HB4493 Engrossed LRB093 19840 DRJ 45583 b

1     AN ACT concerning health facilities.
 
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 10, 40, 55, 60, 76, 110, and 125
6 as follows:
 
7     (210 ILCS 9/10)
8     Sec. 10. Definitions. For purposes of this Act:
9     "Activities of daily living" means eating, dressing,
10 bathing, toileting, transferring, or personal hygiene.
11     "Advisory Board" means the Assisted Living and Shared
12 Housing Standards and Quality of Life Advisory Board.
13     "Assisted living establishment" or "establishment" means a
14 home, building, residence, or any other place where sleeping
15 accommodations are provided for at least 3 unrelated adults, at
16 least 80% of whom are 55 years of age or older and where the
17 following are provided consistent with the purposes of this
18 Act:
19         (1) services consistent with a social model that is
20 based on the premise that the resident's unit in assisted
21 living and shared housing is his or her own home;
22         (2) community-based residential care for persons who
23 need assistance with activities of daily living, including
24 personal, supportive, and intermittent health-related
25 services available 24 hours per day, if needed, to meet the
26 scheduled and unscheduled needs of a resident;
27         (3) mandatory services, whether provided directly by
28 the establishment or by another entity arranged for by the
29 establishment, with the consent of the resident or
30 resident's representative; and
31         (4) a physical environment that is a homelike setting
32 that includes the following and such other elements as

 

 

HB4493 Engrossed - 2 - LRB093 19840 DRJ 45583 b

1 established by the Department in conjunction with the
2 Assisted Living and Shared Housing Standards and Quality of
3 Life Advisory Board: individual living units each of which
4 shall accommodate small kitchen appliances and contain
5 private bathing, washing, and toilet facilities, or
6 private washing and toilet facilities with a common bathing
7 room readily accessible to each resident. Units shall be
8 maintained for single occupancy except in cases in which 2
9 residents choose to share a unit. Sufficient common space
10 shall exist to permit individual and group activities.
11     "Assisted living establishment" or "establishment" does
12 not mean any of the following:
13         (1) A home, institution, or similar place operated by
14 the federal government or the State of Illinois.
15         (2) A long term care facility licensed under the
16 Nursing Home Care Act. However, a long term care facility
17 may convert distinct parts of the facility to assisted
18 living. If the long term care facility elects to do so, the
19 facility shall retain the Certificate of Need for its
20 nursing and sheltered care beds that were converted.
21         (3) A hospital, sanitarium, or other institution, the
22 principal activity or business of which is the diagnosis,
23 care, and treatment of human illness and that is required
24 to be licensed under the Hospital Licensing Act.
25         (4) A facility for child care as defined in the Child
26 Care Act of 1969.
27         (5) A community living facility as defined in the
28 Community Living Facilities Licensing Act.
29         (6) A nursing home or sanitarium operated solely by and
30 for persons who rely exclusively upon treatment by
31 spiritual means through prayer in accordance with the creed
32 or tenants of a well-recognized church or religious
33 denomination.
34         (7) A facility licensed by the Department of Human
35 Services as a community-integrated living arrangement as
36 defined in the Community-Integrated Living Arrangements

 

 

HB4493 Engrossed - 3 - LRB093 19840 DRJ 45583 b

1 Licensure and Certification Act.
2         (8) A supportive residence licensed under the
3 Supportive Residences Licensing Act.
4         (9) A life care facility as defined in the Life Care
5 Facilities Act; a life care facility may apply under this
6 Act to convert sections of the community to assisted
7 living.
8         (10) A free-standing hospice facility licensed under
9 the Hospice Program Licensing Act.
10         (11) A shared housing establishment.
11         (12) A supportive living facility as described in
12 Section 5-5.0la of the Illinois Public Aid Code.
13     "Department" means the Department of Public Health.
14     "Director" means the Director of Public Health.
15     "Emergency situation" means imminent danger of death or
16 serious physical harm to a resident of an establishment.
17     "License" means any of the following types of licenses
18 issued to an applicant or licensee by the Department:
19         (1) "Probationary license" means a license issued to an
20 applicant or licensee that has not held a license under
21 this Act prior to its application or pursuant to a license
22 transfer in accordance with Section 50 of this Act.
23         (2) "Regular license" means a license issued by the
24 Department to an applicant or licensee that is in
25 substantial compliance with this Act and any rules
26 promulgated under this Act.
27     "Licensee" means a person, agency, association,
28 corporation, partnership, or organization that has been issued
29 a license to operate an assisted living or shared housing
30 establishment.
31     "Licensed health care professional" means a registered
32 professional nurse, an advanced practice nurse, a physician
33 assistant, and a licensed practical nurse.
34     "Mandatory services" include the following:
35         (1) 3 meals per day available to the residents prepared
36 by the establishment or an outside contractor;

 

 

HB4493 Engrossed - 4 - LRB093 19840 DRJ 45583 b

1         (2) housekeeping services including, but not limited
2 to, vacuuming, dusting, and cleaning the resident's unit;
3         (3) personal laundry and linen services available to
4 the residents provided or arranged for by the
5 establishment;
6         (4) security provided 24 hours each day including, but
7 not limited to, locked entrances or building or contract
8 security personnel;
9         (5) an emergency communication response system, which
10 is a procedure in place 24 hours each day by which a
11 resident can notify building management, an emergency
12 response vendor, or others able to respond to his or her
13 need for assistance; and
14         (6) assistance with activities of daily living as
15 required by each resident.
16     "Negotiated risk" is the process by which a resident, or
17 his or her representative, may formally negotiate with
18 providers what risks each are willing and unwilling to assume
19 in service provision and the resident's living environment. The
20 provider assures that the resident and the resident's
21 representative, if any, are informed of the risks of these
22 decisions and of the potential consequences of assuming these
23 risks.
24     "Owner" means the individual, partnership, corporation,
25 association, or other person who owns an assisted living or
26 shared housing establishment. In the event an assisted living
27 or shared housing establishment is operated by a person who
28 leases or manages the physical plant, which is owned by another
29 person, "owner" means the person who operates the assisted
30 living or shared housing establishment, except that if the
31 person who owns the physical plant is an affiliate of the
32 person who operates the assisted living or shared housing
33 establishment and has significant control over the day to day
34 operations of the assisted living or shared housing
35 establishment, the person who owns the physical plant shall
36 incur jointly and severally with the owner all liabilities

 

 

HB4493 Engrossed - 5 - LRB093 19840 DRJ 45583 b

1 imposed on an owner under this Act.
2     "Physician" means a person licensed under the Medical
3 Practice Act of 1987 to practice medicine in all of its
4 branches.
5     "Resident" means a person residing in an assisted living or
6 shared housing establishment.
7     "Resident's representative" means a person, other than the
8 owner, agent, or employee of an establishment or of the health
9 care provider unless related to the resident, designated in
10 writing by a resident to be his or her representative. This
11 designation may be accomplished through the Illinois Power of
12 Attorney Act, pursuant to the guardianship process under the
13 Probate Act of 1975, or pursuant to an executed designation of
14 representative form specified by the Department.
15     "Self" means the individual or the individual's designated
16 representative.
17     "Shared housing establishment" or "establishment" means a
18 publicly or privately operated free-standing residence for 12
19 or fewer persons, at least 80% of whom are 55 years of age or
20 older and who are unrelated to the owners and one manager of
21 the residence, where the following are provided:
22         (1) services consistent with a social model that is
23 based on the premise that the resident's unit is his or her
24 own home;
25         (2) community-based residential care for persons who
26 need assistance with activities of daily living, including
27 housing and personal, supportive, and intermittent
28 health-related services available 24 hours per day, if
29 needed, to meet the scheduled and unscheduled needs of a
30 resident; and
31         (3) mandatory services, whether provided directly by
32 the establishment or by another entity arranged for by the
33 establishment, with the consent of the resident or the
34 resident's representative.
35     "Shared housing establishment" or "establishment" does not
36 mean any of the following:

 

 

HB4493 Engrossed - 6 - LRB093 19840 DRJ 45583 b

1         (1) A home, institution, or similar place operated by
2 the federal government or the State of Illinois.
3         (2) A long term care facility licensed under the
4 Nursing Home Care Act. A long term care facility may,
5 however, convert sections of the facility to assisted
6 living. If the long term care facility elects to do so, the
7 facility shall retain the Certificate of Need for its
8 nursing beds that were converted.
9         (3) A hospital, sanitarium, or other institution, the
10 principal activity or business of which is the diagnosis,
11 care, and treatment of human illness and that is required
12 to be licensed under the Hospital Licensing Act.
13         (4) A facility for child care as defined in the Child
14 Care Act of 1969.
15         (5) A community living facility as defined in the
16 Community Living Facilities Licensing Act.
17         (6) A nursing home or sanitarium operated solely by and
18 for persons who rely exclusively upon treatment by
19 spiritual means through prayer in accordance with the creed
20 or tenants of a well-recognized church or religious
21 denomination.
22         (7) A facility licensed by the Department of Human
23 Services as a community-integrated community-intergrated
24 living arrangement as defined in the Community-Integrated
25 Living Arrangements Licensure and Certification Act.
26         (8) A supportive residence licensed under the
27 Supportive Residences Licensing Act.
28         (9) A life care facility as defined in the Life Care
29 Facilities Act; a life care facility may apply under this
30 Act to convert sections of the community to assisted
31 living.
32         (10) A free-standing hospice facility licensed under
33 the Hospice Program Licensing Act.
34         (11) An assisted living establishment.
35         (12) A supportive living facility as described in
36 Section 5-5.01a of the Illinois Public Aid Code.

 

 

HB4493 Engrossed - 7 - LRB093 19840 DRJ 45583 b

1     "Total assistance" means that staff or another individual
2 performs the entire activity of daily living without
3 participation by the resident.
4 (Source: P.A. 91-656, eff. 1-1-01.)
 
5     (210 ILCS 9/40)
6     Sec. 40. Probationary licenses. If the applicant has not
7 been previously licensed under this Act or if the establishment
8 is not in operation at the time the application is made and if
9 the Department determines that the applicant meets the
10 licensure requirements of this Act, the Department shall may
11 issue a probationary license. A probationary license shall be
12 valid for 120 days unless sooner suspended or revoked. Within
13 30 days prior to the termination of a probationary license, the
14 Department shall fully and completely review the establishment
15 and, if the establishment meets the applicable requirements for
16 licensure, shall issue a license. If the Department finds that
17 the establishment does not meet the requirements for licensure,
18 but has made substantial progress toward meeting those
19 requirements, the license may be renewed once for a period not
20 to exceed 120 days from the expiration date of the initial
21 probationary license.
22 (Source: P.A. 91-656, eff. 1-1-01.)
 
23     (210 ILCS 9/55)
24     Sec. 55. Grounds for denial of a license. An application
25 for a license may be denied for any of the following reasons:
26         (1) failure to meet any of the standards set forth in
27 this Act or by rules adopted by the Department under this
28 Act;
29         (2) conviction of the applicant, or if the applicant is
30 a firm, partnership, or association, of any of its members,
31 or if a corporation, the conviction of the corporation or
32 any of its officers or stockholders, or of the person
33 designated to manage or supervise the establishment, of a
34 felony or of 2 or more misdemeanors involving moral

 

 

HB4493 Engrossed - 8 - LRB093 19840 DRJ 45583 b

1 turpitude during the previous 5 years as shown by a
2 certified copy of the record of the court of conviction;
3         (3) personnel insufficient in number or unqualified by
4 training or experience to properly care for the residents;
5         (4) insufficient financial or other resources to
6 operate and conduct the establishment in accordance with
7 standards adopted by the Department under this Act;
8         (5) revocation of a license during the previous 5
9 years, if such prior license was issued to the individual
10 applicant, a controlling owner or controlling combination
11 of owners of the applicant; or any affiliate of the
12 individual applicant or controlling owner of the applicant
13 and such individual applicant, controlling owner of the
14 applicant or affiliate of the applicant was a controlling
15 owner of the prior license; provided, however, that the
16 denial of an application for a license pursuant to this
17 Section must be supported by evidence that the prior
18 revocation renders the applicant unqualified or incapable
19 of meeting or maintaining an establishment in accordance
20 with the standards and rules adopted by the Department
21 under this Act; or
22         (6) the establishment is not under the direct
23 supervision of a full-time director, as defined by rule.
24     The Department shall deny an application for a license if 6
25 months after submitting its initial application the applicant
26 has not provided the Department with all of the information
27 required for review and approval or the applicant is not
28 actively pursuing the processing of its application. In
29 addition, the Department shall determine whether the applicant
30 has violated any provision of the Nursing Home Care Act.
31 (Source: P.A. 91-656, eff. 1-1-01.)
 
32     (210 ILCS 9/60)
33     Sec. 60. Notice of denial; request for hearing; hearing.
34     (a) Immediately upon the denial of any application or
35 reapplication for a license under this Act, the Department

 

 

HB4493 Engrossed - 9 - LRB093 19840 DRJ 45583 b

1 shall notify the applicant in writing. Notice of denial shall
2 include a clear and concise statement of the violations of this
3 Act on which the denial is based and notice of the opportunity
4 for a hearing. If the applicant or licensee wishes to contest
5 the denial of a license, it shall provide written notice to the
6 Department of a request for a hearing within 10 days after
7 receipt of the notice of denial. The Department shall commence
8 a hearing under this Section.
9     (b) A request for a hearing by aggrieved persons shall be
10 taken to the Department as follows:
11         (1) Upon the receipt of a request in writing for a
12 hearing, the Director or a person designated in writing by
13 the Director to act as a hearing officer shall conduct a
14 hearing to review the decision.
15         (2) Before the hearing is held notice of the hearing
16 shall be sent by the Department to the person making the
17 request for the hearing and to the person making the
18 decision which is being reviewed. In the notice the
19 Department shall specify the date, time, and place of the
20 hearing, which shall be held not less than 10 days after
21 the notice is mailed or delivered. The notice shall
22 designate the decision being reviewed. The notice may be
23 served by delivering it personally to the parties or their
24 representatives or by mailing it by certified mail to the
25 parties' addresses.
26         (3) The Department shall commence the hearing within 30
27 days after the receipt of request for hearing. The hearing
28 shall proceed as expeditiously as practicable, but in all
29 cases shall conclude within 90 days after commencement.
30     (b-5) The Director or his or her designee may compel, by
31 subpoena or subpoena duces tecum, the attendance and testimony
32 of witnesses and the production of books, papers, documents,
33 and records and may administer oaths to witnesses.
34     (c) The Director or hearing officer shall permit any party
35 to appear in person and to be represented by counsel at the
36 hearing, at which time the applicant or licensee shall be

 

 

HB4493 Engrossed - 10 - LRB093 19840 DRJ 45583 b

1 afforded an opportunity to present all relevant matter in
2 support of his or her position. In the event of the inability
3 of any party or the Department to procure the attendance of
4 witnesses to give testimony or produce books and papers, any
5 party or the Department may take the deposition of witnesses in
6 accordance with the provisions of the laws of this State. All
7 testimony shall be reduced to writing, and all testimony and
8 other evidence introduced at the hearing shall be a part of the
9 record of the hearing.
10     (d) The Director or hearing officer shall make findings of
11 fact in the hearing, and the Director shall render his or her
12 decision within 30 days after the termination of the hearing,
13 unless additional time not to exceed 90 days is required by him
14 or her for a proper disposition of the matter. When the hearing
15 has been conducted by a hearing officer, the Director shall
16 review the record and findings of fact before rendering a
17 decision. All decisions rendered by the Director shall be
18 binding upon and complied with by the Department, the
19 establishment, or the persons involved in the hearing, as
20 appropriate to each case.
21 (Source: P.A. 91-656, eff. 1-1-01.)
 
22     (210 ILCS 9/76)
23     Sec. 76. Vaccinations. Pneumonia shots.
24     (a) Before a prospective resident's admission to an
25 assisted living establishment or a shared housing
26 establishment that does not provide medication administration
27 as an optional service, the establishment shall advise the
28 prospective resident to consult a physician to determine
29 whether the prospective resident should obtain a vaccination
30 against pneumococcal pneumonia or influenza, or both.
31     (b) An assisted living establishment or shared housing
32 establishment that provides medication administration as an
33 optional service shall annually administer a vaccination
34 against influenza to each resident, in accordance with the
35 recommendations of the Advisory Committee on Immunization

 

 

HB4493 Engrossed - 11 - LRB093 19840 DRJ 45583 b

1 Practices of the Centers for Disease Control and Prevention
2 that are most recent to the time of vaccination, unless the
3 vaccination is medically contraindicated or the resident has
4 refused the vaccine. Influenza vaccinations for all residents
5 age 65 or over shall be completed by November 30 of each year
6 or as soon as practicable if vaccine supplies are not available
7 before November 1. Residents admitted after November 30, during
8 the flu season, and until February 1 shall, as medically
9 appropriate, receive an influenza vaccination prior to or upon
10 admission or as soon as practicable if vaccine supplies are not
11 available at the time of the admission, unless the vaccine is
12 medically contraindicated or the resident has refused the
13 vaccine. In the event that the Advisory Committee on
14 Immunization Practices of the Centers for Disease Control and
15 Prevention determines that dates of administration other than
16 those stated in this Section are optimal to protect the health
17 of residents, the Department is authorized to adopt rules to
18 require vaccinations at those times rather than the times
19 stated in this Section. An establishment shall document in the
20 resident's medication record that an annual vaccination
21 against influenza was administered, refused, or medically
22 contraindicated.
23     An assisted living establishment or shared housing
24 establishment that provides medication administration as an
25 optional service shall administer or arrange for
26 administration of a pneumococcal vaccination to each resident
27 who is age 65 or over, in accordance with the recommendations
28 of the Advisory Committee on Immunization Practices of the
29 Centers for Disease Control and Prevention, who has not
30 received this immunization prior to or upon admission to the
31 establishment, unless the resident refuses the offer for
32 vaccination or the vaccination is medically contraindicated.
33 An establishment shall document in each resident's medication
34 record that a vaccination against pneumococcal pneumonia was
35 offered and administered, refused, or medically
36 contraindicated.

 

 

HB4493 Engrossed - 12 - LRB093 19840 DRJ 45583 b

1 (Source: P.A. 92-562, eff. 6-24-02.)
 
2     (210 ILCS 9/110)
3     Sec. 110. Powers and duties of the Department.
4     (a) The Department shall conduct an annual unannounced
5 on-site visit at each assisted living and shared housing
6 establishment to determine compliance with applicable
7 licensure requirements and standards. Additional visits may be
8 conducted without prior notice to the assisted living or shared
9 housing establishment.
10     (b) Upon receipt of information that may indicate the
11 failure of the assisted living or shared housing establishment
12 or a service provider to comply with a provision of this Act,
13 the Department shall investigate the matter or make appropriate
14 referrals to other government agencies and entities having
15 jurisdiction over the subject matter of the possible violation.
16 The Department may also make referrals to any public or private
17 agency that the Department considers available for appropriate
18 assistance to those involved. The Department may oversee and
19 coordinate the enforcement of State consumer protection
20 policies affecting residents residing in an establishment
21 licensed under this Act.
22     (c) The Department shall establish by rule complaint
23 receipt, investigation, resolution, and involuntary residency
24 termination procedures. Resolution procedures shall provide
25 for on-site review and evaluation of an assisted living or
26 shared housing establishment found to be in violation of this
27 Act within a specified period of time based on the gravity and
28 severity of the violation and any pervasive pattern of
29 occurrences of the same or similar violations.
30     (d) The Governor shall establish an Assisted Living and
31 Shared Housing Standards and Quality of Life Advisory Board.
32     (e) The Department shall by rule establish penalties and
33 sanctions, which shall include, but need not be limited to, the
34 creation of a schedule of graduated penalties and sanctions to
35 include closure.

 

 

HB4493 Engrossed - 13 - LRB093 19840 DRJ 45583 b

1     (f) The Department shall by rule establish procedures for
2 disclosure of information to the public, which shall include,
3 but not be limited to, ownership, licensure status, frequency
4 of complaints, disposition of substantiated complaints, and
5 disciplinary actions.
6     (g) (Blank). The Department shall cooperate with, seek the
7 advice of, and collaborate with the Assisted Living and Shared
8 Housing Quality of Life Advisory Committee in the Department on
9 Aging on matters related to the responsibilities of the
10 Committee. Consistent with subsection (d) of Section 125, the
11 Department shall provide to the Department on Aging for
12 distribution to the committee copies of all administrative
13 rules and changes to administrative rules for review and
14 comment prior to notice being given to the public. If the
15 Committee, having been asked for its review, fails to respond
16 within 90 days, the rules shall be considered acted upon.
17     (h) Beginning January 1, 2000, the Department shall begin
18 drafting rules necessary for the administration of this Act.
19 (Source: P.A. 91-656, eff. 1-1-01.)
 
20     (210 ILCS 9/125)
21     Sec. 125. Assisted Living and Shared Housing Standards and
22 Quality of Life Advisory Board.
23     (a) The Governor shall appoint the Assisted Living and
24 Shared Housing Standards and Quality of Life Advisory Board
25 which shall be responsible for advising the Director in all
26 aspects of the administration of the Act. The Board shall give
27 advice to the Department concerning activities of the assisted
28 living ombudsman and all other matters deemed relevant by the
29 Director and to the Director concerning the delivery of
30 personal care services, the unique needs and concerns of
31 seniors residing in housing projects, and all other issues
32 affecting the quality of life of residents.
33     (b) The Board shall be comprised of the following persons:
34         (1) the Director who shall serve as chair, ex officio
35 and nonvoting;

 

 

HB4493 Engrossed - 14 - LRB093 19840 DRJ 45583 b

1         (2) the Director of Aging who shall serve as
2 vice-chair, ex officio and nonvoting;
3         (3) one representative each of the Departments of
4 Public Health, Public Aid, and Human Services, the
5 Department on Aging, the Office of the State Fire Marshal,
6 and the Illinois Housing Development Authority, and 2
7 representatives of the Department on Aging, all nonvoting
8 members;
9         (4) the State Ombudsman or his or her designee;
10         (5) one representative of the Association of Area
11 Agencies on Aging;
12         (6) four members selected from the recommendations by
13 provider organizations whose membership consist of nursing
14 care or assisted living establishments;
15         (7) one member selected from the recommendations of
16 provider organizations whose membership consists of home
17 health agencies;
18         (8) two residents of assisted living or shared housing
19 establishments;
20         (9) three members selected from the recommendations of
21 consumer organizations which engage solely in advocacy or
22 legal representation on behalf of the senior population;
23         (10) one member who shall be a physician;
24         (11) one member who shall be a registered professional
25 nurse selected from the recommendations of professional
26 nursing associations; and
27         (12) two citizen members with expertise in the area of
28 gerontology research or legal research regarding
29 implementation of assisted living statutes; .
30         (13) two members representing providers of community
31 care services; and
32         (14) one member representing agencies providing case
33 coordination services.
34     (c) Members of the Board appointed under paragraphs (5)
35 through (14) of subsection (b) created by this Act shall be
36 appointed to serve for terms of 3 years except as otherwise

 

 

HB4493 Engrossed - 15 - LRB093 19840 DRJ 45583 b

1 provided in this Section. All members shall be appointed by
2 January 1, 2001, except that the 2 members representing the
3 Department on Aging appointed under paragraph (3) of subsection
4 (b) and the members appointed under paragraphs (13) and (14) of
5 subsection (b) shall be appointed by January 1, 2005. One third
6 of the Board members' initial terms shall expire in one year;
7 one third in 2 years, and one third in 3 years. Of the 3 members
8 appointed under paragraphs (13) and (14) of subsection (b), one
9 shall serve for an initial term of one year, one shall serve
10 for an initial term of 2 years, and one shall serve for an
11 initial term of 3 years. A member's term does not expire until
12 a successor is appointed by the Governor. Any member appointed
13 to fill a vacancy occurring prior to the expiration of the term
14 for which his or her predecessor was appointed shall be
15 appointed for the remainder of that term. The Board shall meet
16 at the call of the Director. The affirmative vote of 10 9
17 members of the Board shall be necessary for Board action.
18 Members of this Board shall receive no compensation for their
19 services, however, resident members shall be reimbursed for
20 their actual expenses.
21     (d) The Board shall be provided copies of all
22 administrative rules and changes to administrative rules for
23 review and comment prior to notice being given to the public.
24 If the Board, having been asked for its review, fails to advise
25 the Department within 90 days, the rules shall be considered
26 acted upon.
27 (Source: P.A. 91-656, eff. 1-1-01.)
 
28     (210 ILCS 9/130 rep.)
29     Section 6. The Assisted Living and Shared Housing Act is
30 amended by repealing Section 130.
 
31     Section 99. Effective date. This Act takes effect upon
32 becoming law.