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Public Act 100-0365 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Specialized Mental Health Rehabilitation | ||||
Act of 2013 is amended by changing Sections 1-101.5, 1-102, | ||||
2-103, 4-105, and 4-108.5 and by adding Section 4-104.5 as | ||||
follows: | ||||
(210 ILCS 49/1-101.5)
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Sec. 1-101.5. Prior law. | ||||
(a) This Act provides for licensure of long term care | ||||
facilities that are federally designated as institutions for | ||||
the mentally diseased on the effective date of this Act and | ||||
specialize in providing services to individuals with a serious | ||||
mental illness. On and after the effective date of this Act, | ||||
these facilities shall be governed by this Act instead of the | ||||
Nursing Home Care Act. The existence of a current or pending | ||||
administrative hearing, notice of violation, or other | ||||
enforcement action, except for a pending notice of revocation, | ||||
authorized under the Nursing Home Care Act shall not be a | ||||
barrier to the provisional licensure of a facility under this | ||||
Act. Provisional licensure under this Act shall not relieve a | ||||
facility from the responsibility for the payment of any past, | ||||
current, or future fines or penalties, or for any other |
enforcement remedy, imposed upon the facility under the Nursing | ||
Home Care Act. | ||
(b) All consent decrees that apply to facilities federally | ||
designated as institutions for the mentally diseased shall | ||
continue to apply to facilities licensed under this Act.
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(c) A facility licensed under this Act may voluntarily | ||
close, and the facility may reopen in an underserved region of | ||
the State, if the facility receives a certificate of need from | ||
the Health Facilities and Services Review Board. At no time | ||
shall the total number of licensed beds under this Act exceed | ||
the total number of licensed beds existing on July 22, 2013 | ||
(the effective date of Public Act 98-104). | ||
(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14.) | ||
(210 ILCS 49/1-102)
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Sec. 1-102. Definitions. For the purposes of this Act, | ||
unless the context otherwise requires: | ||
"Abuse" means any physical or mental injury or sexual | ||
assault inflicted on a consumer other than by accidental means | ||
in a facility. | ||
"Accreditation" means any of the following: | ||
(1) the Joint Commission; | ||
(2) the Commission on Accreditation of Rehabilitation | ||
Facilities; | ||
(3) the Healthcare Facilities Accreditation Program; | ||
or |
(4) any other national standards of care as approved by | ||
the Department. | ||
"Applicant" means any person making application for a | ||
license or a provisional license under this Act. | ||
"Consumer" means a person, 18 years of age or older, | ||
admitted to a mental health rehabilitation facility for | ||
evaluation, observation, diagnosis, treatment, stabilization, | ||
recovery, and rehabilitation. | ||
"Consumer" does not mean any of the following: | ||
(i) an individual requiring a locked setting; | ||
(ii) an individual requiring psychiatric | ||
hospitalization because of an acute psychiatric crisis; | ||
(iii) an individual under 18 years of age; | ||
(iv) an individual who is actively suicidal or violent | ||
toward others; | ||
(v) an individual who has been found unfit to stand | ||
trial; | ||
(vi) an individual who has been found not guilty by | ||
reason of insanity based on committing a violent act, such | ||
as sexual assault, assault with a deadly weapon, arson, or | ||
murder; | ||
(vii) an individual subject to temporary detention and | ||
examination under Section 3-607 of the Mental Health and | ||
Developmental Disabilities Code; | ||
(viii) an individual deemed clinically appropriate for | ||
inpatient admission in a State psychiatric hospital; and |
(ix) an individual transferred by the Department of | ||
Corrections pursuant to Section 3-8-5 of the Unified Code | ||
of Corrections. | ||
"Consumer record" means a record that organizes all | ||
information on the care, treatment, and rehabilitation | ||
services rendered to a consumer in a specialized mental health | ||
rehabilitation facility. | ||
"Controlled drugs" means those drugs covered under the | ||
federal Comprehensive Drug Abuse Prevention Control Act of | ||
1970, as amended, or the Illinois Controlled Substances Act. | ||
"Department" means the Department of Public Health. | ||
"Discharge" means the full release of any consumer from a | ||
facility. | ||
"Drug administration" means the act in which a single dose | ||
of a prescribed drug or biological is given to a consumer. The | ||
complete act of administration entails removing an individual | ||
dose from a container, verifying the dose with the prescriber's | ||
orders, giving the individual dose to the consumer, and | ||
promptly recording the time and dose given. | ||
"Drug dispensing" means the act entailing the following of | ||
a prescription order for a drug or biological and proper | ||
selection, measuring, packaging, labeling, and issuance of the | ||
drug or biological to a consumer. | ||
"Emergency" means a situation, physical condition, or one | ||
or more practices, methods, or operations which present | ||
imminent danger of death or serious physical or mental harm to |
consumers of a facility. | ||
"Facility" means a specialized mental health | ||
rehabilitation facility that provides at least one of the | ||
following services: (1) triage center; (2) crisis | ||
stabilization; (3) recovery and rehabilitation supports; or | ||
(4) transitional living units for 3 or more persons. The | ||
facility shall provide a 24-hour program that provides | ||
intensive support and recovery services designed to assist | ||
persons, 18 years or older, with mental disorders to develop | ||
the skills to become self-sufficient and capable of increasing | ||
levels of independent functioning. It includes facilities that | ||
meet the following criteria: | ||
(1) 100% of the consumer population of the facility has | ||
a diagnosis of serious mental illness; | ||
(2) no more than 15% of the consumer population of the | ||
facility is 65 years of age or older; | ||
(3) none of the consumers are non-ambulatory; | ||
(4) none of the consumers have a primary diagnosis of | ||
moderate, severe, or profound intellectual disability; and | ||
(5) the facility must have been licensed under the | ||
Specialized Mental Health Rehabilitation Act or the | ||
Nursing Home Care Act immediately preceding July 22, 2013 | ||
( the effective date of this Act ) and qualifies as an a | ||
institute for mental disease under the federal definition | ||
of the term. | ||
"Facility" does not include the following: |
(1) a home, institution, or place operated by the | ||
federal government or agency thereof, or by the State of | ||
Illinois; | ||
(2) a hospital, sanitarium, or other institution whose | ||
principal activity or business is the diagnosis, care, and | ||
treatment of human illness through the maintenance and | ||
operation as organized facilities therefor which is | ||
required to be licensed under the Hospital Licensing Act; | ||
(3) a facility for child care as defined in the Child | ||
Care Act of 1969; | ||
(4) a community living facility as defined in the | ||
Community Living Facilities Licensing Act; | ||
(5) a nursing home or sanatorium operated solely by and | ||
for persons who rely exclusively upon treatment by | ||
spiritual means through prayer, in accordance with the | ||
creed or tenets of any well-recognized church or religious | ||
denomination; however, such nursing home or sanatorium | ||
shall comply with all local laws and rules relating to | ||
sanitation and safety; | ||
(6) a facility licensed by the Department of Human | ||
Services as a community-integrated living arrangement as | ||
defined in the Community-Integrated Living Arrangements | ||
Licensure and Certification Act; | ||
(7) a supportive residence licensed under the | ||
Supportive Residences Licensing Act; | ||
(8) a supportive living facility in good standing with |
the program established under Section 5-5.01a of the | ||
Illinois Public Aid Code, except only for purposes of the | ||
employment of persons in accordance with Section 3-206.01 | ||
of the Nursing Home Care Act; | ||
(9) an assisted living or shared housing establishment | ||
licensed under the Assisted Living and Shared Housing Act, | ||
except only for purposes of the employment of persons in | ||
accordance with Section 3-206.01 of the Nursing Home Care | ||
Act; | ||
(10) an Alzheimer's disease management center | ||
alternative health care model licensed under the | ||
Alternative Health Care Delivery Act; | ||
(11) a home, institution, or other place operated by or | ||
under the authority of the Illinois Department of Veterans' | ||
Affairs; | ||
(12) a facility licensed under the ID/DD Community Care | ||
Act; | ||
(13) a facility licensed under the Nursing Home Care | ||
Act after July 22, 2013 ( the effective date of this Act ) ; | ||
or | ||
(14) a facility licensed under the MC/DD Act. | ||
"Executive director" means a person who is charged with the | ||
general administration and supervision of a facility licensed | ||
under this Act and who is a licensed nursing home | ||
administrator, licensed practitioner of the healing arts, or | ||
qualified mental health professional . |
"Guardian" means a person appointed as a guardian of the | ||
person or guardian of the estate, or both, of a consumer under | ||
the Probate Act of 1975. | ||
"Identified offender" means a person who meets any of the | ||
following criteria: | ||
(1) Has been convicted of, found guilty of, adjudicated | ||
delinquent for, found not guilty by reason of insanity for, | ||
or found unfit to stand trial for, any felony offense | ||
listed in Section 25 of the Health Care Worker Background | ||
Check Act, except for the following: | ||
(i) a felony offense described in Section 10-5 of | ||
the Nurse Practice Act; | ||
(ii) a felony offense described in Section 4, 5, 6, | ||
8, or 17.02 of the Illinois Credit Card and Debit Card | ||
Act; | ||
(iii) a felony offense described in Section 5, 5.1, | ||
5.2, 7, or 9 of the Cannabis Control Act; | ||
(iv) a felony offense described in Section 401, | ||
401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois | ||
Controlled Substances Act; and | ||
(v) a felony offense described in the | ||
Methamphetamine Control and Community Protection Act. | ||
(2) Has been convicted of, adjudicated delinquent
for, | ||
found not guilty by reason of insanity for, or found unfit | ||
to stand trial for, any sex offense as defined in | ||
subsection (c) of Section 10 of the Sex Offender Management |
Board Act. | ||
"Transitional living units" are residential units within a | ||
facility that have the purpose of assisting the consumer in | ||
developing and reinforcing the necessary skills to live | ||
independently outside of the facility. The duration of stay in | ||
such a setting shall not exceed 120 days for each consumer. | ||
Nothing in this definition shall be construed to be a | ||
prerequisite for transitioning out of a facility. | ||
"Licensee" means the person, persons, firm, partnership, | ||
association, organization, company, corporation, or business | ||
trust to which a license has been issued. | ||
"Misappropriation of a consumer's property" means the | ||
deliberate misplacement, exploitation, or wrongful temporary | ||
or permanent use of a consumer's belongings or money without | ||
the consent of a consumer or his or her guardian. | ||
"Neglect" means a facility's failure to provide, or willful | ||
withholding of, adequate medical care, mental health | ||
treatment, psychiatric rehabilitation, personal care, or | ||
assistance that is necessary to avoid physical harm and mental | ||
anguish of a consumer. | ||
"Personal care" means assistance with meals, dressing, | ||
movement, bathing, or other personal needs, maintenance, or | ||
general supervision and oversight of the physical and mental | ||
well-being of an individual who is incapable of maintaining a | ||
private, independent residence or who is incapable of managing | ||
his or her person, whether or not a guardian has been appointed |
for such individual. "Personal care" shall not be construed to | ||
confine or otherwise constrain a facility's pursuit to develop | ||
the skills and abilities of a consumer to become | ||
self-sufficient and capable of increasing levels of | ||
independent functioning. | ||
"Recovery and rehabilitation supports" means a program | ||
that facilitates a consumer's longer-term symptom management | ||
and stabilization while preparing the consumer for | ||
transitional living units by improving living skills and | ||
community socialization. The duration of stay in such a setting | ||
shall be established by the Department by rule. | ||
"Restraint" means: | ||
(i) a physical restraint that is any manual method or
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physical or mechanical device, material, or equipment | ||
attached or adjacent to a consumer's body that the consumer | ||
cannot remove easily and restricts freedom of movement or | ||
normal access to one's body; devices used for positioning, | ||
including, but not limited to, bed rails, gait belts, and | ||
cushions, shall not be considered to be restraints for | ||
purposes of this Section; or | ||
(ii) a chemical restraint that is any drug used for
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discipline or convenience and not required to treat medical | ||
symptoms; the Department shall, by rule, designate certain | ||
devices as restraints, including at least all those devices | ||
that have been determined to be restraints by the United | ||
States Department of Health and Human Services in |
interpretive guidelines issued for the purposes of | ||
administering Titles XVIII and XIX of the federal Social | ||
Security Act. For the purposes of this Act, restraint shall | ||
be administered only after utilizing a coercive free | ||
environment and culture. | ||
"Self-administration of medication" means consumers shall | ||
be responsible for the control, management, and use of their | ||
own medication. | ||
"Crisis stabilization" means a secure and separate unit | ||
that provides short-term behavioral, emotional, or psychiatric | ||
crisis stabilization as an alternative to hospitalization or | ||
re-hospitalization for consumers from residential or community | ||
placement. The duration of stay in such a setting shall not | ||
exceed 21 days for each consumer. | ||
"Therapeutic separation" means the removal of a consumer | ||
from the milieu to a room or area which is designed to aid in | ||
the emotional or psychiatric stabilization of that consumer. | ||
"Triage center" means a non-residential 23-hour center | ||
that serves as an alternative to emergency room care, | ||
hospitalization, or re-hospitalization for consumers in need | ||
of short-term crisis stabilization. Consumers may access a | ||
triage center from a number of referral sources, including | ||
family, emergency rooms, hospitals, community behavioral | ||
health providers, federally qualified health providers, or | ||
schools, including colleges or universities. A triage center | ||
may be located in a building separate from the licensed |
location of a facility, but shall not be more than 1,000 feet | ||
from the licensed location of the facility and must meet all of | ||
the facility standards applicable to the licensed location. If | ||
the triage center does operate in a separate building, safety | ||
personnel shall be provided, on site, 24 hours per day and the | ||
triage center shall meet all other staffing requirements | ||
without counting any staff employed in the main facility | ||
building.
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(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14; | ||
99-180, eff. 7-29-15; revised 9-8-16.) | ||
(210 ILCS 49/2-103)
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Sec. 2-103. Staff training. Training for all new employees | ||
specific to the various levels of care offered by a facility | ||
shall be provided to employees during their orientation period | ||
and annually thereafter. Training shall be independent of the | ||
Department and overseen by the Division of Mental Health to | ||
determine the content of all facility employee training and to | ||
provide training for all trainers of facility employees. | ||
Training of employees shall be consistent with nationally | ||
recognized national accreditation standards as defined later | ||
in this Act. Training of existing staff of a recovery and | ||
rehabilitation support center shall be conducted in accordance | ||
with, and on the schedule provided in, the staff training plan | ||
approved by the Division of Mental Health. Training of existing | ||
staff for any other level of care licensed under this Act, |
including triage, crisis stabilization, and transitional | ||
living shall be completed at a facility prior to the | ||
implementation of that level of care. Training shall be | ||
required for all existing staff at a facility prior to the | ||
implementation of any new services authorized under this Act.
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(Source: P.A. 98-104, eff. 7-22-13.) | ||
(210 ILCS 49/4-104.5 new) | ||
Sec. 4-104.5. Waiver of compliance. Upon application by a | ||
facility, the Director may grant or renew the waiver of the | ||
facility's compliance with a rule or standard for a period not | ||
to exceed the duration of the current license or, in the case | ||
of an application for license renewal, the duration of the | ||
renewal period. The waiver may be conditioned upon the facility | ||
taking action prescribed by the Director as a measure | ||
equivalent to compliance. In determining whether to grant or | ||
renew a waiver, the Director shall consider the duration and | ||
basis for any current waiver with respect to the same rule or | ||
standard and the validity and effect upon patient health and | ||
safety of extending it on the same basis, the effect upon the | ||
health and safety of consumers, the quality of consumer care, | ||
the facility's history of compliance with the rules and | ||
standards of this Act and the facility's attempts to comply | ||
with the particular rule or standard in question. Upon request | ||
by a facility, the Department must evaluate or allow for an | ||
evaluation of compliance with the Life Safety Code using the |
Fire Safety Evaluation System. In determining whether to grant | ||
or renew a waiver of a standard pertaining to Chapter 33 of the | ||
National Fire Protection Association (NFPA) 101 Life Safety | ||
Code, the Director shall use Fire Safety Evaluation Systems in | ||
determining whether to grant or renew the waiver. The | ||
Department may provide, by rule, for the automatic renewal of | ||
waivers concerning physical plant requirements upon the | ||
renewal of a license. The Department shall renew waivers | ||
relating to physical plant standards issued in accordance with | ||
this Section at the time of the indicated reviews, unless it | ||
can show why such waivers should not be extended for either of | ||
the following reasons: | ||
(1) the condition of the physical plant has | ||
deteriorated or its use substantially changed so that the | ||
basis upon which the waiver was issued is materially | ||
different; or | ||
(2) the facility is renovated or substantially | ||
remodeled in such a way as to permit compliance with the | ||
applicable rules and standards without a substantial | ||
increase in cost. | ||
A copy of each waiver application and each waiver granted | ||
or renewed shall be on file with the Department and available | ||
for public inspection. | ||
No penalty or fine may be assessed for a condition for | ||
which the facility has received a variance or waiver of a | ||
standard. |
Waivers granted to a facility by the Department under any | ||
other law shall not be considered by the Department in its | ||
determination of a facility's compliance with the requirements | ||
of this Act, including, but not limited to, compliance with the | ||
Life Safety Code. | ||
(210 ILCS 49/4-105)
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Sec. 4-105. Provisional licensure duration. A provisional | ||
license shall be valid upon fulfilling the requirements | ||
established by the Department by emergency rule. The license | ||
shall remain valid as long as a facility remains in compliance | ||
with the licensure provisions established in rule. Provisional | ||
licenses issued upon initial licensure as a specialized mental | ||
health rehabilitation facility shall expire at the end of a | ||
3-year period, which commences on the date the provisional | ||
license is issued. Issuance of a provisional license for any | ||
reason other than initial licensure (including, but not limited | ||
to, change of ownership, location, number of beds, or services) | ||
shall not extend the maximum 3-year period, at the end of which | ||
a facility must be licensed pursuant to Section 4-201. | ||
Notwithstanding any other provision of this Act or the | ||
Specialized Mental Health Rehabilitation Facilities Code, 77 | ||
Ill. Admin. Code 380, to the contrary, if a facility has | ||
received notice from the Department that its application for | ||
provisional licensure to provide recovery and rehabilitation | ||
services has been accepted as complete and the facility has |
attested in writing to the Department that it will comply with | ||
the staff training plan approved by the Division of Mental | ||
Health, then a provisional license for recovery and | ||
rehabilitation services shall be issued to the facility within | ||
60 days after the Department determines that the facility is in | ||
compliance with the requirements of the Life Safety Code in | ||
accordance with Section 4-104.5 of this Act.
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(Source: P.A. 98-104, eff. 7-22-13; 99-712, eff. 8-5-16.) | ||
(210 ILCS 49/4-108.5) | ||
Sec. 4-108.5. Provisional licensure period; surveys. | ||
During the provisional licensure period, the Department shall | ||
conduct surveys to determine compliance with timetables and | ||
benchmarks with a facility's provisional licensure application | ||
plan of operation. Timetables and benchmarks shall be | ||
established in rule and shall include, but not be limited to, | ||
the following: (1) training of new and existing staff; (2) | ||
establishment of a data collection and reporting program for | ||
the facility's Quality Assessment and Performance Improvement | ||
Program; and (3) compliance with building environment | ||
standards beyond compliance with Chapter 33 of the National | ||
Fire Protection Association (NFPA) 101 Life Safety Code. | ||
Waivers granted by the Department in accordance with Section | ||
4-104.5 of this Act shall be considered by the Department in | ||
its determination of the facility's compliance with the Life | ||
Safety Code. |
During the provisional licensure period, the Department | ||
shall conduct State licensure surveys as well as a conformance | ||
standard review to determine compliance with timetables and | ||
benchmarks associated with the accreditation process. | ||
Timetables and benchmarks shall be met in accordance with the | ||
preferred accrediting organization conformance standards and | ||
recommendations and shall include, but not be limited to, | ||
conducting a comprehensive facility self-evaluation in | ||
accordance with an established national accreditation program. | ||
The facility shall submit all data reporting and outcomes | ||
required by accrediting organization to the Department of | ||
Public Health for review to determine progress towards | ||
accreditation. Accreditation status shall supplement but not | ||
replace the State's licensure surveys of facilities licensed | ||
under this Act and their certified programs and services to | ||
determine the extent to which these facilities provide high | ||
quality interventions, especially evidence-based practices, | ||
appropriate to the assessed clinical needs of individuals in | ||
the 4 certified levels of care. | ||
Except for incidents involving the potential for harm, | ||
serious harm, death, or substantial facility failure to address | ||
a serious systemic issue within 60 days, findings of the | ||
facility's root cause analysis of problems and the facility's | ||
Quality Assessment and Performance Improvement program in | ||
accordance with item (22) of Section 4-104 shall not be used as | ||
a basis for non-compliance. |
The Department shall have the authority to hire licensed | ||
practitioners of the healing arts and qualified mental health | ||
professionals to consult with and participate in survey and | ||
inspection activities.
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(Source: P.A. 98-651, eff. 6-16-14.)
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Section 99. Effective date. This Act takes effect July 1, | ||
2017.
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