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


Sen. Heather A. Steans

Filed: 3/8/2016





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2    AMENDMENT NO. ______. Amend Senate Bill 2504 by replacing
3everything after the enacting clause with the following:
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



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1be provided to Illinois participants for the first time and
2will produce a cost savings for the State of Illinois by
3supporting the rebalancing efforts of the Patient Protection
4and Affordable Care Act.
5    (a) Long Term Care Ombudsman Program. The Department shall
6establish a Long Term Care Ombudsman Program, through the
7Office of State Long Term Care Ombudsman ("the Office"), in
8accordance with the provisions of the Older Americans Act of
91965, as now or hereafter amended. The Long Term Care Ombudsman
10Program is authorized, subject to sufficient appropriations,
11to advocate on behalf of older persons and persons with
12disabilities residing in their own homes or community-based
13settings, relating to matters which may adversely affect the
14health, safety, welfare, or rights of such individuals.
15    (b) Definitions. As used in this Section, unless the
16context requires otherwise:
17        (1) "Access" means the right to:
18            (i) Enter any long term care facility or assisted
19        living or shared housing establishment or supportive
20        living facility;
21            (ii) Communicate privately and without restriction
22        with any resident, regardless of age, who consents to
23        the communication;
24            (iii) Seek consent to communicate privately and
25        without restriction with any participant or resident,
26        regardless of age;



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1            (iv) Inspect the clinical and other records of a
2        participant or resident, regardless of age, with the
3        express written consent of the participant or
4        resident;
5            (v) Observe all areas of the long term care
6        facility or supportive living facilities, assisted
7        living or shared housing establishment except the
8        living area of any resident who protests the
9        observation; and
10            (vi) Subject to permission of the participant or
11        resident requesting services or his or her
12        representative, enter a home or community-based
13        setting.
14        (2) "Long Term Care Facility" means (i) any facility as
15    defined by Section 1-113 of the Nursing Home Care Act, as
16    now or hereafter amended; (ii) any skilled nursing facility
17    or a nursing facility which meets the requirements of
18    Section 1819(a), (b), (c), and (d) or Section 1919(a), (b),
19    (c), and (d) of the Social Security Act, as now or
20    hereafter amended (42 U.S.C. 1395i-3(a), (b), (c), and (d)
21    and 42 U.S.C. 1396r(a), (b), (c), and (d)); (iii) any
22    facility as defined by Section 1-113 of the ID/DD Community
23    Care Act, as now or hereafter amended; and (iv) any
24    facility as defined by Section 1-113 of MC/DD Act, as now
25    or hereafter amended; and (v) any facility licensed under
26    Section 4-105 or 4-201 of the Specialized Mental Health



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1    Rehabilitation Act of 2013, as now or hereafter amended.
2        (2.5) "Assisted living establishment" and "shared
3    housing establishment" have the meanings given those terms
4    in Section 10 of the Assisted Living and Shared Housing
5    Act.
6        (2.7) "Supportive living facility" means a facility
7    established under Section 5-5.01a of the Illinois Public
8    Aid Code.
9        (2.8) "Community-based setting" means any place of
10    abode other than an individual's private home.
11        (3) "State Long Term Care Ombudsman" means any person
12    employed by the Department to fulfill the requirements of
13    the Office of State Long Term Care Ombudsman as required
14    under the Older Americans Act of 1965, as now or hereafter
15    amended, and Departmental policy.
16        (3.1) "Ombudsman" means any designated representative
17    of the State Long Term Care Ombudsman Program; provided
18    that the representative, whether he is paid for or
19    volunteers his ombudsman services, shall be qualified and
20    designated by the Office to perform the duties of an
21    ombudsman as specified by the Department in rules and in
22    accordance with the provisions of the Older Americans Act
23    of 1965, as now or hereafter amended.
24        (4) "Participant" means an older person aged 60 or over
25    or an adult with a disability aged 18 through 59 who is
26    eligible for services under any of the following:



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1            (i) A medical assistance waiver administered by
2        the State.
3            (ii) A managed care organization providing care
4        coordination and other services to seniors and persons
5        with disabilities.
6        (5) "Resident" means an older person aged 60 or over or
7    an adult with a disability aged 18 through 59 who resides
8    in a long-term care facility.
9    (c) Ombudsman; rules. The Office of State Long Term Care
10Ombudsman shall be composed of at least one full-time ombudsman
11and shall include a system of designated regional long term
12care ombudsman programs. Each regional program shall be
13designated by the State Long Term Care Ombudsman as a
14subdivision of the Office and any representative of a regional
15program shall be treated as a representative of the Office.
16    The Department, in consultation with the Office, shall
17promulgate administrative rules in accordance with the
18provisions of the Older Americans Act of 1965, as now or
19hereafter amended, to establish the responsibilities of the
20Department and the Office of State Long Term Care Ombudsman and
21the designated regional Ombudsman programs. The administrative
22rules shall include the responsibility of the Office and
23designated regional programs to investigate and resolve
24complaints made by or on behalf of residents of long term care
25facilities, supportive living facilities, and assisted living
26and shared housing establishments, and participants residing



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



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1information specific to assisted living establishments,
2supportive living facilities, shared housing establishments,
3private homes, and community-based settings and to the rights
4of residents and participants guaranteed under the
5corresponding Acts and administrative rules.
6    (c-5) Consumer Choice Information Reports. The Office
8        (1) In collaboration with the Attorney General, create
9    a Consumer Choice Information Report form to be completed
10    by all licensed long term care facilities to aid
11    Illinoisans and their families in making informed choices
12    about long term care. The Office shall create a Consumer
13    Choice Information Report for each type of licensed long
14    term care facility. The Office shall collaborate with the
15    Attorney General and the Department of Human Services to
16    create a Consumer Choice Information Report form for
17    facilities licensed under the ID/DD Community Care Act or
18    the MC/DD 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    ID/DD Community Care Act or the MC/DD Act shall be made
11    accessible to the public by the Department of Human
12    Services, including on the Internet by means of a hyperlink
13    labeled "Resident's and Families' Right to Know" on the
14    Department of Human 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
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. 98-380, eff. 8-16-13; 98-989, eff. 1-1-15;
1699-180, eff. 7-29-15.)
17    Section 10. The Specialized Mental Health Rehabilitation
18Act of 2013 is amended by changing Sections 4-103, 4-105, and
194-201 as follows:
20    (210 ILCS 49/4-103)
21    Sec. 4-103. Provisional licensure emergency rules. The
22Department, in consultation with the Division of Mental Health
23of the Department of Human Services and the Department of
24Healthcare and Family Services, is granted the authority under



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1this Act to establish provisional licensure and licensing
2procedures by emergency rule. The Department shall file
3emergency rules concerning provisional licensure under this
4Act within 120 days after the effective date of this Act. The
5rules to be filed for provisional licensure shall be for a
6period of 3 years, beginning with the adoption date of the
7emergency rules establishing the provisional license, and
8shall not be extended beyond the date of 3 years after the
9effective date of the emergency rules creating the provisional
10license and licensing process. Rules governing the provisional
11license and licensing process shall contain rules for the
12different levels of care offered by the facilities authorized
13under this Act and shall address each type of care hereafter
15        (1) triage centers;
16        (2) crisis stabilization;
17        (3) recovery and rehabilitation supports;
18        (4) transitional living units; or
19        (5) other intensive treatment and stabilization
20    programs designed and developed in collaboration with the
21    Department.
22(Source: P.A. 98-104, eff. 7-22-13.)
23    (210 ILCS 49/4-105)
24    Sec. 4-105. Provisional licensure duration. A provisional
25license shall be valid upon fulfilling the requirements



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1established by the Department by emergency rule. The license
2shall remain valid as long as a facility remains in compliance
3with the licensure provisions established in rule. Provisional
4licenses issued upon initial licensure as a specialized mental
5health rehabilitation facility shall expire at the end of a
63-year period, which commences on the date the provisional
7license is issued. Issuance of a provisional license for any
8reason other than initial licensure (including, but not limited
9to, change of ownership, location, number of beds, or services)
10shall not extend the maximum 3-year period, at the end of which
11a facility must be licensed pursuant to Section 4-201. The
12provisional license shall expire when the administrative rule
13established by the Department for provisional licensure
14expires at the end of a 3-year period.
15(Source: P.A. 98-104, eff. 7-22-13.)
16    (210 ILCS 49/4-201)
17    Sec. 4-201. Accreditation and licensure. At the end of the
18provisional licensure period established in Article 3, Part 1
19of this Article 4 Act, the Department shall license a facility
20as a specialized mental health rehabilitation facility under
21this Act that successfully completes and obtains valid national
22accreditation in behavioral health from a recognized national
23accreditation entity and complies with licensure standards as
24established by the Department of Public Health in
25administrative rule. Rules governing licensure standards shall



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1include, but not be limited to, appropriate fines and sanctions
2associated with violations of laws or regulations. The
3following shall be considered to be valid national
4accreditation in behavioral health from an national
5accreditation entity:
6        (1) the Joint Commission;
7        (2) the Commission on Accreditation of Rehabilitation
8    Facilities;
9        (3) the Healthcare Facilities Accreditation Program;
10    or
11        (4) any other national standards of care as approved by
12    the Department.
13(Source: P.A. 98-104, eff. 7-22-13.)
14    Section 99. Effective date. This Act takes effect upon
15becoming law.".