Illinois General Assembly - Full Text of HB4204
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Full Text of HB4204  99th General Assembly

HB4204 99TH GENERAL ASSEMBLY

  
  

 


 
99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB4204

 

Introduced , by Rep. Tom Demmer

 

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

    Amends the Illinois Act on the Aging. Provides that the Governor shall appoint, and the Senate shall confirm, a State Long Term Care Ombudsman (rather than the Office of State Long Term Care Ombudsman shall be composed of at least one full-time ombudsman). Provides that the State Long Term Care Ombudsman shall be appointed for a term of 4 years and shall function within the Department on Aging and shall report to the Director and the Governor. Provides that the State Long Term Care Ombudsman shall function independently within the Department with respect to the operations of the Office, including the performance of investigations and issuance of findings and recommendations. Provides that the appropriation for the Office of State Long Term Care Ombudsman shall be separate from the overall appropriation for the Department.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4204LRB099 11551 KTG 32994 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 of
8the 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 Ombudsman
3Program is authorized, subject to sufficient appropriations,
4to advocate on behalf of older persons and persons with
5disabilities residing in their own homes or community-based
6settings, relating to matters which may adversely affect the
7health, safety, welfare, or rights of such individuals.
8    (b) Definitions. As used in this Section, unless the
9context requires otherwise:
10        (1) "Access" means the right to:
11            (i) Enter any long term care facility or assisted
12        living or shared housing establishment or supportive
13        living facility;
14            (ii) Communicate privately and without restriction
15        with any resident, regardless of age, who consents to
16        the communication;
17            (iii) Seek consent to communicate privately and
18        without restriction with any participant or resident,
19        regardless of age;
20            (iv) Inspect the clinical and other records of a
21        participant or resident, regardless of age, with the
22        express written consent of the participant or
23        resident;
24            (v) Observe all areas of the long term care
25        facility or supportive living facilities, assisted
26        living or shared housing establishment except the

 

 

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1        living area of any resident who protests the
2        observation; and
3            (vi) Subject to permission of the participant or
4        resident requesting services or his or her
5        representative, enter a home or community-based
6        setting.
7        (2) "Long Term Care Facility" means (i) any facility as
8    defined by Section 1-113 of the Nursing Home Care Act, as
9    now or hereafter amended; and (ii) any skilled nursing
10    facility or a nursing facility which meets the requirements
11    of Section 1819(a), (b), (c), and (d) or Section 1919(a),
12    (b), (c), and (d) of the Social Security Act, as now or
13    hereafter amended (42 U.S.C. 1395i-3(a), (b), (c), and (d)
14    and 42 U.S.C. 1396r(a), (b), (c), and (d)); and any
15    facility as defined by Section 1-113 of the MR/DD Community
16    Care Act, as now or hereafter amended.
17        (2.5) "Assisted living establishment" and "shared
18    housing establishment" have the meanings given those terms
19    in Section 10 of the Assisted Living and Shared Housing
20    Act.
21        (2.7) "Supportive living facility" means a facility
22    established under Section 5-5.01a of the Illinois Public
23    Aid Code.
24        (2.8) "Community-based setting" means any place of
25    abode other than an individual's private home.
26        (3) "State Long Term Care Ombudsman" means any person

 

 

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1    employed by the Department to fulfill the requirements of
2    the Office of State Long Term Care Ombudsman as required
3    under the Older Americans Act of 1965, as now or hereafter
4    amended, and Departmental policy.
5        (3.1) "Ombudsman" means any designated representative
6    of the State Long Term Care Ombudsman Program; provided
7    that the representative, whether he is paid for or
8    volunteers his ombudsman services, shall be qualified and
9    designated by the Office to perform the duties of an
10    ombudsman as specified by the Department in rules and in
11    accordance with the provisions of the Older Americans Act
12    of 1965, as now or hereafter amended.
13        (4) "Participant" means an older person aged 60 or over
14    or an adult with a disability aged 18 through 59 who is
15    eligible for services under any of the following:
16            (i) A medical assistance waiver administered by
17        the State.
18            (ii) A managed care organization providing care
19        coordination and other services to seniors and persons
20        with disabilities.
21        (5) "Resident" means an older person aged 60 or over or
22    an adult with a disability aged 18 through 59 who resides
23    in a long-term care facility.
24    (c) Ombudsman; appointment. The Governor shall appoint,
25and the Senate shall confirm, a State Long Term Care Ombudsman.
26The State Long Term Care Ombudsman shall be appointed for a

 

 

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1term of 4 years and shall function within the Department and
2shall report to the Director and the Governor. The Office of
3State Long Term Care Ombudsman rules. The Office of State Long
4Term Care Ombudsman shall be composed of at least one full-time
5ombudsman and shall include a system of designated regional
6long term care ombudsman programs. Each regional program shall
7be designated by the State Long Term Care Ombudsman as a
8subdivision of the Office and any representative of a regional
9program shall be treated as a representative of the Office.
10    The State Long Term Care Ombudsman shall function
11independently within the Department with respect to the
12operations of the Office, including the performance of
13investigations and issuance of findings and recommendations.
14The appropriation for the Office of State Long Term Care
15Ombudsman shall be separate from the overall appropriation for
16the Department.
17    The Department, in consultation with the Office, shall
18promulgate administrative rules in accordance with the
19provisions of the Older Americans Act of 1965, as now or
20hereafter amended, to establish the responsibilities of the
21Department and the Office of State Long Term Care Ombudsman and
22the designated regional Ombudsman programs. The administrative
23rules shall include the responsibility of the Office and
24designated regional programs to investigate and resolve
25complaints made by or on behalf of residents of long term care
26facilities, supportive living facilities, and assisted living

 

 

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

 

 

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1homes, or community-based settings. The training must include
2information specific to assisted living establishments,
3supportive living facilities, shared housing establishments,
4private homes, and community-based settings and to the rights
5of residents and participants guaranteed under the
6corresponding Acts and administrative rules.
7    (c-5) Consumer Choice Information Reports. The Office
8shall:
9        (1) In collaboration with the Attorney General, create
10    a Consumer Choice Information Report form to be completed
11    by all licensed long term care facilities to aid
12    Illinoisans and their families in making informed choices
13    about long term care. The Office shall create a Consumer
14    Choice Information Report for each type of licensed long
15    term care facility. The Office shall collaborate with the
16    Attorney General and the Department of Human Services to
17    create a Consumer Choice Information Report form for
18    facilities licensed under the MR/DD Community Care Act.
19        (2) Develop a database of Consumer Choice Information
20    Reports completed by licensed long term care facilities
21    that includes information in the following consumer
22    categories:
23            (A) Medical Care, Services, and Treatment.
24            (B) Special Services and Amenities.
25            (C) Staffing.
26            (D) Facility Statistics and Resident Demographics.

 

 

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1            (E) Ownership and Administration.
2            (F) Safety and Security.
3            (G) Meals and Nutrition.
4            (H) Rooms, Furnishings, and Equipment.
5            (I) Family, Volunteer, and Visitation Provisions.
6        (3) Make this information accessible to the public,
7    including on the Internet by means of a hyperlink labeled
8    "Resident's Right to Know" on the Office's World Wide Web
9    home page. Information about facilities licensed under the
10    MR/DD Community Care Act shall be made accessible to the
11    public by the Department of Human Services, including on
12    the Internet by means of a hyperlink labeled "Resident's
13    and Families' Right to Know" on the Department of Human
14    Services' "For Customers" website.
15        (4) Have the authority, with the Attorney General, to
16    verify that information provided by a facility is accurate.
17        (5) Request a new report from any licensed facility
18    whenever it deems necessary.
19        (6) Include in the Office's Consumer Choice
20    Information Report for each type of licensed long term care
21    facility additional information on each licensed long term
22    care facility in the State of Illinois, including
23    information regarding each facility's compliance with the
24    relevant State and federal statutes, rules, and standards;
25    customer satisfaction surveys; and information generated
26    from quality measures developed by the Centers for Medicare

 

 

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1    and Medicaid Services.
2    (d) Access and visitation rights.
3        (1) In accordance with subparagraphs (A) and (E) of
4    paragraph (3) of subsection (c) of Section 1819 and
5    subparagraphs (A) and (E) of paragraph (3) of subsection
6    (c) of Section 1919 of the Social Security Act, as now or
7    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
8    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
9    Older Americans Act of 1965, as now or hereafter amended
10    (42 U.S.C. 3058f), a long term care facility, supportive
11    living facility, assisted living establishment, and shared
12    housing establishment must:
13            (i) permit immediate access to any resident,
14        regardless of age, by a designated ombudsman;
15            (ii) permit representatives of the Office, with
16        the permission of the resident's legal representative
17        or legal guardian, to examine a resident's clinical and
18        other records, regardless of the age of the resident,
19        and if a resident is unable to consent to such review,
20        and has no legal guardian, permit representatives of
21        the Office appropriate access, as defined by the
22        Department, in consultation with the Office, in
23        administrative rules, to the resident's records; and
24            (iii) permit a representative of the Program to
25        communicate privately and without restriction with any
26        participant who consents to the communication

 

 

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

 

 

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

 

 

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

 

 

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1abuse, neglect, and advocacy issues involving participants.
2Each multi-disciplinary team may consist of one or more
3volunteer representatives from any combination of at least 7
4members from the following professions: banking or finance;
5disability care; health care; pharmacology; law; law
6enforcement; emergency responder; mental health care; clergy;
7coroner or medical examiner; substance abuse; domestic
8violence; sexual assault; or other related fields. To support
9multi-disciplinary teams in this role, law enforcement
10agencies and coroners or medical examiners shall supply records
11as may be requested in particular cases. The Regional
12Ombudsman, or his or her designee, of the area in which the
13multi-disciplinary team is created shall be the facilitator of
14the multi-disciplinary team.
15(Source: P.A. 97-38, eff. 6-28-11; 98-380, eff. 8-16-13;
1698-989, eff. 1-1-15.)