20 ILCS 505/7.30: Protecting access to lawful health care for youth placed outside the State of Illinois.

(a) Findings. The General Assembly finds and declares that:

(1) Youth in the care of the Department remain subject to the jurisdiction of Illinois courts regardless of placement location.

(2) Access to medically appropriate health care is essential to youth safety and well-being. Denial or delay of medically appropriate health care may result in serious physical and mental health consequences.

(3) The Department has a continuing obligation to act in the best interests of youth, including ensuring access to lawful, medically appropriate health care permitted under Illinois law, and protection from being forced to receive care that has been prohibited under Illinois law.

(4) It is the policy of this State to ensure that all youth in the care of the Department receive the full measure of protections, rights, and services guaranteed under Illinois law, regardless of where the youth is placed by the Department.

(5) The General Assembly intends to protect the rights of youth placed by the Department outside the State of Illinois and require the Department to take affirmative steps to protect these youth when they are the subjects of a pending case under the Juvenile Court Act of 1987.

(b) Definitions. As used in this Section:

"Coordination of lawful health care" means activities related to arranging, referring, facilitating access to, monitoring, or advocating for health care services, including mental health care, that is lawful in the State of Illinois. This includes communications necessary to effectuate such services, for youth placed outside the State of Illinois.

"Interstate placement" means the placement of a youth in a relative home, foster home, residential facility, or other placement located outside this State, including placements made in accordance with the Interstate Compact on the Placement of Children. It does not include living arrangements involving youth returning to, or remaining in, the custody of a parent out-of-state.

"Protected characteristic" has the meaning ascribed to that term in subsection (b) of Section 7.29.

"Risk of adverse action" means a loss of a protection available under Illinois law that would otherwise be available to a youth if not for the placement of a youth outside the physical boundaries of the State of Illinois that can be reasonably predicted to have the effect of one or more of the following: exposing a youth or a youth's caregiver to criminal prosecution under the laws of another state related to the youth procuring or receiving health care, including mental health care, that is lawful in the State of Illinois; depriving a youth of access to health care, including mental health care, that is lawful in the State of Illinois; subjecting a youth to mental health care in another state that involves "sexual orientation change efforts"; denying a youth the authority to consent to health care that the youth would otherwise be permitted to consent to if the youth were in the State of Illinois; or depriving a youth of the ability to maintain the privacy of the youth's health care records that the youth would otherwise be permitted to deny a parent's or guardian's access to if the youth were participating in health care services in Illinois.

"Sexual orientation change efforts" means any mental health practices or treatments that seek to change an individual's sexual orientation, as defined by subsection (O-1) of Section 1-103 of the Illinois Human Rights Act, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex. "Sexual orientation change efforts" does not include counseling or mental health services that provide acceptance, support, and understanding of a person without seeking to change sexual orientation or mental health services that facilitate a person's coping, social support, and gender identity exploration and development, including sexual orientation neutral interventions to prevent or address unlawful conduct or unsafe sexual practices, without seeking to change sexual orientation.

"Youth" has the meaning ascribed to that term in subsection (b) of Section 4e.

(c) The Department shall not determine that an interstate placement of youth age 8 and older is in a youth's best interests if:

(1) the interstate placement exposes a youth to risk of adverse action, in light of the youth's specific circumstances;

(2) the risk of adverse action cannot be sufficiently and effectively mitigated, as determined by the Department; and

(3) the youth does not affirmatively express support for being placed or remaining placed in that interstate placement.

The Department shall document the youth's preference regarding being placed in or remaining in an interstate placement using age-appropriate and developmentally appropriate methods, including, but not limited to: interviews, written statements, structured surveys, clinical evaluations and consultations, drawings, or guided play.

After affirmatively expressing the youth's preference for being placed or remaining placed in the interstate placement, the youth maintains the right to withdraw support or opposition at any time and the Department has an ongoing obligation to monitor whether the youth continues or withdraws support. The Department shall inform the youth of that right and provide the youth simple options for the youth to communicate withdrawal of support or opposition to the Department. If a youth does not affirmatively express support for being placed in or remaining placed in an interstate placement that would expose the youth to unmitigated risk of adverse action, as determined by the Department, the Department shall not determine it is in a youth's best interest to be placed or remain placed in the interstate placement and the Department shall decline to place or maintain placement based on unmitigated risk of adverse action, as determined by the Department. The Department shall not disclose a youth's lack of support for a placement that exposes the youth to unmitigated risk of adverse action to the prospective or current interstate placement.

(d) Individualized placement assessment for interstate placements.

(1) Prior to interstate placement of a youth age 8 or older outside the State of Illinois, the Department shall conduct an individualized assessment of the suitability and risks of adverse action posed by the proposed placement for the specific youth. If the interstate placement of a youth age 8 or older on and after January 1, 2028, occurred before January 1, 2028 and that youth remains in the Department's care on and after February 1, 2028, the Department shall complete this initial assessment on or before February 1, 2028 and begin monitoring and reassessment of suitability and risk of adverse action as provided under this Section while the youth remains in an interstate placement. If a youth is placed in an interstate placement before turning age 8 and the youth remains in the custody of the Department, the Department shall commence this initial assessment within 30 days of the youth reaching age 8 and begin monitoring and reassessment of suitability and risk of adverse action as provided under this Section while the youth remains in that placement. Assessments required under this Section shall consider, as appropriate:

(A) the youth's age, development, and expressed preferences;

(B) the youth's physical, mental, reproductive, and sexual health needs, including reasonably foreseeable needs that may arise during the placement;

(C) whether the laws and regulations in the placement jurisdiction may limit or interfere with access to care or services that would be lawful under Illinois law, including, but not limited to, reproductive health care as defined in Section 1-10 of the Reproductive Health Act, lawful health care as defined in Section 28-10 of the Lawful Health Care Activity Act, a youth's authority to consent to care under Sections 1, 3, 4, and 5 of the Consent by Minors to Health Care Services Act, the privacy protections afforded to youth under the Mental Health and Developmental Disabilities Confidentiality Act, birth control services and information available to youth under the Birth Control Services to Minors Act, and the ability of youth to request and receive outpatient counseling services and psychotherapy under the Mental Health and Developmental Disabilities Code;

(D) the youth's vulnerability to discrimination, retaliation, or harm based on the youth's protected characteristics or other individualized factors;

(E) whether the Department's plan to mitigate any risk of adverse action is sufficient to meet the youth's needs, which may include plans to arrange equivalent protections or access to relevant health care through contractual obligations and supplemental services or by ensuring the youth's safe return to the State of Illinois to access care; and

(F) the youth's best interest, taking into account the factors listed in subsection (4.05) of Section 1-3 of the Juvenile Court Act of 1987.

The Department shall document the assessment in the youth-specific record, including the basis for the placement, the Department's determination that the placement is or is not in the youth's best interest, the assessment of protections available, risk of adverse action, and the specific actions taken or to be taken, if any, including protective measures to mitigate against any risk of adverse action, as determined by the Department, and report this information to the court as required under Sections 2-27.2, 2-27.4, and 2-28 of the Juvenile Court Act of 1987, in a manner consistent with Department policy regarding documentation of sensitive identity information. If the Department places the youth age 8 or older out-of-state, the Department shall continue to report this information to the court at permanency hearings as part of the Department's required efforts under Section 2-28 of the Juvenile Court Act of 1987, in a manner consistent with Department policy regarding documentation of sensitive identity information. If the Department places a youth under age 8 out-of-state, the Department shall begin to report this information to the court as part of the Department's required efforts under Sections 2-27.2 and 2-27.4 and at permanency hearings under Section 2-28 of the Juvenile Court Act of 1987, in a manner consistent with Department policy regarding documentation of sensitive identity information, when the youth reaches the age of 8.

The Department shall provide the youth's attorney or guardian ad litem appointed under the Juvenile Court Act of 1987 with a copy of the assessment within 10 days of the assessment being finalized. If the Department plans to move the youth to the interstate placement within 10 days after the finalization of the assessment, the Department shall provide the copy of the assessment to the youth's attorney or guardian ad litem immediately upon completion.

(2) If the initial placement assessment for a youth age 8 or older finds that the placement poses risk of adverse action relevant to the youth's specific circumstances and that risk cannot be sufficiently and effectively mitigated for this youth's circumstances, as determined by the Department, the Department shall not place a youth age 8 or older in an interstate placement unless the Department: (i) determines that the placement is in the youth's best interest, (ii) documents that the youth affirmatively expresses support for the placement, as required by this Section, (iii) the youth has been advised of the diminished protections available and the risk of action these diminished protections pose in light of the youth's specific circumstances, and (iv) the youth has been provided the opportunity to consult with the attorney appointed to represent the youth under the Juvenile Court Act of 1987. The Department shall inform the youth that the youth has the right to express or withhold support for placement in these circumstances. If a youth who is affirmatively expressing support for placement despite the unmitigated risk of adverse action is not already represented by an attorney, the Department shall notify the court hearing the youth's case in accordance with the Juvenile Court Act of 1987 that an attorney for the youth should be appointed in accordance with subsection (a-5) of Section 2-27.2 or subsection (c) of Section 2-27.4 of the Juvenile Court Act of 1987. The Department shall provide notice to the court in a manner consistent with Department policy regarding documentation of sensitive identity information.

(3) If a youth was under age 8 at the time of interstate placement and the initial placement assessment required under this subsection for youth reaching the age 8 after interstate placement finds that the jurisdiction in which the youth is placed poses a risk of adverse action relevant to the youth's specific circumstances and that risk of adverse action cannot be sufficiently and effectively mitigated for the youth's circumstances, as determined by the Department, the Department must confirm whether the youth affirmatively expresses support for remaining in the interstate placement. The Department shall inform the youth that the youth has the right to express or withhold support for the placement in these circumstances.

If the youth indicates that the youth does not support remaining in the interstate placement because there is unmitigated risk of adverse action in light of the youth's specific circumstances, the Department shall intervene by returning the youth to Illinois or identifying alternative placement options that comport with the requirements of this Section, consistent with the youth's best interests.

If, in responding to the Department's inquiry, the youth affirmatively expresses support for remaining in the interstate placement despite the unmitigated risk of adverse action the diminished protections pose in light of the youth's specific circumstances, the Department shall not maintain this interstate placement unless: (i) the Department determines that the placement is in the youth's best interest, (ii) the Department documents that the youth affirmatively expresses support for the placement, as required by this Section, (iii) the youth has been advised of the diminished protections available and the risk of adverse action these diminished protections pose in light of the youth's specific circumstances, and (iv) the youth has been provided the opportunity to consult with the attorney appointed to represent the youth under the Juvenile Court Act of 1987. If that youth is not already represented by an attorney, the Department shall notify the court hearing the youth's case in accordance with the Juvenile Court Act of 1987 that an attorney for the youth should be appointed in accordance with subsection (a-5) of Section 2-27.2 or subsection (c) of Section 2-27.4 of the Juvenile Court Act of 1987. The Department shall provide notice to the court in a manner consistent with Department policy regarding documentation of sensitive identity information.

Following the Department's determination that the risk of adverse action cannot be sufficiently and effectively mitigated, the Department shall immediately notify the attorney appointed to represent the youth under the Juvenile Court Act of 1987 when the Department is considering action under this paragraph to allow the youth's attorney to consult with the youth.

(4) Nothing in this subsection requires court approval prior to interstate placement unless otherwise required by law.

(e) Ongoing duty for Illinois-based caseworker contact to monitor risk of adverse action.

(1) For any youth age 8 or older placed outside the State of Illinois, the Department shall ensure that an Illinois-based caseworker maintains regular and meaningful contact with the youth for the purpose of monitoring and reassessing safety, well-being, access to medically appropriate care, and risk of adverse action in light of the youth's specific circumstances. At a minimum, such contact shall include:

(A) direct communication, in person or via videoconferencing, with the youth at intervals consistent with Department policy, but not less frequently than once per month in a manner that permits the youth to speak freely, without the undue influence of others and outside the presence of the caregiver, about the youth's needs and concerns related to health, safety, and well-being;

(B) in person visits at intervals consistent with Department policy based on the youth's placement type and level of need but not less than twice a year for approved foster placements and relative caregivers and not less than quarterly for residential or qualified residential treatment program placements, completed by Department-designated qualified staff;

(C) monitoring whether the youth's placement is complying with the Department's plan to ensure the youth is receiving care that meets or exceeds Illinois standards for safety, well-being, permanency planning, and the provision of, and access to, health care;

(D) identifying emerging or reasonably foreseeable health care needs, including reproductive and sexual health needs, in light of the youth's age, development, and specific circumstances; and

(E) reassessing whether the placement continues to meet the youth's needs, in light of any changes in the youth's circumstances, and revising efforts to mitigate risk of adverse action, as necessary, to ensure the youth's interests are protected and needs are being met. Caseworker contact required under this subsection shall be documented in the case record and reported to the court at permanency hearings as required under Section 2-28 of the Juvenile Court Act of 1987, in a manner consistent with Department policy regarding documentation of sensitive identity information.

(2) The ongoing monitoring and reassessment required under this subsection shall recognize that a youth's health care needs may change over time and shall not be limited to conditions or needs identified at the time of placement. The Department shall document such reassessments in the youth-specific record and include the reassessments in the youth's service plan, in a manner consistent with Department policy regarding documentation of sensitive identity information.

(3) The Department shall also confirm whether a youth affirmatively supports remaining in the interstate placement if either the:

(A) Department's ongoing monitoring and reassessment required under this subsection finds that the interstate placement poses risk of adverse action relevant to the youth's specific circumstances and that risk of adverse action cannot be sufficiently and effectively mitigated for the youth's specific circumstances, as determined by the Department, while the youth remains in the interstate placement, as required under this Section; or

(B) Department learns of a denial, delay, or material interference with health care approved by the Department, ordered by an Illinois court, or consented to by the youth as permitted by Illinois law providing youth the authority to consent.

The Department shall inform the youth that the youth has the right to express or withhold support for the placement in these circumstances. If the youth does not affirmatively express support for remaining in the interstate placement, the Department shall intervene by returning the youth to Illinois or identifying alternative placement options that comport with the requirements of this Section, consistent with the youth's best interests.

If, in responding to the Department's inquiry, the youth affirmatively expresses support for remaining in that interstate placement despite unmitigated risk of adverse action the diminished protections pose in light of the youth's specific circumstances, the Department shall not maintain this interstate placement unless: (i) the Department determines it is in the youth's best interest, (ii) the Department documents that the youth affirmatively expresses support for the placement, as required by this Section, (iii) the youth has been advised of the diminished protections available and the risk of adverse action these diminished protections pose in light of the youth's specific circumstances, and (iv) the youth has been provided the opportunity to consult with the attorney appointed to represent the youth under the Juvenile Court Act of 1987.

If this youth is not already represented by an attorney, the Department shall notify the court hearing the youth's case in accordance with the Juvenile Court Act of 1987 that an attorney for the youth should be appointed in accordance with subsection (a-5) of Section 2-27.2 or subsection (c) of Section 2-27.4 of the Juvenile Court Act of 1987. The Department shall provide notice to the court in a manner consistent with Department policy regarding documentation of sensitive identity information.

Following the Department's determination that risk of adverse action cannot be sufficiently and effectively mitigated, the Department shall immediately notify the attorney appointed to represent the youth under the Juvenile Court Act of 1987 with sufficient notice to allow the youth's attorney to consult with the youth.

(4) Ongoing reassessment under this subsection does not require the completion of an assessment form; instead, the Department's analysis and any revisions to the initial assessment may be documented in the format of a case note.

(f) Protection of Department employees and service providers. No employee of the Department or a service provider responsible for coordination of lawful health care shall be subject to discipline, retaliation, adverse employment action, civil liability, or criminal liability solely for the coordination of lawful health care for a youth in an interstate placement, when such coordination is undertaken in good faith and within the scope of the employee's or service provider's official duties in accordance with Sections 7.29 and 7.30.

To the fullest extent State and federal law permit, the Department shall not cooperate with or provide assistance to any out-of-state investigation, enforcement action, subpoena, or request that seeks to impose civil, criminal, or professional penalties on an employee or service provider based solely on the coordination of lawful health care.

(g) Enforcement. Failure to comply with this Section constitutes grounds for the Department to deny or terminate placement or take licensing action, corrective action, or other remedial action authorized by law. A known, alleged, or suspected violation of a statutory requirement in this Section constitutes a significant event and requires a significant event report by the Department as defined in Section 35.1 of this Act and paragraph (14.2) of Section 1-3 of the Juvenile Court Act of 1987.

(h) The Department retains authority, as guardian, to consent to and authorize health care for youth in accordance with Illinois law and applicable court orders. This authority applies regardless of the youth's physical location, including when a youth is placed in a residential, hospital, or other interstate placement setting, unless a court of competent jurisdiction grants such authority to another guardian or parent.

(i) The requirements of this Section apply to all interstate placements of youth age 8 and older.

(j) Construction.

(1) Nothing in this Section shall be construed to:

(A) provide immunity for any act or omission unrelated to the coordination of lawful health care;

(B) require any person or entity to violate the laws of another state;

(C) authorize conduct that is not otherwise lawful under Illinois law;

(D) regulate the practice of medicine in another state;

(E) limit the authority of Illinois courts over youth for whom the Department retains legal custody;

(F) require another state to permit or provide health care services; or

(G) protect conduct that constitutes willful misconduct or gross negligence under Illinois law.

(2) Nothing in this Section shall be construed to limit or diminish: (i) the rights of a youth to be free from discrimination or to receive care consistent with the protections guaranteed under State and federal law; (ii) the Department's obligation to comply with subsection (o) of Section 5 of this Act or rules and procedures developed in accordance with that subsection (o), Section 2-27.2 and subsection (2.5) of Section 2-28 of the Juvenile Court Act of 1987, and applicable provisions of the Interstate Compact on the Placement of Children; or (iii) the Department's obligation to act in the youth's best interests.

(3) This Section shall be construed broadly to promote the safety, well-being, best interest, and equitable treatment of youth, consistent with the State's compelling interest in protecting youth.

(k) If any provision of this Section or its application to any person or circumstance is held invalid, the invalidity of that provision or application does not affect other provisions or applications of this Section that can be given effect without the invalid provision or application.

(l) The provisions of this Section apply on and after January 1, 2028.