99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB4508

 

Introduced , by Rep. Greg Harris

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.04  from Ch. 23, par. 6104.04

    Amends the Illinois Act on the Aging. Expands the Department on Aging's Long Term Care Ombudsman Program to include advocacy services for residents of community-integrated living arrangements. Makes changes to provisions concerning access and visitation rights. Defines "community-integrated living arrangements". Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
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
17be provided to Illinois participants for the first time and
18will produce a cost savings for the State of Illinois by
19supporting the rebalancing efforts of the Patient Protection
20and Affordable Care Act.
21    (a) Long Term Care Ombudsman Program. The Department shall
22establish a Long Term Care Ombudsman Program, through the
23Office of State Long Term Care Ombudsman ("the Office"), in

 

 

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1accordance with the provisions of the Older Americans Act of
21965, as now or hereafter amended. The Long Term Care Ombudsman
3Program is authorized, subject to sufficient appropriations,
4to advocate on behalf of older persons and persons with
5disabilities residing in their own homes or community-based
6settings, relating to matters which may adversely affect the
7health, safety, welfare, or rights of such individuals.
8    (b) Definitions. As used in this Section, unless the
9context requires otherwise:
10        (1) "Access" means the right to:
11            (i) Enter any long term care facility or assisted
12        living or shared housing establishment or supportive
13        living facility or community-integrated living
14        arrangement;
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 the clinical and other records of a
22        participant or resident, regardless of age, with the
23        express written consent of the participant or
24        resident;
25            (v) Observe all areas of the long term care
26        facility or supportive living facilities,

 

 

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1        community-integrated living arrangement, or assisted
2        living or shared housing establishment except the
3        living area of any resident who protests the
4        observation; and
5            (vi) Subject to permission of the participant or
6        resident requesting services or his or her
7        representative, enter a home or community-based
8        setting.
9        (2) "Long Term Care Facility" means (i) any facility as
10    defined by Section 1-113 of the Nursing Home Care Act, as
11    now or hereafter amended; (ii) any skilled nursing facility
12    or a nursing facility which meets the requirements of
13    Section 1819(a), (b), (c), and (d) or Section 1919(a), (b),
14    (c), and (d) of the Social Security Act, as now or
15    hereafter amended (42 U.S.C. 1395i-3(a), (b), (c), and (d)
16    and 42 U.S.C. 1396r(a), (b), (c), and (d)); (iii) any
17    facility as defined by Section 1-113 of the ID/DD Community
18    Care Act, as now or hereafter amended; and (iv) any
19    facility as defined by Section 1-113 of MC/DD Act, as now
20    or hereafter amended.
21        (2.5) "Assisted living establishment" and "shared
22    housing establishment" have the meanings given those terms
23    in Section 10 of the Assisted Living and Shared Housing
24    Act.
25        (2.7) "Supportive living facility" means a facility
26    established under Section 5-5.01a of the Illinois Public

 

 

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1    Aid Code.
2        (2.8) "Community-based setting" means any place of
3    abode other than an individual's private home.
4        (2.9) "Community-integrated living arrangement" has
5    the meaning ascribed to that term in subsection (d) of
6    Section 3 of the Community-Integrated Living Arrangements
7    Licensure and Certification Act.
8        (3) "State Long Term Care Ombudsman" means any person
9    employed by the Department to fulfill the requirements of
10    the Office of State Long Term Care Ombudsman as required
11    under the Older Americans Act of 1965, as now or hereafter
12    amended, and Departmental policy.
13        (3.1) "Ombudsman" means any designated representative
14    of the State Long Term Care Ombudsman Program; provided
15    that the representative, whether he is paid for or
16    volunteers his ombudsman services, shall be qualified and
17    designated by the Office to perform the duties of an
18    ombudsman as specified by the Department in rules and in
19    accordance with the provisions of the Older Americans Act
20    of 1965, as now or hereafter amended.
21        (4) "Participant" means an older person aged 60 or over
22    or an adult with a disability aged 18 through 59 who is
23    eligible for services under any of the following:
24            (i) A medical assistance waiver administered by
25        the State.
26            (ii) A managed care organization providing care

 

 

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

 

 

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

 

 

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1arrangements, shared housing establishments, private homes,
2and community-based settings and to the rights of residents and
3participants guaranteed under the corresponding Acts and
4administrative 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 ID/DD Community Care Act or
17    the MC/DD Act.
18        (2) Develop a database of Consumer Choice Information
19    Reports completed by licensed long term care facilities
20    that includes information in the following consumer
21    categories:
22            (A) Medical Care, Services, and Treatment.
23            (B) Special Services and Amenities.
24            (C) Staffing.
25            (D) Facility Statistics and Resident Demographics.
26            (E) Ownership and Administration.

 

 

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

 

 

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

 

 

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

 

 

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1        providing information to any representative of the
2        Office.
3        (2) A violation of this Section is a business offense,
4    punishable by a fine not to exceed $501.
5        (3) The State Long Term Care Ombudsman shall notify the
6    State's Attorney of the county in which the long term care
7    facility, supportive living facility, community-integrated
8    living arrangement, or assisted living or shared housing
9    establishment is located, or the Attorney General, of any
10    violations of this Section.
11    (g) Confidentiality of records and identities. The
12Department shall establish procedures for the disclosure by the
13State Ombudsman or the regional ombudsmen entities of files
14maintained by the program. The procedures shall provide that
15the files and records may be disclosed only at the discretion
16of the State Long Term Care Ombudsman or the person designated
17by the State Ombudsman to disclose the files and records, and
18the procedures shall prohibit the disclosure of the identity of
19any complainant, resident, participant, witness, or employee
20of a long term care provider unless:
21        (1) the complainant, resident, participant, witness,
22    or employee of a long term care provider or his or her
23    legal representative consents to the disclosure and the
24    consent is in writing;
25        (2) the complainant, resident, participant, witness,
26    or employee of a long term care provider gives consent

 

 

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

 

 

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1professional knowledge and expertise in handling complex
2abuse, neglect, and advocacy issues involving participants.
3Each multi-disciplinary team may consist of one or more
4volunteer representatives from any combination of at least 7
5members from the following professions: banking or finance;
6disability care; health care; pharmacology; law; law
7enforcement; emergency responder; mental health care; clergy;
8coroner or medical examiner; substance abuse; domestic
9violence; sexual assault; or other related fields. To support
10multi-disciplinary teams in this role, law enforcement
11agencies and coroners or medical examiners shall supply records
12as may be requested in particular cases. The Regional
13Ombudsman, or his or her designee, of the area in which the
14multi-disciplinary team is created shall be the facilitator of
15the multi-disciplinary team.
16(Source: P.A. 98-380, eff. 8-16-13; 98-989, eff. 1-1-15;
1799-180, eff. 7-29-15.)
 
18    Section 99. Effective date. This Act takes effect upon
19becoming law.