State of Illinois
2017 and 2018


Introduced , by Rep. Sara Feigenholtz


210 ILCS 49/1-102
210 ILCS 49/3-213 new
210 ILCS 49/4-105
210 ILCS 49/4-108.5

    Amends the Specialized Mental Health Rehabilitation Act of 2013. Provides that provisional licenses shall be awarded to every entity with a pending application for licensure on the effective date. Provides that the provisional licenses shall be awarded and in effect immediately upon the effective date of the amendatory Act. Provides that for the purpose of compliance with specified Life Safety Code requirements, the Department of Public Health shall accept certain evaluations and waivers. Makes changes to the definition of "executive director". Provides that for comparative purposes, facilities licensed under the Act shall make a specified quarterly report to the Department of specified incidents. Effective July 1, 2017.

LRB100 08234 MJP 18334 b






HB2465LRB100 08234 MJP 18334 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Specialized Mental Health Rehabilitation
5Act of 2013 is amended by changing Sections 1-102, 4-105, and
64-108.5 and by adding Section 3-213 as follows:
7    (210 ILCS 49/1-102)
8    Sec. 1-102. Definitions. For the purposes of this Act,
9unless the context otherwise requires:
10    "Abuse" means any physical or mental injury or sexual
11assault inflicted on a consumer other than by accidental means
12in a facility.
13    "Accreditation" means any of the following:
14        (1) the Joint Commission;
15        (2) the Commission on Accreditation of Rehabilitation
16    Facilities;
17        (3) the Healthcare Facilities Accreditation Program;
18    or
19        (4) any other national standards of care as approved by
20    the Department.
21    "Applicant" means any person making application for a
22license or a provisional license under this Act.
23    "Consumer" means a person, 18 years of age or older,



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1admitted to a mental health rehabilitation facility for
2evaluation, observation, diagnosis, treatment, stabilization,
3recovery, and rehabilitation.
4    "Consumer" does not mean any of the following:
5        (i) an individual requiring a locked setting;
6        (ii) an individual requiring psychiatric
7    hospitalization because of an acute psychiatric crisis;
8        (iii) an individual under 18 years of age;
9        (iv) an individual who is actively suicidal or violent
10    toward others;
11        (v) an individual who has been found unfit to stand
12    trial;
13        (vi) an individual who has been found not guilty by
14    reason of insanity based on committing a violent act, such
15    as sexual assault, assault with a deadly weapon, arson, or
16    murder;
17        (vii) an individual subject to temporary detention and
18    examination under Section 3-607 of the Mental Health and
19    Developmental Disabilities Code;
20        (viii) an individual deemed clinically appropriate for
21    inpatient admission in a State psychiatric hospital; and
22        (ix) an individual transferred by the Department of
23    Corrections pursuant to Section 3-8-5 of the Unified Code
24    of Corrections.
25    "Consumer record" means a record that organizes all
26information on the care, treatment, and rehabilitation



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1services rendered to a consumer in a specialized mental health
2rehabilitation facility.
3    "Controlled drugs" means those drugs covered under the
4federal Comprehensive Drug Abuse Prevention Control Act of
51970, as amended, or the Illinois Controlled Substances Act.
6    "Department" means the Department of Public Health.
7    "Discharge" means the full release of any consumer from a
9    "Drug administration" means the act in which a single dose
10of a prescribed drug or biological is given to a consumer. The
11complete act of administration entails removing an individual
12dose from a container, verifying the dose with the prescriber's
13orders, giving the individual dose to the consumer, and
14promptly recording the time and dose given.
15    "Drug dispensing" means the act entailing the following of
16a prescription order for a drug or biological and proper
17selection, measuring, packaging, labeling, and issuance of the
18drug or biological to a consumer.
19    "Emergency" means a situation, physical condition, or one
20or more practices, methods, or operations which present
21imminent danger of death or serious physical or mental harm to
22consumers of a facility.
23    "Facility" means a specialized mental health
24rehabilitation facility that provides at least one of the
25following services: (1) triage center; (2) crisis
26stabilization; (3) recovery and rehabilitation supports; or



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1(4) transitional living units for 3 or more persons. The
2facility shall provide a 24-hour program that provides
3intensive support and recovery services designed to assist
4persons, 18 years or older, with mental disorders to develop
5the skills to become self-sufficient and capable of increasing
6levels of independent functioning. It includes facilities that
7meet the following criteria:
8        (1) 100% of the consumer population of the facility has
9    a diagnosis of serious mental illness;
10        (2) no more than 15% of the consumer population of the
11    facility is 65 years of age or older;
12        (3) none of the consumers are non-ambulatory;
13        (4) none of the consumers have a primary diagnosis of
14    moderate, severe, or profound intellectual disability; and
15        (5) the facility must have been licensed under the
16    Specialized Mental Health Rehabilitation Act or the
17    Nursing Home Care Act immediately preceding July 22, 2013
18    (the effective date of this Act) and qualifies as an a
19    institute for mental disease under the federal definition
20    of the term.
21    "Facility" does not include the following:
22        (1) a home, institution, or place operated by the
23    federal government or agency thereof, or by the State of
24    Illinois;
25        (2) a hospital, sanitarium, or other institution whose
26    principal activity or business is the diagnosis, care, and



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1    treatment of human illness through the maintenance and
2    operation as organized facilities therefor which is
3    required to be licensed under the Hospital Licensing Act;
4        (3) a facility for child care as defined in the Child
5    Care Act of 1969;
6        (4) a community living facility as defined in the
7    Community Living Facilities Licensing Act;
8        (5) a nursing home or sanatorium operated solely by and
9    for persons who rely exclusively upon treatment by
10    spiritual means through prayer, in accordance with the
11    creed or tenets of any well-recognized church or religious
12    denomination; however, such nursing home or sanatorium
13    shall comply with all local laws and rules relating to
14    sanitation and safety;
15        (6) a facility licensed by the Department of Human
16    Services as a community-integrated living arrangement as
17    defined in the Community-Integrated Living Arrangements
18    Licensure and Certification Act;
19        (7) a supportive residence licensed under the
20    Supportive Residences Licensing Act;
21        (8) a supportive living facility in good standing with
22    the program established under Section 5-5.01a of the
23    Illinois Public Aid Code, except only for purposes of the
24    employment of persons in accordance with Section 3-206.01
25    of the Nursing Home Care Act;
26        (9) an assisted living or shared housing establishment



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1    licensed under the Assisted Living and Shared Housing Act,
2    except only for purposes of the employment of persons in
3    accordance with Section 3-206.01 of the Nursing Home Care
4    Act;
5        (10) an Alzheimer's disease management center
6    alternative health care model licensed under the
7    Alternative Health Care Delivery Act;
8        (11) a home, institution, or other place operated by or
9    under the authority of the Illinois Department of Veterans'
10    Affairs;
11        (12) a facility licensed under the ID/DD Community Care
12    Act;
13        (13) a facility licensed under the Nursing Home Care
14    Act after July 22, 2013 (the effective date of this Act);
15    or
16        (14) a facility licensed under the MC/DD Act.
17    "Executive director" means a person who is charged with the
18general administration and supervision of a facility licensed
19under this Act and who is a Licensed Nursing Home
20Administrator, Licensed Practitioner of the Healing Arts, or
21Qualified Mental Health Professional.
22    "Guardian" means a person appointed as a guardian of the
23person or guardian of the estate, or both, of a consumer under
24the Probate Act of 1975.
25    "Identified offender" means a person who meets any of the
26following criteria:



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1        (1) Has been convicted of, found guilty of, adjudicated
2    delinquent for, found not guilty by reason of insanity for,
3    or found unfit to stand trial for, any felony offense
4    listed in Section 25 of the Health Care Worker Background
5    Check Act, except for the following:
6            (i) a felony offense described in Section 10-5 of
7        the Nurse Practice Act;
8            (ii) a felony offense described in Section 4, 5, 6,
9        8, or 17.02 of the Illinois Credit Card and Debit Card
10        Act;
11            (iii) a felony offense described in Section 5, 5.1,
12        5.2, 7, or 9 of the Cannabis Control Act;
13            (iv) a felony offense described in Section 401,
14        401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois
15        Controlled Substances Act; and
16            (v) a felony offense described in the
17        Methamphetamine Control and Community Protection Act.
18        (2) Has been convicted of, adjudicated delinquent for,
19    found not guilty by reason of insanity for, or found unfit
20    to stand trial for, any sex offense as defined in
21    subsection (c) of Section 10 of the Sex Offender Management
22    Board Act.
23    "Transitional living units" are residential units within a
24facility that have the purpose of assisting the consumer in
25developing and reinforcing the necessary skills to live
26independently outside of the facility. The duration of stay in



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1such a setting shall not exceed 120 days for each consumer.
2Nothing in this definition shall be construed to be a
3prerequisite for transitioning out of a facility.
4    "Licensee" means the person, persons, firm, partnership,
5association, organization, company, corporation, or business
6trust to which a license has been issued.
7    "Misappropriation of a consumer's property" means the
8deliberate misplacement, exploitation, or wrongful temporary
9or permanent use of a consumer's belongings or money without
10the consent of a consumer or his or her guardian.
11    "Neglect" means a facility's failure to provide, or willful
12withholding of, adequate medical care, mental health
13treatment, psychiatric rehabilitation, personal care, or
14assistance that is necessary to avoid physical harm and mental
15anguish of a consumer.
16    "Personal care" means assistance with meals, dressing,
17movement, bathing, or other personal needs, maintenance, or
18general supervision and oversight of the physical and mental
19well-being of an individual who is incapable of maintaining a
20private, independent residence or who is incapable of managing
21his or her person, whether or not a guardian has been appointed
22for such individual. "Personal care" shall not be construed to
23confine or otherwise constrain a facility's pursuit to develop
24the skills and abilities of a consumer to become
25self-sufficient and capable of increasing levels of
26independent functioning.



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1    "Recovery and rehabilitation supports" means a program
2that facilitates a consumer's longer-term symptom management
3and stabilization while preparing the consumer for
4transitional living units by improving living skills and
5community socialization. The duration of stay in such a setting
6shall be established by the Department by rule.
7    "Restraint" means:
8        (i) a physical restraint that is any manual method or
9    physical or mechanical device, material, or equipment
10    attached or adjacent to a consumer's body that the consumer
11    cannot remove easily and restricts freedom of movement or
12    normal access to one's body; devices used for positioning,
13    including, but not limited to, bed rails, gait belts, and
14    cushions, shall not be considered to be restraints for
15    purposes of this Section; or
16        (ii) a chemical restraint that is any drug used for
17    discipline or convenience and not required to treat medical
18    symptoms; the Department shall, by rule, designate certain
19    devices as restraints, including at least all those devices
20    that have been determined to be restraints by the United
21    States Department of Health and Human Services in
22    interpretive guidelines issued for the purposes of
23    administering Titles XVIII and XIX of the federal Social
24    Security Act. For the purposes of this Act, restraint shall
25    be administered only after utilizing a coercive free
26    environment and culture.



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1    "Self-administration of medication" means consumers shall
2be responsible for the control, management, and use of their
3own medication.
4    "Crisis stabilization" means a secure and separate unit
5that provides short-term behavioral, emotional, or psychiatric
6crisis stabilization as an alternative to hospitalization or
7re-hospitalization for consumers from residential or community
8placement. The duration of stay in such a setting shall not
9exceed 21 days for each consumer.
10    "Therapeutic separation" means the removal of a consumer
11from the milieu to a room or area which is designed to aid in
12the emotional or psychiatric stabilization of that consumer.
13    "Triage center" means a non-residential 23-hour center
14that serves as an alternative to emergency room care,
15hospitalization, or re-hospitalization for consumers in need
16of short-term crisis stabilization. Consumers may access a
17triage center from a number of referral sources, including
18family, emergency rooms, hospitals, community behavioral
19health providers, federally qualified health providers, or
20schools, including colleges or universities. A triage center
21may be located in a building separate from the licensed
22location of a facility, but shall not be more than 1,000 feet
23from the licensed location of the facility and must meet all of
24the facility standards applicable to the licensed location. If
25the triage center does operate in a separate building, safety
26personnel shall be provided, on site, 24 hours per day and the



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1triage center shall meet all other staffing requirements
2without counting any staff employed in the main facility
4(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14;
599-180, eff. 7-29-15; revised 9-8-16.)
6    (210 ILCS 49/3-213 new)
7    Sec. 3-213. Common reporting of critical incidents. For
8comparative purposes, facilities licensed under this Act shall
9report to the Department the following incidents on a quarterly
10basis to be consistent with Level I reportable incidents
11collected by the Department of Human Services, Division of
12Mental Health:
13        (1) sexual assault;
14        (2) abuse, neglect, or other maltreatment;
15        (3) all deaths, including deaths of consumers who have
16    been transferred to a hospital;
17        (4) assaults;
18        (5) missing persons after 24 hours;
19        (6) criminal conduct, including arrests and other
20    interactions with police officers; and
21        (7) fires.
22    (210 ILCS 49/4-105)
23    Sec. 4-105. Provisional licensure duration. A provisional
24license shall be valid upon fulfilling the requirements



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1established by the Department by emergency rule. The license
2shall remain valid as long as a facility remains in compliance
3with the licensure provisions established in rule. Provisional
4licenses issued upon initial licensure as a specialized mental
5health rehabilitation facility shall expire at the end of a
63-year period, which commences on the date the provisional
7license is issued. Issuance of a provisional license for any
8reason other than initial licensure (including, but not limited
9to, change of ownership, location, number of beds, or services)
10shall not extend the maximum 3-year period, at the end of which
11a facility must be licensed pursuant to Section 4-201.
12    Notwithstanding any other provision of this Act to the
13contrary, provisional licenses shall be awarded to every entity
14with a pending application for licensure on the effective date
15of this amendatory Act of the 100th General Assembly. The
16provisional licenses shall be awarded and in effect immediately
17upon the effective date of this amendatory Act of the 100th
18General Assembly.
19(Source: P.A. 98-104, eff. 7-22-13; 99-712, eff. 8-5-16.)
20    (210 ILCS 49/4-108.5)
21    Sec. 4-108.5. Provisional licensure period; surveys.
22During the provisional licensure period, the Department shall
23conduct surveys to determine compliance with timetables and
24benchmarks with a facility's provisional licensure application
25plan of operation. Timetables and benchmarks shall be



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1established in rule and shall include, but not be limited to,
2the following: (1) training of new and existing staff; (2)
3establishment of a data collection and reporting program for
4the facility's Quality Assessment and Performance Improvement
5Program; and (3) compliance with building environment
6standards beyond compliance with Chapter 33 of the National
7Fire Protection Association (NFPA) 101 Life Safety Code. For
8the purpose of compliance with Life Safety Code requirements,
9the Department shall accept Fire Safety Evaluation System
10(FSES) evaluations and any existing or previously approved
11waivers that have been granted to facilities previously under
12the Nursing Home Care Act and have not been revoked.
13    During the provisional licensure period, the Department
14shall conduct State licensure surveys as well as a conformance
15standard review to determine compliance with timetables and
16benchmarks associated with the accreditation process.
17Timetables and benchmarks shall be met in accordance with the
18preferred accrediting organization conformance standards and
19recommendations and shall include, but not be limited to,
20conducting a comprehensive facility self-evaluation in
21accordance with an established national accreditation program.
22The facility shall submit all data reporting and outcomes
23required by accrediting organization to the Department of
24Public Health for review to determine progress towards
25accreditation. Accreditation status shall supplement but not
26replace the State's licensure surveys of facilities licensed



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1under this Act and their certified programs and services to
2determine the extent to which these facilities provide high
3quality interventions, especially evidence-based practices,
4appropriate to the assessed clinical needs of individuals in
5the 4 certified levels of care.
6    Except for incidents involving the potential for harm,
7serious harm, death, or substantial facility failure to address
8a serious systemic issue within 60 days, findings of the
9facility's root cause analysis of problems and the facility's
10Quality Assessment and Performance Improvement program in
11accordance with item (22) of Section 4-104 shall not be used as
12a basis for non-compliance.
13    The Department shall have the authority to hire licensed
14practitioners of the healing arts and qualified mental health
15professionals to consult with and participate in survey and
16inspection activities.
17(Source: P.A. 98-651, eff. 6-16-14.)
18    Section 99. Effective date. This Act takes effect July 1,