Bill Text: IL HB4585 | 2013-2014 | 98th General Assembly | Engrossed

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Bill Title: Amends the Nursing Home Care Act. Provides that a restraint may be used only with the informed consent of the resident, the resident's guardian, or the resident's representative (rather than the resident, the resident's guardian, or other authorized representative). Provides that psychotropic medication shall not be prescribed without the informed consent of the resident, the resident's guardian, or the resident's representative (rather than the resident, the resident's guardian, or other authorized representative). Effective immediately.

Spectrum: Moderate Partisan Bill (Democrat 5-1)

Status: (Failed) 2014-12-03 - Session Sine Die [HB4585 Detail]

Download: Illinois-2013-HB4585-Engrossed.html

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HB4585 Engrossed LRB098 16957 RPS 52035 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Nursing Home Care Act is amended by changing
Sections 2-106 and 2-106.1 as follows:
(210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106)
Sec. 2-106. (a) For purposes of this Act, (i) a physical
restraint is any manual method or physical or mechanical
device, material, or equipment attached or adjacent to a
resident's body that the resident cannot remove easily and
restricts freedom of movement or normal access to one's body.
Devices used for positioning, including but not limited to bed
rails, gait belts, and cushions, shall not be considered to be
restraints for purposes of this Section; (ii) a chemical
restraint is any drug used for discipline or convenience and
not required to treat medical symptoms. The Department shall by
rule, designate certain devices as restraints, including at
least all those devices which have been determined to be
restraints by the United States Department of Health and Human
Services in interpretive guidelines issued for the purposes of
administering Titles XVIII and XIX of the Social Security Act.
(b) Neither restraints nor confinements shall be employed
for the purpose of punishment or for the convenience of any

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facility personnel. No restraints or confinements shall be
employed except as ordered by a physician who documents the
need for such restraints or confinements in the resident's
clinical record.
(c) A restraint may be used only with the informed consent
of the resident, the resident's guardian, or the resident's
other authorized representative. A restraint may be used only
for specific periods, if it is the least restrictive means
necessary to attain and maintain the resident's highest
practicable physical, mental or psychosocial well-being,
including brief periods of time to provide necessary
life-saving treatment. A restraint may be used only after
consultation with appropriate health professionals, such as
occupational or physical therapists, and a trial of less
restrictive measures has led to the determination that the use
of less restrictive measures would not attain or maintain the
resident's highest practicable physical, mental or
psychosocial well-being. However, if the resident needs
emergency care, restraints may be used for brief periods to
permit medical treatment to proceed unless the facility has
notice that the resident has previously made a valid refusal of
the treatment in question.
(d) A restraint may be applied only by a person trained in
the application of the particular type of restraint.
(e) Whenever a period of use of a restraint is initiated,
the resident shall be advised of his or her right to have a

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person or organization of his or her choosing, including the
Guardianship and Advocacy Commission, notified of the use of
the restraint. A recipient who is under guardianship may
request that a person or organization of his or her choosing be
notified of the restraint, whether or not the guardian approves
the notice. If the resident so chooses, the facility shall make
the notification within 24 hours, including any information
about the period of time that the restraint is to be used.
Whenever the Guardianship and Advocacy Commission is notified
that a resident has been restrained, it shall contact the
resident to determine the circumstances of the restraint and
whether further action is warranted.
(f) Whenever a restraint is used on a resident whose
primary mode of communication is sign language, the resident
shall be permitted to have his or her hands free from restraint
for brief periods each hour, except when this freedom may
result in physical harm to the resident or others.
(g) The requirements of this Section are intended to
control in any conflict with the requirements of Sections 1-126
and 2-108 of the Mental Health and Developmental Disabilities
Code.
(Source: P.A. 97-135, eff. 7-14-11.)
(210 ILCS 45/2-106.1)
Sec. 2-106.1. Drug treatment.
(a) A resident shall not be given unnecessary drugs. An

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unnecessary drug is any drug used in an excessive dose,
including in duplicative therapy; for excessive duration;
without adequate monitoring; without adequate indications for
its use; or in the presence of adverse consequences that
indicate the drugs should be reduced or discontinued. The
Department shall adopt, by rule, the standards for unnecessary
drugs contained in interpretive guidelines issued by the United
States Department of Health and Human Services for the purposes
of administering Titles XVIII and XIX of the Social Security
Act.
(b) Psychotropic medication shall not be prescribed
without the informed consent of the resident, the resident's
guardian, or the resident's other authorized representative.
"Psychotropic medication" means medication that is used for or
listed as used for antipsychotic, antidepressant, antimanic,
or antianxiety behavior modification or behavior management
purposes in the latest editions of the AMA Drug Evaluations or
the Physician's Desk Reference. The Department shall adopt, by
rule, a protocol specifying how informed consent for
psychotropic medication may be obtained or refused. The
protocol shall require, at a minimum, a discussion between (i)
the resident or the resident's authorized representative and
(ii) the resident's physician, a registered pharmacist (who is
not a dispensing pharmacist for the facility where the resident
lives), or a licensed nurse about the possible risks and
benefits of a recommended medication and the use of

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standardized consent forms designated by the Department. Each
form developed by the Department (i) shall be written in plain
language, (ii) shall be able to be downloaded from the
Department's official website, (iii) shall include information
specific to the psychotropic medication for which consent is
being sought, and (iv) shall be used for every resident for
whom psychotropic drugs are prescribed. In addition to creating
those forms, the Department shall approve the use of any other
informed consent forms that meet criteria developed by the
Department.
In addition to any other penalty prescribed by law, a
facility that is found to have violated this subsection, or the
federal certification requirement that informed consent be
obtained before administering a psychotropic medication, shall
thereafter be required to obtain the signatures of 2 licensed
health care professionals on every form purporting to give
informed consent for the administration of a psychotropic
medication, certifying the personal knowledge of each health
care professional that the consent was obtained in compliance
with the requirements of this subsection.
(c) The requirements of this Section are intended to
control in a conflict with the requirements of Sections 2-102
and 2-107.2 of the Mental Health and Developmental Disabilities
Code with respect to the administration of psychotropic
medication.
(Source: P.A. 95-331, eff. 8-21-07; 96-1372, eff. 7-29-10.)

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