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HB5177 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5177

Introduced 2/10/2026, by Rep. Anne Stava

SYNOPSIS AS INTRODUCED:

New Act

Creates the Aligning Recommendations with Children's Actual Clinical
and Emergency Needs and Determinations Act (ARC-ACEND). Provides that if a
child who is the subject of a custody or parenting-time dispute has a
serious medical condition, all recommendations made by guardian ad litem,
child representative, evaluator, mediator, or other court-appointed
officer are deemed provisional and may not be used by the court until a
qualified medical provider certifies, in writing, that the recommendation
is consistent with the child's clinical needs and medical best interests.
Requires that if a qualified medical provider determines that a
provisional recommendation is not consistent with the child's clinical
needs or medical best interests, the recommendation must be modified to at
least the minimum extent necessary to achieve consistency with the
recommendations of the qualified medical provider. Provides that nothing
in the Act may be construed to limit the court's authority to order
additional or more protective modifications if consistent with the child's
clinical needs or medical best interests, but the court may not impose less
protective measures or measures inconsistent with the qualified medical
provider's recommendations. Requires that if the court alters the
recommended modifications of the qualified medical provider, it must rule
in writing and specify the reasons for the alteration, and the qualified
medical provider and the child's primary caregiver must be given an
opportunity to respond before the order becomes final. Requires medical
consistency for children with a serious medical condition to supersede all
other considerations, including but not limited to, geography, parental
preferences, logistical convenience or feasibility, or generalized notions
of co-parenting balance. Provides that for any child with a serious
medical condition, it is per se contrary to the child's medical best
interests to be separated from a safe parent who is primarily or
predominantly responsible for the child's day-to-day condition-related
care, monitoring, or condition management. Provides that this presumption
may be rebutted only by clear and convincing evidence, supported by
qualified medical testimony, that separation is medically necessary for
the child's safety or clinical well-being.
LRB104 20165 JRC 33616 b

A BILL FOR

HB5177
LRB104 20165 JRC 33616 b
1

AN ACT concerning civil law.

2

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

4

Section 1.
Short title.
This Act may be cited as the
5
Aligning Recommendations with Children's Actual Clinical and
6
Emergency Needs and Determinations (ARC-ACEND) Act.

7

Section 5.
Legislative findings and purpose.
The General
8
Assembly finds that:
9

(1) Children with serious medical conditions require
10

continuity of care, clinically informed decision-making,
11

and stability in their day-to-day care and management.
12

(2) Guardians ad litem, child representatives,
13

evaluators, and mediators often lack specialized medical
14

training and may make recommendations that inadvertently
15

conflict with a child's clinical needs.
16

(3) Courts must have access to reliable medical
17

information when determining parenting time,
18

decision-making, and other matters affecting such
19

children.
20

(4) It is contrary to the medical best interests of a
21

child with a serious or potentially serious medical or
22

behavioral health condition to be separated from a safe
23

parent who is primarily or predominantly responsible for

HB5177
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LRB104 20165 JRC 33616 b
1

the child's daily medical care, monitoring, or condition
2

management.
3

(5) Ensuring that all recommendations and orders are
4

consistent with a child's clinical needs is essential to
5

protecting child safety and welfare.
6

(6) The purpose of this Act is to ensure that family
7

court decisions affecting medically vulnerable children
8

are grounded in qualified medical judgment and that no
9

child is placed at clinical risk because of uninformed or
10

inconsistent recommendations.

11

Section 10.
Definitions.
As used in this Act:
12

"Medical consistency" means full alignment with the
13
child's clinical needs and medical best interests as
14
determined by a qualified medical provider.
15

"Protective parent" means a parent who consistently
16
undertakes, in good faith, to shield the child from
17
involvement in parental disputes and age-inappropriate
18
matters; keeps the child physically safe, provided for, and
19
emotionally and physically healthy; and who does not seek to
20
employ the child as a form of leverage in any dispute between
21
the parents.
22

"Provisional recommendation" means any recommendation made
23
by a guardian ad litem, child representative, evaluator,
24
mediator, or other court-appointed officer that has not yet
25
been certified as clinically consistent under Section 15.

HB5177
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LRB104 20165 JRC 33616 b
1

"Qualified medical provider" means the child's primary
2
care physician or specialist, if available, or another
3
licensed physician or licensed behavioral health specialist
4
physician with sufficient knowledge of the child's condition,
5
who may consult with specialist providers as appropriate.
6
Advanced practice registered nurses, counselors and therapists
7
do not meet this definition.
8

"Safe parent" is designated as a "safe parent" if and only
9
if the parent meets all of the following criteria:
10

(1) does not neglect or abuse the child;
11

(2) does not abuse the other parent;
12

(3) has not previously neglected or abused the child
13

or the other parent, absent a positive assessment, on the
14

record, by a qualified physician who has been the abuser's
15

primary behavioral health provider for at least one year,
16

based on specific and articulable facts, that all of the
17

following are true:
18

(A) the abuse was the result of a behavioral
19

health disorder or psychological or neurological
20

condition;
21

(B) the abuser has successfully completed
22

treatment or is satisfactorily complying with ongoing
23

or indefinite treatment, with at least a 12-month
24

unbroken history of such compliance; and
25

(C) the abuse is unlikely to continue or to recur;
26

(4) is judged by court-appointed officers, acting as

HB5177
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LRB104 20165 JRC 33616 b
1

required by this Act, to be capable of safely interacting
2

with and caring for the child without supervision;
3

(5) is not the respondent to any order of protection,
4

presently in effect, which is sustained after a hearing;
5

(6) is not under the care of a mental health provider
6

for a serious behavioral, psychological, or emotional
7

condition that the court, in consultation with the
8

diagnosing provider, deems to pose a potential risk to the
9

child; and
10

(7) is a protective parent.
11

"Serious medical condition" means any chronic, acute, or
12
clinically significant physical or behavioral condition
13
requiring ongoing monitoring, specialized care, or adherence
14
to a treatment plan, including but not limited to Type 1
15
Diabetes, cystic fibrosis, epilepsy, asthma, major depressive
16
disorder, anxiety disorders, eating disorders, autism spectrum
17
disorder, ADHD, serious physical injury, or other conditions
18
identified by a qualified medical provider.

19

Section 15.
Medical consistency certification requirement.
20

(a) When a child who is the subject of a custody or
21
parenting-time dispute has a serious medical condition, all
22
recommendations made by a guardian ad litem, child
23
representative, evaluator, mediator, or other court-appointed
24
officer shall be deemed provisional until certified under
25
subsection (b).

HB5177
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LRB104 20165 JRC 33616 b
1

(b) A provisional recommendation may not be considered by
2
the court for purposes of entering a temporary or final order
3
unless a qualified medical provider certifies, in writing,
4
that the recommendation is consistent with the child's
5
clinical needs and medical best interests.
6

(c) The qualified medical provider may consult with
7
specialist providers involved in the child's care before
8
issuing certification.
9

(d) The court may not adopt, rely upon, or give weight to
10
any provisional recommendation before certification, except to
11
maintain the child's existing care arrangements necessary to
12
ensure safety and continuity of treatment.
13

(e) The court shall provide reasonably sufficient time for
14
qualified medical providers to make assessments and
15
recommendations and err on the side of caution with regard to
16
any interim instruction or temporary arrangement without
17
regard for considerations including, but not limited to,
18
generalized notions of coparenting balance. In all decisions,
19
the safety and medical consistency of the child is paramount.

20

Section 20.
Modification of inconsistent recommendations.
21

(a)(1) If a qualified medical provider determines that a
22
provisional recommendation is not consistent with the child's
23
clinical needs or medical best interests, the recommendation
24
must be modified to at least to the minimum extent necessary to
25
achieve consistency per the recommendations of the qualified

HB5177
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LRB104 20165 JRC 33616 b
1
medical provider.
2

(2) Nothing in this subsection may be construed to limit
3
the court's authority to order additional or more protective
4
modifications if consistent with the child's clinical needs or
5
medical best interests, but the court may not impose less
6
protective measures or measures inconsistent with the
7
physician's recommendations.
8

(3) If the court alters the recommended modifications of
9
the qualified medical provider, it shall rule in writing and
10
specify the reasons for the alteration. The qualified medical
11
provider and the child's primary caregiver shall then be
12
afforded an opportunity to respond before the order becomes
13
final.
14

(b)(1) Medical consistency for children with a serious
15
medical condition supersedes all other considerations,
16
including, but not limited to, geography, parental
17
preferences, logistical convenience or feasibility, or
18
generalized notions of coparenting balance.
19

(2) No factor that would otherwise weigh against
20
modification may be given weight if doing so would result in a
21
recommendation or order that is not fully consistent with the
22
child's clinical needs or medical best interests as stipulated
23
by the qualified medical provider.

24

Section 25.
Presumption regarding safe primary caregiver.
25

(a)(1) For any child with a serious medical condition, it

HB5177
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LRB104 20165 JRC 33616 b
1
is per se contrary to the child's medical best interests to be
2
separated from a safe parent who is primarily or predominantly
3
responsible for the child's day-to-day condition-related care,
4
monitoring, or condition management.
5

(2) This rule applies universally in all cases in which
6
maintaining contact with the safe, caregiving parent is in any
7
way an option, including, but not limited to, cases involving
8
deportation, visa expiration, work reassignment or transfer,
9
or other nonelective or effectively nonelective relocation.
10

(b) This presumption may be rebutted only by clear and
11
convincing evidence supported by qualified medical testimony
12
that separation is medically necessary for the child's safety
13
or clinical well-being.
14

(c) A parent's role as the primary medical caregiver may
15
not be used to infer gatekeeping, alienation, or obstruction
16
absent independent evidence of bad-faith conduct.

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