Illinois Administrative Code › Title 59 - MENTAL HEALTH › Part 125 - RECIPIENT DISCHARGE/LINKAGE/AFTERCARE › Subpart B - SYSTEM COMPONENTS › Section 125.50 - Discharge planning

Current through Register Vol. 48, No. 28, July 12, 2024
a) During
				the earliest treatment/habilitation planning activities within a State-operated
				facility, active consideration must be given to the current and anticipated
				needs of the recipient. While formal as well as informal planning is conducted
				with the recipient, the individualized services plan is recorded, as it
				evolves, in the recipient's record consistent with professional judgment and
				the provisions set forth in the Code, and Departmental and facility policy.
				Establishing and maintaining the recipient's record is first and foremost a
				necessary practice which contributes to planning for and providing the most
				appropriate services. In addition, recordkeeping establishes the necessary
				documentation which provides an audit trail which is used for a variety of
				accountability purposes such as securing facility certification and
				accreditation, responding to judicial inquiries and the assurance of general
				public accountability.
b) As the
				facility related treatment and habilitation goals contained in the
				individualized services plan come closer to realization, greater attention must
				be paid to numerous DLA related considerations. Prior to making the decision to
				discharge and refer a recipient, the recipient's readiness for that move must
				be assessed as well as the recipient's desire and agreement to participate. In
				this assessment, consideration must be given, not only to the desires of the
				recipient and the recommendations of State-operated facility
				treatment/habilitation staff, but also the desires and recommendations of the
				recipient's guardian, family, follow-up monitoring staff, community agency
				staff previously involved with the recipient or likely to provide services
				after discharge, and staff of other involved State agencies (such as Department
				of Public Aid, Department of Children and Family Services, State Board of
				Education and the Department of Corrections).
c) The following general areas must be
				addressed for all recipients regardless of the aftercare setting to which the
				recipients may be discharged:
1) The need of
				the recipient for various services as detailed in the individualized services
				plan.
2) The readiness and desires
				of the recipient or the recipient's guardian.
3) The recipient's area of origin and/or
				location of social supports.
4) The
				effectiveness of any previous individualized services plans or other services
				the recipient may have received in the community prior to the last admission to
				the State-operated facility.
5) A
				general assessment of the recipient's intellectual and emotional state
				including the recipient's behavior.
6) Medication needs of the
				recipient.
7) Special procedures
				which must be followed related to the legal status of the recipient due to the
				relationship of the recipient to the criminal justice system. This includes
				recipients who are legally classified as:
A)
				Not guilty by reason of insanity (NGRI);
B) Guilty but mentally ill;
C) Unfit to stand trial, to plead or be
				sentenced;
D) Hold order from the
				court.
AGENCY NOTE: These recipients can only be released pursuant
				  to the provisions of the Unified Code of Corrections [730 ILCS 5 ]. Further
				  clarification on this subject is found in the publication entitled
				  "Responsibilities of DMHDD for Persons Admitted as Unfit to Stand Trial, To
				  Plead or Be Sentenced in Accordance With Public Act 81-1217", December,
				  1981.
8) The
				availability of financial resources for recipients discharged from
				State-operated facilities including:
A)
				Consideration of the recipient's ability to be self-supporting;
B) Consideration of other sources of personal
				or family income;
C) Assisting the
				recipient who does not return to independent or semi-independent living in
				accessing necessary financial support, e.g., Supplemental Security Income
				(SSI), Department of Public Aid, and/or other applicable funding;
D) Reasonable assistance in accessing
				financial support for recipients returning to independent or semi-independent
				living.
9) After
				considering the factors listed above, a decision may be made to discharge and
				refer the recipient to available and appropriate aftercare services.
10) Before the actual discharge is completed
				the applicable items listed below on the discharge planning check list need to
				be completed:
A) Secure the recipient's
				informed consent on form DMHDD-146, "Authorization for Release of Information",
				in order to communicate and share records with individuals and organizations
				regarding the recipient.
B)
				Identify the location, when possible, of the aftercare living situation. For a
				recipient being placed in long-term care, the licensed facility shall be
				identified.
C) Facilitate
				appropriate contact and linkage with family and/or other individuals who can
				provide extended social support to the recipient (see Section
				125.50(b)
				 ).
D) Assist the recipient in accessing
				necessary financial resources. Special emphasis must be given to this activity
				when the recipient is not returning to independent or semi-independent living.
				In these cases, applicable funding approval, such as the SSI approval letter or
				Department of Public Aid point count, shall be forwarded to the receiving
				facility.
E) Refer the recipient to
				available support services including social, psychological, vocational and
				transportation, and assist in the actual linkage contact between the aftercare
				service provider(s) and the recipient.
F) Notify the recipient, guardian, attorney
				or person who executed the application for admission of the intent to
				discharge. Special attention as outlined in Section
				125.50(c)(7)
				must be given to the discharge notification process for recipients who are
				associated with the criminal justice system.
G) Notice of discharge has been given and any
				and all written objections relating to it have been heard and an administrative
				decision has been rendered.
H)
				Complete part one of form DMHDD-20, "Discharge Summary", by the date of
				discharge and part two of DMHDD-20, within 48 hours following discharge. For
				recipients placed in a licensed long-term care facility, the DMHDD-20 must be
				transmitted at the time of placement.
I) Forward as necessary, any relevant medical
				or dental reports to the appropriate aftercare agency/facility.
J) Assure the provision of an adequate supply
				of medication sufficient to last until the first scheduled aftercare visit as
				contained in the recipient's DLA plan.
K) Forward a copy of the guardianship papers
				to the aftercare service provider(s) if the recipient is legally
				incompetent.
L) Assist the
				recipient in securing personal clothing, property and funds.
M) Complete parts one and two of form
				DMHDD-189, "Recipient Transfer Summary", for all recipients being placed in a
				long-term care facility and transmit both parts of the form to the facility at
				the time of placement.
N) Notify
				designated mandated follow-up staff of the placement of the recipient in a
				licensed long-term care facility.
O) Transmit to the ICF/DD facility a copy of
				a psychological assessment completed within the past 36 months for recipients
				who are being placed there.
P)
				Provide placement notification, when such agencies are the funding agencies, to
				the Department of Public Aid and the Social Security Administration, stating
				the recipient's name, address of the facility and date of placement.