State of Illinois
92nd General Assembly
Legislation

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[ Introduced ][ Engrossed ][ House Amendment 002 ]
[ Senate Amendment 001 ]


92_SB0624ham001

 










                                           LRB9205151JScsam01

 1                    AMENDMENT TO SENATE BILL 624

 2        AMENDMENT NO.     .  Amend Senate Bill 624  by  replacing
 3    the title with the following:

 4        "AN ACT in relation to health care."; and

 5    by  replacing  everything  after the enacting clause with the
 6    following:

 7        "Section  5.  The   Mental   Health   and   Developmental
 8    Disabilities   Administrative  Act  is  amended  by  changing
 9    Sections 4, 7, and 15 as follows:

10        (20 ILCS 1705/4) (from Ch. 91 1/2, par. 100-4)
11        Sec.  4.  Supervision   of   facilities   and   services;
12    quarterly reports.
13        (a)  To exercise executive and administrative supervision
14    over  all  facilities,  divisions,  programs and services now
15    existing  or  hereafter  acquired  or   created   under   the
16    jurisdiction  of  the  Department, including, but not limited
17    to, the following:
18             The Alton Mental Health Center, at Alton
19             The Clyde L. Choate Mental Health and  Developmental
20        Center, at Anna
21             The Chester Mental Health Center, at Chester
 
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 1             The Chicago-Read Mental Health Center, at Chicago
 2             The Elgin Mental Health Center, at Elgin
 3             The Metropolitan Children and Adolescents Center, at
 4        Chicago
 5             The    Jacksonville    Developmental    Center,   at
 6        Jacksonville
 7             The Governor Samuel H. Shapiro Developmental Center,
 8        at Kankakee
 9             The Tinley Park Mental Health Center, at Tinley Park
10             The  Warren  G.   Murray  Developmental  Center,  at
11        Centralia
12             The Jack Mabley Developmental Center, at Dixon
13             The Lincoln Developmental Center, at Lincoln
14             The   H.   Douglas   Singer   Mental   Health    and
15        Developmental Center, at Rockford
16             The John J. Madden Mental Health Center, at Chicago
17             The George A. Zeller Mental Health Center, at Peoria
18             The   Andrew  McFarland  Mental  Health  Center,  at
19        Springfield
20             The Adolf Meyer Mental Health Center, at Decatur
21             The William W. Fox Developmental Center, at Dwight
22             The Elisabeth Ludeman Developmental Center, at  Park
23        Forest
24             The  William A. Howe Developmental Center, at Tinley
25        Park
26             The Ann M. Kiley Developmental Center, at Waukegan.
27        (b)  Beginning  not  later  than  July   1,   1977,   the
28    Department  shall  cause  each  of  the  facilities under its
29    jurisdiction which provide in-patient  care  to  comply  with
30    standards,  rules and regulations of the Department of Public
31    Health  prescribed  under  Section  6.05  of   the   Hospital
32    Licensing Act.
33        (c)  The  Department  shall  issue  quarterly  reports on
34    admissions,   deflections,    discharges,    bed    closures,
 
                            -3-            LRB9205151JScsam01
 1    staff-resident  ratios,  census,  and average length of stay,
 2    and  any  adverse  federal  certification  or   accreditation
 3    findings,  if  any,  for each State-operated facility for the
 4    mentally ill and developmentally disabled.
 5    (Source: P.A. 91-357, eff. 7-29-99; 91-652, eff. 12-1-99.)

 6        (20 ILCS 1705/7) (from Ch. 91 1/2, par. 100-7)
 7        Sec. 7.  To receive  and  provide  the  highest  possible
 8    quality  of  humane  and rehabilitative care and treatment to
 9    all  persons  admitted  or  committed   or   transferred   in
10    accordance  with  law to the facilities, divisions, programs,
11    and services under the jurisdiction  of  the  Department.  No
12    resident  of  another  state shall be received or retained to
13    the exclusion of any resident of this State.  No resident  of
14    another  state shall be received or retained to the exclusion
15    of any resident of this State.  All recipients of 17 years of
16    age and under in residence in  a  Department  facility  other
17    than  a  facility for the care of the mentally retarded shall
18    be housed in quarters separated from older recipients  except
19    for:  (a) recipients who are placed in medical-surgical units
20    because of physical illness; and (b)  recipients  between  13
21    and 18 years of age who need temporary security measures.
22        All  recipients in a Department facility shall be given a
23    dental examination by a licensed dentist or registered dental
24    hygienist at least once every 18 months and shall be assigned
25    to a dentist  for  such  dental  care  and  treatment  as  is
26    necessary.
27        All  medications  administered  to  recipients  shall  be
28    administered  only by those persons who are legally qualified
29    to do so by the laws of the  State  of  Illinois.  Medication
30    shall   not   be  prescribed  until  a  physical  and  mental
31    examination of the recipient has been completed. If,  in  the
32    clinical   judgment  of  a  physician,  it  is  necessary  to
33    administer medication to a recipient before the completion of
 
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 1    the physical and mental examination, he  may  prescribe  such
 2    medication  but  he  must  file  a  report  with the facility
 3    director setting  forth  the  reasons  for  prescribing  such
 4    medication within 24 hours of the prescription. A copy of the
 5    report shall be part of the recipient's record.
 6        No later than January 1, 2002, the Department shall adopt
 7    a   model  protocol  and  forms  for  recording  all  patient
 8    diagnosis, care, and treatment at every  facility  under  the
 9    jurisdiction of the Department.  The model protocol and forms
10    shall   be  used  by  each  facility  unless  the  Department
11    determines that equivalent alternatives justify an exemption.
12        Every facility under the jurisdiction of  the  Department
13    shall  maintain  a  copy of each report of suspected abuse or
14    neglect of the patient. Copies of those reports shall be made
15    available to the State Auditor General in connection with his
16    biennial program audit of the facility as required by Section
17    3-2 of the Illinois State Auditing Act.
18        No later than January 1, 2002, every facility  under  the
19    jurisdiction  of  the Department and all services provided in
20    those facilities shall comply  with  all  of  the  applicable
21    standards adopted by the Social Security Administration under
22    Subchapter  XVIII  (Medicare)  of the Social Security Act (42
23    U.S.C. 1395 - 1395ccc), if the facility and services  may  be
24    eligible  for  federal  financial  participation  under  that
25    federal law.
26    (Source: P.A. 86-922; 86-1013; 86-1475.)

27        (20 ILCS 1705/15) (from Ch. 91 1/2, par. 100-15)
28        Sec.  15.   Before any person is released from a facility
29    operated by the State pursuant to an absolute discharge or  a
30    conditional  discharge  from  hospitalization under this Act,
31    the facility director of the facility in which such person is
32    hospitalized  shall  determine  that  such  person   is   not
33    currently in need of hospitalization and:
 
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 1             (a)  is able to live independently in the community;
 2        or
 3             (b)  requires further oversight and supervisory care
 4        for  which  arrangements  have been made with responsible
 5        relatives or supervised residential program  approved  by
 6        the Department; or
 7             (c)  requires   further  personal  care  or  general
 8        oversight as defined by the Nursing Home  Care  Act,  for
 9        which  placement  arrangements  have  been  made  with  a
10        suitable  family home or other licensed facility approved
11        by the Department under this Section; or
12             (d)  requires community mental health  services  for
13        which   arrangements  have  been  made  with  a  suitable
14        community  mental  health  provider  in  accordance  with
15        criteria, standards, and procedures promulgated by  rule.
16        The  suitable  community  mental health provider shall be
17        selected  from   among   the   Department's   contractual
18        designees.
19        Such  determination  shall  be  made in writing and shall
20    become a part of the facility record of  such  absolutely  or
21    conditionally  discharged  person.   When  the  determination
22    indicates  that  the condition of the person to be granted an
23    absolute discharge or a conditional  discharge  is  described
24    under  subparagraph  (c) or (d) of this Section, the name and
25    address of the continuing care facility or home to which such
26    person is to be released shall be  entered  in  the  facility
27    record.   Where  a discharge from a mental health facility is
28    made under subparagraph (c), the Department shall assign  the
29    person   so   discharged   to  an  existing  community  based
30    not-for-profit agency for  participation  in  day  activities
31    suitable  to  the  person's needs, such as but not limited to
32    social and vocational rehabilitation, and other recreational,
33    educational and financial  activities  unless  the  community
34    based  not-for-profit  agency is unable unqualified to accept
 
                            -6-            LRB9205151JScsam01
 1    such assignment. Where the clientele  of  any  not-for-profit
 2    agency  increases  as  a  result  of  assignments  under this
 3    amendatory Act of 2001 1977 by more than 3%  over  the  prior
 4    year,  the  Department  shall fully reimburse such agency for
 5    the increased costs of providing services to such persons  in
 6    excess of such 3% increase. The Department shall keep written
 7    records  detailing  how  many persons have been assigned to a
 8    community based not-for-profit agency and  how  many  persons
 9    were  not  so assigned because the community based agency was
10    unable  to  accept  the  assignments,  in   accordance   with
11    criteria,  standards,  and  procedures  promulgated  by rule.
12    Whenever a community based agency is found to  be  unable  to
13    accept the assignments, the name of the agency and the reason
14    for the finding shall be included in the report.
15        Insofar  as  desirable  in  the  interests  of the former
16    recipient,  the  facility,  program  or  home  in  which  the
17    discharged person is to be placed shall be located in or near
18    the  community  in  which  the  person   resided   prior   to
19    hospitalization  or  in  the  community in which the person's
20    family or nearest next of kin presently reside. Placement  of
21    the  discharged  person  in  facilities,  programs  or  homes
22    located  outside  of  this  State  shall  not  be made by the
23    Department  unless  there  are  no  appropriate   facilities,
24    programs  or  homes available within this State. Out-of-state
25    placements shall be subject to return of recipients so placed
26    upon the availability of facilities, programs or homes within
27    this State to  accommodate  these  recipients,  except  where
28    placement  in  a  contiguous  state  results  in  locating  a
29    recipient  in a facility or program closer to the recipient's
30    home or  family.   If  an  appropriate  facility  or  program
31    becomes  available equal to or closer to the recipient's home
32    or family, the recipient shall be returned to and  placed  at
33    the appropriate facility or program within this State.
34        To  place  any  person  who  is  under  a  program of the
 
                            -7-            LRB9205151JScsam01
 1    Department at board in a suitable  family  home  or  in  such
 2    other  facility  or  program  as  the Department may consider
 3    desirable.  The Department  may  place  in  licensed  nursing
 4    homes,  sheltered  care  homes,  or  homes for the aged those
 5    persons  whose  behavioral  manifestations  and  medical  and
 6    nursing  care  needs  are  such  as   to   be   substantially
 7    indistinguishable   from   persons  already  living  in  such
 8    facilities.  Prior to any placement by the  Department  under
 9    this  Section, a determination shall be made by the personnel
10    of the Department, as to the capability  and  suitability  of
11    such  facility  to adequately meet the needs of the person to
12    be discharged.  When specialized programs  are  necessary  in
13    order  to  enable  persons  in  need  of supervised living to
14    develop and improve in the community,  the  Department  shall
15    place  such  persons  only  in  specialized  residential care
16    facilities which shall meet  Department  standards  including
17    restricted admission policy, special staffing and programming
18    for  social and vocational rehabilitation, in addition to the
19    requirements of the appropriate State licensing agency.   The
20    Department  shall  not place any new person in a facility the
21    license of which has been revoked or not renewed  on  grounds
22    of inadequate programming, staffing, or medical or adjunctive
23    services,  regardless  of  the  pendency  of  an  action  for
24    administrative review regarding such revocation or failure to
25    renew.  Before  the  Department  may transfer any person to a
26    licensed nursing home, sheltered care home or  home  for  the
27    aged  or  place  any person in a specialized residential care
28    facility  the  Department  shall  notify  the  person  to  be
29    transferred, or a responsible relative  of  such  person,  in
30    writing,  at least 30 days before the proposed transfer, with
31    respect to all the relevant facts concerning  such  transfer,
32    except  in  cases  of  emergency  when  such  notice  is  not
33    required.  If  either  the  person  to  be  transferred  or a
34    responsible relative of such person objects to such transfer,
 
                            -8-            LRB9205151JScsam01
 1    in writing to the Department, at any time  after  receipt  of
 2    notice  and before the transfer, the facility director of the
 3    facility  in  which  the  person  was   a   recipient   shall
 4    immediately  schedule  a  hearing  at  the  facility with the
 5    presence of the facility director, the person who objected to
 6    such proposed transfer, and a psychiatrist  who  is  familiar
 7    with  the record of the person to be transferred. Such person
 8    to  be  transferred  or  a  responsible   relative   may   be
 9    represented  by  such  counsel  or interested party as he may
10    appoint, who may present such testimony with respect  to  the
11    proposed  transfer. Testimony presented at such hearing shall
12    become   a   part   of   the   facility   record    of    the
13    person-to-be-transferred.  The  record  of testimony shall be
14    held in the person-to-be-transferred's record in the  central
15    files of the facility. If such hearing is held a transfer may
16    only  be  implemented,  if  at  all,  in  accordance with the
17    results of such hearing. Within 15 days  after  such  hearing
18    the facility director shall deliver his findings based on the
19    record  of  the  case  and  the  testimony  presented  at the
20    hearing, by registered or certified mail, to the  parties  to
21    such  hearing. The findings of the facility director shall be
22    deemed a final administrative decision of the Department. For
23    purposes of this Section, "case  of  emergency"  means  those
24    instances in which the health of the person to be transferred
25    is  imperiled  and the most appropriate mental health care or
26    medical  care  is  available  at  a  licensed  nursing  home,
27    sheltered care home or home for the  aged  or  a  specialized
28    residential care facility.
29        Prior to placement of any person in a facility under this
30    Section  the  Department  shall  ensure  that  an appropriate
31    training plan for staff is provided  by  the  facility.  Said
32    training   may   include  instruction  and  demonstration  by
33    Department personnel qualified in the area of mental  illness
34    or  mental  retardation,  as  applicable  to the person to be
 
                            -9-            LRB9205151JScsam01
 1    placed.  Training may be given  both  at  the  facility  from
 2    which  the  recipient  is  transferred  and  at  the facility
 3    receiving the recipient, and may be available on a continuing
 4    basis subsequent  to  placement.   In  a  facility  providing
 5    services  to  former Department recipients, training shall be
 6    available as necessary for  facility  staff.   Such  training
 7    will  be  on  a continuing basis as the needs of the facility
 8    and recipients change and further training is required.
 9        The Department shall not place any person in  a  facility
10    which does not have appropriately trained staff in sufficient
11    numbers  to  accommodate  the recipient population already at
12    the facility.  As a condition of further or future placements
13    of persons, the Department shall require  the  employment  of
14    additional  trained  staff members at the facility where said
15    persons are to be placed.   The  Secretary,  or  his  or  her
16    designate,  shall  establish written guidelines for placement
17    of persons in facilities under this Act. The Department shall
18    keep written records detailing  which  facilities  have  been
19    determined   to   have  appropriately  trained  staff,  which
20    facilities have been determined not to have such  staff,  and
21    all  training  which  it  has provided or required under this
22    Section.
23        Bills for the support for a person boarded out  shall  be
24    payable monthly out of the proper maintenance funds and shall
25    be  audited  as  any  other accounts of the Department.  If a
26    person is  placed  in  a  facility  or  program  outside  the
27    Department,  the  Department  may  pay  the  actual  costs of
28    residence, treatment or maintenance in such facility and  may
29    collect  such  actual  costs  or  a  portion thereof from the
30    recipient or the estate of a person placed in accordance with
31    this Section.
32        Other than those placed in a family home  the  Department
33    shall  cause  all  persons  who  are placed in a facility, as
34    defined by the  Nursing  Home  Care  Act,  or  in  designated
 
                            -10-           LRB9205151JScsam01
 1    community  living  situations  or  programs, to be visited at
 2    least once during the first month  following  placement,  and
 3    once  every  month  thereafter  for  the first year following
 4    placement when indicated, but at least quarterly.  After  the
 5    first  year,  visits shall be made at least once per year for
 6    as long as the placement continues.   If  a  long  term  care
 7    facility  has periodic care plan conferences, the visitor may
 8    participate in those conferences. Visits  shall  be  made  by
 9    qualified   and   trained   Department  personnel,  or  their
10    designee, in the  area  of  mental  health  or  developmental
11    disabilities  applicable  to the person visited, and shall be
12    made on a more frequent basis when indicated.  The Department
13    may not use as  designee  any  personnel  connected  with  or
14    responsible  to  the representatives of any facility in which
15    persons who have been  transferred  under  this  Section  are
16    placed.    In  the  course  of  such  visit  there  shall  be
17    consideration   of  the  following  areas,  but  not  limited
18    thereto:  effects of transfer on physical and  mental  health
19    of  the  person,  sufficiency  of  nursing  care  and medical
20    coverage  required  by  the  person,  sufficiency  of   staff
21    personnel  and  ability to provide basic care for the person,
22    social, recreational and  programmatic  activities  available
23    for the person, and other appropriate aspects of the person's
24    environment.
25        A  report containing the above observations shall be made
26    to  the  Department  and  to  any  other  appropriate  agency
27    subsequent to each visitation. The  report  shall  contain  a
28    detailed  assessment  of  whether  the recipient is receiving
29    necessary services in the least restrictive environment.   If
30    the recipient is not receiving those services, the Department
31    shall  either  require that the facility modify the treatment
32    plan to ensure that  those  services  are  provided  or  make
33    arrangements  necessary  to provide those services elsewhere.
34    At  the  conclusion  of  one  year  following   absolute   or
 
                            -11-           LRB9205151JScsam01
 1    conditional discharge, or a longer period of time if required
 2    by   the   Department,   the  Department  may  terminate  the
 3    visitation requirements of this Section as to a person placed
 4    in  accordance  with  this  Section,  by  filing  a   written
 5    statement   of   termination   setting   forth   reasons   to
 6    substantiate  the  termination of visitations in the person's
 7    file, and sending a copy thereof to the person,  and  to  his
 8    guardian or next of kin.
 9        Upon  the  complaint  of  any person placed in accordance
10    with  this  Section  or  any  responsible  citizen  or   upon
11    discovery  that  such  person  has been abused, neglected, or
12    improperly cared for, or that the placement does not  provide
13    the   type  of  care  required  by  the  recipient's  current
14    condition, the Department immediately shall investigate,  and
15    determine  if  the well-being, health, care, or safety of any
16    person is affected by any of the above  occurrences,  and  if
17    any  one of the above occurrences is verified, the Department
18    shall remove such  person  at  once  to  a  facility  of  the
19    Department  or  to  another  facility outside the Department,
20    provided such person's needs can be  met  at  said  facility.
21    The   Department  may  also  provide  any  person  placed  in
22    accordance with this Section who is without available  funds,
23    and  who  is  permitted  to  engage in employment outside the
24    facility,  such  sums  for  the  transportation,  and   other
25    expenses  as may be needed by him until he receives his wages
26    for such employment.
27        The Department shall  promulgate  rules  and  regulations
28    governing  the  purchase of care for persons who are wards of
29    or who are receiving  services  from  the  Department.   Such
30    rules  and  regulations shall apply to all monies expended by
31    any agency of the State of Illinois for services rendered  by
32    any  person, corporate entity, agency, governmental agency or
33    political subdivision whether public or  private  outside  of
34    the Department whether payment is made through a contractual,
 
                            -12-           LRB9205151JScsam01
 1    per-diem or other arrangement.  No funds shall be paid to any
 2    person, corporation, agency, governmental entity or political
 3    subdivision   without   compliance   with   such   rules  and
 4    regulations.
 5        The rules and  regulations  governing  purchase  of  care
 6    shall   describe  categories  and  types  of  service  deemed
 7    appropriate for purchase by the Department.
 8        Any provider of services under  this  Act  may  elect  to
 9    receive  payment  for  those  services, and the Department is
10    authorized to arrange for that payment, by  means  of  direct
11    deposit   transmittals  to  the  service  provider's  account
12    maintained at a bank, savings and loan association, or  other
13    financial  institution.   The  financial institution shall be
14    approved by the Department, and  the  deposits  shall  be  in
15    accordance   with   rules  and  regulations  adopted  by  the
16    Department.
17    (Source: P.A. 89-507, eff. 7-1-97; 90-423, eff. 8-15-97.)

18        Section 10.  The Hospital Licensing  Act  is  amended  by
19    adding Section 6.19 as follows:

20        (210 ILCS 5/6.19 new)
21        Sec.  6.19.    Use  of restraints. Each hospital licensed
22    under this Act must have a written policy to address the  use
23    of  restraints and seclusion in the hospital.  The Department
24    shall establish, by rule, the provisions that the policy must
25    include,  which,  to  the  extent  practicable,   should   be
26    consistent  with  the  requirements  of  the federal Medicare
27    program.
28        For freestanding psychiatric  hospitals  and  psychiatric
29    units  in  general  hospitals,  restraints or seclusion shall
30    only be ordered by persons as  authorized  under  the  Mental
31    Health and Developmental Disabilities Code.
32        For general hospitals, excluding freestanding psychiatric
 
                            -13-           LRB9205151JScsam01
 1    hospitals   and   psychiatric  units  in  general  hospitals,
 2    restraints or seclusion may only be employed upon the written
 3    order of:
 4             (1)  a physician licensed to  practice  medicine  in
 5        all its branches;
 6             (2)  a  physician  assistant as authorized under the
 7        Physician Assistant Practice Act of 1987 or  an  advanced
 8        practice  nurse  as  authorized  under  the  Nursing  and
 9        Advanced Practice Nursing Act; or
10             (3)  a  registered  nurse, provided that the medical
11        staff of the hospital has adopted  a  policy  authorizing
12        such  practice  and  specifying  the  requirements that a
13        registered  nurse  must  satisfy  to  order  the  use  of
14        restraints or seclusion.

15        Section 15.  The Abused  and  Neglected  Long  Term  Care
16    Facility  Residents  Reporting  Act  is  amended  by changing
17    Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, and 6.8 as follows:

18        (210 ILCS 30/6.2) (from Ch. 111 1/2, par. 4166.2)
19        (Section scheduled to be repealed on January 1, 2002)
20        Sec. 6.2.  Inspector General.
21        (a)  The Governor shall appoint,  and  the  Senate  shall
22    confirm,  an  Inspector General.  The Inspector General shall
23    be appointed for a term of 4 years  and  who  shall  function
24    within  the  Department  of  Human Services and report to the
25    Secretary of Human Services and the Governor.  The  Inspector
26    General shall function independently within the Department of
27    Human  Services with respect to the operations of the office,
28    including the performance of investigations and  issuance  of
29    findings  and  recommendations.   The Inspector General shall
30    independently  submit  to  the  Governor  any   request   for
31    appropriations  necessary  for  the  ordinary  and contingent
32    expenses  of   the   Office   of   Inspector   General,   and
 
                            -14-           LRB9205151JScsam01
 1    appropriations  for  that  office  shall be separate from the
 2    Department of Human Services.  The  Inspector  General  shall
 3    investigate  reports  of suspected abuse or neglect (as those
 4    terms are defined in Section 3 of this Act)  of  patients  or
 5    residents  in any mental health or developmental disabilities
 6    facility operated by the Department  of  Human  Services  and
 7    shall have authority to investigate and take immediate action
 8    on  reports  of  abuse  or  neglect  of  recipients,  whether
 9    patients  or residents, in any mental health or developmental
10    disabilities  facility  or  program  that  is   licensed   or
11    certified  by  the Department of Human Services (as successor
12    to  the  Department  of  Mental  Health   and   Developmental
13    Disabilities)  or  that  is funded by the Department of Human
14    Services (as successor to the Department of Mental Health and
15    Developmental Disabilities) and is not licensed or  certified
16    by any agency of the State.  At the specific, written request
17    of  an agency of the State other than the Department of Human
18    Services (as successor to the Department of Mental Health and
19    Developmental  Disabilities),  the  Inspector   General   may
20    cooperate  in  investigating  reports of abuse and neglect of
21    persons with mental illness  or  persons  with  developmental
22    disabilities.    The   Inspector   General   shall   have  no
23    supervision over or  involvement  in  routine,  programmatic,
24    licensure,  or  certification operations of the Department of
25    Human Services or any of its funded agencies.
26        The Inspector General shall promulgate rules establishing
27    minimum requirements for reporting allegations of  abuse  and
28    neglect    and   initiating,   conducting,   and   completing
29    investigations.  The  promulgated  rules  shall  clearly  set
30    forth  that in instances where 2 or more State agencies could
31    investigate an allegation of abuse or neglect, the  Inspector
32    General  shall not conduct an investigation that is redundant
33    to an investigation conducted by another State agency.    The
34    rules  shall  establish  criteria for determining, based upon
 
                            -15-           LRB9205151JScsam01
 1    the nature of  the  allegation,  the  appropriate  method  of
 2    investigation, which may include, but need not be limited to,
 3    site  visits,  telephone  contacts,  or  requests for written
 4    responses from agencies.  The rules shall  also  clarify  how
 5    the  Office  of the Inspector General shall interact with the
 6    licensing  unit  of  the  Department  of  Human  Services  in
 7    investigations of  allegations  of  abuse  or  neglect.   Any
 8    allegations  or  investigations  of  reports made pursuant to
 9    this Act shall remain confidential until a  final  report  is
10    completed.  The  resident or patient who allegedly was abused
11    or neglected and his or her legal guardian shall be  informed
12    by  the  facility or agency of the report of alleged abuse or
13    neglect. Final reports regarding unsubstantiated or unfounded
14    allegations shall  remain  confidential,  except  that  final
15    reports may be disclosed pursuant to Section 6 of this Act.
16        The  Inspector General shall be appointed for a term of 4
17    years.
18        (b)  The Inspector General shall within  24  hours  after
19    receiving  a  report  of suspected abuse or neglect determine
20    whether the evidence indicates that any possible criminal act
21    has been committed. If he determines that a possible criminal
22    act has been committed, or that special expertise is required
23    in  the  investigation,  he  shall  immediately  notify   the
24    Department  of  State Police.  The Department of State Police
25    shall investigate any report indicating  a  possible  murder,
26    rape,  or  other  felony. All investigations conducted by the
27    Inspector General shall be conducted in a manner designed  to
28    ensure  the  preservation  of  evidence for possible use in a
29    criminal prosecution.
30        (b-5)  The Inspector General shall make  a  determination
31    to accept or reject a preliminary report of the investigation
32    of   alleged   abuse   or   neglect   based   on  established
33    investigative procedures.  The facility or agency may request
34    clarification  or   reconsideration   based   on   additional
 
                            -16-           LRB9205151JScsam01
 1    information.   For  cases  where  the  allegation of abuse or
 2    neglect is substantiated, the Inspector General shall require
 3    the facility or agency to submit  a  written  response.   The
 4    written response from a facility or agency shall address in a
 5    concise  and  reasoned  manner the actions that the agency or
 6    facility will take or has taken to protect  the  resident  or
 7    patient  from  abuse  or  neglect, prevent reoccurrences, and
 8    eliminate   problems    identified    and    shall    include
 9    implementation and completion dates for all such action.
10        (c)  The Inspector General shall, within 10 calendar days
11    after the transmittal date of a completed investigation where
12    abuse or neglect is substantiated or administrative action is
13    recommended,  provide  a  complete  report on the case to the
14    Secretary of Human Services and to the agency  in  which  the
15    abuse  or  neglect  is alleged to have happened. The complete
16    report shall include a written response from  the  agency  or
17    facility  operated by the State to the Inspector General that
18    addresses in a concise and reasoned manner the  actions  that
19    the  agency or facility will take or has taken to protect the
20    resident  or  patient  from   abuse   or   neglect,   prevent
21    reoccurrences,  and  eliminate  problems identified and shall
22    include implementation and  completion  dates  for  all  such
23    action.   The  Secretary  of  Human  Services shall accept or
24    reject the  response and establish how  the  Department  will
25    determine  whether  the  facility  or  program  followed  the
26    approved  response.   The  Secretary  may  require Department
27    personnel to visit  the  facility  or  agency  for  training,
28    technical    assistance,    programmatic,    licensure,    or
29    certification  purposes.   Administrative  action,  including
30    sanctions,  may  be  applied  should the Secretary reject the
31    response or should the facility or agency fail to follow  the
32    approved  response.  Within  30  days after the Secretary has
33    approved a  response,  the  facility  or  agency  making  the
34    response  shall  provide  an  implementation  report  to  the
 
                            -17-           LRB9205151JScsam01
 1    Inspector  General  on  the  status  of the corrective action
 2    implemented.   Within   60   days   after    receiving    the
 3    implementation report, the Inspector General shall conduct an
 4    investigation, which may include, but need not be limited to,
 5    site  visits,  telephone  contacts,  or  requests for written
 6    documentation from  the  facility  or  agency,  to  determine
 7    whether  the  facility  or  agency  is in compliance with the
 8    approved response.   The facility or agency shall inform  the
 9    resident  or  patient  and  the  legal  guardian  whether the
10    reported allegation was  substantiated,  unsubstantiated,  or
11    unfounded.   There shall be an appeals process for any person
12    or  agency  that  is  subject  to  any  action  based  on   a
13    recommendation or recommendations.
14        (d)  The   Inspector   General   may   recommend  to  the
15    Departments of Public Health and Human Services sanctions  to
16    be   imposed   against   mental   health   and  developmental
17    disabilities  facilities  under  the  jurisdiction   of   the
18    Department of Human Services for the protection of residents,
19    including  appointment  of  on-site  monitors  or  receivers,
20    transfer  or  relocation  of residents, and closure of units.
21    The Inspector General may seek the assistance of the Attorney
22    General or any of the several State's attorneys  in  imposing
23    such  sanctions.  Whenever  the  Inspector General issues any
24    recommendations to  the  Secretary  of  Human  Services,  the
25    Secretary shall provide a written response.
26        (e)  The  Inspector  General  shall establish and conduct
27    periodic training programs for Department of  Human  Services
28    employees  concerning the prevention and reporting of neglect
29    and abuse.
30        (f)  The Inspector General shall at all times be  granted
31    access  to  any  mental  health or developmental disabilities
32    facility operated by the Department of Human Services,  shall
33    establish  and  conduct  unannounced  site  visits  to  those
34    facilities  at  least  once  annually,  and  shall be granted
 
                            -18-           LRB9205151JScsam01
 1    access, for the purpose of investigating a report of abuse or
 2    neglect, to the records of the Department of  Human  Services
 3    and  to  any  facility or program funded by the Department of
 4    Human Services that is subject under the provisions  of  this
 5    Section  to  investigation  by  the  Inspector  General for a
 6    report of abuse or neglect.
 7        (g)  Nothing in this Section shall  limit  investigations
 8    by  the  Department  of  Human Services that may otherwise be
 9    required by law or that may be necessary in that Department's
10    capacity as the central administrative authority  responsible
11    for  the  operation  of State mental health and developmental
12    disability facilities.
13        (h)  This Section is repealed on January 1, 2002.
14    (Source: P.A. 90-252, eff.  7-29-97;  90-512,  eff.  8-22-97;
15    90-655, eff. 7-30-98; 91-169, eff. 7-16-99.)

16        (210 ILCS 30/6.3) (from Ch. 111 1/2, par. 4166.3)
17        (Section scheduled to be repealed on January 1, 2002)
18        Sec.  6.3.  Quality Care Board.  There is created, within
19    the Department of Human Services'  Office  of  the  Inspector
20    General,  a  Quality  Care  Board to be composed of 7 members
21    appointed by the Governor with the advice and consent of  the
22    Senate.   One  of the members shall be designated as chairman
23    by the Governor.  Of the initial  appointments  made  by  the
24    Governor,  4 Board members shall each be appointed for a term
25    of 4 years and 3 members shall each be appointed for  a  term
26    of  2  years.   Upon  the expiration of each member's term, a
27    successor shall be appointed for a term of 4 years.   In  the
28    case  of  a vacancy in the office of any member, the Governor
29    shall appoint a successor for the remainder of the  unexpired
30    term.
31        Members  appointed  by the Governor shall be qualified by
32    professional knowledge or experience  in  the  area  of  law,
33    investigatory  techniques,  or  in  the  area  of care of the
 
                            -19-           LRB9205151JScsam01
 1    mentally  ill  or  developmentally  disabled.   Two   members
 2    appointed  by the Governor shall be persons with a disability
 3    or a parent of a person with  a  disability.   Members  shall
 4    serve  without  compensation,  but  shall  be  reimbursed for
 5    expenses incurred in connection with the performance of their
 6    duties as members.
 7        The Board  shall  meet  quarterly,  and  may  hold  other
 8    meetings  on  the  call  of the chairman.  Four members shall
 9    constitute  a  quorum.   The  Board  may  adopt   rules   and
10    regulations it deems necessary to govern its own procedures.
11        This Section is repealed on January 1, 2002.
12    (Source: P.A. 91-169, eff. 7-16-99.)

13        (210 ILCS 30/6.4) (from Ch. 111 1/2, par. 4166.4)
14        (Section scheduled to be repealed on January 1, 2002)
15        Sec.  6.4.  Scope and function of the Quality Care Board.
16    The Board shall monitor and oversee the operations, policies,
17    and procedures of the Inspector General to assure the  prompt
18    and  thorough  investigation  of  allegations  of neglect and
19    abuse.  In fulfilling these responsibilities, the  Board  may
20    do the following:
21             (1)  Provide independent, expert consultation to the
22        Inspector   General   on   policies   and  protocols  for
23        investigations of alleged neglect and abuse.
24             (2)  Review existing  regulations  relating  to  the
25        operation   of   facilities  under  the  control  of  the
26        Department of Human Services.
27             (3)  Advise the Inspector General as to the  content
28        of training activities authorized under Section 6.2.
29             (4)  Recommend   policies   concerning  methods  for
30        improving the intergovernmental relationships between the
31        office of  the  Inspector  General  and  other  State  or
32        federal agencies.
33        This Section is repealed on January 1, 2002.
 
                            -20-           LRB9205151JScsam01
 1    (Source: P.A. 91-169, eff. 7-16-99.)

 2        (210 ILCS 30/6.5) (from Ch. 111 1/2, par. 4166.5)
 3        (Section scheduled to be repealed on January 1, 2002)
 4        Sec.  6.5.  Investigators.   Within  60  days  after  the
 5    effective  date of this amendatory Act of 1992, The Inspector
 6    General shall establish a  comprehensive  program  to  ensure
 7    that   every  person  employed  or  newly  hired  to  conduct
 8    investigations shall receive training on  an  on-going  basis
 9    concerning  investigative  techniques,  communication skills,
10    and the appropriate means of contact with persons admitted or
11    committed to the mental health or developmental  disabilities
12    facilities  under the jurisdiction of the Department of Human
13    Services.
14        This Section is repealed on January 1, 2002.
15    (Source: P.A. 91-169, eff. 7-16-99.)

16        (210 ILCS 30/6.6) (from Ch. 111 1/2, par. 4166.6)
17        (Section scheduled to be repealed on January 1, 2002)
18        Sec. 6.6.  Subpoenas; testimony; penalty.  The  Inspector
19    General shall have the power to subpoena witnesses and compel
20    the   production   of   books  and  papers  pertinent  to  an
21    investigation authorized by this Act, provided that the power
22    to subpoena or to compel the production of books  and  papers
23    shall  not  extend  to  the  person  or  documents of a labor
24    organization or its representatives insofar as the person  or
25    documents  of  a labor organization relate to the function of
26    representing an employee subject to investigation under  this
27    Act.  Mental health records of patients shall be confidential
28    as   provided  under  the  Mental  Health  and  Developmental
29    Disabilities Confidentiality Act.  Any person  who  fails  to
30    appear in response to a subpoena or to answer any question or
31    produce  any  books  or  papers pertinent to an investigation
32    under this Act, except as otherwise provided in this Section,
 
                            -21-           LRB9205151JScsam01
 1    or who knowingly gives false  testimony  in  relation  to  an
 2    investigation   under  this  Act  is  guilty  of  a  Class  A
 3    misdemeanor.
 4        This Section is repealed on January 1, 2002.
 5    (Source: P.A. 91-169, eff. 7-16-99.)

 6        (210 ILCS 30/6.7) (from Ch. 111 1/2, par. 4166.7)
 7        (Section scheduled to be repealed on January 1, 2002)
 8        Sec. 6.7.  Annual report.  The  Inspector  General  shall
 9    provide  to  the  General Assembly and the Governor, no later
10    than January 1  of  each  year,  a  summary  of  reports  and
11    investigations  made under this Act for the prior fiscal year
12    with  respect  to  residents  of   institutions   under   the
13    jurisdiction of the Department of Human Services.  The report
14    shall  detail  the  imposition  of  sanctions  and  the final
15    disposition of those recommendations.   The  summaries  shall
16    not  contain  any  confidential  or  identifying  information
17    concerning  the  subjects  of the reports and investigations.
18    The report shall also include a trend analysis of the  number
19    of  reported  allegations  and  their  disposition,  for each
20    facility and Department-wide, for the most recent 3-year time
21    period  and  a  statement,  for   each   facility,   of   the
22    staffing-to-patient  ratios.   The  ratios shall include only
23    the number of direct  care  staff.   The  report  shall  also
24    include   detailed  recommended  administrative  actions  and
25    matters for consideration by the General Assembly.
26        This Section is repealed on January 1, 2002.
27    (Source: P.A. 91-169, eff. 7-16-99.)

28        (210 ILCS 30/6.8) (from Ch. 111 1/2, par. 4166.8)
29        (Section scheduled to be repealed on January 1, 2002)
30        Sec. 6.8.  Program  audit.   The  Auditor  General  shall
31    conduct  a  biennial  program  audit  of  the  office  of the
32    Inspector General in  relation  to  the  Inspector  General's
 
                            -22-           LRB9205151JScsam01
 1    compliance  with  this  Act.   The  audit  shall specifically
 2    include   the   Inspector    General's    effectiveness    in
 3    investigating   reports   of  alleged  neglect  or  abuse  of
 4    residents in any facility operated by the Department of Human
 5    Services and in making recommendations for sanctions  to  the
 6    Departments of Human Services and Public Health.  The Auditor
 7    General  shall  conduct  the  program  audit according to the
 8    provisions of the  Illinois  State  Auditing  Act  and  shall
 9    report  its  findings  to  the General Assembly no later than
10    January 1 of each odd-numbered year.
11        This Section is repealed on January 1, 2002.
12    (Source: P.A. 91-169, eff. 7-16-99.)

13        Section 20.  The Nursing Home  Care  Act  is  amended  by
14    changing Sections 2-106 and 2-106.1 as follows:

15        (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106)
16        Sec. 2-106.  (a) For purposes of this Act, (i) a physical
17    restraint  is  any  manual  method  or physical or mechanical
18    device, material, or equipment  attached  or  adjacent  to  a
19    resident's  body  that  the resident cannot remove easily and
20    restricts freedom of movement or normal access to one's body;
21    (ii) a chemical restraint is any drug used for discipline  or
22    convenience  and not required to treat medical symptoms.  The
23    Department  shall  by  rule,  designate  certain  devices  as
24    restraints, including at least all those devices  which  have
25    been  determined  to  be  restraints  by  the  United  States
26    Department  of  Health  and  Human  Services  in interpretive
27    guidelines issued for the purposes of administering Titles 18
28    and 19 of the Social Security Acts.
29        (b)  Neither  restraints  nor   confinements   shall   be
30    employed for the purpose of punishment or for the convenience
31    of  any  facility  personnel.  No  restraints or confinements
32    shall be employed  except  as  ordered  by  a  physician  who
 
                            -23-           LRB9205151JScsam01
 1    documents the need for such restraints or confinements in the
 2    resident's   clinical   record.   Whenever   a   resident  is
 3    restrained, a member of the facility staff shall remain  with
 4    the  resident  at  all  times  unless  the  resident has been
 5    confined.  A resident who is restrained and confined shall be
 6    observed by a qualified person  as  often  as  is  clinically
 7    appropriate  but  in  no  event less often than once every 15
 8    minutes.
 9        (c)  A restraint may  be  used  only  with  the  informed
10    consent  of  the  resident, the resident's guardian, or other
11    authorized representative.  A restraint may be used only  for
12    specific  periods,  if  it  is  the  least  restrictive means
13    necessary to  attain  and  maintain  the  resident's  highest
14    practicable  physical,  mental  or  psychosocial  well-being,
15    including   brief   periods  of  time  to  provide  necessary
16    life-saving treatment.  A restraint may be  used  only  after
17    consultation  with  appropriate health professionals, such as
18    occupational or physical therapists,  and  a  trial  of  less
19    restrictive  measures  has  led to the determination that the
20    use of less restrictive measures would not attain or maintain
21    the  resident's  highest  practicable  physical,  mental   or
22    psychosocial  well-being.  However,  if  the  resident  needs
23    emergency  care,  restraints may be used for brief periods to
24    permit medical treatment to proceed unless the  facility  has
25    notice  that the resident has previously made a valid refusal
26    of the treatment in question.
27        (d)  A restraint may be applied only by a person  trained
28    in the application of the particular type of restraint.
29        (e)  Whenever   a   period  of  use  of  a  restraint  is
30    initiated, the resident shall be advised of his or her  right
31    to  have  a  person  or  organization of his or her choosing,
32    including the Guardianship and Advocacy Commission,  notified
33    of  the  use  of  the  restraint.   A  recipient who is under
34    guardianship may request that a person or organization of his
 
                            -24-           LRB9205151JScsam01
 1    or her choosing  be notified of the restraint, whether or not
 2    the guardian  approves  the  notice.    If  the  resident  so
 3    chooses,  the  facility shall make the notification within 24
 4    hours, including any information about  the  period  of  time
 5    that  the  restraint is to be used. Whenever the Guardianship
 6    and Advocacy Commission is notified that a resident has  been
 7    restrained,  it  shall  contact the resident to determine the
 8    circumstances of the restraint and whether further action  is
 9    warranted.
10        (f)  Whenever  a  restraint  is  used on a resident whose
11    primary mode of communication is sign language, the  resident
12    shall  be  permitted  to  have  his  or  her  hands free from
13    restraint for brief  periods  each  hour,  except  when  this
14    freedom  may  result  in  physical  harm  to  the resident or
15    others.
16        (g)  The requirements of this  Section  are  intended  to
17    control  in  any  conflict  with the requirements of Sections
18    1-126 and  2-108  of  the  Mental  Health  and  Developmental
19    Disabilities Code.
20    (Source: P.A. 88-413.)

21        (210 ILCS 45/2-106.1)
22        Sec. 2-106.1.  Drug treatment.
23        (a)  A resident shall not be given unnecessary drugs.  An
24    unnecessary  drug  is  any  drug  used  in an excessive dose,
25    including in duplicative  therapy;  for  excessive  duration;
26    without adequate monitoring; without adequate indications for
27    its  use;  or  in  the  presence of adverse consequences that
28    indicate the drugs should be reduced  or  discontinued.   The
29    Department   shall   adopt,   by   rule,  the  standards  for
30    unnecessary drugs contained in interpretive guidelines issued
31    by the United States Department of Health and Human  Services
32    for  the  purposes  of  administering titles 18 and 19 of the
33    Social Security Act.
 
                            -25-           LRB9205151JScsam01
 1        (b)  Psychotropic  medication  shall  not  be  prescribed
 2    without the informed consent of the resident, the  resident's
 3    guardian,  or other authorized representative.  "Psychotropic
 4    medication" means medication that is used for  or  listed  as
 5    used   for   antipsychotic,   antidepressant,  antimanic,  or
 6    antianxiety  behavior  modification  or  behavior  management
 7    purposes in the latest editions of the AMA  Drug  Evaluations
 8    or the Physician's Desk Reference.
 9        (c)  The  requirements  of  this  Section are intended to
10    control in a conflict with the requirements of Sections 2-102
11    1-102 and 2-107.2 of  the  Mental  Health  and  Developmental
12    Disabilities  Code  with  respect  to  the  administration of
13    psychotropic medication.
14    (Source: P.A. 88-413.)

15        Section 25.  The Nursing and  Advanced  Practice  Nursing
16    Act is amended by changing Section 5-10 as follows:

17        (225 ILCS 65/5-10)
18        Sec.  5-10.   Definitions.   Each of the following terms,
19    when used in this Act, shall have the meaning ascribed to  it
20    in  this  Section, except where the context clearly indicates
21    otherwise:
22        (a)  "Department" means the  Department  of  Professional
23    Regulation.
24        (b)  "Director"   means   the  Director  of  Professional
25    Regulation.
26        (c)  "Board" means the Board of Nursing appointed by  the
27    Director.
28        (d)  "Academic  year" means the customary annual schedule
29    of courses at a  college,  university,  or  approved  school,
30    customarily regarded as the school year as distinguished from
31    the calendar year.
32        (e)  "Approved program of professional nursing education"
 
                            -26-           LRB9205151JScsam01
 1    and  "approved  program  of  practical nursing education" are
 2    programs of professional or practical nursing,  respectively,
 3    approved by the Department under the provisions of this Act.
 4        (f)  "Nursing   Act   Coordinator"   means  a  registered
 5    professional nurse appointed by the Director to carry out the
 6    administrative policies of the Department.
 7        (g)  "Assistant  Nursing   Act   Coordinator"   means   a
 8    registered  professional  nurse  appointed by the Director to
 9    assist in carrying out the  administrative  policies  of  the
10    Department.
11        (h)  "Registered" is the equivalent of "licensed".
12        (i)  "Practical  nurse"  or  "licensed  practical  nurse"
13    means  a  person  who  is licensed as a practical nurse under
14    this Act  and  practices  practical  nursing  as  defined  in
15    paragraph  (j)  of  this  Section.   Only  a  practical nurse
16    licensed  under  this  Act  is  entitled  to  use  the  title
17    "licensed practical nurse" and the abbreviation "L.P.N.".
18        (j)  "Practical nursing" means the performance of nursing
19    acts requiring the basic nursing  knowledge,  judgement,  and
20    skill   acquired  by  means  of  completion  of  an  approved
21    practical  nursing  education  program.   Practical   nursing
22    includes assisting in the nursing process as delegated by and
23    under  the direction of a registered professional nurse.  The
24    practical nurse may work under the direction  of  a  licensed
25    physician,   dentist,   podiatrist,   or  other  health  care
26    professional determined by the Department.
27        (k)  "Registered  Nurse"  or   "Registered   Professional
28    Nurse" means a person who is licensed as a professional nurse
29    under  this Act and practices nursing as defined in paragraph
30    (l) of this Section.  Only a registered nurse licensed  under
31    this Act is entitled to use the titles "registered nurse" and
32    "registered professional nurse" and the abbreviation, "R.N.".
33        (l)  "Registered  professional nursing practice" includes
34    all nursing specialities and means  the  performance  of  any
 
                            -27-           LRB9205151JScsam01
 1    nursing  act based upon professional knowledge, judgment, and
 2    skills  acquired  by  means  of  completion  of  an  approved
 3    registered  professional  nursing   education   program.    A
 4    registered   professional   nurse   provides   nursing   care
 5    emphasizing   the   importance   of   the   whole   and   the
 6    interdependence  of  its parts through the nursing process to
 7    individuals, groups, families, or communities, that  includes
 8    but  is  not  limited  to:  (1)  the assessment of healthcare
 9    needs,  nursing  diagnosis,  planning,  implementation,   and
10    nursing  evaluation;  (2)  the  promotion,  maintenance,  and
11    restoration  of  health;  (3)  counseling, patient education,
12    health   education,   and   patient   advocacy;    (4)    the
13    administration of medications and treatments as prescribed by
14    a  physician  licensed  to  practice  medicine  in all of its
15    branches, a licensed dentist, a  licensed  podiatrist,  or  a
16    licensed   optometrist   or  as  prescribed  by  a  physician
17    assistant in  accordance  with  written  guidelines  required
18    under  the  Physician Assistant Practice Act of 1987 or by an
19    advanced  practice  nurse  in  accordance  with   a   written
20    collaborative   agreement  required  under  the  Nursing  and
21    Advanced Practice  Nursing  Act;  (5)  the  coordination  and
22    management of the nursing plan of care; (6) the delegation to
23    and  supervision  of  individuals  who  assist the registered
24    professional nurse implementing the plan  of  care;  and  (7)
25    teaching  and  supervision  of  nursing students; and (8) the
26    ordering of restraint or seclusion as  authorized  under  the
27    Hospital Licensing Act.  The foregoing shall not be deemed to
28    include  those  acts  of medical diagnosis or prescription of
29    therapeutic  or  corrective  measures   that   are   properly
30    performed  only  by  physicians  licensed  in  the  State  of
31    Illinois.
32        (m)  "Current  nursing  practice  update  course" means a
33    planned  nursing  education  curriculum   approved   by   the
34    Department  consisting  of  activities  that have educational
 
                            -28-           LRB9205151JScsam01
 1    objectives, instructional methods, content or subject matter,
 2    clinical practice, and evaluation methods, related  to  basic
 3    review  and  updating  content  and  specifically planned for
 4    those nurses previously licensed in the United States or  its
 5    territories and preparing for reentry into nursing practice.
 6        (n)  "Professional assistance program for nurses" means a
 7    professional   assistance   program   that   meets   criteria
 8    established  by  the  Board  of  Nursing  and approved by the
 9    Director,  which  provides   a   non-disciplinary   treatment
10    approach  for nurses licensed under this Act whose ability to
11    practice is compromised  by  alcohol  or  chemical  substance
12    addiction.
13    (Source:  P.A.  90-61,  eff.  12-30-97;  90-248, eff. 1-1-98;
14    90-655, eff. 7-30-98; 90-742, eff. 8-13-98.)

15        Section 99.  Effective date.  This Section,  Sections  10
16    and 25, the changes to Sections 6.2, 6.3, 6.4, 6.5, 6.6, 6.7,
17    and  6.8  of the Abused and Neglected Long Term Care Facility
18    Residents Reporting Act, and the changes to Section 3-203  of
19    the Nursing Home Care Act take effect upon becoming law.".

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