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Tinder v. Illinois Dep't of Public Aid

February 24, 2004


[6] Appeal from the Circuit Court of the 14th Judicial Circuit Whiteside County, Illinois No. 01-MR-58 Honorable Dan A. Dunagan Judge, Presiding

[7] The opinion of the court was delivered by: Justice Lytton

[8]  Plaintiff applied to the Illinois Department of Human Services for admission into a Community Integrated Living Arrangement (CILA), a residential program seeking to habilitate the developmentally disabled. The IDHS denied the application and the trial court affirmed the denial. We reverse.

[9]  Plaintiff, Bradley Tinder, is 29 years old. He has suffered from cerebral palsy since birth, and although his IQ is low, he does not suffer from mental retardation. In 1995, he graduated from the Illinois Center for Rehabilitation and Education, a special state school serving the physically disabled and operated by the Illinois Department of Human Services (IDHS). After his graduation, plaintiff was placed in a CILA. CILA provides Medicaid-eligible developmentally disabled persons an opportunity to live in a community setting, often in a single family residence with other participants. The program provides "active treatment," or "habilitation" which may include training and education in cooking, home management, budgeting, and other day to day skills. The program also provides counseling, physical and occupational therapy, and community outings and social events. The objective of the CILA program is to promote optimal independence for persons with developmental disabilities in daily living and economic self-sufficiency in small group settings.

[10]   Plaintiff voluntarily moved from the CILA in 1997, and took residence in an intermediate care facility for the developmentally disabled. He stayed there for two years and then moved to a supervised apartment complex which serves disabled individuals. Plaintiff experienced serious problems while living at the apartment complex and was hospitalized in 1999 with a severe case of bowel impaction. After being discharged from the hospital, plaintiff moved to a nursing home for convalescent care. Later, he transferred to Sterling Pavilion, a general population nursing home where he currently resides.

[11]   In 1999, plaintiff began a long application process seeking placement in a CILA program. The IDHS rejected plaintiff's application finding that he was not "developmentally disabled" and would not benefit from "active treatment." Plaintiff appealed to the Illinois Department of Public Aid (IDPA) and after an administrative hearing, the IDPA upheld the IDHS' denial of the Medicaid waiver for CILA funding. In its administrative decision, the IDPA found that plaintiff was not developmentally disabled. Plaintiff filed a complaint for administrative review in the circuit court. The court upheld the IDPA's determination.

[12]   I. Standard of Review

[13]   In reviewing a final decision under administrative review law, we review the agency's finding, not the circuit court's determination. Metropolitan Airport Authority v. Property Tax Appeal Board, 307 Ill. App. 3d 52, 55 (1999). An agency's findings of fact will be disturbed only if they are against the manifest weight of the evidence. Abrahamson v. Illinois Department of Professional Regulation, 153 Ill. 2d 76, 88 (1992). Questions of law, however, are not entitled to deference and are reviewed de novo. Envirite Corp. v. Illinois Environmental Protection Agency, 158 Ill. 2d 210, 214 (1994).

[14]   II. Developmental Disability

[15]   The IDPA argues that its regulation requires that a developmentally disabled individual exhibit significant cognitive defects in order to be a candidate for active treatment. Further, since active treatment results in enhanced skills and self-reliant behavior, and since plaintiff's limitations are totally physical and cannot be overcome by learned behavior, he is not a candidate for active treatment.

[16]   We disagree and find that neither the statute nor the regulations promulgated under it require an applicant to qualify for active treatment. The state statutory and regulatory scheme defines developmental disability, and explicitly includes, without qualification, those suffering from cerebral palsy.

[17]   A. The IDPA's Regulation

[18]   Under the IDPA's regulation, individuals qualify as developmentally disabled if they have a disability that:

is attributable to a diagnosis of mental retardation (mild, moderate, severe, profound, unspecified), or a related condition. A related condition means the individual has been diagnosed as having infantile autism, infantile cerebral palsy or epilepsy, and this condition is manifested before the age of 22; is likely to continue indefinitely; and results in ...

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