a) Administration of Psychotropic Medication
1) Psychotropic medication shall not be
administered to any offender against his or her will or without the consent of
the parent or guardian of a minor who is under the age of 18, unless:
A) A psychiatrist, or in the absence of a
psychiatrist a physician, has determined that:
i) The offender suffers from a mental illness
or mental disorder; and
ii) The
medication is in the medical interest of the offender; and
iii) The offender is either gravely disabled
or poses a likelihood of serious harm to self or others; and
B) The administration of such
medication has been approved by the Treatment Review Committee after a hearing
(see subsection (b) of this Section). However, no such approval or hearing
shall be required when the medication is administered in an emergency
situation. An emergency situation exists whenever the required determinations
listed in subsection (a)(1)(A) of this Section have been made and a
psychiatrist, or in the absence of a psychiatrist a physician, has determined
that the offender poses an imminent threat of serious physical harm to self or
others. In all emergency situations, the procedures set forth in subsection (e)
of this Section shall be followed.
2) Whenever a physician orders the
administration of psychotropic medication to an offender against the person's
will, the physician shall document in the offender's medical file the facts and
underlying reasons supporting the determination that the standards in
subsection (a)(1) of this Section have been met and:
A) The Chief Administrative Officer shall be
notified as soon as practicable; and
B) Unless the medication was administered in
an emergency situation, the Chairperson of the Treatment Review Committee shall
be notified in writing within three days.
b) Treatment Review Committee Procedures
The Treatment Review Committee shall be comprised of two
members appointed by the Chief Administrative Officer, both of whom shall be
mental health professionals and one of whom shall be a physician. One member
shall serve as Chairperson of the Committee. Neither of the Committee members
may be involved in the current decision to order the medication. The members of
the Committee shall have completed a training program in the procedural and
mental health issues involved that has been approved by the Agency Medical
Director.
1) The Chief Administrative
Officer shall designate a member of the program staff not involved in the
current decision to order medication to assist the offender. The staff
assistant shall have completed a training program in the procedural and mental
health issues involved that has been approved by the Agency Medical
Director.
2) The offender and staff
assistant shall receive written notification of the time and place of the
hearing at least 24 hours prior to the hearing. The notification shall include
the tentative diagnosis and the reasons why the medical staff believes the
medication is necessary. The staff assistant shall meet with the offender prior
to the hearing to discuss the procedural and mental health issues
involved.
3) The offender shall
have the right to attend the hearing unless the Committee determines that it is
likely that the person's attendance would subject the person to substantial
risk of serious physical or emotional harm or pose a threat to the safety of
others. If such a determination is made, the facts and underlying reasons
supporting the determination shall be documented in the offender's medical
file. The staff assistant shall appear at the hearing whether or not the
offender appears.
4) The
documentation in the medical file referred to in subsection (a)(2) of this
Section shall be reviewed by the Committee and the Committee may request the
physician's personal appearance at the hearing.
5) Prior to the hearing, witnesses identified
by the offender and the staff assistant may be interviewed by the staff
assistant after consultation with the offender as to appropriate questions to
ask. Any such questions shall be asked by the staff assistant unless
cumulative, irrelevant, or a threat to the safety of individuals or the
security of the facility.
6) Prior
to the hearing, the offender and the staff assistant may request in writing
that witnesses be interviewed by the Committee and may submit written questions
for witnesses to the Chairperson of the Committee. These questions shall be
asked by the Committee unless cumulative, irrelevant, or a threat to the safety
of individuals or the security of the facility. If any witness is not
interviewed, a written reason shall be provided.
7) Prior to the hearing, the offender and the
staff assistant may request in writing that witnesses appear at the hearing.
Any such request shall include an explanation of what the witnesses would
state. Reasonable efforts shall be made to have such witnesses present at the
hearing, unless their testimony or presence would be cumulative, irrelevant, or
a threat to the safety of individuals or the security of the facility, or for
other reasons including, but not limited to, unavailability of the witness or
matters relating to institutional order. In the event requested witnesses are
unavailable to appear at the hearing but are otherwise available, they shall be
interviewed by the Committee as provided for in subsections (b)(6) and (9) of
this Section.
8) At the hearing,
the offender and the staff assistant may make statements and present documents
that are relevant to the proceedings. The staff assistant may direct relevant
questions to any witnesses appearing at the hearing. The offender may request
that the staff assistant direct relevant questions to any witnesses appearing
at the hearing and the staff assistant shall ask such questions unless
cumulative, irrelevant, or a threat to the safety of individuals or the
security of the facility.
9) The
Committee shall make such investigation as it deems necessary. The staff
assistant shall be informed of any investigation conducted by the Committee and
shall be permitted to direct relevant questions to any witnesses interviewed by
the Committee. The staff assistant shall consult with the offender regarding
any statements made by witnesses interviewed by the Committee and shall comply
with requests by the offender to direct relevant questions to such witnesses
unless cumulative, irrelevant, or a threat to the safety of individuals or the
security of the facility.
10) The
Committee shall consider all relevant information and material that has been
presented in deciding whether to approve administration of the
medication.
11) A written decision
shall be prepared and signed by all members of the Committee that contains a
summary of the hearing and the reasons for approving or disapproving the
administration of the medication. Copies of the decision shall be given to the
offender, the staff assistant, and the Chief Administrative Officer. Any
decision by the Committee to approve involuntary administration of psychotropic
medication must be unanimous. The Chief Administrative Officer shall direct
staff to comply with the decision of the Committee.
12) If the Committee approves administration
of the medication, the offender shall be advised of the opportunity to appeal
the decision to the Agency Medical Director by filing a written appeal with the
Chairperson within five days after the offender's receipt of the written
decision.
c) Review by
Agency Medical Director
1) If the offender
appeals the Treatment Review Committee's decision, staff shall continue to
administer the medication as ordered by the physician and approved by the
Committee while awaiting the Agency Medical Director's decision on the
appeal.
2) The Chairperson of the
Committee shall promptly forward the written notice of appeal to the Agency
Medical Director or a physician designated by the Agency Medical
Director.
3) Within five working
days after receipt of the written notice of appeal, the Agency Medical Director
shall:
A) Review the Committee's decision,
make such further investigation as deemed necessary, and submit a written
decision to the Chief Administrative Officer; and
B) Provide a copy of the written decision to
the offender, the staff assistant, and the Chairperson of the
Committee.
4) The Chief
Administrative Officer shall direct staff to comply with the decision of the
Agency Medical Director.
d) Periodic Review of Medication
1) Whenever any offender has been
involuntarily receiving psychotropic medication continuously or on a regular
basis for a period of six months, the administration of such medication shall,
upon the offender's written request, be reviewed by the Treatment Review
Committee in accordance with the procedures enumerated in subsections (b) and
(c) of this Section. Every six months thereafter, for so long as the
involuntary medication continues on a regular basis, the offender shall have
the right to a review hearing upon written request.
2) Every offender who is involuntarily
receiving psychotropic medication shall be evaluated by a psychiatrist at least
every 30 days, and the psychiatrist shall document in the offender's medical
file the basis for the decision to continue the medication.
e) Emergency Procedures
Subsequent to the involuntary administration of psychotropic
medication in an emergency situation:
1) The basis for the decision to administer
the medication shall be documented in the offender's medical file and a copy of
the documentation shall be given to the offender and to the Agency Medical
Director for review.
2) A mental
health professional shall meet with the offender to discuss the reasons why the
medication was administered and to give the offender an opportunity to express
any concerns he or she may have regarding the medication.
f) Documentation
Copies of all notifications and written decisions shall be
placed in the offender's medical file.
g) Grievances
An offender may submit a grievance concerning the involuntary
administration of psychotropic medication directly to the Administrative Review
Board in accordance with 20 Ill. Adm. Code 504.Subpart F. In considering the
grievance, the Board shall confer with the Agency Medical Director.
h) Treatment of Minors
In the case of an offender who is a minor under the age of 18,
the parent or guardian shall be sent the documentation and written decisions
that are provided to the offender pursuant to this Section and shall be
permitted to attend and participate in any proceedings required by this
Section. Notice of any Treatment Review Committee hearing shall be promptly
sent to the parent or guardian and reasonable attempts shall be made to provide
such notice at least 72 hours prior to the hearing.