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Public Act 102-0913


 

Public Act 0913 102ND GENERAL ASSEMBLY



 


 
Public Act 102-0913
 
HB1592 EnrolledLRB102 03635 KTG 13648 b

    AN ACT concerning State government.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Short title. This Act may be cited as the Mental
Health Inpatient Facility Access Act.
 
    Section 5. Findings. The General Assembly finds that:
        (1) In 1955, Illinois had more than 30,000 adult
    State-operated inpatient mental health beds.
        (2) In 2019, prior to the COVID-19 pandemic, Illinois
    had fewer than 1,200 adult State-operated inpatient mental
    health beds.
        (3) Due to the COVID-19 pandemic, there are now only
    approximately 1,100 State-operated inpatient mental health
    beds.
        (4) More than 500,000 people in Illinois have serious
    mental health conditions.
        (5) While most people with even the most serious
    mental health conditions can be successfully treated in
    the community or in private hospitals, many will need
    inpatient care from a State-operated inpatient mental
    health facility.
        (6) Given the small number of remaining beds in
    State-operated inpatient mental health facilities, it is
    vital that adults who need a hospital-level of care are
    able to obtain services in such facilities.
        (7) Due to the lack of available inpatient mental
    health beds:
            (A) Many people in need of inpatient psychiatric
        care wait for days or weeks in emergency departments
        or non-psychiatric units of general hospitals where it
        is difficult to provide them with safe and effective
        mental health treatment.
            (B) Persons found unfit to stand trial or not
        guilty by reason of insanity and committed to the
        custody of the Department of Human Services often wait
        for weeks or months in county jails where it is
        difficult to provide them with safe and effective
        mental health treatment.
            (C) Adults with a continuing need for mental
        health services are discharged into the community
        before their mental health condition makes such a
        discharge safe and appropriate or before arrangements
        have been made for needed long-term community mental
        health services.
            (D) Adults who need inpatient care are often
        denied access to such care.
 
    Section 10. Strategic plan on improving access to
inpatient psychiatric beds. The Department of Human Services'
Division of Mental Health shall develop a written, strategic
plan that comprehensively addresses improving access to
inpatient psychiatric beds in State-operated mental health
facilities for individuals needing a hospital level of care.
This plan shall address achieving the best use of
State-operated psychiatric beds across Illinois, with
strategies specifically to mitigate inefficient use of
forensic beds and reduce lengths of stays for the forensic
population. A comprehensive approach to this plan shall
include training and education, ongoing assessment of
individuals receiving inpatient services, reviewing and
updating policies and procedures, and increasing
community-based capacity for individuals in all State-operated
forensic beds. The plan shall include:
        (1) Annual training. Required annual training for all
    State-operated inpatient mental health facility clinicians
    shall include:
            (A) Best practices for evaluating whether
        individuals found not guilty by reason of insanity or
        unfit to stand trial meet the legal criteria for
        inpatient treatment.
            (B) Best practices for determining appropriate
        treatment for individuals found not guilty by reason
        of insanity or unfit to stand trial.
            (C) The requirements of treatment plan reports.
            (D) The types of mental health services available
        following discharge, including, but not limited to:
        assertive community treatment, community support
        teams, supportive housing, medication management,
        psychotherapy, peer support services, specialized
        mental health rehabilitation facilities, and nursing
        homes.
        (2) Regular and periodic assessment of mental health
    condition and progress. At least once every year following
    the admission of any individual under Section 5-2-4 of the
    Unified Code of Corrections or Section 104-17 of the Code
    of Criminal Procedure of 1963, the Director of the
    Division of Mental Health, or his or her designee, shall
    meet with the treatment team assigned to that individual
    to review whether:
            (A) The individual continues to meet the standard
        for inpatient care.
            (B) The individual may be appropriate for
        unsupervised on-grounds privileges, off-grounds
        privileges (with or without escort by personnel of the
        Department of Human Services), home visits, and
        participation in work programs.
            (C) The current treatment plan is reasonably
        expected to result in the improvement of the
        individual's clinical condition so that the individual
        no longer needs inpatient treatment, and, if not, what
        other treatments or placements are available to meet
        the individual's needs and safety.
        (3) Updated policies and procedures.
            (A) Revise facility policies and procedures to
        increase opportunities for home visits and work
        programs that assist with community reintegration.
        This shall include a review of unsupervised on-grounds
        privileges, off-grounds privileges (with or without
        escort by personnel of the Department of Human
        Services), home visits, and participation in work or
        educational programs to ensure that policies do not
        limit the ability to approve these activities. The
        plan shall also address the frequency for which
        individuals are assessed to be eligible for these
        activities.
            (B) Ensure all individuals found unfit to stand
        trial or not guilty by reason of insanity, who can be
        treated on an outpatient basis are recommended for
        outpatient services.
            (C) Develop benchmarks to ensure that:
                (i) every individual found unfit to stand
            trial or not guilty by reason of insanity who has
            been committed by a court to the Department for
            treatment shall be admitted to a Department
            facility within the time periods set forth in
            subsection (b) of Section 104-17 of the Code of
            Criminal Procedure of 1963 and subsection (a) of
            Section 5-2-4 of Unified Code of Corrections; and
                (ii) no individual who needs inpatient
            psychiatric care remains in an emergency
            department of any hospital or in any other
            non-psychiatric unit longer than 48 hours.
        (4) Building community treatment capacity.
            (A) Specific steps to increase access to
        community-based mental health services that provide
        (i) outpatient alternatives to those being assessed
        for inpatient stays at State-operated inpatient mental
        health facilities and (ii) step-down services for
        those no longer meeting inpatient stay criteria,
        specifically the population of individuals found not
        guilty by reason of insanity. Such steps must
        specifically identify community-based treatment
        alternatives and how these services will be funded.
            (B) Specific steps to ensure each State-operated
        inpatient mental health facility has sufficient
        qualified psychiatrists, psychologists, social
        workers, peer support professionals, and other staff
        so that the Department may provide adequate and humane
        care and services for all patients. That plan shall
        include:
                (i) an assessment of whether the salary and
            other benefits provided to professional staff are
            sufficient to attract and retain staff;
                (ii) an assessment of the annual budget needed
            to attract and retain staff;
                (iii) an assessment of any other impediments
            to attracting and retaining staff, and a
            mitigation plan for those impediments; and
                (iv) a detailed plan for recruiting
            psychiatrists, psychologists, social workers, peer
            support professionals, and other mental health
            staff.
        (5) Certification of mental health clinicians. The
    Division of Mental Health shall outline in the strategic
    plan a plan for training, implementing standard
    qualifications, and credentialing all psychiatrists,
    clinical social workers, clinical psychologists, and
    qualified examiners who conduct any evaluations, as
    employees, agents, or vendors of the Division concerning:
            (A) findings of unfitness to stand trial and all
        other evaluations of individuals receiving treatment
        in accordance with Section 104-10 of the Code of
        Criminal Procedure of 1963:
            (B) individuals receiving treatment in accordance
        with Section 5-2-4 of the Unified Code of Corrections;
            (C) whether individuals are subject to involuntary
        admission on an inpatient or outpatient basis in
        accordance with the Mental Health and Developmental
        Disabilities Code; and
            (D) whether individuals are subject to
        court-ordered treatment in accordance with Section
        2-107.1 of the Mental Health and Developmental
        Disabilities Code.
        Such evaluations shall include any treatment reports
    required under the Code of Criminal Procedure of 1963 or
    the Mental Health and Developmental Disabilities Code.
        (6) There shall be stakeholder input during the
    planning process from the Division of Mental Health's
    forensic workgroup.
 
    Section 15. Implementation. The strategic plan developed
by the Division of Mental Health shall be finalized and made
publicly available one year after the effective date of this
Act. The plan shall include:
        (1) Benchmarks and timelines for implementing each
    provision of the plan.
        (2) Strategy for obtaining resources needed to
    implement each provision of the plan.
        (3) Ongoing stakeholder engagement during the
    implementation of the plan through the Division of Mental
    Health's forensic workgroup.
 
    Section 20. Prohibition on reduction of State-operated
psychiatric inpatient beds. The Department shall make no
further reductions in State-operated inpatient mental health
bed capacity. Nothing in this Section shall affect the
authority of the Governor to issue emergency executive orders
to protect the health or safety of recipients or employees of
State-operated inpatient psychiatric facilities.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 5/27/2022