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| Public Act 099-0712 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Act on the Aging is amended by | ||||
changing Section 4.04 as follows:
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(20 ILCS 105/4.04) (from Ch. 23, par. 6104.04)
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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.
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(a) Long Term Care Ombudsman Program. The Department shall
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establish a Long Term Care Ombudsman Program, through the | ||||
Office of State
Long Term Care Ombudsman ("the Office"), in | ||||
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.
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(b) Definitions. As used in this Section, unless the | ||
context requires
otherwise:
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(1) "Access" means the right to:
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(i) Enter any long term care facility or assisted | ||
living or shared
housing establishment or supportive | ||
living facility;
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(ii) Communicate privately and without restriction | ||
with any resident, regardless of age,
who consents to | ||
the communication;
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(iii) Seek consent to communicate privately and | ||
without restriction
with any participant or resident, | ||
regardless of age;
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(iv) Inspect the clinical and other records of a | ||
participant or resident, regardless of age, with the
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express written consent of the participant or | ||
resident;
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(v) Observe all areas of the long term care | ||
facility or supportive
living facilities, assisted | ||
living or shared housing establishment except the
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living area of any resident who protests the | ||
observation; and
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(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),
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(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; and (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.
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(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.
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(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.
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(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
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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.
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(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. | ||
(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.
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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 of social services agencies,
which may | ||
adversely affect the health, safety, welfare, or rights of such
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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.
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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 under the | ||
corresponding Acts and administrative rules.
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(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. | ||
(I) Family, Volunteer, and Visitation Provisions. | ||
(3) Make this information accessible to the public, | ||
including on the Internet by means of a hyperlink labeled | ||
"Resident's Right to Know" 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 | ||
labeled "Resident's and Families' Right to Know" 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.
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(6) Include in the Office's Consumer Choice
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Information Report for each type of licensed long term care
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facility additional information on each licensed long term
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care facility in the State of Illinois, including
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information regarding each facility's compliance with the
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relevant State and federal statutes, rules, and standards;
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customer satisfaction surveys; and information generated
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from quality measures developed by the Centers for Medicare
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and Medicaid Services. | ||
(d) Access and visitation rights.
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(1) In accordance with subparagraphs (A) and (E) of | ||
paragraph (3) of
subsection (c) of Section 1819
and | ||
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:
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(i) permit immediate access to any resident, | ||
regardless of age, by a designated
ombudsman;
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(ii) permit representatives of the Office, with | ||
the permission of the
resident's legal representative | ||
or legal guardian, to examine 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
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(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. | ||
(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
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Long Term Care Ombudsman, in a manner prescribed by the | ||
Office.
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(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.
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(f) Business offenses.
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(1) No person shall:
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(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
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(ii) Intentionally retaliate, discriminate | ||
against, or effect reprisals
against any long term care | ||
facility resident or employee for contacting or
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providing information to any representative of the | ||
Office.
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(2) A violation of this Section is a business offense, | ||
punishable by a
fine not to exceed $501.
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(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.
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(g) Confidentiality of records and identities. The | ||
Department shall
establish procedures for the disclosure by the | ||
State Ombudsman or the regional
ombudsmen
entities of files | ||
maintained by the program. The procedures shall provide that
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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
unless:
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(1) the complainant, resident, participant, witness, | ||
or employee of a long term care
provider or his or her | ||
legal representative consents to the disclosure and the
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consent is in writing;
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(2) the complainant, resident, participant, witness, | ||
or employee of a long term care
provider gives consent | ||
orally; and the consent is documented contemporaneously
in | ||
writing in
accordance with such requirements as the | ||
Department shall establish; or
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(3) the disclosure is required by court order.
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(h) Legal representation. The Attorney General shall
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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.
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(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.
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(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 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. 98-380, eff. 8-16-13; 98-989, eff. 1-1-15; | ||
99-180, eff. 7-29-15.)
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Section 10. The Specialized Mental Health Rehabilitation | ||
Act of 2013 is amended by changing Sections 4-103, 4-105, and | ||
4-201 as follows: | ||
(210 ILCS 49/4-103)
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Sec. 4-103. Provisional licensure emergency rules. The | ||
Department, in consultation with the Division of Mental Health | ||
of the Department of Human Services and the Department of | ||
Healthcare and Family Services, is granted the authority under | ||
this Act to establish provisional licensure and licensing | ||
procedures by emergency rule. The Department shall file | ||
emergency rules concerning provisional licensure under this | ||
Act within 120 days after the effective date of this Act. The | ||
rules to be filed for provisional licensure shall be for a | ||
period of 3 years, beginning with the adoption date of the | ||
emergency rules establishing the provisional license, and | ||
shall not be extended beyond the date of 3 years after the | ||
effective date of the emergency rules creating the provisional | ||
license and licensing process. Rules governing the provisional | ||
license and licensing process shall contain rules for the | ||
different levels of care offered by the facilities authorized | ||
under this Act and shall address each type of care hereafter | ||
enumerated: | ||
(1) triage centers; | ||
(2) crisis stabilization; | ||
(3) recovery and rehabilitation supports; | ||
(4) transitional living units; or | ||
(5) other intensive treatment and stabilization | ||
programs designed and developed in collaboration with the | ||
Department.
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(Source: P.A. 98-104, eff. 7-22-13.) | ||
(210 ILCS 49/4-105)
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Sec. 4-105. Provisional licensure duration. A provisional | ||
license shall be valid upon fulfilling the requirements | ||
established by the Department by emergency rule. The license | ||
shall remain valid as long as a facility remains in compliance | ||
with the licensure provisions established in rule. Provisional | ||
licenses issued upon initial licensure as a specialized mental | ||
health rehabilitation facility shall expire at the end of a | ||
3-year period, which commences on the date the provisional | ||
license is issued. Issuance of a provisional license for any | ||
reason other than initial licensure (including, but not limited | ||
to, change of ownership, location, number of beds, or services) | ||
shall not extend the maximum 3-year period, at the end of which | ||
a facility must be licensed pursuant to Section 4-201. The | ||
provisional license shall expire when the administrative rule | ||
established by the Department for provisional licensure | ||
expires at the end of a 3-year period.
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(Source: P.A. 98-104, eff. 7-22-13.) | ||
(210 ILCS 49/4-201)
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Sec. 4-201. Accreditation and licensure. At the end of the | ||
provisional licensure period established in Article 3, Part 1 | ||
of this Article 4 Act, the Department shall license a facility | ||
as a specialized mental health rehabilitation facility under | ||
this Act that successfully completes and obtains valid national | ||
accreditation in behavioral health from a recognized national | ||
accreditation entity and complies with licensure standards as | ||
established by the Department of Public Health in | ||
administrative rule. Rules governing licensure standards shall | ||
include, but not be limited to, appropriate fines and sanctions | ||
associated with violations of laws or regulations. The | ||
following shall be considered to be valid national | ||
accreditation in behavioral health from an national | ||
accreditation entity: | ||
(1) the Joint Commission; | ||
(2) the Commission on Accreditation of Rehabilitation | ||
Facilities; | ||
(3) the Healthcare Facilities Accreditation Program; | ||
or | ||
(4) any other national standards of care as approved by | ||
the Department.
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(Source: P.A. 98-104, eff. 7-22-13.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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