Illinois General Assembly - Full Text of HB1592
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Full Text of HB1592  102nd General Assembly


Rep. Deb Conroy

Filed: 3/9/2022





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2    AMENDMENT NO. ______. Amend House Bill 1592 by replacing
3everything after the enacting clause with the following:
4    "Section 1. Short title. This Act may be cited as the
5Mental Health Inpatient Facility Access Act.
6    Section 5. Findings. The General Assembly finds that:
7        (1) In 1955, Illinois had more than 30,000 adult
8    State-operated inpatient mental health beds.
9        (2) In 2019, prior to the COVID-19 pandemic, Illinois
10    had fewer than 1,200 adult State-operated inpatient mental
11    health beds.
12        (3) Due to the COVID-19 pandemic, there are now only
13    approximately 1,100 State-operated inpatient mental health
14    beds.
15        (4) More than 500,000 people in Illinois have serious
16    mental health conditions.



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1        (5) While most people with even the most serious
2    mental health conditions can be successfully treated in
3    the community or in private hospitals, many will need
4    inpatient care from a State-operated inpatient mental
5    health facility.
6        (6) Given the small number of remaining beds in
7    State-operated inpatient mental health facilities, it is
8    vital that adults who need a hospital-level of care are
9    able to obtain services in such facilities.
10        (7) Due to the lack of available inpatient mental
11    health beds:
12            (A) Many people in need of inpatient psychiatric
13        care wait for days or weeks in emergency departments
14        or non-psychiatric units of general hospitals where it
15        is difficult to provide them with safe and effective
16        mental health treatment.
17            (B) Persons found unfit to stand trial or not
18        guilty by reason of insanity and committed to the
19        custody of the Department of Human Services often wait
20        for weeks or months in county jails where it is
21        difficult to provide them with safe and effective
22        mental health treatment.
23            (C) Adults with a continuing need for mental
24        health services are discharged into the community
25        before their mental health condition makes such a
26        discharge safe and appropriate or before arrangements



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1        have been made for needed long-term community mental
2        health services.
3            (D) Adults who need inpatient care are often
4        denied access to such care.
5    Section 10. Strategic plan on improving access to
6inpatient psychiatric beds. The Department of Human Services'
7Division of Mental Health shall develop a written, strategic
8plan that comprehensively addresses improving access to
9inpatient psychiatric beds in State-operated mental health
10facilities for individuals needing a hospital level of care.
11This plan shall address achieving the best use of
12State-operated psychiatric beds across Illinois, with
13strategies specifically to mitigate inefficient use of
14forensic beds and reduce lengths of stays for the forensic
15population. A comprehensive approach to this plan shall
16include training and education, ongoing assessment of
17individuals receiving inpatient services, reviewing and
18updating policies and procedures, and increasing
19community-based capacity for individuals in all State-operated
20forensic beds. The plan shall include:
21        (1) Annual training. Required annual training for all
22    State-operated inpatient mental health facility clinicians
23    shall include:
24            (A) Best practices for evaluating whether
25        individuals found not guilty by reason of insanity or



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1        unfit to stand trial meet the legal criteria for
2        inpatient treatment.
3            (B) Best practices for determining appropriate
4        treatment for individuals found not guilty by reason
5        of insanity or unfit to stand trial.
6            (C) The requirements of treatment plan reports.
7            (D) The types of mental health services available
8        following discharge, including, but not limited to:
9        assertive community treatment, community support
10        teams, supportive housing, medication management,
11        psychotherapy, peer support services, specialized
12        mental health rehabilitation facilities, and nursing
13        homes.
14        (2) Regular and periodic assessment of mental health
15    condition and progress. At least once every year following
16    the admission of any individual under Section 5-2-4 of the
17    Unified Code of Corrections or Section 104-17 of the Code
18    of Criminal Procedure of 1963, the Director of the
19    Division of Mental Health, or his or her designee, shall
20    meet with the treatment team assigned to that individual
21    to review whether:
22            (A) The individual continues to meet the standard
23        for inpatient care.
24            (B) The individual may be appropriate for
25        unsupervised on-grounds privileges, off-grounds
26        privileges (with or without escort by personnel of the



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1        Department of Human Services), home visits, and
2        participation in work programs.
3            (C) The current treatment plan is reasonably
4        expected to result in the improvement of the
5        individual's clinical condition so that the individual
6        no longer needs inpatient treatment, and, if not, what
7        other treatments or placements are available to meet
8        the individual's needs and safety.
9        (3) Updated policies and procedures.
10            (A) Revise facility policies and procedures to
11        increase opportunities for home visits and work
12        programs that assist with community reintegration.
13        This shall include a review of unsupervised on-grounds
14        privileges, off-grounds privileges (with or without
15        escort by personnel of the Department of Human
16        Services), home visits, and participation in work or
17        educational programs to ensure that policies do not
18        limit the ability to approve these activities. The
19        plan shall also address the frequency for which
20        individuals are assessed to be eligible for these
21        activities.
22            (B) Ensure all individuals found unfit to stand
23        trial or not guilty by reason of insanity, who can be
24        treated on an outpatient basis are recommended for
25        outpatient services.
26            (C) Develop benchmarks to ensure that:



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1                (i) every individual found unfit to stand
2            trial or not guilty by reason of insanity who has
3            been committed by a court to the Department for
4            treatment shall be admitted to a Department
5            facility within the time periods set forth in
6            subsection (b) of Section 104-17 of the Code of
7            Criminal Procedure of 1963 and subsection (a) of
8            Section 5-2-4 of Unified Code of Corrections; and
9                (ii) no individual who needs inpatient
10            psychiatric care remains in an emergency
11            department of any hospital or in any other
12            non-psychiatric unit longer than 48 hours.
13        (4) Building community treatment capacity.
14            (A) Specific steps to increase access to
15        community-based mental health services that provide
16        (i) outpatient alternatives to those being assessed
17        for inpatient stays at State-operated inpatient mental
18        health facilities and (ii) step-down services for
19        those no longer meeting inpatient stay criteria,
20        specifically the population of individuals found not
21        guilty by reason of insanity. Such steps must
22        specifically identify community-based treatment
23        alternatives and how these services will be funded.
24            (B) Specific steps to ensure each State-operated
25        inpatient mental health facility has sufficient
26        qualified psychiatrists, psychologists, social



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1        workers, peer support professionals, and other staff
2        so that the Department may provide adequate and humane
3        care and services for all patients. That plan shall
4        include:
5                (i) an assessment of whether the salary and
6            other benefits provided to professional staff are
7            sufficient to attract and retain staff;
8                (ii) an assessment of the annual budget needed
9            to attract and retain staff;
10                (iii) an assessment of any other impediments
11            to attracting and retaining staff, and a
12            mitigation plan for those impediments; and
13                (iv) a detailed plan for recruiting
14            psychiatrists, psychologists, social workers, peer
15            support professionals, and other mental health
16            staff.
17        (5) Certification of mental health clinicians. The
18    Division of Mental Health shall outline in the strategic
19    plan a plan for training, implementing standard
20    qualifications, and credentialing all psychiatrists,
21    clinical social workers, clinical psychologists, and
22    qualified examiners who conduct any evaluations, as
23    employees, agents, or vendors of the Division concerning:
24            (A) findings of unfitness to stand trial and all
25        other evaluations of individuals receiving treatment
26        in accordance with Section 104-10 of the Code of



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1        Criminal Procedure of 1963:
2            (B) individuals receiving treatment in accordance
3        with Section 5-2-4 of the Unified Code of Corrections;
4            (C) whether individuals are subject to involuntary
5        admission on an inpatient or outpatient basis in
6        accordance with the Mental Health and Developmental
7        Disabilities Code; and
8            (D) whether individuals are subject to
9        court-ordered treatment in accordance with Section
10        2-107.1 of the Mental Health and Developmental
11        Disabilities Code.
12        Such evaluations shall include any treatment reports
13    required under the Code of Criminal Procedure of 1963 or
14    the Mental Health and Developmental Disabilities Code.
15        (6) There shall be stakeholder input during the
16    planning process from the Division of Mental Health's
17    forensic workgroup.
18    Section 15. Implementation. The strategic plan developed
19by the Division of Mental Health shall be finalized and made
20publicly available one year after the effective date of this
21Act. The plan shall include:
22        (1) Benchmarks and timelines for implementing each
23    provision of the plan.
24        (2) Strategy for obtaining resources needed to
25    implement each provision of the plan.



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1        (3) Ongoing stakeholder engagement during the
2    implementation of the plan through the Division of Mental
3    Health's forensic workgroup.
4    Section 20. Prohibition on reduction of State-operated
5psychiatric inpatient beds. The Department shall make no
6further reductions in State-operated inpatient mental health
7bed capacity. Nothing in this Section shall affect the
8authority of the Governor to issue emergency executive orders
9to protect the health or safety of recipients or employees of
10State-operated inpatient psychiatric facilities.
11    Section 99. Effective date. This Act takes effect upon
12becoming law.".