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Public Act 100-0365


 

Public Act 0365 100TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 100-0365
 
HB2465 EnrolledLRB100 08234 MJP 18334 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    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)
    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.
    (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)
    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
    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
    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.
(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)
    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.
(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)
    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.
(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.
(Source: P.A. 98-651, eff. 6-16-14.)
 
    Section 99. Effective date. This Act takes effect July 1,
2017.

Effective Date: 8/25/2017