[ Search ] [ Legislation ]
[ Home ] [ Back ] [ Bottom ]
| [ Engrossed ] | [ Senate Amendment 001 ] | [ Senate Amendment 002 ] |
91_SB1844
LRB9113111RCpk
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 (Text of Section before amendment by P.A. 91-656)
9 Sec. 4.04. Long Term Care Ombudsman Program.
10 (a) Long Term Care Ombudsman Program. The Department
11 shall establish a Long Term Care Ombudsman Program, through
12 the Office of State Long Term Care Ombudsman ("the Office"),
13 in accordance with the provisions of the Older Americans Act
14 of 1965, as now or hereafter amended.
15 (b) Definitions. As used in this Section, unless the
16 context requires otherwise:
17 (1) "Access" has the same meaning as in Section
18 1-104 of the Nursing Home Care Act, as now or hereafter
19 amended; that is, it means the right to:
20 (i) Enter any long term care facility;
21 (ii) Communicate privately and without
22 restriction with any resident who consents to the
23 communication;
24 (iii) Seek consent to communicate privately
25 and without restriction with any resident;
26 (iv) Inspect the clinical and other records of
27 a resident with the express written consent of the
28 resident;
29 (v) Observe all areas of the long term care
30 facility except the living area of any resident who
31 protests the observation.
-2- LRB9113111RCpk
1 (2) "Long Term Care Facility" means (i) any
2 facility as defined by Section 1-113 of the Nursing Home
3 Care Act, as now or hereafter amended; and (ii) any
4 skilled nursing facility or a nursing facility which
5 meets the requirements of Section 1819(a), (b), (c), and
6 (d) or Section 1919(a), (b), (c), and (d) of the Social
7 Security Act, as now or hereafter amended (42 U.S.C.
8 1395i-3(a), (b), (c), and (d) and 42 U.S.C. 1396r(a),
9 (b), (c), and (d)).
10 (3) "Ombudsman" means any person employed by the
11 Department to fulfill the requirements of the Office, or
12 any representative of a sub-State long term care
13 ombudsman program; provided that the representative,
14 whether he is paid for or volunteers his ombudsman
15 services, shall be qualified and authorized by the
16 Department to perform the duties of an ombudsman as
17 specified by the Department in rules.
18 (c) Ombudsman; rules. The Office of State Long Term Care
19 Ombudsman shall be composed of at least one full-time
20 ombudsman within the Department and shall include a system of
21 designated sub-State long term care ombudsman programs. Each
22 sub-State program shall be designated by the Department as a
23 subdivision of the Office and any representative of a
24 sub-State program shall be treated as a representative of the
25 Office.
26 The Department shall promulgate administrative rules to
27 establish the responsibilities of the Department and the
28 Office of State Long Term Care Ombudsman. The administrative
29 rules shall include the responsibility of the Office to
30 investigate and resolve complaints made by or on behalf of
31 residents of long term care facilities relating to actions,
32 inaction, or decisions of providers, or their
33 representatives, of long term care facilities, of public
34 agencies, or of social services agencies, which may adversely
-3- LRB9113111RCpk
1 affect the health, safety, welfare, or rights of such
2 residents. When necessary and appropriate, representatives of
3 the Office shall refer complaints to the appropriate
4 regulatory State agency.
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 (c)(3)(A) and (E)), and Section 712
12 of the Older Americans Act of 1965, as now or hereafter
13 amended (42 U.S.C. 3058f), a long term care facility
14 must:
15 (i) permit immediate access to any resident by
16 an ombudsman; and
17 (ii) permit representatives of the Office,
18 with the permission of the resident's legal
19 representative or legal guardian, to examine a
20 resident's clinical and other records, and if a
21 resident is unable to consent to such review, and
22 has no legal guardian, permit representatives of the
23 Office appropriate access, as defined by the
24 Department in administrative rules, to the
25 resident's records.
26 (2) Each long term care facility shall display, in
27 multiple, conspicuous public places within the facility
28 accessible to both visitors and patients and in an easily
29 readable format, the address and phone number of the
30 Office, in a manner prescribed by the Office.
31 (e) Immunity. An ombudsman or any other representative
32 of the Office participating in the good faith performance of
33 his or her official duties shall have immunity from any
34 liability (civil, criminal or otherwise) in any proceedings
-4- LRB9113111RCpk
1 (civil, criminal or otherwise) brought as a consequence of
2 the performance of his official duties.
3 (f) Business offenses.
4 (1) No person shall:
5 (i) Intentionally prevent, interfere with, or
6 attempt to impede in any way any representative of
7 the Office in the performance of his official duties
8 under this Act and the Older Americans Act of 1965;
9 or
10 (ii) Intentionally retaliate, discriminate
11 against, or effect reprisals against any long term
12 care facility resident or employee for contacting or
13 providing information to any representative of the
14 Office.
15 (2) A violation of this Section is a business
16 offense, punishable by a fine not to exceed $501.
17 (3) The Director of Aging shall notify the State's
18 Attorney of the county in which the long term care
19 facility is located, or the Attorney General, of any
20 violations of this Section.
21 (g) Confidentiality of records and identities. No files
22 or records maintained by the Office of State Long Term Care
23 Ombudsman shall be disclosed unless the State Ombudsman or
24 the ombudsman having the authority over the disposition of
25 such files authorizes the disclosure in writing. The
26 ombudsman shall not disclose the identity of any complainant,
27 resident, witness or employee of a long term care provider
28 involved in a complaint or report unless such person or such
29 person's guardian or legal representative consents in writing
30 to the disclosure, or the disclosure is required by court
31 order.
32 (h) Legal representation. The Attorney General shall
33 provide legal representation to any representative of the
34 Office against whom suit or other legal action is brought in
-5- LRB9113111RCpk
1 connection with the performance of the representative's
2 official duties, in accordance with "An Act to provide for
3 representation and indemnification in certain civil law
4 suits", approved December 3, 1977, as now or hereafter
5 amended.
6 (i) Treatment by prayer and spiritual means. Nothing in
7 this Act shall be construed to authorize or require the
8 medical supervision, regulation or control of remedial care
9 or treatment of any resident in a long term care facility
10 operated exclusively by and for members or adherents of any
11 church or religious denomination the tenets and practices of
12 which include reliance solely upon spiritual means through
13 prayer for healing.
14 (Source: P.A. 90-639, eff. 1-1-99; 91-174, eff. 7-16-99.)
15 (Text of Section after amendment by P.A. 91-656)
16 Sec. 4.04. Long Term Care Ombudsman Program.
17 (a) Long Term Care Ombudsman Program. The Department
18 shall establish a Long Term Care Ombudsman Program, through
19 the Office of State Long Term Care Ombudsman ("the Office"),
20 in accordance with the provisions of the Older Americans Act
21 of 1965, as now or hereafter amended.
22 (b) Definitions. As used in this Section, unless the
23 context requires otherwise:
24 (1) "Access" has the same meaning as in Section
25 1-104 of the Nursing Home Care Act, as now or hereafter
26 amended; that is, it means the right to:
27 (i) Enter any long term care facility or
28 assisted living or shared housing establishment;
29 (ii) Communicate privately and without
30 restriction with any resident who consents to the
31 communication;
32 (iii) Seek consent to communicate privately
33 and without restriction with any resident;
34 (iv) Inspect the clinical and other records of
-6- LRB9113111RCpk
1 a resident with the express written consent of the
2 resident;
3 (v) Observe all areas of the long term care
4 facility or assisted living or shared housing
5 establishment except the living area of any resident
6 who protests the observation.
7 (2) "Long Term Care Facility" means (i) any
8 facility as defined by Section 1-113 of the Nursing Home
9 Care Act, as now or hereafter amended; and (ii) any
10 skilled nursing facility or a nursing facility which
11 meets the requirements of Section 1819(a), (b), (c), and
12 (d) or Section 1919(a), (b), (c), and (d) of the Social
13 Security Act, as now or hereafter amended (42 U.S.C.
14 1395i-3(a), (b), (c), and (d) and 42 U.S.C. 1396r(a),
15 (b), (c), and (d)).
16 (2.5) "Assisted living establishment" and "shared
17 housing establishment" have the meanings given those
18 terms in Section 10 of the Assisted Living and Shared
19 Housing Act.
20 (3) "Ombudsman" means any person employed by the
21 Department to fulfill the requirements of the Office, or
22 any representative of a sub-State long term care
23 ombudsman program; provided that the representative,
24 whether he is paid for or volunteers his ombudsman
25 services, shall be qualified and authorized by the
26 Department to perform the duties of an ombudsman as
27 specified by the Department in rules.
28 (c) Ombudsman; rules. The Office of State Long Term Care
29 Ombudsman shall be composed of at least one full-time
30 ombudsman within the Department and shall include a system of
31 designated sub-State long term care ombudsman programs. Each
32 sub-State program shall be designated by the Department as a
33 subdivision of the Office and any representative of a
34 sub-State program shall be treated as a representative of the
-7- LRB9113111RCpk
1 Office.
2 The Department shall promulgate administrative rules to
3 establish the responsibilities of the Department and the
4 Office of State Long Term Care Ombudsman. The administrative
5 rules shall include the responsibility of the Office to
6 investigate and resolve complaints made by or on behalf of
7 residents of long term care facilities and assisted living
8 and shared housing establishments relating to actions,
9 inaction, or decisions of providers, or their
10 representatives, of long term care facilities, of assisted
11 living and shared housing establishments, of public agencies,
12 or of social services agencies, which may adversely affect
13 the health, safety, welfare, or rights of such residents.
14 When necessary and appropriate, representatives of the Office
15 shall refer complaints to the appropriate regulatory State
16 agency. The Department shall cooperate with the Department of
17 Human Services in providing information and training to
18 designated sub-State long term care ombudsman programs about
19 the appropriate assessment and treatment (including
20 information about appropriate supportive services, treatment
21 options, and assessment of rehabilitation potential) of
22 persons with mental illness (other than Alzheimer's disease
23 and related disorders).
24 (d) Access and visitation rights.
25 (1) In accordance with subparagraphs (A) and (E) of
26 paragraph (3) of subsection (c) of Section 1819 and
27 subparagraphs (A) and (E) of paragraph (3) of subsection
28 (c) of Section 1919 of the Social Security Act, as now or
29 hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E)
30 and 42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712
31 of the Older Americans Act of 1965, as now or hereafter
32 amended (42 U.S.C. 3058f), a long term care facility,
33 assisted living establishment, and shared housing
34 establishment must:
-8- LRB9113111RCpk
1 (i) permit immediate access to any resident by
2 an ombudsman; and
3 (ii) permit representatives of the Office,
4 with the permission of the resident's legal
5 representative or legal guardian, to examine a
6 resident's clinical and other records, and if a
7 resident is unable to consent to such review, and
8 has no legal guardian, permit representatives of the
9 Office appropriate access, as defined by the
10 Department in administrative rules, to the
11 resident's records.
12 (2) Each long term care facility, assisted living
13 establishment, and shared housing establishment shall
14 display, in multiple, conspicuous public places within
15 the facility accessible to both visitors and patients and
16 in an easily readable format, the address and phone
17 number of the Office, in a manner prescribed by the
18 Office.
19 (e) Immunity. An ombudsman or any other representative
20 of the Office participating in the good faith performance of
21 his or her official duties shall have immunity from any
22 liability (civil, criminal or otherwise) in any proceedings
23 (civil, criminal or otherwise) brought as a consequence of
24 the performance of his official duties.
25 (f) Business offenses.
26 (1) No person shall:
27 (i) Intentionally prevent, interfere with, or
28 attempt to impede in any way any representative of
29 the Office in the performance of his official duties
30 under this Act and the Older Americans Act of 1965;
31 or
32 (ii) Intentionally retaliate, discriminate
33 against, or effect reprisals against any long term
34 care facility resident or employee for contacting or
-9- LRB9113111RCpk
1 providing information to any representative of the
2 Office.
3 (2) A violation of this Section is a business
4 offense, punishable by a fine not to exceed $501.
5 (3) The Director of Aging shall notify the State's
6 Attorney of the county in which the long term care
7 facility is located, or the Attorney General, of any
8 violations of this Section.
9 (g) Confidentiality of records and identities. No files
10 or records maintained by the Office of State Long Term Care
11 Ombudsman shall be disclosed unless the State Ombudsman or
12 the ombudsman having the authority over the disposition of
13 such files authorizes the disclosure in writing. The
14 ombudsman shall not disclose the identity of any complainant,
15 resident, witness or employee of a long term care provider
16 involved in a complaint or report unless such person or such
17 person's guardian or legal representative consents in writing
18 to the disclosure, or the disclosure is required by court
19 order.
20 (h) Legal representation. The Attorney General shall
21 provide legal representation to any representative of the
22 Office against whom suit or other legal action is brought in
23 connection with the performance of the representative's
24 official duties, in accordance with the State Employee
25 Indemnification Act.
26 (i) Treatment by prayer and spiritual means. Nothing in
27 this Act shall be construed to authorize or require the
28 medical supervision, regulation or control of remedial care
29 or treatment of any resident in a long term care facility
30 operated exclusively by and for members or adherents of any
31 church or religious denomination the tenets and practices of
32 which include reliance solely upon spiritual means through
33 prayer for healing.
34 (Source: P.A. 90-639, eff. 1-1-99; 91-174, eff. 7-16-99;
-10- LRB9113111RCpk
1 91-656, eff. 1-1-01; revised 1-5-00.)
2 Section 10. The Nursing Home Care Act is amended by
3 changing Section 3-212 and adding Section 3-120 as follows:
4 (210 ILCS 45/3-120 new)
5 Sec. 3-120. Psychiatric rehabilitation services. The
6 provision of psychiatric rehabilitation services to residents
7 who are recipients of assistance under the Illinois Public
8 Aid Code is governed by Article 5F of the Illinois Public Aid
9 Code.
10 (210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
11 Sec. 3-212. Inspection.
12 (a) The Department, whenever it deems necessary in
13 accordance with subsection (b), shall inspect, survey and
14 evaluate every facility to determine compliance with
15 applicable licensure requirements and standards. An
16 inspection should occur within 120 days prior to license
17 renewal. The Department may periodically visit a facility
18 for the purpose of consultation. An inspection, survey, or
19 evaluation, other than an inspection of financial records,
20 shall be conducted without prior notice to the facility. A
21 visit for the sole purpose of consultation may be announced.
22 The Department shall provide training to surveyors about the
23 appropriate assessment, care planning, and care of persons
24 with mental illness (other than Alzheimer's disease or
25 related disorders) to enable its surveyors to determine
26 whether a facility is complying with State and federal
27 requirements about the assessment, care planning, and care of
28 those persons.
29 (a-1) An employee of a State or unit of local government
30 agency charged with inspecting, surveying, and evaluating
31 facilities who directly or indirectly gives prior notice of
-11- LRB9113111RCpk
1 an inspection, survey, or evaluation, other than an
2 inspection of financial records, to a facility or to an
3 employee of a facility is guilty of a Class A misdemeanor.
4 (a-2) An employee of a State or unit of local government
5 agency charged with inspecting, surveying, or evaluating
6 facilities who willfully profits from violating the
7 confidentiality of the inspection, survey, or evaluation
8 process shall be guilty of a Class 4 felony and that conduct
9 shall be deemed unprofessional conduct that may subject a
10 person to loss of his or her professional license. An action
11 to prosecute a person for violating this subsection (a-2) may
12 be brought by either the Attorney General or the State's
13 Attorney in the county where the violation took place.
14 (b) In determining whether to make more than the
15 required number of unannounced inspections, surveys and
16 evaluations of a facility the Department shall consider one
17 or more of the following: previous inspection reports; the
18 facility's history of compliance with standards, rules and
19 regulations promulgated under this Act and correction of
20 violations, penalties or other enforcement actions; the
21 number and severity of complaints received about the
22 facility; any allegations of resident abuse or neglect;
23 weather conditions; health emergencies; other reasonable
24 belief that deficiencies exist.
25 (b-1) The Department shall not be required to determine
26 whether a facility certified to participate in the Medicare
27 program under Title XVIII of the Social Security Act, or the
28 Medicaid program under Title XIX of the Social Security Act,
29 and which the Department determines by inspection under this
30 Section or under Section 3-702 of this Act to be in
31 compliance with the certification requirements of Title XVIII
32 or XIX, is in compliance with any requirement of this Act
33 that is less stringent than or duplicates a federal
34 certification requirement. In accordance with subsection (a)
-12- LRB9113111RCpk
1 of this Section or subsection (d) of Section 3-702, the
2 Department shall determine whether a certified facility is in
3 compliance with requirements of this Act that exceed federal
4 certification requirements. If a certified facility is found
5 to be out of compliance with federal certification
6 requirements, the results of an inspection conducted pursuant
7 to Title XVIII or XIX of the Social Security Act may be used
8 as the basis for enforcement remedies authorized and
9 commenced under this Act. Enforcement of this Act against a
10 certified facility shall be commenced pursuant to the
11 requirements of this Act, unless enforcement remedies sought
12 pursuant to Title XVIII or XIX of the Social Security Act
13 exceed those authorized by this Act. As used in this
14 subsection, "enforcement remedy" means a sanction for
15 violating a federal certification requirement or this Act.
16 (c) Upon completion of each inspection, survey and
17 evaluation, the appropriate Department personnel who
18 conducted the inspection, survey or evaluation shall submit a
19 copy of their report to the licensee upon exiting the
20 facility, and shall submit the actual report to the
21 appropriate regional office of the Department. Such report
22 and any recommendations for action by the Department under
23 this Act shall be transmitted to the appropriate offices of
24 the associate director of the Department, together with
25 related comments or documentation provided by the licensee
26 which may refute findings in the report, which explain
27 extenuating circumstances that the facility could not
28 reasonably have prevented, or which indicate methods and
29 timetables for correction of deficiencies described in the
30 report. Without affecting the application of subsection (a)
31 of Section 3-303, any documentation or comments of the
32 licensee shall be provided within 10 days of receipt of the
33 copy of the report. Such report shall recommend to the
34 Director appropriate action under this Act with respect to
-13- LRB9113111RCpk
1 findings against a facility. The Director shall then
2 determine whether the report's findings constitute a
3 violation or violations of which the facility must be given
4 notice. Such determination shall be based upon the severity
5 of the finding, the danger posed to resident health and
6 safety, the comments and documentation provided by the
7 facility, the diligence and efforts to correct deficiencies,
8 correction of the reported deficiencies, the frequency and
9 duration of similar findings in previous reports and the
10 facility's general inspection history. Violations shall be
11 determined under this subsection no later than 60 days after
12 completion of each inspection, survey and evaluation.
13 (d) The Department shall maintain all inspection, survey
14 and evaluation reports for at least 5 years in a manner
15 accessible to and understandable by the public.
16 (Source: P.A. 88-278; 89-21, eff. 1-1-96; 89-171, eff.
17 1-1-96; 89-197, eff. 7-21-95; 89-626, eff. 8-9-96.)
18 Section 15. The Illinois Public Aid Code is amended by
19 adding Article 5F as follows:
20 (305 ILCS 5/Art. 5F heading new)
21 PSYCHIATRIC REHABILITATION SERVICES
22 (305 ILCS 5/5F-5 new)
23 Sec. 5F-5. Costs.
24 (a) The Illinois Department shall reimburse residential
25 facilities for program costs associated with the delivery of
26 psychiatric rehabilitation services to individuals with
27 mental illness, according to information obtained during each
28 facility's most recent Inspection of Care review conducted by
29 the Illinois Department. The category of facilities that is
30 affected by this Article is nursing facilities with at least
31 one individual with mental illness determined to require
-14- LRB9113111RCpk
1 psychiatric rehabilitation services. The Inspection of Care
2 review assessments of 100% of the Medicaid residents shall be
3 conducted in these facilities every 12 months. Total program
4 reimbursement determination shall be based upon Inspection of
5 Care review criteria specified in this Article.
6 (b) Reimbursement for services under this Article does
7 not include services to maintain generally independent
8 individuals who are able to function with little supervision
9 or in the absence of a continuous psychiatric rehabilitation
10 services program.
11 (305 ILCS 5/5F-10 new)
12 Sec. 5F-10. Psychiatric rehabilitation service
13 requirements for individuals with mental illness in
14 residential facilities.
15 (a) Facilities serving individuals with mental illness
16 must provide a continuous psychiatric rehabilitation service
17 program for each individual as required by Section 1919(b)(4)
18 of the Social Security Act (42 U.S.C. 1396r). This program
19 shall be directed toward:
20 (1) The acquisition of behaviors and skills
21 necessary to reach the highest practical functional level
22 of self-determination and independence in the areas of
23 self-maintenance, social functioning, community living
24 activities, and work related skills; and
25 (2) The reduction of residual psychiatric symptoms
26 with the prevention or deceleration of regression or loss
27 of current optimal functional status.
28 (b) The psychiatric rehabilitation service program for
29 each individual must be delivered through the implementation
30 of a Comprehensive Program Plan consisting of interventions
31 and services that are designed to meet the individual's needs
32 with continuity across all of the environments in which the
33 individual lives. The Comprehensive Program Plan is a plan
-15- LRB9113111RCpk
1 where psychiatric rehabilitation services programming and
2 interventions are consistently implemented throughout the
3 day, regardless of the individual's whereabouts.
4 (c) The Comprehensive Program Plan must be developed by
5 an Interdisciplinary Team that includes the individual, and
6 the professions, disciplines, or service areas that are
7 relevant to identifying and prioritizing the individual's
8 needs and designing programs to address the identified needs.
9 (d) The facility must have qualified professionals
10 available to develop, implement, and monitor the various
11 programs designed to address each individual's identified
12 needs. Qualified professional staff must be licensed,
13 certified, or registered, as follows:
14 (A) A physician licensed under the Medical
15 Practice Act of 1987.
16 (B) A registered nurse licensed under the
17 Nursing and Advanced Practice Nursing Act.
18 (C) An occupational therapist registered under
19 the Illinois Occupational Therapy Practice Act.
20 (D) A psychologist registered under the
21 Clinical Psychologist Licensing Act.
22 (E) A social worker licensed under the Social
23 Work and Social Work Practice Act.
24 (F) A rehabilitation counselor certified by
25 the Commission on Rehabilitation Counselors
26 Certification.
27 (e) Each individual's psychiatric rehabilitation service
28 program must be integrated, coordinated, and monitored by a
29 Psychiatric Rehabilitation Services Coordinator, identified
30 as an individual who meets one of the following criteria and
31 in addition has a minimum of one year of experience working
32 directly with persons with mental illness:
33 (1) A doctor of medicine or osteopathy;
34 (2) A registered nurse;
-16- LRB9113111RCpk
1 (3) An occupational therapist;
2 (4) A psychologist;
3 (5) A social worker; or
4 (6) An individual who has at least a bachelor's
5 degree in a human services field including, but not
6 limited to: sociology, special education, rehabilitation
7 counseling, or psychology.
8 (305 ILCS 5/5F-15 new)
9 Sec. 5F-15. Inspection of Care Review; evaluation of
10 psychiatric rehabilitation services in residential facilities
11 for individuals with mental illness.
12 (a) Medicaid certified facilities serving individuals
13 with mental illness are required to address the needs of each
14 individual through a continuous psychiatric rehabilitation
15 service program. The Interdisciplinary Team is a key
16 component in a facility's ability to develop an appropriate
17 program of psychiatric rehabilitation services for each
18 individual in residence. The responsibility for the
19 composition and quality of the Interdisciplinary Team is the
20 sole responsibility of the licensed provider. The facility is
21 fully responsible for ensuring the delivery of all services
22 as set forth in this Article that are deemed necessary by the
23 Interdisciplinary Team in the psychiatric rehabilitation
24 services program for each individual.
25 (b) The Inspection of Care review criteria shall assess
26 facility performance in meeting the variable needs of
27 individuals with mental illness through individualized
28 programs of psychiatric rehabilitation services. The
29 criteria identified in this Article are the essentials of
30 psychiatric rehabilitation services.
31 (305 ILCS 5/5F-20 new)
32 Sec. 5F-20. Comprehensive functional assessments and
-17- LRB9113111RCpk
1 reassessments.
2 (a) Comprehensive assessments. The Interdisciplinary
3 Team must identify the individual's needs by performing a
4 comprehensive functional assessment as needed to supplement
5 any preliminary evaluation conducted prior to admission of an
6 individual to a residential facility. Assessments must be
7 coordinated by a Psychiatric Rehabilitation Services
8 Coordinator.
9 (1) A comprehensive functional assessment must be
10 administered by the Interdisciplinary Team no later than
11 14 days after admission of an individual to a residential
12 facility or notification from the Illinois Department
13 that a current resident has been identified as being in
14 need of psychiatric rehabilitation services. Reports
15 from the pre-admission screening assessment may be used
16 as part of the comprehensive functional assessment if the
17 assessment reflects the current condition of the
18 individual. The assessment must include:
19 (A) A psychiatric evaluation completed by a
20 board certified psychiatrist, or when countersigned
21 by a psychiatrist, a physician, a Ph.D. clinical
22 psychologist, a Master Degree Psychiatric RN, or a
23 Licensed Clinical Social Worker. The evaluation
24 shall include:
25 (i) A psychiatric history with present
26 and previous psychiatric symptoms;
27 (ii) A comprehensive mental status
28 examination, which includes: a description of
29 intellectual functioning, memory functioning,
30 orientation, affect, suicidal/homicidal
31 ideation, response to reality testing, and
32 current attitudes and overt behaviors; and
33 (iii) A diagnostic formulation, using the
34 Diagnostic Statistical Manual III (Revised).
-18- LRB9113111RCpk
1 (B) A psychosocial history completed by a
2 Social Worker or Occupational Therapist covering the
3 following Points:
4 (i) Personal and family history
5 including the history of mental illness in the
6 family;
7 (ii) Cognitive functioning (attention,
8 memory, information attitudes), perceptual
9 disturbances, thought content, speech, and
10 affect; and an estimation of the ability and
11 willingness to participate in treatment;
12 (iii) History of mental health treatment;
13 (iv) Present level of functioning
14 including social adjustment and daily living
15 skills;
16 (v) Legal status (e.g., guardianship,
17 representative payee, trust beneficiary,
18 pending court order);
19 (vi) Level of education or specialized
20 training;
21 (vii) Previous employment or acquired
22 vocational skills, if applicable;
23 (viii) Activities and interests;
24 (ix) History or current alcohol or
25 chemical dependency;
26 (x) Resource availability (including,
27 but not limited to income entitlements, health
28 care benefits, subsidized housing, and social
29 services); and
30 (xi) Current living arrangements and
31 existing natural support network.
32 (C) Level of functioning scale completed by a
33 social worker or an occupational therapist.
34 (D) Rehabilitation potential completed by a
-19- LRB9113111RCpk
1 social worker, an occupational therapist or a
2 certified rehabilitation counselor.
3 (E) Recreation and leisure activities
4 completed by an occupational therapist or under the
5 direction of an occupational therapist, by the
6 activity director.
7 (F) A physical examination completed by a
8 physician or by a registered nurse and countersigned
9 by a physician.
10 (G) A health assessment completed by a
11 registered nurse that includes:
12 (i) Sensory and physical impairments
13 completed by a physician or by a registered
14 nurse and countersigned by a physician;
15 (ii) Special treatments or procedures;
16 (iii) Medical history if appropriate;
17 (iv) Medication history if appropriate;
18 (v) Oral screening; and
19 (vi) Nutritional screening.
20 (H) Discharge potential completed by a
21 psychiatric rehabilitation services coordinator or a
22 social worker.
23 (I) Other assessments, as indicated by the
24 individual's needs, which, in the Interdisciplinary
25 Team's professional judgment, should be performed.
26 (2) The comprehensive functional assessment must be
27 used to develop a comprehensive program plan that:
28 (A) Addresses presenting problems and areas of
29 need;
30 (B) Identifies the individual's specific
31 functional strengths and deficits;
32 (C) Addresses the reduction of symptoms and
33 the acquisition of skills necessary for the
34 individual to successfully move into the most
-20- LRB9113111RCpk
1 facilitative environment; and
2 (D) Identifies the individual's need for
3 services without regard to the current availability
4 of the services.
5 (b) Reassessments.
6 (1) At least every 3 months, the psychiatric
7 rehabilitation services coordinator shall review each
8 individual and provide an analysis of this review. If
9 needed, the appropriate Interdisciplinary Team members
10 will reassess the individual and revise the resident's
11 assessment, assuring the continued accuracy of the
12 assessment.
13 (2) Comprehensive functional assessments must be
14 conducted in no case less often than once every 12
15 months. Assessments shall be performed by and obtained
16 from the appropriate professional in the following areas:
17 (A) Psychiatric evaluation;
18 (B) Psychosocial history;
19 (C) Level of functioning scale;
20 (D) Rehabilitation potential;
21 (E) Recreation and leisure activities;
22 (F) Physical examination;
23 (G) Health assessment; and
24 (H) Other assessments needed and performed as
25 determined by the interdisciplinary team.
26 (305 ILCS 5/5F-25 new)
27 Sec. 5F-25. Interdisciplinary Team. The
28 Interdisciplinary Team for individuals with mental illness
29 must include representation from the professions, disciplines
30 or service areas that are relevant to the individual's
31 identified needs as described by the comprehensive functional
32 assessments, and to designing programs that meet the
33 individual's need. The team shall identify the treatment
-21- LRB9113111RCpk
1 needs of the individual and collectively assigns priorities
2 to the individual's needs to develop a single Comprehensive
3 Program Plan.
4 (a) The Comprehensive Program Plan shall be developed
5 with the participation of an Interdisciplinary Team comprised
6 of professionals who represent the needs of the individual.
7 The team must, at least, include a physician; a social
8 worker; a psychiatric rehabilitation services coordinator; a
9 psychiatrist or a Ph.D. clinical psychologist or a Master
10 Degree psychiatric RN and a registered nurse or a licensed
11 practical nurse with responsibility for the individual.
12 (b) The individual or the individual's legal guardian
13 must participate on the team unless the individual's or the
14 legal guardian's inability or unwillingness to participate is
15 documented.
16 (c) Upon request of the individual, the individual's
17 parent or advocate may participate as a member of the
18 Interdisciplinary Team.
19 (d) Each individual team member shall collect data or
20 utilize previous data from assessments, interpret data, and
21 clearly summarize and report findings to the
22 Interdisciplinary Team. Each professional team member shall
23 write recommendations regarding appropriate program and
24 service goals.
25 (e) The Team shall integrate data from the comprehensive
26 assessments and prioritize treatment goals and programs.
27 (f) A Comprehensive Program Plan must be developed
28 within 7 days after the completion of the comprehensive
29 functional assessment.
30 (g) The Comprehensive Program Plan shall be signed by
31 each professional Interdisciplinary Team member participating
32 in the development of the individual's plan, and when
33 possible, the individual for whom the plan was developed.
34 (h) There must be documented evidence that the
-22- LRB9113111RCpk
1 Comprehensive Program Plan was explained to the individual or
2 legal guardian of the individual for whom the plan was
3 developed.
4 (305 ILCS 5/5F-30 new)
5 Sec. 5F-30. Comprehensive Program Plan. Each individual
6 must have a Comprehensive Program Plan that is composed of
7 goals and objectives established by an Interdisciplinary
8 Team. The Comprehensive Program Plan shall be developed and
9 modified, as necessary, according to the individual's needs,
10 as identified in the comprehensive functional assessments.
11 The assessment must be reviewed for relevancy and updated as
12 appropriate, at least quarterly by the Interdisciplinary
13 Team. The Comprehensive Program Plan must be reviewed and
14 revised by the Interdisciplinary Team after each assessment
15 to assure that the Comprehensive Program Plan remains
16 relevant and appropriate to meet the needs of the individual.
17 (a) The Comprehensive Program Plan must address major
18 needs of the individual through a program of individualized
19 services.
20 (b) The Comprehensive Program Plan must describe
21 relevant interventions to reduce or stabilize symptoms of the
22 individual's illness and support the individual toward
23 independence.
24 (c) The plan must be a single comprehensive program
25 designed to meet the needs of the individual across all of
26 the environments in which he or she lives, through consistent
27 program implementation and interventions.
28 (d) A discharge plan must be developed by the
29 Interdisciplinary Team as a component of the individual's
30 Comprehensive Program Plan. This Plan shall address the
31 reduction of symptoms and the acquisition of skills necessary
32 for the individual to successfully move into the most
33 facilitative environment.
-23- LRB9113111RCpk
1 (e) The Comprehensive Program Plan shall be based upon
2 each resident's assessed functioning level and shall include
3 the following activities as appropriate for the resident:
4 (1) Self-maintenance training addressing topics
5 such as:
6 (A) Physical functioning;
7 (B) Personal care and hygiene;
8 (C) Grooming;
9 (D) Dressing;
10 (E) Toileting;
11 (F) Nutrition;
12 (G) Speech and Language;
13 (H) Eating habits;
14 (I) Maintenance of personal space and
15 possessions;
16 (J) Health maintenance;
17 (K) Use of medication; and
18 (L) Self-medication program.
19 (2) Social functioning, addressing topics such as:
20 (A) Interaction and involvement with family
21 and significant others;
22 (B) Social skills;
23 (C) Relationships with male or female friends,
24 or both;
25 (D) Peer group involvement;
26 (E) Leisure and recreational activities; and
27 (F) Education regarding alcohol and substance
28 abuse.
29 (3) Community living skills addressing topics such
30 as:
31 (A) Homemaking responsibilities:
32 (i) Cleaning;
33 (ii) Laundry;
34 (iii) Meal preparation and service;
-24- LRB9113111RCpk
1 (iv) Shopping;
2 (v) Financial management;
3 (vi) Using telephone;
4 (B) Use of transportation;
5 (C) Traveling from residence independently;
6 (D) Recognizing and avoiding common dangers;
7 and
8 (E) Use of community services.
9 (4) Work related skills addressing topics such as:
10 (A) Job retention behaviors:
11 (i) Promptness;
12 (ii) Regular attendance;
13 (iii) Relationships with co-workers and
14 supervisors;
15 (iv) Work quality;
16 (v) Work quantity;
17 (vi) Ability to accept, understand, and
18 carry out instructions;
19 (B) Job seeking skills:
20 (i) Ability to initiate and schedule
21 one's own activities;
22 (ii) Ability to seek employment;
23 (iii) Completing an application;
24 (iv) Personal appearance;
25 (v) Communication and interviewing
26 skills;
27 (vi) Ability to set realistic vocational
28 goals;
29 (C) Basic Academic skills; and
30 (D) Alternative vocational placements:
31 (i) Supported employment;
32 (ii) Transitional employment;
33 (iii) Workshop employment.
34 (f) The Comprehensive Program Plan must contain
-25- LRB9113111RCpk
1 objectives to reach each of the individual's goals in the
2 Plan. Each objective:
3 (1) Must be developed by the Interdisciplinary
4 Team;
5 (2) Must be based on the results obtained from the
6 assessment process;
7 (3) Must be stated in measurable terms and identify
8 specific performance measures to assess;
9 (4) Must be developed with a projected completion
10 or review date (month, day, year); and
11 (5) Must be assigned a priority based on the
12 individual's functioning level and on principles of
13 sequential skill development.
14 (g) The plan for each individual must state specific
15 goals that are developed by the Interdisciplinary Team. The
16 individual's needs must be prioritized, and approaches or
17 programs must be developed with specific goals, to address
18 the higher prioritized needs. If there is a lower priority
19 need that is not being addressed through a specific goal or
20 program, a statement must be made as to why it is not being
21 addressed or how the need will be otherwise addressed.
22 (h) The goals must be designed to assist the individual
23 to function at the greatest physical, cognitive, social and
24 vocational level that he or she can presently or potentially
25 achieve.
26 (i) Goals must not be so difficult that they cannot be
27 accomplished in a year's time or so simple that they are
28 already in the individual's repertoire.
29 (j) For each behavioral and service goal identified in
30 the Comprehensive Program Plan, the Interdisciplinary Team
31 must indicate the appropriate person or persons responsible
32 for implementing the program or providing the service.
33 (k) The individuals must be offered choices of relevant
34 rehabilitation activities that are available to meet their
-26- LRB9113111RCpk
1 needs. Community based (off site) rehabilitation programs
2 should be encouraged.
3 (l) Programs designed to implement the objectives in the
4 resident's Comprehensive Program Plan must specify:
5 (1) Program goals (long and short term) with
6 rationale for the goals;
7 (2) Specific objectives to meet the individual
8 goals stated sequentially;
9 (3) Planned service or intervention related to
10 accomplishing the objectives including the frequency,
11 quantity, and duration of services;
12 (4) The evaluation method to be used to monitor
13 provision of the planned service or intervention;
14 (5) The evaluation criteria used to monitor the
15 expected results of accomplishing the objective;
16 (6) Progress evaluation periods; and
17 (7) Identification of the professional staff
18 responsible for implementing specific parts of the
19 program, and for overall program implementation.
20 (m) Comprehensive Program Plan implementation.
21 (1) A single Comprehensive Program Plan must be
22 developed and implemented for each individual.
23 (2) Services relevant to the Comprehensive Program
24 Plan must be provided to implement the Comprehensive
25 Program Plan. Programs must be integrated into the
26 individual's daily life so that he or she receives a
27 continuous psychiatric rehabilitation service program
28 across all environments.
29 (3) If multiple providers are providing mental
30 health services to the client, one master Comprehensive
31 Program Plan shall reflect the coordination of goals and
32 services. With written consent from the individual, a
33 copy of the Comprehensive Program Plan shall be sent to
34 the appropriate providers.
-27- LRB9113111RCpk
1 (4) Program interventions to the extent practical
2 shall be delivered in a natural context during normal,
3 daily occurrences. Specific objectives and services or
4 interventions should be integrated into activities that
5 occur naturally in the individual's environment.
6 (n) Comprehensive Program Plan documentation.
7 (1) The individual's response to the Comprehensive
8 Program Plan and progress toward goals must be documented
9 in progress notes.
10 (2) Significant events that are related to the
11 individual's Comprehensive Program Plan, and assessments
12 that contribute to an overall understanding of his or her
13 ongoing level and quality of functioning, must be
14 documented.
15 (o) Comprehensive Program Plan monitoring and change.
16 Implementation of the individual's Comprehensive Program Plan
17 must be supervised by the psychiatric rehabilitation services
18 coordinator on an ongoing basis. At least monthly, the
19 psychiatric rehabilitation services coordinator must review
20 and document the individual's progress.
21 (1) The psychiatric rehabilitation services
22 coordinator must review progress to determine if the
23 individual:
24 (A) Has successfully completed an objective as
25 identified in the Comprehensive Program Plan;
26 (B) Is regressing or losing skills previously
27 gained;
28 (C) Is failing to progress toward identified
29 objectives after reasonable efforts have been made
30 relative to his or her level of functioning and
31 potential; and
32 (D) Has made sufficient progress toward
33 accomplishing an objective and is ready to move
34 toward a new objective.
-28- LRB9113111RCpk
1 (2) The psychiatric rehabilitation services
2 coordinator must review the progress or lack of progress
3 towards accomplishing program objectives.
4 (3) Based upon this review, the psychiatric
5 rehabilitation services coordinator must suggest
6 revisions in the Comprehensive Program Plan, when
7 necessary, to the Interdisciplinary Team. If revisions
8 are required, the Interdisciplinary Team shall make the
9 revisions in consultation with the psychiatrist or
10 physician, the psychiatric rehabilitation service
11 coordinator, the nurse who is responsible for the
12 individual, and with the individual.
13 (4) The psychiatric rehabilitation services
14 coordinator shall coordinate staff in the delivery of
15 programs, oversee data collection, and review
16 performance.
17 (p) Comprehensive Program Plan outcome. The outcome of
18 the current Comprehensive Program Plan shall provide a
19 measure of how well the program of psychiatric rehabilitation
20 services has moved the individual closer to his or her
21 optimum individual, social, community, and vocational
22 functioning.
23 (305 ILCS 5/5F-35 new)
24 Sec.5F-35. Administration of psychopharmacologic drugs.
25 Psychopharmacologic drugs may only be ordered by a
26 psychiatrist or physician and, when ordered, must be an
27 integrated part of the resident's individual treatment plan
28 that is designed to lead to the most facilitative way of
29 treating the symptoms for which the drugs are employed.
30 (a) No prescription medication shall be administered
31 except upon the written or verbal order of a psychiatrist or
32 physician.
33 (1) Verbal orders may be given only to a licensed
-29- LRB9113111RCpk
1 nurse, pharmacist or another physician. The individual
2 receiving a verbal order must record and sign it
3 immediately.
4 (2) Verbal orders for Schedule II controlled
5 substances are permitted only in the case of a bonafide
6 emergency situation. Two PRNs within a 6 month period
7 shall require a medical review.
8 (3) Verbal orders must be confirmed in writing by
9 the ordering physician within 72 hours.
10 (4) A prescription may not be written for more than
11 a 90 day period.
12 (b) At least every month, the psychiatrist or physician
13 shall review the psychopharmacologic drug regimen of each
14 individual under his or her care.
15 (c) The nursing facility shall establish automatic stop
16 order procedures or other methods for controlling medication
17 dosage when the prescribing physician fails to review the
18 drug regimen, fails to confirm verbal orders, or does not
19 include in the order a specific limit on the time or number
20 of doses. The facility must notify the prescribing physician
21 of this action prior to the expiration date of the
22 medication.
23 (d) Before a psychopharmacologic medication is
24 prescribed, the attending psychiatrist or physician shall
25 record in the resident's medical record the following
26 information:
27 (1) The diagnosis and the specific behaviors or
28 other signs and symptoms that indicate a need for the
29 medication, and assurance that appropriate laboratory
30 tests are performed on a regular basis and analyzed;
31 (2) The method for assessing the resident's
32 progress or response to the treatment, including adverse
33 effects; and
34 (3) Confirmation that the psychiatrist, physician
-30- LRB9113111RCpk
1 or nurse has explained in lay terms to the individual or
2 the individual's legal guardian, or both, the reasons for
3 the treatment, possible benefits and consequences of the
4 medication, and has obtained informed consent for its
5 use.
6 (e) Administration of psychopharmacologic medication.
7 (1) During the course of the administration of
8 psychopharmacologic medication, the nursing facility
9 shall ensure that the resident's progress or response to
10 the treatment, including adverse effects, is monitored
11 and recorded.
12 (2) Pursuant to this requirement, the nursing
13 facility shall ensure that appropriate persons
14 responsible for the resident's physical, mental, and
15 psychosocial care and other treatment are trained as to
16 the potential effects of the medication and record their
17 observations of these effects, including effects of the
18 resident's progress in habilitation and education
19 programs and participation in other activities.
20 (f) Repeated administration of a psychopharmacologic
21 medication, including substitution of medication of the same
22 class, shall never cumulatively exceed one year without the
23 attending psychiatrist or physician effecting a carefully
24 monitored gradual withdrawal of the medication if
25 appropriate. This periodic drug withdrawal shall be used to
26 determine the need for continuing the medication and the
27 prescribed dosage. During the withdrawal, the results shall
28 be noted in the resident's medical record. Withdrawal may
29 proceed as long as the resident's condition has not worsened.
30 (g) The attending psychiatrist or physician shall
31 undertake or order an immediate review of a resident's
32 psychopharmacologic medication regimen when any pharmacist,
33 physician, or nurse states in writing, with reasons for the
34 review, to the attending psychiatrist or physician with
-31- LRB9113111RCpk
1 experience in psychiatric care that the regimen constitutes a
2 hazard of serious adverse effects not warranted by
3 therapeutic benefit to the residents. Special attention
4 shall be paid to the following medication regimens:
5 (1) Concurrent use of more than one anti-psychotic
6 medication or concurrent use of an anti-psychotic
7 medication with an anti-anxiety or anti-depressant
8 medication;
9 (2) Use of any anti-convulsive or anti-Parkinson
10 medication in the absence of current indications that the
11 resident suffers from convulsions or Parkinson-like
12 effect;
13 (3) Use of any anti-psychotic medication in the
14 presence of evidence of side effects, such as tardive
15 dyskinesia.
16 (h) Any individual taking a neuroleptic must be screened
17 for tardive dyskinesia every 6 months. The screening may be
18 conducted by a nurse or physician using any recognized
19 screening instrument. The results of the screening must be
20 documented in the individual's file and reviewed by the
21 prescribing physician.
22 (i) Mandatory review of a resident's
23 psychopharmacological medication regime is necessary whenever
24 the individual or his or her legal guardian informs the
25 attending physician of experiencing effects of taking a
26 medication that he or she finds to be painful, extremely
27 distracting, or that decreases his or her ability to function
28 normally in everyday life. If, after review, the prescribing
29 physician or psychiatrist believes a drug to be causing these
30 effects, informed consent for its continued use must be
31 obtained.
32 (j) All facility staff shall be trained to recognize the
33 symptoms of tardive dyskinesia and any suspected symptoms
34 must be reported immediately to the prescribing physician.
-32- LRB9113111RCpk
1 (305 ILCS 5/5F-40 new)
2 Sec. 5F-40. Behavioral emergencies.
3 (a) There shall be written policies that are followed in
4 the operation of the facility regarding behavior emergencies
5 and the use of restraints.
6 (1) The facility shall develop progressively
7 restrictive levels of behavior intervention that create
8 an incremental approach toward responding to various
9 behavioral emergencies involving residents.
10 (2) The facility shall respond to a given behavior
11 emergency by using the least restrictive method possible
12 that will protect the health and safety of the resident
13 and other residents.
14 (3) When a facility's response to a behavioral
15 emergency does not utilize a lower level of intervention
16 prior to instituting a higher level, the facility shall
17 document in the resident's record why the more
18 restrictive measures are used.
19 (b) The facility shall not confine a resident to a room
20 unattended nor in a manner that prohibits the resident from
21 egressing from that room.
22 (c) When a disturbed or unmanageable resident is
23 separated from the adverse stimuli related to the situation
24 that is occurring, the facility shall record in the
25 resident's record the events and the reasons for removing the
26 resident from the situation.
27 (305 ILCS 5/5F-45 new)
28 Sec. 5F-45. Planning.
29 (a) Upon admission, a discharge plan must be developed
30 by the Interdisciplinary Team as a component of the
31 individual's Comprehensive Program Plan. This plan shall
32 address the reduction of symptoms and the acquisition of
33 behaviors and skills necessary for the individual to move to
-33- LRB9113111RCpk
1 the most facilitative environment.
2 (b) Thirty days before the individual's planned
3 discharge, the psychiatric rehabilitation services
4 coordinator must notify the individual or the individual's
5 legal representative and, when appropriate, the individual's
6 family, both orally and in writing of the upcoming planned
7 discharge. A specific individualized post discharge plan
8 must be developed by the Interdisciplinary Team and, when
9 appropriate, with input from community support agencies,
10 family and friends, 30 days before the planned discharge.
11 The plan shall identify:
12 (1) The alternative living site;
13 (2) Financial resources available;
14 (3) Community service needs and availability;
15 (4) Community mental health services with scheduled
16 psychiatric appointments;
17 (5) Access to medical care and medications; and
18 (6) Case management system responsible for
19 transition and follow-up.
20 (c) At the time of discharge, the Interdisciplinary Team
21 must:
22 (1) Have prepared a discharge summary of the
23 individual's present psychiatric status, self-maintenance
24 skills, behavior and impulse control, social functioning,
25 community living skills, work and work-related skills and
26 general health status, as well as indicating specific
27 issues that may negatively impact community adjustment,
28 with recommendations for future programming and follow-up
29 services; and
30 (2) Provide the post discharge plan of care and
31 discharge summary to the individual's new living
32 environment, to assist in his or her successful
33 adjustment to that environment.
-34- LRB9113111RCpk
1 (305 ILCS 5/5F-50 new)
2 Sec. 5F-50. Reimbursement for additional costs.
3 (a) Nursing facilities (ICF and SNF) providing
4 psychiatric rehabilitation services to individuals, excluding
5 State operated facilities for the mentally ill, shall be
6 reimbursed for providing a psychiatric rehabilitation
7 services program for each client with mental illness as
8 specified in this Article.
9 (b) Facility reimbursement for cost associated with
10 providing psychiatric rehabilitation services to individuals
11 with mental illness shall be made upon conclusion of resident
12 reviews that are conducted by the Department of Human
13 Services or its contracted agent.
14 (c) The additional reimbursement for costs associated
15 with psychiatric rehabilitation services program costs shall
16 be based upon the presence of 3 determinants. The 3
17 determinants are:
18 (1) Minimum Staffing.
19 (A) Direct Services - Facilities must be in
20 compliance with the Health Care Financing
21 Administration's (42 CFR 442.201 or 42 CFR 442.302
22 (1989)) and the Illinois Department of Public
23 Health's minimum staffing standards relative to
24 facility type.
25 (B) The number of additional direct services
26 staff necessary for delivering adequate psychiatric
27 rehabilitation services programs for individuals
28 with mental illness shall be based upon a full-time
29 equivalent staff to client ratio of 1:7.5.
30 (2) Psychiatric rehabilitation services
31 coordinator.
32 (A) Each individual's psychiatric
33 rehabilitation services program must be integrated,
34 coordinated and monitored by a psychiatric
-35- LRB9113111RCpk
1 rehabilitation services coordinator. Any facility
2 required to provide psychiatric rehabilitation
3 services programs to individuals with mental illness
4 must provide psychiatric rehabilitation services
5 coordinator services. Delivery of these services is
6 based upon a full-time equivalent ratio of one
7 psychiatric rehabilitation services coordinator to
8 30 individuals being served.
9 (B) A Psychiatric Rehabilitation Services
10 Coordinator shall be a person who has at least one
11 year of experience working directly with persons
12 with mental illness and is one of the following:
13 (i) A doctor of medicine or osteopathy;
14 (ii) A registered nurse;
15 (iii) An occupational therapist;
16 (iv) A psychologist;
17 (v) A social worker; or
18 (vi) An individual who has at least a
19 bachelor's degree in a human services field
20 including, but not limited to, sociology,
21 special education, rehabilitation counseling,
22 and psychology).
23 (3) Assessment and other program services.
24 (A) A comprehensive functional assessment that
25 identifies an individual's needs must be performed
26 as needed to supplement any preliminary evaluations
27 conducted prior to admission to a nursing facility.
28 (B) A comprehensive functional assessment must
29 include:
30 (i) A psychiatric evaluation completed by
31 a board certified psychiatrist, or when
32 countersigned by a psychiatrist, a physician, a
33 Ph.D. clinical psychologist, a Master Degree
34 psychiatric RN, or a licensed clinical social
-36- LRB9113111RCpk
1 worker.
2 (ii) A psycho-social history completed by
3 a social worker or an occupational therapist.
4 (iii) Level of functioning scale
5 completed by a social worker or an
6 occupational therapist.
7 (iv) A rehabilitation potential completed
8 by a social worker or an occupational
9 therapist.
10 (v) Recreation and leisure activities
11 completed by an occupational therapist or by
12 the activity director.
13 (vi) A physical examination completed by
14 a physician or by a registered nurse
15 countersigned by a physician.
16 (vii) A health assessment completed by a
17 registered nurse.
18 (viii) A discharge potential completed
19 and signed by a psychiatric rehabilitation
20 services coordinator or a social worker.
21 (ix) Other assessments performed by
22 qualified professionals, as indicated by the
23 individual's needs, which the Interdisciplinary
24 Team's professional judgment dictates, may be
25 performed.
26 (d) Costs associated with psychiatric rehabilitation
27 services program reimbursement includes other program costs,
28 such as consultants, inservice training, program-related
29 supplies and other items necessary for the delivery of
30 psychiatric rehabilitation services to clients in accordance
31 with their individual program plans.
32 (e) Total program reimbursement for the additional cost
33 associated with the delivery of psychiatric rehabilitation
34 services to individuals with mental illness residing in
-37- LRB9113111RCpk
1 nursing facilities shall be $10 per day, per individual being
2 served. Facility eligibility for psychiatric rehabilitation
3 services program reimbursement is dependent upon the facility
4 meeting all criteria specified in this Article.
5 Section 99. Effective date. This Act takes effect
6 January 1, 2001.