Section 415.70 Involuntary
Administration of Psychotropic Medication
a) Administration of Psychotropic Medication
1) Psychotropic medication shall not be administered to any offender
against his or her will or without the consent of the parent or guardian of a
minor who is under the age of 18, unless:
A) A psychiatrist, or in the absence of a psychiatrist a
physician, has determined that:
i) The offender suffers from a mental illness or mental
disorder; and
ii) The medication is in the medical interest of the offender;
and
iii) The offender is either gravely disabled or poses a likelihood
of serious harm to self or others; and
B) The administration of such medication has been approved by the
Treatment Review Committee after a hearing (see subsection (b) of this
Section). However, no such approval or hearing shall be required when the
medication is administered in an emergency situation. An emergency situation
exists whenever the required determinations listed in subsection (a)(1)(A) of
this Section have been made and a psychiatrist, or in the absence of a
psychiatrist a physician, has determined that the offender poses an imminent
threat of serious physical harm to self or others. In all emergency
situations, the procedures set forth in subsection (e) of this Section shall be
followed.
2) Whenever a physician orders the administration of psychotropic
medication to an offender against the person's will, the physician shall document
in the offender's medical file the facts and underlying reasons supporting the
determination that the standards in subsection (a)(1) of this Section have been
met and:
A) The Chief Administrative Officer shall be notified as soon as
practicable; and
B) Unless the medication was administered in an emergency
situation, the Chairperson of the Treatment Review Committee shall be notified
in writing within three days.
b) Treatment Review Committee Procedures
The Treatment
Review Committee shall be comprised of two members appointed by the Chief
Administrative Officer, both of whom shall be mental health professionals and
one of whom shall be a physician. One member shall serve as Chairperson of the
Committee. Neither of the Committee members may be involved in the current
decision to order the medication. The members of the Committee shall have
completed a training program in the procedural and mental health issues involved
that has been approved by the Agency Medical Director.
1) The Chief Administrative Officer shall designate a member of
the program staff not involved in the current decision to order medication to
assist the offender. The staff assistant shall have completed a training
program in the procedural and mental health issues involved that has been
approved by the Agency Medical Director.
2) The offender and staff assistant shall receive written
notification of the time and place of the hearing at least 24 hours prior to
the hearing. The notification shall include the tentative diagnosis and the
reasons why the medical staff believes the medication is necessary. The staff
assistant shall meet with the offender prior to the hearing to discuss the
procedural and mental health issues involved.
3) The offender shall have the right to attend the hearing unless
the Committee determines that it is likely that the person's attendance would
subject the person to substantial risk of serious physical or emotional harm or
pose a threat to the safety of others. If such a determination is made, the
facts and underlying reasons supporting the determination shall be documented
in the offender's medical file. The staff assistant shall appear at the
hearing whether or not the offender appears.
4) The documentation in the medical file referred to in
subsection (a)(2) of this Section shall be reviewed by the Committee and the
Committee may request the physician's personal appearance at the hearing.
5) Prior to the hearing, witnesses identified by the offender and
the staff assistant may be interviewed by the staff assistant after
consultation with the offender as to appropriate questions to ask. Any such
questions shall be asked by the staff assistant unless cumulative, irrelevant,
or a threat to the safety of individuals or the security of the facility.
6) Prior to the hearing, the offender and the staff assistant may
request in writing that witnesses be interviewed by the Committee and may
submit written questions for witnesses to the Chairperson of the Committee.
These questions shall be asked by the Committee unless cumulative, irrelevant,
or a threat to the safety of individuals or the security of the facility. If
any witness is not interviewed, a written reason shall be provided.
7) Prior to the hearing, the offender and the staff assistant may
request in writing that witnesses appear at the hearing. Any such request
shall include an explanation of what the witnesses would state. Reasonable
efforts shall be made to have such witnesses present at the hearing, unless
their testimony or presence would be cumulative, irrelevant, or a threat to the
safety of individuals or the security of the facility, or for other reasons
including, but not limited to, unavailability of the witness or matters
relating to institutional order. In the event requested witnesses are
unavailable to appear at the hearing but are otherwise available, they shall be
interviewed by the Committee as provided for in subsections (b)(6) and (9) of
this Section.
8) At the hearing, the offender and the staff assistant may make
statements and present documents that are relevant to the proceedings. The
staff assistant may direct relevant questions to any witnesses appearing at the
hearing. The offender may request that the staff assistant direct relevant
questions to any witnesses appearing at the hearing and the staff assistant
shall ask such questions unless cumulative, irrelevant, or a threat to the
safety of individuals or the security of the facility.
9) The Committee shall make such investigation as it deems
necessary. The staff assistant shall be informed of any investigation
conducted by the Committee and shall be permitted to direct relevant questions
to any witnesses interviewed by the Committee. The staff assistant shall
consult with the offender regarding any statements made by witnesses
interviewed by the Committee and shall comply with requests by the offender to
direct relevant questions to such witnesses unless cumulative, irrelevant, or a
threat to the safety of individuals or the security of the facility.
10) The Committee shall consider all relevant information and
material that has been presented in deciding whether to approve administration
of the medication.
11) A written decision shall be prepared and signed by all
members of the Committee that contains a summary of the hearing and the reasons
for approving or disapproving the administration of the medication. Copies of
the decision shall be given to the offender, the staff assistant, and the Chief
Administrative Officer. Any decision by the Committee to approve involuntary
administration of psychotropic medication must be unanimous. The Chief
Administrative Officer shall direct staff to comply with the decision of the
Committee.
12) If the Committee approves administration of the medication,
the offender shall be advised of the opportunity to appeal the decision to the
Agency Medical Director by filing a written appeal with the Chairperson within
five days after the offender's receipt of the written decision.
c) Review by Agency Medical Director
1) If the offender appeals the Treatment Review Committee's
decision, staff shall continue to administer the medication as ordered by the
physician and approved by the Committee while awaiting the Agency Medical
Director's decision on the appeal.
2) The Chairperson of the Committee shall promptly forward the
written notice of appeal to the Agency Medical Director or a physician
designated by the Agency Medical Director.
3) Within five working days after receipt of the written notice
of appeal, the Agency Medical Director shall:
A) Review the Committee's decision, make such further
investigation as deemed necessary, and submit a written decision to the Chief
Administrative Officer; and
B) Provide a copy of the written decision to the offender, the
staff assistant, and the Chairperson of the Committee.
4) The Chief Administrative Officer shall direct staff to comply
with the decision of the Agency Medical Director.
d) Periodic Review of Medication
1) Whenever any offender has been involuntarily receiving
psychotropic medication continuously or on a regular basis for a period of six
months, the administration of such medication shall, upon the offender's
written request, be reviewed by the Treatment Review Committee in accordance
with the procedures enumerated in subsections (b) and (c) of this Section.
Every six months thereafter, for so long as the involuntary medication
continues on a regular basis, the offender shall have the right to a review
hearing upon written request.
2) Every offender who is involuntarily receiving psychotropic
medication shall be evaluated by a psychiatrist at least every 30 days, and the
psychiatrist shall document in the offender's medical file the basis for the
decision to continue the medication.
e) Emergency Procedures
Subsequent to
the involuntary administration of psychotropic medication in an emergency
situation:
1) The basis for the decision to administer the medication shall
be documented in the offender's medical file and a copy of the documentation
shall be given to the offender and to the Agency Medical Director for review.
2) A mental health professional shall meet with the offender to
discuss the reasons why the medication was administered and to give the offender
an opportunity to express any concerns he or she may have regarding the
medication.
f) Documentation
Copies of all
notifications and written decisions shall be placed in the offender's medical
file.
g) Grievances
An offender
may submit a grievance concerning the involuntary administration of
psychotropic medication directly to the Administrative Review Board in
accordance with 20 Ill. Adm. Code 504.Subpart F. In considering the grievance,
the Board shall confer with the Agency Medical Director.
h) Treatment of Minors
In the case of
an offender who is a minor under the age of 18, the parent or guardian shall be
sent the documentation and written decisions that are provided to the offender
pursuant to this Section and shall be permitted to attend and participate in
any proceedings required by this Section. Notice of any Treatment Review
Committee hearing shall be promptly sent to the parent or guardian and
reasonable attempts shall be made to provide such notice at least 72 hours
prior to the hearing.
(Source: Amended at 29 Ill.
Reg. 3883, effective March 1, 2005)