98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB4585

 

Introduced , by Rep. Lou Lang

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 45/2-106  from Ch. 111 1/2, par. 4152-106
210 ILCS 45/2-106.1

    Amends the Nursing Home Care Act. Provides that a restraint may only be used with the informed consent of the resident, the resident's guardian, or the resident's representative (rather than the resident, the resident's guardian, or other authorized representative). Provides that psychotropic medication shall not be prescribed without the informed consent of the resident, the resident's guardian, or the resident's representative (rather than the resident, the resident's guardian, or other authorized representative). Effective immediately.


LRB098 16957 RPS 52035 b

 

 

A BILL FOR

 

HB4585LRB098 16957 RPS 52035 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Nursing Home Care Act is amended by changing
5Sections 2-106 and 2-106.1 as follows:
 
6    (210 ILCS 45/2-106)  (from Ch. 111 1/2, par. 4152-106)
7    Sec. 2-106. (a) For purposes of this Act, (i) a physical
8restraint is any manual method or physical or mechanical
9device, material, or equipment attached or adjacent to a
10resident's body that the resident cannot remove easily and
11restricts freedom of movement or normal access to one's body.
12Devices used for positioning, including but not limited to bed
13rails, gait belts, and cushions, shall not be considered to be
14restraints for purposes of this Section; (ii) a chemical
15restraint is any drug used for discipline or convenience and
16not required to treat medical symptoms. The Department shall by
17rule, designate certain devices as restraints, including at
18least all those devices which have been determined to be
19restraints by the United States Department of Health and Human
20Services in interpretive guidelines issued for the purposes of
21administering Titles XVIII and XIX of the Social Security Act.
22    (b) Neither restraints nor confinements shall be employed
23for the purpose of punishment or for the convenience of any

 

 

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1facility personnel. No restraints or confinements shall be
2employed except as ordered by a physician who documents the
3need for such restraints or confinements in the resident's
4clinical record.
5    (c) A restraint may be used only with the informed consent
6of the resident, the resident's guardian, or the resident's
7other authorized representative. A restraint may be used only
8for specific periods, if it is the least restrictive means
9necessary to attain and maintain the resident's highest
10practicable physical, mental or psychosocial well-being,
11including brief periods of time to provide necessary
12life-saving treatment. A restraint may be used only after
13consultation with appropriate health professionals, such as
14occupational or physical therapists, and a trial of less
15restrictive measures has led to the determination that the use
16of less restrictive measures would not attain or maintain the
17resident's highest practicable physical, mental or
18psychosocial well-being. However, if the resident needs
19emergency care, restraints may be used for brief periods to
20permit medical treatment to proceed unless the facility has
21notice that the resident has previously made a valid refusal of
22the treatment in question.
23    (d) A restraint may be applied only by a person trained in
24the application of the particular type of restraint.
25    (e) Whenever a period of use of a restraint is initiated,
26the resident shall be advised of his or her right to have a

 

 

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1person or organization of his or her choosing, including the
2Guardianship and Advocacy Commission, notified of the use of
3the restraint. A recipient who is under guardianship may
4request that a person or organization of his or her choosing be
5notified of the restraint, whether or not the guardian approves
6the notice. If the resident so chooses, the facility shall make
7the notification within 24 hours, including any information
8about the period of time that the restraint is to be used.
9Whenever the Guardianship and Advocacy Commission is notified
10that a resident has been restrained, it shall contact the
11resident to determine the circumstances of the restraint and
12whether further action is warranted.
13    (f) Whenever a restraint is used on a resident whose
14primary mode of communication is sign language, the resident
15shall be permitted to have his or her hands free from restraint
16for brief periods each hour, except when this freedom may
17result in physical harm to the resident or others.
18    (g) The requirements of this Section are intended to
19control in any conflict with the requirements of Sections 1-126
20and 2-108 of the Mental Health and Developmental Disabilities
21Code.
22(Source: P.A. 97-135, eff. 7-14-11.)
 
23    (210 ILCS 45/2-106.1)
24    Sec. 2-106.1. Drug treatment.
25    (a) A resident shall not be given unnecessary drugs. An

 

 

HB4585- 4 -LRB098 16957 RPS 52035 b

1unnecessary drug is any drug used in an excessive dose,
2including in duplicative therapy; for excessive duration;
3without adequate monitoring; without adequate indications for
4its use; or in the presence of adverse consequences that
5indicate the drugs should be reduced or discontinued. The
6Department shall adopt, by rule, the standards for unnecessary
7drugs contained in interpretive guidelines issued by the United
8States Department of Health and Human Services for the purposes
9of administering Titles XVIII and XIX of the Social Security
10Act.
11    (b) Psychotropic medication shall not be prescribed
12without the informed consent of the resident, the resident's
13guardian, or the resident's other authorized representative.
14"Psychotropic medication" means medication that is used for or
15listed as used for antipsychotic, antidepressant, antimanic,
16or antianxiety behavior modification or behavior management
17purposes in the latest editions of the AMA Drug Evaluations or
18the Physician's Desk Reference. The Department shall adopt, by
19rule, a protocol specifying how informed consent for
20psychotropic medication may be obtained or refused. The
21protocol shall require, at a minimum, a discussion between (i)
22the resident or the resident's authorized representative and
23(ii) the resident's physician, a registered pharmacist (who is
24not a dispensing pharmacist for the facility where the resident
25lives), or a licensed nurse about the possible risks and
26benefits of a recommended medication and the use of

 

 

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1standardized consent forms designated by the Department. Each
2form developed by the Department (i) shall be written in plain
3language, (ii) shall be able to be downloaded from the
4Department's official website, (iii) shall include information
5specific to the psychotropic medication for which consent is
6being sought, and (iv) shall be used for every resident for
7whom psychotropic drugs are prescribed. In addition to creating
8those forms, the Department shall approve the use of any other
9informed consent forms that meet criteria developed by the
10Department.
11    In addition to any other penalty prescribed by law, a
12facility that is found to have violated this subsection, or the
13federal certification requirement that informed consent be
14obtained before administering a psychotropic medication, shall
15thereafter be required to obtain the signatures of 2 licensed
16health care professionals on every form purporting to give
17informed consent for the administration of a psychotropic
18medication, certifying the personal knowledge of each health
19care professional that the consent was obtained in compliance
20with the requirements of this subsection.
21    (c) The requirements of this Section are intended to
22control in a conflict with the requirements of Sections 2-102
23and 2-107.2 of the Mental Health and Developmental Disabilities
24Code with respect to the administration of psychotropic
25medication.
26(Source: P.A. 95-331, eff. 8-21-07; 96-1372, eff. 7-29-10.)
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.