HB4542 MHDDSA-ONE'S OWN HOME-DEFINED | Illinois Bill

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MHDDSA-ONE'S OWN HOME-DEFINED

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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.

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

Section 5.
The Developmental Disability and Mental
5
Disability Services Act is amended by changing Section 2-3 as
6
follows:

(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
9
requires otherwise:
10

(a) "Agency" means an agency or entity licensed by the
11
Department pursuant to this Article or pursuant to the
12
Community Residential Alternatives Licensing Act.
13

(b) "Department" means the Department of Human Services,
14
as successor to the Department of Mental Health and
15
Developmental Disabilities.
16

(c) "Home-based services" means services provided to an
17
adult with a mental disability who lives in his or her own
18
home. 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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(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
7
of competent jurisdiction to exercise certain powers on behalf
8
of an adult with a mental disability.
9

(e) "Adult with a mental disability" means a person over
10
the age of 18 years who lives in his or her own home; who needs
11
home-based services, but does not require 24-hour-a-day
12
supervision; and who has one of the following conditions:
13
severe autism, severe mental illness, a severe or profound
14
intellectual disability, or severe and multiple impairments.
15

(f) In one's "own home" means that an adult with a mental
16
disability lives alone; or that an adult with a mental
17
disability is in full-time residence with his or her parents,
18
legal guardian, or other relatives; or that an adult with a
19
mental disability is in full-time residence in a setting not
20
subject to licensure under the Nursing Home Care Act, the
21
Specialized Mental Health Rehabilitation Act of 2013, the
22
ID/DD Community Care Act, the MC/DD Act, or the Child Care Act
23
of 1969, as now or hereafter amended, with 3 or fewer other
24
adults unrelated to the adult with a mental disability who do
25
not provide home-based services to the adult with a mental
26
disability
, or a facility licensed by a unit of local

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government authority with 4 or 5 other adults unrelated to the
2
adult with a mental disability who do not provide home-based
3
services to the adult with a mental disability
.
4

(g) "Parent" means the biological or adoptive parent of an
5
adult with a mental disability, or a person licensed as a
6
foster parent under the laws of this State who acts as a foster
7
parent to an adult with a mental disability.
8

(h) "Relative" means any of the following relationships by
9
blood, marriage or adoption: parent, son, daughter, brother,
10
sister, grandparent, uncle, aunt, nephew, niece, great
11
grandparent, great uncle, great aunt, stepbrother, stepsister,
12
stepson, stepdaughter, stepparent or first cousin.
13

(i) "Severe autism" means a lifelong developmental
14
disability which is typically manifested before 30 months of
15
age and is characterized by severe disturbances in reciprocal
16
social interactions; verbal and nonverbal communication and
17
imaginative activity; and repertoire of activities and
18
interests. A person shall be determined severely autistic, for
19
purposes of this Article, if both of the following are
20
present:
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

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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
8
of 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

(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

(D) Work skills.
25

(3) Disability must be present or expected to be
26

present for at least one year.

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A determination of severe mental illness shall be based
2
upon a comprehensive, documented assessment with an evaluation
3
by a licensed clinical psychologist or psychiatrist, and shall
4
not be based solely on behaviors relating to environmental,
5
cultural or economic differences.
6

(k) "Severe or profound intellectual disability" means a
7
manifestation 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
21
disability shall be based upon a comprehensive, documented
22
assessment with an evaluation by a licensed clinical
23
psychologist or certified school psychologist or a
24
psychiatrist, and shall not be based solely on behaviors
25
relating to environmental, cultural or economic differences.
26

(l) "Severe and multiple impairments" means the

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1
manifestation 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

(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,

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LRB104 17801 KTG 31234 b
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(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.

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1

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

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
12
be based upon a comprehensive, documented assessment with an
13
evaluation by a licensed clinical psychologist or
14
psychiatrist.
15

If the examiner is a licensed clinical psychologist,
16
ancillary evaluation of physical impairment, cerebral palsy or
17
epilepsy must be made by a physician licensed to practice
18
medicine in all its branches.
19

Regardless of the discipline of the examiner, ancillary
20
evaluation of visual impairment must be made by an
21
ophthalmologist or a licensed optometrist.
22

Regardless of the discipline of the examiner, ancillary
23
evaluation of hearing impairment must be made by an
24
otolaryngologist or an audiologist with a certificate of
25
clinical competency.
26

The only exception to the above is in the case of a person

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LRB104 17801 KTG 31234 b
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with cerebral palsy or epilepsy who, according to the
2
eligibility criteria listed below, has multiple impairments
3
which are only physical and sensory. In such a case, a
4
physician licensed to practice medicine in all its branches
5
may serve as the examiner.
6

(m) "Twenty-four-hour-a-day supervision" means
7
24-hour-a-day care by a trained mental health or developmental
8
disability professional on an ongoing basis.
9
(Source: P.A. 102-972, eff. 1-1-23
.)

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MHDDSA-ONE'S OWN HOME-DEFINED

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