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1 | AN ACT concerning State government. | ||||||
2 | Be it enacted by the People of the State of Illinois, | ||||||
3 | represented in the General Assembly: | ||||||
4 | Section 5. The Illinois Act on the Aging is amended by | ||||||
5 | changing 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 | ||||||
8 | of the Long Term Care Ombudsman Program is to ensure that older | ||||||
9 | persons and persons with disabilities receive quality | ||||||
10 | services. This is accomplished by providing advocacy services | ||||||
11 | for residents of long term care facilities and participants | ||||||
12 | receiving home care and community-based care. Managed care is | ||||||
13 | increasingly becoming the vehicle for delivering health and | ||||||
14 | long-term services and supports to seniors and persons with | ||||||
15 | disabilities, including dual eligible participants. The | ||||||
16 | additional ombudsman authority will allow advocacy services to | ||||||
17 | be provided to Illinois participants for the first time and | ||||||
18 | will produce a cost savings for the State of Illinois by | ||||||
19 | supporting the rebalancing efforts of the Patient Protection | ||||||
20 | and Affordable Care Act. | ||||||
21 | (a) Long Term Care Ombudsman Program. The Department shall | ||||||
22 | establish a Long Term Care Ombudsman Program, through the | ||||||
23 | Office of State Long Term Care Ombudsman ("the Office"), in |
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1 | accordance with the provisions of the Older Americans Act of | ||||||
2 | 1965, as now or hereafter amended. The Long Term Care | ||||||
3 | Ombudsman Program is authorized, subject to sufficient | ||||||
4 | appropriations, to advocate on behalf of older persons and | ||||||
5 | persons with disabilities residing in their own homes or | ||||||
6 | community-based settings, relating to matters which may | ||||||
7 | adversely affect the health, safety, welfare, or rights of | ||||||
8 | such individuals. | ||||||
9 | (b) Definitions. As used in this Section, unless the | ||||||
10 | context requires otherwise: | ||||||
11 | (1) "Access" means the right to: | ||||||
12 | (i) Enter any long term care facility or assisted | ||||||
13 | living or shared housing establishment or supportive | ||||||
14 | living facility; | ||||||
15 | (ii) Communicate privately and without restriction | ||||||
16 | with any resident, regardless of age, who consents to | ||||||
17 | the communication; | ||||||
18 | (iii) Seek consent to communicate privately and | ||||||
19 | without restriction with any participant or resident, | ||||||
20 | regardless of age; | ||||||
21 | (iv) Inspect and copy the clinical and other | ||||||
22 | records of a participant or resident, regardless of | ||||||
23 | age, with the express written consent of the | ||||||
24 | participant or resident , or if consent is given | ||||||
25 | orally, visually, or through the use of auxiliary aids | ||||||
26 | and services, such consent is documented |
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1 | contemporaneously by a representative of the Office in | ||||||
2 | accordance with such procedures ; | ||||||
3 | (v) Observe all areas of the long term care | ||||||
4 | facility or supportive living facilities, assisted | ||||||
5 | living or shared housing establishment except the | ||||||
6 | living area of any resident who protests the | ||||||
7 | observation; and | ||||||
8 | (vi) Subject to permission of the participant or | ||||||
9 | resident requesting services or his or her | ||||||
10 | representative, enter a home or community-based | ||||||
11 | setting. | ||||||
12 | (2) "Long Term Care Facility" means (i) any facility | ||||||
13 | as defined by Section 1-113 of the Nursing Home Care Act, | ||||||
14 | as now or hereafter amended; (ii) any skilled nursing | ||||||
15 | facility or a nursing facility which meets the | ||||||
16 | requirements of Section 1819(a), (b), (c), and (d) or | ||||||
17 | Section 1919(a), (b), (c), and (d) of the Social Security | ||||||
18 | Act, as now or hereafter amended (42 U.S.C. 1395i-3(a), | ||||||
19 | (b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and | ||||||
20 | (d)); (iii) any facility as defined by Section 1-113 of | ||||||
21 | the ID/DD Community Care Act, as now or hereafter amended; | ||||||
22 | (iv) any facility as defined by Section 1-113 of MC/DD | ||||||
23 | Act, as now or hereafter amended; and (v) any facility | ||||||
24 | licensed under Section 4-105 or 4-201 of the Specialized | ||||||
25 | Mental Health Rehabilitation Act of 2013, as now or | ||||||
26 | hereafter amended. |
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1 | (2.5) "Assisted living establishment" and "shared | ||||||
2 | housing establishment" have the meanings given those terms | ||||||
3 | in Section 10 of the Assisted Living and Shared Housing | ||||||
4 | Act. | ||||||
5 | (2.7) "Supportive living facility" means a facility | ||||||
6 | established under Section 5-5.01a of the Illinois Public | ||||||
7 | Aid Code. | ||||||
8 | (2.8) "Community-based setting" means any place of | ||||||
9 | abode other than an individual's private home. | ||||||
10 | (3) "State Long Term Care Ombudsman" means any person | ||||||
11 | employed by the Department to fulfill the requirements of | ||||||
12 | the Office of State Long Term Care Ombudsman as required | ||||||
13 | under the Older Americans Act of 1965, as now or hereafter | ||||||
14 | amended, and Departmental policy. | ||||||
15 | (3.1) "Ombudsman" means any designated representative | ||||||
16 | of the State Long Term Care Ombudsman Program; provided | ||||||
17 | that the representative, whether he is paid for or | ||||||
18 | volunteers his ombudsman services, shall be qualified and | ||||||
19 | designated by the Office to perform the duties of an | ||||||
20 | ombudsman as specified by the Department in rules and in | ||||||
21 | accordance with the provisions of the Older Americans Act | ||||||
22 | of 1965, as now or hereafter amended. | ||||||
23 | (4) "Participant" means an older person aged 60 or | ||||||
24 | over or an adult with a disability aged 18 through 59 who | ||||||
25 | is eligible for services under any of the following: | ||||||
26 | (i) A medical assistance waiver administered by |
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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 | ||||||
6 | or an adult with a disability aged 18 through 59 who | ||||||
7 | resides in a long-term care facility. | ||||||
8 | (c) Ombudsman; rules. The Office of State Long Term Care | ||||||
9 | Ombudsman shall be composed of at least one full-time | ||||||
10 | ombudsman and shall include a system of designated regional | ||||||
11 | long term care ombudsman programs. Each regional program shall | ||||||
12 | be designated by the State Long Term Care Ombudsman as a | ||||||
13 | subdivision of the Office and any representative of a regional | ||||||
14 | program shall be treated as a representative of the Office. | ||||||
15 | The Department, in consultation with the Office, shall | ||||||
16 | promulgate administrative rules in accordance with the | ||||||
17 | provisions of the Older Americans Act of 1965, as now or | ||||||
18 | hereafter amended, to establish the responsibilities of the | ||||||
19 | Department and the Office of State Long Term Care Ombudsman | ||||||
20 | and the designated regional Ombudsman programs. The | ||||||
21 | administrative rules shall include the responsibility of the | ||||||
22 | Office and designated regional programs to investigate and | ||||||
23 | resolve complaints made by or on behalf of residents of long | ||||||
24 | term care facilities, supportive living facilities, and | ||||||
25 | assisted living and shared housing establishments, and | ||||||
26 | participants residing in their own homes or community-based |
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1 | settings, including the option to serve residents and | ||||||
2 | participants under the age of 60, relating to actions, | ||||||
3 | inaction, or decisions of providers, or their representatives, | ||||||
4 | of such facilities and establishments, of public agencies, or | ||||||
5 | of social services agencies, which may adversely affect the | ||||||
6 | health, safety, welfare, or rights of such residents and | ||||||
7 | participants. The Office and designated regional programs may | ||||||
8 | represent all residents and participants, but are not required | ||||||
9 | by this Act to represent persons under 60 years of age, except | ||||||
10 | to the extent required by federal law. When necessary and | ||||||
11 | appropriate, representatives of the Office shall refer | ||||||
12 | complaints to the appropriate regulatory State agency. The | ||||||
13 | Department, in consultation with the Office, shall cooperate | ||||||
14 | with the Department of Human Services and other State agencies | ||||||
15 | in providing information and training to designated regional | ||||||
16 | long term care ombudsman programs about the appropriate | ||||||
17 | assessment and treatment (including information about | ||||||
18 | appropriate supportive services, treatment options, and | ||||||
19 | assessment of rehabilitation potential) of the participants | ||||||
20 | they serve. | ||||||
21 | The State Long Term Care Ombudsman and all other | ||||||
22 | ombudsmen, as defined in paragraph (3.1) of subsection (b) | ||||||
23 | must submit to background checks under the Health Care Worker | ||||||
24 | Background Check Act and receive training, as prescribed by | ||||||
25 | the Illinois Department on Aging, before visiting facilities, | ||||||
26 | private homes, or community-based settings. The training must |
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1 | include information specific to assisted living | ||||||
2 | establishments, supportive living facilities, shared housing | ||||||
3 | establishments, private homes, and community-based settings | ||||||
4 | and to the rights of residents and participants guaranteed | ||||||
5 | under the corresponding Acts and administrative rules. | ||||||
6 | (c-5) Consumer Choice Information Reports. The Office | ||||||
7 | shall: | ||||||
8 | (1) In collaboration with the Attorney General, create | ||||||
9 | a Consumer Choice Information Report form to be completed | ||||||
10 | by all licensed long term care facilities to aid | ||||||
11 | Illinoisans and their families in making informed choices | ||||||
12 | about long term care. The Office shall create a Consumer | ||||||
13 | Choice Information Report for each type of licensed long | ||||||
14 | term care facility. The Office shall collaborate with the | ||||||
15 | Attorney General and the Department of Human Services to | ||||||
16 | create a Consumer Choice Information Report form for | ||||||
17 | facilities licensed under the ID/DD Community Care Act or | ||||||
18 | the MC/DD Act. | ||||||
19 | (2) Develop a database of Consumer Choice Information | ||||||
20 | Reports completed by licensed long term care facilities | ||||||
21 | that includes information in the following consumer | ||||||
22 | categories: | ||||||
23 | (A) Medical Care, Services, and Treatment. | ||||||
24 | (B) Special Services and Amenities. | ||||||
25 | (C) Staffing. | ||||||
26 | (D) Facility Statistics and Resident Demographics. |
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1 | (E) Ownership and Administration. | ||||||
2 | (F) Safety and Security. | ||||||
3 | (G) Meals and Nutrition. | ||||||
4 | (H) Rooms, Furnishings, and Equipment. | ||||||
5 | (I) Family, Volunteer, and Visitation Provisions. | ||||||
6 | (3) Make this information accessible to the public, | ||||||
7 | including on the Internet by means of a hyperlink on the | ||||||
8 | Office's World Wide Web home page. Information about | ||||||
9 | facilities licensed under the ID/DD Community Care Act or | ||||||
10 | the MC/DD Act shall be made accessible to the public by the | ||||||
11 | Department of Human Services, including on the Internet by | ||||||
12 | means of a hyperlink on the Department of Human Services' | ||||||
13 | "For Customers" website. | ||||||
14 | (4) Have the authority, with the Attorney General, to | ||||||
15 | verify that information provided by a facility is | ||||||
16 | accurate. | ||||||
17 | (5) Request a new report from any licensed facility | ||||||
18 | whenever it deems necessary. | ||||||
19 | (6) Include in the Office's Consumer Choice | ||||||
20 | Information Report for each type of licensed long term | ||||||
21 | care facility additional information on each licensed long | ||||||
22 | term care facility in the State of Illinois, including | ||||||
23 | information regarding each facility's compliance with the | ||||||
24 | relevant State and federal statutes, rules, and standards; | ||||||
25 | customer satisfaction surveys; and information generated | ||||||
26 | from quality measures developed by the Centers for |
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1 | Medicare and Medicaid Services. | ||||||
2 | (d) Access and visitation rights. | ||||||
3 | (1) In accordance with subparagraphs (A) and (E) of | ||||||
4 | paragraph (3) of subsection (c) of Section 1819 and | ||||||
5 | subparagraphs (A) and (E) of paragraph (3) of subsection | ||||||
6 | (c) of Section 1919 of the Social Security Act, as now or | ||||||
7 | hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and | ||||||
8 | 42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the | ||||||
9 | Older Americans Act of 1965, as now or hereafter amended | ||||||
10 | (42 U.S.C. 3058f), a long term care facility, supportive | ||||||
11 | living facility, assisted living establishment, and shared | ||||||
12 | housing establishment must: | ||||||
13 | (i) permit immediate access to any resident, | ||||||
14 | regardless of age, by a designated ombudsman; | ||||||
15 | (ii) permit representatives of the Office, with | ||||||
16 | the permission of the resident, the resident's legal | ||||||
17 | representative, or the resident's legal guardian, to | ||||||
18 | examine and copy a resident's clinical and other | ||||||
19 | records, including facility reports of incidents or | ||||||
20 | occurrences made to State agencies, regardless of the | ||||||
21 | age of the resident, and if a resident is unable to | ||||||
22 | consent to such review, and has no legal guardian, | ||||||
23 | permit representatives of the Office appropriate | ||||||
24 | access, as defined by the Department, in consultation | ||||||
25 | with the Office, in administrative rules, to the | ||||||
26 | resident's records; and |
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1 | (iii) permit a representative of the Program to | ||||||
2 | communicate privately and without restriction with any | ||||||
3 | participant who consents to the communication | ||||||
4 | regardless of the consent of, or withholding of | ||||||
5 | consent by, a legal guardian or an agent named in a | ||||||
6 | power of attorney executed by the participant. | ||||||
7 | (2) Each long term care facility, supportive living | ||||||
8 | facility, assisted living establishment, and shared | ||||||
9 | housing establishment shall display, in multiple, | ||||||
10 | conspicuous public places within the facility accessible | ||||||
11 | to both visitors and residents and in an easily readable | ||||||
12 | format, the address and phone number of the Office of the | ||||||
13 | Long Term Care Ombudsman, in a manner prescribed by the | ||||||
14 | Office. | ||||||
15 | (e) Immunity. An ombudsman or any representative of the | ||||||
16 | Office participating in the good faith performance of his or | ||||||
17 | her official duties shall have immunity from any liability | ||||||
18 | (civil, criminal or otherwise) in any proceedings (civil, | ||||||
19 | criminal or otherwise) brought as a consequence of the | ||||||
20 | performance of his official duties. | ||||||
21 | (f) Business offenses. | ||||||
22 | (1) No person shall: | ||||||
23 | (i) Intentionally prevent, interfere with, or | ||||||
24 | attempt to impede in any way any representative of the | ||||||
25 | Office in the performance of his official duties under | ||||||
26 | this Act and the Older Americans Act of 1965; or |
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1 | (ii) Intentionally retaliate, discriminate | ||||||
2 | against, or effect reprisals against any long term | ||||||
3 | care facility resident or employee for contacting or | ||||||
4 | providing information to any representative of the | ||||||
5 | Office. | ||||||
6 | (2) A violation of this Section is a business offense, | ||||||
7 | punishable by a fine not to exceed $501. | ||||||
8 | (3) The State Long Term Care Ombudsman shall notify | ||||||
9 | the State's Attorney of the county in which the long term | ||||||
10 | care facility, supportive living facility, or assisted | ||||||
11 | living or shared housing establishment is located, or the | ||||||
12 | Attorney General, of any violations of this Section. | ||||||
13 | (g) Confidentiality of records and identities. The | ||||||
14 | Department shall establish procedures for the disclosure by | ||||||
15 | the State Ombudsman or the regional ombudsmen entities of | ||||||
16 | files maintained by the program. The procedures shall provide | ||||||
17 | that the files and records may be disclosed only at the | ||||||
18 | discretion of the State Long Term Care Ombudsman or the person | ||||||
19 | designated by the State Ombudsman to disclose the files and | ||||||
20 | records, and the procedures shall prohibit the disclosure of | ||||||
21 | the identity of any complainant, resident, participant, | ||||||
22 | witness, or employee of a long term care provider unless: | ||||||
23 | (1) the complainant, resident, participant, witness, | ||||||
24 | or employee of a long term care provider or his or her | ||||||
25 | legal representative consents to the disclosure and the | ||||||
26 | consent is in writing; |
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1 | (2) the complainant, resident, participant, witness, | ||||||
2 | or employee of a long term care provider gives consent | ||||||
3 | orally; and the consent is documented contemporaneously in | ||||||
4 | writing in accordance with such requirements as the | ||||||
5 | Department shall establish; or | ||||||
6 | (3) the disclosure is required by court order. | ||||||
7 | (h) Legal representation. The Attorney General shall | ||||||
8 | provide legal representation to any representative of the | ||||||
9 | Office against whom suit or other legal action is brought in | ||||||
10 | connection with the performance of the representative's | ||||||
11 | official duties, in accordance with the State Employee | ||||||
12 | Indemnification Act. | ||||||
13 | (i) Treatment by prayer and spiritual means. Nothing in | ||||||
14 | this Act shall be construed to authorize or require the | ||||||
15 | medical supervision, regulation or control of remedial care or | ||||||
16 | treatment of any resident in a long term care facility | ||||||
17 | operated exclusively by and for members or adherents of any | ||||||
18 | church or religious denomination the tenets and practices of | ||||||
19 | which include reliance solely upon spiritual means through | ||||||
20 | prayer for healing. | ||||||
21 | (j) The Long Term Care Ombudsman Fund is created as a | ||||||
22 | special fund in the State treasury to receive moneys for the | ||||||
23 | express purposes of this Section. All interest earned on | ||||||
24 | moneys in the fund shall be credited to the fund. Moneys | ||||||
25 | contained in the fund shall be used to support the purposes of | ||||||
26 | this Section. |
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1 | (k) Each Regional Ombudsman may, in accordance with rules | ||||||
2 | promulgated by the Office, establish a multi-disciplinary team | ||||||
3 | to act in an advisory role for the purpose of providing | ||||||
4 | professional knowledge and expertise in handling complex | ||||||
5 | abuse, neglect, and advocacy issues involving participants. | ||||||
6 | Each multi-disciplinary team may consist of one or more | ||||||
7 | volunteer representatives from any combination of at least 7 | ||||||
8 | members from the following professions: banking or finance; | ||||||
9 | disability care; health care; pharmacology; law; law | ||||||
10 | enforcement; emergency responder; mental health care; clergy; | ||||||
11 | coroner or medical examiner; substance abuse; domestic | ||||||
12 | violence; sexual assault; or other related fields. To support | ||||||
13 | multi-disciplinary teams in this role, law enforcement | ||||||
14 | agencies and coroners or medical examiners shall supply | ||||||
15 | records as may be requested in particular cases. The Regional | ||||||
16 | Ombudsman, or his or her designee, of the area in which the | ||||||
17 | multi-disciplinary team is created shall be the facilitator of | ||||||
18 | the multi-disciplinary team. | ||||||
19 | (Source: P.A. 102-1033, eff. 1-1-23; 103-329, eff. 1-1-24 .) |