Public Act 094-1066
 		





SB0998 Enrolled
LRB094 04681 RXD 34710 b






    AN ACT concerning health.

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


 
    Section 5. The Mental Health and Developmental 
Disabilities Code is amended  by changing Sections 2-107, 
2-107.1, and 3-209 and  by adding Section 2-107.3 as follows:
 



    (405 ILCS 5/2-107)  (from Ch. 91 1/2, par. 2-107)



    Sec. 2-107. Refusal of services; informing of risks. 

    (a) An adult recipient of services or the recipient's 
guardian,
if the recipient is under guardianship, and the 
recipient's substitute
decision maker, if any, must be informed 
of the recipient's right to
refuse medication.  The recipient 
and the recipient's guardian or substitute
decision maker shall 
be given the opportunity to
refuse generally accepted mental 
health or developmental disability services,
including but not 
limited to medication.  If such services are refused, they
shall 
not be given unless such services are necessary to prevent the 
recipient
from causing serious and imminent physical harm to 
the recipient or others and
no less restrictive alternative is 
available.
The facility director shall inform a recipient, 
guardian, or
substitute decision maker, if any, who refuses 
such
services of alternate services available and the risks of 
such alternate
services, as well as the possible consequences 
to the recipient of refusal of
such services.

    (b) Authorized involuntary treatment may be given under 
this Section for
up to 24 hours only if the circumstances 
leading up to the need for emergency
treatment are set forth in 
writing in the recipient's record.

    (c) Authorized involuntary treatment may not be continued 
unless the need
for such treatment is redetermined at least 
every 24 hours based upon a
personal examination of the 
recipient by a physician or a nurse under the
supervision of a 
physician and the circumstances demonstrating that need are
set 
forth in writing in the recipient's record.

    (d) Authorized involuntary treatment may not be 
administered under this
Section for a period in excess of 72 
hours, excluding Saturdays, Sundays, and
holidays, unless a 
petition is filed  under Section 2-107.1 and the treatment

continues to be necessary under subsection (a) of this Section. 
Once the
petition has been filed, treatment may continue in 
compliance with subsections
(a), (b), and (c) of this Section 
until the final outcome of the hearing on the
petition.

    (e) The Department shall issue rules designed to insure 
that in
State-operated mental health facilities authorized 
involuntary treatment is
administered in accordance with this 
Section and only when appropriately
authorized and monitored by 
a physician or a nurse under the supervision
of a physician
in 
accordance with accepted medical practice.  The facility 
director of each
mental health facility not operated by the 
State shall issue rules designed to
insure that in that 
facility authorized involuntary treatment is administered
in

accordance with this Section and only when appropriately 
authorized and
monitored by a physician or a nurse under the 
supervision of a
physician in accordance with accepted medical 
practice.  Such rules shall be
available for public inspection 
and copying during normal business hours.

    (f) The provisions of this Section with respect to the 
emergency
administration of authorized involuntary treatment 
do not apply to facilities
licensed under the Nursing Home Care 
Act.

    (g) Under no circumstances may long-acting psychotropic 
medications be
administered under this Section.

    (h) Whenever psychotropic medication is refused pursuant 
to subsection (a) of this Section at least once that day, the 
physician shall determine and state in writing the reasons why 
the recipient did not meet the criteria for involuntary 
treatment under subsection (a) and whether the recipient meets 
the  standard for authorized involuntary treatment under 
Section 2-107.1 of this Code. If the physician determines that 
the recipient meets the standard for authorized involuntary 
treatment under Section 2-107.1, the facility director or his 
or her designee shall petition the court for authorized 
involuntary treatment pursuant to that Section unless the 
facility director or his or her designee states in writing in 
the recipient's record why the filing of such a petition is not 
warranted. This subsection (h) applies only to State-operated 
mental health facilities.
    (i) The Department shall conduct annual trainings for all 
physicians and registered nurses working in State-operated 
mental health facilities on the appropriate use of emergency 
authorized involuntary treatment, standards for its use, and 
the methods of authorization under this Section.

(Source: P.A. 90-538, eff. 12-1-97; 91-726, eff. 6-2-00.)

 



    (405 ILCS 5/2-107.1)  (from Ch. 91 1/2, par. 2-107.1)



    Sec. 2-107.1. Administration of authorized involuntary 
treatment upon
application to a court.

    (a) An adult recipient of services and the recipient's 
guardian, if the
recipient is under guardianship, and the 
substitute decision
maker, if any, shall be informed of the 
recipient's right to refuse medication.
The recipient and the 
recipient's guardian or substitute
decision maker shall be 
given the opportunity to refuse generally accepted
mental 
health or developmental disability services, including
but not 
limited to medication.

    (a-5) Notwithstanding the provisions of Section 2-107 of 
this
Code, authorized
involuntary treatment may be 
administered to an adult recipient of
services without the 
informed consent of the recipient under the following

standards:


        (1) Any person 18 years of age or older, including any 
    guardian, may
petition the circuit court for an order 
    authorizing the administration of
authorized involuntary 
    treatment to a recipient
of services.
The petition shall 
    state that the petitioner has made a good faith attempt to

    determine whether the recipient has executed a power of 
    attorney for health
care under the Powers of Attorney for 
    Health Care Law or a declaration for
mental health 
    treatment under the Mental Health Treatment Preference

    Declaration Act and to obtain copies of these instruments 
    if they exist.  If
either of the above-named instruments is 
    available to the petitioner, the
instrument or a copy of 
    the instrument shall be attached to the petition as
an 
    exhibit.
The petitioner shall deliver a copy of the 
    petition, and notice of the time
and place of the hearing, 
    to the respondent, his or her attorney, any known
agent or

    attorney-in-fact, if any, and the
guardian, if any, no 
    later than 3 days prior to the date of the
hearing.
Service 
    of the petition and notice of the time and place of the 
    hearing may
be made by transmitting them via facsimile 
    machine to the
respondent or other party.  Upon receipt of 
    the petition and notice, the party
served, or the person 
    delivering the petition and notice to
the party served, 
    shall acknowledge service.  If the party sending the 
    petition
and notice does not receive acknowledgement of 
    service
within 24 hours, service must be made by personal 
    service.


        The
petition may include a request that the court 
    authorize such testing and
procedures as may be essential 
    for the safe and effective administration of the
authorized 
    involuntary treatment sought to be
administered, but only 
    where the
petition
sets forth the specific testing and 
    procedures sought to be administered.


        If a hearing is requested to be held immediately 
    following the hearing on
a petition for
involuntary 
    admission, then the notice requirement shall be the same as 
    that
for the hearing on
the petition for involuntary 
    admission, and the petition filed pursuant to this
Section 
    shall be filed
with the petition for involuntary admission.


        (2) The court shall hold a hearing within 7 days of the 
    filing
of the petition.  The People, the petitioner, or the 
    respondent shall be
entitled
to a continuance of up to 7 
    days as of right.  An additional
continuance of  not more 
    than 7 days may be granted to
any party (i)
upon a showing 
    that the continuance is needed in order
to adequately

    prepare for or present evidence in a hearing under this 
    Section or
(ii) under exceptional circumstances.  The court 
    may
grant an additional continuance
not to exceed 21 days 
    when, in its discretion, the court determines that such a

    continuance is necessary in order to provide the recipient 
    with an examination
pursuant to Section 3-803 or 3-804 of 
    this Act, to provide the recipient with a
trial by jury as 
    provided in Section 3-802 of this Act, or to arrange for 
    the
substitution of counsel as provided for by the Illinois 
    Supreme Court Rules.
The hearing shall be
separate from a 
    judicial proceeding held to determine whether a person is

    subject to involuntary admission but may be heard 
    immediately preceding or
following such a judicial 
    proceeding and may be heard by the same trier of fact
or 
    law as in that judicial proceeding.


        (3) Unless otherwise provided herein, the procedures 
    set forth in
Article VIII of Chapter 3 of this Act, 
    including the provisions regarding
appointment of counsel, 
    shall govern hearings held under this subsection
(a-5).


        (4) Authorized involuntary treatment shall
not be 
    administered to the recipient
unless
it has been determined 
    by clear and convincing evidence that all of
the following 
    factors are present. In determining whether a person meets 
    the criteria specified in the following
paragraphs (A) 
    through (G), the court may consider evidence of the 
    person's history of
serious violence, repeated past 
    pattern of specific behavior, actions related to the 
    person's
illness, or past outcomes of various treatment 
    options. :


            (A) That the recipient has a serious mental illness 
        or
developmental disability.


            (B) That because of said mental illness or 
        developmental disability,
the recipient currently 
        exhibits any one of the following: (i)
deterioration of 
        his
or her ability to function, as compared to the 
        recipient's ability to
function prior to the current 
        onset of symptoms of the mental illness or
disability 
        for which treatment is presently sought, (ii) 
        suffering, or (iii)
threatening
behavior.


            (C) That the illness or disability has existed for 
        a period marked by
the continuing presence of the 
        symptoms set forth in item (B) of this
subdivision (4) 
        or the repeated episodic occurrence of these symptoms.


            (D) That the benefits of the treatment
outweigh the 
        harm.


            (E) That the recipient lacks the capacity to make a

        reasoned
decision about the treatment.


            (F) That other less restrictive services have been 
        explored
and found inappropriate.


            (G) If the petition seeks authorization for 
        testing and other
procedures,
that such testing and 
        procedures are essential for the safe and effective

        administration of the treatment.


        (5) In no event shall an order issued under this 
    Section be effective
for more than 90 days.
A second 90-day 
    period of involuntary treatment may be authorized pursuant 
    to
a hearing that
complies
with the standards and 
    procedures of this subsection (a-5).
Thereafter, 
    additional 180-day periods of involuntary treatment may be

    authorized pursuant to
the standards and procedures of this 
    Section without limit.
If a new petition to authorize the 
    administration of authorized involuntary
treatment is 
    filed at least 15 days prior to the
expiration of the prior 
    order, and if
any continuance of the hearing is agreed to 
    by the recipient, the
administration of the treatment may 
    continue in accordance
with
the prior order
pending the 
    completion of a hearing under this Section.


        (6) An order issued under this subsection (a-5) shall

    designate the persons
authorized to administer the 
    authorized involuntary treatment under the
standards
and 
    procedures of this subsection (a-5).
Those persons shall 
    have complete discretion not to administer any
treatment 
    authorized under this Section.
The order shall also specify 
    the medications and the anticipated range of
dosages that 
    have been authorized and may include a list of any 
    alternative
medications and range of dosages deemed 
    necessary.

    (b) A guardian may be authorized to consent to the 
administration
of authorized involuntary treatment to an

objecting recipient only under the
standards and procedures of 
subsection (a-5).

    (c) Notwithstanding any other provision of this Section, a 
guardian may
consent to the administration of authorized 
involuntary treatment to a
non-objecting
recipient under 
Article XIa of the Probate Act of 1975.

    (d) Nothing in this Section shall prevent the 
administration of
authorized involuntary treatment to 
recipients
in an emergency under Section 2-107 of
this Act.

    (e) Notwithstanding any of the provisions of this Section, 
authorized
involuntary treatment may be administered pursuant 
to a power of attorney for
health care under the Powers of 
Attorney for Health Care Law or a declaration
for mental health 
treatment under the Mental Health Treatment Preference

Declaration Act.

    (f) The Department shall conduct annual trainings for 
physicians and registered nurses working in State-operated 
mental health facilities on the appropriate use of authorized 
involuntary treatment, standards for its use, and the 
preparation of court petitions under this Section.

(Source: P.A. 92-16, eff. 6-28-01; 93-573, eff. 8-21-03.)

 
    (405 ILCS 5/2-107.3  new)
    Sec. 2-107.3. Reports. Each facility director of a 
State-operated mental health facility shall prepare a 
quarterly report stating the number of persons who were 
determined to meet the

standard for authorized involuntary 
treatment but for whom it was determined that the filing of 
such a petition was not warranted as provided for in subsection 
(h) of Section 2-107 of this Code and the reasons for each such 
determination. The Department shall prepare and publish an 
annual report summarizing the information received under this 
Section. The Department's report shall include the data from 
each facility filing such a report and shall separately report 
the data from each such facility, identified by facility.
 



    (405 ILCS 5/3-209)  (from Ch. 91 1/2, par. 3-209)



    Sec. 3-209. Within three days of admission under this 
Chapter, a treatment
plan shall be prepared for each recipient 
of service and entered into his
or her record.  The plan shall 
include an assessment of the recipient's
treatment needs, a 
description of the services recommended for treatment,
the 
goals of each type of element of service, an anticipated 
timetable for
the accomplishment of the goals, and a 
designation of the qualified professional
responsible for the 
implementation of the plan. The plan shall include a
written 
assessment of whether or not the recipient is in need of 
psychotropic medications.  The plan shall be reviewed
and 
updated as the clinical condition warrants, but not less than 
every 30 days.

(Source: P.A. 81-920.)

 
    Section 99. Effective date. This Act takes effect upon 
becoming law.