093_HB1412enr

 
HB1412 Enrolled                      LRB093 03446 AMC 08879 b

 1        AN ACT concerning assisted living.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The Assisted Living and Shared Housing Act is
 5    amended by changing Sections 25, 35, 75, and 150  and  adding
 6    Section 32 as follows:

 7        (210 ILCS 9/25)
 8        Sec.  25.  License requirement.  No person may establish,
 9    operate, maintain, or offer an establishment as  an  assisted
10    living  establishment  or  shared  housing  establishment  as
11    defined  by  the Act within this State unless and until he or
12    she obtains  a  valid  license,  which  remains  unsuspended,
13    unrevoked,  and  unexpired.    No  public official, agent, or
14    employee may place any  person  in,  or  recommend  that  any
15    person  be  placed  in,  or  directly or indirectly cause any
16    person to be placed  in  any  establishment  that  meets  the
17    definition  under  this  Act that is being operated without a
18    valid license.  No public official, agent,  or  employee  may
19    place  the  name  of  an  unlicensed  establishment  that  is
20    required to be licensed under this Act on a list of programs.
21    An  entity  that  operates  as  an  assisted living or shared
22    housing establishment  as  defined  by  this  Act  without  a
23    license   shall  be  subject  to  the  provisions,  including
24    penalties, of the Nursing Home Care Act.  No entity shall use
25    in its name or advertise "assisted living" unless licensed as
26    an assisted living establishment  under  this  Act  or  as  a
27    shelter  care  facility  under the Nursing Home Care Act that
28    also meets the definition of an assisted living establishment
29    under  this  Act,  except  a  shared  housing   establishment
30    licensed   under  this  Act  may  advertise  assisted  living
31    services.
 
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 1    (Source: P.A. 91-656, eff. 1-1-01.)

 2        (210 ILCS 9/32 new)
 3        Sec. 32.  Floating license. An establishment (i) in which
 4    80% of the residents are at least 55 years of age  or  older,
 5    (ii)  that  is operated as housing for the elderly, and (iii)
 6    that meets the construction and operating standards contained
 7    in Section 20 of this Act may request a floating license  for
 8    any   number   of   individual   living   units   within  the
 9    establishment up to, but not including, total  capacity.   An
10    establishment  requesting a floating license must specify the
11    number of individual living units within the establishment to
12    be licensed.  Living units designated by the establishment as
13    a licensed living  unit  shall,  for  the  purposes  of  this
14    Section,  be  referred  to  as  a  licensed  living unit.  An
15    establishment utilizing a floating license  must  have  staff
16    adequate  to  meet the scheduled and unscheduled needs of the
17    residents  residing  in  licensed  living  units  within  the
18    establishment.  All  staff  providing  services  to  licensed
19    living  units  must meet the requirements of this Act and its
20    rules.  A living unit may only be designated  as  a  licensed
21    unit  if  the living unit and the living unit's resident meet
22    the requirements of this Act and its  rules.   All  mandatory
23    services  must  be  made  available  to residents of licensed
24    living units, and residents  of  licensed  living  units  may
25    receive   any   optional   services   permitted   under   the
26    establishment's  license.   Establishments  may  only provide
27    services under  this  Act  in  the  individual  living  units
28    designated as licensed units.  Designation as a licensed unit
29    may  be  temporary to accommodate a resident's changing needs
30    without requiring the resident to move.
31        An establishment with a  floating  license  must  keep  a
32    current  written  list  of  those  units designated under the
33    floating license.  If a resident elects to  receive  services
 
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 1    in  a  unit  that  is not licensed and the unit qualifies for
 2    licensure, the establishment must notify  the  resident  that
 3    the  unit  must  be licensed and the requirements of this Act
 4    must be met before services can be provided to  residents  in
 5    that  unit.   Upon  the  initiation  of  an initial licensing
 6    inspection, annual inspection,  or  complaint  investigation,
 7    the  establishment  shall provide to the Department a list of
 8    the units designated under  the  floating  license  in  which
 9    residents are receiving services subject to this Act.

10        (210 ILCS 9/35)
11        Sec. 35.  Issuance of license.
12        (a)  Upon  receipt  and  review  of  an application for a
13    license  and  review  of  the  applicant  establishment,  the
14    Director  may issue a license if he or she finds:
15             (1)  that   the   individual   applicant,   or   the
16        corporation,  partnership,  or  other   entity   if   the
17        applicant  is  not an individual, is a person responsible
18        and suitable to operate or to direct  or  participate  in
19        the  operation of an establishment by virtue of financial
20        capacity,   appropriate    business    or    professional
21        experience,  a  record  of  lawful compliance with lawful
22        orders of the Department and  lack  of  revocation  of  a
23        license  issued  under  this Act or the Nursing Home Care
24        Act during the previous 5 years;
25             (2)  that the establishment is under the supervision
26        of a full-time director who is at least 21 years  of  age
27        with ability, training, and education appropriate to meet
28        the  needs  of the residents and to manage the operations
29        of the establishment  and  who  participates  in  ongoing
30        training for these purposes;
31             (3)  that  the establishment has staff sufficient in
32        number with qualifications, adequate  skills,  education,
33        and   experience  to  meet  the  24  hour  scheduled  and
 
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 1        unscheduled needs of residents  and  who  participate  in
 2        ongoing training to serve the resident population;
 3             (4)  that direct care staff meet the requirements of
 4        the Health Care Worker Background Check Act;
 5             (5)  that the applicant is in substantial compliance
 6        with  this  Act and such other requirements for a license
 7        as the Department by rule may establish under this Act;
 8             (6)  that the applicant pays all required fees;
 9             (7)  that  the  applicant  has   provided   to   the
10        Department  an accurate disclosure document in accordance
11        with the Alzheimer's Special Care Disclosure Act  and  in
12        substantial compliance with Section 150 of this Act.
13        Any  license  issued  by  the  Director  shall  state the
14    physical location of the establishment, the date the  license
15    was  issued,  and the expiration date.  All licenses shall be
16    valid for one year, except as provided in Section  40.   Each
17    license  shall  be  issued  only for the premises and persons
18    named in the application, and shall not  be  transferable  or
19    assignable.
20    (Source: P.A. 91-656, eff. 1-1-01.)

21        (210 ILCS 9/75)
22        Sec. 75.  Residency Requirements.
23        (a)  No  individual  shall  be  accepted for residency or
24    remain in residence if the establishment  cannot  provide  or
25    secure  appropriate  services,  if  the individual requires a
26    level  of  service  or  type  of  service   for   which   the
27    establishment is not licensed or which the establishment does
28    not  provide, or if the establishment does not have the staff
29    appropriate in numbers and with appropriate skill to  provide
30    such services.
31        (b)  Only adults may be accepted for residency.
32        (c)  A person shall not be accepted for residency if:
33             (1)  the person poses a serious threat to himself or
 
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 1        herself or to others;
 2             (2)  the  person  is  not able to communicate his or
 3        her needs and no resident representative residing in  the
 4        establishment,  and  with  a  prior  relationship  to the
 5        person, has been appointed to  direct  the  provision  of
 6        services;
 7             (3)  the  person requires total assistance with 2 or
 8        more activities of daily living;
 9             (4)  the person requires the assistance of more than
10        one paid caregiver at any given time with an activity  of
11        daily living;
12             (5)  the   person   requires   more   than   minimal
13        assistance in moving to a safe area in an emergency;
14             (6)  the person has a severe mental  illness,  which
15        for  the  purposes of this Section means a condition that
16        is characterized  by  the  presence  of  a  major  mental
17        disorder  as classified in the Diagnostic and Statistical
18        Manual  of  Mental  Disorders,  Fourth  Edition  (DSM-IV)
19        (American  Psychiatric  Association,  1994),  where   the
20        individual   is  substantially  disabled  due  to  mental
21        illness  in  the  areas   of   self-maintenance,   social
22        functioning,  activities  of  community  living  and work
23        skills, and the disability specified is  expected  to  be
24        present  for a period of not less than one year, but does
25        not mean  Alzheimer's disease and other forms of dementia
26        based on organic or physical disorders;
27             (7)  the  person  requires  intravenous  therapy  or
28        intravenous   feedings   unless   self-administered    or
29        administered   by   a  qualified,  licensed  health  care
30        professional;
31             (8)  the person requires gastrostomy feedings unless
32        self-administered  or administered by a  licensed  health
33        care professional;
34             (9)  the    person   requires   insertion,   sterile
 
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 1        irrigation,  and  replacement  of  catheter,  except  for
 2        routine maintenance of  urinary  catheters,   unless  the
 3        catheter  care  is self-administered or administered by a
 4        licensed health care professional;
 5             (10)  the person requires sterile wound care  unless
 6        care  is  self-administered or administered by a licensed
 7        health care professional;
 8             (11)  the  person  requires  sliding  scale  insulin
 9        administration unless self-performed or administered by a
10        licensed health care professional;
11             (12)  the person is  a  diabetic  requiring  routine
12        insulin    injections    unless    the   injections   are
13        self-administered or administered by  a  licensed  health
14        care professional;
15             (13)  the  person  requires  treatment of stage 3 or
16        stage 4 decubitus ulcers or exfoliative dermatitis;
17             (14)  the person requires 5 or more skilled  nursing
18        visits per week for conditions other than those listed in
19        items (13) and (15) of this subsection for a period of  3
20        consecutive  weeks  or  more  except  when  the course of
21        treatment is expected to extend beyond a  3  week  period
22        for rehabilitative purposes and is certified as temporary
23        by a physician; or
24             (15)  other  reasons prescribed by the Department by
25        rule.
26        (d)  A resident with a  condition  listed  in  items  (1)
27    through   (15)   of  subsection  (c)  shall  have  his or her
28    residency terminated.
29        (e)  Residency  shall   be   terminated   when   services
30    available  to the resident in the establishment are no longer
31    adequate to meet the needs of the resident.  This   provision
32    shall  not  be  interpreted  as limiting the authority of the
33    Department  to  require  the   residency  termination      of
34    individuals.
 
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 1        (f)  Subsection  (d)  of  this Section shall not apply to
 2    terminally ill residents who receive  or  would  qualify  for
 3    hospice  care  and  such  care  is  coordinated by  a hospice
 4    licensed under the Hospice Program  Licensing Act   or  other
 5    licensed health care professional employed by a licensed home
 6    health  agency and the establishment and all parties agree to
 7    the continued residency.
 8        (g)  Items (3), (4), (5), and (9) of subsection (c) shall
 9    not apply to a quadriplegic, paraplegic, or  individual  with
10    neuro-muscular  diseases,  such  as  muscular  dystrophy  and
11    multiple  sclerosis, or other chronic diseases and conditions
12    as defined by rule if the individual is able  to  communicate
13    his or her needs and does not require assistance with complex
14    medical   problems,   and   the   establishment  is  able  to
15    accommodate the individual's needs.    The  Department  shall
16    prescribe rules pursuant to this Section that address special
17    safety and service needs of these individuals.
18        (h)  For  the  purposes  of  items  (7)  through  (11) of
19    subsection (c), a licensed health care professional  may  not
20    be  employed  by  the owner or operator of the establishment,
21    its parent entity, or any other entity with ownership  common
22    to  either  the  owner  or  operator  of the establishment or
23    parent entity, including but not limited to an  affiliate  of
24    the  owner or operator of the establishment.  Nothing in this
25    Section is meant to limit a resident's right to choose his or
26    her health care provider.
27    (Source: P.A. 91-656, eff. 1-1-01.)

28        (210 ILCS 9/150)
29        Sec. 150.  Alzheimer and dementia programs.
30        (a)  In addition to Except as provided in  this  Section,
31    Alzheimer  and dementia programs shall comply with all of the
32    other provisions of this Act.
33        (b)  No person shall  be  admitted  or  retained  if  the
 
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 1    assisted   living  or  shared  housing  establishment  cannot
 2    provide or secure appropriate care, if the resident  requires
 3    a  level  of  service  or  type  of  service  for  which  the
 4    establishment is not licensed or which the establishment does
 5    not  provide, or if the establishment does not have the staff
 6    appropriate in numbers and with appropriate skill to  provide
 7    such services.
 8        (c)  No  person shall be accepted for residency or remain
 9    in residence if the person's mental or physical condition has
10    so deteriorated to render residency in such a program  to  be
11    detrimental to the health, welfare or safety of the person or
12    of  other  residents of the establishment.  The Department by
13    rule shall identify a  validated  dementia-specific  standard
14    with  inter-rater  reliability  that  will  be used to assess
15    individual residents. The assessment must be approved by  the
16    resident's  physician and shall occur prior to acceptance for
17    residency, annually, and at such time that a  change  in  the
18    resident's  condition is identified by a family member, staff
19    of the establishment, or the resident's physician.
20        (d)  No person shall be accepted for residency or  remain
21    in residence if the person is dangerous to self or others and
22    the  establishment  would  be  unable to eliminate the danger
23    through the use of appropriate treatment modalities.
24        (e)  No person shall be accepted for residency or  remain
25    in  residence  if  the  person meets the criteria provided in
26    subsections (b) through (g) of Section 75 of this Act.
27        (f)  An establishment that offers to  provide  a  special
28    program  or  unit  for  persons  with Alzheimer's disease and
29    related disorders shall:
30             (1)  disclose to the Department and to  a  potential
31        or  actual  resident  of the establishment information as
32        specified under the Alzheimer's Special  Care  Disclosure
33        Act;
34             (2)  ensure  that  a  resident's  representative  is
 
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 1        designated for the resident;
 2             (3)  develop  and  implement policies and procedures
 3        that ensure the continued safety of all residents in  the
 4        establishment including, but not limited to, those who:
 5                  (A)  may wander; and
 6                  (B)  may  need  supervision and assistance when
 7             evacuating the building in an emergency;
 8             (4)  provide  coordination  of  communications  with
 9        each resident, resident's representative,  relatives  and
10        other persons identified in the resident's service plan;
11             (5)  provide cognitive stimulation and activities to
12        maximize functioning;
13             (6)  provide  an appropriate number of staff for its
14        resident population, as established by rule;
15             (7)  require  the  director  or  administrator   and
16        direct  care  staff  to complete sufficient comprehensive
17        and ongoing dementia and cognitive deficit training,  the
18        content of which shall be established by rule; and
19             (8)  develop   emergency   procedures  and  staffing
20        patterns to respond to the needs of residents.
21    (Source: P.A. 91-656, eff. 1-1-01.)

22        Section 99.  Effective date.  This Act takes effect  upon
23    becoming law.