SB 26 — MEDICAID-HEALTH BENEFITS SRVCE

"Consumer" means a person, 18 years of age or older, admitted to a mental health rehabilitation facility for evaluation, observation, diagnosis, treatment, stabilization, recovery, and rehabilitation.

"Consumer" does not mean any of the following:

(i) an individual requiring a locked setting;

(ii) an individual requiring psychiatric hospitalization because of an acute psychiatric crisis;

(iii) an individual under 18 years of age;

(iv) an individual who is actively suicidal or violent toward others;

SB0026 Enrolled - 5 - LRB098 05310 KTG 35344 b (v) an individual who has been found unfit to stand trial;

(vi) an individual who has been found not guilty by reason of insanity based on committing a violent act, such as sexual assault, assault with a deadly weapon, arson, or murder;

(vii) an individual subject to temporary detention and examination under Section 3-607 of the Mental Health and Developmental Disabilities Code;

(viii) an individual deemed clinically appropriate for inpatient admission in a State psychiatric hospital;

and (ix) an individual transferred by the Department of Corrections pursuant to Section 3-8-5 of the Unified Code of Corrections.

"Consumer record" means a record that organizes all information on the care, treatment, and rehabilitation services rendered to a consumer in a specialized mental health rehabilitation facility.

"Controlled drugs" means those drugs covered under the federal Comprehensive Drug Abuse Prevention Control Act of 1970, as amended, or the Illinois Controlled Substances Act.

"Department" means the Department of Public Health.

"Discharge" means the full release of any consumer from a facility.

"Drug administration" means the act in which a single dose of a prescribed drug or biological is given to a consumer.

The SB0026 Enrolled - 6 - LRB098 05310 KTG 35344 b complete act of administration entails removing an individual dose from a container, verifying the dose with the prescriber's orders, giving the individual dose to the consumer, and promptly recording the time and dose given.

"Drug dispensing" means the act entailing the following of a prescription order for a drug or biological and proper selection, measuring, packaging, labeling, and issuance of the drug or biological to a consumer.

"Emergency" means a situation, physical condition, or one or more practices, methods, or operations which present imminent danger of death or serious physical or mental harm to consumers of a facility.

"Facility" means a specialized mental health rehabilitation facility that provides at least one of the following services:

(1) triage center;

(2) crisis stabilization;

(3) recovery and rehabilitation supports;

or (4) transitional living units for 3 or more persons.

The facility shall provide a 24-hour program that provides intensive support and recovery services designed to assist persons, 18 years or older, with mental disorders to develop the skills to become self-sufficient and capable of increasing levels of independent functioning.

It includes facilities that meet the following criteria:

(1) 100% of the consumer population of the facility has a diagnosis of serious mental illness;

(2) no more than 15% of the consumer population of the SB0026 Enrolled - 7 - LRB098 05310 KTG 35344 b facility is 65 years of age or older;

(3) none of the consumers are non-ambulatory;

(4) none of the consumers have a primary diagnosis of moderate, severe, or profound intellectual disability;

and (5) the facility must have been licensed under the Specialized Mental Health Rehabilitation Act or the Nursing Home Care Act immediately preceding the effective date of this Act and qualifies as a institute for mental disease under the federal definition of the term.

"Facility" does not include the following:

(1) a home, institution, or place operated by the federal government or agency thereof, or by the State of Illinois;

(2) a hospital, sanitarium, or other institution whose principal activity or business is the diagnosis, care, and treatment of human illness through the maintenance and operation as organized facilities therefor which is required to be licensed under the Hospital Licensing Act;

(3) a facility for child care as defined in the Child Care Act of 1969;

(4) a community living facility as defined in the Community Living Facilities Licensing Act;

(5) a nursing home or sanatorium operated solely by and for persons who rely exclusively upon treatment by spiritual means through prayer, in accordance with the creed or tenets of any well-recognized church or religious SB0026 Enrolled - 8 - LRB098 05310 KTG 35344 b denomination;

however, such nursing home or sanatorium shall comply with all local laws and rules relating to sanitation and safety;

(6) a facility licensed by the Department of Human Services as a community-integrated living arrangement as defined in the Community-Integrated Living Arrangements Licensure and Certification Act;

(7) a supportive residence licensed under the Supportive Residences Licensing Act;

(8) a supportive living facility in good standing with the program established under Section 5-5.01a of the Illinois Public Aid Code, except only for purposes of the employment of persons in accordance with Section 3-206.01 of the Nursing Home Care Act;

(9) an assisted living or shared housing establishment licensed under the Assisted Living and Shared Housing Act, except only for purposes of the employment of persons in accordance with Section 3-206.01 of the Nursing Home Care Act;

(10) an Alzheimer's disease management center alternative health care model licensed under the Alternative Health Care Delivery Act;

(11) a home, institution, or other place operated by or under the authority of the Illinois Department of Veterans' Affairs;

(12) a facility licensed under the ID/DD Community Care SB0026 Enrolled - 9 - LRB098 05310 KTG 35344 b Act;

or (13) a facility licensed under the Nursing Home Care Act after the effective date of this Act.

"Executive director" means a person who is charged with the general administration and supervision of a facility licensed under this Act.

"Guardian" means a person appointed as a guardian of the person or guardian of the estate, or both, of a consumer under the Probate Act of 1975.

"Identified offender" means a person who meets any of the following criteria:

(1) Has been convicted of, found guilty of, adjudicated delinquent for, found not guilty by reason of insanity for, or found unfit to stand trial for, any felony offense listed in Section 25 of the Health Care Worker Background Check Act, except for the following:

(i) a felony offense described in Section 10-5 of the Nurse Practice Act;

(ii) a felony offense described in Section 4, 5, 6, 8, or 17.02 of the Illinois Credit Card and Debit Card Act;

(iii) a felony offense described in Section 5, 5.1, 5.2, 7, or 9 of the Cannabis Control Act;

(iv) a felony offense described in Section 401, 401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois Controlled Substances Act;

and SB0026 Enrolled - 10 - LRB098 05310 KTG 35344 b (v) a felony offense described in the Methamphetamine Control and Community Protection Act.

(2) Has been convicted of, adjudicated delinquent for, found not guilty by reason of insanity for, or found unfit to stand trial for, any sex offense as defined in subsection (c) of Section 10 of the Sex Offender Management Board Act.

"Transitional living units" are residential units within a facility that have the purpose of assisting the consumer in developing and reinforcing the necessary skills to live independently outside of the facility.

The duration of stay in such a setting shall not exceed 120 days for each consumer.

Nothing in this definition shall be construed to be a prerequisite for transitioning out of a facility.

"Licensee" means the person, persons, firm, partnership, association, organization, company, corporation, or business trust to which a license has been issued.

"Misappropriation of a consumer's property" means the deliberate misplacement, exploitation, or wrongful temporary or permanent use of a consumer's belongings or money without the consent of a consumer or his or her guardian.

"Neglect" means a facility's failure to provide, or willful withholding of, adequate medical care, mental health treatment, psychiatric rehabilitation, personal care, or assistance that is necessary to avoid physical harm and mental anguish of a consumer.

SB0026 Enrolled - 11 - LRB098 05310 KTG 35344 b "Personal care" means assistance with meals, dressing, movement, bathing, or other personal needs, maintenance, or general supervision and oversight of the physical and mental well-being of an individual who is incapable of maintaining a private, independent residence or who is incapable of managing his or her person, whether or not a guardian has been appointed for such individual.

"Personal care" shall not be construed to confine or otherwise constrain a facility's pursuit to develop the skills and abilities of a consumer to become self-sufficient and capable of increasing levels of independent functioning.

"Recovery and rehabilitation supports" means a program that facilitates a consumer's longer-term symptom management and stabilization while preparing the consumer for transitional living units by improving living skills and community socialization.

The duration of stay in such a setting shall be established by the Department by rule.

"Restraint" means:

(i) a physical restraint that is any manual method or physical or mechanical device, material, or equipment attached or adjacent to a consumer's body that the consumer 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;

or SB0026 Enrolled - 12 - LRB098 05310 KTG 35344 b (ii) a chemical restraint that 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 that 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 federal Social Security Act.

For the purposes of this Act, restraint shall be administered only after utilizing a coercive free environment and culture.

"Self-administration of medication" means consumers shall be responsible for the control, management, and use of their own medication.

"Crisis stabilization" means a secure and separate unit that provides short-term behavioral, emotional, or psychiatric crisis stabilization as an alternative to hospitalization or re-hospitalization for consumers from residential or community placement.

The duration of stay in such a setting shall not exceed 21 days for each consumer.

"Therapeutic separation" means the removal of a consumer from the milieu to a room or area which is designed to aid in the emotional or psychiatric stabilization of that consumer.

"Triage center" means a non-residential 23-hour center that serves as an alternative to emergency room care, hospitalization, or re-hospitalization for consumers in need SB0026 Enrolled - 13 - LRB098 05310 KTG 35344 b of short-term crisis stabilization.

ARTICLE 2.

GENERAL PROVISIONS Section 2-100.

Rulemaking.

The Department is empowered to promulgate any rules necessary to ensure proper implementation and administration of this Act.

Section 2-101.

Standards for facilities.

The Department shall, by rule, prescribe minimum standards for each level of care for facilities to be in place during the provisional licensure period and thereafter.

These standards shall include, but are not limited to, the following:

(1) life safety standards that will ensure the health, safety and welfare of residents and their protection from hazards;

(2) number and qualifications of all personnel, including management and clinical personnel, having responsibility for any part of the care given to consumers;

specifically, the Department shall establish staffing ratios for facilities which shall specify the number of staff hours per consumer of care that are needed for each level of care offered within the facility;

(3) all sanitary conditions within the facility and its surroundings, including water supply, sewage disposal, SB0026 Enrolled - 14 - LRB098 05310 KTG 35344 b food handling, and general hygiene which shall ensure the health and comfort of consumers;

(4) a program for adequate maintenance of physical plant and equipment;

(5) adequate accommodations, staff, and services for the number and types of services being offered to consumers for whom the facility is licensed to care;

(6) development of evacuation and other appropriate safety plans for use during weather, health, fire, physical plant, environmental, and national defense emergencies;

(7) maintenance of minimum financial or other resources necessary to meet the standards established under this Section, and to operate and conduct the facility in accordance with this Act;

and (8) standards for coercive free environment, restraint, and therapeutic separation.

Section 2-102.

Staffing ratios.

The Department shall establish rules governing the minimum staffing levels and staffing qualifications for facilities.

In crafting the staffing ratios, the Department shall take into account the ambulatory nature and mental health of the population served in the facilities.

Staffing ratios shall be consistent with national accreditation standards in behavioral health from a recognized national accreditation entity as set forth in the definition of "accreditation" in Section 2-102.

The rules shall SB0026 Enrolled - 15 - LRB098 05310 KTG 35344 b be created for each type of care offered at the facilities and be crafted to address the different type of services offered.

The staffing ratios contained in the rules shall specifically list the positions that are to be counted toward the staffing ratio.

In no case shall the staffing ratios contained in rule be less than the following ratios:

(1) a staffing ratio of 3.6 hours of direct care for crisis stabilization;

(2) a staffing ratio of 1.8 hours of direct care for recovery and rehabilitation supports;

and (3) a staffing ratio of 1.6 hours of direct care for transitional living.

Section 2-103.

Staff training.

Training for all new employees specific to the various levels of care offered by a facility shall be provided to employees during their orientation period and annually thereafter.

Training shall be independent of the Department and overseen by the Division of Mental Health to determine the content of all facility employee training and to provide training for all trainers of facility employees.

Training of employees shall be consistent with nationally recognized national accreditation standards as defined later in this Act.

Training shall be required for all existing staff at a facility prior to the implementation of any new services authorized under this Act.

SB0026 Enrolled - 16 - LRB098 05310 KTG 35344 b Section 2-104.

Screening prior to admission.

(a) A facility shall, within 24 hours after admission, request a criminal history background check pursuant to the Uniform Conviction Information Act for all persons age 18 or older seeking admission to the facility, unless a background check was initiated by a hospital pursuant to subsection (d) of Section 6.09 of the Hospital Licensing Act.

Background checks conducted pursuant to this Section shall be based on the consumer's name, date of birth, and other identifiers as required by the Department of State Police.

If the results of the background check are inconclusive, the facility shall initiate a fingerprint-based check, unless the fingerprint check is waived by the Director of Public Health based on verification by the facility that the consumer meets criteria related to the consumer's health or lack of potential risk which may be established by Departmental rule.

A waiver issued pursuant to this Section shall be valid only while the consumer is immobile or while the criteria supporting the waiver exist.

The facility shall provide for or arrange for any required fingerprint-based checks to be taken on the premises of the facility.

If a fingerprint-based check is required, the facility shall arrange for it to be conducted in a manner that is respectful of the consumer's dignity and that minimizes any emotional or physical hardship to the consumer.

(b) If the results of a consumer's criminal history background check reveal that the consumer is an identified SB0026 Enrolled - 17 - LRB098 05310 KTG 35344 b offender as defined in this Act, the facility shall do the following:

(1) Immediately notify the Department of State Police, in the form and manner required by the Department of State Police, in collaboration with the Department of Public Health, that the consumer is an identified offender.

(2) Within 72 hours, arrange for a fingerprint-based criminal history record inquiry to be requested on the identified offender consumer.

The inquiry shall be based on the subject's name, sex, race, date of birth, fingerprint images, and other identifiers required by the Department of State Police.

The inquiry shall be processed through the files of the Department of State Police and the Federal Bureau of Investigation to locate any criminal history record information that may exist regarding the subject.

The Federal Bureau of Investigation shall furnish to the Department of State Police, pursuant to an inquiry under this paragraph (2), any criminal history record information contained in its files.

Section 2-105.

Criminal History Report.

(a) The Department of State Police shall prepare a Criminal History Report when it receives information, through the criminal history background check required pursuant to subsection (d) of Section 6.09 of the Hospital Licensing Act or subsection (c) of Section 2-201.5 of the Nursing Home Care Act, SB0026 Enrolled - 18 - LRB098 05310 KTG 35344 b or through any other means, that a consumer of a facility is an identified offender.

(b) The Department of State Police shall complete the Criminal History Report within 10 business days after receiving information under subsection (a) that a consumer is an identified offender.

(c) The Criminal History Report shall include, but not be limited to, the following:

(1) Copies of the identified offender's parole, mandatory supervised release, or probation orders.

(2) An interview with the identified offender.

(3) A detailed summary of the entire criminal history of the offender, including arrests, convictions, and the date of the identified offender's last conviction relative to the date of admission to a long-term care facility.

(4) If the identified offender is a convicted or registered sex offender, a review of any and all sex offender evaluations conducted on that offender.

If there is no sex offender evaluation available, the Department of State Police shall arrange, through the Department of Public Health, for a sex offender evaluation to be conducted on the identified offender.

If the convicted or registered sex offender is under supervision by the Illinois Department of Corrections or a county probation department, the sex offender evaluation shall be arranged by and at the expense of the supervising agency.

All SB0026 Enrolled - 19 - LRB098 05310 KTG 35344 b evaluations conducted on convicted or registered sex offenders under this Act shall be conducted by sex offender evaluators approved by the Sex Offender Management Board.

(d) The Department of State Police shall provide the Criminal History Report to a licensed forensic psychologist.

After (i) consideration of the Criminal History Report, (ii) consultation with the facility administrator or the facility medical director, or both, regarding the mental and physical condition of the identified offender, and (iii) reviewing the facility's file on the identified offender, including all incident reports, all information regarding medication and medication compliance, and all information regarding previous discharges or transfers from other facilities, the licensed forensic psychologist shall prepare an Identified Offender Report and Recommendation.

The Identified Offender Report and Recommendation shall detail whether and to what extent the identified offender's criminal history necessitates the implementation of security measures within the long-term care facility.

If the identified offender is a convicted or registered sex offender or if the Identified Offender Report and Recommendation reveals that the identified offender poses a significant risk of harm to others within the facility, the offender shall be required to have his or her own room within the facility.

(e) The licensed forensic psychologist shall complete the Identified Offender Report and Recommendation within 14 SB0026 Enrolled - 20 - LRB098 05310 KTG 35344 b business days after receiving the Criminal History Report and shall promptly provide the Identified Offender Report and Recommendation to the Department of State Police, which shall provide the Identified Offender Report and Recommendation to the following:

(1) The facility within which the identified offender resides.

(2) The Chief of Police of the municipality in which the facility is located.

(3) The State of Illinois Long Term Care Ombudsman.

(4) The Department of Public Health.

(e-5) The Department of Public Health shall keep a continuing record of all consumers determined to be identified offenders as defined in Section 1-114.01 of the Nursing Home Care Act and shall report the number of identified offender consumers annually to the General Assembly.

(f) The facility shall incorporate the Identified Offender Report and Recommendation into the identified offender's care plan created pursuant to 42 CFR 483.20.

(g) If, based on the Identified Offender Report and Recommendation, a facility determines that it cannot manage the identified offender consumer safely within the facility, it shall commence involuntary transfer or discharge proceedings pursuant to Section 3-402.

(h) Except for willful and wanton misconduct, any person authorized to participate in the development of a Criminal SB0026 Enrolled - 21 - LRB098 05310 KTG 35344 b History Report or Identified Offender Report and Recommendation is immune from criminal or civil liability for any acts or omissions as the result of his or her good faith effort to comply with this Section.

ARTICLE 3.

RIGHTS AND RESPONSIBILITIES PART 1.

CONSUMER RIGHTS Section 3-101.

Consumers' rights.

Consumers served by a facility under this Act shall have all the rights guaranteed pursuant to Chapter II, Article I of the Mental Health and Developmental Disabilities Code, a list of which shall be prominently posted in English and any other language representing at least 5% of the county population in which the specialized mental health rehabilitation facility is located.

Section 3-102.

Financial affairs.

A consumer shall be permitted to manage his or her own financial affairs unless he or she or his or her guardian authorizes the executive director of the facility in writing to manage the consumer's financial affairs.

Section 3-103.

Consumers' moneys and possessions.

To the SB0026 Enrolled - 22 - LRB098 05310 KTG 35344 b extent possible, each consumer shall be responsible for his or her own moneys and personal property or possessions in his or her own immediate living quarters unless deemed inappropriate by a physician or other facility clinician and so documented in the consumer's record.

In the event the moneys or possessions of a consumer come under the supervision of the facility, either voluntarily on the part of the consumer or so ordered by a facility physician or other clinician, each facility to whom a consumer's moneys or possessions have been entrusted shall comply with the following:

(1) no facility shall commingle consumers' moneys or possessions with those of the facility;

consumers' moneys and possessions shall be maintained separately, intact, and free from any liability that the facility incurs in the use of the facility's funds;

(2) the facility shall provide reasonably adequate space for the possessions of the consumer;

the facility shall provide a means of safeguarding small items of value for its consumers in their rooms or in any other part of the facility so long as the consumers have reasonable and adequate access to such possessions;

and (3) the facility shall make reasonable efforts to prevent loss and theft of consumers' possessions;

those efforts shall be appropriate to the particular facility and particular living setting within each facility and may include staff training and monitoring, labeling SB0026 Enrolled - 23 - LRB098 05310 KTG 35344 b possessions, and frequent possession inventories;

the facility shall develop procedures for investigating complaints concerning theft of consumers' possessions and shall promptly investigate all such complaints.

Section 3-104.

Care, treatment, and records.

Facilities shall provide, at a minimum, the following services:

physician, nursing, pharmaceutical, rehabilitative, and dietary services.

To provide these services, the facility shall adhere to the following:

(1) Each consumer shall be encouraged and assisted to achieve and maintain the highest level of self-care and independence.

Every effort shall be made to keep consumers active and out of bed for reasonable periods of time, except when contraindicated by physician orders.

(2) Every consumer shall be engaged in a person-centered planning process regarding his or her total care and treatment.

(3) All medical treatment and procedures shall be administered as ordered by a physician.

All new physician orders shall be reviewed by the facility's director of nursing or charge nurse designee within 24 hours after such orders have been issued to ensure facility compliance with such orders.

According to rules adopted by the Department, every woman consumer of child bearing age shall receive routine obstetrical and gynecological evaluations as well SB0026 Enrolled - 24 - LRB098 05310 KTG 35344 b as necessary prenatal care.

(4) Each consumer shall be provided with good nutrition and with necessary fluids for hydration.

(5) Each consumer shall be provided visual privacy during treatment and personal care.

(6) Every consumer or consumer's guardian shall be permitted to inspect and copy all his or her clinical and other records concerning his or her care kept by the facility or by his or her physician.

The facility may charge a reasonable fee for duplication of a record.

Section 3-105.

Supplemental Security Income.

The Department of Healthcare and Family Services shall explore potential avenues to enable consumers to continue to receive and possess a portion of, or their full, Supplemental Security Income benefit while receiving services at a facility.

The Department of Healthcare and Family Services shall investigate strategies that are most beneficial to the consumer and cost effective for the State.

The Department of Healthcare and Family Services may implement a strategy to enable a consumer to receive and possess a portion of, or his or her full, Supplemental Security Income in administrative rule.

This Section is subject to the appropriation of the General Assembly.

Section 3-106.

Pharmaceutical treatment.

SB0026 Enrolled - 25 - LRB098 05310 KTG 35344 b (a) A consumer 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 drug should be reduced or discontinued.

The Department shall adopt, by rule, the standards for unnecessary drugs.

(b) Informed consent shall be required for the prescription of psychotropic medication consistent with the requirements contained in subsection (b) of Section 2-106.1 of the Nursing Home Care Act.

(c) No drug shall be administered except upon the order of a person lawfully authorized to prescribe for and treat mental illness.

(d) All drug orders shall be written, dated, and signed by the person authorized to give such an order.

The name, quantity, or specific duration of therapy, dosage, and time or frequency of administration of the drug and the route of administration if other than oral shall be specific.

(e) Verbal orders for drugs and treatment shall be received only by those authorized under Illinois law to do so from their supervising physician.

Such orders shall be recorded immediately in the consumer's record by the person receiving the order and shall include the date and time of the order.

SB0026 Enrolled - 26 - LRB098 05310 KTG 35344 b Section 3-107.

Abuse or neglect;

duty to report.

A licensee, executive director, employee, or agent of a facility shall not abuse or neglect a consumer.

It is the duty of any facility employee or agent who becomes aware of such abuse or neglect to report it to the Department within 24 hours.

Facilities shall comply with Sections 3-610 and 3-810 of the Nursing Home Care Act.

The provisions under Sections 3-610 and 3-810 of the Nursing Home Care Act shall apply to employees of facilities licensed under this Act.

Section 3-108.

Communications;

visits.

Every consumer, except those in triage centers, shall be permitted unimpeded, private, and uncensored communication of his or her choice by mail, telephone, Internet, or visitation.

The executive director shall ensure that correspondence is conveniently received and reasonably accessible.

The executive director shall ensure that consumers may have private visits at any reasonable hour unless such visits are restricted due to the treatment plan of the consumer.

The executive director shall ensure that space for visits is available and that facility personnel reasonably announce their intent to enter, except in an emergency, before entering any consumer's room during such visits.

Consumers shall be free to leave at any time.

If a consumer in a triage center expresses a desire to contact a third party for any purpose, the facility staff shall contact that third SB0026 Enrolled - 27 - LRB098 05310 KTG 35344 b party on behalf of the consumer.

Section 3-109.

Religion.

A consumer shall be permitted the free exercise of religion.

Upon a consumer's request, and if necessary, at the consumer's expense, the executive director may make arrangements for a consumer's attendance at religious services of the consumer's choice.

However, no religious beliefs or practices or attendance at religious services may be imposed upon any consumer.

Section 3-110.

Access to consumers.

(a) Any employee or agent of a public agency, any representative of a community legal services program, or any other member of the general public shall be permitted access at reasonable hours to any individual consumer of any facility, unless the consumer is receiving care and treatment in triage centers.

(b) All persons entering a facility under this Section shall promptly notify appropriate facility personnel of their presence.

They shall, upon request, produce identification to establish their identity.

No such person shall enter the immediate living area of any consumer without first identifying himself or herself and then receiving permission from the consumer to enter.

The rights of other consumers present in the room shall be respected.

A consumer may terminate at any time a visit by a person having access to the consumer's living area SB0026 Enrolled - 28 - LRB098 05310 KTG 35344 b under this Section.

(c) This Section shall not limit the power of the Department or other public agency otherwise permitted or required by law to enter and inspect a facility.

(d) Notwithstanding subsection (a) of this Section, the executive director of a facility may refuse access to the facility to any person if the presence of that person in the facility would be injurious to the health and safety of a consumer or would threaten the security of the property of a consumer or the facility, or if the person seeks access to the facility for commercial purposes.

(e) Nothing in this Section shall be construed to conflict with, or infringe upon, any court orders or consent decrees regarding access.

Section 3-111.

Discharge.

A consumer may be discharged from a facility after he or she gives the executive director, a physician, or a nurse of the facility written notice of the desire to be discharged.

If a guardian has been appointed for a consumer, the consumer shall be discharged upon written consent of his or her guardian.

In the event of a requested consumer discharge, the facility is relieved from any responsibility for the consumer's care, safety, and well-being upon the consumer's discharge.

The Department shall by rule establish criteria, hearings, and procedures for involuntary discharge.

SB0026 Enrolled - 29 - LRB098 05310 KTG 35344 b Section 3-112.

Grievances.

A consumer shall be permitted to present grievances on behalf of himself or herself or others to the executive director, the consumers' advisory council, State governmental agencies, or other persons without threat of discharge or reprisal in any form or manner whatsoever.

The executive director shall provide all consumers or their representatives with the name, address, and telephone number of the appropriate State governmental office where complaints may be lodged.

Section 3-113.

Labor.

A consumer may refuse to perform labor for a facility.

Section 3-114.

Unlawful discrimination.

No consumer shall be subjected to unlawful discrimination as defined in Section 1-103 of the Illinois Human Rights Act by any owner, licensee, executive director, employee, or agent of a facility.

Unlawful discrimination does not include an action by any licensee, executive director, employee, or agent of a facility that is required by this Act or rules adopted under this Act.

Section 3-115.

Informed consent;

restraints.

Informed consent shall be required for restraints consistent with the requirements contained in subsection (c) of Section 2-106 of the Nursing Home Care Act.

SB0026 Enrolled - 30 - LRB098 05310 KTG 35344 b Section 3-116.

Experimental research.

No consumer shall be subjected to experimental research or treatment without first obtaining his or her informed, written consent.

The conduct of any experimental research or treatment shall be authorized and monitored by an institutional review board appointed by the executive director.

The membership, operating procedures and review criteria for the institutional review board shall be prescribed under rules and regulations of the Department and shall comply with the requirements for institutional review boards established by the federal Food and Drug Administration.

No person who has received compensation in the prior 3 years from an entity that manufactures, distributes, or sells pharmaceuticals, biologics, or medical devices may serve on the institutional review board.

No facility shall permit experimental research or treatment to be conducted on a consumer, or give access to any person or person's records for a retrospective study about the safety or efficacy of any care or treatment, without the prior written approval of the institutional review board.

No executive director, or person licensed by the State to provide medical care or treatment to any person, may assist or participate in any experimental research on or treatment of a consumer, including a retrospective study, that does not have the prior written approval of the board.

Such conduct shall be grounds for professional discipline by the Department of Financial and Professional Regulation.

SB0026 Enrolled - 31 - LRB098 05310 KTG 35344 b The institutional review board may exempt from ongoing review research or treatment initiated on a consumer before the individual's admission to a facility and for which the board determines there is adequate ongoing oversight by another institutional review board.

Nothing in this Section shall prevent a facility, any facility employee, or any other person from assisting or participating in any experimental research on or treatment of a consumer, if the research or treatment began before the person's admission to a facility, until the board has reviewed the research or treatment and decided to grant or deny approval or to exempt the research or treatment from ongoing review.

PART 2.

RESPONSIBILITIES Section 3-201.

Screening prior to admission.

Standards for screening prior to admission into a facility under this Act shall be established by rule.

The rules shall recognize the different levels of care provided by these facilities, including, but not limited to, the following:

(1) triage centers;

(2) crisis stabilization;

(3) recovery and rehabilitation supports;

or (4) transitional living units.

SB0026 Enrolled - 32 - LRB098 05310 KTG 35344 b Section 3-203.

Consumers' advisory council.

Each facility shall establish a consumers' advisory council.

The executive director shall designate a member of the facility staff to coordinate the establishment of, and render assistance to, the council.

(1) The composition of the consumers' advisory council shall be specified by rule, but no employee or affiliate of a facility shall be a member of the council.

(2) The council shall meet at least once each month with the staff coordinator who shall provide assistance to the council in preparing and disseminating a report of each meeting to all consumers, the executive director, and the staff.

(3) Records of council meetings shall be maintained in the office of the executive director.

(4) The consumers' advisory council may communicate to the executive director the opinions and concerns of the consumers.

The council shall review procedures for implementing consumer rights and facility responsibilities and make recommendations for changes or additions that will strengthen the facility's policies and procedures as they affect consumer rights and facility responsibilities.

(5) The council shall be a forum for:

(A) obtaining and disseminating information;

(B) soliciting and adopting recommendations for facility programming and improvements;

and SB0026 Enrolled - 33 - LRB098 05310 KTG 35344 b (C) early identification and for recommending orderly resolution of problems.

(6) The council may present complaints on behalf of a consumer to the Department or to any other person it considers appropriate.

Section 3-205.

Disclosure of information to public.

Standards for the disclosure of information to the public shall be established by rule.

These information disclosure standards shall include, but are not limited to, the following:

staffing and personnel levels, licensure and inspection information, national accreditation information, cost and reimbursement information, and consumer complaint information.

Rules for the public disclosure of information shall be in accordance with the provisions for inspection and copying of public records in the Freedom of Information Act.

Section 3-206.

Confidentiality of records.

(a) The Department shall respect the confidentiality of a consumer's record and shall not divulge or disclose the contents of a record in a manner that identifies a consumer, except upon a consumer's death to a relative or guardian or under judicial proceedings.

This Section shall not be construed to limit the right of a consumer to inspect or copy the consumer's own records.

(b) Confidential medical, social, personal, or financial SB0026 Enrolled - 34 - LRB098 05310 KTG 35344 b information identifying a consumer shall not be available for public inspection in a manner that identifies a consumer.

Section 3-207.

Notice of imminent death.

A facility shall immediately notify the consumer's next of kin, representative, and physician of the consumer's death or when the consumer's death appears to be imminent.

Section 3-208.

Policies and procedures.

A facility shall establish written policies and procedures to implement the responsibilities and rights provided under this Article.

The policies shall include the procedure for the investigation and resolution of consumer complaints.

The policies and procedures shall be clear and unambiguous and shall be available for inspection by any person.

A summary of the policies and procedures, printed in not less than 12-point font, shall be distributed to each consumer and representative.

Section 3-209.

Explanation of rights.

Each consumer and consumer's guardian or other person acting on behalf of the consumer shall be given a written explanation of all of his or her rights.

The explanation shall be given at the time of admission to a facility or as soon thereafter as the condition of the consumer permits, but in no event later than 48 hours after admission and again at least annually thereafter.

At the time of the implementation of this Act, each consumer shall be SB0026 Enrolled - 35 - LRB098 05310 KTG 35344 b given a written summary of all of his or her rights.

If a consumer is unable to read such written explanation, it shall be read to the consumer in a language the consumer understands.

Section 3-210.

Staff familiarity with rights and responsibilities.

The facility shall ensure that its staff is familiar with and observes the rights and responsibilities enumerated in this Article.

Section 3-211.

Vaccinations.

(a) A facility shall annually administer or arrange for administration of a vaccination against influenza to each consumer, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that are most recent to the time of vaccination, unless the vaccination is medically contraindicated or the consumer has refused the vaccine.

(b) All persons seeking admission to a facility shall be verbally screened for risk factors associated with hepatitis B, hepatitis C, and the Human Immunodeficiency Virus (HIV) according to guidelines established by the U.S.

Centers for Disease Control and Prevention.

Persons who are identified as being at high risk for hepatitis B, hepatitis C, or HIV shall be offered an opportunity to undergo laboratory testing in order to determine infection status if they will be admitted to the facility for at least 7 days and are not known to be SB0026 Enrolled - 36 - LRB098 05310 KTG 35344 b infected with any of the listed viruses.

All HIV testing shall be conducted in compliance with the AIDS Confidentiality Act.

All persons determined to be susceptible to the hepatitis B virus shall be offered immunization within 10 days after admission to any facility.

A facility shall document in the consumer's medical record that he or she was verbally screened for risk factors associated with hepatitis B, hepatitis C, and HIV, and whether or not the consumer was immunized against hepatitis B.

Section 3-212.

Order for transportation of consumer by ambulance.

If a facility orders transportation of a consumer of the facility by ambulance, then the facility must maintain a written record that shows (i) the name of the person who placed the order for that transportation and (ii) the medical reason for that transportation.

ARTICLE 4.

LICENSING AND ACCREDITATION PART 1.

LICENSING Section 4-101.

Licensure system.

The Department shall be the sole agency responsible for licensure and shall establish a comprehensive system of licensure for facilities in accordance SB0026 Enrolled - 37 - LRB098 05310 KTG 35344 b with this Act for the purpose of:

(1) protecting the health, welfare, and safety of consumers;

and (2) ensuring the accountability for reimbursed care provided in facilities.

Section 4-102.

Necessity of license.

No person may establish, operate, maintain, offer, or advertise a facility within this State unless and until he or she obtains a valid license therefor as hereinafter provided, which license remains unsuspended, unrevoked, and unexpired.

No public official or employee may place any person in, or recommend that any person be in, or directly or indirectly cause any person to be placed in any facility that is being operated without a valid license.

All licenses and licensing procedures established under Article III of the Nursing Home Care Act, except those contained in Section 3-202, shall be deemed valid under this Act until the Department establishes licensure.

The Department is granted the authority under this Act to establish provisional licensure and licensing procedures under this Act by emergency rule and shall do so within 120 days of the effective date of this Act.

Section 4-103.

Provisional licensure emergency rules.

The Department, in consultation with the Division of Mental Health of the Department of Human Services and the Department of SB0026 Enrolled - 38 - LRB098 05310 KTG 35344 b Healthcare and Family Services, is granted the authority under this Act to establish provisional licensure and licensing procedures by emergency rule.

The Department shall file emergency rules concerning provisional licensure under this Act within 120 days after the effective date of this Act.

The rules to be filed for provisional licensure shall be for a period of 3 years, beginning with the adoption date of the emergency rules establishing the provisional license, and shall not be extended beyond the date of 3 years after the effective date of the emergency rules creating the provisional license and licensing process.

Rules governing the provisional license and licensing process shall contain rules for the different levels of care offered by the facilities authorized under this Act and shall address each type of care hereafter enumerated:

(1) triage centers;

(2) crisis stabilization;

(3) recovery and rehabilitation supports;

(4) transitional living units;

or (5) other intensive treatment and stabilization programs designed and developed in collaboration with the Department.

Section 4-104.

Provisional licensure requirements.

Rules governing the provisional license and licensing process shall address, at a minimum, the following provisions:

SB0026 Enrolled - 39 - LRB098 05310 KTG 35344 b (1) mandatory community agency linkage;

(2) discharge and transition planning;

(3) non-residential triage centers and stabilization center requirements;

(4) crisis stabilization;

(5) transitional living units;

(6) recovery and rehabilitation supports;

(7) therapeutic activity and leisure training program;

(8) admission policies;

(9) consumer admission and assessment requirements;

(10) screening and consumer background checks, consistent with Section 1-114.01, subsections (b) and (c) of Section 2-201.5, and Section 2-201.6 of the Nursing Home Care Act;

(11) consumer records;

(12) informed consent;

(13) individualized treatment plan;

(14) consumer rights and confidentiality;

(15) safeguard of consumer funds;

(16) restraints and therapeutic separation;

(17) employee personnel policies and records;

(18) employee health evaluation;

(19) health care worker background check, consistent with the Health Care Worker Background Check Act;

(20) required professional job positions;

(21) consultation and training;

SB0026 Enrolled - 40 - LRB098 05310 KTG 35344 b (22) quality assessment and performance improvement;

(23) consumer information;

(24) reporting of unusual occurrences;

(25) abuse and reporting to local law enforcement;

(26) fire safety and disaster preparedness;

(27) required support services, including, but not limited to, physician, health, pharmaceutical, infection control, dietetic, dental, and environmental;

(28) enhanced services requests and program flexibility requests;

(29) participation in a managed care entity, a coordinated care entity, or an accountable care entity;

and (30) appropriate fines and sanctions associated with violations of laws, rules, or regulations.

Section 4-105.

Provisional licensure duration.

A provisional license shall be valid upon fulfilling the requirements established by the Department by emergency rule.

The license shall remain valid as long as a facility remains in compliance with the licensure provisions established in rule.

The provisional license shall expire when the administrative rule established by the Department for provisional licensure expires at the end of a 3-year period.

Section 4-106.

Provisional licensure outcomes.

The Department of Healthcare and Family Services, in conjunction SB0026 Enrolled - 41 - LRB098 05310 KTG 35344 b with the Division of Mental Health of the Department of Human Services and the Department of Public Health, shall establish a methodology by which financial and clinical data are reported and monitored from each program that is implemented in a facility after the effective date of this Act.

The Department of Healthcare and Family Services shall work in concert with a managed care entity, a care coordination entity, or an accountable care entity to gather the data necessary to report and monitor the progress of the services offered under this Act.

Section 4-107.

Provisional licensure period completion.

After the provisional licensure period is completed, no individual with mental illness whose service plan provides for placement in community-based settings shall be housed or offered placement in a facility at public expense unless, after being fully informed, he or she declines the opportunity to receive services in a community-based setting.

Section 4-108.

Surveys and inspections.

The Department shall conduct surveys of licensed facilities and their certified programs and services.

The Department shall review the records or premises, or both, as it deems appropriate for the purpose of determining compliance with this Act and the rules promulgated under this Act.

The Department shall have access to and may reproduce or photocopy any books, records, SB0026 Enrolled - 42 - LRB098 05310 KTG 35344 b and other documents maintained by the facility to the extent necessary to carry out this Act and the rules promulgated under this Act.

The Department shall not divulge or disclose the contents of a record under this Section as otherwise prohibited by this Act.

Any holder of a license or applicant for a license shall be deemed to have given consent to any authorized officer, employee, or agent of the Department to enter and inspect the facility in accordance with this Article.

Refusal to permit such entry or inspection shall constitute grounds for denial, suspension, or revocation of a license under this Act.

(1) The Department shall conduct surveys to determine compliance and may conduct surveys to investigate complaints.

(2) Determination of compliance with the service requirements shall be based on a survey centered on individuals that sample services being provided.

(3) Determination of compliance with the general administrative requirements shall be based on a review of facility records and observation of individuals and staff.

Section 4-109.

License sanctions and revocation.

(a) The Department may revoke a license for any failure to substantially comply with this Act and the rules promulgated under this Act, including, but not limited to, the following:

(1) fails to correct deficiencies identified as a result of an on-site survey by the Department and fails to SB0026 Enrolled - 43 - LRB098 05310 KTG 35344 b submit a plan of correction within 30 days after receipt of the notice of violation;

(2) submits false information either on Department forms, required certifications, plans of correction or during an on-site inspection;

(3) refuses to permit or participate in a scheduled or unscheduled survey;

or (4) willfully violates any rights of individuals being served.

(b) The Department may refuse to license or relicense a facility if the owner or authorized representative or licensee has been convicted of a felony related to the provision of healthcare or mental health services, as shown by a certified copy of the court of conviction.

(c) Facilities, as a result of an on-site survey, shall be recognized according to levels of compliance with standards as set forth in this Act.

Facilities with findings from Level 1 to Level 3 will be considered to be in good standing with the Department.

Findings from Level 3 to Level 5 will result in a notice of violations, a plan of correction and defined sanctions.

Findings resulting in Level 6 will result in a notice of violations and defined sanction.

The levels of compliance are:

(1) Level 1:

Full compliance with this Act and the rules promulgated under this Act.

(2) Level 2:

Acceptable compliance with this Act and SB0026 Enrolled - 44 - LRB098 05310 KTG 35344 b the rules promulgated under this Act.

No written plan of correction will be required from the licensee.

(3) Level 3:

Partial compliance with this Act and the rules promulgated under this Act.

An administrative warning is issued.

The licensee shall submit a written plan of correction.

(4) Level 4:

Minimal compliance with this Act and the rules promulgated under this Act.

The licensee shall submit a written plan of correction, and the Department will issue a probationary license.

A resurvey shall occur within 90 days.

(5) Level 5:

Unsatisfactory compliance with this Act and the rules promulgated under this Act.

The facility shall submit a written plan of correction, and the Department will issue a restricted license.

A resurvey shall occur within 60 days.

(6) Level 6:

Revocation of the license to provide services.

Revocation may occur as a result of a licensee's consistent and repeated failure to take necessary corrective actions to rectify documented violations, or the failure to protect clients from situations that produce an imminent risk.

(d) Prior to initiating formal action to sanction a license, the Department shall allow the licensee an opportunity to take corrective action to eliminate or ameliorate a violation of this Act except in cases in which the Department SB0026 Enrolled - 45 - LRB098 05310 KTG 35344 b determines that emergency action is necessary to protect the public or individual interest, safety, or welfare.

(e) Subsequent to an on-site survey, the Department shall issue a written notice to the licensee.

The Department shall specify the particular Sections of this Act or the rules promulgated under this Act, if any, with which the facility is not compliant.

The Department's notice shall require any corrective actions be taken within a specified time period as required by this Act.

(f) Sanctions shall be imposed according to the following definitions:

(1) Administrative notice:

A written notice issued by the Department that specifies rule violations requiring a written plan of correction with time frames for corrections to be made and a notice that any additional violation of this Act or the rules promulgated under this Act may result in a higher level sanction.

(Level 3) (2) Probation:

Compliance with this Act and the rules promulgated under this Act is minimally acceptable and necessitates immediate corrective action.

Individuals' life safety or quality of care are not in jeopardy.

The probationary period is time limited to 90 days.

During the probationary period, the facility must make corrective changes sufficient to bring the facility back into good standing with the Department.

Failure to make corrective changes within that given time frame may result in a SB0026 Enrolled - 46 - LRB098 05310 KTG 35344 b determination to initiate a higher-level sanction.

The admission of new individuals shall be prohibited during the probationary period.