Current through Register Vol. 48, No. 12, March 22, 2024
Designated mandated follow-up staff shall assure compliance
with the provisions of the Mental Health and Developmental Disabilities
Administrative Act and compliance with the following Departmental
policies.
a) Recipient monitoring
1) Provide or contract for the provision of
individual monthly monitoring of recipients placed in a licensed long-term care
facility for at least 12 months, including visits on a weekly basis during the
first month.
2) Interview the
recipient during the course of follow-up visits and discuss program involvement
and/or other needs with staff in the licensed long-term care
facility.
3) Observe, review and
document the following:
A) The recipient's
comments and concerns;
B) The
recipient's overall adjustment to the facility; and
C) The adequacy of the recipient's current
individualized services plan as maintained by the facility.
4) The adequacy of the programs
and services available in the facility and in the community for meeting the
needs of the recipient which may include, but are not limited to:
A) Activities;
B) Social (re)habilitation;
C) Restoration nursing;
D) Diagnostic testing; and
E) Psychological and social
services.
5) Sufficiency
of the nursing and medical services to meet the physical health needs of the
recipient.
b) Reporting
and records
1) Reports of deaths, accidents
and unusual occurrences
A) All deaths of
recipients, or accidents and unusual occurrences, such as reports of abuse,
neglect and improper care, involving a recipient, shall be reported by the
facility by telephone within twelve hours to the designated mandated follow-up
staff, guardians (including the Office of the State Guardian, where appointed)
and next of kin and confirmed in writing no later than the next working day
with a complete statement of circumstances. The facility must promptly notify
the coroner of all deaths pursuant to Section 3-3013 of the Counties Code
[55
ILCS 5/3-3013 ].
B) Designated staff shall close cases in
which death occurs in the Department's extramural reporting system by filing
form DMHDD-1006, "Case Information".
2) Monthly facility report - Designated staff
shall report on the results of their onsite visits to each facility on the
monthly evaluation report for long-term care facilities. Copies of this report
shall be submitted to the licensed long-term care facility and to the
designated regional staff, with a copy being retained by the designated
mandated follow-up staff.
3)
Semiannual facility report
A) The regional
administrator will submit to the associate directors, semiannually, a summary
of the monthly facility reports for each facility within the region.
B) These reports may be used for the
evaluation and continued approval or denial of placements in licensed long-term
care facilities.
4)
Monthly and annual information report
Monthly and annually a report shall be produced for Central
Office and regional use by the Department's Bureau of Information Services
including the following information by disability:
A) The total number of facilities serving the
Department's mandated follow-up recipients;
B) The total number of Department recipients
placed during the current month and year-to-date;
C) The total number of Department mandated
follow-up recipients in each facility;
D) The total number of Department mandated
follow-up recipients being monitored on a weekly and monthly basis;
E) The number of mandated follow-up
recipients readmitted to state-operated facilities from licensed long-term
facilities for the current month and year-to-date;
F) The number of mandated follow-up
recipients transferred to another licensed long-term care facility, to a
State-operated facility, to independent living for the current month and
year-to-date;
G) The number of
deaths of Department mandated follow-up recipients for the current month and
year-to-date; and
H) The total
number of drug abusers for the current month and year-to-date.
c) Program development
and monitoring
1) When necessary, designated
mandated follow-up staff may provide training as outlined in Section 15 of the
Mental Health and Developmental Disabilities Administrative Act as outlined to
assist facilities in meeting the unique needs of persons previously served by
the Department.
2) Designated
mandated follow-up staff will assist a facility in arranging for resources to
program for these populations, e.g., activity programs, treatment/habilitation
programs and other specialized programs. These program development functions
may include:
A) Providing time limited direct
services in an effort to train facility staff;
B) Providing workshops on special programs or
procedures;
C) Consulting with
program staff or licensed long-term care facilities regarding the development
of individualized services plans;
D) Developing methods of implementation;
and
E) Evaluating programs
available in the licensed long-term care facility.
3) At least annually, the Department must
review facility training records prescribed by Department of Public Health
standards for licensure of long-term care facilities (Minimum Standards for the
Licensure of Long-Term Care Facilities for the Developmentally Disabled (77
Ill. Adm. Code 350); Minimum Standards for the Licensure of Long-Term Care
Facilities - Persons Under Twenty-Two (22) Years of Age (Divisions 1 through
73); Minimum Standards for the Licensure of Long-Term Care Facilities -
Sheltered Care Facilities (77 Ill. Adm. Code 330); and Minimum Standards for
the Licensure of Long-Term Care Facilities - Skilled Nursing Facilities and
Intermediate Care Facilities (77 Ill. Adm. Code 300)) and make recommendations
regarding future training needs. Specific recommendations regarding orientation
and inservice staff training must be included in the semiannual facility
report. This report must also contain a judgment as to the sufficiency and
capability of the staff in the facility.
4) Program development and monitoring
activities must be documented and maintained in a file readily available to the
appropriate region office.
d) Termination from mandated follow-up
services
1) Termination of follow-up
monitoring services occurs after the 12-month period, except in cases of death,
discharge to other than a licensed long-term care facility, or discharged for
leaving against staff advice. Termination which is an individualized
programmatic and clinical decision is based on the following criteria:
A) A clinical determination has been made
that mandated follow-up services to the recipient are no longer necessary to
maintain adjustment in the licensed long-term care facility.
B) Appropriate and necessary linkage to
community resources have been established which will enable the recipient to
function independently.
C) The
developmentally disabled recipient is receiving specialized programmatic
services to meet the objectives for further personal development as contained
in the individualized services plan, and that procedural continuity is
established which is essential to maintain adaptive levels and/or to prevent
behavioral/developmental regression.
D) The recipient has substantially achieved
the objectives outlined in the individualized services plan.
E) The facility has demonstrated its ability
to provide the necessary continuing support and appropriate programming to the
recipient.
2) The
termination of recipients from mandated follow-up services, however, does not
necessarily mean that contact with these persons shall cease. Statutorily
required follow-up monitoring services and reporting shall cease, services
including but not limited to those covered in the individualized services plan
may continue to be provided. Supportive services and/or case coordination, if
appropriate, should be provided based on the recipient's on-going
needs.
e) Continuing
mandated follow-up status
Monthly comments will be forwarded to the designated
Department region staff on each community placement recipient who exceeds one
year in continuing mandated follow-up status. Comments will relate to specifics
pertaining to inadequate adjustment of the recipient or any other cause
considered significant enough to maintain the case in mandated status.
f) Transfers of recipients
1) Transfers, when necessary, from one
long-term care facility to another may be to assure the recipient's health and
well being. Primary attention shall be given to the needs and choices of the
individual recipient (a recipient cannot be moved against the recipient's will
except in an emergency). A transfer is indicated if the facility cannot meet
the current needs of the recipient; or the recipient has been neglected, abused
or improperly cared for; or if the facility is not in substantial compliance
with previously cited licensure standards or has not developed an acceptable
plan of correction as determined by the Illinois Department of Public
Health.
2) If a transfer is
indicated, designated staff shall cooperate in the transfer of mandated
follow-up recipients from one licensed long-term care facility to another. The
regional DLA plan shall specify how transfer activities shall be coordinated
with involved State agencies.
3) In
times of disaster or emergency, designated staff may need to be involved in the
transfer of recipients who have been terminated from mandated follow-up
monitoring services.
AGENCY NOTE: Designated staff must document all transfer
activities and maintain the documentation in the recipient's record.
4) Routine transfers
A) All recipients shall be transferred
insofar as possible, in or near the communities in which the recipients reside
or in which the recipients' families or significant others, such as a guardian
or a friend, reside. The same considerations and procedures followed for the
initial planning for discharge/linkage/aftercare shall apply (see Section
125.40
).
B) Transfers may be initiated at
the request of the recipient or legally responsible party. Transfers may also
be initiated by the long-term care facility's administrator. Under such
situations, designated staff will work with the Department of Public Aid and
other involved agencies.
5) Inter-region transfers
Recipients may be moved between regions provided there is a
prior agreement with both regional administrators or their designated agents
involved in the transfer.
6) Emergency transfers
A) The Department of Public Health under
Sections 3-401 through 3-423 of the Nursing Home Care Act [210 ILCS 45/3-401
through 3 -423] and the Department under Section 15 of the Mental Health and
Developmental Disabilities Administrative Act are empowered to take specific
action to transfer recipients who are not receiving appropriate services and/or
when conditions exist in a facility which imperil the health or pose a serious
and imminent threat to the life or safety of those recipients.
B) Both Departments must make all reasonable
efforts to eliminate any threats to the safety and well-being of any recipient,
through consultation with the facility, the attending physician, and the
recipient, spouse, parents, responsible relative or guardian (see Section 15 of
the Mental Health and Developmental Disabilities Administrative Act).
C) The Department of Public Health is given
broad statutory authority and primary responsibility to transfer any individual
who is not receiving appropriate services in licensed long-term care
facilities. The Department's legal authority deals specifically with individual
recipients who have been placed by the Department in these
facilities.
D) The Department must
work in close cooperation with the Department of Public Health to effect the
transfer of recipients whose life or safety is in imminent danger. However, the
Department may, in the proper exercise of its statutory mandate, initiate
action to provide for the health and welfare of mandated follow-up recipients
residing in a facility.
AGENCY NOTE: When the decision to terminate has been made,
designated staff shall check the follow-up notes and recipient records to
insure that the recipient's recorded progress clinically supports the decision
to terminate. In cases of developmentally disabled individuals on conditional
discharge, who are being considered for termination from mandated follow-up
services, a copy of the community placement termination summary will be
forwarded to the regional administrator or designee as the recommendation for
termination. The regional administrator or designee must give approval before
the termination is effected.