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1 | AN ACT concerning health.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Department of Human Services Act is amended | |||||||||||||||||||
5 | by changing Section 1-17 as follows:
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6 | (20 ILCS 1305/1-17)
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7 | Sec. 1-17. Inspector General. | |||||||||||||||||||
8 | (a) Nature and purpose. It is the express intent of the | |||||||||||||||||||
9 | General Assembly to ensure the health, safety, and financial | |||||||||||||||||||
10 | condition of individuals receiving services in this State due | |||||||||||||||||||
11 | to mental illness, developmental disability, or both by | |||||||||||||||||||
12 | protecting those persons from acts of abuse, neglect, or both | |||||||||||||||||||
13 | by service providers. To that end, the Office of the Inspector | |||||||||||||||||||
14 | General for the Department of Human Services is created to | |||||||||||||||||||
15 | investigate and report upon allegations of the abuse, neglect, | |||||||||||||||||||
16 | or financial exploitation of individuals receiving services | |||||||||||||||||||
17 | within mental health facilities, developmental disabilities | |||||||||||||||||||
18 | facilities, and community agencies operated, licensed, funded | |||||||||||||||||||
19 | or certified by the Department of Human Services, but not | |||||||||||||||||||
20 | licensed or certified by any other State agency. | |||||||||||||||||||
21 | (b) Definitions. The following definitions apply to this | |||||||||||||||||||
22 | Section: | |||||||||||||||||||
23 | "Adult student with a disability" means an adult student, |
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1 | age 18 through 21, inclusive, with an Individual Education | ||||||
2 | Program, other than a resident of a facility licensed by the | ||||||
3 | Department of Children and Family Services in accordance with | ||||||
4 | the Child Care Act of 1969. For purposes of this definition, | ||||||
5 | "through age 21, inclusive", means through the day before the | ||||||
6 | student's 22nd birthday. | ||||||
7 | "Agency" or "community agency" means (i) a community agency | ||||||
8 | licensed, funded, or certified by the Department, but not | ||||||
9 | licensed or certified by any other human services agency of the | ||||||
10 | State, to provide mental health service or developmental | ||||||
11 | disabilities service, or (ii) a program licensed, funded, or | ||||||
12 | certified by the Department, but not licensed or certified by | ||||||
13 | any other human services agency of the State, to provide mental | ||||||
14 | health service or developmental disabilities service. | ||||||
15 | "Aggravating circumstance" means a factor that is | ||||||
16 | attendant to a finding and that tends to compound or increase | ||||||
17 | the culpability of the accused. | ||||||
18 | "Allegation" means an assertion, complaint, suspicion, or | ||||||
19 | incident involving any of the following conduct by an employee, | ||||||
20 | facility, or agency against an individual or individuals: | ||||||
21 | mental abuse, physical abuse, sexual abuse, neglect, or | ||||||
22 | financial exploitation. | ||||||
23 | "Day" means working day, unless otherwise specified. | ||||||
24 | "Deflection" means a situation in which an individual is | ||||||
25 | presented for admission to a facility or agency, and the | ||||||
26 | facility staff or agency staff do not admit the individual. |
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1 | "Deflection" includes triage, redirection, and denial of | ||||||
2 | admission. | ||||||
3 | "Department" means the Department of Human Services. | ||||||
4 | "Developmental disability" means "developmental | ||||||
5 | disability" as defined in the Mental Health and Developmental | ||||||
6 | Disabilities Code. | ||||||
7 | "Egregious neglect" means a finding of neglect as | ||||||
8 | determined by the Inspector General that (i) represents a gross | ||||||
9 | failure to adequately provide for, or a callused indifference | ||||||
10 | to, the health, safety, or medical needs of an individual and | ||||||
11 | (ii) results in an individual's death or other serious | ||||||
12 | deterioration of an individual's physical condition or mental | ||||||
13 | condition. | ||||||
14 | "Employee" means any person who provides services at the | ||||||
15 | facility or agency on-site or off-site. The service | ||||||
16 | relationship can be with the individual or with the facility or | ||||||
17 | agency. Also, "employee" includes any employee or contractual | ||||||
18 | agent of the Department of Human Services or the community | ||||||
19 | agency involved in providing or monitoring or administering | ||||||
20 | mental health or developmental disability services. This | ||||||
21 | includes but is not limited to: owners, operators, payroll | ||||||
22 | personnel, contractors, subcontractors, and volunteers. | ||||||
23 | "Facility" or "State-operated facility" means a mental | ||||||
24 | health facility or developmental disabilities facility | ||||||
25 | operated by the Department. | ||||||
26 | "Financial exploitation" means taking unjust advantage of |
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1 | an individual's assets, property, or financial resources | ||||||
2 | through deception, intimidation, or conversion for the | ||||||
3 | employee's, facility's, or agency's own advantage or benefit. | ||||||
4 | "Finding" means the Office of Inspector General's | ||||||
5 | determination regarding whether an allegation is | ||||||
6 | substantiated, unsubstantiated, or unfounded. | ||||||
7 | "Health Care Worker Registry" or "Registry" means the | ||||||
8 | Health Care Worker Registry under the Health Care Worker | ||||||
9 | Background Check Act. | ||||||
10 | "Individual" means any person receiving mental health | ||||||
11 | service, developmental disabilities service, or both from a | ||||||
12 | facility or agency, while either on-site or off-site. | ||||||
13 | "Mental abuse" means the use of demeaning, intimidating, or | ||||||
14 | threatening words, signs, gestures, or other actions by an | ||||||
15 | employee about an individual and in the presence of an | ||||||
16 | individual or individuals that results in emotional distress or | ||||||
17 | maladaptive behavior, or could have resulted in emotional | ||||||
18 | distress or maladaptive behavior, for any individual present. | ||||||
19 | "Mental illness" means "mental illness" as defined in the | ||||||
20 | Mental Health and Developmental Disabilities Code. | ||||||
21 | "Mentally ill" means having a mental illness. | ||||||
22 | "Mitigating circumstance" means a condition that (i) is | ||||||
23 | attendant to a finding, (ii) does not excuse or justify the | ||||||
24 | conduct in question, but (iii) may be considered in evaluating | ||||||
25 | the severity of the conduct, the culpability of the accused, or | ||||||
26 | both the severity of the conduct and the culpability of the |
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1 | accused. | ||||||
2 | "Neglect" means an employee's, agency's, or facility's | ||||||
3 | failure to provide adequate medical care, personal care, or | ||||||
4 | maintenance and that, as a consequence, (i) causes an | ||||||
5 | individual pain, injury, or emotional distress, (ii) results in | ||||||
6 | either an individual's maladaptive behavior or the | ||||||
7 | deterioration of an individual's physical condition or mental | ||||||
8 | condition, or (iii) places the individual's health or safety at | ||||||
9 | substantial risk. | ||||||
10 | "Person with a developmental disability" means a person | ||||||
11 | having a developmental disability. | ||||||
12 | "Physical abuse" means an employee's non-accidental and | ||||||
13 | inappropriate contact with an individual that causes bodily | ||||||
14 | harm. "Physical abuse" includes actions that cause bodily harm | ||||||
15 | as a result of an employee directing an individual or person to | ||||||
16 | physically abuse another individual. | ||||||
17 | "Recommendation" means an admonition, separate from a | ||||||
18 | finding, that requires action by the facility, agency, or | ||||||
19 | Department to correct a systemic issue, problem, or deficiency | ||||||
20 | identified during an investigation. | ||||||
21 | "Required reporter" means any employee who suspects, | ||||||
22 | witnesses, or is informed of an allegation of any one or more | ||||||
23 | of the following: mental abuse, physical abuse, sexual abuse, | ||||||
24 | neglect, or financial exploitation. | ||||||
25 | "Secretary" means the Chief Administrative Officer of the | ||||||
26 | Department. |
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1 | "Sexual abuse" means any sexual contact or intimate | ||||||
2 | physical contact between an employee and an individual, | ||||||
3 | including an employee's coercion or encouragement of an | ||||||
4 | individual to engage in sexual behavior that results in sexual | ||||||
5 | contact, intimate physical contact, sexual behavior, or | ||||||
6 | intimate physical behavior. Sexual abuse also includes (i) an | ||||||
7 | employee's actions that result in the sending or showing of | ||||||
8 | sexually explicit images to an individual via computer, | ||||||
9 | cellular phone, electronic mail, portable electronic device, | ||||||
10 | or other media with or without contact with the individual or | ||||||
11 | (ii) an employee's posting of sexually explicit images of an | ||||||
12 | individual online or elsewhere whether or not there is contact | ||||||
13 | with the individual. | ||||||
14 | "Sexually explicit images" includes, but is not limited to, | ||||||
15 | any material which depicts nudity, sexual conduct, or | ||||||
16 | sado-masochistic abuse, or which contains explicit and | ||||||
17 | detailed verbal descriptions or narrative accounts of sexual | ||||||
18 | excitement, sexual conduct, or sado-masochistic abuse. | ||||||
19 | "Substantiated" means there is clear and convincing a | ||||||
20 | preponderance of the evidence to support the allegation. | ||||||
21 | "Unfounded" means there is not a preponderance of no | ||||||
22 | credible evidence to support the allegation. | ||||||
23 | "Unsubstantiated" means there is a preponderance of | ||||||
24 | credible evidence, but less than clear and convincing a | ||||||
25 | preponderance of evidence to support the allegation. | ||||||
26 | (c) Appointment. The Governor shall appoint, and the Senate |
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1 | shall confirm, an Inspector General. The Inspector General | ||||||
2 | shall be appointed for a term of 4 years and shall function | ||||||
3 | within the Department of Human Services and report to the | ||||||
4 | Secretary and the Governor. | ||||||
5 | (d) Operation and appropriation. The Inspector General | ||||||
6 | shall function independently within the Department with | ||||||
7 | respect to the operations of the Office, including the | ||||||
8 | performance of investigations and issuance of findings and | ||||||
9 | recommendations. The appropriation for the Office of Inspector | ||||||
10 | General shall be separate from the overall appropriation for | ||||||
11 | the Department. | ||||||
12 | (e) Powers and duties. The Inspector General shall | ||||||
13 | investigate reports of suspected mental abuse, physical abuse, | ||||||
14 | sexual abuse, neglect, or financial exploitation of | ||||||
15 | individuals in any mental health or developmental disabilities | ||||||
16 | facility or agency and shall have authority to take immediate | ||||||
17 | action to prevent any one or more of the following from | ||||||
18 | happening to individuals under its jurisdiction: mental abuse, | ||||||
19 | physical abuse, sexual abuse, neglect, or financial | ||||||
20 | exploitation. Upon written request of an agency of this State, | ||||||
21 | the Inspector General may assist another agency of the State in | ||||||
22 | investigating reports of the abuse, neglect, or abuse and | ||||||
23 | neglect of persons with mental illness, persons with | ||||||
24 | developmental disabilities, or persons with both. To comply | ||||||
25 | with the requirements of subsection (k) of this Section, the | ||||||
26 | Inspector General shall also review all reportable deaths for |
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1 | which there is no allegation of abuse or neglect. Nothing in | ||||||
2 | this Section shall preempt any duties of the Medical Review | ||||||
3 | Board set forth in the Mental Health and Developmental | ||||||
4 | Disabilities Code. The Inspector General shall have no | ||||||
5 | authority to investigate alleged violations of the State | ||||||
6 | Officials and Employees Ethics Act. Allegations of misconduct | ||||||
7 | under the State Officials and Employees Ethics Act shall be | ||||||
8 | referred to the Office of the Governor's Executive Inspector | ||||||
9 | General for investigation. | ||||||
10 | (f) Limitations. The Inspector General shall not conduct an | ||||||
11 | investigation within an agency or facility if that | ||||||
12 | investigation would be redundant to or interfere with an | ||||||
13 | investigation conducted by another State agency. The Inspector | ||||||
14 | General shall have no supervision over, or involvement in, the | ||||||
15 | routine programmatic, licensing, funding, or certification | ||||||
16 | operations of the Department. Nothing in this subsection limits | ||||||
17 | investigations by the Department that may otherwise be required | ||||||
18 | by law or that may be necessary in the Department's capacity as | ||||||
19 | central administrative authority responsible for the operation | ||||||
20 | of the State's mental health and developmental disabilities | ||||||
21 | facilities. | ||||||
22 | (g) Rulemaking authority. The Inspector General shall | ||||||
23 | promulgate rules establishing minimum requirements for | ||||||
24 | reporting allegations as well as for initiating, conducting, | ||||||
25 | and completing investigations based upon the nature of the | ||||||
26 | allegation or allegations. The rules shall clearly establish |
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1 | that if 2 or more State agencies could investigate an | ||||||
2 | allegation, the Inspector General shall not conduct an | ||||||
3 | investigation that would be redundant to, or interfere with, an | ||||||
4 | investigation conducted by another State agency. The rules | ||||||
5 | shall further clarify the method and circumstances under which | ||||||
6 | the Office of Inspector General may interact with the | ||||||
7 | licensing, funding, or certification units of the Department in | ||||||
8 | preventing further occurrences of mental abuse, physical | ||||||
9 | abuse, sexual abuse, neglect, egregious neglect, and financial | ||||||
10 | exploitation. | ||||||
11 | (h) Training programs. The Inspector General shall (i) | ||||||
12 | establish a comprehensive program to ensure that every person | ||||||
13 | authorized to conduct investigations receives ongoing training | ||||||
14 | relative to investigation techniques, communication skills, | ||||||
15 | community models of providing long-term services and supports | ||||||
16 | for persons with intellectual or developmental disabilities | ||||||
17 | and serious mental illnesses, and the appropriate means of | ||||||
18 | interacting with persons with intellectual disabilities, | ||||||
19 | developmental disabilities, or mental illnesses who are | ||||||
20 | receiving services in a community setting receiving treatment | ||||||
21 | for mental illness, developmental disability, or both mental | ||||||
22 | illness and developmental disability , and (ii) establish and | ||||||
23 | conduct periodic training programs for facility and agency | ||||||
24 | employees concerning the prevention and reporting of any one or | ||||||
25 | more of the following: mental abuse, physical abuse, sexual | ||||||
26 | abuse, neglect, egregious neglect, or financial exploitation. |
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1 | The Inspector General shall ensure all investigators are | ||||||
2 | trained on the role of nurses as provided in 59 Ill. Adm. Code | ||||||
3 | 116. Nothing in this Section shall be deemed to prevent the | ||||||
4 | Office of Inspector General from conducting any other training | ||||||
5 | as determined by the Inspector General to be necessary or | ||||||
6 | helpful. | ||||||
7 | (i) Duty to cooperate. | ||||||
8 | (1) The Inspector General shall at all times be granted | ||||||
9 | access to any facility or agency for the purpose of | ||||||
10 | investigating any allegation, conducting unannounced site | ||||||
11 | visits, monitoring compliance with a written response, or | ||||||
12 | completing any other statutorily assigned duty. The | ||||||
13 | Inspector General shall conduct unannounced site visits to | ||||||
14 | each facility at least annually for the purpose of | ||||||
15 | reviewing and making recommendations on systemic issues | ||||||
16 | relative to preventing, reporting, investigating, and | ||||||
17 | responding to all of the following: mental abuse, physical | ||||||
18 | abuse, sexual abuse, neglect, egregious neglect, or | ||||||
19 | financial exploitation. | ||||||
20 | (2) Any employee who fails to cooperate with an Office | ||||||
21 | of the Inspector General investigation is in violation of | ||||||
22 | this Act. Failure to cooperate with an investigation | ||||||
23 | includes, but is not limited to, any one or more of the | ||||||
24 | following: (i) creating and transmitting a false report to | ||||||
25 | the Office of the Inspector General hotline, (ii) providing | ||||||
26 | false information to an Office of the Inspector General |
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1 | Investigator during an investigation, (iii) colluding with | ||||||
2 | other employees to cover up evidence, (iv) colluding with | ||||||
3 | other employees to provide false information to an Office | ||||||
4 | of the Inspector General investigator, (v) destroying | ||||||
5 | evidence, (vi) withholding evidence, or (vii) otherwise | ||||||
6 | obstructing an Office of the Inspector General | ||||||
7 | investigation. Additionally, any employee who, during an | ||||||
8 | unannounced site visit or written response compliance | ||||||
9 | check, fails to cooperate with requests from the Office of | ||||||
10 | the Inspector General is in violation of this Act. | ||||||
11 | (j) Subpoena powers. The Inspector General shall have the | ||||||
12 | power to subpoena witnesses and compel the production of all | ||||||
13 | documents and physical evidence relating to his or her | ||||||
14 | investigations and any hearings authorized by this Act. This | ||||||
15 | subpoena power shall not extend to persons or documents of a | ||||||
16 | labor organization or its representatives insofar as the | ||||||
17 | persons are acting in a representative capacity to an employee | ||||||
18 | whose conduct is the subject of an investigation or the | ||||||
19 | documents relate to that representation. Any person who | ||||||
20 | otherwise fails to respond to a subpoena or who knowingly | ||||||
21 | provides false information to the Office of the Inspector | ||||||
22 | General by subpoena during an investigation is guilty of a | ||||||
23 | Class A misdemeanor. | ||||||
24 | (k) Reporting allegations and deaths. | ||||||
25 | (1) Allegations. If an employee witnesses, is told of, | ||||||
26 | or has reason to believe an incident of mental abuse, |
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1 | physical abuse, sexual abuse, neglect, or financial | ||||||
2 | exploitation has occurred, the employee, agency, or | ||||||
3 | facility shall report the allegation by phone to the Office | ||||||
4 | of the Inspector General hotline according to the agency's | ||||||
5 | or facility's procedures, but in no event later than 4 | ||||||
6 | hours after the initial discovery of the incident, | ||||||
7 | allegation, or suspicion of any one or more of the | ||||||
8 | following: mental abuse, physical abuse, sexual abuse, | ||||||
9 | neglect, or financial exploitation. A required reporter as | ||||||
10 | defined in subsection (b) of this Section who knowingly or | ||||||
11 | intentionally fails to comply with these reporting | ||||||
12 | requirements is guilty of a Class A misdemeanor. | ||||||
13 | (2) Deaths. Absent an allegation, a required reporter | ||||||
14 | shall, within 24 hours after initial discovery, report by | ||||||
15 | phone to the Office of the Inspector General hotline each | ||||||
16 | of the following: | ||||||
17 | (i) Any death of an individual occurring within 14 | ||||||
18 | calendar days after discharge or transfer of the | ||||||
19 | individual from a residential program or facility. | ||||||
20 | (ii) Any death of an individual occurring within 24 | ||||||
21 | hours after deflection from a residential program or | ||||||
22 | facility. | ||||||
23 | (iii) Any other death of an individual occurring at | ||||||
24 | an agency or facility or at any Department-funded site. | ||||||
25 | (3) Retaliation. It is a violation of this Act for any | ||||||
26 | employee or administrator of an agency or facility to take |
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1 | retaliatory action against an employee who acts in good | ||||||
2 | faith in conformance with his or her duties as a required | ||||||
3 | reporter. | ||||||
4 | (l) Reporting to law enforcement. | ||||||
5 | (1) Reporting criminal acts. Within 24 hours after | ||||||
6 | determining that there is credible evidence indicating | ||||||
7 | that a criminal act may have been committed or that special | ||||||
8 | expertise may be required in an investigation, the | ||||||
9 | Inspector General shall notify the Department of State | ||||||
10 | Police or other appropriate law enforcement authority, or | ||||||
11 | ensure that such notification is made. The Department of | ||||||
12 | State Police shall investigate any report from a | ||||||
13 | State-operated facility indicating a possible murder, | ||||||
14 | sexual assault, or other felony by an employee. All | ||||||
15 | investigations conducted by the Inspector General shall be | ||||||
16 | conducted in a manner designed to ensure the preservation | ||||||
17 | of evidence for possible use in a criminal prosecution. | ||||||
18 | (2) Reporting allegations of adult students with | ||||||
19 | disabilities. Upon receipt of a reportable allegation | ||||||
20 | regarding an adult student with a disability, the | ||||||
21 | Department's Office of the Inspector General shall | ||||||
22 | determine whether the allegation meets the criteria for the | ||||||
23 | Domestic Abuse Program under the Abuse of Adults with | ||||||
24 | Disabilities Intervention Act. If the allegation is | ||||||
25 | reportable to that program, the Office of the Inspector | ||||||
26 | General shall initiate an investigation. If the allegation |
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1 | is not reportable to the Domestic Abuse Program, the Office | ||||||
2 | of the Inspector General shall make an expeditious referral | ||||||
3 | to the respective law enforcement entity. If the alleged | ||||||
4 | victim is already receiving services from the Department, | ||||||
5 | the Office of the Inspector General shall also make a | ||||||
6 | referral to the respective Department of Human Services' | ||||||
7 | Division or Bureau. | ||||||
8 | (m) Investigative reports. Upon completion of an | ||||||
9 | investigation, the Office of Inspector General shall issue an | ||||||
10 | investigative report identifying whether the allegations are | ||||||
11 | substantiated, unsubstantiated, or unfounded. Within 10 | ||||||
12 | business days after the transmittal of a completed | ||||||
13 | investigative report substantiating an allegation, finding an | ||||||
14 | allegation is unsubstantiated, or if a recommendation is made, | ||||||
15 | the Inspector General shall provide the investigative report on | ||||||
16 | the case to the Secretary and to the director of the facility | ||||||
17 | or agency where any one or more of the following occurred: | ||||||
18 | mental abuse, physical abuse, sexual abuse, neglect, egregious | ||||||
19 | neglect, or financial exploitation. The director of the | ||||||
20 | facility or agency shall be responsible for maintaining the | ||||||
21 | confidentiality of the investigative report consistent with | ||||||
22 | State and federal law. In a substantiated case, the | ||||||
23 | investigative report shall include any mitigating or | ||||||
24 | aggravating circumstances that were identified during the | ||||||
25 | investigation. In an unsubstantiated case, the Inspector | ||||||
26 | General shall not issue recommendations to the director of the |
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1 | facility or the agency. If the case involves substantiated | ||||||
2 | neglect, the investigative report shall also state whether | ||||||
3 | egregious neglect was found. An investigative report may also | ||||||
4 | set forth recommendations. All investigative reports prepared | ||||||
5 | by the Office of the Inspector General shall be considered | ||||||
6 | confidential and shall not be released except as provided by | ||||||
7 | the law of this State or as required under applicable federal | ||||||
8 | law. Unsubstantiated and unfounded reports shall not be | ||||||
9 | disclosed except as allowed under Section 6 of the Abused and | ||||||
10 | Neglected Long Term Care Facility Residents Reporting Act. Raw | ||||||
11 | data used to compile the investigative report shall not be | ||||||
12 | subject to release unless required by law or a court order. | ||||||
13 | "Raw data used to compile the investigative report" includes, | ||||||
14 | but is not limited to, any one or more of the following: the | ||||||
15 | initial complaint, witness statements, photographs, | ||||||
16 | investigator's notes, police reports, or incident reports. If | ||||||
17 | the allegations are substantiated, the accused shall be | ||||||
18 | provided with a redacted copy of the investigative report. | ||||||
19 | Death reports where there was no allegation of abuse or neglect | ||||||
20 | shall only be released pursuant to applicable State or federal | ||||||
21 | law or a valid court order. In all final reports, the | ||||||
22 | facility's or agency's director shall be given the opportunity | ||||||
23 | to provide written evaluations of the investigative process. | ||||||
24 | (n) Written responses and reconsideration requests. | ||||||
25 | (1) Written responses. Within 30 calendar days from | ||||||
26 | receipt of a substantiated investigative report or an |
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1 | investigative report which contains recommendations, | ||||||
2 | absent a reconsideration request, the facility or agency | ||||||
3 | shall file a written response that addresses, in a concise | ||||||
4 | and reasoned manner, the actions taken to: (i) protect the | ||||||
5 | individual; (ii) prevent recurrences; and (iii) eliminate | ||||||
6 | the problems identified. The response shall include the | ||||||
7 | implementation and completion dates of such actions. If the | ||||||
8 | facility's or agency's director have recommendations that | ||||||
9 | differ from or are not identical to the recommendations | ||||||
10 | provided in the investigative report, then the Inspector | ||||||
11 | General must review and consider how these recommendations | ||||||
12 | might accomplish the actions required in this Section. If | ||||||
13 | the written response is not filed within the allotted 30 | ||||||
14 | calendar day period, the Secretary shall determine the | ||||||
15 | appropriate corrective action to be taken. | ||||||
16 | (1.5) If, in a final investigative report, the | ||||||
17 | Inspector General recommends that the facility's or | ||||||
18 | agency's director assign or hire additional staff, and if, | ||||||
19 | in the written response, the director indicates additional | ||||||
20 | staff cannot be assigned or hired, then the director may | ||||||
21 | take immediate steps to close the facility or agency. | ||||||
22 | (2) Reconsideration requests. The facility, agency, | ||||||
23 | victim or guardian, or the subject employee may request | ||||||
24 | that the Office of Inspector General reconsider or clarify | ||||||
25 | its finding based upon additional information. | ||||||
26 | (n-5) If an investigative report under this Section is |
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1 | submitted as evidence during the appeals process provided in | ||||||
2 | the Unemployment Insurance Act, then the investigator that | ||||||
3 | completed the report must attend all appeal hearings and Board | ||||||
4 | of Review hearings. | ||||||
5 | (o) Disclosure of the finding by the Inspector General. The | ||||||
6 | Inspector General shall disclose the finding of an | ||||||
7 | investigation to the following persons: (i) the Governor, (ii) | ||||||
8 | the Secretary, (iii) the director of the facility or agency, | ||||||
9 | (iv) the alleged victims and their guardians, (v) the | ||||||
10 | complainant, and (vi) the accused. This information shall | ||||||
11 | include whether the allegations were deemed substantiated, | ||||||
12 | unsubstantiated, or unfounded. | ||||||
13 | (p) Secretary review. Upon review of the Inspector | ||||||
14 | General's investigative report and any agency's or facility's | ||||||
15 | written response, the Secretary shall accept or reject the | ||||||
16 | written response and notify the Inspector General of that | ||||||
17 | determination. The Secretary may further direct that other | ||||||
18 | administrative action be taken, including, but not limited to, | ||||||
19 | any one or more of the following: (i) additional site visits, | ||||||
20 | (ii) training, (iii) provision of technical assistance | ||||||
21 | relative to administrative needs, licensure or certification, | ||||||
22 | or (iv) the imposition of appropriate sanctions. | ||||||
23 | (q) Action by facility or agency. Within 30 days of the | ||||||
24 | date the Secretary approves the written response or directs | ||||||
25 | that further administrative action be taken, the facility or | ||||||
26 | agency shall provide an implementation report to the Inspector |
| |||||||
| |||||||
1 | General that provides the status of the action taken. The | ||||||
2 | facility or agency shall be allowed an additional 30 days to | ||||||
3 | send notice of completion of the action or to send an updated | ||||||
4 | implementation report. If the action has not been completed | ||||||
5 | within the additional 30-day 30 day period, the facility or | ||||||
6 | agency shall send updated implementation reports every 60 days | ||||||
7 | until completion. The Inspector General shall conduct a review | ||||||
8 | of any implementation plan that takes more than 120 days after | ||||||
9 | approval to complete, and shall monitor compliance through a | ||||||
10 | random review of approved written responses, which may include, | ||||||
11 | but are not limited to: (i) site visits, (ii) telephone | ||||||
12 | contact, and (iii) requests for additional documentation | ||||||
13 | evidencing compliance. | ||||||
14 | (r) Sanctions. Sanctions, if imposed by the Secretary under | ||||||
15 | Subdivision (p)(iv) of this Section, shall be designed to | ||||||
16 | prevent further acts of mental abuse, physical abuse, sexual | ||||||
17 | abuse, neglect, egregious neglect, or financial exploitation | ||||||
18 | or some combination of one or more of those acts at a facility | ||||||
19 | or agency, and may include any one or more of the following: | ||||||
20 | (1) Appointment of on-site monitors. | ||||||
21 | (2) Transfer or relocation of an individual or | ||||||
22 | individuals. | ||||||
23 | (3) Closure of units. | ||||||
24 | (4) Termination of any one or more of the following: | ||||||
25 | (i) Department licensing, (ii) funding, or (iii) | ||||||
26 | certification. |
| |||||||
| |||||||
1 | The Inspector General may seek the assistance of the | ||||||
2 | Illinois Attorney General or the office of any State's Attorney | ||||||
3 | in implementing sanctions. | ||||||
4 | (s) Health Care Worker Registry. | ||||||
5 | (1) Reporting to the Registry. The Inspector General | ||||||
6 | shall report to the Department of Public Health's Health | ||||||
7 | Care Worker Registry, a public registry, the identity and | ||||||
8 | finding of each employee of a facility or agency against | ||||||
9 | whom there is a final investigative report containing a | ||||||
10 | substantiated allegation of physical or sexual abuse, | ||||||
11 | financial exploitation, or egregious neglect of an | ||||||
12 | individual. | ||||||
13 | (2) Notice to employee. Prior to reporting the name of | ||||||
14 | an employee, the employee shall be notified of the | ||||||
15 | Department's obligation to report and shall be granted an | ||||||
16 | opportunity to request an administrative hearing, the sole | ||||||
17 | purpose of which is to determine if the substantiated | ||||||
18 | finding warrants reporting to the Registry. Notice to the | ||||||
19 | employee shall contain a clear and concise statement of the | ||||||
20 | grounds on which the report to the Registry is based, offer | ||||||
21 | the employee an opportunity for a hearing, and identify the | ||||||
22 | process for requesting such a hearing. Notice is sufficient | ||||||
23 | if provided by certified mail to the employee's last known | ||||||
24 | address. If the employee fails to request a hearing within | ||||||
25 | 30 days from the date of the notice, the Inspector General | ||||||
26 | shall report the name of the employee to the Registry. |
| |||||||
| |||||||
1 | Nothing in this subdivision (s)(2) shall diminish or impair | ||||||
2 | the rights of a person who is a member of a collective | ||||||
3 | bargaining unit under the Illinois Public Labor Relations | ||||||
4 | Act or under any other federal labor statute. | ||||||
5 | (3) Registry hearings. If the employee requests an | ||||||
6 | administrative hearing, the employee shall be granted an | ||||||
7 | opportunity to appear before an administrative law judge to | ||||||
8 | present reasons why the employee's name should not be | ||||||
9 | reported to the Registry. The Department shall bear the | ||||||
10 | burden of presenting evidence that establishes, by a | ||||||
11 | preponderance of the evidence, that the substantiated | ||||||
12 | finding warrants reporting to the Registry. After | ||||||
13 | considering all the evidence presented, the administrative | ||||||
14 | law judge shall make a recommendation to the Secretary as | ||||||
15 | to whether the substantiated finding warrants reporting | ||||||
16 | the name of the employee to the Registry. The Secretary | ||||||
17 | shall render the final decision. The Department and the | ||||||
18 | employee shall have the right to request that the | ||||||
19 | administrative law judge consider a stipulated disposition | ||||||
20 | of these proceedings. | ||||||
21 | (4) Testimony at Registry hearings. A person who makes | ||||||
22 | a report or who investigates a report under this Act shall | ||||||
23 | testify fully in any judicial proceeding resulting from | ||||||
24 | such a report, as to any evidence of abuse or neglect, or | ||||||
25 | the cause thereof. No evidence shall be excluded by reason | ||||||
26 | of any common law or statutory privilege relating to |
| |||||||
| |||||||
1 | communications between the alleged perpetrator of abuse or | ||||||
2 | neglect, or the individual alleged as the victim in the | ||||||
3 | report, and the person making or investigating the report. | ||||||
4 | Testimony at hearings is exempt from the confidentiality | ||||||
5 | requirements of subsection (f) of Section 10 of the Mental | ||||||
6 | Health and Developmental Disabilities Confidentiality Act. | ||||||
7 | (5) Employee's rights to collateral action. No | ||||||
8 | reporting to the Registry shall occur and no hearing shall | ||||||
9 | be set or proceed if an employee notifies the Inspector | ||||||
10 | General in writing, including any supporting | ||||||
11 | documentation, that he or she is formally contesting an | ||||||
12 | adverse employment action resulting from a substantiated | ||||||
13 | finding by complaint filed with the Illinois Civil Service | ||||||
14 | Commission, or which otherwise seeks to enforce the | ||||||
15 | employee's rights pursuant to any applicable collective | ||||||
16 | bargaining agreement. If an action taken by an employer | ||||||
17 | against an employee as a result of a finding of physical | ||||||
18 | abuse, sexual abuse, or egregious neglect is overturned | ||||||
19 | through an action filed with the Illinois Civil Service | ||||||
20 | Commission or under any applicable collective bargaining | ||||||
21 | agreement and if that employee's name has already been sent | ||||||
22 | to the Registry, the employee's name shall be removed from | ||||||
23 | the Registry. | ||||||
24 | (6) Removal from Registry. At any time after the report | ||||||
25 | to the Registry, but no more than once in any 12-month | ||||||
26 | period, an employee may petition the Department in writing |
| |||||||
| |||||||
1 | to remove his or her name from the Registry. Upon receiving | ||||||
2 | notice of such request, the Inspector General shall conduct | ||||||
3 | an investigation into the petition. Upon receipt of such | ||||||
4 | request, an administrative hearing will be set by the | ||||||
5 | Department. At the hearing, the employee shall bear the | ||||||
6 | burden of presenting evidence that establishes, by a | ||||||
7 | preponderance of the evidence, that removal of the name | ||||||
8 | from the Registry is in the public interest. The parties | ||||||
9 | may jointly request that the administrative law judge | ||||||
10 | consider a stipulated disposition of these proceedings. | ||||||
11 | (t) Review of Administrative Decisions. The Department | ||||||
12 | shall preserve a record of all proceedings at any formal | ||||||
13 | hearing conducted by the Department involving Health Care | ||||||
14 | Worker Registry hearings. Final administrative decisions of | ||||||
15 | the Department are subject to judicial review pursuant to | ||||||
16 | provisions of the Administrative Review Law. | ||||||
17 | (u) Quality Care Board. There is created, within the Office | ||||||
18 | of the Inspector General, a Quality Care Board to be composed | ||||||
19 | of 7 members appointed by the Governor with the advice and | ||||||
20 | consent of the Senate. One of the members shall be designated | ||||||
21 | as chairman by the Governor. Of the initial appointments made | ||||||
22 | by the Governor, 4 Board members shall each be appointed for a | ||||||
23 | term of 4 years and 3 members shall each be appointed for a | ||||||
24 | term of 2 years. Upon the expiration of each member's term, a | ||||||
25 | successor shall be appointed for a term of 4 years. In the case | ||||||
26 | of a vacancy in the office of any member, the Governor shall |
| |||||||
| |||||||
1 | appoint a successor for the remainder of the unexpired term. | ||||||
2 | Members appointed by the Governor shall be qualified by | ||||||
3 | professional knowledge or experience in the area of law, | ||||||
4 | investigatory techniques, or in the area of care of the | ||||||
5 | mentally ill or care of persons with developmental | ||||||
6 | disabilities. Two members appointed by the Governor shall be | ||||||
7 | persons with a disability or a parent of a person with a | ||||||
8 | disability. Members shall serve without compensation, but | ||||||
9 | shall be reimbursed for expenses incurred in connection with | ||||||
10 | the performance of their duties as members. | ||||||
11 | The Board shall meet quarterly, and may hold other meetings | ||||||
12 | on the call of the chairman. Four members shall constitute a | ||||||
13 | quorum allowing the Board to conduct its business. The Board | ||||||
14 | may adopt rules and regulations it deems necessary to govern | ||||||
15 | its own procedures. | ||||||
16 | The Board shall monitor and oversee the operations, | ||||||
17 | policies, and procedures of the Inspector General to ensure the | ||||||
18 | prompt and thorough investigation of allegations of neglect and | ||||||
19 | abuse. In fulfilling these responsibilities, the Board may do | ||||||
20 | the following: | ||||||
21 | (1) Provide independent, expert consultation to the | ||||||
22 | Inspector General on policies and protocols for | ||||||
23 | investigations of alleged abuse, neglect, or both abuse and | ||||||
24 | neglect. | ||||||
25 | (2) Review existing regulations relating to the | ||||||
26 | operation of facilities. |
| |||||||
| |||||||
1 | (3) Advise the Inspector General as to the content of | ||||||
2 | training activities authorized under this Section. | ||||||
3 | (4) Recommend policies concerning methods for | ||||||
4 | improving the intergovernmental relationships between the | ||||||
5 | Office of the Inspector General and other State or federal | ||||||
6 | offices. | ||||||
7 | (v) Annual report. The Inspector General shall provide to | ||||||
8 | the General Assembly and the Governor, no later than January 1 | ||||||
9 | of each year, a summary of reports and investigations made | ||||||
10 | under this Act for the prior fiscal year with respect to | ||||||
11 | individuals receiving mental health or developmental | ||||||
12 | disabilities services. The report shall detail the imposition | ||||||
13 | of sanctions, if any, and the final disposition of any | ||||||
14 | corrective or administrative action directed by the Secretary. | ||||||
15 | The summaries shall not contain any confidential or identifying | ||||||
16 | information of any individual, but shall include objective data | ||||||
17 | identifying any trends in the number of reported allegations, | ||||||
18 | the timeliness of the Office of the Inspector General's | ||||||
19 | investigations, and their disposition, for each facility and | ||||||
20 | Department-wide, for the most recent 3-year time period. The | ||||||
21 | report shall also identify, by facility, the staff-to-patient | ||||||
22 | ratios taking account of direct care staff only. The report | ||||||
23 | shall also include detailed recommended administrative actions | ||||||
24 | and matters for consideration by the General Assembly. | ||||||
25 | (w) Program audit. The Auditor General shall conduct a | ||||||
26 | program audit of the Office of the Inspector General on an |
| |||||||
| |||||||
1 | as-needed basis, as determined by the Auditor General. The | ||||||
2 | audit shall specifically include the Inspector General's | ||||||
3 | compliance with the Act and effectiveness in investigating | ||||||
4 | reports of allegations occurring in any facility or agency. The | ||||||
5 | Auditor General shall conduct the program audit according to | ||||||
6 | the provisions of the Illinois State Auditing Act and shall | ||||||
7 | report its findings to the General Assembly no later than | ||||||
8 | January 1 following the audit period.
| ||||||
9 | (x) Nothing in this Section shall be construed to mean that | ||||||
10 | an individual is a victim of abuse or neglect because of health | ||||||
11 | care services appropriately provided or not provided by health | ||||||
12 | care professionals. | ||||||
13 | (y) Nothing in this Section shall require a facility, | ||||||
14 | including its employees, agents, medical staff members, and | ||||||
15 | health care professionals, to provide a service to an | ||||||
16 | individual in contravention of that individual's stated or | ||||||
17 | implied objection to the provision of that service on the | ||||||
18 | ground that that service conflicts with the individual's | ||||||
19 | religious beliefs or practices, nor shall the failure to | ||||||
20 | provide a service to an individual be considered abuse under | ||||||
21 | this Section if the individual has objected to the provision of | ||||||
22 | that service based on his or her religious beliefs or | ||||||
23 | practices.
| ||||||
24 | (Source: P.A. 99-143, eff. 7-27-15; 99-323, eff. 8-7-15; | ||||||
25 | 99-642, eff. 7-28-16; 100-313, eff. 8-24-17; 100-432, eff. | ||||||
26 | 8-25-17; revised 9-27-17.)
|
| |||||||
| |||||||
1 | Section 10. The Mental Health and Developmental | ||||||
2 | Disabilities Administrative Act is amended by changing Section | ||||||
3 | 15.4 and by adding Section 18.8 as follows:
| ||||||
4 | (20 ILCS 1705/15.4)
| ||||||
5 | Sec. 15.4. Authorization for nursing delegation to permit | ||||||
6 | direct care
staff to
administer medications. | ||||||
7 | (a) This Section applies to (i) all residential programs | ||||||
8 | for persons
with a
developmental disability in settings of 16 | ||||||
9 | persons or fewer that are funded or
licensed by the Department | ||||||
10 | of Human
Services and that distribute or administer | ||||||
11 | medications, (ii) all
intermediate care
facilities for persons | ||||||
12 | with developmental disabilities with 16 beds or fewer that are
| ||||||
13 | licensed by the
Department of Public Health, and (iii) all day | ||||||
14 | programs certified to serve persons with developmental | ||||||
15 | disabilities by the Department of Human Services. The | ||||||
16 | Department of Human Services shall develop a
training program | ||||||
17 | for authorized direct care staff to administer
medications | ||||||
18 | under the
supervision and monitoring of a registered | ||||||
19 | professional nurse.
The training program for authorized direct | ||||||
20 | care staff shall include educational and oversight components | ||||||
21 | for staff who work in day programs that are similar to those | ||||||
22 | for staff who work in residential programs. This training | ||||||
23 | program shall be developed in consultation with professional
| ||||||
24 | associations representing (i) physicians licensed to practice |
| |||||||
| |||||||
1 | medicine in all
its branches, (ii) registered professional | ||||||
2 | nurses, and (iii) pharmacists.
| ||||||
3 | (b) For the purposes of this Section:
| ||||||
4 | "Authorized direct care staff" means non-licensed persons | ||||||
5 | who have
successfully completed a medication administration | ||||||
6 | training program
approved by the Department of Human Services | ||||||
7 | and conducted by a nurse-trainer.
This authorization is | ||||||
8 | specific to an individual receiving service in
a
specific | ||||||
9 | agency and does not transfer to another agency.
| ||||||
10 | "Medications" means oral and topical medications, insulin | ||||||
11 | in an injectable form, oxygen, epinephrine auto-injectors, and | ||||||
12 | vaginal and rectal creams and suppositories. "Oral" includes | ||||||
13 | inhalants and medications administered through enteral tubes, | ||||||
14 | utilizing aseptic technique. "Topical" includes eye, ear, and | ||||||
15 | nasal medications. Any controlled substances must be packaged | ||||||
16 | specifically for an identified individual. | ||||||
17 | "Insulin in an injectable form" means a subcutaneous | ||||||
18 | injection via an insulin pen pre-filled by the manufacturer. | ||||||
19 | Authorized direct care staff may administer insulin, as ordered | ||||||
20 | by a physician, advanced practice registered nurse, or | ||||||
21 | physician assistant, if: (i) the staff has successfully | ||||||
22 | completed a Department-approved advanced training program | ||||||
23 | specific to insulin administration developed in consultation | ||||||
24 | with professional associations listed in subsection (a) of this | ||||||
25 | Section, and (ii) the staff consults with the registered nurse, | ||||||
26 | prior to administration, of any insulin dose that is determined |
| |||||||
| |||||||
1 | based on a blood glucose test result. The authorized direct | ||||||
2 | care staff shall not: (i) calculate the insulin dosage needed | ||||||
3 | when the dose is dependent upon a blood glucose test result, or | ||||||
4 | (ii) administer insulin to individuals who require blood | ||||||
5 | glucose monitoring greater than 3 times daily, unless directed | ||||||
6 | to do so by the registered nurse. | ||||||
7 | "Nurse-training" means a registered professional nurse or | ||||||
8 | advanced practice registered nurse who has successfully | ||||||
9 | completed the Department's nurse-trainer training program and | ||||||
10 | is in possession of one year of clinical registered | ||||||
11 | professional nursing experience within the last 5 years, at | ||||||
12 | least 90 days of which shall preferably have been developmental | ||||||
13 | disabilities experience. | ||||||
14 | "Nurse-trainer training program" means a standardized, | ||||||
15 | competency-based
medication administration train-the-trainer | ||||||
16 | program provided by the
Department of Human Services and | ||||||
17 | conducted by a Department of Human
Services master | ||||||
18 | nurse-trainer for the purpose of training nurse-trainers to
| ||||||
19 | train persons employed or under contract to provide direct care | ||||||
20 | or
treatment to individuals receiving services to administer
| ||||||
21 | medications and provide self-administration of medication | ||||||
22 | training to
individuals under the supervision and monitoring of | ||||||
23 | the nurse-trainer. The
program incorporates adult learning | ||||||
24 | styles, teaching strategies, classroom
management, and a | ||||||
25 | curriculum overview, including the ethical and legal
aspects of | ||||||
26 | supervising those administering medications.
|
| |||||||
| |||||||
1 | "Self-administration of medications" means an individual | ||||||
2 | administers
his or her own medications. To be considered | ||||||
3 | capable to self-administer
their own medication, individuals | ||||||
4 | must, at a minimum, be able to identify
their medication by | ||||||
5 | size, shape, or color, know when they should take
the | ||||||
6 | medication, and know the amount of medication to be taken each | ||||||
7 | time.
| ||||||
8 | "Training program" means a standardized medication | ||||||
9 | administration
training program approved by the Department of | ||||||
10 | Human Services and
conducted by a registered professional nurse | ||||||
11 | for the purpose of training
persons employed or under contract | ||||||
12 | to provide direct care or treatment to
individuals receiving | ||||||
13 | services to administer medications
and provide | ||||||
14 | self-administration of medication training to individuals | ||||||
15 | under
the delegation and supervision of a nurse-trainer. The | ||||||
16 | program incorporates
adult learning styles, teaching | ||||||
17 | strategies, classroom management,
curriculum overview, | ||||||
18 | including ethical-legal aspects, and standardized
| ||||||
19 | competency-based evaluations on administration of medications | ||||||
20 | and
self-administration of medication training programs.
| ||||||
21 | (c) Training and authorization of non-licensed direct care | ||||||
22 | staff by
nurse-trainers must meet the requirements of this | ||||||
23 | subsection.
| ||||||
24 | (1) Prior to training non-licensed direct care staff to | ||||||
25 | administer
medication, the nurse-trainer shall perform the | ||||||
26 | following for each
individual to whom medication will be |
| |||||||
| |||||||
1 | administered by non-licensed
direct care staff:
| ||||||
2 | (A) An assessment of the individual's health | ||||||
3 | history and
physical and mental status.
| ||||||
4 | (B) An evaluation of the medications prescribed.
| ||||||
5 | (2) Non-licensed authorized direct care staff shall | ||||||
6 | meet the
following criteria:
| ||||||
7 | (A) Be 18 years of age or older.
| ||||||
8 | (B) Have completed high school or have a high | ||||||
9 | school equivalency certificate.
| ||||||
10 | (C) Have demonstrated functional literacy.
| ||||||
11 | (D) Have successfully completed the 40-hour | ||||||
12 | classroom training for direct care
staff required by | ||||||
13 | the Division of Developmental Disabilities | ||||||
14 | satisfactorily completed the Health and Safety
| ||||||
15 | component of a Department of Human Services authorized
| ||||||
16 | direct care staff training program .
| ||||||
17 | (E) Have successfully completed competency-based | ||||||
18 | training as provided in 59 Ill. Adm. Code 116.40(d) the | ||||||
19 | training program,
pass the written portion of the | ||||||
20 | comprehensive exam, and score
100% on the | ||||||
21 | competency-based assessment specific to the
individual | ||||||
22 | and his or her medications .
| ||||||
23 | (F) (Blank). Have received additional | ||||||
24 | competency-based assessment
by the nurse-trainer as | ||||||
25 | deemed necessary by the nurse-trainer
whenever a | ||||||
26 | change of medication occurs or a new individual
that |
| |||||||
| |||||||
1 | requires medication administration enters the program.
| ||||||
2 | (3) Authorized direct care staff shall be re-evaluated | ||||||
3 | by a
nurse-trainer at least annually or more frequently at | ||||||
4 | the discretion of
the registered professional nurse. Any | ||||||
5 | necessary retraining shall be
to the extent that is | ||||||
6 | necessary to ensure competency of the authorized
direct | ||||||
7 | care staff to administer medication.
| ||||||
8 | (4) Authorization of direct care staff to administer | ||||||
9 | medication
shall be revoked if, in the opinion of the | ||||||
10 | registered professional nurse,
the authorized direct care | ||||||
11 | staff is no longer competent to administer
medication.
| ||||||
12 | (5) The registered professional nurse shall assess an
| ||||||
13 | individual's health status at least annually or more | ||||||
14 | frequently at the
discretion of the registered | ||||||
15 | professional nurse.
| ||||||
16 | (d) Medication self-administration shall meet the | ||||||
17 | following
requirements:
| ||||||
18 | (1) As part of the normalization process, in order for | ||||||
19 | each
individual to attain the highest possible level of | ||||||
20 | independent
functioning, all individuals shall be | ||||||
21 | permitted to participate in their
total health care | ||||||
22 | program. This program shall include, but not be
limited to, | ||||||
23 | individual training in preventive health and | ||||||
24 | self-medication
procedures.
| ||||||
25 | (A) Every program shall adopt written policies and
| ||||||
26 | procedures for assisting individuals in obtaining |
| |||||||
| |||||||
1 | preventative
health and self-medication skills in | ||||||
2 | consultation with a
registered professional nurse, | ||||||
3 | advanced practice registered nurse,
physician | ||||||
4 | assistant, or physician licensed to practice medicine
| ||||||
5 | in all its branches.
| ||||||
6 | (B) Individuals shall be evaluated to determine | ||||||
7 | their
ability to self-medicate by the nurse-trainer | ||||||
8 | through the use of
the Department's required, | ||||||
9 | standardized screening and assessment
instruments.
| ||||||
10 | (C) When the results of the screening and | ||||||
11 | assessment
indicate an individual not to be capable to | ||||||
12 | self-administer his or her
own medications, programs | ||||||
13 | shall be developed in consultation
with the Community | ||||||
14 | Support Team or Interdisciplinary
Team to provide | ||||||
15 | individuals with self-medication
administration.
| ||||||
16 | (2) Each individual shall be presumed to be competent | ||||||
17 | to self-administer
medications if:
| ||||||
18 | (A) authorized by an order of a physician licensed | ||||||
19 | to
practice medicine in all its branches, an advanced | ||||||
20 | practice registered nurse, or a physician assistant; | ||||||
21 | and
| ||||||
22 | (B) approved to self-administer medication by the
| ||||||
23 | individual's Community Support Team or
| ||||||
24 | Interdisciplinary Team, which includes a registered
| ||||||
25 | professional nurse or an advanced practice registered | ||||||
26 | nurse.
|
| |||||||
| |||||||
1 | (e) Quality Assurance.
| ||||||
2 | (1) A registered professional nurse, advanced practice | ||||||
3 | registered nurse,
licensed practical nurse, physician | ||||||
4 | licensed to practice medicine in all
its branches, | ||||||
5 | physician assistant, or pharmacist shall review the
| ||||||
6 | following for all individuals:
| ||||||
7 | (A) Medication orders.
| ||||||
8 | (B) Medication labels, including medications | ||||||
9 | listed on
the medication administration record for | ||||||
10 | persons who are not
self-medicating to ensure the | ||||||
11 | labels match the orders issued by
the physician | ||||||
12 | licensed to practice medicine in all its branches,
| ||||||
13 | advanced practice registered nurse, or physician | ||||||
14 | assistant.
| ||||||
15 | (C) Medication administration records for persons | ||||||
16 | who
are not self-medicating to ensure that the records | ||||||
17 | are completed
appropriately for:
| ||||||
18 | (i) medication administered as prescribed;
| ||||||
19 | (ii) refusal by the individual; and
| ||||||
20 | (iii) full signatures provided for all | ||||||
21 | initials used.
| ||||||
22 | (2) Reviews shall occur at least quarterly, but may be | ||||||
23 | done
more frequently at the discretion of the registered | ||||||
24 | professional nurse
or advanced practice registered nurse.
| ||||||
25 | (3) A quality assurance review of medication errors and | ||||||
26 | data
collection for the purpose of monitoring and |
| |||||||
| |||||||
1 | recommending
corrective action shall be conducted within 7 | ||||||
2 | days and included in the
required annual review.
| ||||||
3 | (f) Programs using authorized direct care
staff to | ||||||
4 | administer medications are responsible for documenting and | ||||||
5 | maintaining
records
on the training that is completed.
| ||||||
6 | (g) The absence of this training program constitutes a | ||||||
7 | threat to the
public interest,
safety, and welfare and | ||||||
8 | necessitates emergency rulemaking by
the Departments of Human | ||||||
9 | Services and
Public Health
under Section 5-45
of
the
Illinois | ||||||
10 | Administrative Procedure Act.
| ||||||
11 | (h) Direct care staff who fail to qualify for delegated | ||||||
12 | authority to
administer medications pursuant to the provisions | ||||||
13 | of this Section shall be
given
additional education and testing | ||||||
14 | to meet criteria for
delegation authority to administer | ||||||
15 | medications.
Any direct care staff person who fails to qualify | ||||||
16 | as an authorized direct care
staff
after initial training and | ||||||
17 | testing must within 3 months be given another
opportunity for | ||||||
18 | retraining and retesting. A direct care staff person who fails
| ||||||
19 | to
meet criteria for delegated authority to administer | ||||||
20 | medication, including, but
not limited to, failure of the | ||||||
21 | written test on 2 occasions shall be given
consideration for | ||||||
22 | shift transfer or reassignment, if possible. No employee
shall | ||||||
23 | be terminated for failure to qualify during the 3-month time | ||||||
24 | period
following initial testing. Refusal to complete training | ||||||
25 | and testing required
by this Section may be grounds for | ||||||
26 | immediate dismissal.
|
| |||||||
| |||||||
1 | (i) No authorized direct care staff person delegated to | ||||||
2 | administer
medication shall be subject to suspension or | ||||||
3 | discharge for errors
resulting from the staff
person's acts or | ||||||
4 | omissions when performing the functions unless the staff
| ||||||
5 | person's actions or omissions constitute willful and wanton | ||||||
6 | conduct.
Nothing in this subsection is intended to supersede | ||||||
7 | paragraph (4) of subsection
(c).
| ||||||
8 | (j) A registered professional nurse, advanced practice | ||||||
9 | registered nurse,
physician licensed to practice medicine in | ||||||
10 | all its branches, or physician
assistant shall be on
duty or
on | ||||||
11 | call at all times in any program covered by this Section.
| ||||||
12 | (k) The employer shall be responsible for maintaining | ||||||
13 | liability insurance
for any program covered by this Section.
| ||||||
14 | (l) Any direct care staff person who qualifies as | ||||||
15 | authorized direct care
staff pursuant to this Section shall be | ||||||
16 | granted consideration for a one-time
additional
salary | ||||||
17 | differential. The Department shall determine and provide the | ||||||
18 | necessary
funding for
the differential in the base. This | ||||||
19 | subsection (l) is inoperative on and after
June 30, 2000.
| ||||||
20 | (Source: P.A. 99-78, eff. 7-20-15; 99-143, eff. 7-27-15; | ||||||
21 | 99-581, eff. 1-1-17; 100-50, eff. 1-1-18; 100-513, eff. 1-1-18; | ||||||
22 | revised 9-22-17.)
| ||||||
23 | (20 ILCS 1705/18.8 new) | ||||||
24 | Sec. 18.8. Streamlined Department oversight. Within one | ||||||
25 | year after the effective date of this amendatory Act of the |
| |||||||
| |||||||
1 | 100th General Assembly, the Department shall prepare a report | ||||||
2 | that identifies any efficiencies or improvements in Department | ||||||
3 | operations, the oversight of agencies, and the reduction or | ||||||
4 | elimination of duplicative activities. The report shall | ||||||
5 | include a quality assessment of the feasibility of combining | ||||||
6 | the functions of the Division of Developmental Disabilities' | ||||||
7 | Bureau of Quality Management and the Department's Bureau of | ||||||
8 | Accreditation, Licensure, and Certification. Upon the report's | ||||||
9 | completion, the Department shall post the report on the | ||||||
10 | Department's website and submit the report to the General | ||||||
11 | Assembly and Governor. | ||||||
12 | Section 15. The Community-Integrated Living Arrangements | ||||||
13 | Licensure and
Certification Act is amended by changing Section | ||||||
14 | 4 and by adding Section 9.3 as follows:
| ||||||
15 | (210 ILCS 135/4) (from Ch. 91 1/2, par. 1704)
| ||||||
16 | Sec. 4.
(a) Any community mental health or developmental | ||||||
17 | services agency who
wishes to develop and support a variety of | ||||||
18 | community-integrated living
arrangements may do so pursuant to | ||||||
19 | a license issued by the Department under this Act.
However, | ||||||
20 | programs established under or otherwise subject to the Child
| ||||||
21 | Care Act of 1969, the Nursing Home Care Act, the Specialized | ||||||
22 | Mental Health Rehabilitation Act of 2013, the ID/DD Community | ||||||
23 | Care Act, or the MC/DD Act, as now or
hereafter amended, shall | ||||||
24 | remain
subject thereto, and this Act shall not be construed to |
| |||||||
| |||||||
1 | limit the
application of those Acts.
| ||||||
2 | (b) The system of licensure established under this Act | ||||||
3 | shall be for the purposes of:
| ||||||
4 | (1) ensuring Insuring that all recipients residing in | ||||||
5 | community-integrated living
arrangements are receiving | ||||||
6 | appropriate community-based services, including
treatment, | ||||||
7 | training and habilitation or rehabilitation;
| ||||||
8 | (2) ensuring Insuring that recipients' rights are | ||||||
9 | protected and that all programs
provided to and placements | ||||||
10 | arranged for
recipients comply with this Act, the Mental | ||||||
11 | Health and Developmental
Disabilities Code, and applicable | ||||||
12 | Department rules and regulations;
| ||||||
13 | (3) maintaining Maintaining the integrity of | ||||||
14 | communities by requiring regular
monitoring and inspection | ||||||
15 | of placements and other services provided in
| ||||||
16 | community-integrated living arrangements.
| ||||||
17 | The licensure system shall be administered by a quality | ||||||
18 | assurance unit
within the Department which shall be | ||||||
19 | administratively independent of units
responsible for funding | ||||||
20 | of agencies or community services.
| ||||||
21 | (c) As a condition of being licensed by the Department as a | ||||||
22 | community
mental health or developmental services agency under | ||||||
23 | this Act, the agency
shall certify to the Department that:
| ||||||
24 | (1) all All recipients residing in | ||||||
25 | community-integrated living arrangements
are receiving | ||||||
26 | appropriate community-based services, including treatment,
|
| |||||||
| |||||||
1 | training and habilitation or rehabilitation;
| ||||||
2 | (2) all All programs provided to and placements | ||||||
3 | arranged for recipients are
supervised by the agency; and
| ||||||
4 | (3) all All programs provided to and placements | ||||||
5 | arranged for recipients
comply with this Act, the Mental | ||||||
6 | Health and Developmental Disabilities
Code, and applicable | ||||||
7 | Department rules and regulations.
| ||||||
8 | (d) An applicant for licensure as a community mental health | ||||||
9 | or
developmental services agency under this Act shall submit an | ||||||
10 | application
pursuant to the application process established by | ||||||
11 | the Department by rule
and shall pay an application fee in an | ||||||
12 | amount established by the
Department, which amount shall not be | ||||||
13 | more than $200.
| ||||||
14 | (e) If an applicant meets the requirements established by | ||||||
15 | the Department
to be licensed as a community mental health or | ||||||
16 | developmental services
agency under this Act, after payment of | ||||||
17 | the licensing fee, the Department
shall issue a license valid | ||||||
18 | for 3 years from the date thereof unless
suspended or revoked | ||||||
19 | by the Department or voluntarily surrendered by the agency.
| ||||||
20 | (f) Upon application to the Department, the Department may | ||||||
21 | issue a
temporary permit to an applicant for up to a 2-year | ||||||
22 | period to allow the holder
of such permit reasonable time to | ||||||
23 | become eligible for a license under this Act.
| ||||||
24 | (g)(1) The Department may conduct site visits to an agency | ||||||
25 | licensed under this
Act, or to any program or placement | ||||||
26 | certified by the agency, and inspect
the records or premises, |
| |||||||
| |||||||
1 | or both, of such agency, program or placement as
it deems | ||||||
2 | appropriate, for the
purpose of determining compliance with | ||||||
3 | this Act, the Mental Health and
Developmental Disabilities | ||||||
4 | Code, and applicable Department rules and regulations. The | ||||||
5 | Department shall conduct inspections of the records and | ||||||
6 | premises of each community-integrated living arrangement | ||||||
7 | certified under this Act at least once every 2 years.
| ||||||
8 | (2) If the Department determines that an agency licensed | ||||||
9 | under this Act
is not in compliance with this Act or the rules | ||||||
10 | and regulations promulgated
under this Act, the Department | ||||||
11 | shall serve a notice of violation
upon the licensee. Each | ||||||
12 | notice of violation shall be prepared in writing
and shall | ||||||
13 | specify the nature of the violation, the statutory provision or
| ||||||
14 | rule alleged to have been violated, and that the licensee
| ||||||
15 | submit a plan of correction to the Department if required. The | ||||||
16 | notice shall also
inform the licensee of any other action which | ||||||
17 | the Department might take
pursuant to this Act and of the right | ||||||
18 | to a hearing.
| ||||||
19 | (g-5) As determined by the Department, a disproportionate | ||||||
20 | number or percentage of licensure complaints; a | ||||||
21 | disproportionate number or percentage of substantiated cases | ||||||
22 | of abuse, neglect, or exploitation involving an agency; an | ||||||
23 | apparent unnatural death of an individual served by an agency; | ||||||
24 | any egregious or life-threatening abuse or neglect within an | ||||||
25 | agency; or any other significant event as determined by the | ||||||
26 | Department shall initiate a review of the agency's license by |
| |||||||
| |||||||
1 | the Department, as well as a review of its service agreement | ||||||
2 | for funding. The Department shall adopt rules to establish the | ||||||
3 | process by which the determination to initiate a review shall | ||||||
4 | be made and the timeframe to initiate a review upon the making | ||||||
5 | of such determination. | ||||||
6 | (g-6) Using contemporary data gathered on reports of | ||||||
7 | allegations of abuse, neglect, and financial exploitation, the | ||||||
8 | Department shall establish a process by which the Department | ||||||
9 | requires responses from agencies that annually report a number | ||||||
10 | of allegations that are 2 or more standard deviations from the | ||||||
11 | mean for all agencies. | ||||||
12 | (h) Upon the expiration of any license issued under this | ||||||
13 | Act, a license
renewal application shall be required of and a | ||||||
14 | license renewal fee in an
amount established by the Department | ||||||
15 | shall be
charged to a community mental health or
developmental | ||||||
16 | services agency, provided that such fee shall not be more than | ||||||
17 | $200.
| ||||||
18 | (i) A public or private agency, association, partnership, | ||||||
19 | corporation, or organization that has had a license revoked | ||||||
20 | under subsection (b) of Section 6 of this Act may not apply for | ||||||
21 | or possess a license under a different name. | ||||||
22 | (Source: P.A. 99-180, eff. 7-29-15; 100-58, eff. 8-11-17; | ||||||
23 | 100-313, eff. 8-24-17; revised 9-28-17.)
| ||||||
24 | (210 ILCS 135/9.3 new) | ||||||
25 | Sec. 9.3. Emergency closure of a community-integrated |
| |||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||
1 | living arrangement due to inadequate staffing. If an agency has | ||||||||||||||||||||||||||||||||||||||||||||||||||
2 | documented evidence and has determined that the agency cannot | ||||||||||||||||||||||||||||||||||||||||||||||||||
3 | adequately staff a community-integrated living arrangement, | ||||||||||||||||||||||||||||||||||||||||||||||||||
4 | then the agency may take immediate steps to close the | ||||||||||||||||||||||||||||||||||||||||||||||||||
5 | community-integrated living arrangement. The agency shall work | ||||||||||||||||||||||||||||||||||||||||||||||||||
6 | with the Department under established processes and procedures | ||||||||||||||||||||||||||||||||||||||||||||||||||
7 | to ensure residents at the closing of the community-integrated | ||||||||||||||||||||||||||||||||||||||||||||||||||
8 | living arrangement receive services at another | ||||||||||||||||||||||||||||||||||||||||||||||||||
9 | community-integrated living arrangement or through another | ||||||||||||||||||||||||||||||||||||||||||||||||||
10 | agency.
| ||||||||||||||||||||||||||||||||||||||||||||||||||
11 | Section 99. Effective date. This Act takes effect upon | ||||||||||||||||||||||||||||||||||||||||||||||||||
12 | becoming law.
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