HB 4542

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Full Text of HB4542
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	HB4542 - 104th General Assembly
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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4542
Introduced 1/30/2026, by Rep. Amy L. Grant
SYNOPSIS AS INTRODUCED:
405 ILCS 80/2-3	  from Ch. 91 1/2, par. 1802-3
Amends the Developmental Disability and Mental Disability Services Act. Provides that in one's "own home" means that an adult with a mental disability lives alone; or that an adult with a mental disability is in full-time residence with his or her parents, legal guardian, or other relatives; or that an adult with a mental disability is in full-time residence in a setting not subject to licensure under the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, the MC/DD Act, or the Child Care Act of 1969 with 5 (rather than 3) or fewer other adults unrelated to the adult with a mental disability who do not provide home-based services to the adult with a mental disability.
LRB104 17801 KTG 31234 b
A BILL FOR
		HB4542		LRB104 17801 KTG 31234 b
1    AN ACT concerning health.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Developmental Disability and Mental
5Disability Services Act is amended by changing Section 2-3 as
6follows:
7    (405 ILCS 80/2-3)  (from Ch. 91 1/2, par. 1802-3)
8    Sec. 2-3. As used in this Article, unless the context
9requires otherwise:
10    (a) "Agency" means an agency or entity licensed by the
11Department pursuant to this Article or pursuant to the
12Community Residential Alternatives Licensing Act.
13    (b) "Department" means the Department of Human Services,
14as successor to the Department of Mental Health and
15Developmental Disabilities.
16    (c) "Home-based services" means services provided to an
17adult with a mental disability who lives in his or her own
18home. These services include but are not limited to:
19        (1) home health services;
20        (2) case management;
21        (3) crisis management;
22        (4) training and assistance in self-care;
23        (5) personal care services;
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1        (6) habilitation and rehabilitation services;
2        (7) employment-related services;
3        (8) respite care; and
4        (9) other skill training that enables a person to
5    become self-supporting.
6    (d) "Legal guardian" means a person appointed by a court
7of competent jurisdiction to exercise certain powers on behalf
8of an adult with a mental disability.
9    (e) "Adult with a mental disability" means a person over
10the age of 18 years who lives in his or her own home; who needs
11home-based services, but does not require 24-hour-a-day
12supervision; and who has one of the following conditions:
13severe autism, severe mental illness, a severe or profound
14intellectual disability, or severe and multiple impairments.
15    (f) In one's "own home" means that an adult with a mental
16disability lives alone; or that an adult with a mental
17disability is in full-time residence with his or her parents,
18legal guardian, or other relatives; or that an adult with a
19mental disability is in full-time residence in a setting not
20subject to licensure under the Nursing Home Care Act, the
21Specialized Mental Health Rehabilitation Act of 2013, the
22ID/DD Community Care Act, the MC/DD Act, or the Child Care Act
23of 1969, as now or hereafter amended, with 3 or fewer other
24adults unrelated to the adult with a mental disability who do
25not provide home-based services to the adult with a mental
26disability, or a facility licensed by a unit of local 
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1government authority with 4 or 5 other adults unrelated to the 
2adult with a mental disability who do not provide home-based 
3services to the adult with a mental disability.
4    (g) "Parent" means the biological or adoptive parent of an
5adult with a mental disability, or a person licensed as a
6foster parent under the laws of this State who acts as a foster
7parent to an adult with a mental disability.
8    (h) "Relative" means any of the following relationships by
9blood, marriage or adoption: parent, son, daughter, brother,
10sister, grandparent, uncle, aunt, nephew, niece, great
11grandparent, great uncle, great aunt, stepbrother, stepsister,
12stepson, stepdaughter, stepparent or first cousin.
13    (i) "Severe autism" means a lifelong developmental
14disability which is typically manifested before 30 months of
15age and is characterized by severe disturbances in reciprocal
16social interactions; verbal and nonverbal communication and
17imaginative activity; and repertoire of activities and
18interests. A person shall be determined severely autistic, for
19purposes of this Article, if both of the following are
20present:
21        (1) Diagnosis consistent with the criteria for
22    autistic disorder in the current edition of the Diagnostic
23    and Statistical Manual of Mental Disorders.
24        (2) Severe disturbances in reciprocal social
25    interactions; verbal and nonverbal communication and
26    imaginative activity; repertoire of activities and
		HB4542	- 4 -	LRB104 17801 KTG 31234 b
1    interests. A determination of severe autism shall be based
2    upon a comprehensive, documented assessment with an
3    evaluation by a licensed clinical psychologist or
4    psychiatrist. A determination of severe autism shall not
5    be based solely on behaviors relating to environmental,
6    cultural or economic differences.
7    (j) "Severe mental illness" means the manifestation of all
8of the following characteristics:
9        (1) A primary diagnosis of one of the major mental
10    disorders in the current edition of the Diagnostic and
11    Statistical Manual of Mental Disorders listed below:
12            (A) Schizophrenia disorder.
13            (B) Delusional disorder.
14            (C) Schizo-affective disorder.
15            (D) Bipolar affective disorder.
16            (E) Atypical psychosis.
17            (F) Major depression, recurrent.
18        (2) The individual's mental illness must substantially
19    impair his or her functioning in at least 2 of the
20    following areas:
21            (A) Self-maintenance.
22            (B) Social functioning.
23            (C) Activities of community living.
24            (D) Work skills.
25        (3) Disability must be present or expected to be
26    present for at least one year.
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1    A determination of severe mental illness shall be based
2upon a comprehensive, documented assessment with an evaluation
3by a licensed clinical psychologist or psychiatrist, and shall
4not be based solely on behaviors relating to environmental,
5cultural or economic differences.
6    (k) "Severe or profound intellectual disability" means a
7manifestation of all of the following characteristics:
8        (1) A diagnosis which meets Classification in Mental
9    Retardation or criteria in the current edition of the
10    Diagnostic and Statistical Manual of Mental Disorders for
11    severe or profound mental retardation (an IQ of 40 or
12    below). This must be measured by a standardized instrument
13    for general intellectual functioning.
14        (2) A severe or profound level of disturbed adaptive
15    behavior. This must be measured by a standardized adaptive
16    behavior scale or informal appraisal by the professional
17    in keeping with illustrations in Classification in Mental
18    Retardation, 1983.
19        (3) Disability diagnosed before age of 18.
20    A determination of a severe or profound intellectual
21disability shall be based upon a comprehensive, documented
22assessment with an evaluation by a licensed clinical
23psychologist or certified school psychologist or a
24psychiatrist, and shall not be based solely on behaviors
25relating to environmental, cultural or economic differences.
26    (l) "Severe and multiple impairments" means the
		HB4542	- 6 -	LRB104 17801 KTG 31234 b
1manifestation of all of the following characteristics:
2        (1) The evaluation determines the presence of a
3    developmental disability which is expected to continue
4    indefinitely, constitutes a substantial disability and is
5    attributable to any of the following:
6            (A) Intellectual disability as defined in Section
7        1-116 of the Mental Health and Developmental
8        Disabilities Code.
9            (B) Cerebral palsy.
10            (C) Epilepsy.
11            (D) Autism.
12            (E) Any other condition which results in
13        impairment similar to that caused by an intellectual
14        disability and which requires services similar to
15        those required by persons with intellectual
16        disabilities.
17        (2) The evaluation determines multiple disabilities in
18    physical, sensory, behavioral or cognitive functioning
19    which constitute a severe or profound impairment
20    attributable to one or more of the following:
21            (A) Physical functioning, which severely impairs
22        the individual's motor performance that may be due to:
23                (i) Neurological, psychological or physical
24            involvement resulting in a variety of disabling
25            conditions such as hemiplegia, quadriplegia or
26            ataxia,
		HB4542	- 7 -	LRB104 17801 KTG 31234 b
1                (ii) Severe organ systems involvement such as
2            congenital heart defect,
3                (iii) Physical abnormalities resulting in the
4            individual being non-mobile and non-ambulatory or
5            confined to bed and receiving assistance in
6            transferring, or
7                (iv) The need for regular medical or nursing
8            supervision such as gastrostomy care and feeding.
9            Assessment of physical functioning must be based
10        on clinical medical assessment by a physician licensed
11        to practice medicine in all its branches, using the
12        appropriate instruments, techniques and standards of
13        measurement required by the professional.
14            (B) Sensory, which involves severe restriction due
15        to hearing or visual impairment limiting the
16        individual's movement and creating dependence in
17        completing most daily activities. Hearing impairment
18        is defined as a loss of 70 decibels aided or speech
19        discrimination of less than 50% aided. Visual
20        impairment is defined as 20/200 corrected in the
21        better eye or a visual field of 20 degrees or less.
22        Sensory functioning must be based on clinical medical
23        assessment by a physician licensed to practice
24        medicine in all its branches using the appropriate
25        instruments, techniques and standards of measurement
26        required by the professional.
		HB4542	- 8 -	LRB104 17801 KTG 31234 b
1            (C) Behavioral, which involves behavior that is
2        maladaptive and presents a danger to self or others,
3        is destructive to property by deliberately breaking,
4        destroying or defacing objects, is disruptive by
5        fighting, or has other socially offensive behaviors in
6        sufficient frequency or severity to seriously limit
7        social integration. Assessment of behavioral
8        functioning may be measured by a standardized scale or
9        informal appraisal by a clinical psychologist or
10        psychiatrist.
11            (D) Cognitive, which involves intellectual
12        functioning at a measured IQ of 70 or below.
13        Assessment of cognitive functioning must be measured
14        by a standardized instrument for general intelligence.
15        (3) The evaluation determines that development is
16    substantially less than expected for the age in cognitive,
17    affective or psychomotor behavior as follows:
18            (A) Cognitive, which involves intellectual
19        functioning at a measured IQ of 70 or below.
20        Assessment of cognitive functioning must be measured
21        by a standardized instrument for general intelligence.
22            (B) Affective behavior, which involves over and
23        under responding to stimuli in the environment and may
24        be observed in mood, attention to awareness, or in
25        behaviors such as euphoria, anger or sadness that
26        seriously limit integration into society. Affective
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1        behavior must be based on clinical assessment using
2        the appropriate instruments, techniques and standards
3        of measurement required by the professional.
4            (C) Psychomotor, which includes a severe
5        developmental delay in fine or gross motor skills so
6        that development in self-care, social interaction,
7        communication or physical activity will be greatly
8        delayed or restricted.
9        (4) A determination that the disability originated
10    before the age of 18 years.
11    A determination of severe and multiple impairments shall
12be based upon a comprehensive, documented assessment with an
13evaluation by a licensed clinical psychologist or
14psychiatrist.
15    If the examiner is a licensed clinical psychologist,
16ancillary evaluation of physical impairment, cerebral palsy or
17epilepsy must be made by a physician licensed to practice
18medicine in all its branches.
19    Regardless of the discipline of the examiner, ancillary
20evaluation of visual impairment must be made by an
21ophthalmologist or a licensed optometrist.
22    Regardless of the discipline of the examiner, ancillary
23evaluation of hearing impairment must be made by an
24otolaryngologist or an audiologist with a certificate of
25clinical competency.
26    The only exception to the above is in the case of a person
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1with cerebral palsy or epilepsy who, according to the
2eligibility criteria listed below, has multiple impairments
3which are only physical and sensory. In such a case, a
4physician licensed to practice medicine in all its branches
5may serve as the examiner.
6    (m) "Twenty-four-hour-a-day supervision" means
724-hour-a-day care by a trained mental health or developmental
8disability professional on an ongoing basis.
9(Source: P.A. 102-972, eff. 1-1-23.)