103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB2911

 

Introduced 2/16/2023, by Rep. Lakesia Collins

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.04  from Ch. 23, par. 6104.04

    Amends the Illinois Act on the Aging. In provisions concerning the Long Term Care Ombudsman Program, expands the definition of "access" to mean the right to inspect and copy (rather than inspect) the clinical and other records of a participant or resident, regardless of age, with the express written consent of the participant or resident. In provisions concerning access and visitation rights, provides that a long term care facility, supportive living facility, assisted living establishment, and shared housing establishment must permit representatives of the Office of State Long Term Care Ombudsman, with the permission of the resident or other specified persons, to examine and copy the resident's clinical and other records.


LRB103 26014 KTG 52368 b

 

 

A BILL FOR

 

HB2911LRB103 26014 KTG 52368 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Section 4.04 as follows:
 
6    (20 ILCS 105/4.04)  (from Ch. 23, par. 6104.04)
7    Sec. 4.04. Long Term Care Ombudsman Program. The purpose
8of the Long Term Care Ombudsman Program is to ensure that older
9persons and persons with disabilities receive quality
10services. This is accomplished by providing advocacy services
11for residents of long term care facilities and participants
12receiving home care and community-based care. Managed care is
13increasingly becoming the vehicle for delivering health and
14long-term services and supports to seniors and persons with
15disabilities, including dual eligible participants. The
16additional ombudsman authority will allow advocacy services to
17be provided to Illinois participants for the first time and
18will produce a cost savings for the State of Illinois by
19supporting the rebalancing efforts of the Patient Protection
20and Affordable Care Act.
21    (a) Long Term Care Ombudsman Program. The Department shall
22establish a Long Term Care Ombudsman Program, through the
23Office of State Long Term Care Ombudsman ("the Office"), in

 

 

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1accordance with the provisions of the Older Americans Act of
21965, as now or hereafter amended. The Long Term Care
3Ombudsman Program is authorized, subject to sufficient
4appropriations, to advocate on behalf of older persons and
5persons with disabilities residing in their own homes or
6community-based settings, relating to matters which may
7adversely affect the health, safety, welfare, or rights of
8such individuals.
9    (b) Definitions. As used in this Section, unless the
10context requires otherwise:
11        (1) "Access" means the right to:
12            (i) Enter any long term care facility or assisted
13        living or shared housing establishment or supportive
14        living facility;
15            (ii) Communicate privately and without restriction
16        with any resident, regardless of age, who consents to
17        the communication;
18            (iii) Seek consent to communicate privately and
19        without restriction with any participant or resident,
20        regardless of age;
21            (iv) Inspect and copy the clinical and other
22        records of a participant or resident, regardless of
23        age, with the express written consent of the
24        participant or resident;
25            (v) Observe all areas of the long term care
26        facility or supportive living facilities, assisted

 

 

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1        living or shared housing establishment except the
2        living area of any resident who protests the
3        observation; and
4            (vi) Subject to permission of the participant or
5        resident requesting services or his or her
6        representative, enter a home or community-based
7        setting.
8        (2) "Long Term Care Facility" means (i) any facility
9    as defined by Section 1-113 of the Nursing Home Care Act,
10    as now or hereafter amended; (ii) any skilled nursing
11    facility or a nursing facility which meets the
12    requirements of Section 1819(a), (b), (c), and (d) or
13    Section 1919(a), (b), (c), and (d) of the Social Security
14    Act, as now or hereafter amended (42 U.S.C. 1395i-3(a),
15    (b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and
16    (d)); (iii) any facility as defined by Section 1-113 of
17    the ID/DD Community Care Act, as now or hereafter amended;
18    (iv) any facility as defined by Section 1-113 of MC/DD
19    Act, as now or hereafter amended; and (v) any facility
20    licensed under Section 4-105 or 4-201 of the Specialized
21    Mental Health Rehabilitation Act of 2013, as now or
22    hereafter amended.
23        (2.5) "Assisted living establishment" and "shared
24    housing establishment" have the meanings given those terms
25    in Section 10 of the Assisted Living and Shared Housing
26    Act.

 

 

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1        (2.7) "Supportive living facility" means a facility
2    established under Section 5-5.01a of the Illinois Public
3    Aid Code.
4        (2.8) "Community-based setting" means any place of
5    abode other than an individual's private home.
6        (3) "State Long Term Care Ombudsman" means any person
7    employed by the Department to fulfill the requirements of
8    the Office of State Long Term Care Ombudsman as required
9    under the Older Americans Act of 1965, as now or hereafter
10    amended, and Departmental policy.
11        (3.1) "Ombudsman" means any designated representative
12    of the State Long Term Care Ombudsman Program; provided
13    that the representative, whether he is paid for or
14    volunteers his ombudsman services, shall be qualified and
15    designated by the Office to perform the duties of an
16    ombudsman as specified by the Department in rules and in
17    accordance with the provisions of the Older Americans Act
18    of 1965, as now or hereafter amended.
19        (4) "Participant" means an older person aged 60 or
20    over or an adult with a disability aged 18 through 59 who
21    is eligible for services under any of the following:
22            (i) A medical assistance waiver administered by
23        the State.
24            (ii) A managed care organization providing care
25        coordination and other services to seniors and persons
26        with disabilities.

 

 

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1        (5) "Resident" means an older person aged 60 or over
2    or an adult with a disability aged 18 through 59 who
3    resides in a long-term care facility.
4    (c) Ombudsman; rules. The Office of State Long Term Care
5Ombudsman shall be composed of at least one full-time
6ombudsman and shall include a system of designated regional
7long term care ombudsman programs. Each regional program shall
8be designated by the State Long Term Care Ombudsman as a
9subdivision of the Office and any representative of a regional
10program shall be treated as a representative of the Office.
11    The Department, in consultation with the Office, shall
12promulgate administrative rules in accordance with the
13provisions of the Older Americans Act of 1965, as now or
14hereafter amended, to establish the responsibilities of the
15Department and the Office of State Long Term Care Ombudsman
16and the designated regional Ombudsman programs. The
17administrative rules shall include the responsibility of the
18Office and designated regional programs to investigate and
19resolve complaints made by or on behalf of residents of long
20term care facilities, supportive living facilities, and
21assisted living and shared housing establishments, and
22participants residing in their own homes or community-based
23settings, including the option to serve residents and
24participants under the age of 60, relating to actions,
25inaction, or decisions of providers, or their representatives,
26of such facilities and establishments, of public agencies, or

 

 

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1of social services agencies, which may adversely affect the
2health, safety, welfare, or rights of such residents and
3participants. The Office and designated regional programs may
4represent all residents and participants, but are not required
5by this Act to represent persons under 60 years of age, except
6to the extent required by federal law. When necessary and
7appropriate, representatives of the Office shall refer
8complaints to the appropriate regulatory State agency. The
9Department, in consultation with the Office, shall cooperate
10with the Department of Human Services and other State agencies
11in providing information and training to designated regional
12long term care ombudsman programs about the appropriate
13assessment and treatment (including information about
14appropriate supportive services, treatment options, and
15assessment of rehabilitation potential) of the participants
16they serve.
17    The State Long Term Care Ombudsman and all other
18ombudsmen, as defined in paragraph (3.1) of subsection (b)
19must submit to background checks under the Health Care Worker
20Background Check Act and receive training, as prescribed by
21the Illinois Department on Aging, before visiting facilities,
22private homes, or community-based settings. The training must
23include information specific to assisted living
24establishments, supportive living facilities, shared housing
25establishments, private homes, and community-based settings
26and to the rights of residents and participants guaranteed

 

 

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1under the corresponding Acts and administrative rules.
2    (c-5) Consumer Choice Information Reports. The Office
3shall:
4        (1) In collaboration with the Attorney General, create
5    a Consumer Choice Information Report form to be completed
6    by all licensed long term care facilities to aid
7    Illinoisans and their families in making informed choices
8    about long term care. The Office shall create a Consumer
9    Choice Information Report for each type of licensed long
10    term care facility. The Office shall collaborate with the
11    Attorney General and the Department of Human Services to
12    create a Consumer Choice Information Report form for
13    facilities licensed under the ID/DD Community Care Act or
14    the MC/DD Act.
15        (2) Develop a database of Consumer Choice Information
16    Reports completed by licensed long term care facilities
17    that includes information in the following consumer
18    categories:
19            (A) Medical Care, Services, and Treatment.
20            (B) Special Services and Amenities.
21            (C) Staffing.
22            (D) Facility Statistics and Resident Demographics.
23            (E) Ownership and Administration.
24            (F) Safety and Security.
25            (G) Meals and Nutrition.
26            (H) Rooms, Furnishings, and Equipment.

 

 

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1            (I) Family, Volunteer, and Visitation Provisions.
2        (3) Make this information accessible to the public,
3    including on the Internet by means of a hyperlink on the
4    Office's World Wide Web home page. Information about
5    facilities licensed under the ID/DD Community Care Act or
6    the MC/DD Act shall be made accessible to the public by the
7    Department of Human Services, including on the Internet by
8    means of a hyperlink on the Department of Human Services'
9    "For Customers" website.
10        (4) Have the authority, with the Attorney General, to
11    verify that information provided by a facility is
12    accurate.
13        (5) Request a new report from any licensed facility
14    whenever it deems necessary.
15        (6) Include in the Office's Consumer Choice
16    Information Report for each type of licensed long term
17    care facility additional information on each licensed long
18    term care facility in the State of Illinois, including
19    information regarding each facility's compliance with the
20    relevant State and federal statutes, rules, and standards;
21    customer satisfaction surveys; and information generated
22    from quality measures developed by the Centers for
23    Medicare and Medicaid Services.
24    (d) Access and visitation rights.
25        (1) In accordance with subparagraphs (A) and (E) of
26    paragraph (3) of subsection (c) of Section 1819 and

 

 

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1    subparagraphs (A) and (E) of paragraph (3) of subsection
2    (c) of Section 1919 of the Social Security Act, as now or
3    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
4    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
5    Older Americans Act of 1965, as now or hereafter amended
6    (42 U.S.C. 3058f), a long term care facility, supportive
7    living facility, assisted living establishment, and shared
8    housing establishment must:
9            (i) permit immediate access to any resident,
10        regardless of age, by a designated ombudsman;
11            (ii) permit representatives of the Office, with
12        the permission of the resident, the resident's legal
13        representative, or the resident's legal guardian, to
14        examine and copy a resident's clinical and other
15        records, regardless of the age of the resident, and if
16        a resident is unable to consent to such review, and has
17        no legal guardian, permit representatives of the
18        Office appropriate access, as defined by the
19        Department, in consultation with the Office, in
20        administrative rules, to the resident's records; and
21            (iii) permit a representative of the Program to
22        communicate privately and without restriction with any
23        participant who consents to the communication
24        regardless of the consent of, or withholding of
25        consent by, a legal guardian or an agent named in a
26        power of attorney executed by the participant.

 

 

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1        (2) Each long term care facility, supportive living
2    facility, assisted living establishment, and shared
3    housing establishment shall display, in multiple,
4    conspicuous public places within the facility accessible
5    to both visitors and residents and in an easily readable
6    format, the address and phone number of the Office of the
7    Long Term Care Ombudsman, in a manner prescribed by the
8    Office.
9    (e) Immunity. An ombudsman or any representative of the
10Office participating in the good faith performance of his or
11her official duties shall have immunity from any liability
12(civil, criminal or otherwise) in any proceedings (civil,
13criminal or otherwise) brought as a consequence of the
14performance of his official duties.
15    (f) Business offenses.
16        (1) No person shall:
17            (i) Intentionally prevent, interfere with, or
18        attempt to impede in any way any representative of the
19        Office in the performance of his official duties under
20        this Act and the Older Americans Act of 1965; or
21            (ii) Intentionally retaliate, discriminate
22        against, or effect reprisals against any long term
23        care facility resident or employee for contacting or
24        providing information to any representative of the
25        Office.
26        (2) A violation of this Section is a business offense,

 

 

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1    punishable by a fine not to exceed $501.
2        (3) The State Long Term Care Ombudsman shall notify
3    the State's Attorney of the county in which the long term
4    care facility, supportive living facility, or assisted
5    living or shared housing establishment is located, or the
6    Attorney General, of any violations of this Section.
7    (g) Confidentiality of records and identities. The
8Department shall establish procedures for the disclosure by
9the State Ombudsman or the regional ombudsmen entities of
10files maintained by the program. The procedures shall provide
11that the files and records may be disclosed only at the
12discretion of the State Long Term Care Ombudsman or the person
13designated by the State Ombudsman to disclose the files and
14records, and the procedures shall prohibit the disclosure of
15the identity of any complainant, resident, participant,
16witness, or employee of a long term care provider unless:
17        (1) the complainant, resident, participant, witness,
18    or employee of a long term care provider or his or her
19    legal representative consents to the disclosure and the
20    consent is in writing;
21        (2) the complainant, resident, participant, witness,
22    or employee of a long term care provider gives consent
23    orally; and the consent is documented contemporaneously in
24    writing in accordance with such requirements as the
25    Department shall establish; or
26        (3) the disclosure is required by court order.

 

 

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1    (h) Legal representation. The Attorney General shall
2provide legal representation to any representative of the
3Office against whom suit or other legal action is brought in
4connection with the performance of the representative's
5official duties, in accordance with the State Employee
6Indemnification Act.
7    (i) Treatment by prayer and spiritual means. Nothing in
8this Act shall be construed to authorize or require the
9medical supervision, regulation or control of remedial care or
10treatment of any resident in a long term care facility
11operated exclusively by and for members or adherents of any
12church or religious denomination the tenets and practices of
13which include reliance solely upon spiritual means through
14prayer for healing.
15    (j) The Long Term Care Ombudsman Fund is created as a
16special fund in the State treasury to receive moneys for the
17express purposes of this Section. All interest earned on
18moneys in the fund shall be credited to the fund. Moneys
19contained in the fund shall be used to support the purposes of
20this Section.
21    (k) Each Regional Ombudsman may, in accordance with rules
22promulgated by the Office, establish a multi-disciplinary team
23to act in an advisory role for the purpose of providing
24professional knowledge and expertise in handling complex
25abuse, neglect, and advocacy issues involving participants.
26Each multi-disciplinary team may consist of one or more

 

 

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1volunteer representatives from any combination of at least 7
2members from the following professions: banking or finance;
3disability care; health care; pharmacology; law; law
4enforcement; emergency responder; mental health care; clergy;
5coroner or medical examiner; substance abuse; domestic
6violence; sexual assault; or other related fields. To support
7multi-disciplinary teams in this role, law enforcement
8agencies and coroners or medical examiners shall supply
9records as may be requested in particular cases. The Regional
10Ombudsman, or his or her designee, of the area in which the
11multi-disciplinary team is created shall be the facilitator of
12the multi-disciplinary team.
13(Source: P.A. 102-1033, eff. 1-1-23.)