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Public Act 103-0762 |
SB2715 Enrolled | LRB103 36720 KTG 66830 b |
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AN ACT concerning State government. |
Be it enacted by the People of the State of Illinois, |
represented in the General Assembly: |
Section 5. The Illinois Act on the Aging is amended by |
changing Section 4.04 as follows: |
(20 ILCS 105/4.04) (from Ch. 23, par. 6104.04) |
Sec. 4.04. Long Term Care Ombudsman Program. The purpose |
of the Long Term Care Ombudsman Program is to ensure that older |
persons and persons with disabilities receive quality |
services. This is accomplished by providing advocacy services |
for residents of long term care facilities and participants |
receiving home care and community-based care. Managed care is |
increasingly becoming the vehicle for delivering health and |
long-term services and supports to seniors and persons with |
disabilities, including dual eligible participants. The |
additional ombudsman authority will allow advocacy services to |
be provided to Illinois participants for the first time and |
will produce a cost savings for the State of Illinois by |
supporting the rebalancing efforts of the Patient Protection |
and Affordable Care Act. |
(a) Long Term Care Ombudsman Program. The Department shall |
establish a Long Term Care Ombudsman Program, through the |
Office of State Long Term Care Ombudsman ("the Office"), in |
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accordance with the provisions of the Older Americans Act of |
1965, as now or hereafter amended. The Long Term Care |
Ombudsman Program is authorized, subject to sufficient |
appropriations, to advocate on behalf of older persons and |
persons with disabilities residing in their own homes or |
community-based settings, relating to matters which may |
adversely affect the health, safety, welfare, or rights of |
such individuals. |
(b) Definitions. As used in this Section, unless the |
context requires otherwise: |
(1) "Access" means the right to: |
(i) Enter any long term care facility or assisted |
living or shared housing establishment or supportive |
living facility; |
(ii) Communicate privately and without restriction |
with any resident, regardless of age, who consents to |
the communication; |
(iii) Seek consent to communicate privately and |
without restriction with any participant or resident, |
regardless of age; |
(iv) Inspect and copy the clinical and other |
records of a participant or resident, regardless of |
age, with the express written consent of the |
participant or resident; |
(v) Observe all areas of the long term care |
facility or supportive living facilities, assisted |
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living or shared housing establishment except the |
living area of any resident who protests the |
observation; and |
(vi) Subject to permission of the participant or |
resident requesting services or his or her |
representative, enter a home or community-based |
setting. |
(2) "Long Term Care Facility" means (i) any facility |
as defined by Section 1-113 of the Nursing Home Care Act, |
as now or hereafter amended; (ii) any skilled nursing |
facility or a nursing facility which meets the |
requirements of Section 1819(a), (b), (c), and (d) or |
Section 1919(a), (b), (c), and (d) of the Social Security |
Act, as now or hereafter amended (42 U.S.C. 1395i-3(a), |
(b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and |
(d)); (iii) any facility as defined by Section 1-113 of |
the ID/DD Community Care Act, as now or hereafter amended; |
(iv) any facility as defined by Section 1-113 of MC/DD |
Act, as now or hereafter amended; and (v) any facility |
licensed under Section 4-105 or 4-201 of the Specialized |
Mental Health Rehabilitation Act of 2013, as now or |
hereafter amended. |
(2.5) "Assisted living establishment" and "shared |
housing establishment" have the meanings given those terms |
in Section 10 of the Assisted Living and Shared Housing |
Act. |
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(2.7) "Supportive living facility" means a facility |
established under Section 5-5.01a of the Illinois Public |
Aid Code. |
(2.8) "Community-based setting" means any place of |
abode other than an individual's private home. |
(3) "State Long Term Care Ombudsman" means any person |
employed by the Department to fulfill the requirements of |
the Office of State Long Term Care Ombudsman as required |
under the Older Americans Act of 1965, as now or hereafter |
amended, and Departmental policy. |
(3.1) "Ombudsman" means any designated representative |
of the State Long Term Care Ombudsman Program; provided |
that the representative, whether he is paid for or |
volunteers his ombudsman services, shall be qualified and |
designated by the Office to perform the duties of an |
ombudsman as specified by the Department in rules and in |
accordance with the provisions of the Older Americans Act |
of 1965, as now or hereafter amended. |
(4) "Participant" means an older person aged 60 or |
over or an adult with a disability aged 18 through 59 who |
is eligible for services under any of the following: |
(i) A medical assistance waiver administered by |
the State. |
(ii) A managed care organization providing care |
coordination and other services to seniors and persons |
with disabilities. |
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(5) "Resident" means an older person aged 60 or over |
or an adult with a disability aged 18 through 59 who |
resides in a long-term care facility. |
(c) Ombudsman; rules. The Office of State Long Term Care |
Ombudsman shall be composed of at least one full-time |
ombudsman and shall include a system of designated regional |
long term care ombudsman programs. Each regional program shall |
be designated by the State Long Term Care Ombudsman as a |
subdivision of the Office and any representative of a regional |
program shall be treated as a representative of the Office. |
The Department, in consultation with the Office, shall |
promulgate administrative rules in accordance with the |
provisions of the Older Americans Act of 1965, as now or |
hereafter amended, to establish the responsibilities of the |
Department and the Office of State Long Term Care Ombudsman |
and the designated regional Ombudsman programs. The |
administrative rules shall include the responsibility of the |
Office and designated regional programs to investigate and |
resolve complaints made by or on behalf of residents of long |
term care facilities, supportive living facilities, and |
assisted living and shared housing establishments, and |
participants residing in their own homes or community-based |
settings, including the option to serve residents and |
participants under the age of 60, relating to actions, |
inaction, or decisions of providers, or their representatives, |
of such facilities and establishments, of public agencies, or |
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of social services agencies, which may adversely affect the |
health, safety, welfare, or rights of such residents and |
participants. The Office and designated regional programs may |
represent all residents and participants, but are not required |
by this Act to represent persons under 60 years of age, except |
to the extent required by federal law. When necessary and |
appropriate, representatives of the Office shall refer |
complaints to the appropriate regulatory State agency. The |
Department, in consultation with the Office, shall cooperate |
with the Department of Human Services and other State agencies |
in providing information and training to designated regional |
long term care ombudsman programs about the appropriate |
assessment and treatment (including information about |
appropriate supportive services, treatment options, and |
assessment of rehabilitation potential) of the participants |
they serve. |
The State Long Term Care Ombudsman and all other |
ombudsmen, as defined in paragraph (3.1) of subsection (b) |
must submit to background checks under the Health Care Worker |
Background Check Act and receive training, as prescribed by |
the Illinois Department on Aging, before visiting facilities, |
private homes, or community-based settings. The training must |
include information specific to assisted living |
establishments, supportive living facilities, shared housing |
establishments, private homes, and community-based settings |
and to the rights of residents and participants guaranteed |
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under the corresponding Acts and administrative rules. |
(c-5) Consumer Choice Information Reports. The Office |
shall: |
(1) In collaboration with the Attorney General, create |
a Consumer Choice Information Report form to be completed |
by all licensed long term care facilities to aid |
Illinoisans and their families in making informed choices |
about long term care. The Office shall create a Consumer |
Choice Information Report for each type of licensed long |
term care facility. The Office shall collaborate with the |
Attorney General and the Department of Human Services to |
create a Consumer Choice Information Report form for |
facilities licensed under the ID/DD Community Care Act or |
the MC/DD Act. |
(2) Develop a database of Consumer Choice Information |
Reports completed by licensed long term care facilities |
that includes information in the following consumer |
categories: |
(A) Medical Care, Services, and Treatment. |
(B) Special Services and Amenities. |
(C) Staffing. |
(D) Facility Statistics and Resident Demographics. |
(E) Ownership and Administration. |
(F) Safety and Security. |
(G) Meals and Nutrition. |
(H) Rooms, Furnishings, and Equipment. |
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(I) Family, Volunteer, and Visitation Provisions. |
(3) Make this information accessible to the public, |
including on the Internet by means of a hyperlink on the |
Office's World Wide Web home page. Information about |
facilities licensed under the ID/DD Community Care Act or |
the MC/DD Act shall be made accessible to the public by the |
Department of Human Services, including on the Internet by |
means of a hyperlink on the Department of Human Services' |
"For Customers" website. |
(4) Have the authority, with the Attorney General, to |
verify that information provided by a facility is |
accurate. |
(5) Request a new report from any licensed facility |
whenever it deems necessary. |
(6) Include in the Office's Consumer Choice |
Information Report for each type of licensed long term |
care facility additional information on each licensed long |
term care facility in the State of Illinois, including |
information regarding each facility's compliance with the |
relevant State and federal statutes, rules, and standards; |
customer satisfaction surveys; and information generated |
from quality measures developed by the Centers for |
Medicare and Medicaid Services. |
(d) Access and visitation rights. |
(1) In accordance with subparagraphs (A) and (E) of |
paragraph (3) of subsection (c) of Section 1819 and |
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subparagraphs (A) and (E) of paragraph (3) of subsection |
(c) of Section 1919 of the Social Security Act, as now or |
hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and |
42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the |
Older Americans Act of 1965, as now or hereafter amended |
(42 U.S.C. 3058f), a long term care facility, supportive |
living facility, assisted living establishment, and shared |
housing establishment must: |
(i) permit immediate access to any resident, |
regardless of age, by a designated ombudsman; |
(ii) permit representatives of the Office, with |
the permission of the resident, the resident's legal |
representative, or the resident's legal guardian, to |
examine and copy a resident's clinical and other |
records, regardless of the age of the resident, and if |
a resident is unable to consent to such review, and has |
no legal guardian, permit representatives of the |
Office appropriate access, as defined by the |
Department, in consultation with the Office, in |
administrative rules, to the resident's records; and |
(iii) permit a representative of the Program to |
communicate privately and without restriction with any |
participant who consents to the communication |
regardless of the consent of, or withholding of |
consent by, a legal guardian or an agent named in a |
power of attorney executed by the participant. |
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(2) Each long term care facility, supportive living |
facility, assisted living establishment, and shared |
housing establishment shall display, in multiple, |
conspicuous public places within the facility accessible |
to both visitors and residents and in an easily readable |
format, the address and phone number of the Office of the |
Long Term Care Ombudsman, in a manner prescribed by the |
Office. |
(e) Immunity. An ombudsman or any representative of the |
Office participating in the good faith performance of his or |
her official duties shall have immunity from any liability |
(civil, criminal or otherwise) in any proceedings (civil, |
criminal or otherwise) brought as a consequence of the |
performance of his official duties. |
(f) Business offenses. |
(1) No person shall: |
(i) Intentionally prevent, interfere with, or |
attempt to impede in any way any representative of the |
Office in the performance of his official duties under |
this Act and the Older Americans Act of 1965; or |
(ii) Intentionally retaliate, discriminate |
against, or effect reprisals against any long term |
care facility resident or employee for contacting or |
providing information to any representative of the |
Office. |
(2) A violation of this Section is a business offense, |
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punishable by a fine not to exceed $501. |
(3) The State Long Term Care Ombudsman shall notify |
the State's Attorney of the county in which the long term |
care facility, supportive living facility, or assisted |
living or shared housing establishment is located, or the |
Attorney General, of any violations of this Section. |
(g) Confidentiality of records and identities. All records |
containing resident, participant, and complainant information |
collected by the Long Term Care Ombudsman Program are |
confidential and shall not be disclosed outside of the program |
without a lawful subpoena or the permission of the State |
Ombudsman. The State Ombudsman, at his or her discretion, may |
disclose resident or participant information if it is in the |
best interest of the resident or participant. The Department |
shall establish procedures for the disclosure of program |
records by the State Ombudsman . The or the regional ombudsmen |
entities of files maintained by the program. The procedures |
shall provide that the files and records may be disclosed only |
at the discretion of the State Long Term Care Ombudsman or the |
person designated by the State Ombudsman to disclose the files |
and records, and the procedures shall prohibit the disclosure |
of the identity of any complainant, resident, participant, |
witness, or employee of a long term care provider in case |
records unless: |
(1) the complainant, resident, participant, witness, |
or employee of a long term care provider or his or her |
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legal representative consents to the disclosure and the |
consent is in writing; |
(2) the complainant, resident, participant, witness, |
or employee of a long term care provider or the resident or |
participant's legal representative gives consent orally; |
and the consent is documented contemporaneously in writing |
in accordance with such requirements as the Department |
shall establish; or |
(3) the disclosure is required by court order. |
(h) Legal representation. The Attorney General shall |
provide legal representation to any representative of the |
Office against whom suit or other legal action is brought in |
connection with the performance of the representative's |
official duties, in accordance with the State Employee |
Indemnification Act. |
(i) Treatment by prayer and spiritual means. Nothing in |
this Act shall be construed to authorize or require the |
medical supervision, regulation or control of remedial care or |
treatment of any resident in a long term care facility |
operated exclusively by and for members or adherents of any |
church or religious denomination the tenets and practices of |
which include reliance solely upon spiritual means through |
prayer for healing. |
(j) The Long Term Care Ombudsman Fund is created as a |
special fund in the State treasury to receive moneys for the |
express purposes of this Section. All interest earned on |
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moneys in the fund shall be credited to the fund. Moneys |
contained in the fund shall be used to support the purposes of |
this Section. |
(k) Each Regional Ombudsman may, in accordance with rules |
promulgated by the Office, establish a multi-disciplinary team |
to act in an advisory role for the purpose of providing |
professional knowledge and expertise in handling complex |
abuse, neglect, and advocacy issues involving participants. |
Each multi-disciplinary team may consist of one or more |
volunteer representatives from any combination of at least 7 |
members from the following professions: banking or finance; |
disability care; health care; pharmacology; law; law |
enforcement; emergency responder; mental health care; clergy; |
coroner or medical examiner; substance abuse; domestic |
violence; sexual assault; or other related fields. To support |
multi-disciplinary teams in this role, law enforcement |
agencies and coroners or medical examiners shall supply |
records as may be requested in particular cases. The Regional |
Ombudsman, or his or her designee, of the area in which the |
multi-disciplinary team is created shall be the facilitator of |
the multi-disciplinary team. |
(Source: P.A. 102-1033, eff. 1-1-23; 103-329, eff. 1-1-24 .) |