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91_HB0182eng HB0182 Engrossed LRB9100213WHmg 1 AN ACT to amend certain Acts in relation to mental 2 health. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Illinois Act on the Aging is amended by 6 changing Section 4.04 as follows: 7 (20 ILCS 105/4.04) (from Ch. 23, par. 6104.04) 8 Sec. 4.04. Long Term Care Ombudsman Program. 9 (a) Long Term Care Ombudsman Program. The Department 10 shall establish a Long Term Care Ombudsman Program, through 11 the Office of State Long Term Care Ombudsman ("the Office"), 12 in accordance with the provisions of the Older Americans Act 13 of 1965, as now or hereafter amended. 14 (b) Definitions. As used in this Section, unless the 15 context requires otherwise: 16 (1) "Access" has the same meaning as in Section 17 1-104 of the Nursing Home Care Act, as now or hereafter 18 amended; that is, it means the right to: 19 (i) Enter any long term care facility; 20 (ii) Communicate privately and without 21 restriction with any resident who consents to the 22 communication; 23 (iii) Seek consent to communicate privately 24 and without restriction with any resident; 25 (iv) Inspect the clinical and other records of 26 a resident with the express written consent of the 27 resident; 28 (v) Observe all areas of the long term care 29 facility except the living area of any resident who 30 protests the observation. 31 (2) "Long Term Care Facility" means any facility as HB0182 Engrossed -2- LRB9100213WHmg 1 defined by Section 1-113 of the Nursing Home Care Act, as 2 now or hereafter amended. 3 (3) "Ombudsman" means any person employed by the 4 Department to fulfill the requirements of the Office, or 5 any representative of a sub-State long term care 6 ombudsman program; provided that the representative, 7 whether he is paid for or volunteers his ombudsman 8 services, shall be qualified and authorized by the 9 Department to perform the duties of an ombudsman as 10 specified by the Department in rules. 11 (c) Ombudsman; rules. The Office of State Long Term Care 12 Ombudsman shall be composed of at least one full-time 13 ombudsman within the Department and shall include a system of 14 designated sub-State long term care ombudsman programs. Each 15 sub-State program shall be designated by the Department as a 16 subdivision of the Office and any representative of a 17 sub-State program shall be treated as a representative of the 18 Office. 19 The Department shall promulgate administrative rules to 20 establish the responsibilities of the Department and the 21 Office of State Long Term Care Ombudsman. The administrative 22 rules shall include the responsibility of the Office to 23 investigate and resolve complaints made by or on behalf of 24 residents of long term care facilities relating to actions, 25 inaction, or decisions of providers, or their 26 representatives, of long term care facilities, of public 27 agencies, or of social services agencies, which may adversely 28 affect the health, safety, welfare, or rights of such 29 residents. When necessary and appropriate, representatives of 30 the Office shall refer complaints to the appropriate 31 regulatory State agency. The Department shall cooperate with 32 the Department of Human Services in providing information and 33 training to designated sub-State long term care ombudsman 34 programs about the appropriate assessment and treatment HB0182 Engrossed -3- LRB9100213WHmg 1 (including information about appropriate supportive services, 2 treatment options, and assessment of rehabilitation 3 potential) of persons with mental illness (other than 4 Alzheimer's disease and related disorders). 5 (d) Access and visitation rights. 6 (1) In accordance with subparagraphs (A) and (E) of 7 paragraph (3) of subsection (c) of Section 1819 and 8 subparagraphs (A) and (E) of paragraph (3) of subsection 9 (c) of Section 1919 of the Social Security Act, as now or 10 hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) 11 and 42 U.S.C. 1396r-3 (c)(3)(A) and (E)), and Section 12 307(a)(12) of the Older Americans Act of 1965, as now or 13 hereafter amended, a long term care facility must: 14 (i) permit immediate access to any resident by 15 an ombudsman; and 16 (ii) permit representatives of the Office, 17 with the permission of the resident's legal 18 representative or legal guardian, to examine a 19 resident's clinical and other records, and if a 20 resident is unable to consent to such review, and 21 has no legal guardian, permit representatives of the 22 Office appropriate access, as defined by the 23 Department in administrative rules, to the 24 resident's records. 25 (2) Each long term care facility shall display, in 26 multiple, conspicuous public places within the facility 27 accessible to both visitors and patients and in an easily 28 readable format, the address and phone number of the 29 Office, in a manner prescribed by the Office. 30 (e) Immunity. An ombudsman or any other representative 31 of the Office participating in the good faith performance of 32 his or her official duties shall have immunity from any 33 liability (civil, criminal or otherwise) in any proceedings 34 (civil, criminal or otherwise) brought as a consequence of HB0182 Engrossed -4- LRB9100213WHmg 1 the performance of his official duties. 2 (f) Business offenses. 3 (1) No person shall: 4 (i) Intentionally prevent, interfere with, or 5 attempt to impede in any way any representative of 6 the Office in the performance of his official duties 7 under this Act and the Older Americans Act of 1965; 8 or 9 (ii) Intentionally retaliate, discriminate 10 against, or effect reprisals against any long term 11 care facility resident or employee for contacting or 12 providing information to any representative of the 13 Office. 14 (2) A violation of this Section is a business 15 offense, punishable by a fine not to exceed $501. 16 (3) The Director of Aging shall notify the State's 17 Attorney of the county in which the long term care 18 facility is located, or the Attorney General, of any 19 violations of this Section. 20 (g) Confidentiality of records and identities. No files 21 or records maintained by the Office of State Long Term Care 22 Ombudsman shall be disclosed unless the State Ombudsman or 23 the ombudsman having the authority over the disposition of 24 such files authorizes the disclosure in writing. The 25 ombudsman shall not disclose the identity of any complainant, 26 resident, witness or employee of a long term care provider 27 involved in a complaint or report unless such person or such 28 person's guardian or legal representative consents in writing 29 to the disclosure, or the disclosure is required by court 30 order. 31 (h) Legal representation. The Attorney General shall 32 provide legal representation to any representative of the 33 Office against whom suit or other legal action is brought in 34 connection with the performance of the representative's HB0182 Engrossed -5- LRB9100213WHmg 1 official duties, in accordance with "An Act to provide for 2 representation and indemnification in certain civil law 3 suits", approved December 3, 1977, as now or hereafter 4 amended. 5 (i) Treatment by prayer and spiritual means. Nothing in 6 this Act shall be construed to authorize or require the 7 medical supervision, regulation or control of remedial care 8 or treatment of any resident in a long term care facility 9 operated exclusively by and for members or adherents of any 10 church or religious denomination the tenets and practices of 11 which include reliance solely upon spiritual means through 12 prayer for healing. 13 (Source: P.A. 90-639, eff. 1-1-99.) 14 Section 10. The Mental Health and Developmental 15 Disabilities Administrative Act is amended by changing 16 Sections 4, 4.3, 7, and 15 as follows: 17 (20 ILCS 1705/4) (from Ch. 91 1/2, par. 100-4) 18 Sec. 4. Supervision of facilities and services; 19 quarterly reports. 20 (a) To exercise executive and administrative supervision 21 over all facilities, divisions, programs and services now 22 existing or hereafter acquired or created under the 23 jurisdiction of the Department, including, but not limited 24 to, the following: 25 The Alton Mental Health Center, at Alton 26 The Clyde L. Choate Mental Health and Developmental 27 Center, at Anna 28 The Chester Mental Health Center, at Chester 29 The Chicago-Read Mental Health Center, at Chicago 30 The Elgin Mental Health Center, at Elgin 31 The Metropolitan Children and Adolescents Center, at 32 Chicago HB0182 Engrossed -6- LRB9100213WHmg 1 The Jacksonville Developmental Center, at 2 Jacksonville 3 The Governor Samuel H. Shapiro Developmental Center, 4 at Kankakee 5 The Tinley Park Mental Health Center, at Tinley Park 6 The Warren G. Murray Developmental Center, at 7 Centralia 8 The Jack Mabley Developmental Center, at Dixon 9 The Lincoln Developmental Center, at Lincoln 10 The H. Douglas Singer Mental Health and 11 Developmental Center, at Rockford 12 The John J. Madden Mental Health Center, at Chicago 13 The George A. Zeller Mental Health Center, at Peoria 14 The Andrew McFarland Mental Health Center, at 15 Springfield 16 The Adolf Meyer Mental Health Center, at Decatur 17 The William W. Fox Developmental Center, at Dwight 18 The Elisabeth Ludeman Developmental Center, at Park 19 Forest 20 The William A. Howe Developmental Center, at Tinley 21 Park 22 The Ann M. Kiley Developmental Center, at Waukegan. 23 (b) Beginning not later than July 1, 1977, the 24 Department shall cause each of the facilities under its 25 jurisdiction which provide in-patient care to comply with 26 standards, rules and regulations of the Department of Public 27 Health prescribed under Section 6.05 of the"Hospital 28 Licensing Act", approved July 1, 1953, as amended. 29 (c) The Department shall issue quarterly reports on 30 admissions, deflections, discharges, bed closures, 31 staff-resident ratios, census, average length of stay, and 32 any adverse federal certification or accreditation findings, 33 if any, for each State-operated facility for the mentally ill 34 and developmentally disabled. HB0182 Engrossed -7- LRB9100213WHmg 1 (Source: P.A. 87-447; 89-439, eff. 6-1-96; revised 10-31-98.) 2 (20 ILCS 1705/4.3) (from Ch. 91 1/2, par. 100-4.3) 3 Sec. 4.3. Site visits and inspections. 4 (a) Each facility under the jurisdiction of the 5 Department shall be subject to a site visit at least once 6 during each 12-month periodbiennium by the Citizens Council7on Mental Health and Developmental Disabilities as provided8in Section 11A-7 of the Legislative Commission Reorganization9Act of 1984, as now or hereafter amended. 10 (b) The Department shall establish a system of annual 11 on-site inspections of each facility under its jurisdiction. 12 The inspections shall be conducted by the Department 13Department's central officeto: 14 (1) Determine facility compliance with the statutes 15 relating to patient care and the Department policies and 16 procedures; 17 (2) Determine facility compliance with audit 18 recommendations; 19 (3) Evaluate facility compliance with applicable federal 20 standards; 21 (4) Review and follow up on complaints made by 22 legislators, community mental health organizationsagencies23 and advocates, and on findings of the Human Rights Authority 24 division of the Guardianship and Advocacy Commission; and 25 (5) Review administrative and management problems 26 identified by other sources. 27 (c) Before January 30 of each even-numbered year, the 28 Auditor General shall, with the advice of the Department, 29 certify at least 3 non-profit organizations whose primary 30 purpose is to improve the quality of mental health care in 31 State-operated facilities. The certified organization shall 32 ensure that those persons who have access under this Section 33 comply with all statutory and regulatory provisions governing HB0182 Engrossed -8- LRB9100213WHmg 1 recipients' rights, confidentiality, privacy, and safety and 2 that any individual who fails to comply shall not be 3 permitted to continue to participate in assessments. The 4 certified organization shall ensure that individuals shall 5 not be permitted to participate in assessments at any 6 facility at which their presence would conflict with a 7 recipient's right to refuse contact with those individuals. 8 Those organizations shall have access to all the 9 State-operated facilities pursuant to the rules governing the 10 functions of the Inspector General as authorized under the 11 Abused and Neglected Long Term Care Facility Residents 12 Reporting Act. The purpose of the access is to ensure there 13 will be independent assessments for each State-operated 14 facility, not to exceed 4 per year for each facility. 15 However, additional visits may be carried out upon the 16 notification of a specific complaint. The access shall 17 exclude all patient records unless the recipient has 18 permitted the examination of his or her records under the 19 Mental Health and Developmental Disabilities Confidentiality 20 Act. 21 The Department shall adopt rules for certifying the 22 organizations and for establishing reasonable standards and 23 procedures for determining whether the organizations seeking 24 certification provide appropriate training and supervision to 25 those persons who will have access under the statute. 26 The reports of the assessments shall be provided to the 27 Department, to the Speaker of the House of Representatives, 28 the President of the Senate, the Minority Leader of the 29 Senate, the Minority Leader of the House of Representatives, 30 and to others that the organizations may determine. Under no 31 circumstances shall certification or access be denied due to 32 a disagreement by the Department with any positions taken by 33 the organizations with regard to public policy, legislation, 34 regulation, or litigation concerning mental health services, HB0182 Engrossed -9- LRB9100213WHmg 1 the operation of, or the quality of care provided by the 2 Department or any mental health provider. The Department 3 shall adopt rules establishing standards and procedures for 4 internal review of any decision denying or terminating access 5 to any organization, including review by the Director or his 6 or her designee. Any organization denied access under this 7 statute by an administrative decision of the Director or his 8 or her designee may have that decision reviewed under the 9 Administrative Review Act. 10 The assessments shall be conducted by the certified 11 organizations at no charge. 12 (Source: P.A. 86-1013.) 13 (20 ILCS 1705/7) (from Ch. 91 1/2, par. 100-7) 14 Sec. 7. To receive and provide the highest possible 15 quality of humane and rehabilitative care and treatment to 16 all persons admitted or committed or transferred in 17 accordance with law to the facilities, divisions, programs, 18 and services under the jurisdiction of the Department. No 19 resident of another state shall be received or retained to 20 the exclusion of any resident of this State. No resident of 21 another state shall be received or retained to the exclusion 22 of any resident of this State. All recipients of 17 years of 23 age and under in residence in a Department facility other 24 than a facility for the care of the mentally retarded shall 25 be housed in quarters separated from older recipients except 26 for: (a) recipients who are placed in medical-surgical units 27 because of physical illness; and (b) recipients between 13 28 and 18 years of age who need temporary security measures. 29 All recipients in a Department facility shall be given a 30 dental examination by a licensed dentist or registered dental 31 hygienist at least once every 18 months and shall be assigned 32 to a dentist for such dental care and treatment as is 33 necessary. HB0182 Engrossed -10- LRB9100213WHmg 1 All medications administered to recipients shall be 2 administered only by those persons who are legally qualified 3 to do so by the laws of the State of Illinois. Medication 4 shall not be prescribed until a physical and mental 5 examination of the recipient has been completed. If, in the 6 clinical judgment of a physician, it is necessary to 7 administer medication to a recipient before the completion of 8 the physical and mental examination, he may prescribe such 9 medication but he must file a report with the facility 10 director setting forth the reasons for prescribing such 11 medication within 24 hours of the prescription. A copy of the 12 report shall be part of the recipient's record. 13 No later than January 1, 2000, the Department shall adopt 14 a model protocol and forms for recording all patient 15 diagnosis, care, and treatment at every facility under the 16 jurisdiction of the Department. The model protocol and forms 17 shall be used by each facility unless the Department 18 determines that equivalent alternatives justify an exemption. 19 Every facility under the jurisdiction of the Department 20 shall maintain a copy of each report of suspected abuse or 21 neglect of the patient. Copies of those reports shall be made 22 available to the State Auditor General in connection with his 23 biennial program audit of the facility as required by Section 24 3-2 of the Illinois State Auditing Act. 25 No later than January 1, 2000, every facility under the 26 jurisdiction of the Department and all services provided in 27 those facilities shall comply with all of the applicable 28 standards adopted by the Social Security Administration under 29 Subchapter XVIII (Medicare) of the Social Security Act (42 30 U.S.C. 1395 - 1395ccc), if the facility and services may be 31 eligible for federal financial participation under that 32 federal law. 33 (Source: P.A. 86-922; 86-1013; 86-1475.) HB0182 Engrossed -11- LRB9100213WHmg 1 (20 ILCS 1705/15) (from Ch. 91 1/2, par. 100-15) 2 Sec. 15. Before any person is released from a facility 3 operated by the State pursuant to an absolute discharge or a 4 conditional discharge from hospitalization under this Act, 5 the facility director of the facility in which such person is 6 hospitalized shall determine that such person is not 7 currently in need of hospitalization and: 8 (a) is able to live independently in the community; 9 or 10 (b) requires further oversight and supervisory care 11 for which arrangements have been made with responsible 12 relatives or supervised residential program approved by 13 the Department; or 14 (c) requires further personal care or general 15 oversight as defined by the Nursing Home Care Act, for 16 which placement arrangements have been made with a 17 suitable family home or other licensed facility approved 18 by the Department under this Section; or 19 (d) requires community mental health services for 20 which arrangements have been made with a suitable 21 community mental health provider in accordance with 22 criteria, standards, and procedures promulgated by rule. 23 Such determination shall be made in writing and shall 24 become a part of the facility record of such absolutely or 25 conditionally discharged person. When the determination 26 indicates that the condition of the person to be granted an 27 absolute discharge or a conditional discharge is described 28 under subparagraph (c) or (d) of this Section, the name and 29 address of the continuing care facility or home to which such 30 person is to be released shall be entered in the facility 31 record. Where a discharge from a mental health facility is 32 made under subparagraph (c), the Department shall assign the 33 person so discharged to an existing community based 34 not-for-profit agency for participation in day activities HB0182 Engrossed -12- LRB9100213WHmg 1 suitable to the person's needs, such as but not limited to 2 social and vocational rehabilitation, and other recreational, 3 educational and financial activities unless the community 4 based not-for-profit agency is unqualified to accept such 5 assignment. Where the clientele of any not-for-profit agency 6 increases as a result of assignments under this amendatory 7 Act of 1977 by more than 3% over the prior year, the 8 Department shall fully reimburse such agency for the costs of 9 providing services to such persons in excess of such 3% 10 increase. The Department shall keep written records detailing 11 how many persons have been assigned to a community based 12 not-for-profit agency and how many persons were not so 13 assigned because the community based agency was unqualified 14 to accept the assignments, in accordance with criteria, 15 standards, and procedures promulgated by rule. Whenever a 16 community based agency is found to be unqualified, the name 17 of the agency and the reason for the finding shall be 18 included in the report. 19 Insofar as desirable in the interests of the former 20 recipient, the facility, program or home in which the 21 discharged person is to be placed shall be located in or near 22 the community in which the person resided prior to 23 hospitalization or in the community in which the person's 24 family or nearest next of kin presently reside. Placement of 25 the discharged person in facilities, programs or homes 26 located outside of this State shall not be made by the 27 Department unless there are no appropriate facilities, 28 programs or homes available within this State. Out-of-state 29 placements shall be subject to return of recipients so placed 30 upon the availability of facilities, programs or homes within 31 this State to accommodate these recipients, except where 32 placement in a contiguous state results in locating a 33 recipient in a facility or program closer to the recipient's 34 home or family. If an appropriate facility or program HB0182 Engrossed -13- LRB9100213WHmg 1 becomes available equal to or closer to the recipient's home 2 or family, the recipient shall be returned to and placed at 3 the appropriate facility or program within this State. 4 To place any person who is under a program of the 5 Department at board in a suitable family home or in such 6 other facility or program as the Department may consider 7 desirable. The Department may place in licensed nursing 8 homes, sheltered care homes, or homes for the aged those 9 persons whose behavioral manifestations and medical and 10 nursing care needs are such as to be substantially 11 indistinguishable from persons already living in such 12 facilities. Prior to any placement by the Department under 13 this Section, a determination shall be made by the personnel 14 of the Department, as to the capability and suitability of 15 such facility to adequately meet the needs of the person to 16 be discharged. When specialized programs are necessary in 17 order to enable persons in need of supervised living to 18 develop and improve in the community, the Department shall 19 place such persons only in specialized residential care 20 facilities which shall meet Department standards including 21 restricted admission policy, special staffing and programming 22 for social and vocational rehabilitation, in addition to the 23 requirements of the appropriate State licensing agency. The 24 Department shall not place any new person in a facility the 25 license of which has been revoked or not renewed on grounds 26 of inadequate programming, staffing, or medical or adjunctive 27 services, regardless of the pendency of an action for 28 administrative review regarding such revocation or failure to 29 renew. Before the Department may transfer any person to a 30 licensed nursing home, sheltered care home or home for the 31 aged or place any person in a specialized residential care 32 facility the Department shall notify the person to be 33 transferred, or a responsible relative of such person, in 34 writing, at least 30 days before the proposed transfer, with HB0182 Engrossed -14- LRB9100213WHmg 1 respect to all the relevant facts concerning such transfer, 2 except in cases of emergency when such notice is not 3 required. If either the person to be transferred or a 4 responsible relative of such person objects to such transfer, 5 in writing to the Department, at any time after receipt of 6 notice and before the transfer, the facility director of the 7 facility in which the person was a recipient shall 8 immediately schedule a hearing at the facility with the 9 presence of the facility director, the person who objected to 10 such proposed transfer, and a psychiatrist who is familiar 11 with the record of the person to be transferred. Such person 12 to be transferred or a responsible relative may be 13 represented by such counsel or interested party as he may 14 appoint, who may present such testimony with respect to the 15 proposed transfer. Testimony presented at such hearing shall 16 become a part of the facility record of the 17 person-to-be-transferred. The record of testimony shall be 18 held in the person-to-be-transferred's record in the central 19 files of the facility. If such hearing is held a transfer may 20 only be implemented, if at all, in accordance with the 21 results of such hearing. Within 15 days after such hearing 22 the facility director shall deliver his findings based on the 23 record of the case and the testimony presented at the 24 hearing, by registered or certified mail, to the parties to 25 such hearing. The findings of the facility director shall be 26 deemed a final administrative decision of the Department. For 27 purposes of this Section, "case of emergency" means those 28 instances in which the health of the person to be transferred 29 is imperiled and the most appropriate mental health care or 30 medical care is available at a licensed nursing home, 31 sheltered care home or home for the aged or a specialized 32 residential care facility. 33 Prior to placement of any person in a facility under this 34 Section the Department shall ensure that an appropriate HB0182 Engrossed -15- LRB9100213WHmg 1 training plan for staff is provided by the facility. Said 2 training may include instruction and demonstration by 3 Department personnel qualified in the area of mental illness 4 or mental retardation, as applicable to the person to be 5 placed. Training may be given both at the facility from 6 which the recipient is transferred and at the facility 7 receiving the recipient, and may be available on a continuing 8 basis subsequent to placement. In a facility providing 9 services to former Department recipients, training shall be 10 available as necessary for facility staff. Such training 11 will be on a continuing basis as the needs of the facility 12 and recipients change and further training is required. 13 The Department shall not place any person in a facility 14 which does not have appropriately trained staff in sufficient 15 numbers to accommodate the recipient population already at 16 the facility. As a condition of further or future placements 17 of persons, the Department shall require the employment of 18 additional trained staff members at the facility where said 19 persons are to be placed. The Secretary, or his or her 20 designate, shall establish written guidelines for placement 21 of persons in facilities under this Act. The Department shall 22 keep written records detailing which facilities have been 23 determined to have appropriately trained staff, which 24 facilities have been determined not to have such staff, and 25 all training which it has provided or required under this 26 Section. 27 Bills for the support for a person boarded out shall be 28 payable monthly out of the proper maintenance funds and shall 29 be audited as any other accounts of the Department. If a 30 person is placed in a facility or program outside the 31 Department, the Department may pay the actual costs of 32 residence, treatment or maintenance in such facility and may 33 collect such actual costs or a portion thereof from the 34 recipient or the estate of a person placed in accordance with HB0182 Engrossed -16- LRB9100213WHmg 1 this Section. 2 Other than those placed in a family home the Department 3 shall cause all persons who are placed in a facility, as 4 defined by the Nursing Home Care Act, or in designated 5 community living situations or programs, to be visited at 6 least once during the first month following placement, and 7 once every month thereafter for the first year following 8 placement when indicated, but at least quarterly. After the 9 first year, visits shall be made at least once per year for 10 as long as the placement continues. If a long term care 11 facility has periodic care plan conferences, the visitor may 12 participate in those conferences. Visits shall be made by 13 qualified and trained Department personnel, or their 14 designee, in the area of mental health or developmental 15 disabilities applicable to the person visited, and shall be 16 made on a more frequent basis when indicated. The Department 17 may not use as designee any personnel connected with or 18 responsible to the representatives of any facility in which 19 persons who have been transferred under this Section are 20 placed. In the course of such visit there shall be 21 consideration of the following areas, but not limited 22 thereto: effects of transfer on physical and mental health 23 of the person, sufficiency of nursing care and medical 24 coverage required by the person, sufficiency of staff 25 personnel and ability to provide basic care for the person, 26 social, recreational and programmatic activities available 27 for the person, and other appropriate aspects of the person's 28 environment. 29 A report containing the above observations shall be made 30 to the Department and to any other appropriate agency 31 subsequent to each visitation. The report shall contain a 32 detailed assessment of whether the recipient is receiving 33 adequate and humane care and services in the least 34 restrictive environment. If the recipient is not receiving HB0182 Engrossed -17- LRB9100213WHmg 1 those services, the Department shall either require that the 2 facility modify the treatment plan to ensure that those 3 services are provided or make arrangements necessary to 4 provide those services elsewhere.At the conclusion of one5year following absolute or conditional discharge, or a longer6period of time if required by the Department, the Department7may terminate the visitation requirements of this Section as8to a person placed in accordance with this Section, by filing9a written statement of termination setting forth reasons to10substantiate the termination of visitations in the person's11file, and sending a copy thereof to the person, and to his12guardian or next of kin.13 Upon the complaint of any person placed in accordance 14 with this Section or any responsible citizen or upon 15 discovery that such person has been abused, neglected, or 16 improperly cared for, or that the placement does not provide 17 the type of care required by the recipient's current 18 condition, the Department immediately shall investigate, and 19 determine if the well-being, health, care, or safety of any 20 person is affected by any of the above occurrences, and if 21 any one of the above occurrences is verified, the Department 22 shall remove such person at once to a facility of the 23 Department or to another facility outside the Department, 24 provided such person's needs can be met at said facility. 25 The Department may also provide any person placed in 26 accordance with this Section who is without available funds, 27 and who is permitted to engage in employment outside the 28 facility, such sums for the transportation, and other 29 expenses as may be needed by him until he receives his wages 30 for such employment. 31 The Department shall promulgate rules and regulations 32 governing the purchase of care for persons who are wards of 33 or who are receiving services from the Department. Such 34 rules and regulations shall apply to all monies expended by HB0182 Engrossed -18- LRB9100213WHmg 1 any agency of the State of Illinois for services rendered by 2 any person, corporate entity, agency, governmental agency or 3 political subdivision whether public or private outside of 4 the Department whether payment is made through a contractual, 5 per-diem or other arrangement. No funds shall be paid to any 6 person, corporation, agency, governmental entity or political 7 subdivision without compliance with such rules and 8 regulations. 9 The rules and regulations governing purchase of care 10 shall describe categories and types of service deemed 11 appropriate for purchase by the Department. 12 Any provider of services under this Act may elect to 13 receive payment for those services, and the Department is 14 authorized to arrange for that payment, by means of direct 15 deposit transmittals to the service provider's account 16 maintained at a bank, savings and loan association, or other 17 financial institution. The financial institution shall be 18 approved by the Department, and the deposits shall be in 19 accordance with rules and regulations adopted by the 20 Department. 21 The Department shall keep written records of the number 22 of persons it places in long term care facilities each year. 23 The records shall include the name and address of each 24 facility and the diagnosis of each individual so placed. 25 (Source: P.A. 89-507, eff. 7-1-97; 90-423, eff. 8-15-97.) 26 Section 12. The Abused and Neglected Long Term Care 27 Facility Residents Reporting Act is amended by changing 28 Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 and adding 29 Section 6.9 as follows: 30 (210 ILCS 30/6.2) (from Ch. 111 1/2, par. 4166.2) 31 (Section scheduled to be repealed on January 1, 2000) 32 Sec. 6.2. Inspector General. HB0182 Engrossed -19- LRB9100213WHmg 1 (a) The Governor shall appoint, and the Senate shall 2 confirm, an Inspector General. The Inspector General shall 3 be appointed for a term of 4 years andwhoshall function 4 within the Department of Human Services and report to the 5 Secretary of Human Services and the Governor. The Inspector 6 General shall function independently within the Department of 7 Human Services with respect to the operations of the office, 8 including the performance of investigations and issuance of 9 findings and recommendations. The Inspector General shall 10 independently submit to the Governor any request for 11 appropriations necessary for the ordinary and contingent 12 expenses of the Office of Inspector General, and 13 appropriations for that office shall be separate from the 14 Department of Human Services. The Inspector General shall 15 investigate reports of suspected abuse or neglect (as those 16 terms are defined in Section 3 of this Act) of patients or 17 residents in any mental health or developmental disabilities 18 facility operated by the Department of Human Services and 19 shall have authority to investigate and take immediate action 20 on reports of abuse or neglect of recipients, whether 21 patients or residents, in any mental health or developmental 22 disabilities facility or program that is licensed or 23 certified by the Department of Human Services (as successor 24 to the Department of Mental Health and Developmental 25 Disabilities) or that is funded by the Department of Human 26 Services (as successor to the Department of Mental Health and 27 Developmental Disabilities) and is not licensed or certified 28 by any agency of the State. At the specific, written request 29 of an agency of the State other than the Department of Human 30 Services (as successor to the Department of Mental Health and 31 Developmental Disabilities), the Inspector General may 32 cooperate in investigating reports of abuse and neglect of 33 persons with mental illness or persons with developmental 34 disabilities. The Inspector General shall have no HB0182 Engrossed -20- LRB9100213WHmg 1 supervision over or involvement in routine, programmatic, 2 licensure, or certification operations of the Department of 3 Human Services or any of its funded agencies. 4 The Inspector General shall promulgate rules establishing 5 minimum requirements for reporting allegations of abuse and 6 neglect and initiating, conducting, and completing 7 investigations. The promulgated rules shall clearly set 8 forth that in instances where 2 or more State agencies could 9 investigate an allegation of abuse or neglect, the Inspector 10 General shall not conduct an investigation that is redundant 11 to an investigation conducted by another State agency. The 12 rules shall establish criteria for determining, based upon 13 the nature of the allegation, the appropriate method of 14 investigation, which may include, but need not be limited to, 15 site visits, telephone contacts, or requests for written 16 responses from agencies. The rules shall also clarify how 17 the Office of the Inspector General shall interact with the 18 licensing unit of the Department of Human Services in 19 investigations of allegations of abuse or neglect. Any 20 allegations or investigations of reports made pursuant to 21 this Act shall remain confidential until a final report is 22 completed. The resident or patient who allegedly was abused 23 or neglected and his or her legal guardian shall be informed 24 by the facility or agency of the report of alleged abuse or 25 neglect. Final reports regarding unsubstantiated or unfounded 26 allegations shall remain confidential, except that final 27 reports may be disclosed pursuant to Section 6 of this Act. 28The Inspector General shall be appointed for a term of 429years.30 (b) The Inspector General shall within 24 hours after 31 receiving a report of suspected abuse or neglect determine 32 whether the evidence indicates that any possible criminal act 33 has been committed. If he determines that a possible criminal 34 act has been committed, or that special expertise is required HB0182 Engrossed -21- LRB9100213WHmg 1 in the investigation, he shall immediately notify the 2 Department of State Police. The Department of State Police 3 shall investigate any report indicating a possible murder, 4 rape, or other felony. All investigations conducted by the 5 Inspector General shall be conducted in a manner designed to 6 ensure the preservation of evidence for possible use in a 7 criminal prosecution. 8 (b-5) The Inspector General shall make a determination 9 to accept or reject a preliminary report of the investigation 10 of alleged abuse or neglect based on established 11 investigative procedures. The facility or agency may request 12 clarification or reconsideration based on additional 13 information. For cases where the allegation of abuse or 14 neglect is substantiated, the Inspector General shall require 15 the facility or agency to submit a written response. The 16 written response from a facility or agency shall address in a 17 concise and reasoned manner the actions that the agency or 18 facility will take or has taken to protect the resident or 19 patient from abuse or neglect, prevent reoccurrences, and 20 eliminate problems identified and shall include 21 implementation and completion dates for all such action. 22 (c) The Inspector General shall, within 10 calendar days 23 after the transmittal date of a completed investigation where 24 abuse or neglect is substantiated or administrative action is 25 recommended, provide a complete report on the case to the 26 Secretary of Human Services and to the agency in which the 27 abuse or neglect is alleged to have happened. The complete 28 report shall include a written response from the agency or 29 facility operated by the State to the Inspector General that 30 addresses in a concise and reasoned manner the actions that 31 the agency or facility will take or has taken to protect the 32 resident or patient from abuse or neglect, prevent 33 reoccurrences, and eliminate problems identified and shall 34 include implementation and completion dates for all such HB0182 Engrossed -22- LRB9100213WHmg 1 action. The Secretary of Human Services shall accept or 2 reject the response and establish how the Department will 3 determine whether the facility or program followed the 4 approved response. The Secretary may require Department 5 personnel to visit the facility or agency for training, 6 technical assistance, programmatic, licensure, or 7 certification purposes. Administrative action, including 8 sanctions, may be applied should the Secretary reject the 9 response or should the facility or agency fail to follow the 10 approved response. The facility or agency shall inform the 11 resident or patient and the legal guardian whether the 12 reported allegation was substantiated, unsubstantiated, or 13 unfounded. There shall be an appeals process for any person 14 or agency that is subject to any action based on a 15 recommendation or recommendations. 16 (d) The Inspector General may recommend to the 17 Departments of Public Health and Human Services sanctions to 18 be imposed against mental health and developmental 19 disabilities facilities under the jurisdiction of the 20 Department of Human Services for the protection of residents, 21 including appointment of on-site monitors or receivers, 22 transfer or relocation of residents, and closure of units. 23 The Inspector General may seek the assistance of the Attorney 24 General or any of the several State's attorneys in imposing 25 such sanctions. Whenever the Inspector General issues any 26 recommendations to the Secretary of Human Services, the 27 Secretary shall provide a written response. 28 (e) The Inspector General shall establish and conduct 29 periodic training programs for Department of Human Services 30 employees concerning the prevention and reporting of neglect 31 and abuse. 32 (f) The Inspector General shall at all times be granted 33 access to any mental health or developmental disabilities 34 facility operated by the Department of Human Services, shall HB0182 Engrossed -23- LRB9100213WHmg 1 establish and conduct unannounced site visits to those 2 facilities at least once annually, and shall be granted 3 access, for the purpose of investigating a report of abuse or 4 neglect, to the records of the Department of Human Services 5 and to any facility or program funded by the Department of 6 Human Services that is subject under the provisions of this 7 Section to investigation by the Inspector General for a 8 report of abuse or neglect. 9 (g) Nothing in this Section shall limit investigations 10 by the Department of Human Services that may otherwise be 11 required by law or that may be necessary in that Department's 12 capacity as the central administrative authority responsible 13 for the operation of State mental health and developmental 14 disability facilities. 15(h) This Section is repealed on January 1, 2000.16 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97; 17 90-252, eff. 7-29-97; 90-512, eff. 8-22-97; 90-655, eff. 18 7-30-98.) 19 (210 ILCS 30/6.3) (from Ch. 111 1/2, par. 4166.3) 20 (Section scheduled to be repealed on January 1, 2000) 21 Sec. 6.3. Quality Care Board. There is created, within 22 theDepartment of Human Services'Office of the Inspector 23 General, a Quality Care Board to be composed of 7 members 24 appointed by the Governor with the advice and consent of the 25 Senate. One of the members shall be designated as chairman 26 by the Governor. Of the initial appointments made by the 27 Governor, 4 Board members shall each be appointed for a term 28 of 4 years and 3 members shall each be appointed for a term 29 of 2 years. Upon the expiration of each member's term, a 30 successor shall be appointed for a term of 4 years. In the 31 case of a vacancy in the office of any member, the Governor 32 shall appoint a successor for the remainder of the unexpired 33 term. HB0182 Engrossed -24- LRB9100213WHmg 1 Members appointed by the Governor shall be qualified by 2 professional knowledge or experience in the area of law, 3 investigatory techniques, or in the area of care of the 4 mentally ill or developmentally disabled. Two members 5 appointed by the Governor shall be persons with a disability 6 or a parent of a person with a disability. Members shall 7 serve without compensation, but shall be reimbursed for 8 expenses incurred in connection with the performance of their 9 duties as members. 10 The Board shall meet quarterly, and may hold other 11 meetings on the call of the chairman. Four members shall 12 constitute a quorum. The Board may adopt rules and 13 regulations it deems necessary to govern its own procedures. 14This Section is repealed on January 1, 2000.15 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97.) 16 (210 ILCS 30/6.4) (from Ch. 111 1/2, par. 4166.4) 17 (This Section is scheduled to be repealed January 1, 18 2000.) 19 Sec. 6.4. Scope and function of the Quality Care Board. 20 The Board shall monitor and oversee the operations, policies, 21 and procedures of the Inspector General to assure the prompt 22 and thorough investigation of allegations of neglect and 23 abuse. In fulfilling these responsibilities, the Board may 24 do the following: 25 (1) Provide independent, expert consultation to the 26 Inspector General on policies and protocols for 27 investigations of alleged neglect and abuse. 28 (2) Review existing regulations relating to the 29 operation of facilities under the control of the 30 Department of Human Services. 31 (3) Advise the Inspector General as to the content 32 of training activities authorized under Section 6.2. 33 (4) Recommend policies concerning methods for HB0182 Engrossed -25- LRB9100213WHmg 1 improving the intergovernmental relationships between the 2 office of the Inspector General and other State or 3 federal agencies. 4This Section is repealed on January 1, 2000.5 (Source: P.A. 89-427, eff. 12-7-95.) 6 (210 ILCS 30/6.5) (from Ch. 111 1/2, par. 4166.5) 7 (Section scheduled to be repealed on January 1, 2000) 8 Sec. 6.5. Investigators.Within 60 days after the9effective date of this amendatory Act of 1992,The Inspector 10 General shall establish a comprehensive program to ensure 11 that every person employed or newly hired to conduct 12 investigations shall receive training on an on-going basis 13 concerning investigative techniques, communication skills, 14 and the appropriate means of contact with persons admitted or 15 committed to the mental health or developmental disabilities 16 facilities under the jurisdiction of the Department of Human 17 Services. 18This Section is repealed on January 1, 2000.19 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97.) 20 (210 ILCS 30/6.6) (from Ch. 111 1/2, par. 4166.6) 21 (This Section is scheduled to be repealed January 1, 22 2000.) 23 Sec. 6.6. Subpoenas; testimony; penalty. The Inspector 24 General shall have the power to subpoena witnesses and compel 25 the production of books and papers pertinent to an 26 investigation authorized by this Act, provided that the power 27 to subpoena or to compel the production of books and papers 28 shall not extend to the person or documents of a labor 29 organization or its representatives insofar as the person or 30 documents of a labor organization relate to the function of 31 representing an employee subject to investigation under this 32 Act. Mental health records of patients shall be confidential HB0182 Engrossed -26- LRB9100213WHmg 1 as provided under the Mental Health and Developmental 2 Disabilities Confidentiality Act. Any person who fails to 3 appear in response to a subpoena or to answer any question or 4 produce any books or papers pertinent to an investigation 5 under this Act, except as otherwise provided in this Section, 6 or who knowingly gives false testimony in relation to an 7 investigation under this Act is guilty of a Class A 8 misdemeanor. 9This Section is repealed on January 1, 2000.10 (Source: P.A. 89-427, eff. 12-7-95.) 11 (210 ILCS 30/6.7) (from Ch. 111 1/2, par. 4166.7) 12 (This Section is scheduled to be repealed January 1, 13 2000.) 14 Sec. 6.7. Annual report. The Inspector General shall 15 provide to the General Assembly and the Governor, no later 16 than January 1 of each year, a summary of reports and 17 investigations made under this Act for the prior fiscal year 18 with respect to residents of institutions under the 19 jurisdiction of the Department of Human Services. The report 20 shall detail the imposition of sanctions and the final 21 disposition of those recommendations. The summaries shall 22 not contain any confidential or identifying information 23 concerning the subjects of the reports and investigations. 24 The report shall also include a trend analysis of the number 25 of reported allegations and their disposition, for each 26 facility and Department-wide, for the most recent 3-year time 27 period and a statement, for each facility, of the 28 staffing-to-patient ratios. The ratios shall include only 29 the number of direct care staff. The report shall also 30 include detailed recommended administrative actions and 31 matters for consideration by the General Assembly. 32This Section is repealed on July 1, 2000.33 (Source: P.A. 89-427, eff. 12-7-95.) HB0182 Engrossed -27- LRB9100213WHmg 1 (210 ILCS 30/6.8) (from Ch. 111 1/2, par. 4166.8) 2 (Section scheduled to be repealed on January 1, 2000) 3 Sec. 6.8. Program audit. The Auditor General shall 4 conduct a biennial program audit of the office of the 5 Inspector General in relation to the Inspector General's 6 compliance with this Act. The audit shall specifically 7 include the Inspector General's effectiveness in 8 investigating reports of alleged neglect or abuse of 9 residents in any facility operated by the Department of Human 10 Services and in making recommendations for sanctions to the 11 Departments of Human Services and Public Health. The Auditor 12 General shall conduct the program audit according to the 13 provisions of the Illinois State Auditing Act and shall 14 report its findings to the General Assembly no later than 15 January 1 of each odd-numbered year. 16This Section is repealed on January 1, 2000.17 (Source: P.A. 89-427, eff. 12-7-95; 89-507, eff. 7-1-97.) 18 (210 ILCS 30/6.9 new) 19 Sec. 6.9. System evaluations; mental health facilities. 20 The agency designated by the Governor under Section 1 of the 21 Protection and Advocacy for Developmentally Disabled Persons 22 Act is authorized to periodically evaluate abuse, neglect, 23 deaths, and other safety-related issues in mental health 24 facilities, as defined in the Mental Health and Developmental 25 Disabilities Code, and the effectiveness of the State's 26 systems that address these issues. To enable the agency 27 designated by the Governor to fulfill its obligations 28 pursuant to this Section, the agency shall have authority to 29 the same extent as that provided to the Inspector General of 30 the Department of Human Services. Nothing in this Section 31 limits the agency's authority as the State's designated 32 protection and advocacy system. All identifiable information 33 in records provided pursuant to this Section shall not be HB0182 Engrossed -28- LRB9100213WHmg 1 further disclosed except as provided by the Mental Health and 2 Developmental Disabilities Confidentiality Act. The scope of 3 these studies shall be based on the available appropriation. 4 Nothing in this Section prevents the agency designated by the 5 Governor from securing other public or private funds to carry 6 out studies pursuant to this Section. The agency shall 7 provide a report to the General Assembly and the Governor 8 regarding any system evaluations authorized by this Section. 9 Section 15. The Nursing Home Care Act is amended by 10 changing Sections 1-113, 2-104, 2-106, 2-106.1, 3-203, and 11 3-212 as follows: 12 (210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113) 13 Sec. 1-113. "Facility" or "long-term care facility" 14 means a private home, institution, building, residence, or 15 any other place, whether operated for profit or not, or a 16 county home for the infirm and chronically ill operated 17 pursuant to Division 5-21 or 5-22 of the Counties Code, or 18 any similar institution operated by a political subdivision 19 of the State of Illinois, which provides, through its 20 ownership or management, personal care, sheltered care or 21 nursing for 3 or more persons, not related to the applicant 22 or owner by blood or marriage. It includes skilled nursing 23 facilities and intermediate care facilities as those terms 24 are defined in Title XVIII and Title XIX of the Federal 25 Social Security Act. It shall also include classifications of 26 such facilities, including but not limited to "Residential 27 Rehabilitation Facilities" which are primarily engaged in 28 providing diagnosis, treatment, or care of persons with 29 mental illness, which includes medical attention, nursing 30 care and related services. It also includes homes, 31 institutions, or other places operated by or under the 32 authority of the Illinois Department of Veterans' Affairs. HB0182 Engrossed -29- LRB9100213WHmg 1 "Facility" does not include the following: 2 (1) A home, institution, or other place operated by the 3 federal government or agency thereof, or by the State of 4 Illinois, other than homes, institutions, or other places 5 operated by or under the authority of the Illinois Department 6 of Veterans' Affairs; 7 (2) A hospital, sanitarium, or other institution whose 8 principal activity or business is the diagnosis, care, and 9 treatment of human illness through the maintenance and 10 operation as organized facilities therefor, which is required 11 to be licensed under the Hospital Licensing Act; 12 (3) Any "facility for child care" as defined in the 13 Child Care Act of 1969; 14 (4) Any "Community Living Facility" as defined in the 15 Community Living Facilities Licensing Act; 16 (5) Any "community residential alternative" as defined 17 in the Community Residential Alternatives Licensing Act; 18 (6) Any nursing home or sanatorium operated solely by 19 and for persons who rely exclusively upon treatment by 20 spiritual means through prayer, in accordance with the creed 21 or tenets of any well-recognized church or religious 22 denomination. However, such nursing home or sanatorium shall 23 comply with all local laws and rules relating to sanitation 24 and safety; 25 (7) Any facility licensed by the Department of Human 26 Services as a community-integrated living arrangement as 27 defined in the Community-Integrated Living Arrangements 28 Licensure and Certification Act; 29 (8) Any "Supportive Residence" licensed under the 30 Supportive Residences Licensing Act; or 31 (9) Any "supportive living facility" in good standing 32 with the demonstration project established under Section 33 5-5.01a of the Illinois Public Aid Code. 34 (Source: P.A. 89-499, eff. 6-28-96; 89-507, eff. 7-1-97; HB0182 Engrossed -30- LRB9100213WHmg 1 90-14, eff. 7-1-97; 90-763, eff. 8-14-98.) 2 (210 ILCS 45/2-104) (from Ch. 111 1/2, par. 4152-104) 3 Sec. 2-104. (a) A resident shall be permitted to retain 4 the services of his own personal physician at his own expense 5 or under an individual or group plan of health insurance, or 6 under any public or private assistance program providing such 7 coverage. However, the facility is not liable for the 8 negligence of any such personal physician. Every resident 9 shall be permitted to obtain from his own physician or the 10 physician attached to the facility complete and current 11 information concerning his medical diagnosis, treatment and 12 prognosis in terms and language the resident can reasonably 13 be expected to understand. Every resident shall be permitted 14 to participate in the planning of his total care and medical 15 treatment to the extent that his condition permits. No 16 resident shall be subjected to experimental research or 17 treatment without first obtaining his informed, written 18 consent. The conduct of any experimental research or 19 treatment shall be authorized and monitored by an 20 institutional review committee appointed by the administrator 21 of the facility where such research and treatment is 22 conducted. The membership, operating procedures and review 23 criteria for institutional review committees shall be 24 prescribed under rules and regulations of the Department. 25 (b) All medical treatment and procedures shall be 26 administered as ordered by a physician. All new physician 27 orders shall be reviewed by the facility's director of 28 nursing or charge nurse designee within 24 hours after such 29 orders have been issued to assure facility compliance with 30 such orders. 31 According to rules adopted by the Department, every woman 32 resident of child-bearing age shall receive routine 33 obstetrical and gynecological evaluations as well as HB0182 Engrossed -31- LRB9100213WHmg 1 necessary prenatal care. 2 Every resident with a diagnosis of mental illness (other 3 than Alzheimer's disease or a related disorder) shall receive 4 necessary mental health services in accordance with rules 5 promulgated by the Department under Section 3-203 of this 6 Act, including but not limited to medical management, 7 individual and group therapy, psychosocial rehabilitation, 8 vocational services, and partial hospitalization. 9 (c) Every resident shall be permitted to refuse medical 10 treatment and to know the consequences of such action, unless 11 such refusal would be harmful to the health and safety of 12 others and such harm is documented by a physician in the 13 resident's clinical record. The resident's refusal shall 14 free the facility from the obligation to provide the 15 treatment. 16 (d) Every resident, resident's guardian, or parent if 17 the resident is a minor shall be permitted to inspect and 18 copy all his clinical and other records concerning his care 19 and maintenance kept by the facility or by his physician. The 20 facility may charge a reasonable fee for duplication of a 21 record. 22 (Source: P.A. 86-1013.) 23 (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106) 24 Sec. 2-106. (a) For purposes of this Act, (i) a physical 25 restraint is any manual method or physical or mechanical 26 device, material, or equipment attached or adjacent to a 27 resident's body that the resident cannot remove easily and 28 restricts freedom of movement or normal access to one's body; 29 (ii) a chemical restraint is any drug used for discipline or 30 convenience and not required to treat medical symptoms. The 31 Department shall by rule, designate certain devices as 32 restraints, including at least all those devices which have 33 been determined to be restraints by the United States HB0182 Engrossed -32- LRB9100213WHmg 1 Department of Health and Human Services in interpretive 2 guidelines issued for the purposes of administering Titles 18 3 and 19 of the Social Security Acts. 4 (b) Neither restraints nor confinements shall be 5 employed for the purpose of punishment or for the convenience 6 of any facility personnel. No restraints or confinements 7 shall be employed except as ordered by a physician who 8 documents the need for such restraints or confinements in the 9 resident's clinical record. Whenever a resident of an 10 institution for mental diseases is restrained, a member of 11 the facility staff shall remain with the resident at all 12 times unless the recipient has been confined. A resident who 13 is restrained and confined shall be observed by a qualified 14 person as often as is clinically appropriate but in no event 15 less often than once every 15 minutes. 16 (c) A restraint may be used only with the informed 17 consent of the resident, the resident's guardian, or other 18 authorized representative. A restraint may be used only for 19 specific periods, if it is the least restrictive means 20 necessary to attain and maintain the resident's highest 21 practicable physical, mental or psychosocial well-being, 22 including brief periods of time to provide necessary 23 life-saving treatment. A restraint may be used only after 24 consultation with appropriate health professionals, such as 25 occupational or physical therapists, and a trial of less 26 restrictive measures has led to the determination that the 27 use of less restrictive measures would not attain or maintain 28 the resident's highest practicable physical, mental or 29 psychosocial well-being. However, if the resident needs 30 emergency care, restraints may be used for brief periods to 31 permit medical treatment to proceed unless the facility has 32 notice that the resident has previously made a valid refusal 33 of the treatment in question. 34 (d) A restraint may be applied only by a person trained HB0182 Engrossed -33- LRB9100213WHmg 1 in the application of the particular type of restraint. 2 (e) Whenever a period of use of a restraint is 3 initiated, the resident shall be advised of his or her right 4 to have a person or organization of his or her choosing, 5 including the Guardianship and Advocacy Commission, notified 6 of the use of the restraint. A recipient who is under 7 guardianship may request that a person or organization of his 8 or her choosing be notified of the restraint, whether or not 9 the guardian approves the notice. If the resident so 10 chooses, the facility shall make the notification within 24 11 hours, including any information about the period of time 12 that the restraint is to be used. Whenever the Guardianship 13 and Advocacy Commission is notified that a resident has been 14 restrained, it shall contact the resident to determine the 15 circumstances of the restraint and whether further action is 16 warranted. 17 (f) Whenever a restraint is used on a resident whose 18 primary mode of communication is sign language, the resident 19 shall be permitted to have his or her hands free from 20 restraint for brief periods each hour, except when this 21 freedom may result in physical harm to the resident or 22 others. 23 (g) The requirements of this Section are intended to 24 control in any conflict with the requirements of Sections 25 1-126 and 2-108 of the Mental Health and Developmental 26 Disabilities Code. 27 (Source: P.A. 88-413.) 28 (210 ILCS 45/2-106.1) 29 Sec. 2-106.1. Drug treatment. 30 (a) A resident shall not be given unnecessary drugs. An 31 unnecessary drug is any drug used in an excessive dose, 32 including in duplicative therapy; for excessive duration; 33 without adequate monitoring; without adequate indications for HB0182 Engrossed -34- LRB9100213WHmg 1 its use; or in the presence of adverse consequences that 2 indicate the drugs should be reduced or discontinued. The 3 Department shall adopt, by rule, the standards for 4 unnecessary drugs contained in interpretive guidelines issued 5 by the United States Department of Health and Human Services 6 for the purposes of administering titles 18 and 19 of the 7 Social Security Act. 8 (b) Psychotropic medication shall not be prescribed 9 without the informed consent of the resident, the resident's 10 guardian, or other authorized representative. "Psychotropic 11 medication" means medication that is used for or listed as 12 used for antipsychotic, antidepressant, antimanic, or 13 antianxiety behavior modification or behavior management 14 purposes in the latest editions of the AMA Drug Evaluations 15 or the Physician's Desk Reference. 16 (c) The requirements of this Section are intended to 17 control in a conflict with the requirements of Sections 2-102 181-102and 2-107.2 of the Mental Health and Developmental 19 Disabilities Code with respect to the administration of 20 psychotropic medication. 21 (Source: P.A. 88-413.) 22 (210 ILCS 45/3-203) (from Ch. 111 1/2, par. 4153-203) 23 Sec. 3-203. In licensing any facility for persons with a 24 developmental disability or persons suffering from mental 25 illness (other than Alzheimer's disease or related disorders) 26emotional or behavioral disorders, the Department shall 27 consult with the Department of Human Services in developing 28 minimum standards for such persons. The Department shall 29 establish standards for the diagnosis, treatment and care of 30 all persons with mental illness in facilities licensed under 31 this Act, including, but not limited to, the establishment 32 and operation of facilities classified under this Act as 33 "Residential Rehabilitation Facilities". Standards for HB0182 Engrossed -35- LRB9100213WHmg 1 "Residential Rehabilitation Facilities" shall be promulgated 2 and effective by October 1, 1999 or on the effective date of 3 this amendatory Act of the 91st General Assembly, whichever 4 is later. 5 (Source: P.A. 88-380; 89-507, eff. 7-1-97.) 6 (210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212) 7 Sec. 3-212. Inspection. 8 (a) The Department, whenever it deems necessary in 9 accordance with subsection (b), shall inspect, survey and 10 evaluate every facility to determine compliance with 11 applicable licensure requirements and standards. An 12 inspection should occur within 120 days prior to license 13 renewal. The Department may periodically visit a facility 14 for the purpose of consultation. An inspection, survey, or 15 evaluation, other than an inspection of financial records, 16 shall be conducted without prior notice to the facility. A 17 visit for the sole purpose of consultation may be announced. 18 The Department shall provide training to surveyors about the 19 appropriate assessment, care planning, and care of persons 20 with mental illness (other than Alzheimer's disease or 21 related disorders) to enable its surveyors to determine 22 whether a facility is complying with State and federal 23 requirements about the assessment, care planning, and care of 24 those persons. 25 (a-1) An employee of a State or unit of local government 26 agency charged with inspecting, surveying, and evaluating 27 facilities who directly or indirectly gives prior notice of 28 an inspection, survey, or evaluation, other than an 29 inspection of financial records, to a facility or to an 30 employee of a facility is guilty of a Class A misdemeanor. 31 (a-2) An employee of a State or unit of local government 32 agency charged with inspecting, surveying, or evaluating 33 facilities who willfully profits from violating the HB0182 Engrossed -36- LRB9100213WHmg 1 confidentiality of the inspection, survey, or evaluation 2 process shall be guilty of a Class 4 felony and that conduct 3 shall be deemed unprofessional conduct that may subject a 4 person to loss of his or her professional license. An action 5 to prosecute a person for violating this subsection (a-2) may 6 be brought by either the Attorney General or the State's 7 Attorney in the county where the violation took place. 8 (b) In determining whether to make more than the 9 required number of unannounced inspections, surveys and 10 evaluations of a facility the Department shall consider one 11 or more of the following: previous inspection reports; the 12 facility's history of compliance with standards, rules and 13 regulations promulgated under this Act and correction of 14 violations, penalties or other enforcement actions; the 15 number and severity of complaints received about the 16 facility; any allegations of resident abuse or neglect; 17 weather conditions; health emergencies; other reasonable 18 belief that deficiencies exist. 19 (b-1) The Department shall not be required to determine 20 whether a facility certified to participate in the Medicare 21 program under Title XVIII of the Social Security Act, or the 22 Medicaid program under Title XIX of the Social Security Act, 23 and which the Department determines by inspection under this 24 Section or under Section 3-702 of this Act to be in 25 compliance with the certification requirements of Title XVIII 26 or XIX, is in compliance with any requirement of this Act 27 that is less stringent than or duplicates a federal 28 certification requirement. In accordance with subsection (a) 29 of this Section or subsection (d) of Section 3-702, the 30 Department shall determine whether a certified facility is in 31 compliance with requirements of this Act that exceed federal 32 certification requirements. If a certified facility is found 33 to be out of compliance with federal certification 34 requirements, the results of an inspection conducted pursuant HB0182 Engrossed -37- LRB9100213WHmg 1 to Title XVIII or XIX of the Social Security Act may be used 2 as the basis for enforcement remedies authorized and 3 commenced under this Act. Enforcement of this Act against a 4 certified facility shall be commenced pursuant to the 5 requirements of this Act, unless enforcement remedies sought 6 pursuant to Title XVIII or XIX of the Social Security Act 7 exceed those authorized by this Act. As used in this 8 subsection, "enforcement remedy" means a sanction for 9 violating a federal certification requirement or this Act. 10 (c) Upon completion of each inspection, survey and 11 evaluation, the appropriate Department personnel who 12 conducted the inspection, survey or evaluation shall submit a 13 copy of their report to the licensee upon exiting the 14 facility, and shall submit the actual report to the 15 appropriate regional office of the Department. Such report 16 and any recommendations for action by the Department under 17 this Act shall be transmitted to the appropriate offices of 18 the associate director of the Department, together with 19 related comments or documentation provided by the licensee 20 which may refute findings in the report, which explain 21 extenuating circumstances that the facility could not 22 reasonably have prevented, or which indicate methods and 23 timetables for correction of deficiencies described in the 24 report. Without affecting the application of subsection (a) 25 of Section 3-303, any documentation or comments of the 26 licensee shall be provided within 10 days of receipt of the 27 copy of the report. Such report shall recommend to the 28 Director appropriate action under this Act with respect to 29 findings against a facility. The Director shall then 30 determine whether the report's findings constitute a 31 violation or violations of which the facility must be given 32 notice. Such determination shall be based upon the severity 33 of the finding, the danger posed to resident health and 34 safety, the comments and documentation provided by the HB0182 Engrossed -38- LRB9100213WHmg 1 facility, the diligence and efforts to correct deficiencies, 2 correction of the reported deficiencies, the frequency and 3 duration of similar findings in previous reports and the 4 facility's general inspection history. Violations shall be 5 determined under this subsection no later than 60 days after 6 completion of each inspection, survey and evaluation. 7 (d) The Department shall maintain all inspection, survey 8 and evaluation reports for at least 5 years in a manner 9 accessible to and understandable by the public. 10 (Source: P.A. 88-278; 89-21, eff. 1-1-96; 89-171, eff. 11 1-1-96; 89-197, eff. 7-21-95; 89-626, eff. 8-9-96.) 12 Section 20. The Mental Health and Developmental 13 Disabilities Code is amended by changing Sections 3-603, 14 3-701, and 3-704 and adding Section 3-704.1 as follows: 15 (405 ILCS 5/3-603) (from Ch. 91 1/2, par. 3-603) 16 Sec. 3-603. (a) If no physician, qualified examiner, or 17 clinical psychologist or qualified certifier at a 18 participating mental health center is immediately available 19 or it is not possible after a diligent effort to obtain the 20 certificate provided for in Section 3-602, the respondent may 21 be detained for examination in a mental health facility upon 22 presentation of the petition alone pending the obtaining of 23 such a certificate, except that if admission is sought to a 24 State-operated mental health facility and the Community 25 Service Area has a participating mental health center, the 26 participating mental health center shall be notified and 27 shall provide a qualified certifier to conduct a screening 28 within 24 hours. 29 (b) In such instance the petition shall conform to the 30 requirements of Section 3-601 and further specify that: 31 1. the petitioner believes, as a result of his personal 32 observation, that the respondent is subject to involuntary HB0182 Engrossed -39- LRB9100213WHmg 1 admission; 2 2. a diligent effort was made to obtain a certificate; 3and4 3. no physician, qualified examiner, or clinical 5 psychologist could be found who has examined or could examine 6 the respondent; and 7 4. a diligent effort has been made to convince the 8 respondent to appear voluntarily for examination by a 9 physician, qualified examiner, or clinical psychologist, 10 unless the petitioner reasonably believes such an effort 11 would pose a risk of harm to the respondent or others. 12 (Source: P.A. 88-484.) 13 (405 ILCS 5/3-701) (from Ch. 91 1/2, par. 3-701) 14 Sec. 3-701. (a) Any person 18 years of age or older may 15 execute a petition asserting that another person is subject 16 to involuntary admission. The petition shall be prepared 17 pursuant to paragraph (b) of Section 3-601 and shall be filed 18 with the court in the county where the respondent resides or 19 is present. 20 (b) The court may inquire of the petitioner whether 21 there are reasonable grounds to believe that the facts stated 22 in the petition are true and whether the respondent is 23 subject to involuntary admission. The inquiry may proceed 24 without notice to the respondent only if the petitioner 25 alleges facts showing that an emergency exists such that 26 immediate hospitalization is necessary and the petitioner 27 testifies before the court as to the factual basis for the 28 allegations. 29 (Source: P.A. 80-1414.) 30 (405 ILCS 5/3-704) (from Ch. 91 1/2, par. 3-704) 31 Sec. 3-704. Examination; detention. 32 (a) The respondent shall be permitted to remain in his HB0182 Engrossed -40- LRB9100213WHmg 1 place of residence pending any examination. He may be 2 accompanied by one or more of his relatives or friends or by 3 his attorney to the place of examination. If, however, the 4 court finds that it is necessary in order to complete the 5 examination the court may order that the person be admitted 6 to a mental health facility pending examination and may order 7 a peace officer or other person to transport him there. If 8 examination and detention is sought at a State-operated 9 mental health facility and the Community Service Area has a 10 participating mental health center, the person shall be seen 11 for a screening examination by a qualified certifier. After 12 examination, the participating mental health center shall 13 recommend to the court an appropriate treatment setting. If 14 the appropriate setting is a State-operated mental health 15 facility, the participating mental health center shall 16 provide a written statement, as required under Section 17 3-601.1, obtained from a qualified certifier recommending 18 admission to a State-operated mental health facility. 19 Whenever possible the examination shall be conducted at a 20 local mental health facility. No person may be detained for 21 examination under this Section for more than 24 hours. The 22 person shall be released upon completion of the examination 23 unless the physician, qualified examiner or clinical 24 psychologist executes a certificate stating that the person 25 is subject to involuntary admission and in need of immediate 26 hospitalization to protect such person or others from 27 physical harm. Upon admission under this Section treatment 28 may be given pursuant to Section 3-608. 29 (a-5) When a respondent has been transported to a mental 30 health facility for an examination, the admitting facility 31 shall inquire, upon the respondent's arrival, whether the 32 respondent wishes any person or persons to be notified of his 33 or her detention at the facility. If the respondent does 34 wish to have any person or persons notified of his or her HB0182 Engrossed -41- LRB9100213WHmg 1 detention at the facility, the facility must make all 2 reasonable attempts to locate, within one hour after the 3 respondent's arrival, at least 2 individuals identified by 4 the respondent and notify them of the respondent's detention 5 at the facility for a mandatory examination pursuant to court 6 order. 7 (b) Not later than 24 hours, excluding Saturdays, 8 Sundays, and holidays, after admission under this Section, 9 the respondent shall be asked if he desires the petition and 10 the notice required under Section 3-206 sent to any other 11 persons and at least 2 such persons designated by the 12 respondent shall be sent the documents. At the time of his 13 admission the respondent shall be allowed to complete not 14 fewer than 2 telephone calls to such persons as he chooses. 15 (Source: P.A. 88-484.) 16 (405 ILCS 5/3-704.1 new) 17 Sec. 3-704.1. Task Force. 18 (a) The Illinois Law Enforcement Training Standards 19 Board shall convene a task force for the purpose of 20 developing and recommending for adoption by the Board a model 21 protocol concerning the involvement of mental health 22 professionals when a peace officer is required to enforce an 23 order entered under subsection (a) of Section 3-704 to 24 transport an individual for a mandatory mental health 25 examination. The members of the task force shall include 26 representatives from law enforcement, community mental health 27 service providers, and one or more designees of the Director 28 of the Office of Mental Health, Department of Human Services. 29 In establishing the task force, every effort shall be made to 30 ensure that it represents the geographic diversity of the 31 State. 32 (b) The members of the task force shall serve without 33 compensation. HB0182 Engrossed -42- LRB9100213WHmg 1 (c) Before taking any formal action upon the 2 recommendations of the task force, the Board shall hold a 3 public hearing to provide the opportunity for individuals 4 with mental illness and their family members, mental health 5 advocacy organizations, and the public at large to review, 6 comment upon, and suggest any changes to the proposed model 7 protocol. 8 (d) The Board shall submit to the General Assembly, no 9 later than March 1, 2000, the model protocol it has adopted 10 for the coordination of efforts between law enforcement 11 personnel and mental health professionals in the enforcement 12 of orders requiring transport of individuals for emergency 13 mental health examinations. 14 (e) This Section is repealed on January 1, 2001. 15 Section 99. Effective date. This Section, the changes 16 to Section 4.3 of the Mental Health and Developmental 17 Disabilities Administrative Act, the changes to Sections 6.2, 18 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 of the Abused and Neglected 19 Long Term Care Facility Residents Reporting Act, the changes 20 to Section 3-203 of the Nursing Home Care Act, the changes to 21 Sections 3-603, 3-701, and 3-704 of the Mental Health and 22 Developmental Disabilities Code, and the provisions adding 23 Section 3-704.1 to the Mental Health and Developmental 24 Disabilities Code take effect upon becoming law.