Rep. Dan Reitz

Filed: 4/10/2006

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 998

2     AMENDMENT NO. ______. Amend Senate Bill 998, AS AMENDED, by
3 replacing everything after the enacting clause with the
4 following:
 
5     "Section 5. The Mental Health and Developmental
6 Disabilities Code is amended by changing Sections 2-107,
7 2-107.1, and 3-209 and by adding Section 2-107.3 as follows:
 
8     (405 ILCS 5/2-107)  (from Ch. 91 1/2, par. 2-107)
9     Sec. 2-107. Refusal of services; informing of risks.
10     (a) An adult recipient of services or the recipient's
11 guardian, if the recipient is under guardianship, and the
12 recipient's substitute decision maker, if any, must be informed
13 of the recipient's right to refuse medication. The recipient
14 and the recipient's guardian or substitute decision maker shall
15 be given the opportunity to refuse generally accepted mental
16 health or developmental disability services, including but not
17 limited to medication. If such services are refused, they shall
18 not be given unless such services are necessary to prevent the
19 recipient from causing serious and imminent physical harm to
20 the recipient or others and no less restrictive alternative is
21 available. The facility director shall inform a recipient,
22 guardian, or substitute decision maker, if any, who refuses
23 such services of alternate services available and the risks of
24 such alternate services, as well as the possible consequences

 

 

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1 to the recipient of refusal of such services.
2     (b) Authorized involuntary treatment may be given under
3 this Section for up to 24 hours only if the circumstances
4 leading up to the need for emergency treatment are set forth in
5 writing in the recipient's record.
6     (c) Authorized involuntary treatment may not be continued
7 unless the need for such treatment is redetermined at least
8 every 24 hours based upon a personal examination of the
9 recipient by a physician or a nurse under the supervision of a
10 physician and the circumstances demonstrating that need are set
11 forth in writing in the recipient's record.
12     (d) Authorized involuntary treatment may not be
13 administered under this Section for a period in excess of 72
14 hours, excluding Saturdays, Sundays, and holidays, unless a
15 petition is filed under Section 2-107.1 and the treatment
16 continues to be necessary under subsection (a) of this Section.
17 Once the petition has been filed, treatment may continue in
18 compliance with subsections (a), (b), and (c) of this Section
19 until the final outcome of the hearing on the petition.
20     (e) The Department shall issue rules designed to insure
21 that in State-operated mental health facilities authorized
22 involuntary treatment is administered in accordance with this
23 Section and only when appropriately authorized and monitored by
24 a physician or a nurse under the supervision of a physician in
25 accordance with accepted medical practice. The facility
26 director of each mental health facility not operated by the
27 State shall issue rules designed to insure that in that
28 facility authorized involuntary treatment is administered in
29 accordance with this Section and only when appropriately
30 authorized and monitored by a physician or a nurse under the
31 supervision of a physician in accordance with accepted medical
32 practice. Such rules shall be available for public inspection
33 and copying during normal business hours.
34     (f) The provisions of this Section with respect to the

 

 

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1 emergency administration of authorized involuntary treatment
2 do not apply to facilities licensed under the Nursing Home Care
3 Act.
4     (g) Under no circumstances may long-acting psychotropic
5 medications be administered under this Section.
6     (h) Whenever services are refused pursuant to subsection
7 (a) of this Section, the physician shall determine and state in
8 writing the reasons why the recipient did not meet the criteria
9 for involuntary treatment under subsection (a) and whether the
10 recipient meets the standard for authorized involuntary
11 treatment under Section 2-107.1 of this Code. If the physician
12 determines that the recipient meets the standard for authorized
13 involuntary treatment under Section 2-107.1, the facility
14 director shall petition the court for authorized involuntary
15 treatment pursuant to that Section unless the facility director
16 states in writing in the recipient's record why the filing of
17 such a petition is not warranted.
18     (i) The Department shall conduct annual trainings for all
19 clinical personnel on the appropriate use of emergency
20 authorized involuntary treatment, standards for its use, and
21 the methods of authorization under this Section.
22 (Source: P.A. 90-538, eff. 12-1-97; 91-726, eff. 6-2-00.)
 
23     (405 ILCS 5/2-107.1)  (from Ch. 91 1/2, par. 2-107.1)
24     Sec. 2-107.1. Administration of authorized involuntary
25 treatment upon application to a court.
26     (a) An adult recipient of services and the recipient's
27 guardian, if the recipient is under guardianship, and the
28 substitute decision maker, if any, shall be informed of the
29 recipient's right to refuse medication. The recipient and the
30 recipient's guardian or substitute decision maker shall be
31 given the opportunity to refuse generally accepted mental
32 health or developmental disability services, including but not
33 limited to medication.

 

 

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1     (a-5) Notwithstanding the provisions of Section 2-107 of
2 this Code, authorized involuntary treatment may be
3 administered to an adult recipient of services without the
4 informed consent of the recipient under the following
5 standards:
6         (1) Any person 18 years of age or older, including any
7     guardian, may petition the circuit court for an order
8     authorizing the administration of authorized involuntary
9     treatment to a recipient of services. The petition shall
10     state that the petitioner has made a good faith attempt to
11     determine whether the recipient has executed a power of
12     attorney for health care under the Powers of Attorney for
13     Health Care Law or a declaration for mental health
14     treatment under the Mental Health Treatment Preference
15     Declaration Act and to obtain copies of these instruments
16     if they exist. If either of the above-named instruments is
17     available to the petitioner, the instrument or a copy of
18     the instrument shall be attached to the petition as an
19     exhibit. The petitioner shall deliver a copy of the
20     petition, and notice of the time and place of the hearing,
21     to the respondent, his or her attorney, any known agent or
22     attorney-in-fact, if any, and the guardian, if any, no
23     later than 3 days prior to the date of the hearing. Service
24     of the petition and notice of the time and place of the
25     hearing may be made by transmitting them via facsimile
26     machine to the respondent or other party. Upon receipt of
27     the petition and notice, the party served, or the person
28     delivering the petition and notice to the party served,
29     shall acknowledge service. If the party sending the
30     petition and notice does not receive acknowledgement of
31     service within 24 hours, service must be made by personal
32     service.
33         The petition may include a request that the court
34     authorize such testing and procedures as may be essential

 

 

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1     for the safe and effective administration of the authorized
2     involuntary treatment sought to be administered, but only
3     where the petition sets forth the specific testing and
4     procedures sought to be administered.
5         If a hearing is requested to be held immediately
6     following the hearing on a petition for involuntary
7     admission, then the notice requirement shall be the same as
8     that for the hearing on the petition for involuntary
9     admission, and the petition filed pursuant to this Section
10     shall be filed with the petition for involuntary admission.
11         (2) The court shall hold a hearing within 7 days of the
12     filing of the petition. The People, the petitioner, or the
13     respondent shall be entitled to a continuance of up to 7
14     days as of right. An additional continuance of not more
15     than 7 days may be granted to any party (i) upon a showing
16     that the continuance is needed in order to adequately
17     prepare for or present evidence in a hearing under this
18     Section or (ii) under exceptional circumstances. The court
19     may grant an additional continuance not to exceed 21 days
20     when, in its discretion, the court determines that such a
21     continuance is necessary in order to provide the recipient
22     with an examination pursuant to Section 3-803 or 3-804 of
23     this Act, to provide the recipient with a trial by jury as
24     provided in Section 3-802 of this Act, or to arrange for
25     the substitution of counsel as provided for by the Illinois
26     Supreme Court Rules. The hearing shall be separate from a
27     judicial proceeding held to determine whether a person is
28     subject to involuntary admission but may be heard
29     immediately preceding or following such a judicial
30     proceeding and may be heard by the same trier of fact or
31     law as in that judicial proceeding.
32         (3) Unless otherwise provided herein, the procedures
33     set forth in Article VIII of Chapter 3 of this Act,
34     including the provisions regarding appointment of counsel,

 

 

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1     shall govern hearings held under this subsection (a-5).
2         (4) Authorized involuntary treatment shall not be
3     administered to the recipient unless it has been determined
4     by clear and convincing evidence that all of the following
5     factors are present. In determining whether a person meets
6     the criteria specified in the following paragraphs (A)
7     through (G), the court may consider evidence of the
8     person's history of serious violence, repeated past
9     pattern of specific behavior, actions related to the
10     person's illness, or past outcomes of various treatment
11     options. :
12             (A) That the recipient has a serious mental illness
13         or developmental disability.
14             (B) That because of said mental illness or
15         developmental disability, the recipient currently
16         exhibits any one of the following: (i) deterioration of
17         his or her ability to function, as compared to the
18         recipient's ability to function prior to the current
19         onset of symptoms of the mental illness or disability
20         for which treatment is presently sought, (ii)
21         suffering, or (iii) threatening behavior.
22             (C) That the illness or disability has existed for
23         a period marked by the continuing presence of the
24         symptoms set forth in item (B) of this subdivision (4)
25         or the repeated episodic occurrence of these symptoms.
26             (D) That the benefits of the treatment outweigh the
27         harm.
28             (E) That the recipient lacks the capacity to make a
29         reasoned decision about the treatment.
30             (F) That other less restrictive services have been
31         explored and found inappropriate.
32             (G) If the petition seeks authorization for
33         testing and other procedures, that such testing and
34         procedures are essential for the safe and effective

 

 

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1         administration of the treatment.
2         (5) In no event shall an order issued under this
3     Section be effective for more than 90 days. A second 90-day
4     period of involuntary treatment may be authorized pursuant
5     to a hearing that complies with the standards and
6     procedures of this subsection (a-5). Thereafter,
7     additional 180-day periods of involuntary treatment may be
8     authorized pursuant to the standards and procedures of this
9     Section without limit. If a new petition to authorize the
10     administration of authorized involuntary treatment is
11     filed at least 15 days prior to the expiration of the prior
12     order, and if any continuance of the hearing is agreed to
13     by the recipient, the administration of the treatment may
14     continue in accordance with the prior order pending the
15     completion of a hearing under this Section.
16         (6) An order issued under this subsection (a-5) shall
17     designate the persons authorized to administer the
18     authorized involuntary treatment under the standards and
19     procedures of this subsection (a-5). Those persons shall
20     have complete discretion not to administer any treatment
21     authorized under this Section. The order shall also specify
22     the medications and the anticipated range of dosages that
23     have been authorized and may include a list of any
24     alternative medications and range of dosages deemed
25     necessary.
26     (b) A guardian may be authorized to consent to the
27 administration of authorized involuntary treatment to an
28 objecting recipient only under the standards and procedures of
29 subsection (a-5).
30     (c) Notwithstanding any other provision of this Section, a
31 guardian may consent to the administration of authorized
32 involuntary treatment to a non-objecting recipient under
33 Article XIa of the Probate Act of 1975.
34     (d) Nothing in this Section shall prevent the

 

 

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1 administration of authorized involuntary treatment to
2 recipients in an emergency under Section 2-107 of this Act.
3     (e) Notwithstanding any of the provisions of this Section,
4 authorized involuntary treatment may be administered pursuant
5 to a power of attorney for health care under the Powers of
6 Attorney for Health Care Law or a declaration for mental health
7 treatment under the Mental Health Treatment Preference
8 Declaration Act.
9     (f) The Department shall conduct annual trainings for
10 clinical personnel on the appropriate use of authorized
11 involuntary treatment, standards for its use, and the
12 preparation of court petitions under this Section.
13 (Source: P.A. 92-16, eff. 6-28-01; 93-573, eff. 8-21-03.)
 
14     (405 ILCS 5/2-107.3 new)
15     Sec. 2-107.3. Reports. Each facility director of a
16 State-operated mental health facility shall prepare a
17 quarterly report stating the number of persons who were
18 determined to meet the standard for authorized involuntary
19 treatment but for whom it was determined that the filing of
20 such a petition was not warranted as provided for in subsection
21 (h) of Section 2-107 of this Code and the reasons for each such
22 determination. The Department shall prepare and publish an
23 annual report summarizing the information received under this
24 Section. The Department's report shall include the data from
25 each facility filing such a report and shall separately report
26 the data from each such facility, identified by facility.
 
27     (405 ILCS 5/3-209)  (from Ch. 91 1/2, par. 3-209)
28     Sec. 3-209. Within three days of admission under this
29 Chapter, a treatment plan shall be prepared for each recipient
30 of service and entered into his or her record. The plan shall
31 include an assessment of the recipient's treatment needs, a
32 description of the services recommended for treatment, the

 

 

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1 goals of each type of element of service, an anticipated
2 timetable for the accomplishment of the goals, and a
3 designation of the qualified professional responsible for the
4 implementation of the plan. The plan shall include a written
5 assessment of whether or not the recipient is in need of
6 psychotropic medications. The plan shall be reviewed and
7 updated as the clinical condition warrants, but not less than
8 every 30 days.
9 (Source: P.A. 81-920.)
 
10     Section 99. Effective date. This Act takes effect upon
11 becoming law.".