Illinois Administrative Code › Title 59 - MENTAL HEALTH › Part 115 - STANDARDS AND LICENSURE REQUIREMENTS FOR COMMUNITY-INTEGRATED LIVING ARRANGEMENTS › Subpart A - GENERAL PROVISIONS › Section 115.120 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
For the purpose of this Part, the following terms are
				  defined:
"Abuse." See definition found in 59 Ill. Adm. Code
				  50.10.
"Applicant." A person, group of persons, association,
				  organization, partnership, or corporation that applies for a license to provide
				  community-integrated living arrangement services under this Part.
"Assigned Independent Receiver" or "Receiver." A court
				  appointed qualified person, who assumes custodial responsibility for a CILA
				  agency that is operating without a license or whose license has been suspended,
				  revoked, or refused renewal. This person cannot be an owner or an affiliate of
				  the CILA agency which is in receivership.
"Authorized CILA agency representative." The administrative
				  head of a CILA agency, or their designee, appointed by the CILA agency's
				  governing body with overall responsibility for fiscal and programmatic
				  management.
"Authorized electronic monitoring."
The placement and
				  use of an electronic monitoring device by
an individual in their
room in accordance with
the Authorized Electronic Monitoring
				  in Community-Integrated Living Arrangements and Developmental Disability
				  Facilities
Act
[210 ILCS 165/5 ].
"Aversive procedures." The application, contingent on the
				  exhibition of a specific behavior that is not adaptive, of unpleasant or
				  painful stimuli, or stimuli that have a potentially noxious affect. Aversive
				  procedures have the following characteristics:
Obvious signs of physical pain experienced by the
				  individual.
Potential or actual physical side effects, including tissue
				  damage, physical illness, severe stress, and/or death.
Dehumanization of the individual, through means such as
				  social degradation, social isolation, verbal abuse, techniques inappropriate
				  for the individual's age, and treatment out of proportion to the target
				  behavior.
"BALC. " The Department's Bureau of Accreditation, Licensure
				  and Certification.
"BQM. " The Bureau of Quality Management in the Department's
				  Division of Developmental Disabilities.
"Certification." A status granted by the Department to a
				  specific site whose programs operate under this Part, successfully meet its
				  standards, and provide services to promote community-integrated living.
"CILA agency" or "CILA provider." A developmental disability
				  services agency that is licensed by the Department to provide
				  community-integrated living arrangement services for individuals with a
				  developmental disability. (Section 3(b) of the Community-Integrated Living
				  Arrangements Licensure and Certification Act)
"CILA services." Residential supports that a CILA agency is
				  paid to deliver to individuals with developmental disabilities that promote
				  health, well-being, maximum independence, choice-making, access to the greater
				  community to the same degree as individuals not receiving HCBS.
"Code." The Mental Health and Developmental Disabilities Code
				  [405 ILCS
				  5 ].
"Coercion." Any action whereby an individual, guardian, or
				  family member is compelled by force, intimidation, or threat to act, or refrain
				  from action, in a manner contrary to how the individual would have acted if
				  permitted to act in accordance with their free and informed choice.
"Community-integrated living arrangement (CILA)." A
				  residential setting or site that is certified by the Department
where
				  eight or fewer
individuals with a developmental disability
reside
together in an apartment, house, or one or more units
				  in a multi-unit building
under the supervision of
an
agency
and are provided with an array of services. (Section
				  3(d) of the Community-Integrated Living Arrangements Licensure and
				  Certification Act).
"Community integration" or "integration into the community.
				  "Individuals receiving Medicaid HCBS having opportunities to seek employment
				  and work in competitive integrated settings, engage in community life, control
				  personal resources, and receive services in the community to the same degree of
				  access as individuals not receiving Medicaid HCBS (42 CFR
				  441.301(c)(2)(i)). Examples
				  of on-going engagement in community life for individuals with developmental
				  disabilities include:
Time spent out of the home participating in non-disability
				  specific activities chosen by the individual and guardian that are available to
				  the greater community, such as spiritual and cultural interests, places of
				  worship (e.g., church, temple, mosque, synagogue or other places of worship),
				  recreational activities, education, library, clubs, shopping and
				  amusements.
Participation in activities, celebrations, (e.g., holidays,
				  birthdays, reunions) communication (wireless, electronic, and/or mail) and
				  vacations.
"Confidentiality Act." The Mental Health and Developmental
				  Disabilities Confidentiality Act [740 ILCS 110 ].
"Continuous supervision or support." Direction or assistance
				  provided to an individual under the auspices of the licensed CILA agency (i.e.,
				  not an Intermittent CILA). An employee or any other person compensated or in a
				  volunteer capacity, but not the guardian of the individual, with responsibility
				  for care of individuals served from the licensed CILA agency, or another agency
				  through which any portion of CILA services is being provided, must be
				  physically present on-site all hours individuals are present, unless otherwise
				  specified in an individual's Personal Plan and provided for in their
				  Implementation Strategy. Continuous supervision or support may range from being
				  in immediate line of sight to the individual receiving services, to present and
				  accessible to the individual receiving services, depending on the individual's
				  Implementation Strategy.
"Critical Incidents." Any alleged, suspected, or actual
				  occurrence of an incident when there is reason to believe the health or safety
				  of an individual may be adversely affected or an individual may be placed at a
				  reasonable risk of harm. Critical incidents for this Part shall include abuse,
				  neglect, and financial exploitation as defined in 59 Ill. Adm. Code 50.
				  Critical Incidents shall also include deaths not otherwise reportable pursuant
				  to 59 Ill. Adm. Code 50, injuries of known or unknown origin, medical
				  emergencies, unscheduled hospitalizations, missing individuals, peer-to-peer or
				  peer-to-staff acts of aggression, and involvement of law enforcement and/or
				  fire department.
"Day." A calendar day, unless otherwise indicated.
"Department" or "DHS." The Illinois Department of Human
				  Services.
"Developmental disability." An intellectual disability or
				  other severe, chronic disability, other than mental illness, found to be
				  closely related to an intellectual disability because this condition results in
				  impairment of general intellectual functioning or adaptive behavior similar to
				  that of persons with ID, and requires services similar to those required for a
				  person with an intellectual disability. In addition, a developmental
				  disability:
is manifested before the individual reaches 22 years of
				  age;
is likely to continue indefinitely;
results in substantial functional limitations in three or
				  more of the following areas of major life activity: self-care, receptive and
				  expressive language, learning, mobility, self-direction, capacity for
				  independent living, or economic self-sufficiency; and
reflects the individual's need for a combination and sequence
				  of special interdisciplinary or generic services, individualized supports, or
				  other forms of assistance that are of lifelong or extended duration and are
				  individually planned and coordinated (modified from the American Association on
				  Intellectual and Developmental Disabilities, Intellectual Disability:
				  Definition, Diagnosis, Classification, and Systems of Supports,
				  12th Edition (2021)).
"Diagnosis." A category of disability stated in accordance
				  with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
				  (DSM-V) or the most recently published version (800 Maine Avenue, S.W., Suite
				  900, Washington, DC 20024 (2013).
"Direct Support Professional" or "DSP". Any person who
				  provides habilitative care, services, or support to individuals with
				  developmental disabilities and is listed on the Department's Health Care Worker
				  Registry as a trained DSP or DDD Aide under its Program section. DSPs shall be
				  trained in accordance with this Part and function under the supervision of a
				  Qualified Intellectual Disabilities Professional (QIDP), a Licensed/Registered
				  Nurse, or other higher-level employee authorized by the CILA agency.
"Division of Developmental Disabilities," "Division," or
				  "DDD." The Department's Division of Developmental Disabilities.
"Electronic monitoring device."
A surveillance
				  instrument with a fixed position video camera or an audio recording device, or
				  a combination thereof, that is installed in
an individual's
bedroom under the provisions of
the Authorized Electronic
				  Monitoring in Community-Integrated Living Arrangements and Developmental
				  Disability Facilities
Act and broadcasts or records activity or sounds
				  occurring in the room
[210 ILCS 165/5
				  ]
.
"Employee." For the purposes of this Part, any individual
				  hired, employed, or retained by a CILA agency, whether paid or on an unpaid
				  basis.
"Entitlements." Government-related financial benefits
				  available to individuals who qualify on the basis of need, disability and/or
				  income, such as Title XVIII (Medicare) (42 U.S.C. 1395b-1 (1996)), Title
				  XIX (Medicaid) (42 U.S.C.
				  1396a (1996)) and Veteran's Administration
				  benefits (38 U.S.C.
				  521,
				  541,
				  542 (1996)).
"Exploitation" or "Financial Exploitation." See definition of
				  financial exploitation found in 59 Ill. Adm. Code 50.10.
"Governing body." The policy-making authority of a CILA
				  agency that establishes policies concerning the CILA agency's operation and the
				  welfare of individuals; provides for the CILA agency's administration by
				  appointing an authorized CILA agency representative to implement its policies;
				  and exercises general oversight of the CILA agency's operation, its fiscal
				  affairs and programmatic content to implement the organization's
				  mission.
"Guardian." The plenary or limited guardian or conservator of
				  the individual appointed by the court for an individual over age 18 (when the
				  limited guardian's duties encompass concerns related to service requirements),
				  or the natural or adoptive parent of a minor, or a person acting as a parent of
				  a minor. All references in this Part to an "individual and/or guardian" include
				  the guardian only if applicable.
"Habilitation." Individually tailored supports that assist
				  individual with developmental disabilities with the acquisition, retention, or
				  improvement in skills related to living in the community. Services are
				  developed in accordance with the needs of the individual and include supports
				  to foster independence and encourage development of a full life in the
				  community, based upon what is important to and for the individual, as
				  documented in their Person-Centered Plan. This includes assisting and teaching
				  individuals to attain new and maintain and improve existing skills in areas of
				  self-care, daily living, adaptive skills, leisure, and community integration,
				  including building and maintaining relationships. Additionally, it may include
				  efforts to prevent regression or decelerate loss of function.
Habilitation may include, but is not limited to, diagnosis, evaluation,
				  medical services, residential care, day care, special living arrangements,
				  training, education, employment
related services
, protective
				  services, counseling, and other services provided to
individuals
with a developmental disability by developmental disabilities
				  programs
. [405 ILCS 5/1-111 ]
"Host family." One or more persons unrelated to the
				  individual with developmental disabilities, employed by or contracting with the
				  CILA agency, who reside with the individual.
"Host family living arrangement" or "Host family setting". A
				  24-hour residential setting, serving as an alternative to a typical shift staff
				  arrangement. The setting is the residence for the person with a developmental
				  disability and the host family.
"Host family living arrangement - traditional care model." A
				  24-hour residential alternative to a typical shift staff arrangement. The
				  setting is the residence for the person with a developmental disability and the
				  full-time residence for the paid host family. It is owned, leased, or rented by
				  the paid host family. In these settings, host families consist of one or more
				  persons who are unrelated to the individual with a developmental disability,
				  and who contract with the CILA agency.
"Host family living arrangement - shared living model." A
				  24-hour residential alternative to a typical shift staff arrangement. The
				  setting is the residence for the person with a developmental disability and may
				  house either full or part-time paid host family in which more than 50 percent
				  of the residential coverage is provided by individuals other than shift staff
				  employees. It is owned, leased, or rented by the individuals, host family, or
				  CILA agency. In these settings, host families consist of one or more persons
				  who are unrelated to the individual with a developmental disability, and who
				  are employed by or contract with the CILA agency. The difference between
				  traditional care and shared living models is shift employees routinely share
				  supervision, care, and training responsibilities with the host family in the
				  shared living model.
"Host family services." Residential supports, provided in a
				  host family living arrangement, that a CILA agency is paid to deliver to
				  individuals with developmental disabilities that promote health, well-being,
				  maximum independence, choice-making, and access to the greater community to the
				  same degree as individuals not receiving HCBS.
"Imminent risk." A preliminary determination of immediate,
				  threatened, or impending risk of illness, mental injury, or physical injury to
				  an individual as would cause a reasonably prudent person to take immediate
				  action and that is not immediately corrected, such as environmental or safety
				  hazards.
"Implementation Strategy." A document developed by the
				  licensed CILA agency in conjunction with the individual or the individual's
				  guardian that describes and directs the activities and methods used to provide
				  services and supports for the areas of an individual's Personal Plan for which
				  the CILA agency has agreed to be responsible. The priorities, strengths,
				  support needs, and risk factors identified in the Personal Plan must be
				  addressed and accounted for in the Implementation Strategy for those areas of
				  the CILA agency's responsibility. The document must describe how the CILA
				  agency will support the person to pursue the outcomes included in the Personal
				  Plan and be signed by the person, guardian, and ISC.
"Independent Monitor" or "Monitor." An individual, employee,
				  contractor, or any other person compensated or in a volunteer capacity with a
				  business entity who has been assigned by the Department to oversee the business
				  affairs of a CILA when any of the following situations occur:
The CILA agency is operating without a license;
The Department has suspended, revoked, or refused to renew
				  the existing license of the CILA agency;
The Department has issued a notice to terminate or not renew
				  its agreement with the CILA agency;
The CILA agency is closing or has informed the Department
				  that it intends to close and adequate arrangements for transition of
				  individuals have not been made at least 30 days prior to closure;
The Department determines that an emergency (a threat to the
				  health, safety, or welfare of individuals that the CILA agency is unwilling or
				  unable to remedy) exists; or
The Department, with the Department of Healthcare and Family
				  Services, terminates the CILA provider's participation in the federal
				  reimbursement program under Title XIX (Medicaid) of the Social Security Act
				  (42 U.S.C.
				  7).
The monitor cannot be Department or State agency staff. The
				  monitor shall observe operation of the facility, assist the facility by
				  advising it on how to comply with the State regulations, and shall report
				  periodically to the Department on the operation of the facility.
"Independent Service Coordination agency" or "ISC". A
				  contracted entity designated by DDD to carry out certain federal and State
				  requirements related to assessment, determination of eligibility and service
				  coordination for individuals with a developmental disability. This entity
				  provides conflict of interest free case management, including development and
				  monitoring of an individual's Personal Plan, to DDD Medicaid HCBS Waiver
				  participants. They also serve as the front line for information and assistance
				  to help individuals and families navigate the system, ensure informed choice,
				  link individuals to services and address problems related to outcomes and
				  quality.
"Individual" or "individuals." A person or persons who
				  receives or receive community-integrated living arrangement services.
"Individual representatives." Persons chosen by individuals
				  and representing the interests of individuals served by a CILA agency such as
				  family members, guardians, and advocates.
"Individually owned or controlled." A physical setting in
				  which the individual resides that is owned, co-owned, leased, or rented by the
				  individual. This setting is not provider-owned or controlled.
"Informed consent." Permission freely granted by the
				  individual or guardian based on full disclosure to the individual or guardian
				  of the benefits and/or liabilities of participation in specific procedures
				  and/or services, including releases of information, as part of the individual's
				  Personal Plan and Implementation Strategy.
"Intellectual Disability." A disorder with onset during the
				  developmental period (before the individual reaches age 22), that includes both
				  intellectual and adaptive deficits in conceptual, social, and practical
				  domains. The following criteria must be met:
deficits in intellectual functions such as reasoning, problem
				  solving, planning, abstract thinking, judgment, academic learning, and learning
				  from experience confirmed by both clinical assessment and individualized,
				  standardized intelligence testing (generally indicated with an IQ score of
				  about 70 or below);
deficits in adaptive functioning that result in failure to
				  meet developmental and sociocultural standards for personal independence and
				  social responsibility. Without ongoing support, the adaptive deficits limit
				  functioning in one or more activities of daily life, such as communication,
				  social participation, and independent living, across multiple environments,
				  such as home, school, work, and community; and
onset of intellectual and adaptive deficits during the
				  developmental period.
(Modified from the American Psychiatric Association (2013),
				  Diagnostic and Statistical Manual of Mental Disorders
				  (5th ed.) and the American Association on
				  Intellectual and Developmental Disabilities, Intellectual Disability:
				  Definition, Diagnosis, Classification, and Systems of Supports,
				  12th Edition (2021)).
"Intermittent supervision or support." Supervision or support
				  provided to an individual under the auspices of a licensed CILA agency less
				  than 24-hours per day (i.e., not a 24 hour or host family CILA). When employees
				  are not on-site, supervision or support shall be provided by means of 24-hour
				  on-call availability and by a variety of alternatives or supports, such as
				  natural and remote supports.
"Mental health professional" or "MHP." See definition of
				  mental health professional found in 89 Ill. Adm. Code
				  140.453.
"Mental illness." For purposes of this Part, mental illness
				  refers to the target population of adults with serious mental illness (SMI), as
				  established by the Department's Division of Mental Health and defined
				  as:
Individuals with serious mental illness are adults whose
				  emotional or behavioral functioning is so impaired as to interfere with their
				  capacity to remain in the community without supportive treatment. The mental
				  impairment is severe and persistent and may result in a limitation of their
				  capacities for primary activities of daily living, interpersonal relationships,
				  homemaking, self-care, employment, or recreation. This impairment may limit
				  their ability to seek or receive local, State, or federal assistance such as
				  housing, medical and dental care, rehabilitation services, income and food
				  assistance, or protective services.
The individual must have one of the following diagnoses that
				  meets DSM-5 criteria and that is the focus of the treatment being
				  provided:
Delusional Disorder (F22)
Brief Psychotic Disorder (F23)
Schizophreniform Disorder (F20.81)
Schizophrenia (F20.9)
Schizoaffective Disorder (F25.x)
Catatonia Associated with another Mental Disorder (Catatonia
				  Specifier) (F06.1)
Other Specified Schizophrenia Spectrum and Other Psychotic
				  Disorder (F28)
Unspecified Schizophrenia Spectrum and Other Psychotic
				  Disorder (F29)
Bipolar I Disorder (F31.xx)
Bipolar II Disorder (F31.81)
Cyclothymic Disorder (F34.0)
Unspecified Bipolar and Related Disorder (F31.9)
Disruptive Mood Dysregulation Disorder (F34.8)
Major Depressive Disorder Single episode (F32.xx)
Major Depressive Disorder, Recurrent episode (F33.xx)
Obsessive-Compulsive Disorder (F42)
Posttraumatic Stress Disorder (F43.10)
Anorexia Nervosa (F50.0
				  x)
Bulimia Nervosa (F50.2)
Postpartum Depression (F53.0)
Puerperal Psychosis (F53.1)
Factitious Disorder Imposed on another (F68.A)
And the individual must meet the criteria for either
				  treatment history or functional criteria as follows:
Treatment history covers the individual's lifetime treatment
				  and is restricted to treatment for the DSM-5 diagnosis specified in this
				  definition. To qualify under treatment history, the individual must meet at
				  least one of the following criteria:
Continuous treatment of six months or more, including
				  treatment during adolescence, in one, or a combination of, the following
				  modalities: inpatient treatment, day treatment or partial
				  hospitalization;
Six months continuous residence in residential programming
				  (e.g., long-term care facility or assisted, supported, or supervised
				  residential programs);
Two or more admissions of any duration to inpatient
				  treatment, day treatment, partial hospitalization, or residential programming
				  within a 12-month period;
A history of using psychotropic medication management, case
				  management, or outreach and engagement services over a one-year period, either
				  continuously or intermittently; or
Previous treatment in an outpatient modality, and a history
				  of at least one mental health psychiatric hospitalization.
Functional criteria have been purposely narrowed to
				  descriptors of the most serious levels of functional impairment and are not
				  intended to reflect the full range of possible impairment.) To qualify under
				  functional criteria, the individual must meet at least two of the following
				  conditions:
Has a serious impairment in social, occupational, or school
				  functioning;
Is unemployed or working only part-time due to mental illness
				  and not for reasons of physical disability or some other role responsibility
				  (e.g., student or primary caregiver for dependent family member); is employed
				  in a sheltered setting or supportive work situation; or has markedly limited
				  work skills;
Requires help to seek public financial assistance for
				  out-of-hospital maintenance (e.g., Medicaid, SSI, other indicators);
Does not seek appropriate supportive community services,
				  e.g., recreational, educational, or vocational support services, without
				  assistance;
Lacks supportive social systems in the community (e.g., no
				  intimate or confiding relationship with anyone in their personal life, no close
				  friends or group affiliations, is highly transient or has inability to co-exist
				  within a family setting);
Requires assistance in basic life and survival skills (e.g.,
				  must be reminded to take medication, must have transportation to mental health
				  clinic and other supportive services, needs assistance in self-care, household
				  management, food preparation or money management, is homeless or at risk of
				  becoming homeless); or
Exhibits inappropriate or dangerous social behavior that
				  results in demand for intervention by the mental health and/or judicial/legal
				  system.
If the individual does not currently meet the functional
				  criteria, but is currently receiving treatment and has a history within the
				  past five years of functional impairment meeting two of the functional criteria
				  that persisted for at least 12 months, and there is documentation supporting
				  the professional judgment that regression in functional impairment would occur
				  without continuing treatment, then the individual will be determined to have
				  met the functional criteria.
"Natural environment." A setting where an individual not
				  receiving HCBS typically spends time, including home, work, places of worship,
				  community centers, libraries, parks, recreation centers, educational settings,
				  or other public buildings. These sites are not licensed, certified, accredited
				  or identified as a provider.
"Natural supports." Unpaid assistance provided to an
				  individual with a developmental disability typically by a person who has some
				  type of friendship, kinship or other relationship (co-worker, member of the
				  same social group) with the individual, whom the individual accepts into their
				  life and with whom the individual has chosen to spend some duration of time and
				  not just a single action done out of courtesy.
"Neglect." See definition found in 59 Ill. Adm. Code
				  50.10.
"Notice of deficiency." A report submitted to a CILA agency
				  by the Department listing the CILA agency's deficiencies with this Part noted
				  during a survey.
"Personal Plan." A written document developed by an ISC
				  agency in conjunction with the individual and guardian as well as family
				  members, providers of services and others (e.g., friends or individual's
				  representatives) as chosen by the individual and guardian that includes an
				  assessment of the individual's strengths, preferences, needs, and desired
				  outcomes. The document contains the outcomes that the individual requires in
				  their life, describes what is important to the individual regarding delivery of
				  services in a manner which ensures both personal preferences and health and
				  welfare, including risk factors and means to minimize them. It includes the
				  services that are to be furnished to the individual, the amount and frequency
				  of each service, and the type of provider to furnish each service.
"Plan of correction." A written plan submitted by a CILA
				  agency to the Department, in response to a notice of deficiency, that describes
				  the steps the CILA agency will take in order to bring a program or services
				  into compliance, and the time-frames for completion of each step.
"Professional." An employee, contractual worker, or any other
				  person, compensated or in a volunteer capacity designated as a professional by
				  virtue of license, certification, or education. For the purpose of this Part,
				  Direct Support Professionals are not included in this definition.
"Provider." See definition of "CILA agency."
"Provider-owned or controlled." A physical setting in which
				  the individual resides that is:
owned, co-owned, leased or rented by an agency that provides
				  Home and Community-Based Services; or
owned, co-owned, leased or rented by a third party that has a
				  direct or indirect financial relationship with an agency that provides Home and
				  Community-Based Services.
"Provider Support Team." A team consisting of the QIDP and a
				  DSP; a nurse, or other professional staff (such as occupational therapist or
				  speech therapist) when necessary, and other staff as consistent with the
				  individual's Personal Plan and Implementation Strategy, all of whom directly
				  serve the individual.
"Psychotropics." Drugs used for antipsychotic,
				  antidepressant, antimanic and/or antianxiety purposes as listed in the American
				  Hospital Formulary Services (AHFS) Drug Information Manual (American Society of
				  Health-System Pharmacists, 7272 Wisconsin Avenue, Bethesda MD 20814 (2018))
				  (AGENCY NOTE: This document is published annually and updated quarterly.); the
				  Physician's Desk Reference (PDR) (Medical Economics Company, Five Paragon
				  Drive, Montvale NJ 07645-1742 (2017)) (AGENCY NOTE: This document is published
				  annually.); and the Drug Facts and Comparisons (Facts and Comparisons, 111 West
				  Port Plaza, Suite 300, St. Louis MO 63146-3098 (2017)) (AGENCY NOTE: This
				  document is published annually and updated monthly.).
"Qualified Intellectual Disabilities Professional" or "QIDP".
				  A QIDP must have at least one year of experience working directly with
				  individuals with intellectual disabilities or other developmental disabilities
				  and be one of the following (42 CFR 483.430) :
a doctor of medicine or osteopathy licensed pursuant to the
				  Medical Practice Act of 1987 [225 ILCS 60 ];
a registered professional nurse licensed pursuant to the
				  Nurse Practice Act [225 ILCS 65 ];
an occupational therapist or occupational therapist assistant
				  certified by the American Occupational Therapy Association or other comparable
				  body pursuant to the Illinois Occupational Therapy Practice Act [225 ILCS
				  75 ];
a physical therapist certified by the American Physical
				  Therapy Association or other comparable body pursuant to the Illinois Physical
				  Therapy Act [225 ILCS 90 ];
a physical therapist assistant registered by the American
				  Physical Therapy Association or a graduate of a two-year college-level program
				  approved by the American Physical Therapy Association or comparable
				  body;
a psychologist with at least a master's degree in psychology
				  from an accredited school pursuant to the Clinical Psychologist Licensing Act
				  [225 ILCS
				  15 ];
a social worker with a bachelor's degree from a college or
				  university or graduate degree from a school of social work accredited or
				  approved by the Council on Social Work Education or another comparable body,
				  pursuant to the Clinical Social Work and Social Work Practice Act
				  [225 ILCS
				  20 ];
a speech-language pathologist or audiologist with a
				  certificate of Clinical Competence in Speech-Language Pathology or Audiology
				  granted by the American Speech Language Hearing Association or comparable body
				  or meeting the education requirements for licensure and being in the process of
				  accumulating the supervised experience required for licensure pursuant to the
				  Illinois Speech-Language Pathology and Audiology Practice Act [225 ILCS
				  110 ];
a professional recreation staff person with a bachelor's
				  degree in recreation or in a specialty area such as art, dance, music, or
				  physical therapy;
a professional dietician registered by the American Dietetic
				  Association; or
a human services professional with a bachelor's degree in a
				  human services field, including but not limited to sociology, special
				  education, rehabilitation counseling and psychology.
"Quality assurance." A systematic and objective approach to
				  monitoring and evaluating the appropriateness, adequacy and quality of services
				  and supports that enable individuals with a developmental disability to achieve
				  defined outcomes in their lives.
"Quality assurance review." A BQM process to determine the
				  degree of compliance with quality assurance requirements in this Part that a
				  CILA agency has maintained. This can include reviewer observation and an
				  on-site, desk audit, remote or virtual form of examination of the following:
				  policies, procedures, records of individuals, written Personal Plan and
				  Implementation Strategies. Reviewers shall use an instrument containing
				  national indicators to interview individuals and employees. Observation of a
				  sample of individuals, drawn from across CILA sites statewide, is also a part
				  of the review.
"Relative." Spouse, parent, stepparent, son, daughter,
				  brother, sister, stepbrother, stepsister, half-brother, half-sister, uncle,
				  aunt, niece, nephew, first cousin, or any such person denoted by the prefix
				  "grand" or "great" or the spouse of any of the persons specified in this
				  definition.
"Relief." A paid service for caregivers that provides support
				  to individuals with developmental disabilities in host family living
				  arrangements. Relief services enable the caregivers to have free time apart
				  from the individuals with developmental disabilities.
"Remote Monitoring and Supports." The use of electronic
				  interactive technology (e.g., a device, a product, or system) to provide
				  supports and services, absent of direct care staff, in accordance with the
				  Health Care Affordability Act [305 ILCS 5/12-21.21 ]. Remote
				  monitoring and supports are meant to increase independence and daily living
				  skills of individuals.
"Residence." See "living arrangement."
"Respite." Services provided to individuals who are unable to
				  care for themselves, furnished on a short-term basis due to the absence of or
				  need for relief of those persons normally providing care.
"Restraint." The
direct restriction through
				  mechanical means or personal physical force of the limbs, head, or body
				  of
an individual except as part of a medically prescribed procedure
				  for the treatment of an existing physical disorder or the amelioration of a
				  physical disability.
The partial or total immobilization of an
				  individual for the purpose of performing a medical or surgical procedure shall
				  not constitute restraint
.
Momentary periods of physical
				  restriction by direct person-to-person contact, without the aid of material or
				  mechanical devices, accomplished with limited force, and that are designed to
				  prevent
an individual
from completing an act that would result
				  in potential physical harm to
the individual
or another shall
				  not constitute restraint, but shall be documented in the
individual's
				  record. [405 ILCS 5/1-125 ]
"Seclusion."
Sequestration by placement of
an individual
alone in a room from which he
or she
has
				  no means of leaving; seclusion is prohibited.
[405 ILCS
				  5/1-126 ]
"Secretary." The Secretary of the Department or their
				  designee.
"Self-administration of medications." An individual with a
				  developmental disability's ability to correctly take prescribed medications
				  independently or has been assessed and determined to be independent in
				  accordance with 59 Ill. Adm. Code 116.
"Substantial compliance." An evaluation result that
				  determines that a surveyed program meets the requirements set forth in this
				  Part sufficiently to be at a Level 1 or 2, as described in Section
				  115.440, and in good
				  standing.
"Support Services Team" or "SST". Contracted entities that
				  provide an interdisciplinary technical assistance and training response to
				  persons with a developmental disability in a medical or behavioral situation
				  that challenges their ability to live and thrive in the community.
"Survey" or "licensure and certification survey." A process
				  to determine the degree of compliance with this Part that a CILA agency has
				  maintained. This includes surveyor observation and an on-site, desk audit,
				  remote, or virtual examination of the following: policies, procedures, records
				  of individuals, written Personal Plan and Implementation Strategies, and the
				  physical plant. Interviews of individuals and employees and observation of a
				  sample of CILA sites are also a part of the survey.
"Tardive dyskinesia." An abnormal involuntary movement
				  disorder associated with the long-term use of antipsychotic medications. It may
				  be persistent or transient and is characterized by a variable mixture of
				  facial, ocular, oral, lingual, truncal or limb movements.
"Time-out." Contingent removal from a situation in which
				  reinforcement occurs into a situation from which reinforcement does not occur,
				  for a reasonable period of time; time-out is prohibited.
"Treatment."
An effort to accomplish an improvement
				  in the mental condition or related behavior of
an individual
.
				  Treatment includes, but is not limited to, hospitalization, partial
				  hospitalization, outpatient services, examination, diagnosis, evaluation, care,
				  training, psychotherapy, pharmaceuticals, and other services provided
				  for
individuals
by mental health agencies
or
				  psychiatric hospitals. [405 ILCS 5/1-128 ]
"Volunteer." An unpaid person whose activities (e.g., helping
				  with yardwork, assisting in recreational activities, teaching a cooking or yoga
				  class) are organized and supervised by the CILA agency to supplement the
				  services the CILA agency provides or other activities designated by the CILA
				  agency.
"Waiver." An action by the Department in which exceptions to
				  this Part are granted on application by a CILA agency for a period not to
				  exceed the duration of the current license. Waivers may be granted only for
				  that which is allowable under this Part.