Full Text of SB0998 94th General Assembly
SB0998enr 94TH GENERAL ASSEMBLY
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| AN ACT concerning health.
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| Be it enacted by the People of the State of Illinois, | 3 |
| represented in the General Assembly:
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| Section 5. The Mental Health and Developmental | 5 |
| Disabilities Code is amended by changing Sections 2-107, | 6 |
| 2-107.1, and 3-209 and by adding Section 2-107.3 as follows:
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| (405 ILCS 5/2-107) (from Ch. 91 1/2, par. 2-107)
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| Sec. 2-107. Refusal of services; informing of risks.
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| (a) An adult recipient of services or the recipient's | 10 |
| guardian,
if the recipient is under guardianship, and the | 11 |
| recipient's substitute
decision maker, if any, must be informed | 12 |
| of the recipient's right to
refuse medication. The recipient | 13 |
| and the recipient's guardian or substitute
decision maker shall | 14 |
| be given the opportunity to
refuse generally accepted mental | 15 |
| health or developmental disability services,
including but not | 16 |
| limited to medication. If such services are refused, they
shall | 17 |
| not be given unless such services are necessary to prevent the | 18 |
| recipient
from causing serious and imminent physical harm to | 19 |
| the recipient or others and
no less restrictive alternative is | 20 |
| available.
The facility director shall inform a recipient, | 21 |
| guardian, or
substitute decision maker, if any, who refuses | 22 |
| such
services of alternate services available and the risks of | 23 |
| such alternate
services, as well as the possible consequences | 24 |
| to the recipient of refusal of
such services.
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| (b) Authorized involuntary treatment may be given under | 26 |
| this Section for
up to 24 hours only if the circumstances | 27 |
| leading up to the need for emergency
treatment are set forth in | 28 |
| writing in the recipient's record.
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| (c) Authorized involuntary treatment may not be continued | 30 |
| unless the need
for such treatment is redetermined at least | 31 |
| every 24 hours based upon a
personal examination of the | 32 |
| recipient by a physician or a nurse under the
supervision of a |
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| physician and the circumstances demonstrating that need are
set | 2 |
| forth in writing in the recipient's record.
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| (d) Authorized involuntary treatment may not be | 4 |
| administered under this
Section for a period in excess of 72 | 5 |
| hours, excluding Saturdays, Sundays, and
holidays, unless a | 6 |
| petition is filed under Section 2-107.1 and the treatment
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| continues to be necessary under subsection (a) of this Section. | 8 |
| Once the
petition has been filed, treatment may continue in | 9 |
| compliance with subsections
(a), (b), and (c) of this Section | 10 |
| until the final outcome of the hearing on the
petition.
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| (e) The Department shall issue rules designed to insure | 12 |
| that in
State-operated mental health facilities authorized | 13 |
| involuntary treatment is
administered in accordance with this | 14 |
| Section and only when appropriately
authorized and monitored by | 15 |
| a physician or a nurse under the supervision
of a physician
in | 16 |
| accordance with accepted medical practice. The facility | 17 |
| director of each
mental health facility not operated by the | 18 |
| State shall issue rules designed to
insure that in that | 19 |
| facility authorized involuntary treatment is administered
in
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| accordance with this Section and only when appropriately | 21 |
| authorized and
monitored by a physician or a nurse under the | 22 |
| supervision of a
physician in accordance with accepted medical | 23 |
| practice. Such rules shall be
available for public inspection | 24 |
| and copying during normal business hours.
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| (f) The provisions of this Section with respect to the | 26 |
| emergency
administration of authorized involuntary treatment | 27 |
| do not apply to facilities
licensed under the Nursing Home Care | 28 |
| Act.
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| (g) Under no circumstances may long-acting psychotropic | 30 |
| medications be
administered under this Section.
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| (h) Whenever psychotropic medication is refused pursuant | 32 |
| to subsection (a) of this Section at least once that day, the | 33 |
| physician shall determine and state in writing the reasons why | 34 |
| the recipient did not meet the criteria for involuntary | 35 |
| treatment under subsection (a) and whether the recipient meets | 36 |
| the standard for authorized involuntary treatment under |
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| Section 2-107.1 of this Code. If the physician determines that | 2 |
| the recipient meets the standard for authorized involuntary | 3 |
| treatment under Section 2-107.1, the facility director or his | 4 |
| or her designee shall petition the court for authorized | 5 |
| involuntary treatment pursuant to that Section unless the | 6 |
| facility director or his or her designee states in writing in | 7 |
| the recipient's record why the filing of such a petition is not | 8 |
| warranted. This subsection (h) applies only to State-operated | 9 |
| mental health facilities. | 10 |
| (i) The Department shall conduct annual trainings for all | 11 |
| physicians and registered nurses working in State-operated | 12 |
| mental health facilities on the appropriate use of emergency | 13 |
| authorized involuntary treatment, standards for its use, and | 14 |
| the methods of authorization under this Section.
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| (Source: P.A. 90-538, eff. 12-1-97; 91-726, eff. 6-2-00.)
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| (405 ILCS 5/2-107.1) (from Ch. 91 1/2, par. 2-107.1)
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| Sec. 2-107.1. Administration of authorized involuntary | 18 |
| treatment upon
application to a court.
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| (a) An adult recipient of services and the recipient's | 20 |
| guardian, if the
recipient is under guardianship, and the | 21 |
| substitute decision
maker, if any, shall be informed of the | 22 |
| recipient's right to refuse medication.
The recipient and the | 23 |
| recipient's guardian or substitute
decision maker shall be | 24 |
| given the opportunity to refuse generally accepted
mental | 25 |
| health or developmental disability services, including
but not | 26 |
| limited to medication.
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| (a-5) Notwithstanding the provisions of Section 2-107 of | 28 |
| this
Code, authorized
involuntary treatment may be | 29 |
| administered to an adult recipient of
services without the | 30 |
| informed consent of the recipient under the following
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| standards:
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| (1) Any person 18 years of age or older, including any | 33 |
| guardian, may
petition the circuit court for an order | 34 |
| authorizing the administration of
authorized involuntary | 35 |
| treatment to a recipient
of services.
The petition shall |
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| state that the petitioner has made a good faith attempt to
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| determine whether the recipient has executed a power of | 3 |
| attorney for health
care under the Powers of Attorney for | 4 |
| Health Care Law or a declaration for
mental health | 5 |
| treatment under the Mental Health Treatment Preference
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| Declaration Act and to obtain copies of these instruments | 7 |
| if they exist. If
either of the above-named instruments is | 8 |
| available to the petitioner, the
instrument or a copy of | 9 |
| the instrument shall be attached to the petition as
an | 10 |
| exhibit.
The petitioner shall deliver a copy of the | 11 |
| petition, and notice of the time
and place of the hearing, | 12 |
| to the respondent, his or her attorney, any known
agent or
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| attorney-in-fact, if any, and the
guardian, if any, no | 14 |
| later than 3 days prior to the date of the
hearing.
Service | 15 |
| of the petition and notice of the time and place of the | 16 |
| hearing may
be made by transmitting them via facsimile | 17 |
| machine to the
respondent or other party. Upon receipt of | 18 |
| the petition and notice, the party
served, or the person | 19 |
| delivering the petition and notice to
the party served, | 20 |
| shall acknowledge service. If the party sending the | 21 |
| petition
and notice does not receive acknowledgement of | 22 |
| service
within 24 hours, service must be made by personal | 23 |
| service.
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| The
petition may include a request that the court | 25 |
| authorize such testing and
procedures as may be essential | 26 |
| for the safe and effective administration of the
authorized | 27 |
| involuntary treatment sought to be
administered, but only | 28 |
| where the
petition
sets forth the specific testing and | 29 |
| procedures sought to be administered.
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| If a hearing is requested to be held immediately | 31 |
| following the hearing on
a petition for
involuntary | 32 |
| admission, then the notice requirement shall be the same as | 33 |
| that
for the hearing on
the petition for involuntary | 34 |
| admission, and the petition filed pursuant to this
Section | 35 |
| shall be filed
with the petition for involuntary admission.
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| (2) The court shall hold a hearing within 7 days of the |
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| filing
of the petition. The People, the petitioner, or the | 2 |
| respondent shall be
entitled
to a continuance of up to 7 | 3 |
| days as of right. An additional
continuance of not more | 4 |
| than 7 days may be granted to
any party (i)
upon a showing | 5 |
| that the continuance is needed in order
to adequately
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| prepare for or present evidence in a hearing under this | 7 |
| Section or
(ii) under exceptional circumstances. The court | 8 |
| may
grant an additional continuance
not to exceed 21 days | 9 |
| when, in its discretion, the court determines that such a
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| continuance is necessary in order to provide the recipient | 11 |
| with an examination
pursuant to Section 3-803 or 3-804 of | 12 |
| this Act, to provide the recipient with a
trial by jury as | 13 |
| provided in Section 3-802 of this Act, or to arrange for | 14 |
| the
substitution of counsel as provided for by the Illinois | 15 |
| Supreme Court Rules.
The hearing shall be
separate from a | 16 |
| judicial proceeding held to determine whether a person is
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| subject to involuntary admission but may be heard | 18 |
| immediately preceding or
following such a judicial | 19 |
| proceeding and may be heard by the same trier of fact
or | 20 |
| law as in that judicial proceeding.
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| (3) Unless otherwise provided herein, the procedures | 22 |
| set forth in
Article VIII of Chapter 3 of this Act, | 23 |
| including the provisions regarding
appointment of counsel, | 24 |
| shall govern hearings held under this subsection
(a-5).
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| (4) Authorized involuntary treatment shall
not be | 26 |
| administered to the recipient
unless
it has been determined | 27 |
| by clear and convincing evidence that all of
the following | 28 |
| factors are present . In determining whether a person meets | 29 |
| the criteria specified in the following
paragraphs (A) | 30 |
| through (G), the court may consider evidence of the | 31 |
| person's history of
serious violence, repeated past | 32 |
| pattern of specific behavior, actions related to the | 33 |
| person's
illness, or past outcomes of various treatment | 34 |
| options. :
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| (A) That the recipient has a serious mental illness | 36 |
| or
developmental disability.
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| (B) That because of said mental illness or | 2 |
| developmental disability,
the recipient currently | 3 |
| exhibits any one of the following: (i)
deterioration of | 4 |
| his
or her ability to function, as compared to the | 5 |
| recipient's ability to
function prior to the current | 6 |
| onset of symptoms of the mental illness or
disability | 7 |
| for which treatment is presently sought, (ii) | 8 |
| suffering, or (iii)
threatening
behavior.
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| (C) That the illness or disability has existed for | 10 |
| a period marked by
the continuing presence of the | 11 |
| symptoms set forth in item (B) of this
subdivision (4) | 12 |
| or the repeated episodic occurrence of these symptoms.
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| (D) That the benefits of the treatment
outweigh the | 14 |
| harm.
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| (E) That the recipient lacks the capacity to make a
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| reasoned
decision about the treatment.
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| (F) That other less restrictive services have been | 18 |
| explored
and found inappropriate.
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| (G) If the petition seeks authorization for | 20 |
| testing and other
procedures,
that such testing and | 21 |
| procedures are essential for the safe and effective
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| administration of the treatment.
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| (5) In no event shall an order issued under this | 24 |
| Section be effective
for more than 90 days.
A second 90-day | 25 |
| period of involuntary treatment may be authorized pursuant | 26 |
| to
a hearing that
complies
with the standards and | 27 |
| procedures of this subsection (a-5).
Thereafter, | 28 |
| additional 180-day periods of involuntary treatment may be
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| authorized pursuant to
the standards and procedures of this | 30 |
| Section without limit.
If a new petition to authorize the | 31 |
| administration of authorized involuntary
treatment is | 32 |
| filed at least 15 days prior to the
expiration of the prior | 33 |
| order, and if
any continuance of the hearing is agreed to | 34 |
| by the recipient, the
administration of the treatment may | 35 |
| continue in accordance
with
the prior order
pending the | 36 |
| completion of a hearing under this Section.
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| (6) An order issued under this subsection (a-5) shall
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| designate the persons
authorized to administer the | 3 |
| authorized involuntary treatment under the
standards
and | 4 |
| procedures of this subsection (a-5).
Those persons shall | 5 |
| have complete discretion not to administer any
treatment | 6 |
| authorized under this Section.
The order shall also specify | 7 |
| the medications and the anticipated range of
dosages that | 8 |
| have been authorized and may include a list of any | 9 |
| alternative
medications and range of dosages deemed | 10 |
| necessary.
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| (b) A guardian may be authorized to consent to the | 12 |
| administration
of authorized involuntary treatment to an
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| objecting recipient only under the
standards and procedures of | 14 |
| subsection (a-5).
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| (c) Notwithstanding any other provision of this Section, a | 16 |
| guardian may
consent to the administration of authorized | 17 |
| involuntary treatment to a
non-objecting
recipient under | 18 |
| Article XIa of the Probate Act of 1975.
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| (d) Nothing in this Section shall prevent the | 20 |
| administration of
authorized involuntary treatment to | 21 |
| recipients
in an emergency under Section 2-107 of
this Act.
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| (e) Notwithstanding any of the provisions of this Section, | 23 |
| authorized
involuntary treatment may be administered pursuant | 24 |
| to a power of attorney for
health care under the Powers of | 25 |
| Attorney for Health Care Law or a declaration
for mental health | 26 |
| treatment under the Mental Health Treatment Preference
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| Declaration Act.
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| (f) The Department shall conduct annual trainings for | 29 |
| physicians and registered nurses working in State-operated | 30 |
| mental health facilities on the appropriate use of authorized | 31 |
| involuntary treatment, standards for its use, and the | 32 |
| preparation of court petitions under this Section.
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| (Source: P.A. 92-16, eff. 6-28-01; 93-573, eff. 8-21-03.)
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| (405 ILCS 5/2-107.3 new) | 35 |
| Sec. 2-107.3. Reports. Each facility director of a |
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| State-operated mental health facility shall prepare a | 2 |
| quarterly report stating the number of persons who were | 3 |
| determined to meet the
standard for authorized involuntary | 4 |
| treatment but for whom it was determined that the filing of | 5 |
| such a petition was not warranted as provided for in subsection | 6 |
| (h) of Section 2-107 of this Code and the reasons for each such | 7 |
| determination. The Department shall prepare and publish an | 8 |
| annual report summarizing the information received under this | 9 |
| Section. The Department's report shall include the data from | 10 |
| each facility filing such a report and shall separately report | 11 |
| the data from each such facility, identified by facility.
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| (405 ILCS 5/3-209) (from Ch. 91 1/2, par. 3-209)
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| Sec. 3-209. Within three days of admission under this | 14 |
| Chapter, a treatment
plan shall be prepared for each recipient | 15 |
| of service and entered into his
or her record. The plan shall | 16 |
| include an assessment of the recipient's
treatment needs, a | 17 |
| description of the services recommended for treatment,
the | 18 |
| goals of each type of element of service, an anticipated | 19 |
| timetable for
the accomplishment of the goals, and a | 20 |
| designation of the qualified professional
responsible for the | 21 |
| implementation of the plan. The plan shall include a
written | 22 |
| assessment of whether or not the recipient is in need of | 23 |
| psychotropic medications. The plan shall be reviewed
and | 24 |
| updated as the clinical condition warrants, but not less than | 25 |
| every 30 days.
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| (Source: P.A. 81-920.)
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| Section 99. Effective date. This Act takes effect upon | 28 |
| becoming law. |
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