Sen. Heather A. Steans

Filed: 2/25/2014

 

 


 

 


 
09800SB0798sam001LRB098 05008 KTG 55915 a

1
AMENDMENT TO SENATE BILL 798

2    AMENDMENT NO. ______. Amend Senate Bill 798 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

 

 

09800SB0798sam001- 2 -LRB098 05008 KTG 55915 a

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" has the same meaning as in Section 1-104
18    of the Nursing Home Care Act, as now or hereafter amended;
19    that is, it means the right to:
20            (i) Enter any long term care facility or assisted
21        living or shared housing establishment or supportive
22        living facility;
23            (ii) Communicate privately and without restriction
24        with any resident, regardless of age, who consents to
25        the communication;
26            (iii) Seek consent to communicate privately and

 

 

09800SB0798sam001- 3 -LRB098 05008 KTG 55915 a

1        without restriction with any participant or resident,
2        regardless of age;
3            (iv) Inspect the clinical and other records of a
4        participant or resident, regardless of age, with the
5        express written consent of the participant or
6        resident;
7            (v) Observe all areas of the long term care
8        facility or supportive living facilities, assisted
9        living or shared housing establishment except the
10        living area of any resident who protests the
11        observation; and
12            (vi) Subject to permission of the participant or
13        resident requesting services or his or her
14        representative, enter a home or community-based
15        setting.
16        (2) "Long Term Care Facility" means (i) any facility as
17    defined by Section 1-113 of the Nursing Home Care Act, as
18    now or hereafter amended; and (ii) any skilled nursing
19    facility or a nursing facility which meets the requirements
20    of Section 1819(a), (b), (c), and (d) or Section 1919(a),
21    (b), (c), and (d) of the Social Security Act, as now or
22    hereafter amended (42 U.S.C. 1395i-3(a), (b), (c), and (d)
23    and 42 U.S.C. 1396r(a), (b), (c), and (d)); and any
24    facility as defined by Section 1-113 of the MR/DD Community
25    Care Act, as now or hereafter amended.
26        (2.5) "Assisted living establishment" and "shared

 

 

09800SB0798sam001- 4 -LRB098 05008 KTG 55915 a

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

 

 

09800SB0798sam001- 5 -LRB098 05008 KTG 55915 a

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

 

 

09800SB0798sam001- 6 -LRB098 05008 KTG 55915 a

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

 

 

09800SB0798sam001- 7 -LRB098 05008 KTG 55915 a

1supportive living facilities, shared housing establishments,
2private homes, and community-based settings and to the rights
3of residents and participants guaranteed under the
4corresponding Acts and administrative rules.
5    (c-5) Consumer Choice Information Reports. The Office
6shall:
7        (1) In collaboration with the Attorney General, create
8    a Consumer Choice Information Report form to be completed
9    by all licensed long term care facilities to aid
10    Illinoisans and their families in making informed choices
11    about long term care. The Office shall create a Consumer
12    Choice Information Report for each type of licensed long
13    term care facility. The Office shall collaborate with the
14    Attorney General and the Department of Human Services to
15    create a Consumer Choice Information Report form for
16    facilities licensed under the MR/DD Community Care Act.
17        (2) Develop a database of Consumer Choice Information
18    Reports completed by licensed long term care facilities
19    that includes information in the following consumer
20    categories:
21            (A) Medical Care, Services, and Treatment.
22            (B) Special Services and Amenities.
23            (C) Staffing.
24            (D) Facility Statistics and Resident Demographics.
25            (E) Ownership and Administration.
26            (F) Safety and Security.

 

 

09800SB0798sam001- 8 -LRB098 05008 KTG 55915 a

1            (G) Meals and Nutrition.
2            (H) Rooms, Furnishings, and Equipment.
3            (I) Family, Volunteer, and Visitation Provisions.
4        (3) Make this information accessible to the public,
5    including on the Internet by means of a hyperlink labeled
6    "Resident's Right to Know" on the Office's World Wide Web
7    home page. Information about facilities licensed under the
8    MR/DD Community Care Act shall be made accessible to the
9    public by the Department of Human Services, including on
10    the Internet by means of a hyperlink labeled "Resident's
11    and Families' Right to Know" on the Department of Human
12    Services' "For Customers" website.
13        (4) Have the authority, with the Attorney General, to
14    verify that information provided by a facility is accurate.
15        (5) Request a new report from any licensed facility
16    whenever it deems necessary.
17        (6) Include in the Office's Consumer Choice
18    Information Report for each type of licensed long term care
19    facility additional information on each licensed long term
20    care facility in the State of Illinois, including
21    information regarding each facility's compliance with the
22    relevant State and federal statutes, rules, and standards;
23    customer satisfaction surveys; and information generated
24    from quality measures developed by the Centers for Medicare
25    and Medicaid Services.
26    (d) Access and visitation rights.

 

 

09800SB0798sam001- 9 -LRB098 05008 KTG 55915 a

1        (1) In accordance with subparagraphs (A) and (E) of
2    paragraph (3) of subsection (c) of Section 1819 and
3    subparagraphs (A) and (E) of paragraph (3) of subsection
4    (c) of Section 1919 of the Social Security Act, as now or
5    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
6    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
7    Older Americans Act of 1965, as now or hereafter amended
8    (42 U.S.C. 3058f), a long term care facility, supportive
9    living facility, assisted living establishment, and shared
10    housing establishment must:
11            (i) permit immediate access to any resident,
12        regardless of age, by a designated ombudsman; and
13            (ii) permit representatives of the Office, with
14        the permission of the resident's legal representative
15        or legal guardian, to examine a resident's clinical and
16        other records, regardless of the age of the resident,
17        and if a resident is unable to consent to such review,
18        and has no legal guardian, permit representatives of
19        the Office appropriate access, as defined by the
20        Department, in consultation with the Office, in
21        administrative rules, to the resident's records; and .
22            (iii) permit a representative of the Program to:
23                (A) communicate privately and without
24            restriction with any resident or participant who
25            consents to the communication; and
26                (B) approach and communicate privately with

 

 

09800SB0798sam001- 10 -LRB098 05008 KTG 55915 a

1            any resident or participant regardless of the
2            consent of, or withholding of consent by, any
3            health care agent or guardian of the resident or
4            participant.
5        (2) Each long term care facility, supportive living
6    facility, assisted living establishment, and shared
7    housing establishment shall display, in multiple,
8    conspicuous public places within the facility accessible
9    to both visitors and residents and in an easily readable
10    format, the address and phone number of the Office of the
11    Long Term Care Ombudsman, in a manner prescribed by the
12    Office.
13    (e) Immunity. An ombudsman or any representative of the
14Office participating in the good faith performance of his or
15her official duties shall have immunity from any liability
16(civil, criminal or otherwise) in any proceedings (civil,
17criminal or otherwise) brought as a consequence of the
18performance of his official duties.
19    (f) Business offenses.
20        (1) No person shall:
21            (i) Intentionally prevent, interfere with, or
22        attempt to impede in any way any representative of the
23        Office in the performance of his official duties under
24        this Act and the Older Americans Act of 1965; or
25            (ii) Intentionally retaliate, discriminate
26        against, or effect reprisals against any long term care

 

 

09800SB0798sam001- 11 -LRB098 05008 KTG 55915 a

1        facility resident or employee for contacting or
2        providing information to any representative of the
3        Office.
4        (2) A violation of this Section is a business offense,
5    punishable by a fine not to exceed $5,000 for a first
6    offense, $10,000 for a second offense, and $15,000 for a
7    third and each subsequent offense. All fines collected
8    under this paragraph shall be deposited into the Long Term
9    Care Ombudsman Fund. $501.
10        (3) The State Long Term Care Ombudsman Director of
11    Aging, in consultation with the Office, shall notify the
12    State's Attorney of the county in which the long term care
13    facility, supportive living facility, or assisted living
14    or shared housing establishment is located, or the Attorney
15    General, of any violations of this Section.
16    (g) Confidentiality of records and identities. The
17Department shall establish procedures for the disclosure by the
18State Ombudsman or the regional ombudsmen entities of files
19maintained by the program. The procedures shall provide that
20the files and records may be disclosed only at the discretion
21of the State Long Term Care Ombudsman or the person designated
22by the State Ombudsman to disclose the files and records, and
23the procedures shall prohibit the disclosure of the identity of
24any complainant, resident, participant, witness, or employee
25of a long term care provider unless:
26        (1) the complainant, resident, participant, witness,

 

 

09800SB0798sam001- 12 -LRB098 05008 KTG 55915 a

1    or employee of a long term care provider or his or her
2    legal representative consents to the disclosure and the
3    consent is in writing;
4        (2) the complainant, resident, participant, witness,
5    or employee of a long term care provider gives consent
6    orally; and the consent is documented contemporaneously in
7    writing in accordance with such requirements as the
8    Department shall establish; or
9        (3) the disclosure is required by court order.
10    (h) Legal representation. The Attorney General shall
11provide legal representation to any representative of the
12Office against whom suit or other legal action is brought in
13connection with the performance of the representative's
14official duties, in accordance with the State Employee
15Indemnification Act.
16    (i) Treatment by prayer and spiritual means. Nothing in
17this Act shall be construed to authorize or require the medical
18supervision, regulation or control of remedial care or
19treatment of any resident in a long term care facility operated
20exclusively by and for members or adherents of any church or
21religious denomination the tenets and practices of which
22include reliance solely upon spiritual means through prayer for
23healing.
24    (j) The Long Term Care Ombudsman Fund is created as a
25special fund in the State treasury to receive moneys for the
26express purposes of this Section. All interest earned on moneys

 

 

09800SB0798sam001- 13 -LRB098 05008 KTG 55915 a

1in the fund shall be credited to the fund. Moneys contained in
2the fund shall be used to support the purposes of this Section.
3    (k) Each Regional Ombudsman may, in accordance with rules
4promulgated by the Office, establish a multi-disciplinary team
5to act in an advisory role for the purpose of providing
6professional knowledge and expertise in handling complex
7abuse, neglect, and advocacy issues involving participants.
8Each multi-disciplinary team may consist of one or more
9volunteer representatives from any combination of at least 7
10members from the following professions: banking or finance;
11disability care; health care; pharmacology; law; law
12enforcement; emergency responder; mental health care; clergy;
13coroner or medical examiner; substance abuse; domestic
14violence; sexual assault; or other related fields. To support
15multi-disciplinary teams in this role, law enforcement
16agencies and coroners or medical examiners shall supply records
17as may be requested in particular cases. The Regional
18Ombudsman, or his or her designee, of the area in which the
19multi-disciplinary team is created shall be the facilitator of
20the multi-disciplinary team.
21(Source: P.A. 97-38, eff. 6-28-11; 98-380, eff. 8-16-13.)
 
22    Section 99. Effective date. This Act takes effect January
231, 2015.".