State of Illinois
92nd General Assembly
Legislation

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92_HB0064

 
                                               LRB9200853ACcd

 1        AN ACT to  amend  certain  Acts  in  relation  to  mental
 2    health.

 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:

 5        Section  5.   The   Mental   Health   and   Developmental
 6    Disabilities   Administrative  Act  is  amended  by  changing
 7    Sections 4, 4.3, 7, and 15 as follows:

 8        (20 ILCS 1705/4) (from Ch. 91 1/2, par. 100-4)
 9        Sec.  4.  Supervision   of   facilities   and   services;
10    quarterly reports.
11        (a)  To exercise executive and administrative supervision
12    over  all  facilities,  divisions,  programs and services now
13    existing  or  hereafter  acquired  or   created   under   the
14    jurisdiction  of  the  Department, including, but not limited
15    to, the following:
16             The Alton Mental Health Center, at Alton
17             The Clyde L. Choate Mental Health and  Developmental
18        Center, at Anna
19             The Chester Mental Health Center, at Chester
20             The Chicago-Read Mental Health Center, at Chicago
21             The Elgin Mental Health Center, at Elgin
22             The Metropolitan Children and Adolescents Center, at
23        Chicago
24             The    Jacksonville    Developmental    Center,   at
25        Jacksonville
26             The Governor Samuel H. Shapiro Developmental Center,
27        at Kankakee
28             The Tinley Park Mental Health Center, at Tinley Park
29             The  Warren  G.   Murray  Developmental  Center,  at
30        Centralia
31             The Jack Mabley Developmental Center, at Dixon
 
                             -2-               LRB9200853ACcd
 1             The Lincoln Developmental Center, at Lincoln
 2             The   H.   Douglas   Singer   Mental   Health    and
 3        Developmental Center, at Rockford
 4             The John J. Madden Mental Health Center, at Chicago
 5             The George A. Zeller Mental Health Center, at Peoria
 6             The   Andrew  McFarland  Mental  Health  Center,  at
 7        Springfield
 8             The Adolf Meyer Mental Health Center, at Decatur
 9             The William W. Fox Developmental Center, at Dwight
10             The Elisabeth Ludeman Developmental Center, at  Park
11        Forest
12             The  William A. Howe Developmental Center, at Tinley
13        Park
14             The Ann M. Kiley Developmental Center, at Waukegan.
15        (b)  Beginning  not  later  than  July   1,   1977,   the
16    Department  shall  cause  each  of  the  facilities under its
17    jurisdiction which provide in-patient  care  to  comply  with
18    standards,  rules and regulations of the Department of Public
19    Health  prescribed  under  Section  6.05  of   the   Hospital
20    Licensing Act.
21        (c)  The  Department  shall  issue  quarterly  reports on
22    admissions,   deflections,    discharges,    bed    closures,
23    staff-resident  ratios,  census,  and average length of stay,
24    and  any  adverse  federal  certification  or   accreditation
25    findings,  if  any,  for each State-operated facility for the
26    mentally ill and developmentally disabled.
27    (Source: P.A. 91-357, eff. 7-29-99; 91-652, eff. 12-1-99.)

28        (20 ILCS 1705/4.3) (from Ch. 91 1/2, par. 100-4.3)
29        Sec. 4.3. Site visits and inspections.
30        (a)  Each  facility  under  the   jurisdiction   of   the
31    Department  shall  be  subject  to a site visit at least once
32    during each 12-month period biennium by the Citizens  Council
33    on  Mental  Health and Developmental Disabilities as provided
 
                             -3-               LRB9200853ACcd
 1    in Section 11A-7 of the Legislative Commission Reorganization
 2    Act of 1984, as now or hereafter amended.
 3        (b)  The Department shall establish a  system  of  annual
 4    on-site  inspections of each facility under its jurisdiction.
 5    The  inspections  shall  be  conducted  by   the   Department
 6    Department's central office to:
 7        (1)  Determine  facility  compliance  with  the  statutes
 8    relating  to  patient  care  and  the Department policies and
 9    procedures;
10        (2)  Determine    facility    compliance    with    audit
11    recommendations;
12        (3)  Evaluate facility compliance with applicable federal
13    standards;
14        (4)  Review  and  follow  up  on   complaints   made   by
15    legislators,  community  mental health organizations agencies
16    and advocates, and on findings of the Human Rights  Authority
17    division of the Guardianship and Advocacy Commission; and
18        (5)  Review   administrative   and   management  problems
19    identified by other sources.
20        (c)  Before January 30 of each  even-numbered  year,  the
21    Auditor  General  shall,  with  the advice of the Department,
22    certify at least 3  non-profit  organizations  whose  primary
23    purpose  is  to  improve the quality of mental health care in
24    State-operated facilities.  The certified organization  shall
25    ensure  that those persons who have access under this Section
26    comply with all statutory and regulatory provisions governing
27    recipients' rights, confidentiality, privacy, and safety  and
28    that  any  individual  who  fails  to  comply  shall  not  be
29    permitted  to  continue  to  participate in assessments.  The
30    certified organization shall ensure  that  individuals  shall
31    not  be  permitted  to  participate  in  assessments  at  any
32    facility  at  which  their  presence  would  conflict  with a
33    recipient's right to refuse contact with  those  individuals.
34    Those   organizations   shall   have   access   to   all  the
 
                             -4-               LRB9200853ACcd
 1    State-operated facilities pursuant to the rules governing the
 2    functions of the Inspector General as  authorized  under  the
 3    Abused  and  Neglected  Long  Term  Care  Facility  Residents
 4    Reporting  Act.  The purpose of the access is to ensure there
 5    will  be  independent  assessments  for  each  State-operated
 6    facility, not  to  exceed  4  per  year  for  each  facility.
 7    However,  additional  visits  may  be  carried  out  upon the
 8    notification of  a  specific  complaint.   The  access  shall
 9    exclude   all   patient  records  unless  the  recipient  has
10    permitted the examination of his or  her  records  under  the
11    Mental  Health and Developmental Disabilities Confidentiality
12    Act.
13        The Department  shall  adopt  rules  for  certifying  the
14    organizations  and  for establishing reasonable standards and
15    procedures for determining whether the organizations  seeking
16    certification provide appropriate training and supervision to
17    those persons who will have access under the statute.
18        The  reports  of the assessments shall be provided to the
19    Department, to the Speaker of the House  of  Representatives,
20    the  President  of  the  Senate,  the  Minority Leader of the
21    Senate, the Minority Leader of the House of  Representatives,
22    and to others that the organizations may determine.  Under no
23    circumstances  shall certification or access be denied due to
24    a disagreement by the Department with any positions taken  by
25    the  organizations with regard to public policy, legislation,
26    regulation, or litigation concerning mental health  services,
27    the  operation  of,  or  the  quality of care provided by the
28    Department or any mental health  provider.    The  Department
29    shall  adopt  rules establishing standards and procedures for
30    internal review of any decision denying or terminating access
31    to any organization, including review by the Director or  his
32    or  her  designee.  Any organization denied access under this
33    statute by an administrative decision of the Director or  his
34    or  her  designee  may  have that decision reviewed under the
 
                             -5-               LRB9200853ACcd
 1    Administrative Review Law.
 2        The assessments  shall  be  conducted  by  the  certified
 3    organizations at no charge.
 4    (Source: P.A. 86-1013.)

 5        (20 ILCS 1705/7) (from Ch. 91 1/2, par. 100-7)
 6        Sec.  7.  To  receive  and  provide  the highest possible
 7    quality of humane and rehabilitative care  and  treatment  to
 8    all   persons   admitted   or  committed  or  transferred  in
 9    accordance with law to the facilities,  divisions,  programs,
10    and  services  under  the  jurisdiction of the Department. No
11    resident of another state shall be received  or  retained  to
12    the  exclusion of any resident of this State.  No resident of
13    another state shall be received or retained to the  exclusion
14    of any resident of this State.  All recipients of 17 years of
15    age  and  under  in  residence in a Department facility other
16    than a facility for the care of the mentally  retarded  shall
17    be  housed in quarters separated from older recipients except
18    for: (a) recipients who are placed in medical-surgical  units
19    because  of  physical  illness; and (b) recipients between 13
20    and 18 years of age who need temporary security measures.
21        All recipients in a Department facility shall be given  a
22    dental examination by a licensed dentist or registered dental
23    hygienist at least once every 18 months and shall be assigned
24    to  a  dentist  for  such  dental  care  and  treatment as is
25    necessary.
26        All  medications  administered  to  recipients  shall  be
27    administered only by those persons who are legally  qualified
28    to  do  so  by  the laws of the State of Illinois. Medication
29    shall  not  be  prescribed  until  a  physical   and   mental
30    examination  of  the recipient has been completed. If, in the
31    clinical  judgment  of  a  physician,  it  is  necessary   to
32    administer medication to a recipient before the completion of
33    the  physical  and  mental examination, he may prescribe such
 
                             -6-               LRB9200853ACcd
 1    medication but he  must  file  a  report  with  the  facility
 2    director  setting  forth  the  reasons  for  prescribing such
 3    medication within 24 hours of the prescription. A copy of the
 4    report shall be part of the recipient's record.
 5        No later than January 1, 2002, the Department shall adopt
 6    a  model  protocol  and  forms  for  recording  all   patient
 7    diagnosis,  care,  and  treatment at every facility under the
 8    jurisdiction of the Department.  The model protocol and forms
 9    shall  be  used  by  each  facility  unless  the   Department
10    determines that equivalent alternatives justify an exemption.
11        Every  facility  under the jurisdiction of the Department
12    shall maintain a copy of each report of  suspected  abuse  or
13    neglect of the patient. Copies of those reports shall be made
14    available to the State Auditor General in connection with his
15    biennial program audit of the facility as required by Section
16    3-2 of the Illinois State Auditing Act.
17        No  later  than January 1, 2002, every facility under the
18    jurisdiction of the Department and all services  provided  in
19    those  facilities  shall  comply  with  all of the applicable
20    standards adopted by the Social Security Administration under
21    Subchapter XVIII (Medicare) of the Social  Security  Act  (42
22    U.S.C.  1395  - 1395ccc), if the facility and services may be
23    eligible  for  federal  financial  participation  under  that
24    federal law.
25    (Source: P.A. 86-922; 86-1013; 86-1475.)

26        (20 ILCS 1705/15) (from Ch. 91 1/2, par. 100-15)
27        Sec. 15.  Before any person is released from  a  facility
28    operated  by the State pursuant to an absolute discharge or a
29    conditional discharge from hospitalization  under  this  Act,
30    the facility director of the facility in which such person is
31    hospitalized   shall   determine  that  such  person  is  not
32    currently in need of hospitalization and:
33             (a)  is able to live independently in the community;
 
                             -7-               LRB9200853ACcd
 1        or
 2             (b)  requires further oversight and supervisory care
 3        for which arrangements have been  made  with  responsible
 4        relatives  or  supervised residential program approved by
 5        the Department; or
 6             (c)  requires  further  personal  care  or   general
 7        oversight  as  defined  by the Nursing Home Care Act, for
 8        which  placement  arrangements  have  been  made  with  a
 9        suitable family home or other licensed facility  approved
10        by the Department under this Section; or
11             (d)  requires  community  mental health services for
12        which  arrangements  have  been  made  with  a   suitable
13        community  mental  health  provider  in  accordance  with
14        criteria, standards, and procedures promulgated by rule.
15        Such  determination  shall  be  made in writing and shall
16    become a part of the facility record of  such  absolutely  or
17    conditionally  discharged  person.   When  the  determination
18    indicates  that  the condition of the person to be granted an
19    absolute discharge or a conditional  discharge  is  described
20    under  subparagraph  (c) or (d) of this Section, the name and
21    address of the continuing care facility or home to which such
22    person is to be released shall be  entered  in  the  facility
23    record.   Where  a discharge from a mental health facility is
24    made under subparagraph (c), the Department shall assign  the
25    person   so   discharged   to  an  existing  community  based
26    not-for-profit agency for  participation  in  day  activities
27    suitable  to  the  person's needs, such as but not limited to
28    social and vocational rehabilitation, and other recreational,
29    educational and financial  activities  unless  the  community
30    based  not-for-profit  agency  is  unqualified to accept such
31    assignment. Where the clientele of any not-for-profit  agency
32    increases  as  a  result of assignments under this amendatory
33    Act of 1977  by  more  than  3%  over  the  prior  year,  the
34    Department shall fully reimburse such agency for the costs of
 
                             -8-               LRB9200853ACcd
 1    providing  services  to  such  persons  in  excess of such 3%
 2    increase. The Department shall keep written records detailing
 3    how many persons have been  assigned  to  a  community  based
 4    not-for-profit  agency  and  how  many  persons  were  not so
 5    assigned because the community based agency  was  unqualified
 6    to  accept  the  assignments,  in  accordance  with criteria,
 7    standards, and procedures promulgated by  rule.   Whenever  a
 8    community  based  agency is found to be unqualified, the name
 9    of the agency  and  the  reason  for  the  finding  shall  be
10    included in the report.
11        Insofar  as  desirable  in  the  interests  of the former
12    recipient,  the  facility,  program  or  home  in  which  the
13    discharged person is to be placed shall be located in or near
14    the  community  in  which  the  person   resided   prior   to
15    hospitalization  or  in  the  community in which the person's
16    family or nearest next of kin presently reside. Placement  of
17    the  discharged  person  in  facilities,  programs  or  homes
18    located  outside  of  this  State  shall  not  be made by the
19    Department  unless  there  are  no  appropriate   facilities,
20    programs  or  homes available within this State. Out-of-state
21    placements shall be subject to return of recipients so placed
22    upon the availability of facilities, programs or homes within
23    this State to  accommodate  these  recipients,  except  where
24    placement  in  a  contiguous  state  results  in  locating  a
25    recipient  in a facility or program closer to the recipient's
26    home or  family.   If  an  appropriate  facility  or  program
27    becomes  available equal to or closer to the recipient's home
28    or family, the recipient shall be returned to and  placed  at
29    the appropriate facility or program within this State.
30        To  place  any  person  who  is  under  a  program of the
31    Department at board in a suitable  family  home  or  in  such
32    other  facility  or  program  as  the Department may consider
33    desirable.  The Department  may  place  in  licensed  nursing
34    homes,  sheltered  care  homes,  or  homes for the aged those
 
                             -9-               LRB9200853ACcd
 1    persons  whose  behavioral  manifestations  and  medical  and
 2    nursing  care  needs  are  such  as   to   be   substantially
 3    indistinguishable   from   persons  already  living  in  such
 4    facilities.  Prior to any placement by the  Department  under
 5    this  Section, a determination shall be made by the personnel
 6    of the Department, as to the capability  and  suitability  of
 7    such  facility  to adequately meet the needs of the person to
 8    be discharged.  When specialized programs  are  necessary  in
 9    order  to  enable  persons  in  need  of supervised living to
10    develop and improve in the community,  the  Department  shall
11    place  such  persons  only  in  specialized  residential care
12    facilities which shall meet  Department  standards  including
13    restricted admission policy, special staffing and programming
14    for  social and vocational rehabilitation, in addition to the
15    requirements of the appropriate State licensing agency.   The
16    Department  shall  not place any new person in a facility the
17    license of which has been revoked or not renewed  on  grounds
18    of inadequate programming, staffing, or medical or adjunctive
19    services,  regardless  of  the  pendency  of  an  action  for
20    administrative review regarding such revocation or failure to
21    renew.  Before  the  Department  may transfer any person to a
22    licensed nursing home, sheltered care home or  home  for  the
23    aged  or  place  any person in a specialized residential care
24    facility  the  Department  shall  notify  the  person  to  be
25    transferred, or a responsible relative  of  such  person,  in
26    writing,  at least 30 days before the proposed transfer, with
27    respect to all the relevant facts concerning  such  transfer,
28    except  in  cases  of  emergency  when  such  notice  is  not
29    required.  If  either  the  person  to  be  transferred  or a
30    responsible relative of such person objects to such transfer,
31    in writing to the Department, at any time  after  receipt  of
32    notice  and before the transfer, the facility director of the
33    facility  in  which  the  person  was   a   recipient   shall
34    immediately  schedule  a  hearing  at  the  facility with the
 
                             -10-              LRB9200853ACcd
 1    presence of the facility director, the person who objected to
 2    such proposed transfer, and a psychiatrist  who  is  familiar
 3    with  the record of the person to be transferred. Such person
 4    to  be  transferred  or  a  responsible   relative   may   be
 5    represented  by  such  counsel  or interested party as he may
 6    appoint, who may present such testimony with respect  to  the
 7    proposed  transfer. Testimony presented at such hearing shall
 8    become   a   part   of   the   facility   record    of    the
 9    person-to-be-transferred.  The  record  of testimony shall be
10    held in the person-to-be-transferred's record in the  central
11    files of the facility. If such hearing is held a transfer may
12    only  be  implemented,  if  at  all,  in  accordance with the
13    results of such hearing. Within 15 days  after  such  hearing
14    the facility director shall deliver his findings based on the
15    record  of  the  case  and  the  testimony  presented  at the
16    hearing, by registered or certified mail, to the  parties  to
17    such  hearing. The findings of the facility director shall be
18    deemed a final administrative decision of the Department. For
19    purposes of this Section, "case  of  emergency"  means  those
20    instances in which the health of the person to be transferred
21    is  imperiled  and the most appropriate mental health care or
22    medical  care  is  available  at  a  licensed  nursing  home,
23    sheltered care home or home for the  aged  or  a  specialized
24    residential care facility.
25        Prior to placement of any person in a facility under this
26    Section  the  Department  shall  ensure  that  an appropriate
27    training plan for staff is provided  by  the  facility.  Said
28    training   may   include  instruction  and  demonstration  by
29    Department personnel qualified in the area of mental  illness
30    or  mental  retardation,  as  applicable  to the person to be
31    placed.  Training may be given  both  at  the  facility  from
32    which  the  recipient  is  transferred  and  at  the facility
33    receiving the recipient, and may be available on a continuing
34    basis subsequent  to  placement.   In  a  facility  providing
 
                             -11-              LRB9200853ACcd
 1    services  to  former Department recipients, training shall be
 2    available as necessary for  facility  staff.   Such  training
 3    will  be  on  a continuing basis as the needs of the facility
 4    and recipients change and further training is required.
 5        The Department shall not place any person in  a  facility
 6    which does not have appropriately trained staff in sufficient
 7    numbers  to  accommodate  the recipient population already at
 8    the facility.  As a condition of further or future placements
 9    of persons, the Department shall require  the  employment  of
10    additional  trained  staff members at the facility where said
11    persons are to be placed.   The  Secretary,  or  his  or  her
12    designate,  shall  establish written guidelines for placement
13    of persons in facilities under this Act. The Department shall
14    keep written records detailing  which  facilities  have  been
15    determined   to   have  appropriately  trained  staff,  which
16    facilities have been determined not to have such  staff,  and
17    all  training  which  it  has provided or required under this
18    Section.
19        Bills for the support for a person boarded out  shall  be
20    payable monthly out of the proper maintenance funds and shall
21    be  audited  as  any  other accounts of the Department.  If a
22    person is  placed  in  a  facility  or  program  outside  the
23    Department,  the  Department  may  pay  the  actual  costs of
24    residence, treatment or maintenance in such facility and  may
25    collect  such  actual  costs  or  a  portion thereof from the
26    recipient or the estate of a person placed in accordance with
27    this Section.
28        Other than those placed in a family home  the  Department
29    shall  cause  all  persons  who  are placed in a facility, as
30    defined by the  Nursing  Home  Care  Act,  or  in  designated
31    community  living  situations  or  programs, to be visited at
32    least once during the first month  following  placement,  and
33    once  every  month  thereafter  for  the first year following
34    placement when indicated, but at least quarterly.  After  the
 
                             -12-              LRB9200853ACcd
 1    first  year,  visits shall be made at least once per year for
 2    as long as the placement continues.   If  a  long  term  care
 3    facility  has periodic care plan conferences, the visitor may
 4    participate in those conferences. Visits  shall  be  made  by
 5    qualified   and   trained   Department  personnel,  or  their
 6    designee, in the  area  of  mental  health  or  developmental
 7    disabilities  applicable  to the person visited, and shall be
 8    made on a more frequent basis when indicated.  The Department
 9    may not use as  designee  any  personnel  connected  with  or
10    responsible  to  the representatives of any facility in which
11    persons who have been  transferred  under  this  Section  are
12    placed.    In  the  course  of  such  visit  there  shall  be
13    consideration   of  the  following  areas,  but  not  limited
14    thereto:  effects of transfer on physical and  mental  health
15    of  the  person,  sufficiency  of  nursing  care  and medical
16    coverage  required  by  the  person,  sufficiency  of   staff
17    personnel  and  ability to provide basic care for the person,
18    social, recreational and  programmatic  activities  available
19    for the person, and other appropriate aspects of the person's
20    environment.
21        A  report containing the above observations shall be made
22    to  the  Department  and  to  any  other  appropriate  agency
23    subsequent to each visitation. The  report  shall  contain  a
24    detailed  assessment  of  whether  the recipient is receiving
25    adequate  and  humane  care  and  services   in   the   least
26    restrictive  environment.   If the recipient is not receiving
27    those services, the Department shall either require that  the
28    facility  modify  the  treatment  plan  to  ensure that those
29    services are  provided  or  make  arrangements  necessary  to
30    provide  those  services  elsewhere. At the conclusion of one
31    year following absolute or conditional discharge, or a longer
32    period of time if required by the Department, the  Department
33    may  terminate the visitation requirements of this Section as
34    to a person placed in accordance with this Section, by filing
 
                             -13-              LRB9200853ACcd
 1    a written statement of termination setting forth  reasons  to
 2    substantiate  the  termination of visitations in the person's
 3    file, and sending a copy thereof to the person,  and  to  his
 4    guardian or next of kin.
 5        Upon  the  complaint  of  any person placed in accordance
 6    with  this  Section  or  any  responsible  citizen  or   upon
 7    discovery  that  such  person  has been abused, neglected, or
 8    improperly cared for, or that the placement does not  provide
 9    the   type  of  care  required  by  the  recipient's  current
10    condition, the Department immediately shall investigate,  and
11    determine  if  the well-being, health, care, or safety of any
12    person is affected by any of the above  occurrences,  and  if
13    any  one of the above occurrences is verified, the Department
14    shall remove such  person  at  once  to  a  facility  of  the
15    Department  or  to  another  facility outside the Department,
16    provided such person's needs can be  met  at  said  facility.
17    The   Department  may  also  provide  any  person  placed  in
18    accordance with this Section who is without available  funds,
19    and  who  is  permitted  to  engage in employment outside the
20    facility,  such  sums  for  the  transportation,  and   other
21    expenses  as may be needed by him until he receives his wages
22    for such employment.
23        The Department shall  promulgate  rules  and  regulations
24    governing  the  purchase of care for persons who are wards of
25    or who are receiving  services  from  the  Department.   Such
26    rules  and  regulations shall apply to all monies expended by
27    any agency of the State of Illinois for services rendered  by
28    any  person, corporate entity, agency, governmental agency or
29    political subdivision whether public or  private  outside  of
30    the Department whether payment is made through a contractual,
31    per-diem or other arrangement.  No funds shall be paid to any
32    person, corporation, agency, governmental entity or political
33    subdivision   without   compliance   with   such   rules  and
34    regulations.
 
                             -14-              LRB9200853ACcd
 1        The rules and  regulations  governing  purchase  of  care
 2    shall   describe  categories  and  types  of  service  deemed
 3    appropriate for purchase by the Department.
 4        Any provider of services under  this  Act  may  elect  to
 5    receive  payment  for  those  services, and the Department is
 6    authorized to arrange for that payment, by  means  of  direct
 7    deposit   transmittals  to  the  service  provider's  account
 8    maintained at a bank, savings and loan association, or  other
 9    financial  institution.   The  financial institution shall be
10    approved by the Department, and  the  deposits  shall  be  in
11    accordance   with   rules  and  regulations  adopted  by  the
12    Department.
13        The Department shall keep written records of  the  number
14    of  persons it places in long term care facilities each year.
15    The records shall  include  the  name  and  address  of  each
16    facility and the diagnosis of each individual so placed.
17    (Source: P.A. 89-507, eff. 7-1-97; 90-423, eff. 8-15-97.)

18        Section  10.   The  Abused  and  Neglected Long Term Care
19    Facility Residents  Reporting  Act  is  amended  by  changing
20    Sections  6.2,  6.3,  6.4,  6.5, 6.6, 6.7, and 6.8 and adding
21    Section 6.9 as follows:

22        (210 ILCS 30/6.2) (from Ch. 111 1/2, par. 4166.2)
23        (Section scheduled to be repealed on January 1, 2002)
24        Sec. 6.2.  Inspector General.
25        (a)  The Governor shall appoint,  and  the  Senate  shall
26    confirm,  an  Inspector General.  The Inspector General shall
27    be appointed for a term of 4 years  and  who  shall  function
28    within  the  Department  of  Human Services and report to the
29    Secretary of Human Services and the Governor.  The  Inspector
30    General shall function independently within the Department of
31    Human  Services with respect to the operations of the office,
32    including the performance of investigations and  issuance  of
 
                             -15-              LRB9200853ACcd
 1    findings  and  recommendations.   The Inspector General shall
 2    independently  submit  to  the  Governor  any   request   for
 3    appropriations  necessary  for  the  ordinary  and contingent
 4    expenses  of   the   Office   of   Inspector   General,   and
 5    appropriations  for  that  office  shall be separate from the
 6    Department of Human Services.  The  Inspector  General  shall
 7    investigate  reports  of suspected abuse or neglect (as those
 8    terms are defined in Section 3 of this Act)  of  patients  or
 9    residents  in any mental health or developmental disabilities
10    facility operated by the Department  of  Human  Services  and
11    shall have authority to investigate and take immediate action
12    on  reports  of  abuse  or  neglect  of  recipients,  whether
13    patients  or residents, in any mental health or developmental
14    disabilities  facility  or  program  that  is   licensed   or
15    certified  by  the Department of Human Services (as successor
16    to  the  Department  of  Mental  Health   and   Developmental
17    Disabilities)  or  that  is funded by the Department of Human
18    Services (as successor to the Department of Mental Health and
19    Developmental Disabilities) and is not licensed or  certified
20    by any agency of the State.  At the specific, written request
21    of  an agency of the State other than the Department of Human
22    Services (as successor to the Department of Mental Health and
23    Developmental  Disabilities),  the  Inspector   General   may
24    cooperate  in  investigating  reports of abuse and neglect of
25    persons with mental illness  or  persons  with  developmental
26    disabilities.    The   Inspector   General   shall   have  no
27    supervision over or  involvement  in  routine,  programmatic,
28    licensure,  or  certification operations of the Department of
29    Human Services or any of its funded agencies.
30        The Inspector General shall promulgate rules establishing
31    minimum requirements for reporting allegations of  abuse  and
32    neglect    and   initiating,   conducting,   and   completing
33    investigations.  The  promulgated  rules  shall  clearly  set
34    forth  that in instances where 2 or more State agencies could
 
                             -16-              LRB9200853ACcd
 1    investigate an allegation of abuse or neglect, the  Inspector
 2    General  shall not conduct an investigation that is redundant
 3    to an investigation conducted by another State agency.    The
 4    rules  shall  establish  criteria for determining, based upon
 5    the nature of  the  allegation,  the  appropriate  method  of
 6    investigation, which may include, but need not be limited to,
 7    site  visits,  telephone  contacts,  or  requests for written
 8    responses from agencies.  The rules shall  also  clarify  how
 9    the  Office  of the Inspector General shall interact with the
10    licensing  unit  of  the  Department  of  Human  Services  in
11    investigations of  allegations  of  abuse  or  neglect.   Any
12    allegations  or  investigations  of  reports made pursuant to
13    this Act shall remain confidential until a  final  report  is
14    completed.  The  resident or patient who allegedly was abused
15    or neglected and his or her legal guardian shall be  informed
16    by  the  facility or agency of the report of alleged abuse or
17    neglect. Final reports regarding unsubstantiated or unfounded
18    allegations shall  remain  confidential,  except  that  final
19    reports may be disclosed pursuant to Section 6 of this Act.
20        The  Inspector General shall be appointed for a term of 4
21    years.
22        (b)  The Inspector General shall within  24  hours  after
23    receiving  a  report  of suspected abuse or neglect determine
24    whether the evidence indicates that any possible criminal act
25    has been committed. If he determines that a possible criminal
26    act has been committed, or that special expertise is required
27    in  the  investigation,  he  shall  immediately  notify   the
28    Department  of  State Police.  The Department of State Police
29    shall investigate any report indicating  a  possible  murder,
30    rape,  or  other  felony. All investigations conducted by the
31    Inspector General shall be conducted in a manner designed  to
32    ensure  the  preservation  of  evidence for possible use in a
33    criminal prosecution.
34        (b-5)  The Inspector General shall make  a  determination
 
                             -17-              LRB9200853ACcd
 1    to accept or reject a preliminary report of the investigation
 2    of   alleged   abuse   or   neglect   based   on  established
 3    investigative procedures.  The facility or agency may request
 4    clarification  or   reconsideration   based   on   additional
 5    information.   For  cases  where  the  allegation of abuse or
 6    neglect is substantiated, the Inspector General shall require
 7    the facility or agency to submit  a  written  response.   The
 8    written response from a facility or agency shall address in a
 9    concise  and  reasoned  manner the actions that the agency or
10    facility will take or has taken to protect  the  resident  or
11    patient  from  abuse  or  neglect, prevent reoccurrences, and
12    eliminate   problems    identified    and    shall    include
13    implementation and completion dates for all such action.
14        (c)  The Inspector General shall, within 10 calendar days
15    after the transmittal date of a completed investigation where
16    abuse or neglect is substantiated or administrative action is
17    recommended,  provide  a  complete  report on the case to the
18    Secretary of Human Services and to the agency  in  which  the
19    abuse  or  neglect  is alleged to have happened. The complete
20    report shall include a written response from  the  agency  or
21    facility  operated by the State to the Inspector General that
22    addresses in a concise and reasoned manner the  actions  that
23    the  agency or facility will take or has taken to protect the
24    resident  or  patient  from   abuse   or   neglect,   prevent
25    reoccurrences,  and  eliminate  problems identified and shall
26    include implementation and  completion  dates  for  all  such
27    action.   The  Secretary  of  Human  Services shall accept or
28    reject the  response and establish how  the  Department  will
29    determine  whether  the  facility  or  program  followed  the
30    approved  response.   The  Secretary  may  require Department
31    personnel to visit  the  facility  or  agency  for  training,
32    technical    assistance,    programmatic,    licensure,    or
33    certification  purposes.   Administrative  action,  including
34    sanctions,  may  be  applied  should the Secretary reject the
 
                             -18-              LRB9200853ACcd
 1    response or should the facility or agency fail to follow  the
 2    approved  response.   The facility or agency shall inform the
 3    resident or  patient  and  the  legal  guardian  whether  the
 4    reported  allegation  was  substantiated, unsubstantiated, or
 5    unfounded.  There shall be an appeals process for any  person
 6    or   agency  that  is  subject  to  any  action  based  on  a
 7    recommendation or recommendations.
 8        (d)  The  Inspector  General   may   recommend   to   the
 9    Departments  of Public Health and Human Services sanctions to
10    be  imposed   against   mental   health   and   developmental
11    disabilities   facilities   under  the  jurisdiction  of  the
12    Department of Human Services for the protection of residents,
13    including  appointment  of  on-site  monitors  or  receivers,
14    transfer or relocation of residents, and  closure  of  units.
15    The Inspector General may seek the assistance of the Attorney
16    General  or  any of the several State's attorneys in imposing
17    such sanctions. Whenever the  Inspector  General  issues  any
18    recommendations  to  the  Secretary  of  Human  Services, the
19    Secretary shall provide a written response.
20        (e)  The Inspector General shall  establish  and  conduct
21    periodic  training  programs for Department of Human Services
22    employees concerning the prevention and reporting of  neglect
23    and abuse.
24        (f)  The  Inspector General shall at all times be granted
25    access to any mental  health  or  developmental  disabilities
26    facility  operated by the Department of Human Services, shall
27    establish  and  conduct  unannounced  site  visits  to  those
28    facilities at least  once  annually,  and  shall  be  granted
29    access, for the purpose of investigating a report of abuse or
30    neglect,  to  the records of the Department of Human Services
31    and to any facility or program funded by  the  Department  of
32    Human  Services  that is subject under the provisions of this
33    Section to investigation  by  the  Inspector  General  for  a
34    report of abuse or neglect.
 
                             -19-              LRB9200853ACcd
 1        (g)  Nothing  in  this Section shall limit investigations
 2    by the Department of Human Services  that  may  otherwise  be
 3    required by law or that may be necessary in that Department's
 4    capacity  as the central administrative authority responsible
 5    for the operation of State mental  health  and  developmental
 6    disability facilities.
 7        (h)  This Section is repealed on January 1, 2002.
 8    (Source: P.A.  90-252,  eff.  7-29-97;  90-512, eff. 8-22-97;
 9    90-655, eff. 7-30-98; 91-169, eff. 7-16-99.)

10        (210 ILCS 30/6.3) (from Ch. 111 1/2, par. 4166.3)
11        (Section scheduled to be repealed on January 1, 2002)
12        Sec. 6.3.  Quality Care Board.  There is created,  within
13    the  Department  of  Human  Services' Office of the Inspector
14    General, a Quality Care Board to be  composed  of  7  members
15    appointed  by the Governor with the advice and consent of the
16    Senate.  One of the members shall be designated  as  chairman
17    by  the  Governor.   Of  the initial appointments made by the
18    Governor, 4 Board members shall each be appointed for a  term
19    of  4  years and 3 members shall each be appointed for a term
20    of 2 years.  Upon the expiration of  each  member's  term,  a
21    successor  shall  be appointed for a term of 4 years.  In the
22    case of a vacancy in the office of any member,  the  Governor
23    shall  appoint a successor for the remainder of the unexpired
24    term.
25        Members appointed by the Governor shall be  qualified  by
26    professional  knowledge  or  experience  in  the area of law,
27    investigatory techniques, or in  the  area  of  care  of  the
28    mentally   ill  or  developmentally  disabled.   Two  members
29    appointed by the Governor shall be persons with a  disability
30    or  a  parent  of  a person with a disability.  Members shall
31    serve without  compensation,  but  shall  be  reimbursed  for
32    expenses incurred in connection with the performance of their
33    duties as members.
 
                             -20-              LRB9200853ACcd
 1        The  Board  shall  meet  quarterly,  and  may  hold other
 2    meetings on the call of the  chairman.   Four  members  shall
 3    constitute   a   quorum.   The  Board  may  adopt  rules  and
 4    regulations it deems necessary to govern its own procedures.
 5        This Section is repealed on January 1, 2002.
 6    (Source: P.A. 91-169, eff. 7-16-99.)

 7        (210 ILCS 30/6.4) (from Ch. 111 1/2, par. 4166.4)
 8        (Section scheduled to be repealed on January 1, 2002)
 9        Sec. 6.4.  Scope and function of the Quality Care  Board.
10    The Board shall monitor and oversee the operations, policies,
11    and  procedures of the Inspector General to assure the prompt
12    and thorough investigation  of  allegations  of  neglect  and
13    abuse.   In  fulfilling these responsibilities, the Board may
14    do the following:
15             (1)  Provide independent, expert consultation to the
16        Inspector  General  on   policies   and   protocols   for
17        investigations of alleged neglect and abuse.
18             (2)  Review  existing  regulations  relating  to the
19        operation  of  facilities  under  the  control   of   the
20        Department of Human Services.
21             (3)  Advise  the Inspector General as to the content
22        of training activities authorized under Section 6.2.
23             (4)  Recommend  policies  concerning   methods   for
24        improving the intergovernmental relationships between the
25        office  of  the  Inspector  General  and  other  State or
26        federal agencies.
27        This Section is repealed on January 1, 2002.
28    (Source: P.A. 91-169, eff. 7-16-99.)

29        (210 ILCS 30/6.5) (from Ch. 111 1/2, par. 4166.5)
30        (Section scheduled to be repealed on January 1, 2002)
31        Sec.  6.5.  Investigators.   Within  60  days  after  the
32    effective date of this amendatory Act of 1992, the  Inspector
 
                             -21-              LRB9200853ACcd
 1    General  shall  establish  a  comprehensive program to ensure
 2    that  every  person  employed  or  newly  hired  to   conduct
 3    investigations  shall  receive  training on an on-going basis
 4    concerning investigative  techniques,  communication  skills,
 5    and the appropriate means of contact with persons admitted or
 6    committed  to the mental health or developmental disabilities
 7    facilities under the jurisdiction of the Department of  Human
 8    Services.
 9        This Section is repealed on January 1, 2002.
10    (Source: P.A. 91-169, eff. 7-16-99.)

11        (210 ILCS 30/6.6) (from Ch. 111 1/2, par. 4166.6)
12        (Section scheduled to be repealed on January 1, 2002)
13        Sec.  6.6.  Subpoenas; testimony; penalty.  The Inspector
14    General shall have the power to subpoena witnesses and compel
15    the  production  of  books  and  papers   pertinent   to   an
16    investigation authorized by this Act, provided that the power
17    to  subpoena  or to compel the production of books and papers
18    shall not extend to  the  person  or  documents  of  a  labor
19    organization  or its representatives insofar as the person or
20    documents of a labor organization relate to the  function  of
21    representing  an employee subject to investigation under this
22    Act.  Mental health records of patients shall be confidential
23    as  provided  under  the  Mental  Health  and   Developmental
24    Disabilities  Confidentiality  Act.   Any person who fails to
25    appear in response to a subpoena or to answer any question or
26    produce any books or papers  pertinent  to  an  investigation
27    under this Act, except as otherwise provided in this Section,
28    or  who  knowingly  gives  false  testimony in relation to an
29    investigation  under  this  Act  is  guilty  of  a  Class   A
30    misdemeanor.
31        This Section is repealed on January 1, 2002.
32    (Source: P.A. 91-169, eff. 7-16-99.)
 
                             -22-              LRB9200853ACcd
 1        (210 ILCS 30/6.7) (from Ch. 111 1/2, par. 4166.7)
 2        (Section scheduled to be repealed on January 1, 2002)
 3        Sec.  6.7.  Annual  report.   The Inspector General shall
 4    provide to the General Assembly and the  Governor,  no  later
 5    than  January  1  of  each  year,  a  summary  of reports and
 6    investigations made under this Act for the prior fiscal  year
 7    with   respect   to   residents  of  institutions  under  the
 8    jurisdiction of the Department of Human Services.  The report
 9    shall detail  the  imposition  of  sanctions  and  the  final
10    disposition  of  those  recommendations.  The summaries shall
11    not  contain  any  confidential  or  identifying  information
12    concerning the subjects of the  reports  and  investigations.
13    The  report shall also include a trend analysis of the number
14    of reported  allegations  and  their  disposition,  for  each
15    facility and Department-wide, for the most recent 3-year time
16    period   and   a   statement,   for  each  facility,  of  the
17    staffing-to-patient ratios.  The ratios  shall  include  only
18    the  number  of  direct  care  staff.   The report shall also
19    include  detailed  recommended  administrative  actions   and
20    matters for consideration by the General Assembly.
21        This Section is repealed on January 1, 2002.
22    (Source: P.A. 91-169, eff. 7-16-99.)

23        (210 ILCS 30/6.8) (from Ch. 111 1/2, par. 4166.8)
24        (Section scheduled to be repealed on January 1, 2002)
25        Sec.  6.8.  Program  audit.   The  Auditor  General shall
26    conduct a  biennial  program  audit  of  the  office  of  the
27    Inspector  General  in  relation  to  the Inspector General's
28    compliance with  this  Act.   The  audit  shall  specifically
29    include    the    Inspector    General's   effectiveness   in
30    investigating  reports  of  alleged  neglect  or   abuse   of
31    residents in any facility operated by the Department of Human
32    Services  and  in making recommendations for sanctions to the
33    Departments of Human Services and Public Health.  The Auditor
 
                             -23-              LRB9200853ACcd
 1    General shall conduct the  program  audit  according  to  the
 2    provisions  of  the  Illinois  State  Auditing  Act and shall
 3    report its findings to the General  Assembly  no  later  than
 4    January 1 of each odd-numbered year.
 5        This Section is repealed on January 1, 2002.
 6    (Source: P.A. 91-169, eff. 7-16-99.).

 7        (210 ILCS 30/6.9 new)
 8        Sec.  6.9.  System evaluations; mental health facilities.
 9    The agency designated by the Governor under Section 1 of  the
10    Protection  and Advocacy for Developmentally Disabled Persons
11    Act is authorized to periodically  evaluate  abuse,  neglect,
12    deaths,  and  other  safety-related  issues  in mental health
13    facilities, as defined in the Mental Health and Developmental
14    Disabilities Code,  and  the  effectiveness  of  the  State's
15    systems  that  address  these  issues.  To  enable the agency
16    designated  by  the  Governor  to  fulfill  its   obligations
17    pursuant  to this Section, the agency shall have authority to
18    the same extent as that provided to the Inspector General  of
19    the  Department  of  Human Services.  Nothing in this Section
20    limits the  agency's  authority  as  the  State's  designated
21    protection  and advocacy system. All identifiable information
22    in records provided pursuant to this  Section  shall  not  be
23    further disclosed except as provided by the Mental Health and
24    Developmental  Disabilities Confidentiality Act. The scope of
25    these studies shall be based on the available  appropriation.
26    Nothing in this Section prevents the agency designated by the
27    Governor from securing other public or private funds to carry
28    out  studies  pursuant  to  this  Section.  The  agency shall
29    provide a report to the General  Assembly  and  the  Governor
30    regarding any system evaluations authorized by this Section.

31        Section  15.   The  Nursing  Home  Care Act is amended by
32    changing Sections 1-113, 2-104, 2-106, 2-106.1, and 3-203  as
 
                             -24-              LRB9200853ACcd
 1    follows:

 2        (210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113)
 3        Sec.  1-113.  "Facility"  or  "long-term  care  facility"
 4    means  a  private  home, institution, building, residence, or
 5    any other place, whether operated for profit  or  not,  or  a
 6    county  home  for  the  infirm  and  chronically ill operated
 7    pursuant to Division 5-21 or 5-22 of the  Counties  Code,  or
 8    any  similar  institution operated by a political subdivision
 9    of  the  State  of  Illinois,  which  provides,  through  its
10    ownership or management, personal  care,  sheltered  care  or
11    nursing  for  3 or more persons, not related to the applicant
12    or owner by blood or marriage.  It includes  skilled  nursing
13    facilities  and  intermediate  care facilities as those terms
14    are defined in Title XVIII  and  Title  XIX  of  the  Federal
15    Social Security Act. It shall also include classifications of
16    such  facilities,  including  but not limited to "Residential
17    Rehabilitation Facilities"  that  are  primarily  engaged  in
18    providing  diagnosis,  treatment,  or  care  of  persons with
19    mental illness, which  includes  medical  attention,  nursing
20    care,   and   related   services.  It  also  includes  homes,
21    institutions, or  other  places  operated  by  or  under  the
22    authority of the Illinois Department of Veterans' Affairs.
23        "Facility" does not include the following:
24        (1)  A  home, institution, or other place operated by the
25    federal government or agency thereof,  or  by  the  State  of
26    Illinois,  other  than  homes,  institutions, or other places
27    operated by or under the authority of the Illinois Department
28    of Veterans' Affairs;
29        (2)  A hospital, sanitarium, or other  institution  whose
30    principal  activity  or  business is the diagnosis, care, and
31    treatment  of  human  illness  through  the  maintenance  and
32    operation as organized facilities therefor, which is required
33    to be licensed under the Hospital Licensing Act;
 
                             -25-              LRB9200853ACcd
 1        (3)  Any "facility for child  care"  as  defined  in  the
 2    Child Care Act of 1969;
 3        (4)  Any  "Community  Living  Facility" as defined in the
 4    Community Living Facilities Licensing Act;
 5        (5)  Any "community residential alternative"  as  defined
 6    in the Community Residential Alternatives Licensing Act;
 7        (6)  Any  nursing  home  or sanatorium operated solely by
 8    and for  persons  who  rely  exclusively  upon  treatment  by
 9    spiritual  means through prayer, in accordance with the creed
10    or  tenets  of  any  well-recognized  church   or   religious
11    denomination.  However, such nursing home or sanatorium shall
12    comply with all local laws and rules relating  to  sanitation
13    and safety;
14        (7)  Any  facility  licensed  by  the Department of Human
15    Services as  a  community-integrated  living  arrangement  as
16    defined   in  the  Community-Integrated  Living  Arrangements
17    Licensure and Certification Act;
18        (8)  Any  "Supportive  Residence"  licensed   under   the
19    Supportive Residences Licensing Act;
20        (9)  Any  "supportive  living  facility" in good standing
21    with the  demonstration  project  established  under  Section
22    5-5.01a of the Illinois Public Aid Code;
23        (10)  Any assisted living or shared housing establishment
24    licensed under the Assisted Living and Shared Housing Act; or
25        (11)  An    Alzheimer's    disease    management   center
26    alternative health care model licensed under the  Alternative
27    Health Care Delivery Act.
28    (Source:  P.A.  90-14,  eff.  7-1-97;  90-763,  eff. 8-14-98;
29    91-656, eff. 1-1-01; 91-838, eff. 6-16-00.)

30        (210 ILCS 45/2-104) (from Ch. 111 1/2, par. 4152-104)
31        Sec. 2-104.  (a) A resident shall be permitted to  retain
32    the services of his own personal physician at his own expense
33    or  under an individual or group plan of health insurance, or
 
                             -26-              LRB9200853ACcd
 1    under any public or private assistance program providing such
 2    coverage.  However,  the  facility  is  not  liable  for  the
 3    negligence  of  any  such personal physician.  Every resident
 4    shall be permitted to obtain from his own  physician  or  the
 5    physician  attached  to  the  facility  complete  and current
 6    information concerning his medical diagnosis,  treatment  and
 7    prognosis  in  terms and language the resident can reasonably
 8    be expected to understand.  Every resident shall be permitted
 9    to participate in the planning of his total care and  medical
10    treatment  to  the  extent  that  his  condition permits.  No
11    resident shall  be  subjected  to  experimental  research  or
12    treatment  without  first  obtaining  his  informed,  written
13    consent.    The  conduct  of  any  experimental  research  or
14    treatment  shall  be   authorized   and   monitored   by   an
15    institutional review committee appointed by the administrator
16    of   the  facility  where  such  research  and  treatment  is
17    conducted.  The membership, operating procedures  and  review
18    criteria   for   institutional  review  committees  shall  be
19    prescribed under rules and regulations of the Department.
20        (b)  All  medical  treatment  and  procedures  shall   be
21    administered  as  ordered  by  a physician. All new physician
22    orders shall  be  reviewed  by  the  facility's  director  of
23    nursing  or  charge nurse designee within 24 hours after such
24    orders have been issued to assure  facility  compliance  with
25    such orders.
26        According to rules adopted by the Department, every woman
27    resident   of   child-bearing   age   shall  receive  routine
28    obstetrical  and  gynecological  evaluations   as   well   as
29    necessary prenatal care.
30        Every  resident with a diagnosis of mental illness (other
31    than Alzheimer's disease or a related disorder) shall receive
32    necessary mental health services  in  accordance  with  rules
33    promulgated  by  the  Department  under Section 3-203 of this
34    Act,  including  but  not  limited  to  medical   management,
 
                             -27-              LRB9200853ACcd
 1    individual  and  group  therapy, psychosocial rehabilitation,
 2    vocational services, and partial hospitalization.
 3        (c)  Every resident shall be permitted to refuse  medical
 4    treatment and to know the consequences of such action, unless
 5    such  refusal  would  be  harmful to the health and safety of
 6    others and such harm is documented  by  a  physician  in  the
 7    resident's  clinical  record.   The  resident's refusal shall
 8    free  the  facility  from  the  obligation  to  provide   the
 9    treatment.
10        (d)  Every  resident,  resident's  guardian, or parent if
11    the resident is a minor shall be  permitted  to  inspect  and
12    copy  all  his clinical and other records concerning his care
13    and maintenance kept by the facility or by his physician. The
14    facility may charge a reasonable fee  for  duplication  of  a
15    record.
16    (Source: P.A. 86-1013.)

17        (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106)
18        Sec. 2-106.  (a) For purposes of this Act, (i) a physical
19    restraint  is  any  manual  method  or physical or mechanical
20    device, material, or equipment  attached  or  adjacent  to  a
21    resident's  body  that  the resident cannot remove easily and
22    restricts freedom of movement or normal access to one's body;
23    (ii) a chemical restraint is any drug used for discipline  or
24    convenience  and not required to treat medical symptoms.  The
25    Department  shall  by  rule,  designate  certain  devices  as
26    restraints, including at least all those devices  which  have
27    been  determined  to  be  restraints  by  the  United  States
28    Department  of  Health  and  Human  Services  in interpretive
29    guidelines issued for the purposes of administering Titles 18
30    and 19 of the Social Security Acts.
31        (b)  Neither  restraints  nor   confinements   shall   be
32    employed for the purpose of punishment or for the convenience
33    of  any  facility  personnel.  No  restraints or confinements
 
                             -28-              LRB9200853ACcd
 1    shall be employed  except  as  ordered  by  a  physician  who
 2    documents the need for such restraints or confinements in the
 3    resident's   clinical  record.  Whenever  a  resident  of  an
 4    institution for mental diseases is restrained,  a  member  of
 5    the  facility  staff  shall  remain  with the resident at all
 6    times unless the recipient has been confined.  A resident who
 7    is restrained and confined shall be observed by  a  qualified
 8    person  as often as is clinically appropriate but in no event
 9    less often than once every 15 minutes.
10        (c)  A restraint may  be  used  only  with  the  informed
11    consent  of  the  resident, the resident's guardian, or other
12    authorized representative.  A restraint may be used only  for
13    specific  periods,  if  it  is  the  least  restrictive means
14    necessary to  attain  and  maintain  the  resident's  highest
15    practicable  physical,  mental  or  psychosocial  well-being,
16    including   brief   periods  of  time  to  provide  necessary
17    life-saving treatment.  A restraint may be  used  only  after
18    consultation  with  appropriate health professionals, such as
19    occupational or physical therapists,  and  a  trial  of  less
20    restrictive  measures  has  led to the determination that the
21    use of less restrictive measures would not attain or maintain
22    the  resident's  highest  practicable  physical,  mental   or
23    psychosocial  well-being.  However,  if  the  resident  needs
24    emergency  care,  restraints may be used for brief periods to
25    permit medical treatment to proceed unless the  facility  has
26    notice  that the resident has previously made a valid refusal
27    of the treatment in question.
28        (d)  A restraint may be applied only by a person  trained
29    in the application of the particular type of restraint.
30        (e)  Whenever   a   period  of  use  of  a  restraint  is
31    initiated, the resident shall be advised of his or her  right
32    to  have  a  person  or  organization of his or her choosing,
33    including the Guardianship and Advocacy Commission,  notified
34    of  the  use  of  the  restraint.   A  recipient who is under
 
                             -29-              LRB9200853ACcd
 1    guardianship may request that a person or organization of his
 2    or her choosing  be notified of the restraint, whether or not
 3    the guardian  approves  the  notice.    If  the  resident  so
 4    chooses,  the  facility shall make the notification within 24
 5    hours, including any information about  the  period  of  time
 6    that  the  restraint is to be used. Whenever the Guardianship
 7    and Advocacy Commission is notified that a resident has  been
 8    restrained,  it  shall  contact the resident to determine the
 9    circumstances of the restraint and whether further action  is
10    warranted.
11        (f)  Whenever  a  restraint  is  used on a resident whose
12    primary mode of communication is sign language, the  resident
13    shall  be  permitted  to  have  his  or  her  hands free from
14    restraint for brief  periods  each  hour,  except  when  this
15    freedom  may  result  in  physical  harm  to  the resident or
16    others.
17        (g)  The requirements of this  Section  are  intended  to
18    control  in  any  conflict  with the requirements of Sections
19    1-126 and  2-108  of  the  Mental  Health  and  Developmental
20    Disabilities Code.
21    (Source: P.A. 88-413.)

22        (210 ILCS 45/2-106.1)
23        Sec. 2-106.1.  Drug treatment.
24        (a)  A resident shall not be given unnecessary drugs.  An
25    unnecessary  drug  is  any  drug  used  in an excessive dose,
26    including in duplicative  therapy;  for  excessive  duration;
27    without adequate monitoring; without adequate indications for
28    its  use;  or  in  the  presence of adverse consequences that
29    indicate the drugs should be reduced  or  discontinued.   The
30    Department   shall   adopt,   by   rule,  the  standards  for
31    unnecessary drugs contained in interpretive guidelines issued
32    by the United States Department of Health and Human  Services
33    for  the  purposes  of  administering titles 18 and 19 of the
 
                             -30-              LRB9200853ACcd
 1    Social Security Act.
 2        (b)  Psychotropic  medication  shall  not  be  prescribed
 3    without the informed consent of the resident, the  resident's
 4    guardian,  or other authorized representative.  "Psychotropic
 5    medication" means medication that is used for  or  listed  as
 6    used   for   antipsychotic,   antidepressant,  antimanic,  or
 7    antianxiety  behavior  modification  or  behavior  management
 8    purposes in the latest editions of the AMA  Drug  Evaluations
 9    or the Physician's Desk Reference.
10        (c)  The  requirements  of  this  Section are intended to
11    control in a conflict with the requirements of Sections 2-102
12    1-102 and 2-107.2 of  the  Mental  Health  and  Developmental
13    Disabilities  Code  with  respect  to  the  administration of
14    psychotropic medication.
15    (Source: P.A. 88-413.)

16        (210 ILCS 45/3-203) (from Ch. 111 1/2, par. 4153-203)
17        Sec. 3-203. In licensing any facility for persons with  a
18    developmental  disability  or  persons  suffering from mental
19    illness (other than Alzheimer's disease or related disorders)
20    emotional  or  behavioral  disorders,  the  Department  shall
21    consult with the Department of Human Services  in  developing
22    minimum  standards  for  such  persons.  The Department shall
23    establish standards for the diagnosis, treatment, and care of
24    all persons with mental illness in facilities licensed  under
25    this  Act,  including,  but not limited to, the establishment
26    and operation of facilities  classified  under  this  Act  as
27    "Residential   Rehabilitation   Facilities".   Standards  for
28    "Residential Rehabilitation Facilities" shall be  promulgated
29    and  effective by October 1, 2001 or on the effective date of
30    this amendatory Act of the 92nd General  Assembly,  whichever
31    is later.
32    (Source: P.A. 88-380; 89-507, eff. 7-1-97.)
 
                             -31-              LRB9200853ACcd
 1        Section   20.  The   Mental   Health   and  Developmental
 2    Disabilities Code is amended by  changing  Section  3-704  as
 3    follows:

 4        (405 ILCS 5/3-704) (from Ch. 91 1/2, par. 3-704)
 5        Sec. 3-704.  Examination; detention.
 6        (a)  The  respondent  shall be permitted to remain in his
 7    or her place  of  residence  pending  any  examination.   The
 8    respondent  may  be  accompanied by one or more of his or her
 9    relatives or friends or by his or her attorney to  the  place
10    of  examination.  If,  however,  the  court  finds that it is
11    necessary in order to complete the examination the court  may
12    order that the person be admitted to a mental health facility
13    pending  examination  and  may order a peace officer or other
14    person to transport the person there.  The examination  shall
15    be  conducted  at  a local mental health facility or hospital
16    or, if possible, in the respondent's own place of residence.
17    No person may be detained for examination under this  Section
18    for  more  than  24 hours.  The person shall be released upon
19    completion of the examination unless the physician, qualified
20    examiner or  clinical  psychologist  executes  a  certificate
21    stating  that  the person is subject to involuntary admission
22    and in need of  immediate  hospitalization  to  protect  such
23    person  or  others  from physical harm.  Upon admission under
24    this Section treatment  may  be  given  pursuant  to  Section
25    3-608.
26        (a-5)  Whenever  a  respondent  has been transported to a
27    mental health facility  for  an  examination,  the  admitting
28    facility   shall  inquire,  upon  the  respondent's  arrival,
29    whether the respondent wishes any person  or  persons  to  be
30    notified  of  his  or her detention at that facility.  If the
31    respondent does wish to have any person or  persons  notified
32    of  his  or  her detention at the facility, the facility must
33    promptly make all reasonable attempts to locate,  within  one
 
                             -32-              LRB9200853ACcd
 1    hour   after   the   respondent's   arrival,  the  individual
 2    identified by the  respondent,  or  at  least  2  individuals
 3    identified  by  the  respondent  if  more  than  one has been
 4    identified, and notify them of the respondent's detention  at
 5    the  facility  for  a mandatory examination pursuant to court
 6    order.
 7        (b)  Not  later  than  24  hours,  excluding   Saturdays,
 8    Sundays,  and  holidays,  after admission under this Section,
 9    the respondent shall be asked if he desires the petition  and
10    the  notice  required  under  Section 3-206 sent to any other
11    persons and  at  least  2  such  persons  designated  by  the
12    respondent  shall  be sent the documents.  At the time of his
13    admission the respondent shall be  allowed  to  complete  not
14    fewer than 2 telephone calls to such persons as he chooses.
15    (Source:  P.A.  91-726,  eff.  6-2-00;  91-837, eff. 6-16-00;
16    revised 7-5-00.)

17        Section 99.  Effective date.  This Section,  the  changes
18    to  Section  4.3  of  the  Mental  Health  and  Developmental
19    Disabilities Administrative Act, the changes to Sections 6.2,
20    6.3,  6.4, 6.5, 6.6, 6.7, and 6.8 of the Abused and Neglected
21    Long Term Care Facility Residents Reporting Act, the  changes
22    to  Section  3-203  of  the  Nursing  Home  Care Act, and the
23    changes  to  Section  3-704  of   the   Mental   Health   and
24    Developmental  Disabilities  Code  take  effect upon becoming
25    law.
 
                             -33-              LRB9200853ACcd
 1                                INDEX
 2               Statutes amended in order of appearance
 3    20 ILCS 1705/4            from Ch. 91 1/2, par. 100-4
 4    20 ILCS 1705/4.3          from Ch. 91 1/2, par. 100-4.3
 5    20 ILCS 1705/7            from Ch. 91 1/2, par. 100-7
 6    20 ILCS 1705/15           from Ch. 91 1/2, par. 100-15
 7    210 ILCS 30/6.2           from Ch. 111 1/2, par. 4166.2
 8    210 ILCS 30/6.3           from Ch. 111 1/2, par. 4166.3
 9    210 ILCS 30/6.4           from Ch. 111 1/2, par. 4166.4
10    210 ILCS 30/6.5           from Ch. 111 1/2, par. 4166.5
11    210 ILCS 30/6.6           from Ch. 111 1/2, par. 4166.6
12    210 ILCS 30/6.7           from Ch. 111 1/2, par. 4166.7
13    210 ILCS 30/6.8           from Ch. 111 1/2, par. 4166.8
14    210 ILCS 30/6.9 new
15    210 ILCS 45/1-113         from Ch. 111 1/2, par. 4151-113
16    210 ILCS 45/2-104         from Ch. 111 1/2, par. 4152-104
17    210 ILCS 45/2-106         from Ch. 111 1/2, par. 4152-106
18    210 ILCS 45/2-106.1
19    210 ILCS 45/3-203         from Ch. 111 1/2, par. 4153-203
20    405 ILCS 5/3-704          from Ch. 91 1/2, par. 3-704

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