SB3750 - 104th General Assembly
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| 1 | AMENDMENT TO SENATE BILL 3750 | ||||||
| 2 | AMENDMENT NO. ______. Amend Senate Bill 3750 by replacing | ||||||
| 3 | everything after the enacting clause with the following: | ||||||
| 4 | "Section 5. The Mental Health and Developmental | ||||||
| 5 | Disabilities Code is amended by changing Sections 1-109, | ||||||
| 6 | 1-129, 2-107, 2-107.1, 3-611, and 3-807 and by adding Section | ||||||
| 7 | 1-103.5 as follows: | ||||||
| 8 | (405 ILCS 5/1-103.5 new) | ||||||
| 9 | Sec. 1-103.5. Confinement. "Confinement", with respect to | ||||||
| 10 | a mental health facility, means that an individual is | ||||||
| 11 | prevented or otherwise not permitted to leave the facility. | ||||||
| 12 | (405 ILCS 5/1-109) (from Ch. 91 1/2, par. 1-109) | ||||||
| 13 | Sec. 1-109. "Discharge" means the full and physical | ||||||
| 14 | release of any person admitted or otherwise detained under | ||||||
| 15 | this Act from treatment, habilitation, or care and custody. | ||||||
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| 1 | (Source: P.A. 80-1414.) | ||||||
| 2 | (405 ILCS 5/1-129) | ||||||
| 3 | Sec. 1-129. Mental illness. "Mental illness" means a | ||||||
| 4 | mental, or emotional disorder that substantially impairs a | ||||||
| 5 | person's thought, perception of reality, emotional process, | ||||||
| 6 | judgment, behavior, or ability to cope with the ordinary | ||||||
| 7 | demands of life, but does not include a developmental | ||||||
| 8 | disability, a neurocognitive disorder dementia or Alzheimer's | ||||||
| 9 | disease absent psychosis, a substance use disorder, or an | ||||||
| 10 | abnormality manifested only by repeated criminal or otherwise | ||||||
| 11 | antisocial conduct. | ||||||
| 12 | (Source: P.A. 100-759, eff. 1-1-19.) | ||||||
| 13 | (405 ILCS 5/2-107) (from Ch. 91 1/2, par. 2-107) | ||||||
| 14 | Sec. 2-107. Refusal of services; informing of risks. | ||||||
| 15 | (a) An adult recipient of services or the recipient's | ||||||
| 16 | guardian, if the recipient is under guardianship, and the | ||||||
| 17 | recipient's substitute decision maker, if any, must be | ||||||
| 18 | informed of the recipient's right to refuse medication or | ||||||
| 19 | electroconvulsive therapy. The recipient and the recipient's | ||||||
| 20 | guardian or substitute decision maker shall be given the | ||||||
| 21 | opportunity to refuse generally accepted mental health or | ||||||
| 22 | developmental disability services, including but not limited | ||||||
| 23 | to medication or electroconvulsive therapy. If such services | ||||||
| 24 | are refused, they shall not be given unless such services are | ||||||
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| 1 | necessary to prevent the recipient from causing serious and | ||||||
| 2 | imminent physical harm to the recipient or others and no less | ||||||
| 3 | restrictive alternative is available. The facility director | ||||||
| 4 | shall inform a recipient, guardian, or substitute decision | ||||||
| 5 | maker, if any, who refuses such services of alternate services | ||||||
| 6 | available and the risks of such alternate services, as well as | ||||||
| 7 | the possible consequences to the recipient of refusal of such | ||||||
| 8 | services. | ||||||
| 9 | (b) Psychotropic medication or electroconvulsive therapy | ||||||
| 10 | may be administered under this Section for up to 24 hours only | ||||||
| 11 | if the circumstances leading up to the need for emergency | ||||||
| 12 | treatment are set forth in writing in the recipient's record. | ||||||
| 13 | (c) Administration of medication or electroconvulsive | ||||||
| 14 | therapy may not be continued unless the need for such | ||||||
| 15 | treatment is redetermined at least every 24 hours based upon a | ||||||
| 16 | personal examination of the recipient by a physician or a | ||||||
| 17 | nurse under the supervision of a physician and the | ||||||
| 18 | circumstances demonstrating that need are set forth in writing | ||||||
| 19 | in the recipient's record. | ||||||
| 20 | (d) Neither psychotropic medication nor electroconvulsive | ||||||
| 21 | therapy may be administered under this Section for a period in | ||||||
| 22 | excess of 72 hours, excluding Saturdays, Sundays, and | ||||||
| 23 | holidays, unless a petition is filed under Section 2-107.1 and | ||||||
| 24 | the treatment continues to be necessary under subsection (a) | ||||||
| 25 | of this Section. Once the petition has been filed, treatment | ||||||
| 26 | may continue in compliance with subsections (a), (b), and (c) | ||||||
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| 1 | of this Section until the final outcome of the hearing on the | ||||||
| 2 | petition. | ||||||
| 3 | (e) The Department shall issue rules designed to ensure | ||||||
| 4 | insure that in State-operated mental health facilities | ||||||
| 5 | psychotropic medication and electroconvulsive therapy are | ||||||
| 6 | administered in accordance with this Section and only when | ||||||
| 7 | appropriately authorized and monitored by a physician or a | ||||||
| 8 | nurse under the supervision of a physician in accordance with | ||||||
| 9 | accepted medical practice. The facility director of each | ||||||
| 10 | mental health facility not operated by the State shall issue | ||||||
| 11 | rules designed to ensure insure that in that facility | ||||||
| 12 | psychotropic medication and electroconvulsive therapy are | ||||||
| 13 | administered in accordance with this Section and only when | ||||||
| 14 | appropriately authorized and monitored by a physician or a | ||||||
| 15 | nurse under the supervision of a physician in accordance with | ||||||
| 16 | accepted medical practice. Such rules shall be available for | ||||||
| 17 | public inspection and copying during normal business hours. | ||||||
| 18 | (f) The provisions of this Section with respect to the | ||||||
| 19 | emergency administration of psychotropic medication and | ||||||
| 20 | electroconvulsive therapy do not apply to facilities licensed | ||||||
| 21 | under the Nursing Home Care Act, the Specialized Mental Health | ||||||
| 22 | Rehabilitation Act of 2013, the ID/DD Community Care Act, or | ||||||
| 23 | the MC/DD Act. | ||||||
| 24 | (g) Under no circumstances may long-acting psychotropic | ||||||
| 25 | medications be administered under this Section. | ||||||
| 26 | (h) Whenever psychotropic medication or electroconvulsive | ||||||
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| 1 | therapy is refused pursuant to subsection (a) of this Section | ||||||
| 2 | at least once that day, the physician or advanced practice | ||||||
| 3 | psychiatric nurse shall determine and state in writing the | ||||||
| 4 | reasons why the recipient did not meet the criteria for | ||||||
| 5 | administration of medication or electroconvulsive therapy | ||||||
| 6 | under subsection (a) and whether the recipient meets the | ||||||
| 7 | standard for administration of psychotropic medication or | ||||||
| 8 | electroconvulsive therapy under Section 2-107.1 of this Code. | ||||||
| 9 | If the physician or advanced practice psychiatric nurse | ||||||
| 10 | determines that the recipient meets the standard for | ||||||
| 11 | administration of psychotropic medication or electroconvulsive | ||||||
| 12 | therapy under Section 2-107.1, the facility director or his or | ||||||
| 13 | her designee shall petition the court for administration of | ||||||
| 14 | psychotropic medication or electroconvulsive therapy pursuant | ||||||
| 15 | to that Section unless the facility director or his or her | ||||||
| 16 | designee states in writing in the recipient's record why the | ||||||
| 17 | filing of such a petition is not warranted. This subsection | ||||||
| 18 | (h) applies only to State-operated mental health facilities. | ||||||
| 19 | (i) The Department shall conduct annual trainings for all | ||||||
| 20 | physicians and registered nurses working in State-operated | ||||||
| 21 | mental health facilities on the appropriate use of emergency | ||||||
| 22 | administration of psychotropic medication and | ||||||
| 23 | electroconvulsive therapy, standards for their use, and the | ||||||
| 24 | methods of authorization under this Section. | ||||||
| 25 | (Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.) | ||||||
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| 1 | (405 ILCS 5/2-107.1) (from Ch. 91 1/2, par. 2-107.1) | ||||||
| 2 | Sec. 2-107.1. Administration of psychotropic medication | ||||||
| 3 | and electroconvulsive therapy upon application to a court. | ||||||
| 4 | (a) (Blank). | ||||||
| 5 | (a-5) Notwithstanding the provisions of Section 2-107 of | ||||||
| 6 | this Code, psychotropic medication and electroconvulsive | ||||||
| 7 | therapy may be administered to an adult recipient of services | ||||||
| 8 | on an inpatient or outpatient basis without the informed | ||||||
| 9 | consent of the recipient under the following standards: | ||||||
| 10 | (1) Any person 18 years of age or older, including any | ||||||
| 11 | guardian, may petition the circuit court for an order | ||||||
| 12 | authorizing the administration of psychotropic medication | ||||||
| 13 | and electroconvulsive therapy to a recipient of services. | ||||||
| 14 | The petition shall state that the petitioner has made a | ||||||
| 15 | good faith attempt to determine whether the recipient has | ||||||
| 16 | executed a power of attorney for health care under the | ||||||
| 17 | Powers of Attorney for Health Care Law or a declaration | ||||||
| 18 | for mental health treatment under the Mental Health | ||||||
| 19 | Treatment Preference Declaration Act and to obtain copies | ||||||
| 20 | of these instruments if they exist. If either of the | ||||||
| 21 | above-named instruments is available to the petitioner, | ||||||
| 22 | the instrument or a copy of the instrument shall be | ||||||
| 23 | attached to the petition as an exhibit. The petitioner | ||||||
| 24 | shall deliver a copy of the petition, and notice of the | ||||||
| 25 | time and place of the hearing, to the respondent, his or | ||||||
| 26 | her attorney, any known agent or attorney-in-fact, if any, | ||||||
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| 1 | and the guardian, if any, no later than 3 days prior to the | ||||||
| 2 | date of the hearing. Service of the petition and notice of | ||||||
| 3 | the time and place of the hearing may be made by | ||||||
| 4 | transmitting them via facsimile machine or secured | ||||||
| 5 | electronic mail to the respondent or other party. Upon | ||||||
| 6 | receipt of the petition and notice, the party served, or | ||||||
| 7 | the person delivering the petition and notice to the party | ||||||
| 8 | served, shall acknowledge service. If the party sending | ||||||
| 9 | the petition and notice does not receive acknowledgement | ||||||
| 10 | of service within 24 hours, service must be made by | ||||||
| 11 | personal service. A petition requesting that the court | ||||||
| 12 | authorize treatment with psychotropic medication shall | ||||||
| 13 | specify the full names of the medications and anticipated | ||||||
| 14 | range of dosage that comprise such treatment. The petition | ||||||
| 15 | also may include a request that the court authorize | ||||||
| 16 | alternative or alternate treatments with psychotropic | ||||||
| 17 | medications, but only where the petition sets forth the | ||||||
| 18 | psychotropic medications and the anticipated range of | ||||||
| 19 | dosages for each alternative or alternate and each | ||||||
| 20 | combination of psychotropic medications that may be | ||||||
| 21 | administered simultaneously. | ||||||
| 22 | The petition may include a request that the court | ||||||
| 23 | authorize such testing and procedures as may be essential | ||||||
| 24 | for the safe and effective administration of the | ||||||
| 25 | psychotropic medication or electroconvulsive therapy | ||||||
| 26 | sought to be administered, but only where the petition | ||||||
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| 1 | sets forth the specific testing and procedures sought to | ||||||
| 2 | be administered. | ||||||
| 3 | If a hearing is requested to be held immediately | ||||||
| 4 | following the hearing on a petition for involuntary | ||||||
| 5 | admission, then the notice requirement shall be the same | ||||||
| 6 | as that for the hearing on the petition for involuntary | ||||||
| 7 | admission, and the petition filed pursuant to this Section | ||||||
| 8 | shall be filed with the petition for involuntary | ||||||
| 9 | admission. | ||||||
| 10 | (2) The court shall hold a hearing within 7 days of the | ||||||
| 11 | filing of the petition. The People, the petitioner, or the | ||||||
| 12 | respondent shall be entitled to a continuance of up to 7 | ||||||
| 13 | days as of right. An additional continuance of not more | ||||||
| 14 | than 7 days may be granted to any party (i) upon a showing | ||||||
| 15 | that the continuance is needed in order to adequately | ||||||
| 16 | prepare for or present evidence in a hearing under this | ||||||
| 17 | Section or (ii) under exceptional circumstances. The court | ||||||
| 18 | may grant an additional continuance not to exceed 21 days | ||||||
| 19 | when, in its discretion, the court determines that such a | ||||||
| 20 | continuance is necessary in order to provide the recipient | ||||||
| 21 | with an examination pursuant to Section 3-803 or 3-804 of | ||||||
| 22 | this Act, to provide the recipient with a trial by jury as | ||||||
| 23 | provided in Section 3-802 of this Act, or to arrange for | ||||||
| 24 | the substitution of counsel as provided for by the | ||||||
| 25 | Illinois Supreme Court Rules. The hearing shall be | ||||||
| 26 | separate from a judicial proceeding held to determine | ||||||
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| 1 | whether a person is subject to involuntary admission but | ||||||
| 2 | may be heard immediately preceding or following such a | ||||||
| 3 | judicial proceeding and may be heard by the same trier of | ||||||
| 4 | fact or law as in that judicial proceeding. | ||||||
| 5 | (3) Unless otherwise provided herein, the procedures | ||||||
| 6 | set forth in Article VIII of Chapter III of this Act, | ||||||
| 7 | including the provisions regarding appointment of counsel, | ||||||
| 8 | shall govern hearings held under this subsection (a-5). | ||||||
| 9 | (4) Psychotropic medication and electroconvulsive | ||||||
| 10 | therapy may be administered to the recipient if and only | ||||||
| 11 | if it has been determined by clear and convincing evidence | ||||||
| 12 | that: all of the following factors are present. In | ||||||
| 13 | determining whether a person meets the criteria specified | ||||||
| 14 | in the following paragraphs (A) through (G), the court may | ||||||
| 15 | consider evidence of the person's history of serious | ||||||
| 16 | violence, repeated past pattern of specific behavior, | ||||||
| 17 | actions related to the person's illness, or past outcomes | ||||||
| 18 | of various treatment options. | ||||||
| 19 | (A) That the recipient has a serious mental | ||||||
| 20 | illness or developmental disability; . | ||||||
| 21 | (B) That because of said mental illness or | ||||||
| 22 | developmental disability, the recipient currently | ||||||
| 23 | exhibits any one of the following: (i) deterioration | ||||||
| 24 | of his or her ability to function, as compared to the | ||||||
| 25 | recipient's ability to function prior to the current | ||||||
| 26 | onset of symptoms of the mental illness or disability | ||||||
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| 1 | for which treatment is presently sought, (ii) | ||||||
| 2 | suffering, or (iii) threatening behavior; . | ||||||
| 3 | (C) That the illness or disability has existed for | ||||||
| 4 | a period marked by the continuing presence of the | ||||||
| 5 | symptoms set forth in item (B) of this subdivision (4) | ||||||
| 6 | or the repeated episodic occurrence of these | ||||||
| 7 | symptoms; . | ||||||
| 8 | (D) That the benefits of the treatment outweigh | ||||||
| 9 | the harm; . | ||||||
| 10 | (E) That the recipient lacks the capacity to make | ||||||
| 11 | a reasoned decision about the treatment; . | ||||||
| 12 | (F) That other less restrictive services have been | ||||||
| 13 | explored and found inappropriate; and . | ||||||
| 14 | (G) if If the petition seeks authorization for | ||||||
| 15 | testing and other procedures, that such testing and | ||||||
| 16 | procedures are essential for the safe and effective | ||||||
| 17 | administration of the treatment. | ||||||
| 18 | (4.5) In determining whether there is clear and | ||||||
| 19 | convincing evidence, the court may consider evidence | ||||||
| 20 | presented, if any, about a recipient's history of serious | ||||||
| 21 | violence, repeated past pattern of specific behavior | ||||||
| 22 | related to the recipient's illness, or outcomes of past | ||||||
| 23 | treatments. | ||||||
| 24 | (5) In no event shall an order issued under this | ||||||
| 25 | Section be effective for more than 90 days. A second | ||||||
| 26 | 90-day period of involuntary treatment may be authorized | ||||||
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| 1 | pursuant to a hearing that complies with the standards and | ||||||
| 2 | procedures of this subsection (a-5). Thereafter, | ||||||
| 3 | additional 180-day periods of involuntary treatment may be | ||||||
| 4 | authorized pursuant to the standards and procedures of | ||||||
| 5 | this Section without limit. If a new petition to authorize | ||||||
| 6 | the administration of psychotropic medication or | ||||||
| 7 | electroconvulsive therapy is filed at least 15 days prior | ||||||
| 8 | to the expiration of the prior order, and if any | ||||||
| 9 | continuance of the hearing is agreed to by the recipient, | ||||||
| 10 | the administration of the treatment may continue in | ||||||
| 11 | accordance with the prior order pending the completion of | ||||||
| 12 | a hearing under this Section. | ||||||
| 13 | (6) An order issued under this subsection (a-5) shall | ||||||
| 14 | designate the persons authorized to administer the | ||||||
| 15 | treatment under the standards and procedures of this | ||||||
| 16 | subsection (a-5). Those persons shall have complete | ||||||
| 17 | discretion not to administer any treatment authorized | ||||||
| 18 | under this Section. The order shall also specify the | ||||||
| 19 | medications and the anticipated range of dosages that have | ||||||
| 20 | been authorized and may include a list of any alternative | ||||||
| 21 | medications and range of dosages deemed necessary. In | ||||||
| 22 | addition, the order may authorize the administration of | ||||||
| 23 | any alternative or alternate treatment that is requested | ||||||
| 24 | in the petition and for which the court finds clear and | ||||||
| 25 | convincing evidence that the benefits of the alternative | ||||||
| 26 | or alternate treatment outweigh the harm and the recipient | ||||||
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| 1 | lacks the capacity to make a reasoned decision about the | ||||||
| 2 | treatment. The medications and the anticipated range of | ||||||
| 3 | dosages for any alternative or alternate treatment that | ||||||
| 4 | the court authorizes shall be included in the order. Where | ||||||
| 5 | the simultaneous use of multiple psychotropic medications | ||||||
| 6 | is authorized, the order shall specify the combinations | ||||||
| 7 | that are authorized. | ||||||
| 8 | (a-10) The court may, in its discretion, appoint a | ||||||
| 9 | guardian ad litem for a recipient before the court or | ||||||
| 10 | authorize an existing guardian of the person to monitor | ||||||
| 11 | treatment and compliance with court orders under this Section. | ||||||
| 12 | (b) A guardian may be authorized to consent to the | ||||||
| 13 | administration of psychotropic medication or electroconvulsive | ||||||
| 14 | therapy to an objecting recipient only under the standards and | ||||||
| 15 | procedures of subsection (a-5). | ||||||
| 16 | (c) Notwithstanding any other provision of this Section, a | ||||||
| 17 | guardian may consent to the administration of psychotropic | ||||||
| 18 | medication or electroconvulsive therapy to a non-objecting | ||||||
| 19 | recipient under Article XIa of the Probate Act of 1975. | ||||||
| 20 | (d) Nothing in this Section shall prevent the | ||||||
| 21 | administration of psychotropic medication or electroconvulsive | ||||||
| 22 | therapy to recipients in an emergency under Section 2-107 of | ||||||
| 23 | this Act. | ||||||
| 24 | (e) Notwithstanding any of the provisions of this Section, | ||||||
| 25 | psychotropic medication or electroconvulsive therapy may be | ||||||
| 26 | administered pursuant to a power of attorney for health care | ||||||
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| 1 | under the Powers of Attorney for Health Care Law or a | ||||||
| 2 | declaration for mental health treatment under the Mental | ||||||
| 3 | Health Treatment Preference Declaration Act over the objection | ||||||
| 4 | of the recipient if the recipient has not revoked the power of | ||||||
| 5 | attorney or declaration for mental health treatment as | ||||||
| 6 | provided in the relevant statute. | ||||||
| 7 | (f) The Department shall conduct annual trainings for | ||||||
| 8 | physicians and registered nurses working in State-operated | ||||||
| 9 | mental health facilities on the appropriate use of | ||||||
| 10 | psychotropic medication and electroconvulsive therapy, | ||||||
| 11 | standards for their use, and the preparation of court | ||||||
| 12 | petitions under this Section before any such psychiatrists or | ||||||
| 13 | advanced practice psychiatric nurses may petition the court or | ||||||
| 14 | testify at a hearing under this Section. | ||||||
| 15 | (Source: P.A. 100-710, eff. 8-3-18.) | ||||||
| 16 | (405 ILCS 5/3-611) (from Ch. 91 1/2, par. 3-611) | ||||||
| 17 | Sec. 3-611. Filing petition, first certificate, and proof | ||||||
| 18 | of service. | ||||||
| 19 | (a) Within 24 hours, excluding Saturdays, Sundays and | ||||||
| 20 | holidays, after the respondent's admission under this Article, | ||||||
| 21 | the facility director of the facility shall file 2 copies of | ||||||
| 22 | the petition, the first certificate, and proof of service of | ||||||
| 23 | the petition and statement of rights upon the respondent with | ||||||
| 24 | the court in the county in which the facility is located. | ||||||
| 25 | (b) Upon completion of the second certificate, the | ||||||
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| 1 | facility director shall promptly file it with the court and | ||||||
| 2 | provide a copy to the respondent. | ||||||
| 3 | (c) The facility director shall make copies of the | ||||||
| 4 | certificates available to the attorneys for the parties upon | ||||||
| 5 | request. | ||||||
| 6 | (d) Upon the filing of the petition and first certificate, | ||||||
| 7 | the court shall set a hearing to be held within 5 days, | ||||||
| 8 | excluding Saturdays, Sundays and holidays, after receipt of | ||||||
| 9 | the petition. The court shall direct that notice of the time | ||||||
| 10 | and place of the hearing be served upon the respondent, his | ||||||
| 11 | responsible relatives, and the persons entitled to receive a | ||||||
| 12 | copy of the petition pursuant to Section 3-609. | ||||||
| 13 | (e) For purposes of this Section, (1) a respondent is | ||||||
| 14 | admitted to a mental health facility at the earlier of the | ||||||
| 15 | respondent's confinement or receipt of treatment and (2) a | ||||||
| 16 | respondent who is ordered discharged in accordance with | ||||||
| 17 | Section 3-809 or subsection (b) of Section 3-901, or | ||||||
| 18 | discharged upon notice by the facility director as provided by | ||||||
| 19 | subsection (a) of Section 3-903, remains admitted to a mental | ||||||
| 20 | health facility until the respondent is physically released | ||||||
| 21 | from the mental health facility and thereafter physically | ||||||
| 22 | enters a mental health facility. | ||||||
| 23 | (Source: P.A. 98-865, eff. 8-8-14.) | ||||||
| 24 | (405 ILCS 5/3-807) (from Ch. 91 1/2, par. 3-807) | ||||||
| 25 | Sec. 3-807. Testimony. No respondent may be found subject | ||||||
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| 1 | to involuntary admission on an inpatient or outpatient basis | ||||||
| 2 | unless at least one psychiatrist, clinical social worker, | ||||||
| 3 | clinical psychologist, advanced practice psychiatric nurse, or | ||||||
| 4 | qualified examiner who has examined the respondent testifies | ||||||
| 5 | in person at the hearing. No administration of psychotropic | ||||||
| 6 | medication or electroconvulsive therapy without the informed | ||||||
| 7 | consent of the recipient may be authorized unless at least one | ||||||
| 8 | psychiatrist or advanced practice psychiatric nurse who has | ||||||
| 9 | examined the recipient testifies in person at the hearing. The | ||||||
| 10 | respondent may waive the requirement of the testimony subject | ||||||
| 11 | to the approval of the court. | ||||||
| 12 | (Source: P.A. 101-587, eff. 1-1-20.)". | ||||||
