101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB5113

 

Introduced 2/18/2020, by Rep. Deb Conroy

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Improving Access to State-operated Mental Health Facilities Act. Provides that the Department of Human Services, Division of Mental Health, shall provide education and training on an annual basis for all psychiatrists and clinical psychologists who provide care to forensic patients in State-operated mental health facilities utilizing nationally recognized best practices for determining when forensic patients are no longer, due to mental illness, reasonably expected to inflict serious physical harm upon themselves or others or when they may be safely restored to fitness to stand trial and subject to treatment on an outpatient basis under the Code of Criminal Procedure of 1963. Provides that the Division shall also provide training to psychiatrists and clinical psychologists concerning how to provide expert testimony in court hearings to determine whether forensic patients should be released. Provides that the Division shall provide education and training on an annual basis for all clinical social workers who provide care to forensic patient in State-operated mental health facilities concerning the types of community mental health services available in the community. Defines "forensic patient" as a person in an Illinois State-operated mental health facility who has been committed to the facility after having been found not guilty by reason of insanity or unfit to stand trial. Defines other terms. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Improving Access to State-operated Mental Health Facilities
6Act.
 
7    Section 5. Definitions. In this Act:
8    "Clinical psychologist" has the meaning ascribed to it in
9Section 1-103 of the Mental Health and Developmental
10Disabilities Code.
11    "Clinical social worker" has the meaning ascribed to it in
12Section 1-122.1 of the Mental Health and Developmental
13Disabilities Code.
14    "Division" means the Department of Human Services,
15Division of Mental Health.
16    "Forensic patient" means a person in an Illinois
17State-operated mental health facility who has been committed to
18the facility under Section 5-2-4 of the Unified Code of
19Corrections or paragraph (2) of subsection (g) of Section
20104-25 of the Code of Criminal Procedure of 1963.
21    "Patient" means a recipient of services under the Mental
22Health and Developmental Disabilities Code.
23    "Psychiatrist" has the meaning ascribed to it in Section

 

 

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11-121 of the Mental Health and Developmental Disabilities Code.
 
2    Section 10. Improving access to inpatient beds in
3State-operated mental health facilities. In order to improve
4the availability of inpatient beds for those who need inpatient
5care in State-operated mental health facilities, the Division
6shall adopt and implement medically appropriate policies,
7procedures, and practices at each of the State-operated mental
8health facilities to recommend and facilitate the diversion or
9the conditional release of forensic patients to
10community-based treatment when those patients are no longer,
11due to mental illness, reasonably expected to inflict serious
12physical harm upon themselves or others, or when they may be
13safely restored to fitness to stand trial and subject to
14treatment on an outpatient basis under Section 104-17 of the
15Code of Criminal Procedure of 1963. Nothing in this Act shall
16circumvent the judicial process that is required by law for a
17forensic patient to be diverted or discharged from a
18State-operated mental health facility to community-based
19treatment.
 
20    Section 15. Education and training.
21    (a) The Division shall provide education and training on an
22annual basis for all psychiatrists and clinical psychologists
23who provide care to forensic patients in State-operated mental
24health facilities utilizing nationally recognized best

 

 

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1practices for determining when forensic patients are no longer,
2due to mental illness, reasonably expected to inflict serious
3physical harm upon themselves or others or when they may be
4safely restored to fitness on an outpatient basis pursuant to
5Section 104-17 of the Code of Criminal Procedure of 1963. The
6Division shall also provide training to psychiatrists and
7clinical psychologists concerning how to provide expert
8testimony in court hearings to determine whether forensic
9patients should be released.
10    (b) The Division shall provide education and training on an
11annual basis for all clinical social workers who provide care
12to forensic patient in State-operated mental health facilities
13concerning the types of community mental health services
14available in the community.
15    (c) The education and training shall include regular
16on-site presentations at State-operated mental health
17facilities, webinars, and written materials. All training
18materials shall be available to the public upon request.
 
19    Section 20. Supporting the transition of forensic patients
20to community-based care. To incentivize community-based mental
21health providers to accept forensic patients who are being
22discharged from the State-operated mental health facilities or
23the forensic population that is initially determined to be
24appropriately served in community-based treatment, the
25Division in consultation with the Department of Healthcare and

 

 

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1Family Services, shall develop a reimbursement mechanism such
2as a supplemental or rate add-on payment, or other funding
3source or mechanism for both Medicaid and non-Medicaid forensic
4patients being diverted or discharged from State-operated
5mental health facilities, to cover the additional provider
6costs associated with court-mandated appearances, filings and
7documentation for the forensic population. The payment
8mechanism shall be established and implemented within one year
9after the effective date of this Act. If federal approval is
10required to implement this Section, the Department of
11Healthcare and Family Services shall apply for federal approval
12in sufficient time to meet the implementation timeline
13established in this Section.
 
14    Section 25. Removing obstacles to inpatient care. The
15Division shall develop policies and practices across all
16State-operated mental health facilities to enable the
17admission and treatment of individuals that have low-to
18moderate-level medical conditions such as diabetes and other
19medical conditions in addition to their mental illness,
20consistent with the generally accepted standards within other
21psychiatric hospital units across the State. These policies and
22practices shall be put in place in each of the State-operated
23mental health facilities within one year after the effective
24date of this Act.
 

 

 

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1    Section 30. Implementing the hospital presumptive
2eligibility process. The Department of healthcare and Family
3Services shall allow for hospital presumptive eligibility for
4Medicaid enrollment for individuals presenting in hospital
5emergency rooms who are in psychiatric crisis who meet the
6federal criteria for such eligibility. If Illinois' 1115
7Medicaid waiver that includes waiving the federal requirement
8of hospital presumptive eligibility for Medicaid enrollment is
9required to be amended to implement this Section, the
10Department of Healthcare and Family Services shall amend the
11waiver within 60 days after the effective date of this Act. The
12Division and the Department of healthcare and Family Services,
13with meaningful stakeholder input, shall develop a process by
14which those individuals are linked to a community-based mental
15health provider or other appropriate organization, to
16facilitate enrollment in Medicaid immediately following
17hospital or emergency room discharge and linkage to
18community-based treatment.
 
19    Section 35. Annual reporting. The Division shall submit a
20written report to the General Assembly on or before January 1,
212021 that includes a summary of the new policies, procedures
22and practices required by Section 15 that will be put in place
23at each facility by June 30, 2021 and its plan for
24implementation, including the education of psychiatrists and
25other hospital clinical staff that play a role in inpatient

 

 

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1care and the determination of when placement in the community
2rather than a State-operated mental health facility is
3appropriate under Article 104 of the Code of Criminal Procedure
4of 1963 and Section 5-2-4 of the Unified Code of Corrections.
5The Division shall submit an annual report to the General
6Assembly every year thereafter, due on December 31st, outlining
7the progress of the new policies and practices in reducing the
8length of stay of forensic patients consistent with Article 104
9of the Code of Criminal Procedure of 1963 and Section 5-2-4 of
10the Unified Code of Corrections and the average number of beds
11available annually in each of the State-operated mental health
12facilities annually for non-forensic patients. Included in
13each annual report shall be a progress report on the number of
14clinicians that participated in the education and training
15required by Section 15, the number of clinicians who have not
16received the education and training, and the Division's ongoing
17plan for implementation of the education and training
18requirements under Section 15. The Division shall include an
19evaluation of the impact the education and training for
20clinicians has had on improving access to inpatient beds in the
21State-operated mental health facilities in each annual report.
22The Division shall submit a written report to the General
23Assembly on or before January 1, 2021 with a summary of the new
24policies and practices required under Section 25 to enable the
25admission and treatment of individuals in State-operated
26mental health facilities with psychiatric needs who also have

 

 

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1low-to moderate medical conditions.
 
2    Section 99. Effective date. This Act takes effect upon
3becoming law.