Sen. Sara Feigenholtz

Filed: 4/17/2024

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 774

2    AMENDMENT NO. ______. Amend Senate Bill 774 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Assisted Living and Shared Housing Act is
5amended by changing Sections 10 and 70 and by adding Section 79
6as follows:
 
7    (210 ILCS 9/10)
8    Sec. 10. Definitions. For purposes of this Act:
9    "Activities of daily living" means eating, dressing,
10bathing, toileting, transferring, or personal hygiene.
11    "Assisted living establishment" or "establishment" means a
12home, building, residence, or any other place where sleeping
13accommodations are provided for at least 3 unrelated adults,
14at least 80% of whom are 55 years of age or older and where the
15following are provided consistent with the purposes of this
16Act:

 

 

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1        (1) services consistent with a social model that is
2    based on the premise that the resident's unit in assisted
3    living and shared housing is his or her own home;
4        (2) community-based residential care for persons who
5    need assistance with activities of daily living, including
6    personal, supportive, and intermittent health-related
7    services available 24 hours per day, if needed, to meet
8    the scheduled and unscheduled needs of a resident;
9        (3) mandatory services, whether provided directly by
10    the establishment or by another entity arranged for by the
11    establishment, with the consent of the resident or
12    resident's representative; and
13        (4) a physical environment that is a homelike setting
14    that includes the following and such other elements as
15    established by the Department: individual living units
16    each of which shall accommodate small kitchen appliances
17    and contain private bathing, washing, and toilet
18    facilities, or private washing and toilet facilities with
19    a common bathing room readily accessible to each resident.
20    Units shall be maintained for single occupancy except in
21    cases in which 2 residents choose to share a unit.
22    Sufficient common space shall exist to permit individual
23    and group activities.
24    "Assisted living establishment" or "establishment" does
25not mean any of the following:
26        (1) A home, institution, or similar place operated by

 

 

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1    the federal government or the State of Illinois.
2        (2) A long term care facility licensed under the
3    Nursing Home Care Act, a facility licensed under the
4    Specialized Mental Health Rehabilitation Act of 2013, a
5    facility licensed under the ID/DD Community Care Act, or a
6    facility licensed under the MC/DD Act. However, a facility
7    licensed under any of those Acts may convert distinct
8    parts of the facility to assisted living. If the facility
9    elects to do so, the facility shall retain the Certificate
10    of Need for its nursing and sheltered care beds that were
11    converted.
12        (3) A hospital, sanitarium, or other institution, the
13    principal activity or business of which is the diagnosis,
14    care, and treatment of human illness and that is required
15    to be licensed under the Hospital Licensing Act.
16        (4) A facility for child care as defined in the Child
17    Care Act of 1969.
18        (5) A community living facility as defined in the
19    Community Living Facilities Licensing Act.
20        (6) A nursing home or sanitarium operated solely by
21    and for persons who rely exclusively upon treatment by
22    spiritual means through prayer in accordance with the
23    creed or tenants of a well-recognized church or religious
24    denomination.
25        (7) A facility licensed by the Department of Human
26    Services as a community-integrated living arrangement as

 

 

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1    defined in the Community-Integrated Living Arrangements
2    Licensure and Certification Act.
3        (8) A supportive residence licensed under the
4    Supportive Residences Licensing Act.
5        (9) The portion of a life care facility as defined in
6    the Life Care Facilities Act not licensed as an assisted
7    living establishment under this Act; a life care facility
8    may apply under this Act to convert sections of the
9    community to assisted living.
10        (10) A free-standing hospice facility licensed under
11    the Hospice Program Licensing Act.
12        (11) A shared housing establishment.
13        (12) A supportive living facility as described in
14    Section 5-5.01a of the Illinois Public Aid Code.
15    "Certified medication aide" means a person who has met the
16qualifications for certification under Section 79 and assists
17with medication administration while under the supervision of
18a registered professional nurse as authorized by Section 50-75
19of the Nurse Practice Act in an assisted living establishment.
20    "Department" means the Department of Public Health.
21    "Director" means the Director of Public Health.
22    "Emergency situation" means imminent danger of death or
23serious physical harm to a resident of an establishment.
24    "License" means any of the following types of licenses
25issued to an applicant or licensee by the Department:
26        (1) "Probationary license" means a license issued to

 

 

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1    an applicant or licensee that has not held a license under
2    this Act prior to its application or pursuant to a license
3    transfer in accordance with Section 50 of this Act.
4        (2) "Regular license" means a license issued by the
5    Department to an applicant or licensee that is in
6    substantial compliance with this Act and any rules
7    promulgated under this Act.
8    "Licensee" means a person, agency, association,
9corporation, partnership, or organization that has been issued
10a license to operate an assisted living or shared housing
11establishment.
12    "Licensed health care professional" means a registered
13professional nurse, an advanced practice registered nurse, a
14physician assistant, and a licensed practical nurse.
15    "Mandatory services" include the following:
16        (1) 3 meals per day available to the residents
17    prepared by the establishment or an outside contractor;
18        (2) housekeeping services including, but not limited
19    to, vacuuming, dusting, and cleaning the resident's unit;
20        (3) personal laundry and linen services available to
21    the residents provided or arranged for by the
22    establishment;
23        (4) security provided 24 hours each day including, but
24    not limited to, locked entrances or building or contract
25    security personnel;
26        (5) an emergency communication response system, which

 

 

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1    is a procedure in place 24 hours each day by which a
2    resident can notify building management, an emergency
3    response vendor, or others able to respond to his or her
4    need for assistance; and
5        (6) assistance with activities of daily living as
6    required by each resident.
7    "Negotiated risk" is the process by which a resident, or
8his or her representative, may formally negotiate with
9providers what risks each are willing and unwilling to assume
10in service provision and the resident's living environment.
11The provider assures that the resident and the resident's
12representative, if any, are informed of the risks of these
13decisions and of the potential consequences of assuming these
14risks.
15    "Owner" means the individual, partnership, corporation,
16association, or other person who owns an assisted living or
17shared housing establishment. In the event an assisted living
18or shared housing establishment is operated by a person who
19leases or manages the physical plant, which is owned by
20another person, "owner" means the person who operates the
21assisted living or shared housing establishment, except that
22if the person who owns the physical plant is an affiliate of
23the person who operates the assisted living or shared housing
24establishment and has significant control over the day to day
25operations of the assisted living or shared housing
26establishment, the person who owns the physical plant shall

 

 

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1incur jointly and severally with the owner all liabilities
2imposed on an owner under this Act.
3    "Physician" means a person licensed under the Medical
4Practice Act of 1987 to practice medicine in all of its
5branches.
6    "Program" means the Certified Medication Aide Program.
7    "Qualified establishment" means an assisted living and
8shared housing establishment licensed by the Department of
9Public Health.
10    "Resident" means a person residing in an assisted living
11or shared housing establishment.
12    "Resident's representative" means a person, other than the
13owner, agent, or employee of an establishment or of the health
14care provider unless related to the resident, designated in
15writing by a resident to be his or her representative. This
16designation may be accomplished through the Illinois Power of
17Attorney Act, pursuant to the guardianship process under the
18Probate Act of 1975, or pursuant to an executed designation of
19representative form specified by the Department.
20    "Self" means the individual or the individual's designated
21representative.
22    "Shared housing establishment" or "establishment" means a
23publicly or privately operated free-standing residence for 16
24or fewer persons, at least 80% of whom are 55 years of age or
25older and who are unrelated to the owners and one manager of
26the residence, where the following are provided:

 

 

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1        (1) services consistent with a social model that is
2    based on the premise that the resident's unit is his or her
3    own home;
4        (2) community-based residential care for persons who
5    need assistance with activities of daily living, including
6    housing and personal, supportive, and intermittent
7    health-related services available 24 hours per day, if
8    needed, to meet the scheduled and unscheduled needs of a
9    resident; and
10        (3) mandatory services, whether provided directly by
11    the establishment or by another entity arranged for by the
12    establishment, with the consent of the resident or the
13    resident's representative.
14    "Shared housing establishment" or "establishment" does not
15mean any of the following:
16        (1) A home, institution, or similar place operated by
17    the federal government or the State of Illinois.
18        (2) A long term care facility licensed under the
19    Nursing Home Care Act, a facility licensed under the
20    Specialized Mental Health Rehabilitation Act of 2013, a
21    facility licensed under the ID/DD Community Care Act, or a
22    facility licensed under the MC/DD Act. A facility licensed
23    under any of those Acts may, however, convert sections of
24    the facility to assisted living. If the facility elects to
25    do so, the facility shall retain the Certificate of Need
26    for its nursing beds that were converted.

 

 

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1        (3) A hospital, sanitarium, or other institution, the
2    principal activity or business of which is the diagnosis,
3    care, and treatment of human illness and that is required
4    to be licensed under the Hospital Licensing Act.
5        (4) A facility for child care as defined in the Child
6    Care Act of 1969.
7        (5) A community living facility as defined in the
8    Community Living Facilities Licensing Act.
9        (6) A nursing home or sanitarium operated solely by
10    and for persons who rely exclusively upon treatment by
11    spiritual means through prayer in accordance with the
12    creed or tenants of a well-recognized church or religious
13    denomination.
14        (7) A facility licensed by the Department of Human
15    Services as a community-integrated living arrangement as
16    defined in the Community-Integrated Living Arrangements
17    Licensure and Certification Act.
18        (8) A supportive residence licensed under the
19    Supportive Residences Licensing Act.
20        (9) A life care facility as defined in the Life Care
21    Facilities Act; a life care facility may apply under this
22    Act to convert sections of the community to assisted
23    living.
24        (10) A free-standing hospice facility licensed under
25    the Hospice Program Licensing Act.
26        (11) An assisted living establishment.

 

 

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1        (12) A supportive living facility as described in
2    Section 5-5.01a of the Illinois Public Aid Code.
3    "Total assistance" means that staff or another individual
4performs the entire activity of daily living without
5participation by the resident.
6(Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18.)
 
7    (210 ILCS 9/70)
8    Sec. 70. Service requirements. An establishment must
9provide all mandatory services and may provide optional
10services, including medication reminders, supervision of
11self-administered medication and medication administration as
12defined by this Section and nonmedical services defined by
13rule, whether provided directly by the establishment or by
14another entity arranged for by the establishment with the
15consent of the resident or the resident's representative.
16    For the purposes of this Section, "medication reminders"
17means reminding residents to take pre-dispensed,
18self-administered medication, observing the resident, and
19documenting whether or not the resident took the medication.
20    For the purposes of this Section, "supervision of
21self-administered medication" means assisting the resident
22with self-administered medication using any combination of the
23following: reminding residents to take medication, reading the
24medication label to residents, checking the self-administered
25medication dosage against the label of the medication,

 

 

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1confirming that residents have obtained and are taking the
2dosage as prescribed, and documenting in writing that the
3resident has taken (or refused to take) the medication. If
4residents are physically unable to open the container, the
5container may be opened for them. Supervision of
6self-administered medication shall be under the direction of a
7licensed health care professional or, in the case of a
8certified medication aide, under the supervision and
9delegation of a registered nurse as authorized by Section
1050-75 of the Nurse Practice Act.
11    For the purposes of this Section, "medication
12administration" refers to a licensed health care professional
13employed by an establishment engaging in administering insulin
14and vitamin B-12 injections, oral medications, topical
15treatments, eye and ear drops, or nitroglycerin patches. A
16certified medication aide may administer medications under the
17supervision and delegation of a registered nurse as authorized
18by Section 50-75 of the Nurse Practice Act, except (i)
19Schedule II controlled substances as set forth in the Illinois
20Controlled Substances Act and (ii) any subcutaneous,
21intramuscular, intradermal, or intravenous medication
22Non-licensed staff may not administer any medication.
23    The Department shall specify by rule procedures for
24medication reminders, supervision of self-administered
25medication, and medication administration.
26    Nothing in this Act shall preclude a physician licensed

 

 

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1under the Medical Practice Act of 1987 from providing services
2within the scope of his or her license to any resident.
3(Source: P.A. 96-353, eff. 8-13-09.)
 
4    (210 ILCS 9/79 new)
5    Sec. 79. Certified Medication Aide Program.
6    (a) The Department shall administer and enforce a
7Certified Medication Aide Program and regulate certified
8medication aides. To be approved as an establishment qualified
9to participate in the program, an establishment must satisfy
10all of the following requirements:
11        (1) Be licensed and in good standing as an assisted
12    living or shared housing establishment by the Department.
13        (2) Certify that the employment of a certified
14    medication aide will not replace or diminish the
15    employment of registered nurses or licensed practical
16    nurses at the establishment.
17        (3) Certify that a registered nurse will be on duty
18    and present in the establishment to delegate and supervise
19    the administration of medication by a certified medication
20    aide at all times.
21        (4) Certify that, with the exception of licensed
22    health care professionals, only certified medication aides
23    will be employed in the capacity of administering
24    medication.
25        (5) Provide information regarding patient safety,

 

 

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1    efficiency, and errors as determined by the Department.
2    Failure to submit any required report may be grounds for
3discipline or sanctions as prescribed by the Department. The
4Department shall submit a report regarding patient safety,
5efficiency, and errors, as determined by rule, to the General
6Assembly no later than 2 years after the effective date of this
7amendatory Act of the 103rd General Assembly.
8    (b) No person shall practice as a medication aide or hold
9himself or herself out as a certified medication aide in this
10State unless he or she is certified in accordance with this
11Section. Nothing in this Section shall be construed as
12preventing or restricting the practice, services, or
13activities of:
14        (1) any person licensed in this State by any other law
15    from engaging in the profession or occupation for which he
16    or she is licensed;
17        (2) any person employed as a medication aide by the
18    government of the United States, if such person practices
19    as a medication aide solely under the direction or control
20    of the organization by which he or she is employed; or
21        (3) any person pursuing a course of study leading to a
22    certificate in medication aide at an accredited or
23    approved educational program if such activities and
24    services constitute a part of a supervised course of study
25    and if such person is designated by a title which clearly
26    indicates his or her status as a student or trainee.

 

 

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1    Nothing in this Section shall be construed to limit the
2delegation of tasks or duties by a physician, dentist,
3advanced practice registered nurse, or podiatric physician as
4authorized by law.
5    (c) A certified medication aide may only practice in a
6qualified establishment. Certified medication aides must be
7supervised by and receive delegation by a registered nurse, as
8authorized by Section 50-75 of the Nurse Practice Act, that is
9on duty and present in the establishment at all times.
10Certified medication aides shall not have a direct-care
11assignment when scheduled to work as a certified medication
12aide, but may assist residents as needed. Certified medication
13aides shall not administer any medication until a physician
14has conducted an initial assessment of the resident.
15    Certified medication aides shall not administer any
16Schedule II controlled substances as set forth in the Illinois
17Controlled Substances Act and may not administer any
18subcutaneous, intramuscular, intradermal, or intravenous
19medication.
20    (d) In addition to any other penalty provided by law, any
21person who practices, offers to practice, attempts to
22practice, or holds oneself out to practice as a medication
23aide without being certified in accordance with this Section
24shall pay a civil penalty to the Department as determined by
25the Department. The Department has the authority and power to
26investigate any and all uncertified activity. The civil

 

 

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1penalty shall be paid within 60 days after the date of the
2order imposing the civil penalty. The order shall constitute a
3judgment and may be filed and execution had thereon in the same
4manner as any judgment from any court of record.
5    (e) Applications for original certification shall be made
6to the Department in writing on forms prescribed by the
7Department and shall be accompanied by the required fee, which
8shall not be refundable. The application shall require such
9information that, in the judgment of the Department, enables
10the Department to pass on the qualifications of the applicant
11for certification.
12    (f) The Department shall authorize examinations of
13applicants for a certificate under this Section at the times
14and places as it may designate. The examination shall be of a
15character to give a fair test of the qualifications of the
16applicant to practice as a medication aide.
17    Applicants for examination as a medication aide shall be
18required to pay, either to the Department or the designated
19testing service, a fee covering the cost of providing the
20examination. Failure to appear for the examination on the
21scheduled date, at the time and place specified, after the
22applicant's application for examination has been received and
23acknowledged by the Department or the designated testing
24service, shall result in the forfeiture of the examination
25fee.
26    If an applicant fails to pass an examination for

 

 

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1certification in accordance with this Section within 3 years
2after filing his or her application, then the application
3shall be denied. The applicant may thereafter make a new
4application accompanied by the required fee; however, the
5applicant shall meet all requirements in effect at the time of
6subsequent application before obtaining certification. The
7Department may employ consultants for the purposes of
8preparing and conducting examinations.
9    (g) An applicant for certification by examination to
10practice as a certified medication aide must:
11        (1) submit a completed written application on forms
12    provided by the Department and fees as established by the
13    Department;
14        (2) be age 18 or older;
15        (3) have a high school diploma or a high school
16    equivalency certificate;
17        (4) demonstrate the ability to speak, read, and write
18    the English language, as determined by rule;
19        (5) demonstrate competency in math, as determined by
20    rule;
21        (6) be currently certified in good standing as a
22    certified nursing assistant and provide proof of 2,000
23    hours of practice as a certified nursing assistant within
24    3 years before application for a certificate under this
25    Section;
26        (7) submit to the criminal history records check

 

 

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1    required under Section 46 of the Health Care Worker
2    Background Check Act;
3        (8) be currently certified to perform cardiopulmonary
4    resuscitation by the American Heart Association or
5    American Red Cross;
6        (9) have successfully completed a course of study
7    approved by the Department as defined by rule; to be
8    approved, the program must include a minimum of 60 hours
9    of classroom-based medication aide education, a minimum of
10    10 hours of simulation laboratory study, and a minimum of
11    30 hours of registered nurse-supervised clinical practicum
12    with progressive responsibility of patient medication
13    assistance;
14        (10) have successfully completed the Medication Aide
15    Certification Examination or other examination authorized
16    by the Department; and
17        (11) submit proof of employment by a qualifying
18    establishment.
19    (h) The expiration date for each certification to practice
20as a certified medication aide shall be set by rule.
21    (i) No person shall use the title "certified medication
22aide" unless he or she holds a valid certificate issued by the
23Department in accordance with this Section.
24    (j) The Department shall adopt rules to implement the
25provisions of this Section within 180 days after the effective
26date of this amendatory Act of the 103rd General Assembly.
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.".