Illinois Administrative Code › Title 59 - MENTAL HEALTH › Part 112 - TREATMENT AND HABILITATION SERVICES › Section 112.90 - Administration of Psychotropic Medications and ECT

Current through Register Vol. 48, No. 28, July 12, 2024
This Section addresses the use of psychotropic medications or
				electroconvulsive therapy (ECT) in the treatment of patients receiving services
				within Department programs.
Definitions
"Authorized involuntary treatment" means psychotropic
				medication or electroconvulsive therapy, including those tests and related
				procedures that are essential for the safe and effective administration of the
				treatment. [405 ILCS 5/1-121.5]
"Capable" means the ability of the recipient to make reasoned
				decisions regarding treatment/habilitation alternatives.
"Code" means the Mental Health and Developmental Disabilities
				Code [405 ILCS 5 ].
"Electroconvulsive therapy (ECT)" means the use of electrical
				stimulation, for therapeutic ends, to induce a generalized seizure.
"Guardianship" refers to the legal relationship between an
				adult recipient or ward and a court appointed guardian, including a public
				guardian such as the Office of State Guardian. Illinois guardians may make
				legally binding decisions on behalf of wards in personal or financial affairs,
				or both. For the purposes of this Part, the guardian must have court authority
				to make personal decisions for the ward. Guardians with personal
				decision-making authority will typically act under a plenary guardianship. A
				plenary guardian is one who has full decision-making authority over the person
				without restrictions. However, a guardian may also legitimately act under a
				temporary or a limited guardianship in which the guardian has clearly defined
				medical decision-making authority. A parent of an adult recipient without
				guardianship is not legally authorized to make binding decisions on behalf of a
				recipient. When doubt exists as to the decision-making authority of a guardian,
				the guardian shall supply either letters of office or a copy of a court order
				documenting legal authority to act on behalf of the ward.
"Informed consent" means the voluntary and knowing choice by a
				recipient or his/her legal guardian.
"Lack of capacity" means the inability, due to mental
				impairment, to make reasoned decisions regarding treatment/habilitation
				alternatives, including the taking of medication, by evaluating, among other
				factors, information about the likelihood of therapeutic benefits and the risk
				of side effects.
"Legally and clinically competent recipient" means an
				individual who is not under guardianship and has the capacity to make reasoned
				decisions and give informed consent.
"Legally and clinically incompetent recipient" means an
				individual under guardianship or who lacks the capacity to make reasoned
				decisions and give informed consent.
"Long-acting psychotropic medication" means psychotropic
				medications, including but not limited to Haldol Decanoate and Prolixin
				Decanoate, that are designed so that a single dose will have an intended
				clinical effect for a period of at least 48 hours. [405 ILCS
				5/1-113.5]
"Medical Coordinator" means the Medical Coordinator for Mental
				Health (if the recipient resides in a mental health facility) or the Medical
				Coordinator for Developmental Disabilities (if the recipient resides in a
				developmental disabilities facility).
"Medication", as used in this Section, means psychotropic
				medication.
"Psychotropic medication" means medication used for
				antipsychotic, antidepressant, antimanic, antianxiety, behavioral modification
				or behavioral management purposes, as listed in the Physician's Desk Reference
				(PDR), Drug Information Manual and Drug Facts and Comparisons, as incorporated
				by Section
				112.80(a),
				or where there is a body of peer reviewed medical literature supporting its
				use.
"Substitute decision maker" means a person who possesses the
				authority to make decisions under the Powers of Attorney for Health Care Law
				[755 ILCS 45 /Art. IV] or under the Mental Health Treatment Preference
				Declaration Act [755 ILCS 43 ]. [405 ILCS 5/1-110.5]
Procedures
a)
			 Evaluation
1) No psychotropic medication or
			 electroconvulsive therapy (ECT) shall be prescribed for a recipient unless
			 examinations have been conducted in accordance with Section
			 112.30.
			 The prescribing physician shall conduct the examinations personally, or shall
			 review the record of the examinations. The prescribing physician shall record,
			 sign, and date (with time) the prescription. The prescribing physician shall
			 also document in the recipient's clinical record any appropriate clinical
			 information.
2) With regard to
			 psychotropic medication on an emergency basis, the requirements of subsection
			 (a)(1) need not be met when the prescribing physician has determined by
			 personal observation or from information supplied by another clinician with
			 thorough knowledge of the recipient's current clinical condition that the
			 recipient is in need of immediate medication in order to prevent the recipient
			 from causing serious and imminent physical harm to self or others.