Full Text of HB4585 98th General Assembly
HB4585eng 98TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Nursing Home Care Act is amended by changing | 5 | | Sections 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 | 8 | | restraint is any
manual method or physical or
mechanical | 9 | | device, material, or equipment attached or adjacent to a
| 10 | | resident's body that the resident cannot remove easily and
| 11 | | restricts
freedom of movement or normal access to one's
body. | 12 | | Devices used for
positioning, including but not limited to bed | 13 | | rails,
gait belts, and cushions, shall not be considered to be | 14 | | restraints for
purposes of this Section;
(ii) a chemical | 15 | | restraint
is
any drug used for discipline or convenience and | 16 | | not required to treat medical
symptoms. The Department shall by | 17 | | rule, designate certain devices as
restraints,
including at | 18 | | least all those devices which have been determined
to be | 19 | | restraints by the United States Department of Health and Human | 20 | | Services
in
interpretive guidelines issued for the purposes of | 21 | | administering Titles XVIII and XIX of the Social Security Act.
| 22 | | (b) Neither restraints nor confinements shall be employed
| 23 | | for the purpose of punishment or for the convenience of any |
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| 1 | | facility personnel.
No restraints or confinements shall be | 2 | | employed except as ordered
by a physician who documents the | 3 | | need for such restraints or confinements
in the
resident's | 4 | | clinical record.
| 5 | | (c) A restraint may be used only with the informed consent | 6 | | of the
resident, the resident's guardian, or the resident's | 7 | | other authorized representative. A
restraint may be used only | 8 | | for specific periods, if it is the
least restrictive means | 9 | | necessary to attain and maintain the resident's highest
| 10 | | practicable physical, mental or psychosocial well-being, | 11 | | including brief
periods of time to provide necessary | 12 | | life-saving treatment. A restraint may be
used only after | 13 | | consultation with appropriate health professionals, such as
| 14 | | occupational or physical therapists, and a trial of less | 15 | | restrictive measures
has led to the determination that the use | 16 | | of less restrictive measures
would not attain or maintain the | 17 | | resident's highest practicable physical,
mental or | 18 | | psychosocial well-being.
However, if the resident needs | 19 | | emergency care, restraints may be used for brief
periods to
| 20 | | permit medical treatment to proceed unless the facility has | 21 | | notice that the
resident has previously made a valid refusal of | 22 | | the treatment in
question.
| 23 | | (d) A restraint may be applied only by a person trained in | 24 | | the application
of the particular type of restraint.
| 25 | | (e) Whenever a period of use of a restraint is initiated, | 26 | | the resident shall
be advised of his or her right to have a |
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| 1 | | person or organization of his or
her
choosing,
including the | 2 | | Guardianship and Advocacy Commission, notified of the use of | 3 | | the
restraint. A recipient
who is under guardianship may | 4 | | request that a person or organization of his or
her choosing be | 5 | | notified of the restraint, whether or not the guardian
approves | 6 | | the notice.
If the resident so chooses, the facility shall make | 7 | | the notification
within 24 hours, including any information
| 8 | | about
the period of time that the restraint is to be used.
| 9 | | Whenever the Guardianship and Advocacy Commission is notified | 10 | | that a resident
has been restrained, it shall contact the | 11 | | resident to determine the
circumstances of the restraint and | 12 | | whether further action is warranted.
| 13 | | (f) Whenever a restraint is used on a resident whose | 14 | | primary mode of
communication is sign language, the resident | 15 | | shall be permitted to have his or
her
hands free from restraint | 16 | | for brief periods each hour, except when this freedom
may
| 17 | | result in physical harm to the resident or others.
| 18 | | (g) The requirements of this Section are intended to | 19 | | control in any conflict
with the requirements of Sections
1-126 | 20 | | and 2-108 of the Mental Health and Developmental Disabilities | 21 | | Code.
| 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
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| 1 | | unnecessary drug is any drug used in an excessive dose, | 2 | | including in
duplicative therapy; for excessive duration; | 3 | | without adequate
monitoring; without adequate indications for | 4 | | its use; or in the
presence of adverse consequences that | 5 | | indicate the drugs should be reduced or
discontinued. The | 6 | | Department shall adopt, by rule, the standards
for unnecessary
| 7 | | drugs
contained in interpretive guidelines issued by the United | 8 | | States Department of
Health and Human Services for the purposes | 9 | | of administering Titles XVIII and XIX of
the Social Security | 10 | | Act.
| 11 | | (b) Psychotropic medication shall not be prescribed | 12 | | without the informed
consent of the resident, the resident's | 13 | | guardian, or the resident's other authorized
representative. | 14 | | "Psychotropic medication"
means medication that
is used for or | 15 | | listed as used for antipsychotic, antidepressant, antimanic, | 16 | | or
antianxiety behavior modification or behavior management | 17 | | purposes in the latest
editions of the AMA Drug Evaluations or | 18 | | the Physician's Desk Reference.
The Department shall adopt, by | 19 | | rule, a protocol specifying how informed consent for | 20 | | psychotropic medication may be obtained or refused. The | 21 | | protocol shall require, at a minimum, a discussion between (i) | 22 | | the resident or the resident's authorized representative and | 23 | | (ii) the resident's physician, a registered pharmacist (who is | 24 | | not a dispensing pharmacist for the facility where the resident | 25 | | lives), or a licensed nurse about the possible risks and | 26 | | benefits of a recommended medication and the use of |
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| 1 | | standardized consent forms designated by the Department. Each | 2 | | form developed by the Department (i) shall be written in plain | 3 | | language, (ii) shall be able to be downloaded from the | 4 | | Department's official website, (iii) shall include information | 5 | | specific to the psychotropic medication for which consent is | 6 | | being sought, and (iv) shall be used for every resident for | 7 | | whom psychotropic drugs are prescribed. In addition to creating | 8 | | those forms, the Department shall approve the use of any other | 9 | | informed consent forms that meet criteria developed by the | 10 | | Department. | 11 | | In addition to any other penalty prescribed by law, a | 12 | | facility that is found to have violated this subsection, or the | 13 | | federal certification requirement that informed consent be | 14 | | obtained before administering a psychotropic medication, shall | 15 | | thereafter be required to obtain the signatures of 2 licensed | 16 | | health care professionals on every form purporting to give | 17 | | informed consent for the administration of a psychotropic | 18 | | medication, certifying the personal knowledge of each health | 19 | | care professional that the consent was obtained in compliance | 20 | | with the requirements of this subsection.
| 21 | | (c) The requirements of
this Section are intended to | 22 | | control in a conflict
with the requirements of Sections 2-102 | 23 | | and 2-107.2
of the Mental Health and Developmental Disabilities | 24 | | Code with respect to the
administration of psychotropic | 25 | | medication.
| 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 | 2 | | becoming law.
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