State of Illinois
92nd General Assembly

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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, and average  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 unable unqualified  to  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  2001 1977 by more than 3% over the prior
25    year, the Department shall fully reimburse  such  agency  for
26    the  increased costs of providing services to such persons in
27    excess 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.
21    At   the   conclusion  of  one  year  following  absolute  or
22    conditional discharge, or a longer period of time if required
23    by  the  Department,  the  Department   may   terminate   the
24    visitation requirements of this Section as to a person placed
25    in   accordance  with  this  Section,  by  filing  a  written
26    statement   of   termination   setting   forth   reasons   to
27    substantiate the termination of visitations in  the  person's
28    file,  and  sending  a copy thereof to the person, and to his
29    guardian 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 and who shall 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.
 3        The Inspector General shall be appointed for a term of  4
 4    years.
 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    the  Department  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.
31        This 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.
21        This 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  the
26    effective 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.
 2        This 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.
24        This 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.
14        This 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.
31        This 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
31    1-102  and  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.

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