Disabilities Guidebook: Community Integrated Living Arrangements

Disabilities Guidebook: Community Integrated Living Arrangements

Last updated: August 2013

Chapter 10 Section 6 from Guidebook of Laws and Programs for People with Disabilities)

The Community Integrated Living Arrangements Licensure Act

What Is It? This is an Illinois law which establishes minimum standards that must be met by programs that provide supported living arrangements for adults with a mental illness or a developmental disability.

What Is Its Purpose? To make sure that people participating in these programs receive appropriate care and services to develop independent living skills.

Who Can Benefit? Persons residing in a Community Integrated Living Arrangement (CILA).

I. Your Legal Rights

Types of CILA Living Arrangements

In General
The Community Integrated Living Arrangement Licensure Act (Act) is an Illinois law which establishes standards that must be met by Community Integrated Living Arrangement (CILA) programs. A CILA serves adults with a mental or developmental disability. The Act requires CILA programs to meet certain requirements so that participants have safe and stable housing arrangements. The Act also requires CILA programs to provide services to assist participants in achieving independence in daily living and economic self-sufficiency.

The Illinois Department of Human Services (IDHS) is the state agency given the authority to enforce these standards. Under the Act, a community mental health or developmental services organization may obtain a license from IDHS to operate a CILA program.

What is a "Community Integrated Living Arrangement"?

A Community Integrated Living Arrangement (CILA) is a living arrangement in which 8 or fewer people with a mental illness or a developmental disability reside together in a supervised home environment.

A CILA may provide different levels of supervision and support, depending on the needs of the residents. The following are some examples of CILA living arrangements:

1. Adult Foster Care. The participant lives in the home of a family to whom he is not related.

2. 24 Hour Care. A group of participants live together in a facility, with constant, on-site supervision.

3. Intermittent Care. A group of participants live together in a facility, with intermittent on-site supervision.

A CILA participant also can remain living in the home of his natural family. In this case, the CILA program does not provide housing, but will provide other services to assist the participant in achieving independence in daily living and economic self-sufficiency

Eligibility to Participate in a CILA

In order to be eligible to participate in a CILA program, you must:

  • Be at least 18 years of age, and
  • Have a mental or developmental disability, and
  • Be in need of an array of services and a supervised living arrangement.

In addition, you or your guardian must agree to help develop and implement your individual integrated services plan. Participation in a CILA is voluntary; you or your guardian must give your consent to participate in all aspects of the CILA program.

In addition to assisting you with safe and stable community integrated housing, a CILA also must help you make progress toward the goal of self-sufficiency and economic independence. The CILA program should provide assistance with the following, depending on your individual needs:

  • Locating and obtaining education or vocational training, or employment;
  • Obtaining necessary medical attention and rehabilitation services or therapy;
  • Developing independent living skills, such as bathing, housekeeping, cooking, and shopping;
  • Developing money management skills;
  • Meeting transportation needs;
  • Locating and participating in leisure, recreation, religion and social activities.

Individual Integrated Services Plan
So that you receive the services you need, the program must develop an individual integrated services plan.

The individual integrated services plan is a written plan which includes:

  • An assessment of your strengths and needs;
  • A description of the services you need;
  • Your role and that of your guardian, significant others and family in implementing the plan;
  • A timetable for reaching your goals; and
  • The name of the person(s) responsible for providing and supervising the services called for by the plan.

Developing Individual Integrated Services Plan
In order to determine the services you will need, the CILA program first will perform a thorough assessment. This will include a medical and dental exam, an evaluation of your mental condition, an evaluation of your education and work experience, and an evaluation of your ability to independently perform daily activities.

After the evaluations are performed, the mental health and/or developmental disability professionals working with the CILA program develop the service plan. You, your parent or guardian, or other persons close to you, are entitled to be involved in the process of developing the plan. The CILA must complete the service plan within 30 days after you enter the CILA program. The program must re-evaluate the service plan every 6 months for participants with mental illness, and annually for persons with a developmental disability.

How To Find and Get Into a CILA Program
You can locate CILA programs and other supported living arrangements in your area by contacting the Center for Independent Living (CIL) serving your area. You also can contact the Illinois Department of Human Services. A Center for Independent Living is a not-for-profit program that assists people with disabilities in locating and obtaining a wide array of independent living services. For more detailed information about CILs, see the section in this Chapter titled Independent Living Services.

Your Rights As a CILA Participant

The Mental Health and Developmental Disability Code (MHDD Code) protects the rights of persons participating in CILA programs. For a detailed discussion of your rights under the MHDD Code, see the section of this guidebook titled "Rights of Recipients of Mental Health and Developmental Disability Services" in Chapter 12, Institutional Care.

The CILA Act further provides that a program should never impose seclusion on a CILA participant. Seclusion means the placement of a person alone in a room from which he or she has no means of leaving.

II. How to Protect or Enforce Your Rights

Appeals to the Illinois Department of Healthcare and Family Services In many cases, the services you receive from a CILA may be funded by Medicaid, under a program called the Medicaid Home and Community Based Services Waiver Program. If you are applying for or receiving CILA services covered by Medicaid under the Waiver Program, you have the right to appeal to the Illinois Department of Healthcare and Family Services (HFS) if:

  • you are notified that you are not eligible for the Medicaid Waiver Program; or
  • you are notified that the Waiver funded CILA services you receive will be reduced, suspended, or terminated.

You are entitled to receive a written notice informing you of any decision to deny, reduce, suspend, or terminate your Waiver funded services, and informing you of the right to file an appeal. You must file the appeal within 60 days of the date of the notice. If you file your appeal within 10 days of the date of the notice, your services should not be suspended or reduced while the appeal process is ongoing. The appeal must be filed in writing and sent to:

Illinois Department of Healthcare and Family Services
Bureau of Administrative Hearings
401 S. Clinton Avenue, 6th Floor
Chicago, IL 60607
(312) 793-2658

Upon receiving your appeal, the Department of Healthcare and Family Services will schedule a "fair hearing," which will be held in HFS office nearest your home. At the hearing you will have the opportunity to present your case before a hearing officer, and HFS will then issue a written decision. At the hearing, you have the following rights:

  • To be represented by a lawyer, a friend or relative;
  • To present the testimony of witnesses;
  • To present documents supporting your case.

Review by a Court
If the hearing officer rules against you, you may file a lawsuit in the Illinois Circuit Court. You must file any such lawsuit no later than 35 days from the date that the decision was sent to you.

You or your lawyer will have the opportunity to make written and oral arguments in support of your case. The judge will then decide whether HFS and the hearing officer fairly considered the facts and properly applied the law. The judge can approve your claim, deny your claim, or remand your case to the HFS to be reevaluated in accordance with the judge's instructions.

Complaints to Department of Human Services
The Illinois Department of Human Services (IDHS) is the state agency which enforces the Community Integrated Living Arrangements Licensure Act.

If you believe that a facility is violating the Act, you may file a complaint with IDHS, at:

Illinois Dept. of Human Services
Bureau of Accreditation, Licensure and Certification
401 N. 4th Street
Springfield, IL 62701-1402
(217) 557-9282
or
160 N. LaSalle, Suite N-700
Chicago, IL 60601
(312) 814-4951

To file a complaint concerning physical abuse, call the Abuse Hotline at (800) 368-1463.

Upon receiving your complaint, IDHS will conduct an investigation. If the investigation shows that the CILA is in violation of the Act, IDHS will send a notice of the violation to the CILA. IDHS will notify you of the results of their investigation if you make a written request.

If the facility fails or refuses to correct the violation, IDHS may suspend their funding or close down individual sites. In extreme cases, IDHS also can revoke the program's license and force them to shut down.

IDHS will not reveal your identity without your written permission, unless IDHS needs to file a court case. The facility cannot transfer, discharge, evict, harass, or retaliate against you because you made a complaint or gave information in an IDHS investigation.

Appeals to the CILA Program
In addition to filing a complaint with IDHS, you or your guardian can present grievances directly to the CILA provider agency. The CILA program must establish and inform you of their procedures by which you may file a grievance. The grievance process must allow you to obtain a final decision from the person in charge of the provider agency that operates the CILA program.

Court Review
If you are not satisfied with the final decision made on your appeal by the CILA program, you may file a complaint in Illinois Circuit Court. You must file this lawsuit no later than 35 days from the date that the final decision was made.

You or your lawyer will have the opportunity to make written and oral arguments in support of your case. The judge will then decide whether the program fairly considered the facts and properly applied the law. The judge can approve your appeal, deny your appeal, or remand your case to the program to be reevaluated in accordance with the judge's instructions.

III. Where to Go for More Information

Statutes and Regulations
The Community Integrated Living Arrangements Licensure Act is found at 210 ILCS 135/1.

The regulations which establish the specific standards which Community Living Facilities must meet are found at 59 Ill.Admin.Code Part 115.

The portion of the regulations concerning residents rights and appeals is found at 59 Ill.Admin.Code 115.250.

The regulations concerning the Medicaid Home and Community Based Services Waiver Program are found at 59 Ill.Admin.Code Part 120.

The regulations concerning the Medicaid appeals process are found at 89 Ill.Admin.Code Part 104.

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