Public Act 93-0636

HB0088 Re-Enrolled                   LRB093 02345 AMC 02704 b

    AN ACT in relation to health care.

    Be it enacted by the People of  the  State  of  Illinois,
represented in the General Assembly:

    Section   5.    The   Mental   Health  and  Developmental
Disabilities  Administrative  Act  is  amended  by   changing
Sections 4, 7, and 15 as follows:

    (20 ILCS 1705/4) (from Ch. 91 1/2, par. 100-4)
    Sec.   4.  Supervision   of   facilities   and  services;
quarterly reports.
    (a)  To exercise executive and administrative supervision
over all facilities, divisions,  programs  and  services  now
existing   or   hereafter   acquired  or  created  under  the
jurisdiction of the Department, including,  but  not  limited
to, the following:
         The Alton Mental Health Center, at Alton
         The  Clyde L. Choate Mental Health and Developmental
    Center, at Anna
         The Chester Mental Health Center, at Chester
         The Chicago-Read Mental Health Center, at Chicago
         The Elgin Mental Health Center, at Elgin
         The Metropolitan Children and Adolescents Center, at
    Chicago
         The   Jacksonville    Developmental    Center,    at
    Jacksonville
         The Governor Samuel H. Shapiro Developmental Center,
    at Kankakee
         The Tinley Park Mental Health Center, at Tinley Park
         The  Warren  G.   Murray  Developmental  Center,  at
    Centralia
         The Jack Mabley Developmental Center, at Dixon
         The Lincoln Developmental Center, at Lincoln
         The    H.   Douglas   Singer   Mental   Health   and
    Developmental Center, at Rockford
         The John J. Madden Mental Health Center, at Chicago
         The George A. Zeller Mental Health Center, at Peoria
         The  Andrew  McFarland  Mental  Health  Center,   at
    Springfield
         The Adolf Meyer Mental Health Center, at Decatur
         The William W. Fox Developmental Center, at Dwight
         The  Elisabeth Ludeman Developmental Center, at Park
    Forest
         The William A. Howe Developmental Center, at  Tinley
    Park
         The Ann M. Kiley Developmental Center, at Waukegan.
    (b)  Beginning   not   later   than  July  1,  1977,  the
Department shall cause  each  of  the  facilities  under  its
jurisdiction  which  provide  in-patient  care to comply with
standards, rules and regulations of the Department of  Public
Health   prescribed   under  Section  6.05  of  the  Hospital
Licensing Act.
    (c)  The Department  shall  issue  quarterly  reports  on
admissions,    deflections,    discharges,    bed   closures,
staff-resident ratios, census, and average  length  of  stay,
and   any  adverse  federal  certification  or  accreditation
findings, if any, for each State-operated  facility  for  the
mentally ill and developmentally disabled.
(Source: P.A. 91-357, eff. 7-29-99; 91-652, eff. 12-1-99.)

    (20 ILCS 1705/7) (from Ch. 91 1/2, par. 100-7)
    Sec.  7.  To  receive  and  provide  the highest possible
quality of humane and rehabilitative care  and  treatment  to
all   persons   admitted   or  committed  or  transferred  in
accordance with law to the facilities,  divisions,  programs,
and  services  under  the  jurisdiction of the Department. No
resident of another state shall be received  or  retained  to
the  exclusion of any resident of this State.  No resident of
another state shall be received or retained to the  exclusion
of any resident of this State.  All recipients of 17 years of
age  and  under  in  residence in a Department facility other
than a facility for the care of the mentally  retarded  shall
be  housed in quarters separated from older recipients except
for: (a) recipients who are placed in medical-surgical  units
because  of  physical  illness; and (b) recipients between 13
and 18 years of age who need temporary security measures.
    All recipients in a Department facility shall be given  a
dental examination by a licensed dentist or registered dental
hygienist at least once every 18 months and shall be assigned
to  a  dentist  for  such  dental  care  and  treatment as is
necessary.
    All  medications  administered  to  recipients  shall  be
administered only by those persons who are legally  qualified
to  do  so  by  the laws of the State of Illinois. Medication
shall  not  be  prescribed  until  a  physical   and   mental
examination  of  the recipient has been completed. If, in the
clinical  judgment  of  a  physician,  it  is  necessary   to
administer medication to a recipient before the completion of
the  physical  and  mental examination, he may prescribe such
medication but he  must  file  a  report  with  the  facility
director  setting  forth  the  reasons  for  prescribing such
medication within 24 hours of the prescription. A copy of the
report shall be part of the recipient's record.
    No later than January 1, 2005, the Department shall adopt
a  model  protocol  and  forms  for  recording  all   patient
diagnosis,   care,   and  treatment  at  each  State-operated
facility for the mentally ill  and  developmentally  disabled
under the jurisdiction of the Department.  The model protocol
and   forms  shall  be  used  by  each  facility  unless  the
Department determines that equivalent alternatives justify an
exemption.
    Every facility under the jurisdiction of  the  Department
shall  maintain  a  copy of each report of suspected abuse or
neglect of the patient. Copies of those reports shall be made
available to the State Auditor General in connection with his
biennial program audit of the facility as required by Section
3-2 of the Illinois State Auditing Act.
    No later than January 1 2004, the Department shall report
to  the  Governor  and  the  General  Assembly  whether  each
State-operated   facility   for   the   mentally   ill    and
developmentally   disabled  under  the  jurisdiction  of  the
Department and all  services  provided  in  those  facilities
comply  with  all  of the applicable standards adopted by the
Social  Security  Administration   under   Subchapter   XVIII
(Medicare)   of   the   Social   Security   Act   (42  U.S.C.
1395-1395ccc), if the facility and services may  be  eligible
for  federal  financial participation under that federal law.
For  those  facilities  that  do  comply,  the  report  shall
indicate what actions need to be taken  to  ensure  continued
compliance.  For  those  facilities  that  do not comply, the
report shall indicate what actions need to be taken to  bring
each facility into compliance.
(Source: P.A. 86-922; 86-1013; 86-1475.)

    (20 ILCS 1705/15) (from Ch. 91 1/2, par. 100-15)
    Sec.  15.   Before any person is released from a facility
operated by the State pursuant to an absolute discharge or  a
conditional  discharge  from  hospitalization under this Act,
the facility director of the facility in which such person is
hospitalized  shall  determine  that  such  person   is   not
currently in need of hospitalization and:
         (a)  is able to live independently in the community;
    or
         (b)  requires further oversight and supervisory care
    for  which  arrangements  have been made with responsible
    relatives or supervised residential program  approved  by
    the Department; or
         (c)  requires   further  personal  care  or  general
    oversight as defined by the Nursing Home  Care  Act,  for
    which  placement  arrangements  have  been  made  with  a
    suitable  family home or other licensed facility approved
    by the Department under this Section; or
         (d)  requires community mental health  services  for
    which arrangements have been made with a community mental
    health  provider  in accordance with criteria, standards,
    and procedures promulgated by rule.
    Such determination shall be made  in  writing  and  shall
become  a  part  of the facility record of such absolutely or
conditionally  discharged  person.   When  the  determination
indicates that the condition of the person to be  granted  an
absolute  discharge  or  a conditional discharge is described
under subparagraph (c) or (d) of this Section, the  name  and
address of the continuing care facility or home to which such
person  is  to  be  released shall be entered in the facility
record.  Where a discharge from a mental health  facility  is
made  under subparagraph (c), the Department shall assign the
person  so  discharged  to  an   existing   community   based
not-for-profit  agency  for  participation  in day activities
suitable to the person's needs, such as but  not  limited  to
social and vocational rehabilitation, and other recreational,
educational  and  financial  activities  unless the community
based not-for-profit agency is  unqualified  to  accept  such
assignment.  Where the clientele of any not-for-profit agency
increases as a result of assignments  under  this  amendatory
Act  of  1977  by  more  than  3%  over  the  prior year, the
Department shall fully reimburse such agency for the costs of
providing services to such  persons  in  excess  of  such  3%
increase. The Department shall keep written records detailing
how  many  persons  have  been  assigned to a community based
not-for-profit agency  and  how  many  persons  were  not  so
assigned  because  the  community  based agency was unable to
accept  the  assignments,  in   accordance   with   criteria,
standards,  and  procedures  promulgated by rule.  Whenever a
community based agency is found to be unable  to  accept  the
assignments,  the  name  of the agency and the reason for the
finding shall be included in the report.
    Insofar as desirable  in  the  interests  of  the  former
recipient,  the  facility,  program  or  home  in  which  the
discharged person is to be placed shall be located in or near
the   community   in   which  the  person  resided  prior  to
hospitalization or in the community  in  which  the  person's
family  or nearest next of kin presently reside. Placement of
the  discharged  person  in  facilities,  programs  or  homes
located outside of this  State  shall  not  be  made  by  the
Department   unless  there  are  no  appropriate  facilities,
programs or homes available within this  State.  Out-of-state
placements shall be subject to return of recipients so placed
upon the availability of facilities, programs or homes within
this  State  to  accommodate  these  recipients, except where
placement  in  a  contiguous  state  results  in  locating  a
recipient in a facility or program closer to the  recipient's
home  or  family.   If  an  appropriate  facility  or program
becomes available equal to or closer to the recipient's  home
or  family,  the recipient shall be returned to and placed at
the appropriate facility or program within this State.
    To place any  person  who  is  under  a  program  of  the
Department  at  board  in  a  suitable family home or in such
other facility or program  as  the  Department  may  consider
desirable.   The  Department  may  place  in licensed nursing
homes, sheltered care homes, or  homes  for  the  aged  those
persons  whose  behavioral  manifestations  and  medical  and
nursing   care   needs   are  such  as  to  be  substantially
indistinguishable  from  persons  already  living   in   such
facilities.   Prior  to any placement by the Department under
this Section, a determination shall be made by the  personnel
of  the  Department,  as to the capability and suitability of
such facility to adequately meet the needs of the  person  to
be  discharged.   When  specialized programs are necessary in
order to enable persons  in  need  of  supervised  living  to
develop  and  improve  in the community, the Department shall
place such  persons  only  in  specialized  residential  care
facilities  which  shall  meet Department standards including
restricted admission policy, special staffing and programming
for social and vocational rehabilitation, in addition to  the
requirements  of the appropriate State licensing agency.  The
Department shall not place any new person in a  facility  the
license  of  which has been revoked or not renewed on grounds
of inadequate programming, staffing, or medical or adjunctive
services,  regardless  of  the  pendency  of  an  action  for
administrative review regarding such revocation or failure to
renew. Before the Department may transfer  any  person  to  a
licensed  nursing  home,  sheltered care home or home for the
aged or place any person in a  specialized  residential  care
facility  the  Department  shall  notify  the  person  to  be
transferred,  or  a  responsible  relative of such person, in
writing, at least 30 days before the proposed transfer,  with
respect  to  all the relevant facts concerning such transfer,
except  in  cases  of  emergency  when  such  notice  is  not
required. If  either  the  person  to  be  transferred  or  a
responsible relative of such person objects to such transfer,
in  writing  to  the Department, at any time after receipt of
notice and before the transfer, the facility director of  the
facility   in   which   the  person  was  a  recipient  shall
immediately schedule a  hearing  at  the  facility  with  the
presence of the facility director, the person who objected to
such  proposed  transfer,  and a psychiatrist who is familiar
with the record of the person to be transferred. Such  person
to   be   transferred   or  a  responsible  relative  may  be
represented by such counsel or interested  party  as  he  may
appoint,  who  may present such testimony with respect to the
proposed transfer. Testimony presented at such hearing  shall
become    a    part   of   the   facility   record   of   the
person-to-be-transferred. The record of  testimony  shall  be
held  in the person-to-be-transferred's record in the central
files of the facility. If such hearing is held a transfer may
only be implemented,  if  at  all,  in  accordance  with  the
results  of  such  hearing. Within 15 days after such hearing
the facility director shall deliver his findings based on the
record of  the  case  and  the  testimony  presented  at  the
hearing,  by  registered or certified mail, to the parties to
such hearing. The findings of the facility director shall  be
deemed a final administrative decision of the Department. For
purposes  of  this  Section,  "case of emergency" means those
instances in which the health of the person to be transferred
is imperiled and the most appropriate mental health  care  or
medical  care  is  available  at  a  licensed  nursing  home,
sheltered  care  home  or  home for the aged or a specialized
residential care facility.
    Prior to placement of any person in a facility under this
Section the  Department  shall  ensure  that  an  appropriate
training  plan  for  staff  is provided by the facility. Said
training  may  include  instruction  and   demonstration   by
Department  personnel qualified in the area of mental illness
or mental retardation, as applicable  to  the  person  to  be
placed.   Training  may  be  given  both at the facility from
which the  recipient  is  transferred  and  at  the  facility
receiving the recipient, and may be available on a continuing
basis  subsequent  to  placement.   In  a  facility providing
services to former Department recipients, training  shall  be
available  as  necessary  for  facility staff.  Such training
will be on a continuing basis as the needs  of  the  facility
and recipients change and further training is required.
    The  Department  shall not place any person in a facility
which does not have appropriately trained staff in sufficient
numbers to accommodate the recipient  population  already  at
the facility.  As a condition of further or future placements
of  persons,  the  Department shall require the employment of
additional trained staff members at the facility  where  said
persons  are  to  be  placed.   The  Secretary, or his or her
designate, shall establish written guidelines  for  placement
of persons in facilities under this Act. The Department shall
keep  written  records  detailing  which facilities have been
determined to have staff who have been appropriately  trained
by  the  Department and all training which it has provided or
required under this Section.
    Bills for the support for a person boarded out  shall  be
payable monthly out of the proper maintenance funds and shall
be  audited  as  any  other accounts of the Department.  If a
person is  placed  in  a  facility  or  program  outside  the
Department,  the  Department  may  pay  the  actual  costs of
residence, treatment or maintenance in such facility and  may
collect  such  actual  costs  or  a  portion thereof from the
recipient or the estate of a person placed in accordance with
this Section.
    Other than those placed in a family home  the  Department
shall  cause  all  persons  who  are placed in a facility, as
defined by the  Nursing  Home  Care  Act,  or  in  designated
community  living  situations  or  programs, to be visited at
least once during the first month  following  placement,  and
once  every  month  thereafter  for  the first year following
placement when indicated, but at least quarterly.  After  the
first  year, the Department shall determine at what point the
appropriate licensing entity for the facility  or  designated
community   living  situation  or  program  will  assume  the
responsibility of  ensuring  that  appropriate  services  are
being  provided to the resident.  Once that responsibility is
assumed, the Department may discontinue such  visits.   If  a
long  term  care facility has periodic care plan conferences,
the visitor may participate in  those  conferences,  if  such
participation  is  approved by the resident or the resident's
guardian. Visits shall  be  made  by  qualified  and  trained
Department  personnel,  or  their  designee,  in  the area of
mental health or developmental disabilities applicable to the
person visited, and shall be made on a  more  frequent  basis
when  indicated.   The Department may not use as designee any
personnel   connected   with   or    responsible    to    the
representatives  of  any  facility  in which persons who have
been transferred under this  Section  are  placed.    In  the
course  of  such  visit  there  shall be consideration of the
following  areas,  but  not  limited  thereto:   effects   of
transfer  on  physical  and  mental  health  of  the  person,
sufficiency  of nursing care and medical coverage required by
the person, sufficiency of staff  personnel  and  ability  to
provide  basic  care for the person, social, recreational and
programmatic activities available for the person,  and  other
appropriate aspects of the person's environment.
    A  report containing the above observations shall be made
to the Department, to the licensing agency, and to any  other
appropriate agency subsequent to each visitation.  The report
shall   contain  recommendations  to  improve  the  care  and
treatment of the  resident,  as  necessary,  which  shall  be
reviewed  by  the  facility's  interdisciplinary team and the
resident or the resident's legal guardian. At the  conclusion
of one year following absolute or conditional discharge, or a
longer  period  of  time  if  required by the Department, the
Department may terminate the visitation requirements of  this
Section  as  to  a  person  placed  in  accordance  with this
Section, by filing a written statement of termination setting
forth reasons to substantiate the termination of  visitations
in  the  person's  file,  and  sending  a copy thereof to the
person, and to his guardian or next of kin.
    Upon the complaint of any  person  placed  in  accordance
with   this  Section  or  any  responsible  citizen  or  upon
discovery that such person has  been  abused,  neglected,  or
improperly  cared for, or that the placement does not provide
the  type  of  care  required  by  the  recipient's   current
condition,  the Department immediately shall investigate, and
determine if the well-being, health, care, or safety  of  any
person  is  affected  by any of the above occurrences, and if
any one of the above occurrences is verified, the  Department
shall  remove  such  person  at  once  to  a  facility of the
Department or to another  facility  outside  the  Department,
provided  such  person's  needs  can be met at said facility.
The  Department  may  also  provide  any  person  placed   in
accordance  with this Section who is without available funds,
and who is permitted to  engage  in  employment  outside  the
facility,   such  sums  for  the  transportation,  and  other
expenses as may be needed by him until he receives his  wages
for such employment.
    The  Department  shall  promulgate  rules and regulations
governing the purchase of care for persons who are  wards  of
or  who  are  receiving  services  from the Department.  Such
rules and regulations shall apply to all monies  expended  by
any  agency of the State of Illinois for services rendered by
any person, corporate entity, agency, governmental agency  or
political  subdivision  whether  public or private outside of
the Department whether payment is made through a contractual,
per-diem or other arrangement.  No funds shall be paid to any
person, corporation, agency, governmental entity or political
subdivision  without   compliance   with   such   rules   and
regulations.
    The  rules  and  regulations  governing  purchase of care
shall  describe  categories  and  types  of  service   deemed
appropriate for purchase by the Department.
    Any  provider  of  services  under  this Act may elect to
receive payment for those services,  and  the  Department  is
authorized  to  arrange  for that payment, by means of direct
deposit  transmittals  to  the  service  provider's   account
maintained  at a bank, savings and loan association, or other
financial institution.  The financial  institution  shall  be
approved  by  the  Department,  and  the deposits shall be in
accordance  with  rules  and  regulations  adopted   by   the
Department.
(Source: P.A. 89-507, eff. 7-1-97; 90-423, eff. 8-15-97.)

    Section  10.   The  Abused  and  Neglected Long Term Care
Facility Residents  Reporting  Act  is  amended  by  changing
Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 as follows:

    (210 ILCS 30/6.2) (from Ch. 111 1/2, par. 4166.2)
    (Section scheduled to be repealed on January 1, 2004)
    Sec. 6.2.  Inspector General.
    (a)  The  Governor  shall  appoint,  and the Senate shall
confirm, an Inspector General.  The Inspector  General  shall
be  appointed  for  a  term of 4 years and who shall function
within the Department of Human Services  and  report  to  the
Secretary  of  Human Services and the Governor. The Inspector
General shall function independently within the Department of
Human Services with respect to the operations of the  office,
including  the  performance of investigations and issuance of
findings and  recommendations.   The  appropriation  for  the
Office  of  Inspector  General  shall  be  separate  from the
overall appropriation for the Department of  Human  Services.
The  Inspector General shall investigate reports of suspected
abuse or neglect (as those terms are defined in Section 3  of
this  Act)  of  patients or residents in any mental health or
developmental   disabilities   facility   operated   by   the
Department of Human Services  and  shall  have  authority  to
investigate  and take immediate action on reports of abuse or
neglect of recipients, whether patients or residents, in  any
mental  health  or  developmental  disabilities  facility  or
program  that  is  licensed or certified by the Department of
Human Services (as successor  to  the  Department  of  Mental
Health  and  Developmental Disabilities) or that is funded by
the  Department  of  Human  Services  (as  successor  to  the
Department of Mental Health and  Developmental  Disabilities)
and  is not licensed or certified by any agency of the State.
At the specific, written request of an agency  of  the  State
other  than the Department of Human Services (as successor to
the   Department   of   Mental   Health   and   Developmental
Disabilities),  the  Inspector  General  may   cooperate   in
investigating  reports  of  abuse and neglect of persons with
mental illness or persons  with  developmental  disabilities.
The  Inspector  General  shall  have  no  supervision over or
involvement   in   routine,   programmatic,   licensure,   or
certification operations of the Department of Human  Services
or any of its funded agencies.
    The Inspector General shall promulgate rules establishing
minimum  requirements  for reporting allegations of abuse and
neglect   and   initiating,   conducting,   and    completing
investigations.   The  promulgated  rules  shall  clearly set
forth that in instances where 2 or more State agencies  could
investigate  an allegation of abuse or neglect, the Inspector
General shall not conduct an investigation that is  redundant
to  an  investigation  conducted by another State agency. The
rules shall establish criteria for  determining,  based  upon
the  nature  of  the  allegation,  the  appropriate method of
investigation, which may include, but need not be limited to,
site visits, telephone  contacts,  or  requests  for  written
responses from agencies. The rules shall also clarify how the
Office  of  the  Inspector  General  shall  interact with the
licensing  unit  of  the  Department  of  Human  Services  in
investigations of  allegations  of  abuse  or  neglect.   Any
allegations  or  investigations  of  reports made pursuant to
this Act shall remain confidential until a  final  report  is
completed.  The  resident or patient who allegedly was abused
or neglected and his or her legal guardian shall be  informed
by  the  facility or agency of the report of alleged abuse or
neglect. Final reports regarding unsubstantiated or unfounded
allegations shall  remain  confidential,  except  that  final
reports may be disclosed pursuant to Section 6 of this Act.
    The  Inspector General shall be appointed for a term of 4
years.
    When  the   Office   of   the   Inspector   General   has
substantiated  a  case  of  abuse  or  neglect, the Inspector
General shall include in the final report any  mitigating  or
aggravating  circumstances  that  were  identified during the
investigation.  Upon determination that a report  of  neglect
is  substantiated, the Inspector General shall then determine
whether such neglect rises to the level of egregious neglect.
    (b)  The Inspector General shall within  24  hours  after
receiving  a  report  of suspected abuse or neglect determine
whether the evidence indicates that any possible criminal act
has been committed. If he determines that a possible criminal
act has been committed, or that special expertise is required
in  the  investigation,  he  shall  immediately  notify   the
Department  of  State Police.  The Department of State Police
shall investigate any report indicating  a  possible  murder,
rape,  or  other  felony. All investigations conducted by the
Inspector General shall be conducted in a manner designed  to
ensure  the  preservation  of  evidence for possible use in a
criminal prosecution.
    (b-5)  The Inspector General shall make  a  determination
to accept or reject a preliminary report of the investigation
of   alleged   abuse   or   neglect   based   on  established
investigative procedures. Notice of the  Inspector  General's
determination  must  be  given to the person who claims to be
the victim of the abuse or neglect, to the person or  persons
alleged to have been responsible for abuse or neglect, and to
the  facility or agency. The facility or agency or the person
or persons alleged to have been responsible for the abuse  or
neglect  and  the  person  who claims to be the victim of the
abuse or neglect may request clarification or reconsideration
based  on  additional  information.   For  cases  where   the
allegation   of   abuse  or  neglect  is  substantiated,  the
Inspector General shall require the  facility  or  agency  to
submit  a  written  response.   The  written  response from a
facility or agency shall address in a  concise  and  reasoned
manner  the  actions that the agency or facility will take or
has taken to protect the resident or patient  from  abuse  or
neglect,   prevent   reoccurrences,  and  eliminate  problems
identified and shall include  implementation  and  completion
dates for all such action.
    (c)  The Inspector General shall, within 10 calendar days
after the transmittal date of a completed investigation where
abuse or neglect is substantiated or administrative action is
recommended,  provide  a  complete  report on the case to the
Secretary of Human Services and to the agency  in  which  the
abuse  or  neglect  is alleged to have happened. The complete
report shall include a written response from  the  agency  or
facility  operated by the State to the Inspector General that
addresses in a concise and reasoned manner the  actions  that
the  agency or facility will take or has taken to protect the
resident  or  patient  from   abuse   or   neglect,   prevent
reoccurrences,  and  eliminate  problems identified and shall
include implementation and  completion  dates  for  all  such
action.   The  Secretary  of  Human  Services shall accept or
reject the response and establish  how  the  Department  will
determine  whether  the  facility  or  program  followed  the
approved  response.   The  Secretary  may  require Department
personnel to visit  the  facility  or  agency  for  training,
technical    assistance,    programmatic,    licensure,    or
certification  purposes.   Administrative  action,  including
sanctions,  may  be  applied  should the Secretary reject the
response or should the facility or agency fail to follow  the
approved  response.    Within 30 days after the Secretary has
approved a  response,  the  facility  or  agency  making  the
response  shall  provide  an  implementation  report  to  the
Inspector  General  on  the  status  of the corrective action
implemented. Within 60 days after the Secretary has  approved
the response, the facility or agency shall send notice of the
completion  of the corrective action or shall send an updated
implementation report. The facility or agency shall  continue
sending  updated  implementation  reports every 60 days until
the facility or agency sends a notice of  the  completion  of
the corrective action. The Inspector General shall review any
implementation  plan  that  takes  more  than  120  days. The
Inspector General shall monitor compliance through  a  random
review  of  completed corrective actions. This monitoring may
include, but need not be limited to, site  visits,  telephone
contacts,  or  requests  for  written  documentation from the
facility or agency  to  determine  whether  the  facility  or
agency  is  in  compliance  with  the approved response.  The
facility or agency shall inform the resident or  patient  and
the  legal  guardian  whether  the  reported  allegation  was
substantiated, unsubstantiated, or unfounded.  There shall be
an  appeals  process for any person or agency that is subject
to any action based on a recommendation or recommendations.
    (d)  The  Inspector  General   may   recommend   to   the
Departments  of Public Health and Human Services sanctions to
be  imposed   against   mental   health   and   developmental
disabilities   facilities   under  the  jurisdiction  of  the
Department of Human Services for the protection of residents,
including  appointment  of  on-site  monitors  or  receivers,
transfer or relocation of residents, and  closure  of  units.
The Inspector General may seek the assistance of the Attorney
General  or  any of the several State's attorneys in imposing
such sanctions.  Whenever the Inspector  General  issues  any
recommendations  to  the  Secretary  of  Human  Services, the
Secretary shall provide a written response.
    (e)  The Inspector General shall  establish  and  conduct
periodic  training  programs for Department of Human Services
employees concerning the prevention and reporting of  neglect
and abuse.
    (f)  The  Inspector General shall at all times be granted
access to any mental  health  or  developmental  disabilities
facility  operated by the Department of Human Services, shall
establish  and  conduct  unannounced  site  visits  to  those
facilities at least  once  annually,  and  shall  be  granted
access, for the purpose of investigating a report of abuse or
neglect,  to  the records of the Department of Human Services
and to any facility or program funded by  the  Department  of
Human  Services  that is subject under the provisions of this
Section to investigation  by  the  Inspector  General  for  a
report of abuse or neglect.
    (g)  Nothing  in  this Section shall limit investigations
by the Department of Human Services  that  may  otherwise  be
required by law or that may be necessary in that Department's
capacity  as the central administrative authority responsible
for the operation of State mental  health  and  developmental
disability facilities.
    (g-5)  After notice and an opportunity for a hearing that
is  separate  and  distinct  from the Office of the Inspector
General's appeals process as implemented under subsection (c)
of this Section, the Inspector General shall  report  to  the
Department  of  Public  Health's  nurse  aide  registry under
Section 3-206.01 of the Nursing Home Care Act the identity of
individuals against  whom  there  has  been  a  substantiated
finding of physical or sexual abuse or egregious neglect of a
service recipient.
    Nothing  in  this subsection shall diminish or impair the
rights of a person who is a member of a collective bargaining
unit pursuant to the Illinois Public Labor Relations  Act  or
pursuant to any federal labor statute. An individual who is a
member  of  a  collective  bargaining unit as described above
shall not be reported to the Department  of  Public  Health's
nurse aide registry until the exhaustion of that individual's
grievance and arbitration rights, or until 3 months after the
initiation  of the grievance process, whichever occurs first,
provided that the Department of Human Services' hearing under
subsection (c), that is separate and distinct from the Office
of the Inspector General's appeals  process,  has  concluded.
Notwithstanding  anything hereinafter or previously provided,
if an action taken by an employer against an individual as  a
result of the circumstances that led to a finding of physical
or  sexual  abuse  or  egregious  neglect is later overturned
under a grievance or arbitration procedure  provided  for  in
Section 8 of the Illinois Public Labor Relations Act or under
a collective bargaining agreement, the report must be removed
from the registry.
    The  Department  of  Human  Services  shall promulgate or
amend  rules  as  necessary  or  appropriate   to   establish
procedures  for  reporting  to  the  registry,  including the
definition of egregious neglect, procedures for notice to the
individual and victim, appeal  and  hearing  procedures,  and
petition  for  removal  of  the report from the registry. The
portion of the rules pertaining  to  hearings  shall  provide
that,  at  the  hearing, both parties may present written and
oral evidence. The Department shall be required to  establish
by  a  preponderance  of  the evidence that the Office of the
Inspector General's finding of physical or  sexual  abuse  or
egregious  neglect  warrants  reporting  to the Department of
Public Health's nurse aide registry under Section 3-206.01 of
the Nursing Home Care Act.
    Notice to  the  individual  shall  include  a  clear  and
concise  statement  of the grounds on which the report to the
registry is based and notice of the opportunity for a hearing
to contest the report. The Department of Human Services shall
provide the notice  by  certified  mail  to  the  last  known
address   of  the  individual.  The  notice  shall  give  the
individual an opportunity to contest the report in a  hearing
before  the  Department  of  Human  Services  or  to submit a
written response to the  findings  instead  of  requesting  a
hearing.  If  the individual does not request a hearing or if
after notice and a hearing the Department of  Human  Services
finds that the report is valid, the finding shall be included
as  part  of  the registry, as well as a brief statement from
the reported individual if  he  or  she  chooses  to  make  a
statement.   The  Department  of  Public  Health  shall  make
available to the public information reported to the registry.
In a case of inquiries concerning an individual listed in the
registry, any information disclosed concerning a  finding  of
abuse  or  neglect  shall  also  include  disclosure  of  the
individual's  brief statement in the registry relating to the
reported finding or include a clear and accurate  summary  of
the statement.
    At  any  time  after  the  report  of  the  registry,  an
individual  may petition the Department of Human Services for
removal from the registry of the finding against him or  her.
Upon  receipt  of  such  a  petition, the Department of Human
Services shall conduct an investigation and  hearing  on  the
petition.   Upon completion of the investigation and hearing,
the Department of Human Services shall report the removal  of
the  finding  to  the registry unless the Department of Human
Services  determines  that  removal  is  not  in  the  public
interest.
    (h)  This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff.  7-16-99;  92-358,  eff.  8-15-01;
92-473, eff. 1-1-02; 92-651, eff. 7-11-02.)

    (210 ILCS 30/6.3) (from Ch. 111 1/2, par. 4166.3)
    (Section scheduled to be repealed on January 1, 2004)
    Sec.  6.3.  Quality Care Board.  There is created, within
the Department of Human Services'  Office  of  the  Inspector
General,  a  Quality  Care  Board to be composed of 7 members
appointed by the Governor with the advice and consent of  the
Senate.   One  of the members shall be designated as chairman
by the Governor.  Of the initial  appointments  made  by  the
Governor,  4 Board members shall each be appointed for a term
of 4 years and 3 members shall each be appointed for  a  term
of  2  years.   Upon  the expiration of each member's term, a
successor shall be appointed for a term of 4 years.   In  the
case  of  a vacancy in the office of any member, the Governor
shall appoint a successor for the remainder of the  unexpired
term.
    Members  appointed  by the Governor shall be qualified by
professional knowledge or experience  in  the  area  of  law,
investigatory  techniques,  or  in  the  area  of care of the
mentally  ill  or  developmentally  disabled.   Two   members
appointed  by the Governor shall be persons with a disability
or a parent of a person with  a  disability.   Members  shall
serve  without  compensation,  but  shall  be  reimbursed for
expenses incurred in connection with the performance of their
duties as members.
    The Board  shall  meet  quarterly,  and  may  hold  other
meetings  on  the  call  of the chairman.  Four members shall
constitute  a  quorum.   The  Board  may  adopt   rules   and
regulations it deems necessary to govern its own procedures.
    This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff. 7-16-99; 92-358, eff. 8-15-01.)

    (210 ILCS 30/6.4) (from Ch. 111 1/2, par. 4166.4)
    (Section scheduled to be repealed on January 1, 2004)
    Sec.  6.4.  Scope and function of the Quality Care Board.
The Board shall monitor and oversee the operations, policies,
and procedures of the Inspector General to assure the  prompt
and  thorough  investigation  of  allegations  of neglect and
abuse.  In fulfilling these responsibilities, the  Board  may
do the following:
         (1)  Provide independent, expert consultation to the
    Inspector   General   on   policies   and  protocols  for
    investigations of alleged neglect and abuse.
         (2)  Review existing  regulations  relating  to  the
    operation   of   facilities  under  the  control  of  the
    Department of Human Services.
         (3)  Advise the Inspector General as to the  content
    of training activities authorized under Section 6.2.
         (4)  Recommend   policies   concerning  methods  for
    improving the intergovernmental relationships between the
    office of  the  Inspector  General  and  other  State  or
    federal agencies.
    This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff. 7-16-99; 92-358, eff. 8-15-01.)

    (210 ILCS 30/6.5) (from Ch. 111 1/2, par. 4166.5)
    (Section scheduled to be repealed on January 1, 2004)
    Sec.  6.5.  Investigators.   Within  60  days  after  the
effective  date of this amendatory Act of 1992, The Inspector
General shall establish a  comprehensive  program  to  ensure
that   every  person  employed  or  newly  hired  to  conduct
investigations shall receive training on  an  on-going  basis
concerning  investigative  techniques,  communication skills,
and the appropriate means of contact with persons admitted or
committed to the mental health or developmental  disabilities
facilities  under the jurisdiction of the Department of Human
Services.
    This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff. 7-16-99; 92-358, eff. 8-15-01.)

    (210 ILCS 30/6.6) (from Ch. 111 1/2, par. 4166.6)
    (Section scheduled to be repealed on January 1, 2004)
    Sec. 6.6.  Subpoenas; testimony; penalty.  The  Inspector
General shall have the power to subpoena witnesses and compel
the   production   of   books  and  papers  pertinent  to  an
investigation authorized by this Act, provided that the power
to subpoena or to compel the production of books  and  papers
shall  not  extend  to  the  person  or  documents of a labor
organization or its representatives insofar as the person  or
documents  of  a labor organization relate to the function of
representing an employee subject to investigation under  this
Act.  Mental health records of patients shall be confidential
as   provided  under  the  Mental  Health  and  Developmental
Disabilities Confidentiality Act.  Any person  who  fails  to
appear in response to a subpoena or to answer any question or
produce  any  books  or  papers pertinent to an investigation
under this Act, except as otherwise provided in this Section,
or who knowingly gives false  testimony  in  relation  to  an
investigation   under  this  Act  is  guilty  of  a  Class  A
misdemeanor.
    This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff. 7-16-99; 92-358, eff. 8-15-01.)

    (210 ILCS 30/6.7) (from Ch. 111 1/2, par. 4166.7)
    (Section scheduled to be repealed on January 1, 2004)
    Sec. 6.7.  Annual report.  The  Inspector  General  shall
provide  to  the  General Assembly and the Governor, no later
than January 1  of  each  year,  a  summary  of  reports  and
investigations  made under this Act for the prior fiscal year
with  respect  to  residents  of   institutions   under   the
jurisdiction of the Department of Human Services.  The report
shall  detail  the  imposition  of  sanctions  and  the final
disposition of those recommendations.   The  summaries  shall
not  contain  any  confidential  or  identifying  information
concerning  the  subjects  of the reports and investigations.
The report shall also include a trend analysis of the  number
of  reported  allegations  and  their  disposition,  for each
facility and Department-wide, for the most recent 3-year time
period  and  a  statement,  for   each   facility,   of   the
staffing-to-patient  ratios.   The  ratios shall include only
the number of direct  care  staff.   The  report  shall  also
include   detailed  recommended  administrative  actions  and
matters for consideration by the General Assembly.
    This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff. 7-16-99; 92-358, eff. 8-15-01.)

    (210 ILCS 30/6.8) (from Ch. 111 1/2, par. 4166.8)
    (Section scheduled to be repealed on January 1, 2004)
    Sec. 6.8.  Program  audit.   The  Auditor  General  shall
conduct  a  biennial  program  audit  of  the  office  of the
Inspector General in  relation  to  the  Inspector  General's
compliance  with  this  Act.   The  audit  shall specifically
include   the   Inspector    General's    effectiveness    in
investigating   reports   of  alleged  neglect  or  abuse  of
residents in any facility operated by the Department of Human
Services and in making recommendations for sanctions  to  the
Departments of Human Services and Public Health.  The Auditor
General  shall  conduct  the  program  audit according to the
provisions of the  Illinois  State  Auditing  Act  and  shall
report  its  findings  to  the General Assembly no later than
January 1 of each odd-numbered year.
    This Section is repealed on January 1, 2004.
(Source: P.A. 91-169, eff. 7-16-99; 92-358, eff. 8-15-01.).

    Section 15.  The Nursing Home  Care  Act  is  amended  by
changing Sections 2-106 and 2-106.1 as follows:

    (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106)
    Sec. 2-106.  (a) For purposes of this Act, (i) a physical
restraint  is  any  manual  method  or physical or mechanical
device, material, or equipment  attached  or  adjacent  to  a
resident's  body  that  the resident cannot remove easily and
restricts freedom of movement or normal access to one's body.
Devices used for positioning, including but  not  limited  to
bed  rails, gait belts, and cushions, shall not be considered
to be restraints for purposes of  this  Section;      (ii)  a
chemical  restraint  is  any  drug  used  for  discipline  or
convenience  and not required to treat medical symptoms.  The
Department  shall  by  rule,  designate  certain  devices  as
restraints, including at least all those devices  which  have
been  determined  to  be  restraints  by  the  United  States
Department  of  Health  and  Human  Services  in interpretive
guidelines issued for the purposes of administering Titles 18
and 19 of the Social Security Acts.
    (b)  Neither  restraints  nor   confinements   shall   be
employed for the purpose of punishment or for the convenience
of  any  facility  personnel.  No  restraints or confinements
shall be employed  except  as  ordered  by  a  physician  who
documents the need for such restraints or confinements in the
resident's  clinical  record.   Each  facility licensed under
this Act must have a written policy to  address  the  use  of
restraints  and seclusion.  The Department shall establish by
rule the provisions that the policy must include,  which,  to
the   extent  practicable,  should  be  consistent  with  the
requirements  for  participation  in  the  federal   Medicare
program.   Each  policy  shall include periodic review of the
use of restraints.
    (c)  A restraint may  be  used  only  with  the  informed
consent  of  the  resident, the resident's guardian, or other
authorized representative.  A restraint may be used only  for
specific  periods,  if  it  is  the  least  restrictive means
necessary to  attain  and  maintain  the  resident's  highest
practicable  physical,  mental  or  psychosocial  well-being,
including   brief   periods  of  time  to  provide  necessary
life-saving treatment.  A restraint may be  used  only  after
consultation  with  appropriate health professionals, such as
occupational or physical therapists,  and  a  trial  of  less
restrictive  measures  has  led to the determination that the
use of less restrictive measures would not attain or maintain
the  resident's  highest  practicable  physical,  mental   or
psychosocial  well-being.  However,  if  the  resident  needs
emergency  care,  restraints may be used for brief periods to
permit medical treatment to proceed unless the  facility  has
notice  that the resident has previously made a valid refusal
of the treatment in question.
    (d)  A restraint may be applied only by a person  trained
in the application of the particular type of restraint.
    (e)  Whenever   a   period  of  use  of  a  restraint  is
initiated, the resident shall be advised of his or her  right
to  have  a  person  or  organization of his or her choosing,
including the Guardianship and Advocacy Commission,  notified
of  the  use  of  the  restraint.   A  recipient who is under
guardianship may request that a person or organization of his
or her choosing  be notified of the restraint, whether or not
the guardian  approves  the  notice.    If  the  resident  so
chooses,  the  facility shall make the notification within 24
hours, including any information about  the  period  of  time
that  the  restraint is to be used. Whenever the Guardianship
and Advocacy Commission is notified that a resident has  been
restrained,  it  shall  contact the resident to determine the
circumstances of the restraint and whether further action  is
warranted.
    (f)  Whenever  a  restraint  is  used on a resident whose
primary mode of communication is sign language, the  resident
shall  be  permitted  to  have  his  or  her  hands free from
restraint for brief  periods  each  hour,  except  when  this
freedom  may  result  in  physical  harm  to  the resident or
others.
    (g)  The requirements of this  Section  are  intended  to
control  in  any  conflict  with the requirements of Sections
1-126 and  2-108  of  the  Mental  Health  and  Developmental
Disabilities Code.
(Source: P.A. 88-413.)

    (210 ILCS 45/2-106.1)
    Sec. 2-106.1.  Drug treatment.
    (a)  A resident shall not be given unnecessary drugs.  An
unnecessary  drug  is  any  drug  used  in an excessive dose,
including in duplicative  therapy;  for  excessive  duration;
without adequate monitoring; without adequate indications for
its  use;  or  in  the  presence of adverse consequences that
indicate the drugs should be reduced  or  discontinued.   The
Department   shall   adopt,   by   rule,  the  standards  for
unnecessary drugs contained in interpretive guidelines issued
by the United States Department of Health and Human  Services
for  the  purposes  of  administering titles 18 and 19 of the
Social Security Act.
    (b)  Psychotropic  medication  shall  not  be  prescribed
without the informed consent of the resident, the  resident's
guardian,  or other authorized representative.  "Psychotropic
medication" means medication that is used for  or  listed  as
used   for   antipsychotic,   antidepressant,  antimanic,  or
antianxiety  behavior  modification  or  behavior  management
purposes in the latest editions of the AMA  Drug  Evaluations
or the Physician's Desk Reference.
    (c)  The  requirements  of  this  Section are intended to
control in a conflict with the requirements of Sections 2-102
1-102 and 2-107.2 of  the  Mental  Health  and  Developmental
Disabilities  Code  with  respect  to  the  administration of
psychotropic medication.
(Source: P.A. 88-413.)

    Section 99.  Effective date.  This Section,  Section  10,
the changes to Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8
of the Abused and Neglected Long Term Care Facility Residents
Reporting  Act,  and  the  changes  to  Section  3-203 of the
Nursing Home Care Act take effect upon becoming law.
                            INDEX
           Statutes amended in order of appearance
                          SEE INDEX
20 ILCS 1705/4            from Ch. 91 1/2, par. 100-4
20 ILCS 1705/7            from Ch. 91 1/2, par. 100-7
20 ILCS 1705/15           from Ch. 91 1/2, par. 100-15
210 ILCS 30/6.2           from Ch. 111 1/2, par. 4166.2
210 ILCS 30/6.3           from Ch. 111 1/2, par. 4166.3
210 ILCS 30/6.4           from Ch. 111 1/2, par. 4166.4
210 ILCS 30/6.5           from Ch. 111 1/2, par. 4166.5
210 ILCS 30/6.6           from Ch. 111 1/2, par. 4166.6
210 ILCS 30/6.7           from Ch. 111 1/2, par. 4166.7
210 ILCS 30/6.8           from Ch. 111 1/2, par. 4166.8
210 ILCS 45/2-106         from Ch. 111 1/2, par. 4152-106
210 ILCS 45/2-106.1
210 ILCS 85/6.20
225 ILCS 65/5-10