Public Act 094-1066
 
SB0998 Enrolled LRB094 04681 RXD 34710 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Mental Health and Developmental
Disabilities Code is amended by changing Sections 2-107,
2-107.1, and 3-209 and by adding Section 2-107.3 as follows:
 
    (405 ILCS 5/2-107)  (from Ch. 91 1/2, par. 2-107)
    Sec. 2-107. Refusal of services; informing of risks.
    (a) An adult recipient of services or the recipient's
guardian, if the recipient is under guardianship, and the
recipient's substitute decision maker, if any, must be informed
of the recipient's right to refuse medication. The recipient
and the recipient's guardian or substitute decision maker shall
be given the opportunity to refuse generally accepted mental
health or developmental disability services, including but not
limited to medication. If such services are refused, they shall
not be given unless such services are necessary to prevent the
recipient from causing serious and imminent physical harm to
the recipient or others and no less restrictive alternative is
available. The facility director shall inform a recipient,
guardian, or substitute decision maker, if any, who refuses
such services of alternate services available and the risks of
such alternate services, as well as the possible consequences
to the recipient of refusal of such services.
    (b) Authorized involuntary treatment may be given under
this Section for up to 24 hours only if the circumstances
leading up to the need for emergency treatment are set forth in
writing in the recipient's record.
    (c) Authorized involuntary treatment may not be continued
unless the need for such treatment is redetermined at least
every 24 hours based upon a personal examination of the
recipient by a physician or a nurse under the supervision of a
physician and the circumstances demonstrating that need are set
forth in writing in the recipient's record.
    (d) Authorized involuntary treatment may not be
administered under this Section for a period in excess of 72
hours, excluding Saturdays, Sundays, and holidays, unless a
petition is filed under Section 2-107.1 and the treatment
continues to be necessary under subsection (a) of this Section.
Once the petition has been filed, treatment may continue in
compliance with subsections (a), (b), and (c) of this Section
until the final outcome of the hearing on the petition.
    (e) The Department shall issue rules designed to insure
that in State-operated mental health facilities authorized
involuntary treatment is administered in accordance with this
Section and only when appropriately authorized and monitored by
a physician or a nurse under the supervision of a physician in
accordance with accepted medical practice. The facility
director of each mental health facility not operated by the
State shall issue rules designed to insure that in that
facility authorized involuntary treatment is administered in
accordance with this Section and only when appropriately
authorized and monitored by a physician or a nurse under the
supervision of a physician in accordance with accepted medical
practice. Such rules shall be available for public inspection
and copying during normal business hours.
    (f) The provisions of this Section with respect to the
emergency administration of authorized involuntary treatment
do not apply to facilities licensed under the Nursing Home Care
Act.
    (g) Under no circumstances may long-acting psychotropic
medications be administered under this Section.
    (h) Whenever psychotropic medication is refused pursuant
to subsection (a) of this Section at least once that day, the
physician shall determine and state in writing the reasons why
the recipient did not meet the criteria for involuntary
treatment under subsection (a) and whether the recipient meets
the standard for authorized involuntary treatment under
Section 2-107.1 of this Code. If the physician determines that
the recipient meets the standard for authorized involuntary
treatment under Section 2-107.1, the facility director or his
or her designee shall petition the court for authorized
involuntary treatment pursuant to that Section unless the
facility director or his or her designee states in writing in
the recipient's record why the filing of such a petition is not
warranted. This subsection (h) applies only to State-operated
mental health facilities.
    (i) The Department shall conduct annual trainings for all
physicians and registered nurses working in State-operated
mental health facilities on the appropriate use of emergency
authorized involuntary treatment, standards for its use, and
the methods of authorization under this Section.
(Source: P.A. 90-538, eff. 12-1-97; 91-726, eff. 6-2-00.)
 
    (405 ILCS 5/2-107.1)  (from Ch. 91 1/2, par. 2-107.1)
    Sec. 2-107.1. Administration of authorized involuntary
treatment upon application to a court.
    (a) An adult recipient of services and the recipient's
guardian, if the recipient is under guardianship, and the
substitute decision maker, if any, shall be informed of the
recipient's right to refuse medication. The recipient and the
recipient's guardian or substitute decision maker shall be
given the opportunity to refuse generally accepted mental
health or developmental disability services, including but not
limited to medication.
    (a-5) Notwithstanding the provisions of Section 2-107 of
this Code, authorized involuntary treatment may be
administered to an adult recipient of services without the
informed consent of the recipient under the following
standards:
        (1) Any person 18 years of age or older, including any
    guardian, may petition the circuit court for an order
    authorizing the administration of authorized involuntary
    treatment to a recipient of services. The petition shall
    state that the petitioner has made a good faith attempt to
    determine whether the recipient has executed a power of
    attorney for health care under the Powers of Attorney for
    Health Care Law or a declaration for mental health
    treatment under the Mental Health Treatment Preference
    Declaration Act and to obtain copies of these instruments
    if they exist. If either of the above-named instruments is
    available to the petitioner, the instrument or a copy of
    the instrument shall be attached to the petition as an
    exhibit. The petitioner shall deliver a copy of the
    petition, and notice of the time and place of the hearing,
    to the respondent, his or her attorney, any known agent or
    attorney-in-fact, if any, and the guardian, if any, no
    later than 3 days prior to the date of the hearing. Service
    of the petition and notice of the time and place of the
    hearing may be made by transmitting them via facsimile
    machine to the respondent or other party. Upon receipt of
    the petition and notice, the party served, or the person
    delivering the petition and notice to the party served,
    shall acknowledge service. If the party sending the
    petition and notice does not receive acknowledgement of
    service within 24 hours, service must be made by personal
    service.
        The petition may include a request that the court
    authorize such testing and procedures as may be essential
    for the safe and effective administration of the authorized
    involuntary treatment sought to be administered, but only
    where the petition sets forth the specific testing and
    procedures sought to be administered.
        If a hearing is requested to be held immediately
    following the hearing on a petition for involuntary
    admission, then the notice requirement shall be the same as
    that for the hearing on the petition for involuntary
    admission, and the petition filed pursuant to this Section
    shall be filed with the petition for involuntary admission.
        (2) The court shall hold a hearing within 7 days of the
    filing of the petition. The People, the petitioner, or the
    respondent shall be entitled to a continuance of up to 7
    days as of right. An additional continuance of not more
    than 7 days may be granted to any party (i) upon a showing
    that the continuance is needed in order to adequately
    prepare for or present evidence in a hearing under this
    Section or (ii) under exceptional circumstances. The court
    may grant an additional continuance not to exceed 21 days
    when, in its discretion, the court determines that such a
    continuance is necessary in order to provide the recipient
    with an examination pursuant to Section 3-803 or 3-804 of
    this Act, to provide the recipient with a trial by jury as
    provided in Section 3-802 of this Act, or to arrange for
    the substitution of counsel as provided for by the Illinois
    Supreme Court Rules. The hearing shall be separate from a
    judicial proceeding held to determine whether a person is
    subject to involuntary admission but may be heard
    immediately preceding or following such a judicial
    proceeding and may be heard by the same trier of fact or
    law as in that judicial proceeding.
        (3) Unless otherwise provided herein, the procedures
    set forth in Article VIII of Chapter 3 of this Act,
    including the provisions regarding appointment of counsel,
    shall govern hearings held under this subsection (a-5).
        (4) Authorized involuntary treatment shall not be
    administered to the recipient unless it has been determined
    by clear and convincing evidence that all of the following
    factors are present. In determining whether a person meets
    the criteria specified in the following paragraphs (A)
    through (G), the court may consider evidence of the
    person's history of serious violence, repeated past
    pattern of specific behavior, actions related to the
    person's illness, or past outcomes of various treatment
    options. :
            (A) That the recipient has a serious mental illness
        or developmental disability.
            (B) That because of said mental illness or
        developmental disability, the recipient currently
        exhibits any one of the following: (i) deterioration of
        his or her ability to function, as compared to the
        recipient's ability to function prior to the current
        onset of symptoms of the mental illness or disability
        for which treatment is presently sought, (ii)
        suffering, or (iii) threatening behavior.
            (C) That the illness or disability has existed for
        a period marked by the continuing presence of the
        symptoms set forth in item (B) of this subdivision (4)
        or the repeated episodic occurrence of these symptoms.
            (D) That the benefits of the treatment outweigh the
        harm.
            (E) That the recipient lacks the capacity to make a
        reasoned decision about the treatment.
            (F) That other less restrictive services have been
        explored and found inappropriate.
            (G) If the petition seeks authorization for
        testing and other procedures, that such testing and
        procedures are essential for the safe and effective
        administration of the treatment.
        (5) In no event shall an order issued under this
    Section be effective for more than 90 days. A second 90-day
    period of involuntary treatment may be authorized pursuant
    to a hearing that complies with the standards and
    procedures of this subsection (a-5). Thereafter,
    additional 180-day periods of involuntary treatment may be
    authorized pursuant to the standards and procedures of this
    Section without limit. If a new petition to authorize the
    administration of authorized involuntary treatment is
    filed at least 15 days prior to the expiration of the prior
    order, and if any continuance of the hearing is agreed to
    by the recipient, the administration of the treatment may
    continue in accordance with the prior order pending the
    completion of a hearing under this Section.
        (6) An order issued under this subsection (a-5) shall
    designate the persons authorized to administer the
    authorized involuntary treatment under the standards and
    procedures of this subsection (a-5). Those persons shall
    have complete discretion not to administer any treatment
    authorized under this Section. The order shall also specify
    the medications and the anticipated range of dosages that
    have been authorized and may include a list of any
    alternative medications and range of dosages deemed
    necessary.
    (b) A guardian may be authorized to consent to the
administration of authorized involuntary treatment to an
objecting recipient only under the standards and procedures of
subsection (a-5).
    (c) Notwithstanding any other provision of this Section, a
guardian may consent to the administration of authorized
involuntary treatment to a non-objecting recipient under
Article XIa of the Probate Act of 1975.
    (d) Nothing in this Section shall prevent the
administration of authorized involuntary treatment to
recipients in an emergency under Section 2-107 of this Act.
    (e) Notwithstanding any of the provisions of this Section,
authorized involuntary treatment may be administered pursuant
to a power of attorney for health care under the Powers of
Attorney for Health Care Law or a declaration for mental health
treatment under the Mental Health Treatment Preference
Declaration Act.
    (f) The Department shall conduct annual trainings for
physicians and registered nurses working in State-operated
mental health facilities on the appropriate use of authorized
involuntary treatment, standards for its use, and the
preparation of court petitions under this Section.
(Source: P.A. 92-16, eff. 6-28-01; 93-573, eff. 8-21-03.)
 
    (405 ILCS 5/2-107.3 new)
    Sec. 2-107.3. Reports. Each facility director of a
State-operated mental health facility shall prepare a
quarterly report stating the number of persons who were
determined to meet the standard for authorized involuntary
treatment but for whom it was determined that the filing of
such a petition was not warranted as provided for in subsection
(h) of Section 2-107 of this Code and the reasons for each such
determination. The Department shall prepare and publish an
annual report summarizing the information received under this
Section. The Department's report shall include the data from
each facility filing such a report and shall separately report
the data from each such facility, identified by facility.
 
    (405 ILCS 5/3-209)  (from Ch. 91 1/2, par. 3-209)
    Sec. 3-209. Within three days of admission under this
Chapter, a treatment plan shall be prepared for each recipient
of service and entered into his or her record. The plan shall
include an assessment of the recipient's treatment needs, a
description of the services recommended for treatment, the
goals of each type of element of service, an anticipated
timetable for the accomplishment of the goals, and a
designation of the qualified professional responsible for the
implementation of the plan. The plan shall include a written
assessment of whether or not the recipient is in need of
psychotropic medications. The plan shall be reviewed and
updated as the clinical condition warrants, but not less than
every 30 days.
(Source: P.A. 81-920.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.