Public Act 101-0587
 
SB1702 EnrolledLRB101 06196 RLC 51220 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Mental Health and Developmental
Disabilities Code is amended by changing Sections 2-108, 2-109,
3-602, 3-603, 3-610, 3-702, 3-703, 3-752, 3-753, and 3-807 and
by adding Section 1-101.3 as follows:
 
    (405 ILCS 5/1-101.3 new)
    Sec. 1-101.3. Advanced practice psychiatric nurse.
"Advanced practice psychiatric nurse" means a nurse who is
licensed to practice as an advanced practice registered nurse
under Section 65-5 of the Nurse Practice Act and has been
certified by the American Nurses Credentialing Center as a
psychiatric mental health clinical nurse specialist or a
psychiatric mental health nurse practitioner.
 
    (405 ILCS 5/2-108)  (from Ch. 91 1/2, par. 2-108)
    Sec. 2-108. Use of restraint. Restraint may be used only as
a therapeutic measure to prevent a recipient from causing
physical harm to himself or physical abuse to others. Restraint
may only be applied by a person who has been trained in the
application of the particular type of restraint to be utilized.
In no event shall restraint be utilized to punish or discipline
a recipient, nor is restraint to be used as a convenience for
the staff.
    (a) Except as provided in this Section, restraint shall be
employed only upon the written order of a physician, clinical
psychologist, clinical social worker, clinical professional
counselor, advanced practice psychiatric nurse, or registered
nurse with supervisory responsibilities. No restraint shall be
ordered unless the physician, clinical psychologist, clinical
social worker, clinical professional counselor, advanced
practice psychiatric nurse, or registered nurse with
supervisory responsibilities, after personally observing and
examining the recipient, is clinically satisfied that the use
of restraint is justified to prevent the recipient from causing
physical harm to himself or others. In no event may restraint
continue for longer than 2 hours unless within that time period
a nurse with supervisory responsibilities, advanced practice
psychiatric nurse, or a physician confirms, in writing,
following a personal examination of the recipient, that the
restraint does not pose an undue risk to the recipient's health
in light of the recipient's physical or medical condition. The
order shall state the events leading up to the need for
restraint and the purposes for which restraint is employed. The
order shall also state the length of time restraint is to be
employed and the clinical justification for that length of
time. No order for restraint shall be valid for more than 16
hours. If further restraint is required, a new order must be
issued pursuant to the requirements provided in this Section.
    (b) In the event there is an emergency requiring the
immediate use of restraint, it may be ordered temporarily by a
qualified person only where a physician, clinical
psychologist, clinical social worker, clinical professional
counselor, advanced practice psychiatric nurse, or registered
nurse with supervisory responsibilities is not immediately
available. In that event, an order by a nurse, clinical
psychologist, clinical social worker, clinical professional
counselor, advanced practice psychiatric nurse, or physician
shall be obtained pursuant to the requirements of this Section
as quickly as possible, and the recipient shall be examined by
a physician or supervisory nurse within 2 hours after the
initial employment of the emergency restraint. Whoever orders
restraint in emergency situations shall document its necessity
and place that documentation in the recipient's record.
    (c) The person who orders restraint shall inform the
facility director or his designee in writing of the use of
restraint within 24 hours.
    (d) The facility director shall review all restraint orders
daily and shall inquire into the reasons for the orders for
restraint by any person who routinely orders them.
    (e) Restraint may be employed during all or part of one 24
hour period, the period commencing with the initial application
of the restraint. However, once restraint has been employed
during one 24 hour period, it shall not be used again on the
same recipient during the next 48 hours without the prior
written authorization of the facility director.
    (f) Restraint shall be employed in a humane and therapeutic
manner and the person being restrained shall be observed by a
qualified person as often as is clinically appropriate but in
no event less than once every 15 minutes. The qualified person
shall maintain a record of the observations. Specifically,
unless there is an immediate danger that the recipient will
physically harm himself or others, restraint shall be loosely
applied to permit freedom of movement. Further, the recipient
shall be permitted to have regular meals and toilet privileges
free from the restraint, except when freedom of action may
result in physical harm to the recipient or others.
    (g) Every facility that employs restraint shall provide
training in the safe and humane application of each type of
restraint employed. The facility shall not authorize the use of
any type of restraint by an employee who has not received
training in the safe and humane application of that type of
restraint. Each facility in which restraint is used shall
maintain records detailing which employees have been trained
and are authorized to apply restraint, the date of the training
and the type of restraint that the employee was trained to use.
    (h) Whenever restraint is imposed upon any recipient whose
primary mode of communication is sign language, the recipient
shall be permitted to have his hands free from restraint for
brief periods each hour, except when freedom may result in
physical harm to the recipient or others.
    (i) A recipient who is restrained may only be secluded at
the same time pursuant to an explicit written authorization as
provided in Section 2-109 of this Code. Whenever a recipient is
restrained, a member of the facility staff shall remain with
the recipient at all times unless the recipient has been
secluded. A recipient who is restrained and secluded shall be
observed by a qualified person as often as is clinically
appropriate but in no event less than every 15 minutes.
    (j) Whenever restraint is used, the recipient shall be
advised of his right, pursuant to Sections 2-200 and 2-201 of
this Code, to have any person of his choosing, including the
Guardianship and Advocacy Commission or the agency designated
pursuant to the Protection and Advocacy for Persons with
Developmental Disabilities Act notified of the restraint. A
recipient who is under guardianship may request that any person
of his choosing be notified of the restraint whether or not the
guardian approves of the notice. Whenever the Guardianship and
Advocacy Commission is notified that a recipient has been
restrained, it shall contact that recipient to determine the
circumstances of the restraint and whether further action is
warranted.
(Source: P.A. 98-137, eff. 8-2-13; 99-143, eff. 7-27-15.)
 
    (405 ILCS 5/2-109)  (from Ch. 91 1/2, par. 2-109)
    Sec. 2-109. Seclusion. Seclusion may be used only as a
therapeutic measure to prevent a recipient from causing
physical harm to himself or physical abuse to others. In no
event shall seclusion be utilized to punish or discipline a
recipient, nor is seclusion to be used as a convenience for the
staff.
    (a) Seclusion shall be employed only upon the written order
of a physician, clinical psychologist, clinical social worker,
clinical professional counselor, advanced practice psychiatric
nurse, or registered nurse with supervisory responsibilities.
No seclusion shall be ordered unless the physician, clinical
psychologist, clinical social worker, clinical professional
counselor, advanced practice psychiatric nurse, or registered
nurse with supervisory responsibilities, after personally
observing and examining the recipient, is clinically satisfied
that the use of seclusion is justified to prevent the recipient
from causing physical harm to himself or others. In no event
may seclusion continue for longer than 2 hours unless within
that time period a nurse with supervisory responsibilities,
advanced practice psychiatric nurse, or a physician confirms in
writing, following a personal examination of the recipient,
that the seclusion does not pose an undue risk to the
recipient's health in light of the recipient's physical or
medical condition. The order shall state the events leading up
to the need for seclusion and the purposes for which seclusion
is employed. The order shall also state the length of time
seclusion is to be employed and the clinical justification for
the length of time. No order for seclusion shall be valid for
more than 16 hours. If further seclusion is required, a new
order must be issued pursuant to the requirements provided in
this Section.
    (b) The person who orders seclusion shall inform the
facility director or his designee in writing of the use of
seclusion within 24 hours.
    (c) The facility director shall review all seclusion orders
daily and shall inquire into the reasons for the orders for
seclusion by any person who routinely orders them.
    (d) Seclusion may be employed during all or part of one 16
hour period, that period commencing with the initial
application of the seclusion. However, once seclusion has been
employed during one 16 hour period, it shall not be used again
on the same recipient during the next 48 hours without the
prior written authorization of the facility director.
    (e) The person who ordered the seclusion shall assign a
qualified person to observe the recipient at all times. A
recipient who is restrained and secluded shall be observed by a
qualified person as often as is clinically appropriate but in
no event less than once every 15 minutes.
    (f) Safety precautions shall be followed to prevent
injuries to the recipient in the seclusion room. Seclusion
rooms shall be adequately lighted, heated, and furnished. If a
door is locked, someone with a key shall be in constant
attendance nearby.
    (g) Whenever seclusion is used, the recipient shall be
advised of his right, pursuant to Sections 2-200 and 2-201 of
this Code, to have any person of his choosing, including the
Guardianship and Advocacy Commission notified of the
seclusion. A person who is under guardianship may request that
any person of his choosing be notified of the seclusion whether
or not the guardian approves of the notice. Whenever the
Guardianship and Advocacy Commission is notified that a
recipient has been secluded, it shall contact that recipient to
determine the circumstances of the seclusion and whether
further action is warranted.
(Source: P.A. 98-137, eff. 8-2-13.)
 
    (405 ILCS 5/3-602)  (from Ch. 91 1/2, par. 3-602)
    Sec. 3-602. The petition shall be accompanied by a
certificate executed by a physician, qualified examiner,
psychiatrist, advanced practice psychiatric nurse, or clinical
psychologist which states that the respondent is subject to
involuntary admission on an inpatient basis and requires
immediate hospitalization. The certificate shall indicate that
the physician, qualified examiner, psychiatrist, advanced
practice psychiatric nurse, or clinical psychologist
personally examined the respondent not more than 72 hours prior
to admission. It shall also contain the physician's, qualified
examiner's, psychiatrist's, advanced practice psychiatric
nurse's, or clinical psychologist's clinical observations,
other factual information relied upon in reaching a diagnosis,
and a statement as to whether the respondent was advised of his
rights under Section 3-208.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-603)  (from Ch. 91 1/2, par. 3-603)
    Sec. 3-603. (a) If no physician, qualified examiner,
psychiatrist, advanced practice psychiatric nurse, or clinical
psychologist is immediately available or it is not possible
after a diligent effort to obtain the certificate provided for
in Section 3-602, the respondent may be detained for
examination in a mental health facility upon presentation of
the petition alone pending the obtaining of such a certificate.
    (b) In such instance the petition shall conform to the
requirements of Section 3-601 and further specify that:
        1. the petitioner believes, as a result of his personal
    observation, that the respondent is subject to involuntary
    admission on an inpatient basis;
        2. a diligent effort was made to obtain a certificate;
        3. no physician, qualified examiner, psychiatrist, or
    clinical psychologist could be found who has examined or
    could examine the respondent; and
        4. a diligent effort has been made to convince the
    respondent to appear voluntarily for examination by a
    physician, qualified examiner, psychiatrist, or clinical
    psychologist, unless the petitioner reasonably believes
    that effort would impose a risk of harm to the respondent
    or others.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-610)  (from Ch. 91 1/2, par. 3-610)
    Sec. 3-610. As soon as possible but not later than 24
hours, excluding Saturdays, Sundays and holidays, after
admission of a respondent pursuant to this Article, the
respondent shall be personally examined by a psychiatrist. The
psychiatrist may be a member of the staff of the facility but
shall not be the person who executed the first certificate. If
a certificate has already been completed by a psychiatrist
following the respondent's admission, the respondent shall be
examined by another psychiatrist or by a physician, clinical
psychologist, advanced practice psychiatric nurse, or
qualified examiner. If, as a result of this second examination,
a certificate is executed, the certificate shall be promptly
filed with the court. If the certificate states that the
respondent is subject to involuntary admission but not in need
of immediate hospitalization, the respondent may remain in his
or her place of residence pending a hearing on the petition
unless he or she voluntarily agrees to inpatient treatment. If
the respondent is not examined or if the psychiatrist,
physician, clinical psychologist, advanced practice
psychiatric nurse, or qualified examiner does not execute a
certificate pursuant to Section 3-602, the respondent shall be
released forthwith. For the purpose of this Section, a personal
examination includes an examination performed in real time
(synchronous examination) via an Interactive Telecommunication
System as defined in 89 Ill. Adm. Code 140.403(a)(5). An
examination via an Interactive Telecommunication System may
only be used for certification under this Section when a
psychiatrist is not on-site within the time period set forth in
this Section. If the examination is performed via an
Interactive Communication System, that fact shall be noted on
the certificate.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-702)  (from Ch. 91 1/2, par. 3-702)
    Sec. 3-702. (a) The petition may be accompanied by the
certificate of a physician, qualified examiner, psychiatrist,
advanced practice psychiatric nurse, or clinical psychologist
which certifies that the respondent is subject to involuntary
admission on an inpatient basis and which contains the other
information specified in Section 3-602.
    (b) Upon receipt of the petition either with or without a
certificate, if the court finds the documents are in order, it
may make such orders pursuant to Section 3-703 as are necessary
to provide for examination of the respondent. If the petition
is not accompanied by 2 certificates executed pursuant to
Section 3-703, the court may order the respondent to present
himself for examination at a time and place designated by the
court. If the petition is accompanied by 2 certificates
executed pursuant to Section 3-703 and the court finds the
documents are in order, it shall set the matter for hearing.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-703)  (from Ch. 91 1/2, par. 3-703)
    Sec. 3-703. If no certificate was filed, the respondent
shall be examined separately by a physician, or clinical
psychologist, advanced practice psychiatric nurse, or
qualified examiner and by a psychiatrist. If a certificate
executed by a psychiatrist was filed, the respondent shall be
examined by a physician, clinical psychologist, qualified
examiner, advanced practice psychiatric nurse, or
psychiatrist. If a certificate executed by a qualified
examiner, clinical psychologist, advanced practice psychiatric
nurse, or a physician who is not a psychiatrist was filed, the
respondent shall be examined by a psychiatrist. The examining
physician, clinical psychologist, qualified examiner, advanced
practice psychiatric nurse, or psychiatrist may interview by
telephone or in person any witnesses or other persons listed in
the petition for involuntary admission. If, as a result of an
examination, a certificate is executed, the certificate shall
be promptly filed with the court. If a certificate is executed,
the examining physician, clinical psychologist, qualified
examiner, advanced practice psychiatric nurse, or psychiatrist
may also submit for filing with the court a report in which his
findings are described in detail, and may rely upon such
findings for his opinion that the respondent is subject to
involuntary admission on an inpatient basis. Copies of the
certificates shall be made available to the attorneys for the
parties upon request prior to the hearing. A certificate
prepared in compliance with this Article shall state whether or
not the respondent is in need of immediate hospitalization.
However, if both the certificates state that the respondent is
not in need of immediate hospitalization, the respondent may
remain in his or her place of residence pending a hearing on
the petition unless he or she voluntarily agrees to inpatient
treatment.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-752)
    Sec. 3-752. Certificate.
    (a) The petition may be accompanied by the certificate of a
physician, qualified examiner, psychiatrist, advanced practice
psychiatric nurse, or clinical psychologist which certifies
that the respondent is subject to involuntary admission on an
outpatient basis. The certificate shall indicate that the
physician, qualified examiner, advanced practice psychiatric
nurse, or clinical psychologist personally examined the
respondent not more than 72 hours prior to the completion of
the certificate. It shall also contain the physician's,
qualified examiner's, advanced practice psychiatric nurse's,
or clinical psychologist's clinical observations, other
factual information relied upon in reaching a diagnosis, and a
statement as to whether the respondent was advised of his or
her rights under Section 3-208.
    (b) Upon receipt of the petition either with or without a
certificate, if the court finds the documents are in order, it
may make such orders pursuant to Section 3-753 as are necessary
to provide for examination of the respondent. If the petition
is not accompanied by 2 certificates executed pursuant to
Section 3-753, the court may order the respondent to present
himself or herself for examination at a time and place
designated by the court. If the petition is accompanied by 2
certificates executed pursuant to Section 3-753 and the court
finds the documents are in order, the court shall set the
matter for hearing.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-753)
    Sec. 3-753. Examination. If no certificate was filed, the
respondent shall be examined separately by a physician, or
clinical psychologist, advanced practice psychiatric nurse, or
qualified examiner and by a psychiatrist. If a certificate
executed by a psychiatrist was filed, the respondent shall be
examined by a physician, clinical psychologist, qualified
examiner, advanced practice psychiatric nurse, or
psychiatrist. If a certificate executed by a qualified
examiner, clinical psychologist, advanced practice psychiatric
nurse, or a physician who is not a psychiatrist was filed, the
respondent shall be examined by a psychiatrist. The examining
physician, clinical psychologist, qualified examiner, advanced
practice psychiatric nurse, or psychiatrist may interview by
telephone or in person any witnesses or other persons listed in
the petition for involuntary admission. If, as a result of an
examination, a certificate is executed, the certificate shall
be promptly filed with the court. If a certificate is executed,
the examining physician, clinical psychologist, qualified
examiner, advanced practice psychiatric nurse, or psychiatrist
may also submit for filing with the court a report in which his
or her findings are described in detail, and may rely upon such
findings for his opinion that the respondent is subject to
involuntary admission. Copies of the certificates shall be made
available to the attorneys for the parties upon request prior
to the hearing.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10.)
 
    (405 ILCS 5/3-807)  (from Ch. 91 1/2, par. 3-807)
    Sec. 3-807. No respondent may be found subject to
involuntary admission on an inpatient or outpatient basis
unless at least one psychiatrist, clinical social worker,
clinical psychologist, advanced practice psychiatric nurse, or
qualified examiner who has examined the respondent testifies in
person at the hearing. The respondent may waive the requirement
of the testimony subject to the approval of the court.
(Source: P.A. 96-1399, eff. 7-29-10; 96-1453, eff. 8-20-10;
97-121, eff. 7-14-11.)