Public Act 102-0913
 
HB1592 EnrolledLRB102 03635 KTG 13648 b



    AN ACT concerning State government.

 
    Be it enacted by the People of the State of Illinois, 
represented in the General Assembly: 




 
 
    Section 1. Short title. This Act may be cited as the Mental 
Health Inpatient Facility Access Act.
 
    Section 5. Findings. The General Assembly finds that:
        (1) In 1955, Illinois had more than 30,000 adult 
    State-operated inpatient mental health beds.
        (2) In 2019, prior to the COVID-19 pandemic, Illinois 
    had fewer than 1,200 adult State-operated inpatient mental 
    health beds.
        (3) Due to the COVID-19 pandemic, there are now only 
    approximately 1,100 State-operated inpatient mental health 
    beds.
        (4) More than 500,000 people in Illinois have serious 
    mental health conditions.
        (5) While most people with even the most serious 
    mental health conditions can be successfully treated in 
    the community or in private hospitals, many will need 
    inpatient care from a State-operated inpatient mental 
    health facility.
        (6) Given the small number of remaining beds in 
    State-operated inpatient mental health facilities, it is 
    vital that adults who need a hospital-level of care are 
    able to obtain services in such facilities.
        (7) Due to the lack of available inpatient mental 
    health beds:
            (A) Many people in need of inpatient psychiatric 
        care wait for days or weeks in emergency departments 
        or non-psychiatric units of general hospitals where it 
        is difficult to provide them with safe and effective 
        mental health treatment.
            (B) Persons found unfit to stand trial or not 
        guilty by reason of insanity and committed to the 
        custody of the Department of Human Services often wait 
        for weeks or months in county jails where it is 
        difficult to provide them with safe and effective 
        mental health treatment.
            (C) Adults with a continuing need for mental 
        health services are discharged into the community 
        before their mental health condition makes such a 
        discharge safe and appropriate or before arrangements 
        have been made for needed long-term community mental 
        health services.
            (D) Adults who need inpatient care are often 
        denied access to such care.
 
    Section 10. Strategic plan on improving access to 
inpatient psychiatric beds.   The Department of Human Services' 
Division of Mental Health shall develop a written, strategic 
plan that comprehensively addresses improving access to 
inpatient psychiatric beds in State-operated mental health 
facilities for individuals needing a hospital level of care. 
This plan shall address achieving the best use of 
State-operated psychiatric beds across Illinois, with 
strategies specifically to mitigate inefficient use of 
forensic beds and reduce lengths of stays for the forensic 
population. A comprehensive approach to this plan shall 
include training and education, ongoing assessment of 
individuals receiving inpatient services, reviewing and 
updating policies and procedures, and increasing 
community-based capacity for individuals in all State-operated 
forensic beds. The plan shall include:
        (1) Annual training. Required annual training for all 
    State-operated inpatient mental health facility clinicians 
    shall include:
            (A) Best practices for evaluating whether 
        individuals found not guilty by reason of insanity or 
        unfit to stand trial meet the legal criteria for 
        inpatient treatment. 
            (B) Best practices for determining appropriate 
        treatment for individuals found not guilty by reason 
        of insanity or unfit to stand trial.
            (C) The requirements of treatment plan reports.
            (D) The types of mental health services available 
        following discharge, including, but not limited to: 
        assertive community treatment, community support 
        teams, supportive housing, medication management, 
        psychotherapy, peer support services, specialized 
        mental health rehabilitation facilities, and nursing 
        homes.
        (2) Regular and periodic assessment of mental health 
    condition and progress. At least once every year following 
    the admission of any individual under Section 5-2-4 of the 
    Unified Code of Corrections or Section 104-17 of the Code 
    of Criminal Procedure of 1963, the Director of the 
    Division of Mental Health, or his or her designee, shall 
    meet with the treatment team assigned to that individual 
    to review whether:
            (A) The individual continues to meet the standard 
        for inpatient care.
            (B) The individual may be appropriate for  
        unsupervised on-grounds privileges, off-grounds 
        privileges (with or without escort by personnel of the 
        Department of Human Services), home visits, and 
        participation in work programs.
            (C) The current treatment plan is reasonably 
        expected to result in the improvement of the 
        individual's clinical condition so that the individual 
        no longer needs inpatient treatment, and, if not, what 
        other treatments or placements are available to meet 
        the individual's needs and safety.
        (3) Updated policies and procedures.
            (A) Revise facility policies and procedures to 
        increase opportunities for home visits and work 
        programs that assist with community reintegration. 
        This shall include a review of unsupervised on-grounds 
        privileges, off-grounds privileges (with or without 
        escort by personnel of the Department of Human 
        Services), home visits, and participation in work or 
        educational programs to ensure that policies do not 
        limit the ability to approve these activities. The 
        plan shall also address the frequency for which 
        individuals are assessed to be eligible for these 
        activities.
            (B) Ensure all individuals found unfit to stand 
        trial or not guilty by reason of insanity, who can be 
        treated on an outpatient basis are recommended for 
        outpatient services.
            (C) Develop benchmarks to ensure that:
                (i) every individual found unfit to stand 
            trial or not guilty by reason of insanity who has 
            been committed by a court to the Department for 
            treatment shall be admitted to a Department 
            facility within the time periods set forth in

            subsection (b) of Section 104-17 of the Code of

            Criminal Procedure of 1963 and subsection (a) of

            Section 5-2-4 of Unified Code of Corrections; and
                (ii) no individual who needs inpatient 
            psychiatric care remains in an emergency 
            department of any hospital or in any other 
            non-psychiatric unit longer than 48 hours.
        (4) Building community treatment capacity.
            (A) Specific steps to increase access to 
        community-based mental health services that provide 
        (i) outpatient alternatives to those being assessed 
        for inpatient stays at State-operated inpatient mental 
        health facilities and (ii) step-down services for 
        those no longer meeting inpatient stay criteria, 
        specifically the population of individuals found not 
        guilty by reason of insanity. Such steps must 
        specifically identify community-based treatment 
        alternatives and how these services will be funded. 
            (B) Specific steps to ensure each State-operated 
        inpatient mental health facility has sufficient 
        qualified psychiatrists, psychologists, social 
        workers, peer support professionals, and other staff 
        so that the Department may provide adequate and humane 
        care and services for all patients.  That plan shall 
        include:
                (i) an assessment of whether the salary and 
            other benefits provided to professional staff are 
            sufficient to attract and retain staff;
                (ii) an assessment of the annual budget needed 
            to attract and retain staff;
                (iii) an assessment of any other impediments 
            to attracting and retaining staff, and a 
            mitigation plan for those impediments; and
                (iv) a detailed plan for recruiting 
            psychiatrists, psychologists, social workers, peer 
            support professionals, and other mental health 
            staff.
        (5) Certification of mental health clinicians.  The 
    Division of Mental Health shall outline in the strategic

    plan a plan for training, implementing standard

    qualifications, and credentialing all psychiatrists, 
    clinical social workers, clinical psychologists, and 
    qualified examiners who conduct any evaluations, as 
    employees, agents, or vendors of the Division concerning:
            (A) findings of unfitness to stand trial and all 
        other evaluations of individuals receiving treatment 
        in accordance with Section 104-10 of the Code of 
        Criminal Procedure of 1963:
            (B) individuals receiving treatment in accordance 
        with Section 5-2-4 of the Unified Code of Corrections; 
            (C) whether individuals are subject to involuntary 
        admission on an inpatient or outpatient basis in 
        accordance with the Mental Health and Developmental 
        Disabilities Code; and
            (D) whether individuals are subject to 
        court-ordered treatment in accordance with Section 
        2-107.1 of the Mental Health and Developmental 
        Disabilities Code.
        Such evaluations shall include any treatment reports 
    required under the Code of Criminal Procedure of 1963 or 
    the Mental Health and Developmental Disabilities Code.
        (6) There shall be stakeholder input during the 
    planning process from the Division of Mental Health's 
    forensic workgroup.
 
    Section 15. Implementation.   The strategic plan developed 
by the Division of Mental Health shall be finalized and made 
publicly available one year after the effective date of this 
Act. The plan shall include:
        (1) Benchmarks and timelines for implementing each 
    provision of the plan.
        (2) Strategy for obtaining resources needed to 
    implement each provision of the plan.
        (3) Ongoing stakeholder engagement during the 
    implementation of the plan through the Division of Mental 
    Health's forensic workgroup.
 
    Section 20. Prohibition on reduction of State-operated 
psychiatric inpatient beds.  The Department shall make no 
further reductions in State-operated inpatient mental health 
bed capacity.  Nothing in
this Section shall affect the 
authority of the Governor to
issue emergency executive orders 
to protect the health or
safety of recipients or employees of 
State-operated inpatient psychiatric facilities.
  
 
    Section 99. Effective date. This Act takes effect upon 
becoming law.