Full Text of HB1592 102nd General Assembly
HB1592ham001 102ND GENERAL ASSEMBLY | Rep. Deb Conroy Filed: 3/9/2022
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| 1 | | AMENDMENT TO HOUSE BILL 1592
| 2 | | AMENDMENT NO. ______. Amend House Bill 1592 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Mental Health Inpatient Facility Access Act. | 6 | | Section 5. Findings. The General Assembly finds that: | 7 | | (1) In 1955, Illinois had more than 30,000 adult | 8 | | State-operated inpatient mental health beds. | 9 | | (2) In 2019, prior to the COVID-19 pandemic, Illinois | 10 | | had fewer than 1,200 adult State-operated inpatient mental | 11 | | health beds. | 12 | | (3) Due to the COVID-19 pandemic, there are now only | 13 | | approximately 1,100 State-operated inpatient mental health | 14 | | beds. | 15 | | (4) More than 500,000 people in Illinois have serious | 16 | | mental health conditions. |
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| 1 | | (5) While most people with even the most serious | 2 | | mental health conditions can be successfully treated in | 3 | | the community or in private hospitals, many will need | 4 | | inpatient care from a State-operated inpatient mental | 5 | | health facility. | 6 | | (6) Given the small number of remaining beds in | 7 | | State-operated inpatient mental health facilities, it is | 8 | | vital that adults who need a hospital-level of care are | 9 | | able to obtain services in such facilities. | 10 | | (7) Due to the lack of available inpatient mental | 11 | | health beds: | 12 | | (A) Many people in need of inpatient psychiatric | 13 | | care wait for days or weeks in emergency departments | 14 | | or non-psychiatric units of general hospitals where it | 15 | | is difficult to provide them with safe and effective | 16 | | mental health treatment. | 17 | | (B) Persons found unfit to stand trial or not | 18 | | guilty by reason of insanity and committed to the | 19 | | custody of the Department of Human Services often wait | 20 | | for weeks or months in county jails where it is | 21 | | difficult to provide them with safe and effective | 22 | | mental health treatment. | 23 | | (C) Adults with a continuing need for mental | 24 | | health services are discharged into the community | 25 | | before their mental health condition makes such a | 26 | | discharge safe and appropriate or before arrangements |
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| 1 | | have been made for needed long-term community mental | 2 | | health services. | 3 | | (D) Adults who need inpatient care are often | 4 | | denied access to such care. | 5 | | Section 10. Strategic plan on improving access to | 6 | | inpatient psychiatric beds. The Department of Human Services' | 7 | | Division of Mental Health shall develop a written, strategic | 8 | | plan that comprehensively addresses improving access to | 9 | | inpatient psychiatric beds in State-operated mental health | 10 | | facilities for individuals needing a hospital level of care. | 11 | | This plan shall address achieving the best use of | 12 | | State-operated psychiatric beds across Illinois, with | 13 | | strategies specifically to mitigate inefficient use of | 14 | | forensic beds and reduce lengths of stays for the forensic | 15 | | population. A comprehensive approach to this plan shall | 16 | | include training and education, ongoing assessment of | 17 | | individuals receiving inpatient services, reviewing and | 18 | | updating policies and procedures, and increasing | 19 | | community-based capacity for individuals in all State-operated | 20 | | forensic beds. The plan shall include: | 21 | | (1) Annual training. Required annual training for all | 22 | | State-operated inpatient mental health facility clinicians | 23 | | shall include: | 24 | | (A) Best practices for evaluating whether | 25 | | individuals found not guilty by reason of insanity or |
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| 1 | | unfit to stand trial meet the legal criteria for | 2 | | inpatient treatment. | 3 | | (B) Best practices for determining appropriate | 4 | | treatment for individuals found not guilty by reason | 5 | | of insanity or unfit to stand trial. | 6 | | (C) The requirements of treatment plan reports. | 7 | | (D) The types of mental health services available | 8 | | following discharge, including, but not limited to: | 9 | | assertive community treatment, community support | 10 | | teams, supportive housing, medication management, | 11 | | psychotherapy, peer support services, specialized | 12 | | mental health rehabilitation facilities, and nursing | 13 | | homes. | 14 | | (2) Regular and periodic assessment of mental health | 15 | | condition and progress. At least once every year following | 16 | | the admission of any individual under Section 5-2-4 of the | 17 | | Unified Code of Corrections or Section 104-17 of the Code | 18 | | of Criminal Procedure of 1963, the Director of the | 19 | | Division of Mental Health, or his or her designee, shall | 20 | | meet with the treatment team assigned to that individual | 21 | | to review whether: | 22 | | (A) The individual continues to meet the standard | 23 | | for inpatient care. | 24 | | (B) The individual may be appropriate for | 25 | | unsupervised on-grounds privileges, off-grounds | 26 | | privileges (with or without escort by personnel of the |
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| 1 | | Department of Human Services), home visits, and | 2 | | participation in work programs. | 3 | | (C) The current treatment plan is reasonably | 4 | | expected to result in the improvement of the | 5 | | individual's clinical condition so that the individual | 6 | | no longer needs inpatient treatment, and, if not, what | 7 | | other treatments or placements are available to meet | 8 | | the individual's needs and safety. | 9 | | (3) Updated policies and procedures. | 10 | | (A) Revise facility policies and procedures to | 11 | | increase opportunities for home visits and work | 12 | | programs that assist with community reintegration. | 13 | | This shall include a review of unsupervised on-grounds | 14 | | privileges, off-grounds privileges (with or without | 15 | | escort by personnel of the Department of Human | 16 | | Services), home visits, and participation in work or | 17 | | educational programs to ensure that policies do not | 18 | | limit the ability to approve these activities. The | 19 | | plan shall also address the frequency for which | 20 | | individuals are assessed to be eligible for these | 21 | | activities. | 22 | | (B) Ensure all individuals found unfit to stand | 23 | | trial or not guilty by reason of insanity, who can be | 24 | | treated on an outpatient basis are recommended for | 25 | | outpatient services. | 26 | | (C) Develop benchmarks to ensure that: |
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| 1 | | (i) every individual found unfit to stand | 2 | | trial or not guilty by reason of insanity who has | 3 | | been committed by a court to the Department for | 4 | | treatment shall be admitted to a Department | 5 | | facility within the time periods set forth in
| 6 | | subsection (b) of Section 104-17 of the Code of
| 7 | | Criminal Procedure of 1963 and subsection (a) of
| 8 | | Section 5-2-4 of Unified Code of Corrections; and | 9 | | (ii) no individual who needs inpatient | 10 | | psychiatric care remains in an emergency | 11 | | department of any hospital or in any other | 12 | | non-psychiatric unit longer than 48 hours. | 13 | | (4) Building community treatment capacity. | 14 | | (A) Specific steps to increase access to | 15 | | community-based mental health services that provide | 16 | | (i) outpatient alternatives to those being assessed | 17 | | for inpatient stays at State-operated inpatient mental | 18 | | health facilities and (ii) step-down services for | 19 | | those no longer meeting inpatient stay criteria, | 20 | | specifically the population of individuals found not | 21 | | guilty by reason of insanity. Such steps must | 22 | | specifically identify community-based treatment | 23 | | alternatives and how these services will be funded. | 24 | | (B) Specific steps to ensure each State-operated | 25 | | inpatient mental health facility has sufficient | 26 | | qualified psychiatrists, psychologists, social |
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| 1 | | workers, peer support professionals, and other staff | 2 | | so that the Department may provide adequate and humane | 3 | | care and services for all patients. That plan shall | 4 | | include: | 5 | | (i) an assessment of whether the salary and | 6 | | other benefits provided to professional staff are | 7 | | sufficient to attract and retain staff; | 8 | | (ii) an assessment of the annual budget needed | 9 | | to attract and retain staff; | 10 | | (iii) an assessment of any other impediments | 11 | | to attracting and retaining staff, and a | 12 | | mitigation plan for those impediments; and | 13 | | (iv) a detailed plan for recruiting | 14 | | psychiatrists, psychologists, social workers, peer | 15 | | support professionals, and other mental health | 16 | | staff. | 17 | | (5) Certification of mental health clinicians. The | 18 | | Division of Mental Health shall outline in the strategic
| 19 | | plan a plan for training, implementing standard
| 20 | | qualifications, and credentialing all psychiatrists, | 21 | | clinical social workers, clinical psychologists, and | 22 | | qualified examiners who conduct any evaluations, as | 23 | | employees, agents, or vendors of the Division concerning: | 24 | | (A) findings of unfitness to stand trial and all | 25 | | other evaluations of individuals receiving treatment | 26 | | in accordance with Section 104-10 of the Code of |
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| 1 | | Criminal Procedure of 1963: | 2 | | (B) individuals receiving treatment in accordance | 3 | | with Section 5-2-4 of the Unified Code of Corrections; | 4 | | (C) whether individuals are subject to involuntary | 5 | | admission on an inpatient or outpatient basis in | 6 | | accordance with the Mental Health and Developmental | 7 | | Disabilities Code; and | 8 | | (D) whether individuals are subject to | 9 | | court-ordered treatment in accordance with Section | 10 | | 2-107.1 of the Mental Health and Developmental | 11 | | Disabilities Code. | 12 | | Such evaluations shall include any treatment reports | 13 | | required under the Code of Criminal Procedure of 1963 or | 14 | | the Mental Health and Developmental Disabilities Code. | 15 | | (6) There shall be stakeholder input during the | 16 | | planning process from the Division of Mental Health's | 17 | | forensic workgroup. | 18 | | Section 15. Implementation. The strategic plan developed | 19 | | by the Division of Mental Health shall be finalized and made | 20 | | publicly available one year after the effective date of this | 21 | | Act. The plan shall include: | 22 | | (1) Benchmarks and timelines for implementing each | 23 | | provision of the plan. | 24 | | (2) Strategy for obtaining resources needed to | 25 | | implement each provision of the plan. |
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| 1 | | (3) Ongoing stakeholder engagement during the | 2 | | implementation of the plan through the Division of Mental | 3 | | Health's forensic workgroup. | 4 | | Section 20. Prohibition on reduction of State-operated | 5 | | psychiatric inpatient beds. The Department shall make no | 6 | | further reductions in State-operated inpatient mental health | 7 | | bed capacity. Nothing in
this Section shall affect the | 8 | | authority of the Governor to
issue emergency executive orders | 9 | | to protect the health or
safety of recipients or employees of | 10 | | State-operated inpatient psychiatric facilities.
| 11 | | Section 99. Effective date. This Act takes effect upon | 12 | | becoming law.".
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