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91_HB0182ham005
LRB9100213WHdvam07
1 AMENDMENT TO HOUSE BILL 182
2 AMENDMENT NO. . Amend House Bill 182, AS AMENDED, by
3 replacing the title with the following:
4 "AN ACT to amend certain Acts in relation to mental
5 health."; and
6 by replacing everything after the enacting clause with the
7 following:
8 "Section 5. The Illinois Act on the Aging is amended by
9 changing Section 4.04 as follows:
10 (20 ILCS 105/4.04) (from Ch. 23, par. 6104.04)
11 Sec. 4.04. Long Term Care Ombudsman Program.
12 (a) Long Term Care Ombudsman Program. The Department
13 shall establish a Long Term Care Ombudsman Program, through
14 the Office of State Long Term Care Ombudsman ("the Office"),
15 in accordance with the provisions of the Older Americans Act
16 of 1965, as now or hereafter amended.
17 (b) Definitions. As used in this Section, unless the
18 context requires otherwise:
19 (1) "Access" has the same meaning as in Section
20 1-104 of the Nursing Home Care Act, as now or hereafter
21 amended; that is, it means the right to:
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1 (i) Enter any long term care facility;
2 (ii) Communicate privately and without
3 restriction with any resident who consents to the
4 communication;
5 (iii) Seek consent to communicate privately
6 and without restriction with any resident;
7 (iv) Inspect the clinical and other records of
8 a resident with the express written consent of the
9 resident;
10 (v) Observe all areas of the long term care
11 facility except the living area of any resident who
12 protests the observation.
13 (2) "Long Term Care Facility" means any facility as
14 defined by Section 1-113 of the Nursing Home Care Act, as
15 now or hereafter amended.
16 (3) "Ombudsman" means any person employed by the
17 Department to fulfill the requirements of the Office, or
18 any representative of a sub-State long term care
19 ombudsman program; provided that the representative,
20 whether he is paid for or volunteers his ombudsman
21 services, shall be qualified and authorized by the
22 Department to perform the duties of an ombudsman as
23 specified by the Department in rules.
24 (c) Ombudsman; rules. The Office of State Long Term Care
25 Ombudsman shall be composed of at least one full-time
26 ombudsman within the Department and shall include a system of
27 designated sub-State long term care ombudsman programs. Each
28 sub-State program shall be designated by the Department as a
29 subdivision of the Office and any representative of a
30 sub-State program shall be treated as a representative of the
31 Office.
32 The Department shall promulgate administrative rules to
33 establish the responsibilities of the Department and the
34 Office of State Long Term Care Ombudsman. The administrative
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1 rules shall include the responsibility of the Office to
2 investigate and resolve complaints made by or on behalf of
3 residents of long term care facilities relating to actions,
4 inaction, or decisions of providers, or their
5 representatives, of long term care facilities, of public
6 agencies, or of social services agencies, which may adversely
7 affect the health, safety, welfare, or rights of such
8 residents. When necessary and appropriate, representatives of
9 the Office shall refer complaints to the appropriate
10 regulatory State agency. The Department shall cooperate with
11 the Department of Human Services in providing information and
12 training to designated sub-State long term care ombudsman
13 programs about the appropriate assessment and treatment
14 (including information about appropriate supportive services,
15 treatment options, and assessment of rehabilitation
16 potential) of persons with mental illness (other than
17 Alzheimer's disease and related disorders).
18 (d) Access and visitation rights.
19 (1) In accordance with subparagraphs (A) and (E) of
20 paragraph (3) of subsection (c) of Section 1819 and
21 subparagraphs (A) and (E) of paragraph (3) of subsection
22 (c) of Section 1919 of the Social Security Act, as now or
23 hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E)
24 and 42 U.S.C. 1396r-3 (c)(3)(A) and (E)), and Section
25 307(a)(12) of the Older Americans Act of 1965, as now or
26 hereafter amended, a long term care facility must:
27 (i) permit immediate access to any resident by
28 an ombudsman; and
29 (ii) permit representatives of the Office,
30 with the permission of the resident's legal
31 representative or legal guardian, to examine a
32 resident's clinical and other records, and if a
33 resident is unable to consent to such review, and
34 has no legal guardian, permit representatives of the
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1 Office appropriate access, as defined by the
2 Department in administrative rules, to the
3 resident's records.
4 (2) Each long term care facility shall display, in
5 multiple, conspicuous public places within the facility
6 accessible to both visitors and patients and in an easily
7 readable format, the address and phone number of the
8 Office, in a manner prescribed by the Office.
9 (e) Immunity. An ombudsman or any other representative
10 of the Office participating in the good faith performance of
11 his or her official duties shall have immunity from any
12 liability (civil, criminal or otherwise) in any proceedings
13 (civil, criminal or otherwise) brought as a consequence of
14 the performance of his official duties.
15 (f) Business offenses.
16 (1) No person shall:
17 (i) Intentionally prevent, interfere with, or
18 attempt to impede in any way any representative of
19 the Office in the performance of his official duties
20 under this Act and the Older Americans Act of 1965;
21 or
22 (ii) Intentionally retaliate, discriminate
23 against, or effect reprisals against any long term
24 care facility resident or employee for contacting or
25 providing information to any representative of the
26 Office.
27 (2) A violation of this Section is a business
28 offense, punishable by a fine not to exceed $501.
29 (3) The Director of Aging shall notify the State's
30 Attorney of the county in which the long term care
31 facility is located, or the Attorney General, of any
32 violations of this Section.
33 (g) Confidentiality of records and identities. No files
34 or records maintained by the Office of State Long Term Care
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1 Ombudsman shall be disclosed unless the State Ombudsman or
2 the ombudsman having the authority over the disposition of
3 such files authorizes the disclosure in writing. The
4 ombudsman shall not disclose the identity of any complainant,
5 resident, witness or employee of a long term care provider
6 involved in a complaint or report unless such person or such
7 person's guardian or legal representative consents in writing
8 to the disclosure, or the disclosure is required by court
9 order.
10 (h) Legal representation. The Attorney General shall
11 provide legal representation to any representative of the
12 Office against whom suit or other legal action is brought in
13 connection with the performance of the representative's
14 official duties, in accordance with "An Act to provide for
15 representation and indemnification in certain civil law
16 suits", approved December 3, 1977, as now or hereafter
17 amended.
18 (i) Treatment by prayer and spiritual means. Nothing in
19 this Act shall be construed to authorize or require the
20 medical supervision, regulation or control of remedial care
21 or treatment of any resident in a long term care facility
22 operated exclusively by and for members or adherents of any
23 church or religious denomination the tenets and practices of
24 which include reliance solely upon spiritual means through
25 prayer for healing.
26 (Source: P.A. 90-639, eff. 1-1-99.)
27 Section 10. The Mental Health and Developmental
28 Disabilities Administrative Act is amended by changing
29 Sections 4, 4.3, 7, and 15 as follows:
30 (20 ILCS 1705/4) (from Ch. 91 1/2, par. 100-4)
31 Sec. 4. Supervision of facilities and services;
32 quarterly reports.
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1 (a) To exercise executive and administrative supervision
2 over all facilities, divisions, programs and services now
3 existing or hereafter acquired or created under the
4 jurisdiction of the Department, including, but not limited
5 to, the following:
6 The Alton Mental Health Center, at Alton
7 The Clyde L. Choate Mental Health and Developmental
8 Center, at Anna
9 The Chester Mental Health Center, at Chester
10 The Chicago-Read Mental Health Center, at Chicago
11 The Elgin Mental Health Center, at Elgin
12 The Metropolitan Children and Adolescents Center, at
13 Chicago
14 The Jacksonville Developmental Center, at
15 Jacksonville
16 The Governor Samuel H. Shapiro Developmental Center,
17 at Kankakee
18 The Tinley Park Mental Health Center, at Tinley Park
19 The Warren G. Murray Developmental Center, at
20 Centralia
21 The Jack Mabley Developmental Center, at Dixon
22 The Lincoln Developmental Center, at Lincoln
23 The H. Douglas Singer Mental Health and
24 Developmental Center, at Rockford
25 The John J. Madden Mental Health Center, at Chicago
26 The George A. Zeller Mental Health Center, at Peoria
27 The Andrew McFarland Mental Health Center, at
28 Springfield
29 The Adolf Meyer Mental Health Center, at Decatur
30 The William W. Fox Developmental Center, at Dwight
31 The Elisabeth Ludeman Developmental Center, at Park
32 Forest
33 The William A. Howe Developmental Center, at Tinley
34 Park
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1 The Ann M. Kiley Developmental Center, at Waukegan.
2 (b) Beginning not later than July 1, 1977, the
3 Department shall cause each of the facilities under its
4 jurisdiction which provide in-patient care to comply with
5 standards, rules and regulations of the Department of Public
6 Health prescribed under Section 6.05 of the "Hospital
7 Licensing Act", approved July 1, 1953, as amended.
8 (c) The Department shall issue quarterly reports on
9 admissions, deflections, discharges, bed closures,
10 staff-resident ratios, census, average length of stay, and
11 any adverse federal certification or accreditation findings,
12 if any, for each State-operated facility for the mentally ill
13 and developmentally disabled.
14 (Source: P.A. 87-447; 89-439, eff. 6-1-96; revised 10-31-98.)
15 (20 ILCS 1705/4.3) (from Ch. 91 1/2, par. 100-4.3)
16 Sec. 4.3. Site visits and inspections.
17 (a) Each facility under the jurisdiction of the
18 Department shall be subject to a site visit at least once
19 during each 12-month period biennium by the Citizens Council
20 on Mental Health and Developmental Disabilities as provided
21 in Section 11A-7 of the Legislative Commission Reorganization
22 Act of 1984, as now or hereafter amended.
23 (b) The Department shall establish a system of annual
24 on-site inspections of each facility under its jurisdiction.
25 The inspections shall be conducted by the Department
26 Department's central office to:
27 (1) Determine facility compliance with the statutes
28 relating to patient care and the Department policies and
29 procedures;
30 (2) Determine facility compliance with audit
31 recommendations;
32 (3) Evaluate facility compliance with applicable federal
33 standards;
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1 (4) Review and follow up on complaints made by
2 legislators, community mental health organizations agencies
3 and advocates, and on findings of the Human Rights Authority
4 division of the Guardianship and Advocacy Commission; and
5 (5) Review administrative and management problems
6 identified by other sources.
7 (c) Before January 30 of each even-numbered year, the
8 Auditor General shall, with the advice of the Department,
9 certify at least 3 non-profit organizations whose primary
10 purpose is to improve the quality of mental health care in
11 State-operated facilities. The certified organization shall
12 ensure that those persons who have access under this Section
13 comply with all statutory and regulatory provisions governing
14 recipients' rights, confidentiality, privacy, and safety and
15 that any individual who fails to comply shall not be
16 permitted to continue to participate in assessments. The
17 certified organization shall ensure that individuals shall
18 not be permitted to participate in assessments at any
19 facility at which their presence would conflict with a
20 recipient's right to refuse contact with those individuals.
21 Those organizations shall have access to all the
22 State-operated facilities pursuant to the rules governing the
23 functions of the Inspector General as authorized under the
24 Abused and Neglected Long Term Care Facility Residents
25 Reporting Act. The purpose of the access is to insure there
26 will be independent assessments for each State-operated
27 facility, not to exceed 4 per year for each facility.
28 However, additional visits may be carried out upon the
29 notification of a specific complaint. The access shall
30 exclude all patient records unless the recipient has
31 permitted the examination of his or her records under the
32 Mental Health and Developmental Disabilities Confidentiality
33 Act.
34 The Department shall adopt rules for certifying the
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1 organizations and for establishing reasonable standards and
2 procedures for determining whether the organizations seeking
3 certification provide appropriate training and supervision to
4 those persons who will have access under the statute.
5 The reports of the assessments shall be provided to the
6 Department, to the Speaker of the House of Representatives,
7 the President of the Senate, the Minority Leader of the
8 Senate, the Minority Leader of the House of Representatives,
9 and to others that the organizations may determine. Under no
10 circumstances shall certification or access be denied due to
11 a disagreement by the Department with any positions taken by
12 the organizations with regard to public policy, legislation,
13 regulation, or litigation concerning mental health services,
14 the operation of, or the quality of care provided by the
15 Department or any mental health provider. The Department
16 shall adopt rules establishing standards and procedures for
17 internal review of any decision denying or terminating access
18 to any organization, including review by the Director or his
19 or her designee. Any organization denied access under this
20 statute by an administrative decision of the Director or his
21 or her designee may have that decision reviewed under the
22 Administrative Review Act.
23 The assessments shall be conducted by the certified
24 organizations at no charge.
25 (Source: P.A. 86-1013.)
26 (20 ILCS 1705/7) (from Ch. 91 1/2, par. 100-7)
27 Sec. 7. To receive and provide the highest possible
28 quality of humane and rehabilitative care and treatment to
29 all persons admitted or committed or transferred in
30 accordance with law to the facilities, divisions, programs,
31 and services under the jurisdiction of the Department. No
32 resident of another state shall be received or retained to
33 the exclusion of any resident of this State. No resident of
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1 another state shall be received or retained to the exclusion
2 of any resident of this State. All recipients of 17 years of
3 age and under in residence in a Department facility other
4 than a facility for the care of the mentally retarded shall
5 be housed in quarters separated from older recipients except
6 for: (a) recipients who are placed in medical-surgical units
7 because of physical illness; and (b) recipients between 13
8 and 18 years of age who need temporary security measures.
9 All recipients in a Department facility shall be given a
10 dental examination by a licensed dentist or registered dental
11 hygienist at least once every 18 months and shall be assigned
12 to a dentist for such dental care and treatment as is
13 necessary.
14 All medications administered to recipients shall be
15 administered only by those persons who are legally qualified
16 to do so by the laws of the State of Illinois. Medication
17 shall not be prescribed until a physical and mental
18 examination of the recipient has been completed. If, in the
19 clinical judgment of a physician, it is necessary to
20 administer medication to a recipient before the completion of
21 the physical and mental examination, he may prescribe such
22 medication but he must file a report with the facility
23 director setting forth the reasons for prescribing such
24 medication within 24 hours of the prescription. A copy of the
25 report shall be part of the recipient's record.
26 No later than January 1, 2000, the Department shall adopt
27 a model protocol and forms for recording all patient
28 diagnosis, care, and treatment at every facility under the
29 jurisdiction of the Department. The model protocol and forms
30 shall be used by each facility unless the Department
31 determines that equivalent alternatives justify an exemption.
32
33 Every facility under the jurisdiction of the Department
34 shall maintain a copy of each report of suspected abuse or
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1 neglect of the patient. Copies of those reports shall be made
2 available to the State Auditor General in connection with his
3 biennial program audit of the facility as required by Section
4 3-2 of the Illinois State Auditing Act.
5 No later than January 1, 2000, every facility under the
6 jurisdiction of the Department and all services provided in
7 those facilities shall comply with all of the applicable
8 standards adopted by the Social Security Administration under
9 Subchapter XVIII (Medicare) of the Social Security Act (42
10 U.S.C. 1395 - 1395ccc), if the facility and services may be
11 eligible for federal financial participation under that
12 federal law.
13 (Source: P.A. 86-922; 86-1013; 86-1475.)
14 (20 ILCS 1705/15) (from Ch. 91 1/2, par. 100-15)
15 Sec. 15. Before any person is released from a facility
16 operated by the State pursuant to an absolute discharge or a
17 conditional discharge from hospitalization under this Act,
18 the facility director of the facility in which such person is
19 hospitalized shall determine that such person is not
20 currently in need of hospitalization and:
21 (a) is able to live independently in the community;
22 or
23 (b) requires further oversight and supervisory care
24 for which arrangements have been made with responsible
25 relatives or supervised residential program approved by
26 the Department; or
27 (c) requires further personal care or general
28 oversight as defined by the Nursing Home Care Act, for
29 which placement arrangements have been made with a
30 suitable family home or other licensed facility approved
31 by the Department under this Section; or
32 (d) requires community mental health services for
33 which arrangements have been made with a suitable
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1 community mental health provider in accordance with
2 criteria, standards, and procedures promulgated by rule.
3 Such determination shall be made in writing and shall
4 become a part of the facility record of such absolutely or
5 conditionally discharged person. When the determination
6 indicates that the condition of the person to be granted an
7 absolute discharge or a conditional discharge is described
8 under subparagraph (c) or (d) of this Section, the name and
9 address of the continuing care facility or home to which such
10 person is to be released shall be entered in the facility
11 record. Where a discharge from a mental health facility is
12 made under subparagraph (c), the Department shall assign the
13 person so discharged to an existing community based
14 not-for-profit agency for participation in day activities
15 suitable to the person's needs, such as but not limited to
16 social and vocational rehabilitation, and other recreational,
17 educational and financial activities unless the community
18 based not-for-profit agency is unqualified to accept such
19 assignment. Where the clientele of any not-for-profit agency
20 increases as a result of assignments under this amendatory
21 Act of 1977 by more than 3% over the prior year, the
22 Department shall fully reimburse such agency for the costs of
23 providing services to such persons in excess of such 3%
24 increase. The Department shall keep written records detailing
25 how many persons have been assigned to a community based
26 not-for-profit agency and how many persons were not so
27 assigned because the community based agency was unqualified
28 to accept the assignments, in accordance with criteria,
29 standards, and procedures promulgated by rule. Whenever a
30 community based agency is found to be unqualified, the name
31 of the agency and the reason for the finding shall be
32 included in the report.
33 Insofar as desirable in the interests of the former
34 recipient, the facility, program or home in which the
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1 discharged person is to be placed shall be located in or near
2 the community in which the person resided prior to
3 hospitalization or in the community in which the person's
4 family or nearest next of kin presently reside. Placement of
5 the discharged person in facilities, programs or homes
6 located outside of this State shall not be made by the
7 Department unless there are no appropriate facilities,
8 programs or homes available within this State. Out-of-state
9 placements shall be subject to return of recipients so placed
10 upon the availability of facilities, programs or homes within
11 this State to accommodate these recipients, except where
12 placement in a contiguous state results in locating a
13 recipient in a facility or program closer to the recipient's
14 home or family. If an appropriate facility or program
15 becomes available equal to or closer to the recipient's home
16 or family, the recipient shall be returned to and placed at
17 the appropriate facility or program within this State.
18 To place any person who is under a program of the
19 Department at board in a suitable family home or in such
20 other facility or program as the Department may consider
21 desirable. The Department may place in licensed nursing
22 homes, sheltered care homes, or homes for the aged those
23 persons whose behavioral manifestations and medical and
24 nursing care needs are such as to be substantially
25 indistinguishable from persons already living in such
26 facilities. Prior to any placement by the Department under
27 this Section, a determination shall be made by the personnel
28 of the Department, as to the capability and suitability of
29 such facility to adequately meet the needs of the person to
30 be discharged. When specialized programs are necessary in
31 order to enable persons in need of supervised living to
32 develop and improve in the community, the Department shall
33 place such persons only in specialized residential care
34 facilities which shall meet Department standards including
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1 restricted admission policy, special staffing and programming
2 for social and vocational rehabilitation, in addition to the
3 requirements of the appropriate State licensing agency. The
4 Department shall not place any new person in a facility the
5 license of which has been revoked or not renewed on grounds
6 of inadequate programming, staffing, or medical or adjunctive
7 services, regardless of the pendency of an action for
8 administrative review regarding such revocation or failure to
9 renew. Before the Department may transfer any person to a
10 licensed nursing home, sheltered care home or home for the
11 aged or place any person in a specialized residential care
12 facility the Department shall notify the person to be
13 transferred, or a responsible relative of such person, in
14 writing, at least 30 days before the proposed transfer, with
15 respect to all the relevant facts concerning such transfer,
16 except in cases of emergency when such notice is not
17 required. If either the person to be transferred or a
18 responsible relative of such person objects to such transfer,
19 in writing to the Department, at any time after receipt of
20 notice and before the transfer, the facility director of the
21 facility in which the person was a recipient shall
22 immediately schedule a hearing at the facility with the
23 presence of the facility director, the person who objected to
24 such proposed transfer, and a psychiatrist who is familiar
25 with the record of the person to be transferred. Such person
26 to be transferred or a responsible relative may be
27 represented by such counsel or interested party as he may
28 appoint, who may present such testimony with respect to the
29 proposed transfer. Testimony presented at such hearing shall
30 become a part of the facility record of the
31 person-to-be-transferred. The record of testimony shall be
32 held in the person-to-be-transferred's record in the central
33 files of the facility. If such hearing is held a transfer may
34 only be implemented, if at all, in accordance with the
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1 results of such hearing. Within 15 days after such hearing
2 the facility director shall deliver his findings based on the
3 record of the case and the testimony presented at the
4 hearing, by registered or certified mail, to the parties to
5 such hearing. The findings of the facility director shall be
6 deemed a final administrative decision of the Department. For
7 purposes of this Section, "case of emergency" means those
8 instances in which the health of the person to be transferred
9 is imperiled and the most appropriate mental health care or
10 medical care is available at a licensed nursing home,
11 sheltered care home or home for the aged or a specialized
12 residential care facility.
13 Prior to placement of any person in a facility under this
14 Section the Department shall ensure that an appropriate
15 training plan for staff is provided by the facility. Said
16 training may include instruction and demonstration by
17 Department personnel qualified in the area of mental illness
18 or mental retardation, as applicable to the person to be
19 placed. Training may be given both at the facility from
20 which the recipient is transferred and at the facility
21 receiving the recipient, and may be available on a continuing
22 basis subsequent to placement. In a facility providing
23 services to former Department recipients, training shall be
24 available as necessary for facility staff. Such training
25 will be on a continuing basis as the needs of the facility
26 and recipients change and further training is required.
27 The Department shall not place any person in a facility
28 which does not have appropriately trained staff in sufficient
29 numbers to accommodate the recipient population already at
30 the facility. As a condition of further or future placements
31 of persons, the Department shall require the employment of
32 additional trained staff members at the facility where said
33 persons are to be placed. The Secretary, or his or her
34 designate, shall establish written guidelines for placement
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1 of persons in facilities under this Act. The Department shall
2 keep written records detailing which facilities have been
3 determined to have appropriately trained staff, which
4 facilities have been determined not to have such staff, and
5 all training which it has provided or required under this
6 Section.
7 Bills for the support for a person boarded out shall be
8 payable monthly out of the proper maintenance funds and shall
9 be audited as any other accounts of the Department. If a
10 person is placed in a facility or program outside the
11 Department, the Department may pay the actual costs of
12 residence, treatment or maintenance in such facility and may
13 collect such actual costs or a portion thereof from the
14 recipient or the estate of a person placed in accordance with
15 this Section.
16 Other than those placed in a family home the Department
17 shall cause all persons who are placed in a facility, as
18 defined by the Nursing Home Care Act, or in designated
19 community living situations or programs, to be visited at
20 least once during the first month following placement, and
21 once every month thereafter for the first year following
22 placement when indicated, but at least quarterly. After the
23 first year, visits shall be made at least once per year for
24 as long as the placement continues. If a long term care
25 facility has periodic care plan conferences, the visitor may
26 participate in those conferences. Visits shall be made by
27 qualified and trained Department personnel, or their
28 designee, in the area of mental health or developmental
29 disabilities applicable to the person visited, and shall be
30 made on a more frequent basis when indicated. The Department
31 may not use as designee any personnel connected with or
32 responsible to the representatives of any facility in which
33 persons who have been transferred under this Section are
34 placed. In the course of such visit there shall be
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1 consideration of the following areas, but not limited
2 thereto: effects of transfer on physical and mental health
3 of the person, sufficiency of nursing care and medical
4 coverage required by the person, sufficiency of staff
5 personnel and ability to provide basic care for the person,
6 social, recreational and programmatic activities available
7 for the person, and other appropriate aspects of the person's
8 environment.
9 A report containing the above observations shall be made
10 to the Department and to any other appropriate agency
11 subsequent to each visitation. The report shall contain a
12 detailed assessment of whether the recipient is receiving
13 adequate and humane care and services in the least
14 restrictive environment. If the recipient is not receiving
15 those services, the Department shall either require that the
16 facility modify the treatment plan to ensure that those
17 services are provided or make arrangements necessary to
18 provide those services elsewhere. At the conclusion of one
19 year following absolute or conditional discharge, or a longer
20 period of time if required by the Department, the Department
21 may terminate the visitation requirements of this Section as
22 to a person placed in accordance with this Section, by filing
23 a written statement of termination setting forth reasons to
24 substantiate the termination of visitations in the person's
25 file, and sending a copy thereof to the person, and to his
26 guardian or next of kin.
27 Upon the complaint of any person placed in accordance
28 with this Section or any responsible citizen or upon
29 discovery that such person has been abused, neglected, or
30 improperly cared for, or that the placement does not provide
31 the type of care required by the recipient's current
32 condition, the Department immediately shall investigate, and
33 determine if the well-being, health, care, or safety of any
34 person is affected by any of the above occurrences, and if
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1 any one of the above occurrences is verified, the Department
2 shall remove such person at once to a facility of the
3 Department or to another facility outside the Department,
4 provided such person's needs can be met at said facility.
5 The Department may also provide any person placed in
6 accordance with this Section who is without available funds,
7 and who is permitted to engage in employment outside the
8 facility, such sums for the transportation, and other
9 expenses as may be needed by him until he receives his wages
10 for such employment.
11 The Department shall promulgate rules and regulations
12 governing the purchase of care for persons who are wards of
13 or who are receiving services from the Department. Such
14 rules and regulations shall apply to all monies expended by
15 any agency of the State of Illinois for services rendered by
16 any person, corporate entity, agency, governmental agency or
17 political subdivision whether public or private outside of
18 the Department whether payment is made through a contractual,
19 per-diem or other arrangement. No funds shall be paid to any
20 person, corporation, agency, governmental entity or political
21 subdivision without compliance with such rules and
22 regulations.
23 The rules and regulations governing purchase of care
24 shall describe categories and types of service deemed
25 appropriate for purchase by the Department.
26 Any provider of services under this Act may elect to
27 receive payment for those services, and the Department is
28 authorized to arrange for that payment, by means of direct
29 deposit transmittals to the service provider's account
30 maintained at a bank, savings and loan association, or other
31 financial institution. The financial institution shall be
32 approved by the Department, and the deposits shall be in
33 accordance with rules and regulations adopted by the
34 Department.
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1 The Department shall keep written records of the number
2 of persons it places in long term care facilities each year.
3 The records shall include the name and address of each
4 facility and the diagnosis of each individual so placed.
5 (Source: P.A. 89-507, eff. 7-1-97; 90-423, eff. 8-15-97.)
6 Section 12. The Abused and Neglected Long Term Care
7 Facility Residents Reporting Act is amended by changing
8 Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 and adding
9 Section 6.9 as follows:
10 (210 ILCS 30/6.2) (from Ch. 111 1/2, par. 4166.2)
11 (Section scheduled to be repealed on January 1, 2000)
12 Sec. 6.2. Inspector General.
13 (a) The Governor shall appoint, and the Senate shall
14 confirm, an Inspector General. The Inspector General shall
15 be appointed for a term of 4 years and who shall function
16 within the Department of Human Services and report to the
17 Secretary of Human Services and the Governor. The Inspector
18 General shall function independently within the Department of
19 Human Services with respect to the operations of the office,
20 including the performance of investigations and issuance of
21 findings and recommendations. The Inspector General shall
22 independently submit to the Governor any request for
23 appropriations necessary for the ordinary and contingent
24 expenses of the Office of Inspector General, and
25 appropriations for that office shall be separate from the
26 Department of Human Services. The Inspector General shall
27 investigate reports of suspected abuse or neglect (as those
28 terms are defined in Section 3 of this Act) of patients or
29 residents in any mental health or developmental disabilities
30 facility operated by the Department of Human Services and
31 shall have authority to investigate and take immediate action
32 on reports of abuse or neglect of recipients, whether
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1 patients or residents, in any mental health or developmental
2 disabilities facility or program that is licensed or
3 certified by the Department of Human Services (as successor
4 to the Department of Mental Health and Developmental
5 Disabilities) or that is funded by the Department of Human
6 Services (as successor to the Department of Mental Health and
7 Developmental Disabilities) and is not licensed or certified
8 by any agency of the State. At the specific, written request
9 of an agency of the State other than the Department of Human
10 Services (as successor to the Department of Mental Health and
11 Developmental Disabilities), the Inspector General may
12 cooperate in investigating reports of abuse and neglect of
13 persons with mental illness or persons with developmental
14 disabilities. The Inspector General shall have no
15 supervision over or involvement in routine, programmatic,
16 licensure, or certification operations of the Department of
17 Human Services or any of its funded agencies.
18 The Inspector General shall promulgate rules establishing
19 minimum requirements for reporting allegations of abuse and
20 neglect and initiating, conducting, and completing
21 investigations. The promulgated rules shall clearly set
22 forth that in instances where 2 or more State agencies could
23 investigate an allegation of abuse or neglect, the Inspector
24 General shall not conduct an investigation that is redundant
25 to an investigation conducted by another State agency. The
26 rules shall establish criteria for determining, based upon
27 the nature of the allegation, the appropriate method of
28 investigation, which may include, but need not be limited to,
29 site visits, telephone contacts, or requests for written
30 responses from agencies. The rules shall also clarify how
31 the Office of the Inspector General shall interact with the
32 licensing unit of the Department of Human Services in
33 investigations of allegations of abuse or neglect. Any
34 allegations or investigations of reports made pursuant to
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1 this Act shall remain confidential until a final report is
2 completed. The resident or patient who allegedly was abused
3 or neglected and his or her legal guardian shall be informed
4 by the facility or agency of the report of alleged abuse or
5 neglect. Final reports regarding unsubstantiated or unfounded
6 allegations shall remain confidential, except that final
7 reports may be disclosed pursuant to Section 6 of this Act.
8 The Inspector General shall be appointed for a term of 4
9 years.
10 (b) The Inspector General shall within 24 hours after
11 receiving a report of suspected abuse or neglect determine
12 whether the evidence indicates that any possible criminal act
13 has been committed. If he determines that a possible criminal
14 act has been committed, or that special expertise is required
15 in the investigation, he shall immediately notify the
16 Department of State Police. The Department of State Police
17 shall investigate any report indicating a possible murder,
18 rape, or other felony. All investigations conducted by the
19 Inspector General shall be conducted in a manner designed to
20 ensure the preservation of evidence for possible use in a
21 criminal prosecution.
22 (b-5) The Inspector General shall make a determination
23 to accept or reject a preliminary report of the investigation
24 of alleged abuse or neglect based on established
25 investigative procedures. The facility or agency may request
26 clarification or reconsideration based on additional
27 information. For cases where the allegation of abuse or
28 neglect is substantiated, the Inspector General shall require
29 the facility or agency to submit a written response. The
30 written response from a facility or agency shall address in a
31 concise and reasoned manner the actions that the agency or
32 facility will take or has taken to protect the resident or
33 patient from abuse or neglect, prevent reoccurrences, and
34 eliminate problems identified and shall include
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1 implementation and completion dates for all such action.
2 (c) The Inspector General shall, within 10 calendar days
3 after the transmittal date of a completed investigation where
4 abuse or neglect is substantiated or administrative action is
5 recommended, provide a complete report on the case to the
6 Secretary of Human Services and to the agency in which the
7 abuse or neglect is alleged to have happened. The complete
8 report shall include a written response from the agency or
9 facility operated by the State to the Inspector General that
10 addresses in a concise and reasoned manner the actions that
11 the agency or facility will take or has taken to protect the
12 resident or patient from abuse or neglect, prevent
13 reoccurrences, and eliminate problems identified and shall
14 include implementation and completion dates for all such
15 action. The Secretary of Human Services shall accept or
16 reject the response and establish how the Department will
17 determine whether the facility or program followed the
18 approved response. The Secretary may require Department
19 personnel to visit the facility or agency for training,
20 technical assistance, programmatic, licensure, or
21 certification purposes. Administrative action, including
22 sanctions, may be applied should the Secretary reject the
23 response or should the facility or agency fail to follow the
24 approved response. The facility or agency shall inform the
25 resident or patient and the legal guardian whether the
26 reported allegation was substantiated, unsubstantiated, or
27 unfounded. There shall be an appeals process for any person
28 or agency that is subject to any action based on a
29 recommendation or recommendations.
30 (d) The Inspector General may recommend to the
31 Departments of Public Health and Human Services sanctions to
32 be imposed against mental health and developmental
33 disabilities facilities under the jurisdiction of the
34 Department of Human Services for the protection of residents,
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1 including appointment of on-site monitors or receivers,
2 transfer or relocation of residents, and closure of units.
3 The Inspector General may seek the assistance of the Attorney
4 General or any of the several State's attorneys in imposing
5 such sanctions. Whenever the Inspector General issues any
6 recommendations to the Secretary of Human Services, the
7 Secretary shall provide a written response.
8 (e) The Inspector General shall establish and conduct
9 periodic training programs for Department of Human Services
10 employees concerning the prevention and reporting of neglect
11 and abuse.
12 (f) The Inspector General shall at all times be granted
13 access to any mental health or developmental disabilities
14 facility operated by the Department of Human Services, shall
15 establish and conduct unannounced site visits to those
16 facilities at least once annually, and shall be granted
17 access, for the purpose of investigating a report of abuse or
18 neglect, to the records of the Department of Human Services
19 and to any facility or program funded by the Department of
20 Human Services that is subject under the provisions of this
21 Section to investigation by the Inspector General for a
22 report of abuse or neglect.
23 (g) Nothing in this Section shall limit investigations
24 by the Department of Human Services that may otherwise be
25 required by law or that may be necessary in that Department's
26 capacity as the central administrative authority responsible
27 for the operation of State mental health and developmental
28 disability facilities.
29 (h) This Section is repealed on January 1, 2000.
30 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97;
31 90-252, eff. 7-29-97; 90-512, eff. 8-22-97; 90-655, eff.
32 7-30-98.)
33 (210 ILCS 30/6.3) (from Ch. 111 1/2, par. 4166.3)
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1 (Section scheduled to be repealed on January 1, 2000)
2 Sec. 6.3. Quality Care Board. There is created, within
3 the Department of Human Services' Office of the Inspector
4 General, a Quality Care Board to be composed of 7 members
5 appointed by the Governor with the advice and consent of the
6 Senate. One of the members shall be designated as chairman
7 by the Governor. Of the initial appointments made by the
8 Governor, 4 Board members shall each be appointed for a term
9 of 4 years and 3 members shall each be appointed for a term
10 of 2 years. Upon the expiration of each member's term, a
11 successor shall be appointed for a term of 4 years. In the
12 case of a vacancy in the office of any member, the Governor
13 shall appoint a successor for the remainder of the unexpired
14 term.
15 Members appointed by the Governor shall be qualified by
16 professional knowledge or experience in the area of law,
17 investigatory techniques, or in the area of care of the
18 mentally ill or developmentally disabled. Two members
19 appointed by the Governor shall be persons with a disability
20 or a parent of a person with a disability. Members shall
21 serve without compensation, but shall be reimbursed for
22 expenses incurred in connection with the performance of their
23 duties as members.
24 The Board shall meet quarterly, and may hold other
25 meetings on the call of the chairman. Four members shall
26 constitute a quorum. The Board may adopt rules and
27 regulations it deems necessary to govern its own procedures.
28 This Section is repealed on January 1, 2000.
29 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97.)
30 (210 ILCS 30/6.4) (from Ch. 111 1/2, par. 4166.4)
31 (This Section is scheduled to be repealed January 1,
32 2000.)
33 Sec. 6.4. Scope and function of the Quality Care Board.
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1 The Board shall monitor and oversee the operations, policies,
2 and procedures of the Inspector General to assure the prompt
3 and thorough investigation of allegations of neglect and
4 abuse. In fulfilling these responsibilities, the Board may
5 do the following:
6 (1) Provide independent, expert consultation to the
7 Inspector General on policies and protocols for
8 investigations of alleged neglect and abuse.
9 (2) Review existing regulations relating to the
10 operation of facilities under the control of the
11 Department of Human Services.
12 (3) Advise the Inspector General as to the content
13 of training activities authorized under Section 6.2.
14 (4) Recommend policies concerning methods for
15 improving the intergovernmental relationships between the
16 office of the Inspector General and other State or
17 federal agencies.
18 This Section is repealed on January 1, 2000.
19 (Source: P.A. 89-427, eff. 12-7-95.)
20 (210 ILCS 30/6.5) (from Ch. 111 1/2, par. 4166.5)
21 (Section scheduled to be repealed on January 1, 2000)
22 Sec. 6.5. Investigators. Within 60 days after the
23 effective date of this amendatory Act of 1992, The Inspector
24 General shall establish a comprehensive program to ensure
25 that every person employed or newly hired to conduct
26 investigations shall receive training on an on-going basis
27 concerning investigative techniques, communication skills,
28 and the appropriate means of contact with persons admitted or
29 committed to the mental health or developmental disabilities
30 facilities under the jurisdiction of the Department of Human
31 Services.
32 This Section is repealed on January 1, 2000.
33 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97.)
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1 (210 ILCS 30/6.6) (from Ch. 111 1/2, par. 4166.6)
2 (This Section is scheduled to be repealed January 1,
3 2000.)
4 Sec. 6.6. Subpoenas; testimony; penalty. The Inspector
5 General shall have the power to subpoena witnesses and compel
6 the production of books and papers pertinent to an
7 investigation authorized by this Act, provided that the power
8 to subpoena or to compel the production of books and papers
9 shall not extend to the person or documents of a labor
10 organization or its representatives insofar as the person or
11 documents of a labor organization relate to the function of
12 representing an employee subject to investigation under this
13 Act. Mental health records of patients shall be confidential
14 as provided under the Mental Health and Developmental
15 Disabilities Confidentiality Act. Any person who fails to
16 appear in response to a subpoena or to answer any question or
17 produce any books or papers pertinent to an investigation
18 under this Act, except as otherwise provided in this Section,
19 or who knowingly gives false testimony in relation to an
20 investigation under this Act is guilty of a Class A
21 misdemeanor.
22 This Section is repealed on January 1, 2000.
23 (Source: P.A. 89-427, eff. 12-7-95.)
24 (210 ILCS 30/6.7) (from Ch. 111 1/2, par. 4166.7)
25 (This Section is scheduled to be repealed January 1,
26 2000.)
27 Sec. 6.7. Annual report. The Inspector General shall
28 provide to the General Assembly and the Governor, no later
29 than January 1 of each year, a summary of reports and
30 investigations made under this Act for the prior fiscal year
31 with respect to residents of institutions under the
32 jurisdiction of the Department of Human Services. The report
33 shall detail the imposition of sanctions and the final
-27- LRB9100213WHdvam07
1 disposition of those recommendations. The summaries shall
2 not contain any confidential or identifying information
3 concerning the subjects of the reports and investigations.
4 The report shall also include a trend analysis of the number
5 of reported allegations and their disposition, for each
6 facility and Department-wide, for the most recent 3-year time
7 period and a statement, for each facility, of the
8 staffing-to-patient ratios. The ratios shall include only
9 the number of direct care staff. The report shall also
10 include detailed recommended administrative actions and
11 matters for consideration by the General Assembly.
12 This Section is repealed on July 1, 2000.
13 (Source: P.A. 89-427, eff. 12-7-95.)
14 (210 ILCS 30/6.8) (from Ch. 111 1/2, par. 4166.8)
15 (Section scheduled to be repealed on January 1, 2000)
16 Sec. 6.8. Program audit. The Auditor General shall
17 conduct a biennial program audit of the office of the
18 Inspector General in relation to the Inspector General's
19 compliance with this Act. The audit shall specifically
20 include the Inspector General's effectiveness in
21 investigating reports of alleged neglect or abuse of
22 residents in any facility operated by the Department of Human
23 Services and in making recommendations for sanctions to the
24 Departments of Human Services and Public Health. The Auditor
25 General shall conduct the program audit according to the
26 provisions of the Illinois State Auditing Act and shall
27 report its findings to the General Assembly no later than
28 January 1 of each odd-numbered year.
29 This Section is repealed on January 1, 2000.
30 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97.)
31 (210 ILCS 30/6.9 new)
32 Sec. 6.9. System evaluations; mental health facilities.
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1 The agency designated by the Governor under Section 1 of the
2 Protection and Advocacy for Developmentally Disabled Persons
3 Act is authorized to periodically evaluate abuse, neglect,
4 deaths, and other safety-related issues in mental health
5 facilities, as defined in the Mental Health and Developmental
6 Disabilities Code, and the effectiveness of the State's
7 systems that address these issues. To enable the agency
8 designated by the Governor to fulfill its obligations
9 pursuant to this Section, the agency shall have authority to
10 the same extent as that provided to the Inspector General of
11 the Department of Human Services. Nothing in this Section
12 limits the agency's authority as the State's designated
13 protection and advocacy system. All identifiable information
14 in records provided pursuant to this Section shall not be
15 further disclosed except as provided by the Mental Health and
16 Developmental Disabilities Confidentiality Act. The scope of
17 these studies shall be based on the available appropriation.
18 Nothing in this Section prevents the agency designated by the
19 Governor from securing other public or private funds to carry
20 out studies pursuant to this Section. The agency shall
21 provide a report to the General Assembly and the Governor
22 regarding any system evaluations authorized by this Section.
23 Section 15. The Nursing Home Care Act is amended by
24 changing Sections 1-113, 2-104, 2-106, 2-106.1, 3-203, and
25 3-212 as follows:
26 (210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113)
27 Sec. 1-113. "Facility" or "long-term care facility"
28 means a private home, institution, building, residence, or
29 any other place, whether operated for profit or not, or a
30 county home for the infirm and chronically ill operated
31 pursuant to Division 5-21 or 5-22 of the Counties Code, or
32 any similar institution operated by a political subdivision
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1 of the State of Illinois, which provides, through its
2 ownership or management, personal care, sheltered care or
3 nursing for 3 or more persons, not related to the applicant
4 or owner by blood or marriage. It includes skilled nursing
5 facilities and intermediate care facilities as those terms
6 are defined in Title XVIII and Title XIX of the Federal
7 Social Security Act. It shall also include classifications of
8 such facilities, including but not limited to "Residential
9 Rehabilitation Facilities" which are primarily engaged in
10 providing diagnosis, treatment, or care of persons with
11 mental illness, which includes medical attention, nursing
12 care and related services. It also includes homes,
13 institutions, or other places operated by or under the
14 authority of the Illinois Department of Veterans' Affairs.
15 "Facility" does not include the following:
16 (1) A home, institution, or other place operated by the
17 federal government or agency thereof, or by the State of
18 Illinois, other than homes, institutions, or other places
19 operated by or under the authority of the Illinois Department
20 of Veterans' Affairs;
21 (2) A hospital, sanitarium, or other institution whose
22 principal activity or business is the diagnosis, care, and
23 treatment of human illness through the maintenance and
24 operation as organized facilities therefor, which is required
25 to be licensed under the Hospital Licensing Act;
26 (3) Any "facility for child care" as defined in the
27 Child Care Act of 1969;
28 (4) Any "Community Living Facility" as defined in the
29 Community Living Facilities Licensing Act;
30 (5) Any "community residential alternative" as defined
31 in the Community Residential Alternatives Licensing Act;
32 (6) Any nursing home or sanatorium operated solely by
33 and for persons who rely exclusively upon treatment by
34 spiritual means through prayer, in accordance with the creed
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1 or tenets of any well-recognized church or religious
2 denomination. However, such nursing home or sanatorium shall
3 comply with all local laws and rules relating to sanitation
4 and safety;
5 (7) Any facility licensed by the Department of Human
6 Services as a community-integrated living arrangement as
7 defined in the Community-Integrated Living Arrangements
8 Licensure and Certification Act;
9 (8) Any "Supportive Residence" licensed under the
10 Supportive Residences Licensing Act; or
11 (9) Any "supportive living facility" in good standing
12 with the demonstration project established under Section
13 5-5.01a of the Illinois Public Aid Code.
14 (Source: P.A. 89-499, eff. 6-28-96; 89-507, eff. 7-1-97;
15 90-14, eff. 7-1-97; 90-763, eff. 8-14-98.)
16 (210 ILCS 45/2-104) (from Ch. 111 1/2, par. 4152-104)
17 Sec. 2-104. (a) A resident shall be permitted to retain
18 the services of his own personal physician at his own expense
19 or under an individual or group plan of health insurance, or
20 under any public or private assistance program providing such
21 coverage. However, the facility is not liable for the
22 negligence of any such personal physician. Every resident
23 shall be permitted to obtain from his own physician or the
24 physician attached to the facility complete and current
25 information concerning his medical diagnosis, treatment and
26 prognosis in terms and language the resident can reasonably
27 be expected to understand. Every resident shall be permitted
28 to participate in the planning of his total care and medical
29 treatment to the extent that his condition permits. No
30 resident shall be subjected to experimental research or
31 treatment without first obtaining his informed, written
32 consent. The conduct of any experimental research or
33 treatment shall be authorized and monitored by an
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1 institutional review committee appointed by the administrator
2 of the facility where such research and treatment is
3 conducted. The membership, operating procedures and review
4 criteria for institutional review committees shall be
5 prescribed under rules and regulations of the Department.
6 (b) All medical treatment and procedures shall be
7 administered as ordered by a physician. All new physician
8 orders shall be reviewed by the facility's director of
9 nursing or charge nurse designee within 24 hours after such
10 orders have been issued to assure facility compliance with
11 such orders.
12 According to rules adopted by the Department, every woman
13 resident of child-bearing age shall receive routine
14 obstetrical and gynecological evaluations as well as
15 necessary prenatal care.
16 Every resident with a diagnosis of mental illness (other
17 than Alzheimer's disease or a related disorder) shall receive
18 necessary mental health services in accordance with rules
19 promulgated by the Department under Section 3-203 of this
20 Act, including but not limited to medical management,
21 individual and group therapy, psychosocial rehabilitation,
22 vocational services, and partial hospitalization.
23 (c) Every resident shall be permitted to refuse medical
24 treatment and to know the consequences of such action, unless
25 such refusal would be harmful to the health and safety of
26 others and such harm is documented by a physician in the
27 resident's clinical record. The resident's refusal shall
28 free the facility from the obligation to provide the
29 treatment.
30 (d) Every resident, resident's guardian, or parent if
31 the resident is a minor shall be permitted to inspect and
32 copy all his clinical and other records concerning his care
33 and maintenance kept by the facility or by his physician. The
34 facility may charge a reasonable fee for duplication of a
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1 record.
2 (Source: P.A. 86-1013.)
3 (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106)
4 Sec. 2-106. (a) For purposes of this Act, (i) a physical
5 restraint is any manual method or physical or mechanical
6 device, material, or equipment attached or adjacent to a
7 resident's body that the resident cannot remove easily and
8 restricts freedom of movement or normal access to one's body;
9 (ii) a chemical restraint is any drug used for discipline or
10 convenience and not required to treat medical symptoms. The
11 Department shall by rule, designate certain devices as
12 restraints, including at least all those devices which have
13 been determined to be restraints by the United States
14 Department of Health and Human Services in interpretive
15 guidelines issued for the purposes of administering Titles 18
16 and 19 of the Social Security Acts.
17 (b) Neither restraints nor confinements shall be
18 employed for the purpose of punishment or for the convenience
19 of any facility personnel. No restraints or confinements
20 shall be employed except as ordered by a physician who
21 documents the need for such restraints or confinements in the
22 resident's clinical record. Whenever a resident of an
23 institution for mental diseases is restrained, a member of
24 the facility staff shall remain with the resident at all
25 times unless the recipient has been confined. A resident who
26 is restrained and confined shall be observed by a qualified
27 person as often as is clinically appropriate but in no event
28 less often than once every 15 minutes.
29 (c) A restraint may be used only with the informed
30 consent of the resident, the resident's guardian, or other
31 authorized representative. A restraint may be used only for
32 specific periods, if it is the least restrictive means
33 necessary to attain and maintain the resident's highest
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1 practicable physical, mental or psychosocial well-being,
2 including brief periods of time to provide necessary
3 life-saving treatment. A restraint may be used only after
4 consultation with appropriate health professionals, such as
5 occupational or physical therapists, and a trial of less
6 restrictive measures has led to the determination that the
7 use of less restrictive measures would not attain or maintain
8 the resident's highest practicable physical, mental or
9 psychosocial well-being. However, if the resident needs
10 emergency care, restraints may be used for brief periods to
11 permit medical treatment to proceed unless the facility has
12 notice that the resident has previously made a valid refusal
13 of the treatment in question.
14 (d) A restraint may be applied only by a person trained
15 in the application of the particular type of restraint.
16 (e) Whenever a period of use of a restraint is
17 initiated, the resident shall be advised of his or her right
18 to have a person or organization of his or her choosing,
19 including the Guardianship and Advocacy Commission, notified
20 of the use of the restraint. A recipient who is under
21 guardianship may request that a person or organization of his
22 or her choosing be notified of the restraint, whether or not
23 the guardian approves the notice. If the resident so
24 chooses, the facility shall make the notification within 24
25 hours, including any information about the period of time
26 that the restraint is to be used. Whenever the Guardianship
27 and Advocacy Commission is notified that a resident has been
28 restrained, it shall contact the resident to determine the
29 circumstances of the restraint and whether further action is
30 warranted.
31 (f) Whenever a restraint is used on a resident whose
32 primary mode of communication is sign language, the resident
33 shall be permitted to have his or her hands free from
34 restraint for brief periods each hour, except when this
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1 freedom may result in physical harm to the resident or
2 others.
3 (g) The requirements of this Section are intended to
4 control in any conflict with the requirements of Sections
5 1-126 and 2-108 of the Mental Health and Developmental
6 Disabilities Code.
7 (Source: P.A. 88-413.)
8 (210 ILCS 45/2-106.1)
9 Sec. 2-106.1. Drug treatment.
10 (a) A resident shall not be given unnecessary drugs. An
11 unnecessary drug is any drug used in an excessive dose,
12 including in duplicative therapy; for excessive duration;
13 without adequate monitoring; without adequate indications for
14 its use; or in the presence of adverse consequences that
15 indicate the drugs should be reduced or discontinued. The
16 Department shall adopt, by rule, the standards for
17 unnecessary drugs contained in interpretive guidelines issued
18 by the United States Department of Health and Human Services
19 for the purposes of administering titles 18 and 19 of the
20 Social Security Act.
21 (b) Psychotropic medication shall not be prescribed
22 without the informed consent of the resident, the resident's
23 guardian, or other authorized representative. "Psychotropic
24 medication" means medication that is used for or listed as
25 used for antipsychotic, antidepressant, antimanic, or
26 antianxiety behavior modification or behavior management
27 purposes in the latest editions of the AMA Drug Evaluations
28 or the Physician's Desk Reference.
29 (c) The requirements of this Section are intended to
30 control in a conflict with the requirements of Sections 2-102
31 1-102 and 2-107.2 of the Mental Health and Developmental
32 Disabilities Code with respect to the administration of
33 psychotropic medication.
-35- LRB9100213WHdvam07
1 (Source: P.A. 88-413.)
2 (210 ILCS 45/3-203) (from Ch. 111 1/2, par. 4153-203)
3 Sec. 3-203. In licensing any facility for persons with a
4 developmental disability or persons suffering from mental
5 illness (other than Alzheimer's disease or related disorders)
6 emotional or behavioral disorders, the Department shall
7 consult with the Department of Human Services in developing
8 minimum standards for such persons. The Department shall
9 establish standards for the diagnosis, treatment and care of
10 all persons with mental illness in facilities licensed under
11 this Act, including, but not limited to, the establishment
12 and operation of facilities classified under this Act as
13 "Residential Rehabilitation Facilities". Standards for
14 "Residential Rehabilitation Facilities" shall be promulgated
15 and effective by October 1, 1999 or on the effective date of
16 this amendatory Act of the 91st General Assembly, whichever
17 is later.
18 (Source: P.A. 88-380; 89-507, eff. 7-1-97.)
19 (210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
20 Sec. 3-212. Inspection.
21 (a) The Department, whenever it deems necessary in
22 accordance with subsection (b), shall inspect, survey and
23 evaluate every facility to determine compliance with
24 applicable licensure requirements and standards. An
25 inspection should occur within 120 days prior to license
26 renewal. The Department may periodically visit a facility
27 for the purpose of consultation. An inspection, survey, or
28 evaluation, other than an inspection of financial records,
29 shall be conducted without prior notice to the facility. A
30 visit for the sole purpose of consultation may be announced.
31 The Department shall provide training to surveyors about the
32 appropriate assessment, care planning, and care of persons
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1 with mental illness (other than Alzheimer's disease or
2 related disorders) to enable its surveyors to determine
3 whether a facility is complying with State and federal
4 requirements about the assessment, care planning, and care of
5 those persons.
6 (a-1) An employee of a State or unit of local government
7 agency charged with inspecting, surveying, and evaluating
8 facilities who directly or indirectly gives prior notice of
9 an inspection, survey, or evaluation, other than an
10 inspection of financial records, to a facility or to an
11 employee of a facility is guilty of a Class A misdemeanor.
12 (a-2) An employee of a State or unit of local government
13 agency charged with inspecting, surveying, or evaluating
14 facilities who willfully profits from violating the
15 confidentiality of the inspection, survey, or evaluation
16 process shall be guilty of a Class 4 felony and that conduct
17 shall be deemed unprofessional conduct that may subject a
18 person to loss of his or her professional license. An action
19 to prosecute a person for violating this subsection (a-2) may
20 be brought by either the Attorney General or the State's
21 Attorney in the county where the violation took place.
22 (b) In determining whether to make more than the
23 required number of unannounced inspections, surveys and
24 evaluations of a facility the Department shall consider one
25 or more of the following: previous inspection reports; the
26 facility's history of compliance with standards, rules and
27 regulations promulgated under this Act and correction of
28 violations, penalties or other enforcement actions; the
29 number and severity of complaints received about the
30 facility; any allegations of resident abuse or neglect;
31 weather conditions; health emergencies; other reasonable
32 belief that deficiencies exist.
33 (b-1) The Department shall not be required to determine
34 whether a facility certified to participate in the Medicare
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1 program under Title XVIII of the Social Security Act, or the
2 Medicaid program under Title XIX of the Social Security Act,
3 and which the Department determines by inspection under this
4 Section or under Section 3-702 of this Act to be in
5 compliance with the certification requirements of Title XVIII
6 or XIX, is in compliance with any requirement of this Act
7 that is less stringent than or duplicates a federal
8 certification requirement. In accordance with subsection (a)
9 of this Section or subsection (d) of Section 3-702, the
10 Department shall determine whether a certified facility is in
11 compliance with requirements of this Act that exceed federal
12 certification requirements. If a certified facility is found
13 to be out of compliance with federal certification
14 requirements, the results of an inspection conducted pursuant
15 to Title XVIII or XIX of the Social Security Act may be used
16 as the basis for enforcement remedies authorized and
17 commenced under this Act. Enforcement of this Act against a
18 certified facility shall be commenced pursuant to the
19 requirements of this Act, unless enforcement remedies sought
20 pursuant to Title XVIII or XIX of the Social Security Act
21 exceed those authorized by this Act. As used in this
22 subsection, "enforcement remedy" means a sanction for
23 violating a federal certification requirement or this Act.
24 (c) Upon completion of each inspection, survey and
25 evaluation, the appropriate Department personnel who
26 conducted the inspection, survey or evaluation shall submit a
27 copy of their report to the licensee upon exiting the
28 facility, and shall submit the actual report to the
29 appropriate regional office of the Department. Such report
30 and any recommendations for action by the Department under
31 this Act shall be transmitted to the appropriate offices of
32 the associate director of the Department, together with
33 related comments or documentation provided by the licensee
34 which may refute findings in the report, which explain
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1 extenuating circumstances that the facility could not
2 reasonably have prevented, or which indicate methods and
3 timetables for correction of deficiencies described in the
4 report. Without affecting the application of subsection (a)
5 of Section 3-303, any documentation or comments of the
6 licensee shall be provided within 10 days of receipt of the
7 copy of the report. Such report shall recommend to the
8 Director appropriate action under this Act with respect to
9 findings against a facility. The Director shall then
10 determine whether the report's findings constitute a
11 violation or violations of which the facility must be given
12 notice. Such determination shall be based upon the severity
13 of the finding, the danger posed to resident health and
14 safety, the comments and documentation provided by the
15 facility, the diligence and efforts to correct deficiencies,
16 correction of the reported deficiencies, the frequency and
17 duration of similar findings in previous reports and the
18 facility's general inspection history. Violations shall be
19 determined under this subsection no later than 60 days after
20 completion of each inspection, survey and evaluation.
21 (d) The Department shall maintain all inspection, survey
22 and evaluation reports for at least 5 years in a manner
23 accessible to and understandable by the public.
24 (Source: P.A. 88-278; 89-21, eff. 1-1-96; 89-171, eff.
25 1-1-96; 89-197, eff. 7-21-95; 89-626, eff. 8-9-96.)
26 Section 20. The Mental Health and Developmental
27 Disabilities Code is amended by changing Sections 3-603,
28 3-701, and 3-704 and adding Section 3-704.1 as follows:
29 (405 ILCS 5/3-603) (from Ch. 91 1/2, par. 3-603)
30 Sec. 3-603. (a) If no physician, qualified examiner, or
31 clinical psychologist or qualified certifier at a
32 participating mental health center is immediately available
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1 or it is not possible after a diligent effort to obtain the
2 certificate provided for in Section 3-602, the respondent may
3 be detained for examination in a mental health facility upon
4 presentation of the petition alone pending the obtaining of
5 such a certificate, except that if admission is sought to a
6 State-operated mental health facility and the Community
7 Service Area has a participating mental health center, the
8 participating mental health center shall be notified and
9 shall provide a qualified certifier to conduct a screening
10 within 24 hours.
11 (b) In such instance the petition shall conform to the
12 requirements of Section 3-601 and further specify that:
13 1. the petitioner believes, as a result of his personal
14 observation, that the respondent is subject to involuntary
15 admission;
16 2. a diligent effort was made to obtain a certificate;
17 and
18 3. no physician, qualified examiner, or clinical
19 psychologist could be found who has examined or could examine
20 the respondent; and
21 4. a diligent effort has been made to convince the
22 respondent to appear voluntarily for examination by a
23 physician, qualified examiner, or clinical psychologist,
24 unless the petitioner reasonably believes such an effort
25 would pose a risk of harm to the respondent or others.
26 (Source: P.A. 88-484.)
27 (405 ILCS 5/3-701) (from Ch. 91 1/2, par. 3-701)
28 Sec. 3-701. (a) Any person 18 years of age or older may
29 execute a petition asserting that another person is subject
30 to involuntary admission. The petition shall be prepared
31 pursuant to paragraph (b) of Section 3-601 and shall be filed
32 with the court in the county where the respondent resides or
33 is present.
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1 (b) The court may inquire of the petitioner whether
2 there are reasonable grounds to believe that the facts stated
3 in the petition are true and whether the respondent is
4 subject to involuntary admission. The inquiry may proceed
5 without notice to the respondent only if the petitioner
6 alleges facts showing that an emergency exists such that
7 immediate hospitalization is necessary and the petitioner
8 testifies before the court as to the factual basis for the
9 allegations.
10 (Source: P.A. 80-1414.)
11 (405 ILCS 5/3-704) (from Ch. 91 1/2, par. 3-704)
12 Sec. 3-704. Examination; detention.
13 (a) The respondent shall be permitted to remain in his
14 place of residence pending any examination. He may be
15 accompanied by one or more of his relatives or friends or by
16 his attorney to the place of examination. If, however, the
17 court finds that it is necessary in order to complete the
18 examination the court may order that the person be admitted
19 to a mental health facility pending examination and may order
20 a peace officer or other person to transport him there. If
21 examination and detention is sought at a State-operated
22 mental health facility and the Community Service Area has a
23 participating mental health center, the person shall be seen
24 for a screening examination by a qualified certifier. After
25 examination, the participating mental health center shall
26 recommend to the court an appropriate treatment setting. If
27 the appropriate setting is a State-operated mental health
28 facility, the participating mental health center shall
29 provide a written statement, as required under Section
30 3-601.1, obtained from a qualified certifier recommending
31 admission to a State-operated mental health facility.
32 Whenever possible the examination shall be conducted at a
33 local mental health facility. No person may be detained for
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1 examination under this Section for more than 24 hours. The
2 person shall be released upon completion of the examination
3 unless the physician, qualified examiner or clinical
4 psychologist executes a certificate stating that the person
5 is subject to involuntary admission and in need of immediate
6 hospitalization to protect such person or others from
7 physical harm. Upon admission under this Section treatment
8 may be given pursuant to Section 3-608.
9 (a-5) When a respondent has been transported to a mental
10 health facility for an examination, the admitting facility
11 shall inquire, upon the respondent's arrival, whether the
12 respondent wishes any person or persons to be notified of his
13 or her detention at the facility. If the respondent does
14 wish to have any person or persons notified of his or her
15 detention at the facility, the facility must make all
16 reasonable attempts to locate, within one hour after the
17 respondent's arrival, at least 2 individuals identified by
18 the respondent and notify them of the respondent's detention
19 at the facility for a mandatory examination pursuant to court
20 order.
21 (b) Not later than 24 hours, excluding Saturdays,
22 Sundays, and holidays, after admission under this Section,
23 the respondent shall be asked if he desires the petition and
24 the notice required under Section 3-206 sent to any other
25 persons and at least 2 such persons designated by the
26 respondent shall be sent the documents. At the time of his
27 admission the respondent shall be allowed to complete not
28 fewer than 2 telephone calls to such persons as he chooses.
29 (Source: P.A. 88-484.)
30 (405 ILCS 5/3-704.1 new)
31 Sec. 3-704.1. Task Force.
32 (a) The Illinois Law Enforcement Training Standards
33 Board shall convene a task force for the purpose of
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1 developing and recommending for adoption by the Board a model
2 protocol concerning the involvement of mental health
3 professionals when a peace officer is required to enforce an
4 order entered under subsection (a) of Section 3-704 to
5 transport an individual for a mandatory mental health
6 examination. The members of the task force shall include
7 representatives from law enforcement, community mental health
8 service providers, and one or more designees of the Director
9 of the Office of Mental Health, Department of Human Services.
10 In establishing the task force, every effort shall be made to
11 ensure that it represents the geographic diversity of the
12 State.
13 (b) The members of the task force shall serve without
14 compensation.
15 (c) Before taking any formal action upon the
16 recommendations of the task force, the Board shall hold a
17 public hearing to provide the opportunity for individuals
18 with mental illness and their family members, mental health
19 advocacy organizations, and the public at large to review,
20 comment upon, and suggest any changes to the proposed model
21 protocol.
22 (d) The Board shall submit to the General Assembly, no
23 later than March 1, 2000, the model protocol it has adopted
24 for the coordination of efforts between law enforcement
25 personnel and mental health professionals in the enforcement
26 of orders requiring transport of individuals for emergency
27 mental health examinations.
28 (e) This Section is repealed on January 1, 2001.
29 Section 99. Effective date. This Section, the changes
30 to Section 4.3 of the Mental Health and Developmental
31 Disabilities Administrative Act, the changes to Sections 6.2,
32 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 of the Abused and Neglected
33 Long Term Care Facility Residents Reporting Act, the changes
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1 to Section 3-203 of the Nursing Home Care Act, the changes to
2 Sections 3-603, 3-701, and 3-704 of the Mental Health and
3 Mental Health and Developmental Disabilities Code, and the
4 provisions adding Section 3-704.1 to the Mental Health and
5 Developmental Disabilities Code take effect upon becoming
6 law.".