Illinois General Assembly - Full Text of SB2504
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Full Text of SB2504  99th General Assembly




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1    AN ACT concerning regulation.
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; (ii) any skilled nursing facility
10    or a nursing facility which meets the requirements of
11    Section 1819(a), (b), (c), and (d) or Section 1919(a), (b),
12    (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)); (iii) any
15    facility as defined by Section 1-113 of the ID/DD Community
16    Care Act, as now or hereafter amended; and (iv) any
17    facility as defined by Section 1-113 of MC/DD Act, as now
18    or hereafter amended; and (v) any facility licensed under
19    Section 4-105 or 4-201 of the Specialized Mental Health
20    Rehabilitation Act of 2013, as now or hereafter amended.
21        (2.5) "Assisted living establishment" and "shared
22    housing establishment" have the meanings given those terms
23    in Section 10 of the Assisted Living and Shared Housing
24    Act.
25        (2.7) "Supportive living facility" means a facility
26    established under Section 5-5.01a of the Illinois Public



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



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



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



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



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1    "Resident's Right to Know" on the Office's World Wide Web
2    home page. Information about facilities licensed under the
3    ID/DD Community Care Act or the MC/DD Act shall be made
4    accessible to the public by the Department of Human
5    Services, including on the Internet by means of a hyperlink
6    labeled "Resident's and Families' Right to Know" on the
7    Department of Human Services' "For Customers" website.
8        (4) Have the authority, with the Attorney General, to
9    verify that information provided by a facility is accurate.
10        (5) Request a new report from any licensed facility
11    whenever it deems necessary.
12        (6) Include in the Office's Consumer Choice
13    Information Report for each type of licensed long term care
14    facility additional information on each licensed long term
15    care facility in the State of Illinois, including
16    information regarding each facility's compliance with the
17    relevant State and federal statutes, rules, and standards;
18    customer satisfaction surveys; and information generated
19    from quality measures developed by the Centers for Medicare
20    and Medicaid Services.
21    (d) Access and visitation rights.
22        (1) In accordance with subparagraphs (A) and (E) of
23    paragraph (3) of subsection (c) of Section 1819 and
24    subparagraphs (A) and (E) of paragraph (3) of subsection
25    (c) of Section 1919 of the Social Security Act, as now or
26    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and



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



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1    to both visitors and residents and in an easily readable
2    format, the address and phone number of the Office of the
3    Long Term Care Ombudsman, in a manner prescribed by the
4    Office.
5    (e) Immunity. An ombudsman or any representative of the
6Office participating in the good faith performance of his or
7her official duties shall have immunity from any liability
8(civil, criminal or otherwise) in any proceedings (civil,
9criminal or otherwise) brought as a consequence of the
10performance of his official duties.
11    (f) Business offenses.
12        (1) No person shall:
13            (i) Intentionally prevent, interfere with, or
14        attempt to impede in any way any representative of the
15        Office in the performance of his official duties under
16        this Act and the Older Americans Act of 1965; or
17            (ii) Intentionally retaliate, discriminate
18        against, or effect reprisals against any long term care
19        facility resident or employee for contacting or
20        providing information to any representative of the
21        Office.
22        (2) A violation of this Section is a business offense,
23    punishable by a fine not to exceed $501.
24        (3) The State Long Term Care Ombudsman shall notify the
25    State's Attorney of the county in which the long term care
26    facility, supportive living facility, or assisted living



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1    or shared housing establishment is located, or the Attorney
2    General, of any violations of this Section.
3    (g) Confidentiality of records and identities. The
4Department shall establish procedures for the disclosure by the
5State Ombudsman or the regional ombudsmen entities of files
6maintained by the program. The procedures shall provide that
7the files and records may be disclosed only at the discretion
8of the State Long Term Care Ombudsman or the person designated
9by the State Ombudsman to disclose the files and records, and
10the procedures shall prohibit the disclosure of the identity of
11any complainant, resident, participant, witness, or employee
12of a long term care provider unless:
13        (1) the complainant, resident, participant, witness,
14    or employee of a long term care provider or his or her
15    legal representative consents to the disclosure and the
16    consent is in writing;
17        (2) the complainant, resident, participant, witness,
18    or employee of a long term care provider gives consent
19    orally; and the consent is documented contemporaneously in
20    writing in accordance with such requirements as the
21    Department shall establish; or
22        (3) the disclosure is required by court order.
23    (h) Legal representation. The Attorney General shall
24provide legal representation to any representative of the
25Office against whom suit or other legal action is brought in
26connection with the performance of the representative's



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1official duties, in accordance with the State Employee
2Indemnification Act.
3    (i) Treatment by prayer and spiritual means. Nothing in
4this Act shall be construed to authorize or require the medical
5supervision, regulation or control of remedial care or
6treatment of any resident in a long term care facility operated
7exclusively by and for members or adherents of any church or
8religious denomination the tenets and practices of which
9include reliance solely upon spiritual means through prayer for
11    (j) The Long Term Care Ombudsman Fund is created as a
12special fund in the State treasury to receive moneys for the
13express purposes of this Section. All interest earned on moneys
14in the fund shall be credited to the fund. Moneys contained in
15the fund shall be used to support the purposes of this Section.
16    (k) Each Regional Ombudsman may, in accordance with rules
17promulgated by the Office, establish a multi-disciplinary team
18to act in an advisory role for the purpose of providing
19professional knowledge and expertise in handling complex
20abuse, neglect, and advocacy issues involving participants.
21Each multi-disciplinary team may consist of one or more
22volunteer representatives from any combination of at least 7
23members from the following professions: banking or finance;
24disability care; health care; pharmacology; law; law
25enforcement; emergency responder; mental health care; clergy;
26coroner or medical examiner; substance abuse; domestic



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1violence; sexual assault; or other related fields. To support
2multi-disciplinary teams in this role, law enforcement
3agencies and coroners or medical examiners shall supply records
4as may be requested in particular cases. The Regional
5Ombudsman, or his or her designee, of the area in which the
6multi-disciplinary team is created shall be the facilitator of
7the multi-disciplinary team.
8(Source: P.A. 98-380, eff. 8-16-13; 98-989, eff. 1-1-15;
999-180, eff. 7-29-15.)
10    Section 10. The Specialized Mental Health Rehabilitation
11Act of 2013 is amended by changing Sections 4-103, 4-105, and
124-201 as follows:
13    (210 ILCS 49/4-103)
14    Sec. 4-103. Provisional licensure emergency rules. The
15Department, in consultation with the Division of Mental Health
16of the Department of Human Services and the Department of
17Healthcare and Family Services, is granted the authority under
18this Act to establish provisional licensure and licensing
19procedures by emergency rule. The Department shall file
20emergency rules concerning provisional licensure under this
21Act within 120 days after the effective date of this Act. The
22rules to be filed for provisional licensure shall be for a
23period of 3 years, beginning with the adoption date of the
24emergency rules establishing the provisional license, and



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1shall not be extended beyond the date of 3 years after the
2effective date of the emergency rules creating the provisional
3license and licensing process. Rules governing the provisional
4license and licensing process shall contain rules for the
5different levels of care offered by the facilities authorized
6under this Act and shall address each type of care hereafter
8        (1) triage centers;
9        (2) crisis stabilization;
10        (3) recovery and rehabilitation supports;
11        (4) transitional living units; or
12        (5) other intensive treatment and stabilization
13    programs designed and developed in collaboration with the
14    Department.
15(Source: P.A. 98-104, eff. 7-22-13.)
16    (210 ILCS 49/4-105)
17    Sec. 4-105. Provisional licensure duration. A provisional
18license shall be valid upon fulfilling the requirements
19established by the Department by emergency rule. The license
20shall remain valid as long as a facility remains in compliance
21with the licensure provisions established in rule. Provisional
22licenses issued upon initial licensure as a specialized mental
23health rehabilitation facility shall expire at the end of a
243-year period, which commences on the date the provisional
25license is issued. Issuance of a provisional license for any



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1reason other than initial licensure (including, but not limited
2to, change of ownership, location, number of beds, or services)
3shall not extend the maximum 3-year period, at the end of which
4a facility must be licensed pursuant to Section 4-201. The
5provisional license shall expire when the administrative rule
6established by the Department for provisional licensure
7expires at the end of a 3-year period.
8(Source: P.A. 98-104, eff. 7-22-13.)
9    (210 ILCS 49/4-201)
10    Sec. 4-201. Accreditation and licensure. At the end of the
11provisional licensure period established in Article 3, Part 1
12of this Article 4 Act, the Department shall license a facility
13as a specialized mental health rehabilitation facility under
14this Act that successfully completes and obtains valid national
15accreditation in behavioral health from a recognized national
16accreditation entity and complies with licensure standards as
17established by the Department of Public Health in
18administrative rule. Rules governing licensure standards shall
19include, but not be limited to, appropriate fines and sanctions
20associated with violations of laws or regulations. The
21following shall be considered to be valid national
22accreditation in behavioral health from an national
23accreditation entity:
24        (1) the Joint Commission;
25        (2) the Commission on Accreditation of Rehabilitation



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1    Facilities;
2        (3) the Healthcare Facilities Accreditation Program;
3    or
4        (4) any other national standards of care as approved by
5    the Department.
6(Source: P.A. 98-104, eff. 7-22-13.)
7    Section 99. Effective date. This Act takes effect upon
8becoming law.