board member other than the State
Superintendent of Education.
(p) The Review Board shall seek the advice of the Advisory
Council on Education of Children with Disabilities on the
rules and regulations to be promulgated by it relative to
providing special education services.
(q) If a child has been placed in a program in which the
actual per pupil costs of tuition for special education and
related services based on program enrollment, excluding room,
board and transportation costs, exceed $4,500 and such costs
have been approved by the Review Board, the district shall pay
such total costs which exceed $4,500. A district making such
tuition payments in excess of $4,500 pursuant to this Section
shall be responsible for an amount in excess of $4,500 equal to
the district per capita tuition charge and shall be eligible
for reimbursement from the State for the amount of such
payments actually made in excess of the districts per capita
tuition charge for students not receiving special education
services.
(r) If a child has been placed in an approved individual
program and the tuition costs including room and board costs
have been approved by the Review Board, then such room and
board costs shall be paid by the appropriate State agency
subject to the provisions of Section 14-8.01 of this Act. Room
and board costs not provided by a State agency other than the
State Board of Education shall be provided by the State Board
of Education on a current basis. In no event, however, shall
the State's liability for funding of these tuition costs begin
until after the legal obligations of third party payors have
been subtracted from such costs. If the money appropriated by
the General Assembly for such purpose for any year is
insufficient, it shall be apportioned on the basis of the
claims approved. Each district shall submit estimated claims
to the State Superintendent of Education. Upon approval of
such claims, the State Superintendent of Education shall
direct the State Comptroller to make payments on a monthly
basis. The frequency for submitting estimated claims and the
method of determining payment shall be prescribed in rules and
regulations adopted by the State Board of Education. Such
current state reimbursement shall be reduced by an amount
equal to the proceeds which the child or child's parents are
eligible to receive under any public or private insurance or
assistance program. Nothing in this Section shall be construed
as relieving an insurer or similar third party from an
otherwise valid obligation to provide or to pay for services
provided to a child with a disability.
(s) If it otherwise qualifies, a school district is
eligible for the transportation reimbursement under Section
14-13.01 and for the reimbursement of tuition payments under
this Section whether the non-public school or special
education facility, public out-of-state school or county
special education facility, attended by a child who resides in
that district and requires special educational services, is
within or outside of the State of Illinois. However, a
district is not eligible to claim transportation reimbursement
under this Section unless the district certifies to the State
Superintendent of Education that the district is unable to
provide special educational services required by the child for
the current school year.
(t) Nothing in this Section authorizes the reimbursement
of a school district for the amount paid for tuition of a child
attending a non-public school or special education facility,
public out-of-state school or county special education
facility unless the school district certifies to the State
Superintendent of Education that the special education program
of that district is unable to meet the needs of that child
because of his disability and the State Superintendent of
Education finds that the school district is in substantial
compliance with Section 14-4.01. However, if a child is
unilaterally placed by a State agency or any court in a
non-public school or special education facility, public
out-of-state school, or county special education facility, a
school district shall not be required to certify to the State
Superintendent of Education, for the purpose of tuition
reimbursement, that the special education program of that
district is unable to meet the needs of a child because of his
or her disability.
(u) Any educational or related services provided, pursuant
to this Section in a non-public school or special education
facility or a special education facility owned and operated by
a county government unit shall be at no cost to the parent or
guardian of the child. However, current law and practices
relative to contributions by parents or guardians for costs
other than educational or related services are not affected by
this amendatory Act of 1978.
(v) Reimbursement for children attending public school
residential facilities shall be made in accordance with the
provisions of this Section.
(w) Notwithstanding any other provision of law, any school
district receiving a payment under this Section or under
Section 14-7.02b, 14-13.01, or 29-5 of this Code may classify
all or a portion of the funds that it receives in a particular
fiscal year or from general State aid pursuant to Section
18-8.05 of this Code as funds received in connection with any
funding program for which it is entitled to receive funds from
the State in that fiscal year (including, without limitation,
any funding program referenced in this Section), regardless of
the source or timing of the receipt. The district may not
classify more funds as funds received in connection with the
funding program than the district is entitled to receive in
that fiscal year for that program. Any classification by a
district must be made by a resolution of its board of
education. The resolution must identify the amount of any
payments or general State aid to be classified under this
paragraph and must specify the funding program to which the
funds are to be treated as received in connection therewith.
This resolution is controlling as to the classification of
funds referenced therein. A certified copy of the resolution
must be sent to the State Superintendent of Education. The
resolution shall still take effect even though a copy of the
resolution has not been sent to the State Superintendent of
Education in a timely manner. No classification under this
paragraph by a district shall affect the total amount or
timing of money the district is entitled to receive under this
Code. No classification under this paragraph by a district
shall in any way relieve the district from or affect any
requirements that otherwise would apply with respect to that
funding program, including any accounting of funds by source,
reporting expenditures by original source and purpose,
reporting requirements, or requirements of providing services.
(Source: P.A. 101-10, eff. 6-5-19; 102-254, eff. 8-6-21;
102-703, eff. 4-22-22.)
(105 ILCS 5/14-15.01) (from Ch. 122, par. 14-15.01)
Sec. 14-15.01. Community and Residential Services
Authority.
(a) (1) The Community and Residential Services Authority
is hereby created and shall consist of the following members:
A representative of the State Board of Education;
Four representatives of the Department of Human Services
appointed by the Secretary of Human Services, with one member
from the Division of Community Health and Prevention, one
member from the Division of Developmental Disabilities, one
member from the Division of Mental Health, and one member from
the Division of Rehabilitation Services;
A representative of the Department of Children and Family
Services;
A representative of the Department of Juvenile Justice;
A representative of the Department of Healthcare and
Family Services;
A representative of the Attorney General's Disability
Rights Advocacy Division;
The Chairperson and Minority Spokesperson of the House and
Senate Committees on Elementary and Secondary Education or
their designees; and
Six persons appointed by the Governor. Five of such
appointees shall be experienced or knowledgeable relative to
provision of services for individuals with a behavior disorder
or a severe emotional disturbance and shall include
representatives of both the private and public sectors, except
that no more than 2 of those 5 appointees may be from the
public sector and at least 2 must be or have been directly
involved in provision of services to such individuals. The
remaining member appointed by the Governor shall be or shall
have been a parent of an individual with a behavior disorder or
a severe emotional disturbance, and that appointee may be from
either the private or the public sector.
(2) Members appointed by the Governor shall be appointed
for terms of 4 years and shall continue to serve until their
respective successors are appointed; provided that the terms
of the original appointees shall expire on August 1, 1990. Any
vacancy in the office of a member appointed by the Governor
shall be filled by appointment of the Governor for the
remainder of the term.
A vacancy in the office of a member appointed by the
Governor exists when one or more of the following events
occur:
(i) An appointee dies;
(ii) An appointee files a written resignation with the
Governor;
(iii) An appointee ceases to be a legal resident of
the State of Illinois; or
(iv) An appointee fails to attend a majority of
regularly scheduled Authority meetings in a fiscal year.
Members who are representatives of an agency shall serve
at the will of the agency head. Membership on the Authority
shall cease immediately upon cessation of their affiliation
with the agency. If such a vacancy occurs, the appropriate
agency head shall appoint another person to represent the
agency.
If a legislative member of the Authority ceases to be
Chairperson or Minority Spokesperson of the designated
Committees, they shall automatically be replaced on the
Authority by the person who assumes the position of
Chairperson or Minority Spokesperson.
(b) The Community and Residential Services Authority shall
have the following powers and duties:
(1) Serve as a Parent/Guardian Navigator Assistance
Program, to work directly with parents/guardians of youth
with behavioral health concerns to provide assistance
coordinating efforts with public agencies, including but
not limited to local school district, State Board of
Education, the Department of Human Services, Department of
Children and Family Services, the Department of Healthcare
and Family Services, Department of Public Health, and
Department of Juvenile Justice. To conduct surveys to
determine the extent of need, the degree to which
documented need is currently being met and feasible
alternatives for matching need with resources.
(2) Work in conjunction with the new Care Portal and
Care Portal Team to utilize the centralized IT platform
for communication and case management, including
collaboration on the development of Portal training,
communications to the public, business processes for case
triage, assignment, and referral. To develop policy
statements for interagency cooperation to cover all
aspects of service delivery, including laws, regulations
and procedures, and clear guidelines for determining
responsibility at all times.
(3) To develop and submit to the Governor, the General
Assembly, the Directors of the agencies represented on the
Authority, and State Board of Education a master plan for
operating the Parent/Guardian Navigator Assistance
Program, including how referrals are made, plan for
dispute relative to plans of service or funding for plans
of service, plans to include parents with lived experience
as peer supports. To recommend policy statements and
provide information regarding effective programs for
delivery of services to all individuals under 22 years of
age with a behavior disorder or a severe emotional
disturbance in public or private situations.
(4) (Blank). To review the criteria for service
eligibility, provision and availability established by the
governmental agencies represented on this Authority, and
to recommend changes, additions or deletions to such
criteria.
(5) (Blank). To develop and submit to the Governor,
the General Assembly, the Directors of the agencies
represented on the Authority, and the State Board of
Education a master plan for individuals under 22 years of
age with a behavior disorder or a severe emotional
disturbance, including detailed plans of service ranging
from the least to the most restrictive options; and to
assist local communities, upon request, in developing or
strengthening collaborative interagency networks.
(6) (Blank). To develop a process for making
determinations in situations where there is a dispute
relative to a plan of service for individuals or funding
for a plan of service.
(7) (Blank). To provide technical assistance to
parents, service consumers, providers, and member agency
personnel regarding statutory responsibilities of human
service and educational agencies, and to provide such
assistance as deemed necessary to appropriately access
needed services.
(8) (Blank). To establish a pilot program to act as a
residential research hub to research and identify
appropriate residential settings for youth who are being
housed in an emergency room for more than 72 hours or who
are deemed beyond medical necessity in a psychiatric
hospital. If a child is deemed beyond medical necessity in
a psychiatric hospital and is in need of residential
placement, the goal of the program is to prevent a
lock-out pursuant to the goals of the Custody
Relinquishment Prevention Act.
(c) (1) The members of the Authority shall receive no
compensation for their services but shall be entitled to
reimbursement of reasonable expenses incurred while performing
their duties.
(2) The Authority may appoint special study groups to
operate under the direction of the Authority and persons
appointed to such groups shall receive only reimbursement of
reasonable expenses incurred in the performance of their
duties.
(3) The Authority shall elect from its membership a
chairperson, vice-chairperson and secretary.
(4) The Authority may employ and fix the compensation of
such employees and technical assistants as it deems necessary
to carry out its powers and duties under this Act. Staff
assistance for the Authority shall be provided by the State
Board of Education.
(5) Funds for the ordinary and contingent expenses of the
Authority shall be appropriated to the State Board of
Education in a separate line item.
(d) (1) The Authority shall have power to promulgate rules
and regulations to carry out its powers and duties under this
Act.
(2) The Authority may accept monetary gifts or grants from
the federal government or any agency thereof, from any
charitable foundation or professional association or from any
other reputable source for implementation of any program
necessary or desirable to the carrying out of the general
purposes of the Authority. Such gifts and grants may be held in
trust by the Authority and expended in the exercise of its
powers and performance of its duties as prescribed by law.
(3) The Authority shall submit an annual report of its
activities and expenditures to the Governor, the General
Assembly, the directors of agencies represented on the
Authority, and the State Superintendent of Education, due
January 1 of each year.
(e) The Executive Director of the Authority or his or her
designee shall be added as a participant on the Interagency
Clinical Team established in the intergovernmental agreement
among the Department of Healthcare and Family Services, the
Department of Children and Family Services, the Department of
Human Services, the State Board of Education, the Department
of Juvenile Justice, and the Department of Public Health, with
consent of the youth or the youth's guardian or family
pursuant to the Custody Relinquishment Prevention Act.
(Source: P.A. 102-43, eff. 7-6-21.)
Section 25. The Illinois Public Aid Code is amended by
changing Section 5-30.1 as follows:
(305 ILCS 5/5-30.1)
Sec. 5-30.1. Managed care protections.
(a) As used in this Section:
"Managed care organization" or "MCO" means any entity
which contracts with the Department to provide services where
payment for medical services is made on a capitated basis.
"Emergency services" include:
(1) emergency services, as defined by Section 10 of
the Managed Care Reform and Patient Rights Act;
(2) emergency medical screening examinations, as
defined by Section 10 of the Managed Care Reform and
Patient Rights Act;
(3) post-stabilization medical services, as defined by
Section 10 of the Managed Care Reform and Patient Rights
Act; and
(4) emergency medical conditions, as defined by
Section 10 of the Managed Care Reform and Patient Rights
Act.
(b) As provided by Section 5-16.12, managed care
organizations are subject to the provisions of the Managed
Care Reform and Patient Rights Act.
(c) An MCO shall pay any provider of emergency services
that does not have in effect a contract with the contracted
Medicaid MCO. The default rate of reimbursement shall be the
rate paid under Illinois Medicaid fee-for-service program
methodology, including all policy adjusters, including but not
limited to Medicaid High Volume Adjustments, Medicaid
Percentage Adjustments, Outpatient High Volume Adjustments,
and all outlier add-on adjustments to the extent such
adjustments are incorporated in the development of the
applicable MCO capitated rates.
(d) An MCO shall pay for all post-stabilization services
as a covered service in any of the following situations:
(1) the MCO authorized such services;
(2) such services were administered to maintain the
enrollee's stabilized condition within one hour after a
request to the MCO for authorization of further
post-stabilization services;
(3) the MCO did not respond to a request to authorize
such services within one hour;
(4) the MCO could not be contacted; or
(5) the MCO and the treating provider, if the treating
provider is a non-affiliated provider, could not reach an
agreement concerning the enrollee's care and an affiliated
provider was unavailable for a consultation, in which case
the MCO must pay for such services rendered by the
treating non-affiliated provider until an affiliated
provider was reached and either concurred with the
treating non-affiliated provider's plan of care or assumed
responsibility for the enrollee's care. Such payment shall
be made at the default rate of reimbursement paid under
Illinois Medicaid fee-for-service program methodology,
including all policy adjusters, including but not limited
to Medicaid High Volume Adjustments, Medicaid Percentage
Adjustments, Outpatient High Volume Adjustments and all
outlier add-on adjustments to the extent that such
adjustments are incorporated in the development of the
applicable MCO capitated rates.
(e) The following requirements apply to MCOs in
determining payment for all emergency services:
(1) MCOs shall not impose any requirements for prior
approval of emergency services.
(2) The MCO shall cover emergency services provided to
enrollees who are temporarily away from their residence
and outside the contracting area to the extent that the
enrollees would be entitled to the emergency services if
they still were within the contracting area.
(3) The MCO shall have no obligation to cover medical
services provided on an emergency basis that are not
covered services under the contract.
(4) The MCO shall not condition coverage for emergency
services on the treating provider notifying the MCO of the
enrollee's screening and treatment within 10 days after
presentation for emergency services.
(5) The determination of the attending emergency
physician, or the provider actually treating the enrollee,
of whether an enrollee is sufficiently stabilized for
discharge or transfer to another facility, shall be
binding on the MCO. The MCO shall cover emergency services
for all enrollees whether the emergency services are
provided by an affiliated or non-affiliated provider.
(6) The MCO's financial responsibility for
post-stabilization care services it has not pre-approved
ends when:
(A) a plan physician with privileges at the
treating hospital assumes responsibility for the
enrollee's care;
(B) a plan physician assumes responsibility for
the enrollee's care through transfer;
(C) a contracting entity representative and the
treating physician reach an agreement concerning the
enrollee's care; or
(D) the enrollee is discharged.
(f) Network adequacy and transparency.
(1) The Department shall:
(A) ensure that an adequate provider network is in
place, taking into consideration health professional
shortage areas and medically underserved areas;
(B) publicly release an explanation of its process
for analyzing network adequacy;
(C) periodically ensure that an MCO continues to
have an adequate network in place;
(D) require MCOs, including Medicaid Managed Care
Entities as defined in Section 5-30.2, to meet
provider directory requirements under Section 5-30.3;
(E) require MCOs to ensure that any
Medicaid-certified provider under contract with an MCO
and previously submitted on a roster on the date of
service is paid for any medically necessary,
Medicaid-covered, and authorized service rendered to
any of the MCO's enrollees, regardless of inclusion on
the MCO's published and publicly available directory
of available providers; and
(F) require MCOs, including Medicaid Managed Care
Entities as defined in Section 5-30.2, to meet each of
the requirements under subsection (d-5) of Section 10
of the Network Adequacy and Transparency Act; with
necessary exceptions to the MCO's network to ensure
that admission and treatment with a provider or at a
treatment facility in accordance with the network
adequacy standards in paragraph (3) of subsection
(d-5) of Section 10 of the Network Adequacy and
Transparency Act is limited to providers or facilities
that are Medicaid certified.
(2) Each MCO shall confirm its receipt of information
submitted specific to physician or dentist additions or
physician or dentist deletions from the MCO's provider
network within 3 days after receiving all required
information from contracted physicians or dentists, and
electronic physician and dental directories must be
updated consistent with current rules as published by the
Centers for Medicare and Medicaid Services or its
successor agency.
(g) Timely payment of claims.
(1) The MCO shall pay a claim within 30 days of
receiving a claim that contains all the essential
information needed to adjudicate the claim.
(2) The MCO shall notify the billing party of its
inability to adjudicate a claim within 30 days of
receiving that claim.
(3) The MCO shall pay a penalty that is at least equal
to the timely payment interest penalty imposed under
Section 368a of the Illinois Insurance Code for any claims
not timely paid.
(A) When an MCO is required to pay a timely payment
interest penalty to a provider, the MCO must calculate
and pay the timely payment interest penalty that is
due to the provider within 30 days after the payment of
the claim. In no event shall a provider be required to
request or apply for payment of any owed timely
payment interest penalties.
(B) Such payments shall be reported separately
from the claim payment for services rendered to the
MCO's enrollee and clearly identified as interest
payments.
(4)(A) The Department shall require MCOs to expedite
payments to providers identified on the Department's
expedited provider list, determined in accordance with 89
Ill. Adm. Code 140.71(b), on a schedule at least as
frequently as the providers are paid under the
Department's fee-for-service expedited provider schedule.
(B) Compliance with the expedited provider requirement
may be satisfied by an MCO through the use of a Periodic
Interim Payment (PIP) program that has been mutually
agreed to and documented between the MCO and the provider,
if the PIP program ensures that any expedited provider
receives regular and periodic payments based on prior
period payment experience from that MCO. Total payments
under the PIP program may be reconciled against future PIP
payments on a schedule mutually agreed to between the MCO
and the provider.
(C) The Department shall share at least monthly its
expedited provider list and the frequency with which it
pays providers on the expedited list.
(g-5) Recognizing that the rapid transformation of the
Illinois Medicaid program may have unintended operational
challenges for both payers and providers:
(1) in no instance shall a medically necessary covered
service rendered in good faith, based upon eligibility
information documented by the provider, be denied coverage
or diminished in payment amount if the eligibility or
coverage information available at the time the service was
rendered is later found to be inaccurate in the assignment
of coverage responsibility between MCOs or the
fee-for-service system, except for instances when an
individual is deemed to have not been eligible for
coverage under the Illinois Medicaid program; and
(2) the Department shall, by December 31, 2016, adopt
rules establishing policies that shall be included in the
Medicaid managed care policy and procedures manual
addressing payment resolutions in situations in which a
provider renders services based upon information obtained
after verifying a patient's eligibility and coverage plan
through either the Department's current enrollment system
or a system operated by the coverage plan identified by
the patient presenting for services:
(A) such medically necessary covered services
shall be considered rendered in good faith;
(B) such policies and procedures shall be
developed in consultation with industry
representatives of the Medicaid managed care health
plans and representatives of provider associations
representing the majority of providers within the
identified provider industry; and
(C) such rules shall be published for a review and
comment period of no less than 30 days on the
Department's website with final rules remaining
available on the Department's website.
The rules on payment resolutions shall include, but
not be limited to:
(A) the extension of the timely filing period;
(B) retroactive prior authorizations; and
(C) guaranteed minimum payment rate of no less
than the current, as of the date of service,
fee-for-service rate, plus all applicable add-ons,
when the resulting service relationship is out of
network.
The rules shall be applicable for both MCO coverage
and fee-for-service coverage.
If the fee-for-service system is ultimately determined to
have been responsible for coverage on the date of service, the
Department shall provide for an extended period for claims
submission outside the standard timely filing requirements.
(g-6) MCO Performance Metrics Report.
(1) The Department shall publish, on at least a
quarterly basis, each MCO's operational performance,
including, but not limited to, the following categories of
metrics:
(A) claims payment, including timeliness and
accuracy;
(B) prior authorizations;
(C) grievance and appeals;
(D) utilization statistics;
(E) provider disputes;
(F) provider credentialing; and
(G) member and provider customer service.
(2) The Department shall ensure that the metrics
report is accessible to providers online by January 1,
2017.
(3) The metrics shall be developed in consultation
with industry representatives of the Medicaid managed care
health plans and representatives of associations
representing the majority of providers within the
identified industry.
(4) Metrics shall be defined and incorporated into the
applicable Managed Care Policy Manual issued by the
Department.
(g-7) MCO claims processing and performance analysis. In
order to monitor MCO payments to hospital providers, pursuant
to Public Act 100-580, the Department shall post an analysis
of MCO claims processing and payment performance on its
website every 6 months. Such analysis shall include a review
and evaluation of a representative sample of hospital claims
that are rejected and denied for clean and unclean claims and
the top 5 reasons for such actions and timeliness of claims
adjudication, which identifies the percentage of claims
adjudicated within 30, 60, 90, and over 90 days, and the dollar
amounts associated with those claims.
(g-8) Dispute resolution process. The Department shall
maintain a provider complaint portal through which a provider
can submit to the Department unresolved disputes with an MCO.
An unresolved dispute means an MCO's decision that denies in
whole or in part a claim for reimbursement to a provider for
health care services rendered by the provider to an enrollee
of the MCO with which the provider disagrees. Disputes shall
not be submitted to the portal until the provider has availed
itself of the MCO's internal dispute resolution process.
Disputes that are submitted to the MCO internal dispute
resolution process may be submitted to the Department of
Healthcare and Family Services' complaint portal no sooner
than 30 days after submitting to the MCO's internal process
and not later than 30 days after the unsatisfactory resolution
of the internal MCO process or 60 days after submitting the
dispute to the MCO internal process. Multiple claim disputes
involving the same MCO may be submitted in one complaint,
regardless of whether the claims are for different enrollees,
when the specific reason for non-payment of the claims
involves a common question of fact or policy. Within 10
business days of receipt of a complaint, the Department shall
present such disputes to the appropriate MCO, which shall then
have 30 days to issue its written proposal to resolve the
dispute. The Department may grant one 30-day extension of this
time frame to one of the parties to resolve the dispute. If the
dispute remains unresolved at the end of this time frame or the
provider is not satisfied with the MCO's written proposal to
resolve the dispute, the provider may, within 30 days, request
the Department to review the dispute and make a final
determination. Within 30 days of the request for Department
review of the dispute, both the provider and the MCO shall
present all relevant information to the Department for
resolution and make individuals with knowledge of the issues
available to the Department for further inquiry if needed.
Within 30 days of receiving the relevant information on the
dispute, or the lapse of the period for submitting such
information, the Department shall issue a written decision on
the dispute based on contractual terms between the provider
and the MCO, contractual terms between the MCO and the
Department of Healthcare and Family Services and applicable
Medicaid policy. The decision of the Department shall be
final. By January 1, 2020, the Department shall establish by
rule further details of this dispute resolution process.
Disputes between MCOs and providers presented to the
Department for resolution are not contested cases, as defined
in Section 1-30 of the Illinois Administrative Procedure Act,
conferring any right to an administrative hearing.
(g-9)(1) The Department shall publish annually on its
website a report on the calculation of each managed care
organization's medical loss ratio showing the following:
(A) Premium revenue, with appropriate adjustments.
(B) Benefit expense, setting forth the aggregate
amount spent for the following:
(i) Direct paid claims.
(ii) Subcapitation payments.
(iii) Other claim payments.
(iv) Direct reserves.
(v) Gross recoveries.
(vi) Expenses for activities that improve health
care quality as allowed by the Department.
(2) The medical loss ratio shall be calculated consistent
with federal law and regulation following a claims runout
period determined by the Department.
(g-10)(1) "Liability effective date" means the date on
which an MCO becomes responsible for payment for medically
necessary and covered services rendered by a provider to one
of its enrollees in accordance with the contract terms between
the MCO and the provider. The liability effective date shall
be the later of:
(A) The execution date of a network participation
contract agreement.
(B) The date the provider or its representative
submits to the MCO the complete and accurate standardized
roster form for the provider in the format approved by the
Department.
(C) The provider effective date contained within the
Department's provider enrollment subsystem within the
Illinois Medicaid Program Advanced Cloud Technology
(IMPACT) System.
(2) The standardized roster form may be submitted to the
MCO at the same time that the provider submits an enrollment
application to the Department through IMPACT.
(3) By October 1, 2019, the Department shall require all
MCOs to update their provider directory with information for
new practitioners of existing contracted providers within 30
days of receipt of a complete and accurate standardized roster
template in the format approved by the Department provided
that the provider is effective in the Department's provider
enrollment subsystem within the IMPACT system. Such provider
directory shall be readily accessible for purposes of
selecting an approved health care provider and comply with all
other federal and State requirements.
(g-11) The Department shall work with relevant
stakeholders on the development of operational guidelines to
enhance and improve operational performance of Illinois'
Medicaid managed care program, including, but not limited to,
improving provider billing practices, reducing claim
rejections and inappropriate payment denials, and
standardizing processes, procedures, definitions, and response
timelines, with the goal of reducing provider and MCO
administrative burdens and conflict. The Department shall
include a report on the progress of these program improvements
and other topics in its Fiscal Year 2020 annual report to the
General Assembly.
(g-12) Notwithstanding any other provision of law, if the
Department or an MCO requires submission of a claim for
payment in a non-electronic format, a provider shall always be
afforded a period of no less than 90 business days, as a
correction period, following any notification of rejection by
either the Department or the MCO to correct errors or
omissions in the original submission.
Under no circumstances, either by an MCO or under the
State's fee-for-service system, shall a provider be denied
payment for failure to comply with any timely submission
requirements under this Code or under any existing contract,
unless the non-electronic format claim submission occurs after
the initial 180 days following the latest date of service on
the claim, or after the 90 business days correction period
following notification to the provider of rejection or denial
of payment.
(h) The Department shall not expand mandatory MCO
enrollment into new counties beyond those counties already
designated by the Department as of June 1, 2014 for the
individuals whose eligibility for medical assistance is not
the seniors or people with disabilities population until the
Department provides an opportunity for accountable care
entities and MCOs to participate in such newly designated
counties.
(h-5) Leading indicator data sharing. By January 1, 2024,
the Department shall obtain input from the Department of Human
Services, the Department of Juvenile Justice, the Department
of Children and Family Services, the State Board of Education,
managed care organizations, providers, and clinical experts to
identify and analyze key indicators from assessments and data
sets available to the Department that can be shared with
managed care organizations and similar care coordination
entities contracted with the Department as leading indicators
for elevated behavioral health crisis risk for children. To
the extent permitted by State and federal law, the identified
leading indicators shall be shared with managed care
organizations and similar care coordination entities
contracted with the Department within 6 months of
identification for the purpose of improving care coordination
with the early detection of elevated risk. Leading indicators
shall be reassessed annually with stakeholder input.
(i) The requirements of this Section apply to contracts
with accountable care entities and MCOs entered into, amended,
or renewed after June 16, 2014 (the effective date of Public
Act 98-651).
(j) Health care information released to managed care
organizations. A health care provider shall release to a
Medicaid managed care organization, upon request, and subject
to the Health Insurance Portability and Accountability Act of
1996 and any other law applicable to the release of health
information, the health care information of the MCO's
enrollee, if the enrollee has completed and signed a general
release form that grants to the health care provider
permission to release the recipient's health care information
to the recipient's insurance carrier.
(k) The Department of Healthcare and Family Services,
managed care organizations, a statewide organization
representing hospitals, and a statewide organization
representing safety-net hospitals shall explore ways to
support billing departments in safety-net hospitals.
(l) The requirements of this Section added by Public Act
102-4 shall apply to services provided on or after the first
day of the month that begins 60 days after April 27, 2021 (the
effective date of Public Act 102-4).
(Source: P.A. 101-209, eff. 8-5-19; 102-4, eff. 4-27-21;
102-43, eff. 7-6-21; 102-144, eff. 1-1-22; 102-454, eff.
8-20-21; 102-813, eff. 5-13-22.)
Section 30. The Juvenile Court Act of 1987 is amended by
changing Section 3-5 as follows:
(705 ILCS 405/3-5) (from Ch. 37, par. 803-5)
Sec. 3-5. Interim crisis intervention services.
(a) Any minor who is taken into limited custody, or who
independently requests or is referred for assistance, may be
provided crisis intervention services by an agency or
association, as defined in this Act, provided the association
or agency staff (i) immediately investigate the circumstances
of the minor and the facts surrounding the minor being taken
into custody and promptly explain these facts and
circumstances to the minor, and (ii) make a reasonable effort
to inform the minor's parent, guardian or custodian of the
fact that the minor has been taken into limited custody and
where the minor is being kept, and (iii) if the minor consents,
make a reasonable effort to transport, arrange for the
transportation of, or otherwise release the minor to the
parent, guardian or custodian. Upon release of the child who
is believed to need or benefit from medical, psychological,
psychiatric or social services, the association or agency may
inform the minor and the person to whom the minor is released
of the nature and location of appropriate services and shall,
if requested, assist in establishing contact between the
family and other associations or agencies providing such
services. If the agency or association is unable by all
reasonable efforts to contact a parent, guardian or custodian,
or if the person contacted lives an unreasonable distance
away, or if the minor refuses to be taken to his or her home or
other appropriate residence, or if the agency or association
is otherwise unable despite all reasonable efforts to make
arrangements for the safe return of the minor, the minor may be
taken to a temporary living arrangement which is in compliance
with the Child Care Act of 1969 or which is with persons agreed
to by the parents and the agency or association.
(b) An agency or association is authorized to permit a
minor to be sheltered in a temporary living arrangement
provided the agency seeks to effect the minor's return home or
alternative living arrangements agreeable to the minor and the
parent, guardian, or custodian as soon as practicable. No
minor shall be sheltered in a temporary living arrangement for
more than 21 business days. Throughout such limited custody,
the agency or association shall work with the parent,
guardian, or custodian and the minor's local school district,
the Department of Human Services, the Department of Healthcare
and Family Services, the Department of Juvenile Justice, and
the Department of Children and Family Services to identify
immediate and long-term treatment or placement. 48 hours,
excluding Saturdays, Sundays, and court-designated holidays,
when the agency has reported the minor as neglected or abused
because the parent, guardian, or custodian refuses to permit
the child to return home, provided that in all other instances
the minor may be sheltered when the agency obtains the consent
of the parent, guardian, or custodian or documents its
unsuccessful efforts to obtain the consent or authority of the
parent, guardian, or custodian, including recording the date
and the staff involved in all telephone calls, telegrams,
letters, and personal contacts to obtain the consent or
authority, in which instances the minor may be so sheltered
for not more than 21 days. If at any time during the crisis
intervention there is a concern that the minor has experienced
abuse or neglect, the Comprehensive Community Based-Youth
Services provider shall contact the parent, guardian or
custodian refuses to permit the minor to return home, and no
other living arrangement agreeable to the parent, guardian, or
custodian can be made, and the parent, guardian, or custodian
has not made any other appropriate living arrangement for the
child, the agency may deem the minor to be neglected and report
the neglect to the Department of Children and Family Services
as provided in the Abused and Neglected Child Reporting Act.
The Child Protective Service Unit of the Department of
Children and Family Services shall begin an investigation of
the report within 24 hours after receiving the report and
shall determine whether to file a petition alleging that the
minor is neglected or abused as described in Section 2-3 of
this Act. Subject to appropriation, the Department may take
the minor into temporary protective custody at any time after
receiving the report, provided that the Department shall take
temporary protective custody within 48 hours of receiving the
report if its investigation is not completed. If the
Department of Children and Family Services determines that the
minor is not a neglected minor because the minor is an
immediate physical danger to himself, herself, or others
living in the home, then the Department shall take immediate
steps to either secure the minor's immediate admission to a
mental health facility, arrange for law enforcement
authorities to take temporary custody of the minor as a
delinquent minor, or take other appropriate action to assume
protective custody in order to safeguard the minor or others
living in the home from immediate physical danger.
(c) Any agency or association or employee thereof acting
reasonably and in good faith in the care of a minor being
provided interim crisis intervention services and shelter care
shall be immune from any civil or criminal liability resulting
from such care.
(Source: P.A. 95-443, eff. 1-1-08.)