Public Act 099-0712
 
HB5009 EnrolledLRB099 18341 MJP 42716 b

    AN ACT concerning regulation.
 
    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
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 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
        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; 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.
        (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.
        (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.
        (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 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 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.
            (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.
        (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
    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'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
            (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
    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,
    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. 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
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:
        (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
    consent is in writing;
        (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
        (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 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.)
 
    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)
    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.
(Source: P.A. 98-104, eff. 7-22-13.)
 
    (210 ILCS 49/4-105)
    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.
(Source: P.A. 98-104, eff. 7-22-13.)
 
    (210 ILCS 49/4-201)
    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.
(Source: P.A. 98-104, eff. 7-22-13.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.