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92_HB0064eng HB0064 Engrossed LRB9200853ACcd 1 AN ACT in relation to health care. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Mental Health and Developmental 5 Disabilities Administrative Act is amended by changing 6 Sections 4, 7, and 15 as follows: 7 (20 ILCS 1705/4) (from Ch. 91 1/2, par. 100-4) 8 Sec. 4. Supervision of facilities and services; 9 quarterly reports. 10 (a) To exercise executive and administrative supervision 11 over all facilities, divisions, programs and services now 12 existing or hereafter acquired or created under the 13 jurisdiction of the Department, including, but not limited 14 to, the following: 15 The Alton Mental Health Center, at Alton 16 The Clyde L. Choate Mental Health and Developmental 17 Center, at Anna 18 The Chester Mental Health Center, at Chester 19 The Chicago-Read Mental Health Center, at Chicago 20 The Elgin Mental Health Center, at Elgin 21 The Metropolitan Children and Adolescents Center, at 22 Chicago 23 The Jacksonville Developmental Center, at 24 Jacksonville 25 The Governor Samuel H. Shapiro Developmental Center, 26 at Kankakee 27 The Tinley Park Mental Health Center, at Tinley Park 28 The Warren G. Murray Developmental Center, at 29 Centralia 30 The Jack Mabley Developmental Center, at Dixon 31 The Lincoln Developmental Center, at Lincoln HB0064 Engrossed -2- LRB9200853ACcd 1 The H. Douglas Singer Mental Health and 2 Developmental Center, at Rockford 3 The John J. Madden Mental Health Center, at Chicago 4 The George A. Zeller Mental Health Center, at Peoria 5 The Andrew McFarland Mental Health Center, at 6 Springfield 7 The Adolf Meyer Mental Health Center, at Decatur 8 The William W. Fox Developmental Center, at Dwight 9 The Elisabeth Ludeman Developmental Center, at Park 10 Forest 11 The William A. Howe Developmental Center, at Tinley 12 Park 13 The Ann M. Kiley Developmental Center, at Waukegan. 14 (b) Beginning not later than July 1, 1977, the 15 Department shall cause each of the facilities under its 16 jurisdiction which provide in-patient care to comply with 17 standards, rules and regulations of the Department of Public 18 Health prescribed under Section 6.05 of the Hospital 19 Licensing Act. 20 (c) The Department shall issue quarterly reports on 21 admissions, deflections, discharges, bed closures, 22 staff-resident ratios, census,andaverage length of stay, 23 and any adverse federal certification or accreditation 24 findings, if any, for each State-operated facility for the 25 mentally ill and developmentally disabled. 26 (Source: P.A. 91-357, eff. 7-29-99; 91-652, eff. 12-1-99.) 27 (20 ILCS 1705/7) (from Ch. 91 1/2, par. 100-7) 28 Sec. 7. To receive and provide the highest possible 29 quality of humane and rehabilitative care and treatment to 30 all persons admitted or committed or transferred in 31 accordance with law to the facilities, divisions, programs, 32 and services under the jurisdiction of the Department. No 33 resident of another state shall be received or retained to HB0064 Engrossed -3- LRB9200853ACcd 1 the exclusion of any resident of this State. No resident of 2 another state shall be received or retained to the exclusion 3 of any resident of this State. All recipients of 17 years of 4 age and under in residence in a Department facility other 5 than a facility for the care of the mentally retarded shall 6 be housed in quarters separated from older recipients except 7 for: (a) recipients who are placed in medical-surgical units 8 because of physical illness; and (b) recipients between 13 9 and 18 years of age who need temporary security measures. 10 All recipients in a Department facility shall be given a 11 dental examination by a licensed dentist or registered dental 12 hygienist at least once every 18 months and shall be assigned 13 to a dentist for such dental care and treatment as is 14 necessary. 15 All medications administered to recipients shall be 16 administered only by those persons who are legally qualified 17 to do so by the laws of the State of Illinois. Medication 18 shall not be prescribed until a physical and mental 19 examination of the recipient has been completed. If, in the 20 clinical judgment of a physician, it is necessary to 21 administer medication to a recipient before the completion of 22 the physical and mental examination, he may prescribe such 23 medication but he must file a report with the facility 24 director setting forth the reasons for prescribing such 25 medication within 24 hours of the prescription. A copy of the 26 report shall be part of the recipient's record. 27 No later than January 1, 2002, the Department shall adopt 28 a model protocol and forms for recording all patient 29 diagnosis, care, and treatment at every facility under the 30 jurisdiction of the Department. The model protocol and forms 31 shall be used by each facility unless the Department 32 determines that equivalent alternatives justify an exemption. 33 Every facility under the jurisdiction of the Department 34 shall maintain a copy of each report of suspected abuse or HB0064 Engrossed -4- LRB9200853ACcd 1 neglect of the patient. Copies of those reports shall be made 2 available to the State Auditor General in connection with his 3 biennial program audit of the facility as required by Section 4 3-2 of the Illinois State Auditing Act. 5 No later than January 1, 2002, every facility under the 6 jurisdiction of the Department and all services provided in 7 those facilities shall comply with all of the applicable 8 standards adopted by the Social Security Administration under 9 Subchapter XVIII (Medicare) of the Social Security Act (42 10 U.S.C. 1395 - 1395ccc), if the facility and services may be 11 eligible for federal financial participation under that 12 federal law. 13 (Source: P.A. 86-922; 86-1013; 86-1475.) 14 (20 ILCS 1705/15) (from Ch. 91 1/2, par. 100-15) 15 Sec. 15. Before any person is released from a facility 16 operated by the State pursuant to an absolute discharge or a 17 conditional discharge from hospitalization under this Act, 18 the facility director of the facility in which such person is 19 hospitalized shall determine that such person is not 20 currently in need of hospitalization and: 21 (a) is able to live independently in the community; 22 or 23 (b) requires further oversight and supervisory care 24 for which arrangements have been made with responsible 25 relatives or supervised residential program approved by 26 the Department; or 27 (c) requires further personal care or general 28 oversight as defined by the Nursing Home Care Act, for 29 which placement arrangements have been made with a 30 suitable family home or other licensed facility approved 31 by the Department under this Section; or 32 (d) requires community mental health services for 33 which arrangements have been made with a suitable HB0064 Engrossed -5- LRB9200853ACcd 1 community mental health provider in accordance with 2 criteria, standards, and procedures promulgated by rule. 3 The suitable community mental health provider shall be 4 selected from among the Department's contractual 5 designees. 6 Such determination shall be made in writing and shall 7 become a part of the facility record of such absolutely or 8 conditionally discharged person. When the determination 9 indicates that the condition of the person to be granted an 10 absolute discharge or a conditional discharge is described 11 under subparagraph (c) or (d) of this Section, the name and 12 address of the continuing care facility or home to which such 13 person is to be released shall be entered in the facility 14 record. Where a discharge from a mental health facility is 15 made under subparagraph (c), the Department shall assign the 16 person so discharged to an existing community based 17 not-for-profit agency for participation in day activities 18 suitable to the person's needs, such as but not limited to 19 social and vocational rehabilitation, and other recreational, 20 educational and financial activities unless the community 21 based not-for-profit agency is unableunqualifiedto accept 22 such assignment. Where the clientele of any not-for-profit 23 agency increases as a result of assignments under this 24 amendatory Act of 20011977 by more than 3% over the prior25year, the Department shall fully reimburse such agency for 26 the increased costs of providing services to such personsin27excess of such 3% increase. The Department shall keep written 28 records detailing how many persons have been assigned to a 29 community based not-for-profit agency and how many persons 30 were not so assigned because the community based agency was 31 unable to accept the assignments, in accordance with 32 criteria, standards, and procedures promulgated by rule. 33 Whenever a community based agency is found to be unable to 34 accept the assignments, the name of the agency and the reason HB0064 Engrossed -6- LRB9200853ACcd 1 for the finding shall be included in the report. 2 Insofar as desirable in the interests of the former 3 recipient, the facility, program or home in which the 4 discharged person is to be placed shall be located in or near 5 the community in which the person resided prior to 6 hospitalization or in the community in which the person's 7 family or nearest next of kin presently reside. Placement of 8 the discharged person in facilities, programs or homes 9 located outside of this State shall not be made by the 10 Department unless there are no appropriate facilities, 11 programs or homes available within this State. Out-of-state 12 placements shall be subject to return of recipients so placed 13 upon the availability of facilities, programs or homes within 14 this State to accommodate these recipients, except where 15 placement in a contiguous state results in locating a 16 recipient in a facility or program closer to the recipient's 17 home or family. If an appropriate facility or program 18 becomes available equal to or closer to the recipient's home 19 or family, the recipient shall be returned to and placed at 20 the appropriate facility or program within this State. 21 To place any person who is under a program of the 22 Department at board in a suitable family home or in such 23 other facility or program as the Department may consider 24 desirable. The Department may place in licensed nursing 25 homes, sheltered care homes, or homes for the aged those 26 persons whose behavioral manifestations and medical and 27 nursing care needs are such as to be substantially 28 indistinguishable from persons already living in such 29 facilities. Prior to any placement by the Department under 30 this Section, a determination shall be made by the personnel 31 of the Department, as to the capability and suitability of 32 such facility to adequately meet the needs of the person to 33 be discharged. When specialized programs are necessary in 34 order to enable persons in need of supervised living to HB0064 Engrossed -7- LRB9200853ACcd 1 develop and improve in the community, the Department shall 2 place such persons only in specialized residential care 3 facilities which shall meet Department standards including 4 restricted admission policy, special staffing and programming 5 for social and vocational rehabilitation, in addition to the 6 requirements of the appropriate State licensing agency. The 7 Department shall not place any new person in a facility the 8 license of which has been revoked or not renewed on grounds 9 of inadequate programming, staffing, or medical or adjunctive 10 services, regardless of the pendency of an action for 11 administrative review regarding such revocation or failure to 12 renew. Before the Department may transfer any person to a 13 licensed nursing home, sheltered care home or home for the 14 aged or place any person in a specialized residential care 15 facility the Department shall notify the person to be 16 transferred, or a responsible relative of such person, in 17 writing, at least 30 days before the proposed transfer, with 18 respect to all the relevant facts concerning such transfer, 19 except in cases of emergency when such notice is not 20 required. If either the person to be transferred or a 21 responsible relative of such person objects to such transfer, 22 in writing to the Department, at any time after receipt of 23 notice and before the transfer, the facility director of the 24 facility in which the person was a recipient shall 25 immediately schedule a hearing at the facility with the 26 presence of the facility director, the person who objected to 27 such proposed transfer, and a psychiatrist who is familiar 28 with the record of the person to be transferred. Such person 29 to be transferred or a responsible relative may be 30 represented by such counsel or interested party as he may 31 appoint, who may present such testimony with respect to the 32 proposed transfer. Testimony presented at such hearing shall 33 become a part of the facility record of the 34 person-to-be-transferred. The record of testimony shall be HB0064 Engrossed -8- LRB9200853ACcd 1 held in the person-to-be-transferred's record in the central 2 files of the facility. If such hearing is held a transfer may 3 only be implemented, if at all, in accordance with the 4 results of such hearing. Within 15 days after such hearing 5 the facility director shall deliver his findings based on the 6 record of the case and the testimony presented at the 7 hearing, by registered or certified mail, to the parties to 8 such hearing. The findings of the facility director shall be 9 deemed a final administrative decision of the Department. For 10 purposes of this Section, "case of emergency" means those 11 instances in which the health of the person to be transferred 12 is imperiled and the most appropriate mental health care or 13 medical care is available at a licensed nursing home, 14 sheltered care home or home for the aged or a specialized 15 residential care facility. 16 Prior to placement of any person in a facility under this 17 Section the Department shall ensure that an appropriate 18 training plan for staff is provided by the facility. Said 19 training may include instruction and demonstration by 20 Department personnel qualified in the area of mental illness 21 or mental retardation, as applicable to the person to be 22 placed. Training may be given both at the facility from 23 which the recipient is transferred and at the facility 24 receiving the recipient, and may be available on a continuing 25 basis subsequent to placement. In a facility providing 26 services to former Department recipients, training shall be 27 available as necessary for facility staff. Such training 28 will be on a continuing basis as the needs of the facility 29 and recipients change and further training is required. 30 The Department shall not place any person in a facility 31 which does not have appropriately trained staff in sufficient 32 numbers to accommodate the recipient population already at 33 the facility. As a condition of further or future placements 34 of persons, the Department shall require the employment of HB0064 Engrossed -9- LRB9200853ACcd 1 additional trained staff members at the facility where said 2 persons are to be placed. The Secretary, or his or her 3 designate, shall establish written guidelines for placement 4 of persons in facilities under this Act. The Department shall 5 keep written records detailing which facilities have been 6 determined to have appropriately trained staff, which 7 facilities have been determined not to have such staff, and 8 all training which it has provided or required under this 9 Section. 10 Bills for the support for a person boarded out shall be 11 payable monthly out of the proper maintenance funds and shall 12 be audited as any other accounts of the Department. If a 13 person is placed in a facility or program outside the 14 Department, the Department may pay the actual costs of 15 residence, treatment or maintenance in such facility and may 16 collect such actual costs or a portion thereof from the 17 recipient or the estate of a person placed in accordance with 18 this Section. 19 Other than those placed in a family home the Department 20 shall cause all persons who are placed in a facility, as 21 defined by the Nursing Home Care Act, or in designated 22 community living situations or programs, to be visited at 23 least once during the first month following placement, and 24 once every month thereafter for the first year following 25 placement when indicated, but at least quarterly. After the 26 first year, visits shall be made at least once per year for 27 as long as the placement continues. If a long term care 28 facility has periodic care plan conferences, the visitor may 29 participate in those conferences. Visits shall be made by 30 qualified and trained Department personnel, or their 31 designee, in the area of mental health or developmental 32 disabilities applicable to the person visited, and shall be 33 made on a more frequent basis when indicated. The Department 34 may not use as designee any personnel connected with or HB0064 Engrossed -10- LRB9200853ACcd 1 responsible to the representatives of any facility in which 2 persons who have been transferred under this Section are 3 placed. In the course of such visit there shall be 4 consideration of the following areas, but not limited 5 thereto: effects of transfer on physical and mental health 6 of the person, sufficiency of nursing care and medical 7 coverage required by the person, sufficiency of staff 8 personnel and ability to provide basic care for the person, 9 social, recreational and programmatic activities available 10 for the person, and other appropriate aspects of the person's 11 environment. 12 A report containing the above observations shall be made 13 to the Department and to any other appropriate agency 14 subsequent to each visitation. The report shall contain a 15 detailed assessment of whether the recipient is receiving 16 necessary services in the least restrictive environment. If 17 the recipient is not receiving those services, the Department 18 shall either require that the facility modify the treatment 19 plan to ensure that those services are provided or make 20 arrangements necessary to provide those services elsewhere. 21At the conclusion of one year following absolute or22conditional discharge, or a longer period of time if required23by the Department, the Department may terminate the24visitation requirements of this Section as to a person placed25in accordance with this Section, by filing a written26statement of termination setting forth reasons to27substantiate the termination of visitations in the person's28file, and sending a copy thereof to the person, and to his29guardian or next of kin.30 Upon the complaint of any person placed in accordance 31 with this Section or any responsible citizen or upon 32 discovery that such person has been abused, neglected, or 33 improperly cared for, or that the placement does not provide 34 the type of care required by the recipient's current HB0064 Engrossed -11- LRB9200853ACcd 1 condition, the Department immediately shall investigate, and 2 determine if the well-being, health, care, or safety of any 3 person is affected by any of the above occurrences, and if 4 any one of the above occurrences is verified, the Department 5 shall remove such person at once to a facility of the 6 Department or to another facility outside the Department, 7 provided such person's needs can be met at said facility. 8 The Department may also provide any person placed in 9 accordance with this Section who is without available funds, 10 and who is permitted to engage in employment outside the 11 facility, such sums for the transportation, and other 12 expenses as may be needed by him until he receives his wages 13 for such employment. 14 The Department shall promulgate rules and regulations 15 governing the purchase of care for persons who are wards of 16 or who are receiving services from the Department. Such 17 rules and regulations shall apply to all monies expended by 18 any agency of the State of Illinois for services rendered by 19 any person, corporate entity, agency, governmental agency or 20 political subdivision whether public or private outside of 21 the Department whether payment is made through a contractual, 22 per-diem or other arrangement. No funds shall be paid to any 23 person, corporation, agency, governmental entity or political 24 subdivision without compliance with such rules and 25 regulations. 26 The rules and regulations governing purchase of care 27 shall describe categories and types of service deemed 28 appropriate for purchase by the Department. 29 Any provider of services under this Act may elect to 30 receive payment for those services, and the Department is 31 authorized to arrange for that payment, by means of direct 32 deposit transmittals to the service provider's account 33 maintained at a bank, savings and loan association, or other 34 financial institution. The financial institution shall be HB0064 Engrossed -12- LRB9200853ACcd 1 approved by the Department, and the deposits shall be in 2 accordance with rules and regulations adopted by the 3 Department. 4 (Source: P.A. 89-507, eff. 7-1-97; 90-423, eff. 8-15-97.) 5 Section 10. The Hospital Licensing Act is amended by 6 adding Section 6.19 as follows: 7 (210 ILCS 5/6.19 new) 8 Sec. 6.19. Use of restraints. Each hospital licensed 9 under this Act must have a written policy to address the use 10 of restraints and seclusion in the hospital. The Department 11 shall establish, by rule, the provisions that the policy must 12 include, which, to the extent practicable, should be 13 consistent with the requirements of the federal Medicare 14 program. 15 For freestanding psychiatric hospitals and psychiatric 16 units in general hospitals, restraints or seclusion shall 17 only be ordered by persons as authorized under the Mental 18 Health and Developmental Disabilities Code. 19 For general hospitals, excluding freestanding psychiatric 20 hospitals and psychiatric units in general hospitals, 21 restraints or seclusion may only be employed upon the written 22 order of: 23 (1) a physician licensed to practice medicine in 24 all its branches; 25 (2) a physician assistant as authorized under the 26 Physician Assistant Practice Act of 1987 or an advanced 27 practice nurse as authorized under the Nursing and 28 Advanced Practice Nursing Act; or 29 (3) a registered nurse, provided that the medical 30 staff of the hospital has adopted a policy authorizing 31 such practice and specifying the requirements that a 32 registered nurse must satisfy to order the use of HB0064 Engrossed -13- LRB9200853ACcd 1 restraints or seclusion. 2 Section 15. The Abused and Neglected Long Term Care 3 Facility Residents Reporting Act is amended by changing 4 Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 as follows: 5 (210 ILCS 30/6.2) (from Ch. 111 1/2, par. 4166.2) 6 (Section scheduled to be repealed on January 1, 2002) 7 Sec. 6.2. Inspector General. 8 (a) The Governor shall appoint, and the Senate shall 9 confirm, an Inspector General. The Inspector General shall 10 be appointed for a term of 4 years andwhoshall function 11 within the Department of Human Services and report to the 12 Secretary of Human Services and the Governor. The Inspector 13 General shall function independently within the Department of 14 Human Services with respect to the operations of the office, 15 including the performance of investigations and issuance of 16 findings and recommendations. The Inspector General shall 17 independently submit to the Governor any request for 18 appropriations necessary for the ordinary and contingent 19 expenses of the Office of Inspector General, and 20 appropriations for that office shall be separate from the 21 Department of Human Services. The Inspector General shall 22 investigate reports of suspected abuse or neglect (as those 23 terms are defined in Section 3 of this Act) of patients or 24 residents in any mental health or developmental disabilities 25 facility operated by the Department of Human Services and 26 shall have authority to investigate and take immediate action 27 on reports of abuse or neglect of recipients, whether 28 patients or residents, in any mental health or developmental 29 disabilities facility or program that is licensed or 30 certified by the Department of Human Services (as successor 31 to the Department of Mental Health and Developmental 32 Disabilities) or that is funded by the Department of Human HB0064 Engrossed -14- LRB9200853ACcd 1 Services (as successor to the Department of Mental Health and 2 Developmental Disabilities) and is not licensed or certified 3 by any agency of the State. At the specific, written request 4 of an agency of the State other than the Department of Human 5 Services (as successor to the Department of Mental Health and 6 Developmental Disabilities), the Inspector General may 7 cooperate in investigating reports of abuse and neglect of 8 persons with mental illness or persons with developmental 9 disabilities. The Inspector General shall have no 10 supervision over or involvement in routine, programmatic, 11 licensure, or certification operations of the Department of 12 Human Services or any of its funded agencies. 13 The Inspector General shall promulgate rules establishing 14 minimum requirements for reporting allegations of abuse and 15 neglect and initiating, conducting, and completing 16 investigations. The promulgated rules shall clearly set 17 forth that in instances where 2 or more State agencies could 18 investigate an allegation of abuse or neglect, the Inspector 19 General shall not conduct an investigation that is redundant 20 to an investigation conducted by another State agency. The 21 rules shall establish criteria for determining, based upon 22 the nature of the allegation, the appropriate method of 23 investigation, which may include, but need not be limited to, 24 site visits, telephone contacts, or requests for written 25 responses from agencies. The rules shall also clarify how 26 the Office of the Inspector General shall interact with the 27 licensing unit of the Department of Human Services in 28 investigations of allegations of abuse or neglect. Any 29 allegations or investigations of reports made pursuant to 30 this Act shall remain confidential until a final report is 31 completed. The resident or patient who allegedly was abused 32 or neglected and his or her legal guardian shall be informed 33 by the facility or agency of the report of alleged abuse or 34 neglect. Final reports regarding unsubstantiated or unfounded HB0064 Engrossed -15- LRB9200853ACcd 1 allegations shall remain confidential, except that final 2 reports may be disclosed pursuant to Section 6 of this Act. 3The Inspector General shall be appointed for a term of 44years.5 (b) The Inspector General shall within 24 hours after 6 receiving a report of suspected abuse or neglect determine 7 whether the evidence indicates that any possible criminal act 8 has been committed. If he determines that a possible criminal 9 act has been committed, or that special expertise is required 10 in the investigation, he shall immediately notify the 11 Department of State Police. The Department of State Police 12 shall investigate any report indicating a possible murder, 13 rape, or other felony. All investigations conducted by the 14 Inspector General shall be conducted in a manner designed to 15 ensure the preservation of evidence for possible use in a 16 criminal prosecution. 17 (b-5) The Inspector General shall make a determination 18 to accept or reject a preliminary report of the investigation 19 of alleged abuse or neglect based on established 20 investigative procedures. The facility or agency may request 21 clarification or reconsideration based on additional 22 information. For cases where the allegation of abuse or 23 neglect is substantiated, the Inspector General shall require 24 the facility or agency to submit a written response. The 25 written response from a facility or agency shall address in a 26 concise and reasoned manner the actions that the agency or 27 facility will take or has taken to protect the resident or 28 patient from abuse or neglect, prevent reoccurrences, and 29 eliminate problems identified and shall include 30 implementation and completion dates for all such action. 31 (c) The Inspector General shall, within 10 calendar days 32 after the transmittal date of a completed investigation where 33 abuse or neglect is substantiated or administrative action is 34 recommended, provide a complete report on the case to the HB0064 Engrossed -16- LRB9200853ACcd 1 Secretary of Human Services and to the agency in which the 2 abuse or neglect is alleged to have happened. The complete 3 report shall include a written response from the agency or 4 facility operated by the State to the Inspector General that 5 addresses in a concise and reasoned manner the actions that 6 the agency or facility will take or has taken to protect the 7 resident or patient from abuse or neglect, prevent 8 reoccurrences, and eliminate problems identified and shall 9 include implementation and completion dates for all such 10 action. The Secretary of Human Services shall accept or 11 reject the response and establish how the Department will 12 determine whether the facility or program followed the 13 approved response. The Secretary may require Department 14 personnel to visit the facility or agency for training, 15 technical assistance, programmatic, licensure, or 16 certification purposes. Administrative action, including 17 sanctions, may be applied should the Secretary reject the 18 response or should the facility or agency fail to follow the 19 approved response. Within 30 days after the Secretary has 20 approved a response, the facility or agency making the 21 response shall provide an implementation report to the 22 Inspector General on the status of the corrective action 23 implemented. Within 60 days after receiving the 24 implementation report, the Inspector General shall conduct an 25 investigation, which may include, but need not be limited to, 26 site visits, telephone contacts, or requests for written 27 documentation from the facility or agency, to determine 28 whether the facility or agency is in compliance with the 29 approved response. The facility or agency shall inform the 30 resident or patient and the legal guardian whether the 31 reported allegation was substantiated, unsubstantiated, or 32 unfounded. There shall be an appeals process for any person 33 or agency that is subject to any action based on a 34 recommendation or recommendations. HB0064 Engrossed -17- LRB9200853ACcd 1 (d) The Inspector General may recommend to the 2 Departments of Public Health and Human Services sanctions to 3 be imposed against mental health and developmental 4 disabilities facilities under the jurisdiction of the 5 Department of Human Services for the protection of residents, 6 including appointment of on-site monitors or receivers, 7 transfer or relocation of residents, and closure of units. 8 The Inspector General may seek the assistance of the Attorney 9 General or any of the several State's attorneys in imposing 10 such sanctions. Whenever the Inspector General issues any 11 recommendations to the Secretary of Human Services, the 12 Secretary shall provide a written response. 13 (e) The Inspector General shall establish and conduct 14 periodic training programs for Department of Human Services 15 employees concerning the prevention and reporting of neglect 16 and abuse. 17 (f) The Inspector General shall at all times be granted 18 access to any mental health or developmental disabilities 19 facility operated by the Department of Human Services, shall 20 establish and conduct unannounced site visits to those 21 facilities at least once annually, and shall be granted 22 access, for the purpose of investigating a report of abuse or 23 neglect, to the records of the Department of Human Services 24 and to any facility or program funded by the Department of 25 Human Services that is subject under the provisions of this 26 Section to investigation by the Inspector General for a 27 report of abuse or neglect. 28 (g) Nothing in this Section shall limit investigations 29 by the Department of Human Services that may otherwise be 30 required by law or that may be necessary in that Department's 31 capacity as the central administrative authority responsible 32 for the operation of State mental health and developmental 33 disability facilities. 34(h) This Section is repealed on January 1, 2002.HB0064 Engrossed -18- LRB9200853ACcd 1 (Source: P.A. 90-252, eff. 7-29-97; 90-512, eff. 8-22-97; 2 90-655, eff. 7-30-98; 91-169, eff. 7-16-99.) 3 (210 ILCS 30/6.3) (from Ch. 111 1/2, par. 4166.3) 4 (Section scheduled to be repealed on January 1, 2002) 5 Sec. 6.3. Quality Care Board. There is created, within 6 theDepartment of Human Services'Office of the Inspector 7 General, a Quality Care Board to be composed of 7 members 8 appointed by the Governor with the advice and consent of the 9 Senate. One of the members shall be designated as chairman 10 by the Governor. Of the initial appointments made by the 11 Governor, 4 Board members shall each be appointed for a term 12 of 4 years and 3 members shall each be appointed for a term 13 of 2 years. Upon the expiration of each member's term, a 14 successor shall be appointed for a term of 4 years. In the 15 case of a vacancy in the office of any member, the Governor 16 shall appoint a successor for the remainder of the unexpired 17 term. 18 Members appointed by the Governor shall be qualified by 19 professional knowledge or experience in the area of law, 20 investigatory techniques, or in the area of care of the 21 mentally ill or developmentally disabled. Two members 22 appointed by the Governor shall be persons with a disability 23 or a parent of a person with a disability. Members shall 24 serve without compensation, but shall be reimbursed for 25 expenses incurred in connection with the performance of their 26 duties as members. 27 The Board shall meet quarterly, and may hold other 28 meetings on the call of the chairman. Four members shall 29 constitute a quorum. The Board may adopt rules and 30 regulations it deems necessary to govern its own procedures. 31This Section is repealed on January 1, 2002.32 (Source: P.A. 91-169, eff. 7-16-99.) HB0064 Engrossed -19- LRB9200853ACcd 1 (210 ILCS 30/6.4) (from Ch. 111 1/2, par. 4166.4) 2 (Section scheduled to be repealed on January 1, 2002) 3 Sec. 6.4. Scope and function of the Quality Care Board. 4 The Board shall monitor and oversee the operations, policies, 5 and procedures of the Inspector General to assure the prompt 6 and thorough investigation of allegations of neglect and 7 abuse. In fulfilling these responsibilities, the Board may 8 do the following: 9 (1) Provide independent, expert consultation to the 10 Inspector General on policies and protocols for 11 investigations of alleged neglect and abuse. 12 (2) Review existing regulations relating to the 13 operation of facilities under the control of the 14 Department of Human Services. 15 (3) Advise the Inspector General as to the content 16 of training activities authorized under Section 6.2. 17 (4) Recommend policies concerning methods for 18 improving the intergovernmental relationships between the 19 office of the Inspector General and other State or 20 federal agencies. 21This Section is repealed on January 1, 2002.22 (Source: P.A. 91-169, eff. 7-16-99.) 23 (210 ILCS 30/6.5) (from Ch. 111 1/2, par. 4166.5) 24 (Section scheduled to be repealed on January 1, 2002) 25 Sec. 6.5. Investigators.Within 60 days after the26effective date of this amendatory Act of 1992,The Inspector 27 General shall establish a comprehensive program to ensure 28 that every person employed or newly hired to conduct 29 investigations shall receive training on an on-going basis 30 concerning investigative techniques, communication skills, 31 and the appropriate means of contact with persons admitted or 32 committed to the mental health or developmental disabilities 33 facilities under the jurisdiction of the Department of Human HB0064 Engrossed -20- LRB9200853ACcd 1 Services. 2This Section is repealed on January 1, 2002.3 (Source: P.A. 91-169, eff. 7-16-99.) 4 (210 ILCS 30/6.6) (from Ch. 111 1/2, par. 4166.6) 5 (Section scheduled to be repealed on January 1, 2002) 6 Sec. 6.6. Subpoenas; testimony; penalty. The Inspector 7 General shall have the power to subpoena witnesses and compel 8 the production of books and papers pertinent to an 9 investigation authorized by this Act, provided that the power 10 to subpoena or to compel the production of books and papers 11 shall not extend to the person or documents of a labor 12 organization or its representatives insofar as the person or 13 documents of a labor organization relate to the function of 14 representing an employee subject to investigation under this 15 Act. Mental health records of patients shall be confidential 16 as provided under the Mental Health and Developmental 17 Disabilities Confidentiality Act. Any person who fails to 18 appear in response to a subpoena or to answer any question or 19 produce any books or papers pertinent to an investigation 20 under this Act, except as otherwise provided in this Section, 21 or who knowingly gives false testimony in relation to an 22 investigation under this Act is guilty of a Class A 23 misdemeanor. 24This Section is repealed on January 1, 2002.25 (Source: P.A. 91-169, eff. 7-16-99.) 26 (210 ILCS 30/6.7) (from Ch. 111 1/2, par. 4166.7) 27 (Section scheduled to be repealed on January 1, 2002) 28 Sec. 6.7. Annual report. The Inspector General shall 29 provide to the General Assembly and the Governor, no later 30 than January 1 of each year, a summary of reports and 31 investigations made under this Act for the prior fiscal year 32 with respect to residents of institutions under the HB0064 Engrossed -21- LRB9200853ACcd 1 jurisdiction of the Department of Human Services. The report 2 shall detail the imposition of sanctions and the final 3 disposition of those recommendations. The summaries shall 4 not contain any confidential or identifying information 5 concerning the subjects of the reports and investigations. 6 The report shall also include a trend analysis of the number 7 of reported allegations and their disposition, for each 8 facility and Department-wide, for the most recent 3-year time 9 period and a statement, for each facility, of the 10 staffing-to-patient ratios. The ratios shall include only 11 the number of direct care staff. The report shall also 12 include detailed recommended administrative actions and 13 matters for consideration by the General Assembly. 14This Section is repealed on January 1, 2002.15 (Source: P.A. 91-169, eff. 7-16-99.) 16 (210 ILCS 30/6.8) (from Ch. 111 1/2, par. 4166.8) 17 (Section scheduled to be repealed on January 1, 2002) 18 Sec. 6.8. Program audit. The Auditor General shall 19 conduct a biennial program audit of the office of the 20 Inspector General in relation to the Inspector General's 21 compliance with this Act. The audit shall specifically 22 include the Inspector General's effectiveness in 23 investigating reports of alleged neglect or abuse of 24 residents in any facility operated by the Department of Human 25 Services and in making recommendations for sanctions to the 26 Departments of Human Services and Public Health. The Auditor 27 General shall conduct the program audit according to the 28 provisions of the Illinois State Auditing Act and shall 29 report its findings to the General Assembly no later than 30 January 1 of each odd-numbered year. 31This Section is repealed on January 1, 2002.32 (Source: P.A. 91-169, eff. 7-16-99.) HB0064 Engrossed -22- LRB9200853ACcd 1 Section 20. The Nursing Home Care Act is amended by 2 changing Sections 2-106 and 2-106.1 as follows: 3 (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106) 4 Sec. 2-106. (a) For purposes of this Act, (i) a physical 5 restraint is any manual method or physical or mechanical 6 device, material, or equipment attached or adjacent to a 7 resident's body that the resident cannot remove easily and 8 restricts freedom of movement or normal access to one's body; 9 (ii) a chemical restraint is any drug used for discipline or 10 convenience and not required to treat medical symptoms. The 11 Department shall by rule, designate certain devices as 12 restraints, including at least all those devices which have 13 been determined to be restraints by the United States 14 Department of Health and Human Services in interpretive 15 guidelines issued for the purposes of administering Titles 18 16 and 19 of the Social Security Acts. 17 (b) Neither restraints nor confinements shall be 18 employed for the purpose of punishment or for the convenience 19 of any facility personnel. No restraints or confinements 20 shall be employed except as ordered by a physician who 21 documents the need for such restraints or confinements in the 22 resident's clinical record. Whenever a resident is 23 restrained, a member of the facility staff shall remain with 24 the resident at all times unless the resident has been 25 confined. A resident who is restrained and confined shall be 26 observed by a qualified person as often as is clinically 27 appropriate but in no event less often than once every 15 28 minutes. 29 (c) A restraint may be used only with the informed 30 consent of the resident, the resident's guardian, or other 31 authorized representative. A restraint may be used only for 32 specific periods, if it is the least restrictive means 33 necessary to attain and maintain the resident's highest HB0064 Engrossed -23- LRB9200853ACcd 1 practicable physical, mental or psychosocial well-being, 2 including brief periods of time to provide necessary 3 life-saving treatment. A restraint may be used only after 4 consultation with appropriate health professionals, such as 5 occupational or physical therapists, and a trial of less 6 restrictive measures has led to the determination that the 7 use of less restrictive measures would not attain or maintain 8 the resident's highest practicable physical, mental or 9 psychosocial well-being. However, if the resident needs 10 emergency care, restraints may be used for brief periods to 11 permit medical treatment to proceed unless the facility has 12 notice that the resident has previously made a valid refusal 13 of the treatment in question. 14 (d) A restraint may be applied only by a person trained 15 in the application of the particular type of restraint. 16 (e) Whenever a period of use of a restraint is 17 initiated, the resident shall be advised of his or her right 18 to have a person or organization of his or her choosing, 19 including the Guardianship and Advocacy Commission, notified 20 of the use of the restraint. A recipient who is under 21 guardianship may request that a person or organization of his 22 or her choosing be notified of the restraint, whether or not 23 the guardian approves the notice. If the resident so 24 chooses, the facility shall make the notification within 24 25 hours, including any information about the period of time 26 that the restraint is to be used. Whenever the Guardianship 27 and Advocacy Commission is notified that a resident has been 28 restrained, it shall contact the resident to determine the 29 circumstances of the restraint and whether further action is 30 warranted. 31 (f) Whenever a restraint is used on a resident whose 32 primary mode of communication is sign language, the resident 33 shall be permitted to have his or her hands free from 34 restraint for brief periods each hour, except when this HB0064 Engrossed -24- LRB9200853ACcd 1 freedom may result in physical harm to the resident or 2 others. 3 (g) The requirements of this Section are intended to 4 control in any conflict with the requirements of Sections 5 1-126 and 2-108 of the Mental Health and Developmental 6 Disabilities Code. 7 (Source: P.A. 88-413.) 8 (210 ILCS 45/2-106.1) 9 Sec. 2-106.1. Drug treatment. 10 (a) A resident shall not be given unnecessary drugs. An 11 unnecessary drug is any drug used in an excessive dose, 12 including in duplicative therapy; for excessive duration; 13 without adequate monitoring; without adequate indications for 14 its use; or in the presence of adverse consequences that 15 indicate the drugs should be reduced or discontinued. The 16 Department shall adopt, by rule, the standards for 17 unnecessary drugs contained in interpretive guidelines issued 18 by the United States Department of Health and Human Services 19 for the purposes of administering titles 18 and 19 of the 20 Social Security Act. 21 (b) Psychotropic medication shall not be prescribed 22 without the informed consent of the resident, the resident's 23 guardian, or other authorized representative. "Psychotropic 24 medication" means medication that is used for or listed as 25 used for antipsychotic, antidepressant, antimanic, or 26 antianxiety behavior modification or behavior management 27 purposes in the latest editions of the AMA Drug Evaluations 28 or the Physician's Desk Reference. 29 (c) The requirements of this Section are intended to 30 control in a conflict with the requirements of Sections 2-102 311-102and 2-107.2 of the Mental Health and Developmental 32 Disabilities Code with respect to the administration of 33 psychotropic medication. HB0064 Engrossed -25- LRB9200853ACcd 1 (Source: P.A. 88-413.) 2 Section 25. The Nursing and Advanced Practice Nursing 3 Act is amended by changing Section 5-10 as follows: 4 (225 ILCS 65/5-10) 5 Sec. 5-10. Definitions. Each of the following terms, 6 when used in this Act, shall have the meaning ascribed to it 7 in this Section, except where the context clearly indicates 8 otherwise: 9 (a) "Department" means the Department of Professional 10 Regulation. 11 (b) "Director" means the Director of Professional 12 Regulation. 13 (c) "Board" means the Board of Nursing appointed by the 14 Director. 15 (d) "Academic year" means the customary annual schedule 16 of courses at a college, university, or approved school, 17 customarily regarded as the school year as distinguished from 18 the calendar year. 19 (e) "Approved program of professional nursing education" 20 and "approved program of practical nursing education" are 21 programs of professional or practical nursing, respectively, 22 approved by the Department under the provisions of this Act. 23 (f) "Nursing Act Coordinator" means a registered 24 professional nurse appointed by the Director to carry out the 25 administrative policies of the Department. 26 (g) "Assistant Nursing Act Coordinator" means a 27 registered professional nurse appointed by the Director to 28 assist in carrying out the administrative policies of the 29 Department. 30 (h) "Registered" is the equivalent of "licensed". 31 (i) "Practical nurse" or "licensed practical nurse" 32 means a person who is licensed as a practical nurse under HB0064 Engrossed -26- LRB9200853ACcd 1 this Act and practices practical nursing as defined in 2 paragraph (j) of this Section. Only a practical nurse 3 licensed under this Act is entitled to use the title 4 "licensed practical nurse" and the abbreviation "L.P.N.". 5 (j) "Practical nursing" means the performance of nursing 6 acts requiring the basic nursing knowledge, judgement, and 7 skill acquired by means of completion of an approved 8 practical nursing education program. Practical nursing 9 includes assisting in the nursing process as delegated by and 10 under the direction of a registered professional nurse. The 11 practical nurse may work under the direction of a licensed 12 physician, dentist, podiatrist, or other health care 13 professional determined by the Department. 14 (k) "Registered Nurse" or "Registered Professional 15 Nurse" means a person who is licensed as a professional nurse 16 under this Act and practices nursing as defined in paragraph 17 (l) of this Section. Only a registered nurse licensed under 18 this Act is entitled to use the titles "registered nurse" and 19 "registered professional nurse" and the abbreviation, "R.N.". 20 (l) "Registered professional nursing practice" includes 21 all nursing specialities and means the performance of any 22 nursing act based upon professional knowledge, judgment, and 23 skills acquired by means of completion of an approved 24 registered professional nursing education program. A 25 registered professional nurse provides nursing care 26 emphasizing the importance of the whole and the 27 interdependence of its parts through the nursing process to 28 individuals, groups, families, or communities, that includes 29 but is not limited to: (1) the assessment of healthcare 30 needs, nursing diagnosis, planning, implementation, and 31 nursing evaluation; (2) the promotion, maintenance, and 32 restoration of health; (3) counseling, patient education, 33 health education, and patient advocacy; (4) the 34 administration of medications and treatments as prescribed by HB0064 Engrossed -27- LRB9200853ACcd 1 a physician licensed to practice medicine in all of its 2 branches, a licensed dentist, a licensed podiatrist, or a 3 licensed optometrist or as prescribed by a physician 4 assistant in accordance with written guidelines required 5 under the Physician Assistant Practice Act of 1987 or by an 6 advanced practice nurse in accordance with a written 7 collaborative agreement required under the Nursing and 8 Advanced Practice Nursing Act; (5) the coordination and 9 management of the nursing plan of care; (6) the delegation to 10 and supervision of individuals who assist the registered 11 professional nurse implementing the plan of care;and(7) 12 teaching and supervision of nursing students; and (8) the 13 ordering of restraint or seclusion as authorized under the 14 Hospital Licensing Act. The foregoing shall not be deemed to 15 include those acts of medical diagnosis or prescription of 16 therapeutic or corrective measures that are properly 17 performed only by physicians licensed in the State of 18 Illinois. 19 (m) "Current nursing practice update course" means a 20 planned nursing education curriculum approved by the 21 Department consisting of activities that have educational 22 objectives, instructional methods, content or subject matter, 23 clinical practice, and evaluation methods, related to basic 24 review and updating content and specifically planned for 25 those nurses previously licensed in the United States or its 26 territories and preparing for reentry into nursing practice. 27 (n) "Professional assistance program for nurses" means a 28 professional assistance program that meets criteria 29 established by the Board of Nursing and approved by the 30 Director, which provides a non-disciplinary treatment 31 approach for nurses licensed under this Act whose ability to 32 practice is compromised by alcohol or chemical substance 33 addiction. 34 (Source: P.A. 90-61, eff. 12-30-97; 90-248, eff. 1-1-98; HB0064 Engrossed -28- LRB9200853ACcd 1 90-655, eff. 7-30-98; 90-742, eff. 8-13-98.) 2 Section 99. Effective date. This Section, Sections 10 3 and 25, the changes to Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 4 and 6.8 of the Abused and Neglected Long Term Care Facility 5 Residents Reporting Act, and the changes to Section 3-203 of 6 the Nursing Home Care Act take effect upon becoming law.