Bill Text: IL SB1982 | 2011-2012 | 97th General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Nursing Home Care Act. Sets forth a definition for "institution for mental diseases". Provides that electroconvulsive therapy may only be administered to a resident who has provided informed consent pursuant the Mental Health and Developmental Disabilities Code or under a Court order pursuant to the Mental Health and Developmental Disabilities Code. Provides that no adult may be admitted to institutions for mental diseases or to certain sections of nursing homes except as provided for in certain provisions of the Mental Health and Developmental Disabilities Code. Makes other changes. Amends the Mental Health and Developmental Disabilities Code to make changes in provisions concerning emergency administration of psychotropic medication. Effective immediately.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2013-01-08 - Session Sine Die [SB1982 Detail]

Download: Illinois-2011-SB1982-Introduced.html

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97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 SB1982 Introduced 2/10/2011, by Sen. Heather A. Steans SYNOPSIS AS INTRODUCED:
210 ILCS 45/1-114.2 new
210 ILCS 45/2-106.1
210 ILCS 45/2-106.2 new
210 ILCS 45/2-202 from Ch. 111 1/2, par. 4152-202
405 ILCS 5/2-107 from Ch. 91 1/2, par. 2-107
Amends the Nursing Home Care Act. Sets forth a definition for "institution for mental diseases". Provides that electroconvulsive therapy may only be administered to a resident who has provided informed consent pursuant the Mental Health and Developmental Disabilities Code or under a Court order pursuant to the Mental Health and Developmental Disabilities Code. Provides that no adult may be admitted to institutions for mental diseases or to certain sections of nursing homes except as provided for in certain provisions of the Mental Health and Developmental Disabilities Code. Makes other changes. Amends the Mental Health and Developmental Disabilities Code to make changes in provisions concerning emergency administration of psychotropic medication. Effective immediately.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning health facilities.
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 2-106.1 and 2-202 and by adding Sections 1-114.2 and
2-106.2 as follows:
(210 ILCS 45/1-114.2 new)
Sec. 1-114.2. Institution for mental diseases.
"Institution for mental diseases" means a nursing facility that
is primarily engaged in providing diagnosis, treatment, or care
of persons with mental diseases, including medical attention,
nursing care, and related services.
(210 ILCS 45/2-106.1)
Sec. 2-106.1. Drug treatment.
(a) A resident shall not be given unnecessary drugs. An
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

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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 except as provided
in subsection (d) of this Section , the resident's guardian, or
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 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

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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.
(d) If the resident is unable to give informed consent to
psychotropic medication pursuant to subsection (b) of this
Section, then such medications may only be administered
pursuant to Sections 2-107 or 2-107.1 of the Mental Health and
Developmental Disabilities Code.
(Source: P.A. 95-331, eff. 8-21-07; 96-1372, eff. 7-29-10.)
(210 ILCS 45/2-106.2 new)

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Sec. 2-106.2. Electroconvulsive therapy. Electroconvulsive
therapy may only be administered to a resident who has provided
informed consent pursuant to Section 2-102 of the Mental Health
and Developmental Disabilities Code or under a court order
pursuant to Section 2-107.1 of the Mental Health and
Developmental Disabilities Code.
(210 ILCS 45/2-202) (from Ch. 111 1/2, par. 4152-202)
Sec. 2-202. (a) Before a person is admitted to a facility,
or at the expiration of the period of previous contract, or
when the source of payment for the resident's care changes from
private to public funds or from public to private funds, a
written contract shall be executed between a licensee and the
following in order of priority:
(1) the person, or if the person is a minor, his parent
or guardian; or
(2) the person's guardian, if any, or agent, if any, as
defined in Section 2-3 of the Illinois Power of Attorney
Act; or
(3) a member of the person's immediate family.
An adult person shall be presumed to have the capacity to
contract for admission to a long term care facility unless he
has been adjudicated a "disabled person" within the meaning of
Section 11a-2 of the Probate Act of 1975, or unless a petition
for such an adjudication is pending in a circuit court of
Illinois.

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If there is no guardian, agent or member of the person's
immediate family available, able or willing to execute the
contract required by this Section and a physician determines
that a person is so disabled as to be unable to consent to
placement in a facility, or if a person has already been found
to be a "disabled person", but no order has been entered
allowing residential placement of the person, that person may
be admitted to a facility before the execution of a contract
required by this Section; provided that a petition for
guardianship or for modification of guardianship is filed
within 15 days of the person's admission to a facility, and
provided further that such a contract is executed within 10
days of the disposition of the petition.
No adult shall be admitted to a facility if he objects,
orally or in writing, to such admission, except as otherwise
provided in Chapters III and IV of the Mental Health and
Developmental Disabilities Code or Section 11a-14.1 of the
Probate Act of 1975. Notwithstanding any other provision in
this Act, no adult may be admitted to institutions for mental
diseases or to those sections of nursing homes that are
primarily engaged in providing diagnosis, treatment, or care of
persons with mental diseases, except as provided for in
Chapters III and IV of the Mental Health and Developmental
Disabilities Code.
If a person has not executed a contract as required by this
Section, then such a contract shall be executed on or before

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July 1, 1981, or within 10 days after the disposition of a
petition for guardianship or modification of guardianship that
was filed prior to July 1, 1981, whichever is later.
Before a licensee enters a contract under this Section, it
shall provide the prospective resident and his guardian, if
any, with written notice of the licensee's policy regarding
discharge of a resident whose private funds for payment of care
are exhausted.
(b) A resident shall not be discharged or transferred at
the expiration of the term of a contract, except as provided in
Sections 3-401 through 3-423.
(c) At the time of the resident's admission to the
facility, a copy of the contract shall be given to the
resident, his guardian, if any, and any other person who
executed the contract.
(d) A copy of the contract for a resident who is supported
by nonpublic funds other than the resident's own funds shall be
made available to the person providing the funds for the
resident's support.
(e) The original or a copy of the contract shall be
maintained in the facility and be made available upon request
to representatives of the Department and the Department of
Healthcare and Family Services.
(f) The contract shall be written in clear and unambiguous
language and shall be printed in not less than 12-point type.
The general form of the contract shall be prescribed by the

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Department.
(g) The contract shall specify:
(1) the term of the contract;
(2) the services to be provided under the contract and
the charges for the services;
(3) the services that may be provided to supplement the
contract and the charges for the services;
(4) the sources liable for payments due under the
contract;
(5) the amount of deposit paid; and
(6) the rights, duties and obligations of the resident,
except that the specification of a resident's rights may be
furnished on a separate document which complies with the
requirements of Section 2-211.
(h) The contract shall designate the name of the resident's
representative, if any. The resident shall provide the facility
with a copy of the written agreement between the resident and
the resident's representative which authorizes the resident's
representative to inspect and copy the resident's records and
authorizes the resident's representative to execute the
contract on behalf of the resident required by this Section.
(i) The contract shall provide that if the resident is
compelled by a change in physical or mental health to leave the
facility, the contract and all obligations under it shall
terminate on 7 days notice. No prior notice of termination of
the contract shall be required, however, in the case of a

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resident's death. The contract shall also provide that in all
other situations, a resident may terminate the contract and all
obligations under it with 30 days notice. All charges shall be
prorated as of the date on which the contract terminates, and,
if any payments have been made in advance, the excess shall be
refunded to the resident. This provision shall not apply to
life-care contracts through which a facility agrees to provide
maintenance and care for a resident throughout the remainder of
his life nor to continuing-care contracts through which a
facility agrees to supplement all available forms of financial
support in providing maintenance and care for a resident
throughout the remainder of his life.
(j) In addition to all other contract specifications
contained in this Section admission contracts shall also
specify:
(1) whether the facility accepts Medicaid clients;
(2) whether the facility requires a deposit of the
resident or his family prior to the establishment of
Medicaid eligibility;
(3) in the event that a deposit is required, a clear
and concise statement of the procedure to be followed for
the return of such deposit to the resident or the
appropriate family member or guardian of the person;
(4) that all deposits made to a facility by a resident,
or on behalf of a resident, shall be returned by the
facility within 30 days of the establishment of Medicaid

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eligibility, unless such deposits must be drawn upon or
encumbered in accordance with Medicaid eligibility
requirements established by the Department of Healthcare
and Family Services.
(k) It shall be a business offense for a facility to
knowingly and intentionally both retain a resident's deposit
and accept Medicaid payments on behalf of that resident.
(Source: P.A. 95-331, eff. 8-21-07.)
Section 10. The Mental Health and Developmental
Disabilities Code is amended by changing Section 2-107 as
follows:
(405 ILCS 5/2-107) (from Ch. 91 1/2, par. 2-107)
Sec. 2-107. Refusal of services; informing of risks.
(a) An adult recipient of services or the recipient's
guardian, if the recipient is under guardianship, and the
recipient's substitute decision maker, if any, must be informed
of the recipient's right to refuse medication or
electroconvulsive therapy. The recipient and the recipient's
guardian or substitute decision maker shall be given the
opportunity to refuse generally accepted mental health or
developmental disability services, including but not limited
to medication or electroconvulsive therapy. If such services
are refused, they shall not be given unless such services are
necessary to prevent the recipient from causing serious and

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imminent physical harm to the recipient or others and no less
restrictive alternative is available. The facility director
shall inform a recipient, guardian, or substitute decision
maker, if any, who refuses such services of alternate services
available and the risks of such alternate services, as well as
the possible consequences to the recipient of refusal of such
services.
(b) Psychotropic medication or electroconvulsive therapy
may be administered under this Section for up to 24 hours only
if the circumstances leading up to the need for emergency
treatment are set forth in writing in the recipient's record.
(c) Administration of medication or electroconvulsive
therapy may not be continued unless the need for such treatment
is redetermined at least every 24 hours based upon a personal
examination of the recipient by a physician or a nurse under
the supervision of a physician and the circumstances
demonstrating that need are set forth in writing in the
recipient's record.
(d) Neither psychotropic medication nor electroconvulsive
therapy may be administered under this Section for a period in
excess of 72 hours, excluding Saturdays, Sundays, and holidays,
unless a petition is filed under Section 2-107.1 and the
treatment continues to be necessary under subsection (a) of
this Section. Once the petition has been filed, treatment may
continue in compliance with subsections (a), (b), and (c) of
this Section until the final outcome of the hearing on the

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petition.
(e) The Department shall issue rules designed to insure
that in State-operated mental health facilities psychotropic
medication and electroconvulsive therapy are administered in
accordance with this Section and only when appropriately
authorized and monitored by a physician or a nurse under the
supervision of a physician in accordance with accepted medical
practice. The facility director of each mental health facility
not operated by the State shall issue rules designed to insure
that in that facility psychotropic medication and
electroconvulsive therapy are administered in accordance with
this Section and only when appropriately authorized and
monitored by a physician or a nurse under the supervision of a
physician in accordance with accepted medical practice. Such
rules shall be available for public inspection and copying
during normal business hours.
(f) The provisions of this Section with respect to the
emergency administration of psychotropic medication and
electroconvulsive therapy do not apply to facilities licensed
under the Nursing Home Care Act or the MR/DD Community Care
Act. The provisions of this Section concerning the emergency
administration of psychotropic medication do not apply to
facilities licensed under the MR/DD Community Care Act.
(g) Under no circumstances may long-acting psychotropic
medications be administered under this Section.
(h) Whenever psychotropic medication or electroconvulsive

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therapy is refused pursuant to subsection (a) of this Section
at least once that day, the physician shall determine and state
in writing the reasons why the recipient did not meet the
criteria for administration of medication or electroconvulsive
therapy under subsection (a) and whether the recipient meets
the standard for administration of psychotropic medication or
electroconvulsive therapy under Section 2-107.1 of this Code.
If the physician determines that the recipient meets the
standard for administration of psychotropic medication or
electroconvulsive therapy under Section 2-107.1, the facility
director or his or her designee shall petition the court for
administration of psychotropic medication or electroconvulsive
therapy pursuant to that Section unless the facility director
or his or her designee states in writing in the recipient's
record why the filing of such a petition is not warranted. This
subsection (h) applies only to State-operated mental health
facilities.
(i) The Department shall conduct annual trainings for all
physicians and registered nurses working in State-operated
mental health facilities on the appropriate use of emergency
administration of psychotropic medication and
electroconvulsive therapy, standards for their use, and the
methods of authorization under this Section.
(Source: P.A. 95-172, eff. 8-14-07; 96-339, eff. 7-1-10.)
Section 99. Effective date. This Act takes effect upon
becoming law.