HB5544 99TH GENERAL ASSEMBLY

LRB099 18954 MJP 43343 b

99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB5544

Introduced , by Rep. Carol Ammons

SYNOPSIS AS INTRODUCED:

210 ILCS 9/90
210 ILCS 9/150

Amends the Assisted Living and Shared Housing Act. Requires assisted living and shared housing establishment's service delivery contracts to include a copy of the establishment's emergency involuntary termination of residency plan and the establishment's discharge protocol. Requires establishments covered by the Act to develop a discharge protocol and an emergency involuntary termination plan. Defines "emergency involuntary termination of residency plan" and "discharge protocol". Requires establishments that accept Alzheimer's and dementia patients within 30 days of admission or 30 days after an establishment's existing resident is diagnosed with Alzheimer's or dementia to develop a pre-emptive plan of discharge for the resident. Contains requirements for emergency involuntary termination of residency plans and discharge protocols. Effective immediately.

A BILL FOR

AN ACT concerning regulation.

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

Section 5. The Assisted Living and Shared Housing Act is amended by changing Sections 90 and 150 as follows:

(210 ILCS 9/90)

Sec. 90. Contents of service delivery contract. A contract between an establishment and a resident must be entitled "assisted living establishment contract" or "shared housing establishment contract" as applicable, shall be printed in no less than 12 point type, and shall include at least the following elements in the body or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if the owner or owners are not natural persons, the type of business entity of the owner or owners;

(3) the name and mailing address of the managing agent of the establishment, whether hired under a management agreement or lease agreement, if the managing agent is different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept service on behalf of the owners and managing agent;

(5) a statement describing the license status of the establishment and the license status of all providers of health-related or supportive services to a resident under arrangement with the establishment;

(6) the duration of the contract;

(7) the base rate to be paid by the resident and a description of the services to be provided as part of this rate;

(8) a description of any additional services to be provided for an additional fee by the establishment directly or by a third party provider under arrangement with the establishment;

(9) the fee schedules outlining the cost of any additional services;

(10) a description of the process through which the contract may be modified, amended, or terminated;

(11) a description of the establishment's complaint resolution process available to residents and notice of the availability of the Department on Aging's Senior Helpline for complaints;

(12) the name of the resident's designated representative, if any;

(13) the resident's obligations in order to maintain residency and receive services including compliance with all assessments required under Section 15;

(14) the billing and payment procedures and requirements;

(15) a statement affirming the resident's freedom to receive services from service providers with whom the establishment does not have a contractual arrangement, which may also disclaim liability on the part of the establishment for those services;

(16) a statement that medical assistance under Article V or Article VI of the Illinois Public Aid Code is not available for payment for services provided in an establishment, excluding contracts executed with residents residing in licensed establishments participating in the Department on Aging's Comprehensive Care in Residential Settings Demonstration Project;

(17) a statement detailing the admission, risk management, and residency termination criteria and procedures;

(18) a statement listing the rights specified in Section 95 and acknowledging that, by contracting with the assisted living or shared housing establishment, the resident does not forfeit those rights;

(19) a statement detailing the Department's annual on-site review process including what documents contained in a resident's personal file shall be reviewed by the on-site reviewer as defined by rule; and

(20) a statement outlining whether the establishment charges a community fee and, if so, the amount of the fee and whether it is refundable; if the fee is refundable, the contract must describe the conditions under which it is refundable and how the amount of the refund is determined; and .

(21) a copy of the establishment's emergency involuntary termination of residency plan and the establishment's discharge protocol, as defined in Section 150 of this Act.

(Source: P.A. 93-775, eff. 1-1-05; 94-256, eff. 7-19-05.)

(210 ILCS 9/150)

Sec. 150. Alzheimer and dementia programs.

(a) In addition to this Section, Alzheimer and dementia programs shall comply with all of the other provisions of this Act.

(b) No person shall be admitted or retained if the assisted living or shared housing establishment cannot provide or secure appropriate care, if the resident requires a level of service or type of service for which the establishment is not licensed or which the establishment does not provide, or if the establishment does not have the staff appropriate in numbers and with appropriate skill to provide such services.

(c) No person shall be accepted for residency or remain in residence if the person's mental or physical condition has so deteriorated to render residency in such a program to be detrimental to the health, welfare or safety of the person or of other residents of the establishment. The Department by rule shall identify a validated dementia-specific standard with inter-rater reliability that will be used to assess individual residents. The assessment must be approved by the resident's physician and shall occur prior to acceptance for residency, annually, and at such time that a change in the resident's condition is identified by a family member, staff of the establishment, or the resident's physician.

(d) No person shall be accepted for residency or remain in residence if the person is dangerous to self or others and the establishment would be unable to eliminate the danger through the use of appropriate treatment modalities.

(e) No person shall be accepted for residency or remain in residence if the person meets the criteria provided in subsections (b) through (g) of Section 75 of this Act.

(f) An establishment that offers to provide a special program or unit for persons with Alzheimer's disease and related disorders shall:

(1) disclose to the Department and to a potential or actual resident of the establishment information as specified under the Alzheimer's Disease and Related Dementias Special Care Disclosure Act;

(2) ensure that a resident's representative is designated for the resident;

(3) develop and implement policies and procedures that ensure the continued safety of all residents in the establishment including, but not limited to, those who:

(A) may wander; and

(B) may need supervision and assistance when evacuating the building in an emergency;

(4) provide coordination of communications with each resident, resident's representative, relatives and other persons identified in the resident's service plan;

(5) provide cognitive stimulation and activities to maximize functioning;

(6) provide an appropriate number of staff for its resident population, as established by rule;

(7) require the director or administrator and direct care staff to complete sufficient comprehensive and ongoing dementia and cognitive deficit training, the content of which shall be established by rule; and

(8) develop emergency procedures, a discharge protocol, an emergency involuntary termination plan, and staffing patterns to respond to the needs of residents.

(g) For the purposes of this Section, an emergency involuntary termination of residency plan applies only to residents with Alzheimer's disease or a related dementia. In this Section, "emergency involuntary termination of residency plan" means a plan to better inform individuals being admitted, caregivers, legal guardians, health care power of attorneys, or family members who are seeking to place an individual with Alzheimer's disease or related dementias, of the discharge process. Some individuals with Alzheimer's disease or related dementias may be at risk of dangerous behavior due to their cognitive impairment and difficulty understanding and adjusting to a new environment, particularly if that environment is not structured to meet their needs. This Section serves to ensure that the establishment has developed and communicates to individuals served, legal representatives, and family members their strategy for preventing discharge, and their discharge protocol. In this Section, "discharge protocol" means the involuntary discharge procedures of the applicable facility. The discharge protocol includes resources that would potentially be accessed should discharge be considered and the rights and responsibilities of the individuals being served and their representatives.

Within 30 days of admission, an establishment that accepts Alzheimer's and dementia patients is required to develop a pre-emptive plan of discharge to be used should an involuntary discharge occur based on disruptive behavior or physical harm to themselves or others housed in the establishment.

If an individual is diagnosed while a resident of an establishment, the establishment has 30 days after the official diagnosis date to develop a pre-emptive plan of discharge to be used should an involuntary discharge occur.

The emergency involuntary termination of residency plan shall include the following:

(1) An inventory of the individual's interests and preferences.

(2) An inventory of the individual's dislikes, triggers, and early warning signs.

(3) Strategies tailored to the individual's interests and preferences designed to prevent disruptive or harmful behavior or to aid the individual in calming when they are upset. Best practice examples include access to the individual's music preferences or engaging in an activity that they enjoy.

(4) A method of educating care staff about the items (1) through (3) and verifying their competence to carry out the strategies.

The establishment's discharge protocol is a description of the procedures to prevent and respond to dangerous behavior and includes the following:

(A) The establishment's strategy for identifying warning signs of dangerous behavior.

(B) The establishment's strategy for creating a calming environment to decrease common triggers such as noise levels, over-stimulus from televisions, and lack of a comfortable quiet space.

(C) The establishment's strategy for responding to warning signs to prevent escalation.

(D) After the occurrence of a dangerous behavior, the establishment's strategy for preventing additional dangerous behaviors such as a time-limited assignment of extra staff to assist in engaging the individual in positive behaviors.

(E) Resources that would be used by the establishment as a temporary measure to assure safety such as evaluation by a dementia expert, respite in a more structured facility, and evaluation in a hospital or geriatric psychiatry unit.

(F) The individual, family, and legal representative's rights and responsibilities in these situations, including the process for appeal or providing feedback.

(G) A list of facilities that are potential placement resources should discharge be needed.

(Source: P.A. 96-990, eff. 7-2-10.)

Section 99. Effective date. This Act takes effect upon becoming law.