State of Illinois
91st General Assembly
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91_HB1315

 
                                               LRB9102021SMpr

 1        AN ACT regarding abuse and neglect  of  the  elderly  and
 2    disabled.

 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:

 5        Section 5.  The  Abused  and  Neglected  Long  Term  Care
 6    Facility  Residents  Reporting  Act  is  amended  by changing
 7    Section 3 as follows:

 8        (210 ILCS 30/3) (from Ch. 111 1/2, par. 4163)
 9        Sec. 3.  As used in this Act unless the context otherwise
10    requires:
11        a.  "Department" means the Department of Public Health of
12    the State of Illinois.
13        b.  "Resident" means a person residing in  and  receiving
14    personal  care from a long term care facility, or residing in
15    a mental health facility or developmental disability facility
16    as  defined  in   the   Mental   Health   and   Developmental
17    Disabilities Code.
18        c.  "Long  term  care  facility"  has  the  same  meaning
19    ascribed  to  such  term in the Nursing Home Care Act, except
20    that the term as used in this Act shall  include  any  mental
21    health  facility  or  developmental  disability  facility  as
22    defined  in  the Mental Health and Developmental Disabilities
23    Code.
24        d.  "Abuse"  means  physical  abuse,  sexual  abuse,  and
25    emotional or psychological abuse any physical injury,  sexual
26    abuse  or mental injury inflicted on a resident other than by
27    accidental means.
28        e.  "Neglect" means the refusal or failure to fulfill any
29    part of a person's  obligations  or  duties  to  a  resident.
30    Neglect  may  also  include  failure  of  a  person  who  has
31    fiduciary  responsibilities  to  provide care for a resident.
 
                            -2-                LRB9102021SMpr
 1    Neglect typically means the refusal or failure to  provide  a
 2    resident with such life necessities as food, water, clothing,
 3    shelter,   personal   hygiene,  medicine,  comfort,  personal
 4    safety, and other essentials    included  in  an  implied  or
 5    agreed-upon responsibility to a resident.
 6        Signs and symptoms of neglect include but are not limited
 7    to:      dehydration,  malnutrition, untreated bed sores, and
 8    poor  personal  hygiene;  unattended  or   untreated   health
 9    problems;   hazardous   or   unsafe   living   condition   or
10    arrangements  (for  example,  improper wiring, no heat, or no
11    running water); unsanitary and unclean living conditions (for
12    example, dirt, fleas, lice on  the  person,  soiled  bedding,
13    fecal   or  urine  smell,  or  inadequate  clothing);  and  a
14    resident's report of  being mistreated.
15        "Neglect" also means abandonment, financial  or  material
16    exploitation, and self-neglect. a failure in a long term care
17    facility  to  provide  adequate  medical  or personal care or
18    maintenance, which failure  results  in  physical  or  mental
19    injury  to a resident or in the deterioration of a resident's
20    physical or mental condition.
21        f.  "Protective services" means services  provided  to  a
22    resident who has been abused or neglected, which may include,
23    but  are  not  limited to alternative temporary institutional
24    placement, nursing care, counseling,  other  social  services
25    provided at the nursing home where the resident resides or at
26    some  other  facility,  personal  care  and  such  protective
27    services of voluntary agencies as are available.
28        g.  Unless  the  context  otherwise  requires,  direct or
29    indirect references in this Act to the  programs,  personnel,
30    facilities,   services,   service   providers,   or   service
31    recipients  of  the  Department  of  Human  Services shall be
32    construed  to  refer  only  to  those  programs,   personnel,
33    facilities,   services,   service   providers,   or   service
34    recipients  that pertain to the Department of Human Services'
 
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 1    mental health and developmental disabilities functions.
 2        h.  "Physical abuse" means the use of physical force that
 3    may result in bodily  injury, physical pain,  or  impairment.
 4    Physical  abuse  may include but is not  limited to such acts
 5    of violence as striking (with or without an object), hitting,
 6    beating,  pushing,  shoving,  shaking,   slapping,   kicking,
 7    pinching,  and burning. In addition, the inappropriate use of
 8    drugs and physical restraints,  force-feeding,  and  physical
 9    punishment of any kind also are examples of physical abuse.
10        Signs  and symptoms of physical abuse include but are not
11    limited to:  bruises, black  eyes,  welts,  lacerations,  and
12    rope   marks;   bone   fractures,  broken  bones,  and  skull
13    fractures;  open  wounds,  cuts,  punctures,  and   untreated
14    injuries in various stages of healing; sprains, dislocations,
15    and  internal  injuries  or  bleeding;   broken eyeglasses or
16    frames, physical signs of being subjected to punishment,  and
17    signs  of being restrained; laboratory findings of medication
18    overdose  or  under-utilization  of   prescribed   drugs;   a
19    resident's   report   of   being  hit,  slapped,  kicked,  or
20    mistreated; a resident's sudden change in behavior;  and  the
21    long  term care facility's refusal to allow visitors to see a
22    resident alone.
23        i.  "Sexual abuse" means nonconsensual sexual contact  of
24    any  kind  with  a  resident.  Sexual contact with any person
25    incapable of giving consent is also considered sexual  abuse.
26    It  includes  but is not limited to unwanted touching and all
27    types of sexual assault or battery,  such  as  rape,  sodomy,
28    coerced nudity, and  sexually explicit photographing.
29        Signs  and  symptoms  of sexual abuse include but are not
30    limited to: bruises  around  the  breasts  or  genital  area;
31    unexplained   venereal   disease   or  genital    infections;
32    unexplained vaginal  or  anal  bleeding;  torn,  stained,  or
33    bloody    underclothing;  and  a  resident's  report of being
34    sexually assaulted or raped.
 
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 1        j.  "Emotional abuse" or "psychological abuse" means  the
 2    infliction  of  anguish,  pain, or distress through verbal or
 3    nonverbal acts. Emotional or psychological    abuse  includes
 4    but  is  not  limited  to  verbal assaults, insults, threats,
 5    intimidation,  humiliation,  and  harassment.  In   addition,
 6    treating a resident like an infant; isolating a resident from
 7    his  or  her family, friends, or regular activities; giving a
 8    resident  the  "silent  treatment";   and   enforced   social
 9    isolation are examples of emotional or psychological abuse.
10        Signs  and  symptoms  of emotional or psychological abuse
11    include but are not limited to:  being emotionally  upset  or
12    agitated;  being  extremely withdrawn and noncommunicative or
13    nonresponsive;  unusual  behavior   usually   attributed   to
14    dementia  (for  example,  sucking, biting, or rocking); and a
15    resident's  report   of   being   verbally   or   emotionally
16    mistreated.
17        k.  "Abandonment" means the desertion of a resident by an
18    individual  who has assumed responsibility for providing care
19    for a resident, or by a  person with physical  custody  of  a
20    resident.
21        Signs  and  symptoms  of  abandonment include but are not
22    limited to:  the  desertion of a resident at  a  hospital  or
23    other  similar institution;  the desertion of a resident at a
24    shopping center or other public location;  and  a  resident's
25    own report of being abandoned.
26        l.  "Financial  exploitation"  or "material exploitation"
27    means the illegal or improper  use  of  a  resident's  funds,
28    property,  or assets. Examples include but are not limited to
29    cashing  a  resident's  checks   without   authorization   or
30    permission;  forging  a  resident's  signature;  misusing  or
31    stealing  a  resident's  money  or   possessions; coercing or
32    deceiving a resident into signing any document (for  example,
33    a   contract   or   a   will);   and   the  improper  use  of
34    conservatorship, guardianship, or power of attorney.
 
                            -5-                LRB9102021SMpr
 1        Signs and symptoms of financial or material  exploitation
 2    include  but  are  not  limited  to:   sudden changes in bank
 3    account  or  banking  practice,  including   an   unexplained
 4    withdrawal  of  large  sums of money by a person accompanying
 5    the  resident;  the  inclusion  of  additional  names  on   a
 6    resident's  bank  signature  card; unauthorized withdrawal of
 7    the resident's funds using the resident's  ATM  card;  abrupt
 8    changes  in  a will or other financial documents; unexplained
 9    disappearance of funds or valuable possessions;   substandard
10    care   being   provided   for   bills  unpaid    despite  the
11    availability of adequate financial resources; discovery of  a
12    resident's  signature being forged for financial transactions
13    and  for  the  titles  of  his  or  her  possessions;  sudden
14    appearance of previously uninvolved relatives claiming  their
15    rights  to  a resident's affairs and possessions; unexplained
16    sudden transfer of assets  to  a  family  member  or  someone
17    outside  the  family;  the provision of services that are not
18    necessary; and a resident's report of financial exploitation.
19        m.  "Self-neglect" means the behavior of a resident  that
20    threatens  his  or  her    own health or safety. Self-neglect
21    generally manifests itself in a  resident  as  a  refusal  or
22    failure  to  provide  himself  or herself with adequate food,
23    water, clothing, shelter, personal hygiene, medication  (when
24    indicated),   and   safety  precautions.  The  definition  of
25    self-neglect  excludes  a  situation  in  which  a   mentally
26    competent  resident,  who understands the consequences of his
27    or her decisions, makes a conscious and voluntary decision to
28    engage in acts that threaten his or her health or safety as a
29    matter of personal choice.
30        Signs and symptoms of self-neglect include  but  are  not
31    limited   to:      dehydration,  malnutrition,  untreated  or
32    improperly attended medical  conditions,  and  poor  personal
33    hygiene;   hazardous   or   unsafe   living   conditions   or
34    arrangements;  unsanitary  or  unclean  living  quarters (for
 
                            -6-                LRB9102021SMpr
 1    example, animal or insect infestation, no functioning toilet,
 2    or  fecal  or  urine  smell);  inappropriate  or   inadequate
 3    clothing;  and  lack  of  the  necessary  medical  aids  (for
 4    example, eyeglasses, hearing aids, or dentures).
 5    (Source: P.A. 89-507, eff. 7-1-97.)

 6        Section  10.   The Elder Abuse and Neglect Act is amended
 7    by changing Section 2 as follows:

 8        (320 ILCS 20/2) (from Ch. 23, par. 6602)
 9        Sec. 2.  Definitions.  As used in this  Act,  unless  the
10    context requires otherwise:
11        (a)  "Abuse"  means  physical  abuse,  sexual  abuse, and
12    emotional or psychological abuse causing any physical, mental
13    or sexual injury to an eligible adult, including exploitation
14    of such adult's financial resources.
15        Nothing in this Act shall be construed to  mean  that  an
16    eligible  adult  is a victim of abuse or neglect for the sole
17    reason that he or she is being furnished with or relies  upon
18    treatment   by  spiritual  means  through  prayer  alone,  in
19    accordance with the tenets  and  practices  of  a  recognized
20    church or religious denomination.
21        Nothing  in  this  Act shall be construed to mean that an
22    eligible adult is a victim of abuse because  of  health  care
23    services  provided  or  not  provided by licensed health care
24    professionals.
25        (a-5)  "Abuser" means a person who abuses,  neglects,  or
26    financially exploits an eligible adult.
27        (a-7)  "Caregiver"  means a person who either as a result
28    of a family relationship, voluntarily,  or  in  exchange  for
29    compensation  has assumed responsibility for all or a portion
30    of the care of an eligible adult who  needs  assistance  with
31    activities of daily living.
32        (b)  "Department"  means  the  Department on Aging of the
 
                            -7-                LRB9102021SMpr
 1    State of Illinois.
 2        (c)  "Director" means the Director of the Department.
 3        (d)  "Domestic living situation" means a residence  where
 4    the eligible adult lives alone or with his or her family or a
 5    caregiver,  or  others,  or  a  board  and care home or other
 6    community-based unlicensed facility, but is not:
 7             (1)  A licensed facility as defined in Section 1-113
 8        of the Nursing Home Care Act;
 9             (2)  A "life care facility" as defined in  the  Life
10        Care Facilities Act;
11             (3)  A home, institution, or other place operated by
12        the  federal government or agency thereof or by the State
13        of Illinois;
14             (4)  A hospital, sanitarium, or  other  institution,
15        the  principal  activity  or  business  of  which  is the
16        diagnosis, care, and treatment of human  illness  through
17        the  maintenance  and  operation  of organized facilities
18        therefor, which is required  to  be  licensed  under  the
19        Hospital Licensing Act;
20             (5)  A "community living facility" as defined in the
21        Community Living Facilities Licensing Act;
22             (6)  A   "community   residential   alternative"  as
23        defined  in  the   Community   Residential   Alternatives
24        Licensing Act; and
25             (7)  A  "community-integrated living arrangement" as
26        defined in the Community-Integrated  Living  Arrangements
27        Licensure and Certification Act.
28        (e)  "Eligible  adult"  means a person 60 years of age or
29    older who resides in a domestic living situation and  is,  or
30    is alleged to be, abused, neglected, or financially exploited
31    by another individual.
32        (f)  "Emergency"  means  a situation in which an eligible
33    adult is living in conditions presenting a risk of  death  or
34    physical, mental or sexual injury and the provider agency has
 
                            -8-                LRB9102021SMpr
 1    reason  to believe the eligible adult is unable to consent to
 2    services which would alleviate that risk.
 3        (f-5)  "Mandated reporter" means  any  of  the  following
 4    persons  while  engaged  in  carrying  out their professional
 5    duties:
 6             (1)  a professional or professional's delegate while
 7        engaged in: (i) social services,  (ii)  law  enforcement,
 8        (iii)  education,  (iv)  the care of an eligible adult or
 9        eligible adults, or (v) any of the  occupations  required
10        to  be licensed under the Clinical Psychologist Licensing
11        Act, the Clinical Social Work and  Social  Work  Practice
12        Act,  the  Illinois Dental Practice Act, the Dietetic and
13        Nutrition Services Practice Act, the Marriage and  Family
14        Therapy  Licensing Act, the Medical Practice Act of 1987,
15        the Naprapathic Practice Act, the  Illinois  Nursing  and
16        Advanced  Practice  Nursing Act of 1987, the Nursing Home
17        Administrators  Licensing  and    Disciplinary  Act,  the
18        Illinois Occupational Therapy Practice Act, the  Illinois
19        Optometric  Practice  Act  of 1987, the Pharmacy Practice
20        Act of 1987,  the  Illinois  Physical  Therapy  Act,  the
21        Physician  Assistant  Practice Act of 1987, the Podiatric
22        Medical Practice Act of 1987, the Professional  Counselor
23        and  Clinical  Professional  Counselor Licensing Act, the
24        Illinois Speech-Language Pathology and Audiology Practice
25        Act, the Veterinary Medicine and Surgery Practice Act  of
26        1994, and the Illinois Public Accounting Act;
27             (2)  an  employee  of  a  vocational  rehabilitation
28        facility  prescribed  or  supervised by the Department of
29        Human Services;
30             (3)  an administrator, employee, or person providing
31        services in or  through  an  unlicensed  community  based
32        facility;
33             (4)  a Christian Science Practitioner;
34             (5)  field  personnel  of  the  Department of Public
 
                            -9-                LRB9102021SMpr
 1        Aid, Department of Public Health, and Department of Human
 2        Services, and any county or municipal health department;
 3             (6)  personnel of the Department of Human  Services,
 4        the  Guardianship and Advocacy Commission, the State Fire
 5        Marshal, local fire departments, the Department on  Aging
 6        and  its  subsidiary  Area Agencies on Aging and provider
 7        agencies,  and  the  Office  of  State  Long  Term   Care
 8        Ombudsman;
 9             (7)  any  employee  of  the  State  of  Illinois not
10        otherwise specified herein who is involved  in  providing
11        services  to  eligible  adults,  including  professionals
12        providing  medical  or  rehabilitation  services  and all
13        other persons having direct contact with eligible adults;
14        or
15             (9)  a person who performs the duties of  a  coroner
16        or medical examiner.
17        (g)  "Neglect"  means  the  refusal or failure to fulfill
18    any part of a person's obligations or duties to  an  eligible
19    adult.   Neglect may also include failure of a person who has
20    fiduciary responsibilities to provide care  for  an  eligible
21    adult  (for  example, pay for necessary home care service) or
22    the failure on the part of an  in-home  service  provider  to
23    provide  necessary care.  Neglect typically means the refusal
24    or failure to  provide  an  eligible  adult  with  such  life
25    necessities  as  food,  water,  clothing,  shelter,  personal
26    hygiene,   medicine,  comfort,  personal  safety,  and  other
27    essentials   included   in   an   implied   or    agreed-upon
28    responsibility to an eligible adult.
29        Signs and symptoms of neglect include but are not limited
30    to:  dehydration, malnutrition, untreated bed sores, and poor
31    personal    hygiene;  unattended    or    untreated    health
32    problems;  hazardous    or   unsafe   living   condition   or
33    arrangements (for example, improper wiring, no  heat,  or  no
34    running  water);  unsanitary  and  unclean  living conditions
 
                            -10-               LRB9102021SMpr
 1    (for  example,  dirt,  fleas,  lice  on  the  person,  soiled
 2    bedding, fecal or urine  smell, or inadequate clothing);  and
 3    an eligible adult's report of being mistreated.
 4        "Neglect"  also  means abandonment, financial or material
 5    exploitation, and self-neglect. another individual's  failure
 6    to provide an eligible adult with or willful withholding from
 7    an  eligible adult the necessities of life including, but not
 8    limited to, food, clothing, shelter  or  medical  care.  This
 9    subsection  does  not  create  any  new  affirmative  duty to
10    provide support to eligible  adults.   Nothing  in  this  Act
11    shall be construed to mean that an eligible adult is a victim
12    of  neglect  because  of health care services provided or not
13    provided by licensed health care professionals.
14        (h)  "Provider agency"  means  any  public  or  nonprofit
15    agency  in  a  planning  and  service  area  appointed by the
16    regional administrative agency with  prior  approval  by  the
17    Department  on Aging to receive and assess reports of alleged
18    or suspected abuse, neglect, or financial exploitation.
19        (i)  "Regional administrative agency" means any public or
20    nonprofit agency in a planning and service area so designated
21    by the Department, provided that the designated  Area  Agency
22    on  Aging  shall  be  designated  the regional administrative
23    agency if it so requests. The  Department  shall  assume  the
24    functions  of  the  regional  administrative  agency  for any
25    planning and service area where  another  agency  is  not  so
26    designated.
27        (j)  "Substantiated   case"  means  a  reported  case  of
28    alleged   or   suspected   abuse,   neglect,   or   financial
29    exploitation in which a provider  agency,  after  assessment,
30    determines that there is reason to believe abuse, neglect, or
31    financial exploitation has occurred.
32        (k)  "Physical  abuse"  means  the  use of physical force
33    that  may  result  in  bodily  injury,  physical   pain,   or
34    impairment.  Physical abuse may include but is not limited to
 
                            -11-               LRB9102021SMpr
 1    such  acts  of  violence  as  striking  (with  or  without an
 2    object),  hitting,  beating,   pushing,   shoving,   shaking,
 3    slapping,  kicking,  pinching, and burning.  In addition, the
 4    inappropriate  use  of   drugs   and   physical   restraints,
 5    force-feeding,  and  physical punishment of any kind also are
 6    examples of physical abuse.
 7        Signs and symptoms of physical abuse include but are  not
 8    limited  to:    bruises,  black eyes, welts, lacerations, and
 9    rope  marks;   bone  fractures,  broken  bones,   and   skull
10    fractures;   open  wounds,  cuts,  punctures,  and  untreated
11    injuries    in   various   stages   of   healing;    sprains,
12    dislocations, and  internal  injuries  or  bleeding;   broken
13    eyeglasses  or  frames,  physical signs of being subjected to
14    punishment,  and  signs  of  being  restrained;    laboratory
15    findings  of  medication  overdose  or  under-utilization  of
16    prescribed  drugs;   an  eligible  adult's  sudden  change in
17    behavior;  and the caregiver's refusal to allow  visitors  to
18    see an eligible adult alone.

19        (1)  "Sexual abuse" means nonconsensual sexual contact of
20    any  kind  with  an  eligible adult.  Sexual contact with any
21    person incapable of giving consent is also considered  sexual
22    abuse.   It  includes but is not limited to unwanted touching
23    and all types of sexual assault or  battery,  such  as  rape,
24    sodomy, coerced nudity, and sexually explicit photographing.
25        Signs  and  symptoms  of sexual abuse include but are not
26    limited to:  bruises around  the  breasts  or  genital  area;
27    unexplained   venereal   disease   or   genital   infections;
28    unexplained  vaginal  or  anal  bleeding;   torn, stained, or
29    bloody underclothing;  and  an  eligible  adult's  report  of
30    being sexually assaulted or raped.
31        (m)  "Emotional abuse" or "psychological abuse" means the
32    infliction  of  anguish,  pain, or distress through verbal or
33    nonverbal acts.  Emotional or  psychological  abuse  includes
 
                            -12-               LRB9102021SMpr
 1    but  is  not  limited  to  verbal assaults, insults, threats,
 2    intimidation,  humiliation,  and  harassment.   In  addition,
 3    treating an eligible adult  like  an  infant;   isolating  an
 4    eligible  adult  from  his or her family, friends, or regular
 5    activities;  giving an eligible adult the "silent treatment";
 6    and enforced social isolation are examples  of  emotional  or
 7    psychological abuse.
 8        Signs  and  symptoms  of emotional or psychological abuse
 9    include but are not limited to:  being emotionally  upset  or
10    agitated;   being extremely withdrawn and noncommunicative or
11    nonresponsive;   unusual  behavior  usually   attributed   to
12    dementia  (for  example, sucking, biting, or rocking); and an
13    eligible adult's report  of  being  verbally  or  emotionally
14    mistreated.
15        (n)  "Abandonment"  means  the  desertion  of an eligible
16    adult by an individual who  has  assumed  responsibility  for
17    providing  care  for  an  eligible adult, or by a person with
18    physical custody of an eligible adult.
19        Signs and symptoms of  abandoment  include  but  are  not
20    limited  to:   the  desertion  of  an  eligible  adult  at  a
21    hospital,  a  nursing facility, or other similar institution;
22    the desertion of an eligible adult at a  shopping  center  or
23    other public location;  and an eligible adult's own report of
24    being abandoned.
25        (o)  "Financial  exploitation" or "material exploitation"
26    means the illegal or improper  use  of  an  eligible  adult's
27    funds,  property,  or  assets.   Examples include but are not
28    limited  to  cashing  an  eligible  adult's  checks   without
29    authorization  or  permission;   forging  an eligible adult's
30    signature;  misusing or stealing an eligible adult's money or
31    possessions; coercing or deceiving  an  eligible  adult  into
32    signing  any  document  (for  example, a contract or a will);
33    and the improper use  of  conservatorship,  guardianship,  or
34    power of attorney.
 
                            -13-               LRB9102021SMpr
 1        Signs  and symptoms of financial or material exploitation
 2    include but are not  limited  to:   sudden  changes  in  bank
 3    account   or   banking  practice,  including  an  unexplained
 4    withdrawal of large sums of money by  a  person  accompanying
 5    the  eligible  adult's  bank  signature  card;   unauthorized
 6    withdrawal  of  the eligible adult's funds using the eligible
 7    adult's  ATM  card;   abrupt  changes  in  a  will  or  other
 8    financial documents;  unexplained disappearance of  funds  or
 9    valuable  possessions;   substandard  care being provided for
10    bills unpaid despite the availability of  adequate  financial
11    resources;   discovery of an eligible adult's signature being
12    forged for financial transactions and for the titles  of  his
13    or   her   possessions;    sudden  appearance  of  previously
14    uninvolved relatives claiming their  rights  to  an  eligible
15    adult's affairs and possessions;  unexplained sudden transfer
16    of  assets  to a family member or someone outside the family;
17    the provision of services that are  not  necessary;   and  an
18    eligible adult's report of financial exploitation.
19        (p)  "Self-neglect"  means  the  behavior  of  an elderly
20    person that threatens  his  or  her  own  health  or  safety.
21    Self-neglect  generally manifests itself in an eligible adult
22    as a refusal or failure to provide himself  or  herself  with
23    adequate  food,  water,  clothing, shelter, personal hygiene,
24    medication (when indicated),  and  safety  precautions.   The
25    definition  of  self-neglect  excludes a situation in which a
26    mentally  competent  eligible  adult,  who  understands   the
27    consequences  of  his or her decisions, makes a conscious and
28    voluntary decision to engage in acts that threaten his or her
29    health or safety as a matter of personal choice.
30        Signs and symptoms of self-neglect include  but  are  not
31    limited   to:      dehydration,  malnutrition,  untreated  or
32    improperly attended medical  conditions,  and  poor  personal
33    hygiene;    hazardous   or   unsafe   living   conditions  or
34    arrangements  (for  example,  improper  wiring,   no   indoor
 
                            -14-               LRB9102021SMpr
 1    plumbing,  no  heat,  or  no  running  water);  unsanitary or
 2    unclean  living  quarters  (for  example,  animal  or  insect
 3    infestation, no functioning toilet, or fecal or urine smell);
 4    inappropriate or inadequate clothing or lack of the necessary
 5    medical aids  (for  example,  eyeglasses,  hearing  aids,  or
 6    dentures);   and  grossly inadequate housing or homelessness.
 7    (Source: P.A. 90-628, eff. 1-1-99; revised 9-24-98.)

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