Monthly treatment plan reviews

TPRs, or "staffings" as they are called at EMHC, are supposed to be held every month for every involuntary "patient". This statutory requirement is elaborated under the Illinois Mental Health and Developmental Disabilities Code, 405 ILCS 5/1-100, et seq.

Section 2-102(a) of the Code reads:

A recipient of services shall be provided with adequate and humane care and services in the least restrictive environment, pursuant to an individual services plan. The Plan shall be formulated and periodically reviewed with the participation of the recipient to the extent feasible and the recipient's guardian, the recipient's substitute decision maker, if any, or any other individual designated in writing by the recipient. The facility shall advise the recipient of his or her right to designate a family member or other individual to participate in the formulation and review of the treatment plan. In determining whether care and services are being provided in the least restrictive environment, the facility shall consider the views of the recipient, if any, concerning the treatment being provided. The recipient's preferences regarding emergency interventions under subsection (d) of Section 2-200 shall be noted in the recipient's treatment plan.

Section 3-209 additionally requires that process to occur at least every 30 days:

Within three days of admission under this Chapter, a treatment plan shall be prepared for each recipient of service and entered into his or her record. The plan shall include an assessment of the recipient's treatment needs, a description of the services recommended for treatment, the goals of each type of element of service, an anticipated timetable for the accomplishment of the goals, and a designation of the qualified professional responsible for the implementation of the plan. The plan shall include a written assessment of whether or not the recipient is in need of psychotropic medications. The plan shall be reviewed and updated as the clinical condition warrants, but not less than every 30 days.

If a recipient has only one treatment plan review meeting in a four-month period despite being willing to attend monthly, the facility is obviously out of compliance with this statutory mandate. One meeting in four months does not reconcile with the legal scheme. Also, a team member's intentional creation (e.g., that of an N Unit social worker named Terriana Gregory) of conditions to impede the patient's participation, including his ability to have his chosen advocate or attorney present, is contrary to (at least) the spirit of the law.

What could be even more incriminating would be if the social worker were to threaten to create a misleading clinical record saying that the patient refused to participate in treatment planning, when he was only seeking meaningful participation with his attorney present.