Illinois General Assembly - Full Text of SB2957
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Full Text of SB2957  103rd General Assembly

SB2957eng 103RD GENERAL ASSEMBLY

 


 
SB2957 EngrossedLRB103 38874 KTG 69011 b

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
8of the 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
3Ombudsman Program is authorized, subject to sufficient
4appropriations, to advocate on behalf of older persons and
5persons with disabilities residing in their own homes or
6community-based settings, relating to matters which may
7adversely affect the health, safety, welfare, or rights of
8such individuals.
9    (b) Definitions. As used in this Section, unless the
10context requires otherwise:
11        (1) "Access" means the right to:
12            (i) Enter any long term care facility or assisted
13        living or shared housing establishment or supportive
14        living facility;
15            (ii) Communicate privately and without restriction
16        with any resident, regardless of age, who consents to
17        the communication;
18            (iii) Seek consent to communicate privately and
19        without restriction with any participant or resident,
20        regardless of age;
21            (iv) Inspect and copy the clinical and other
22        records of a participant or resident, regardless of
23        age, with the express written consent of the
24        participant or resident, or if consent is given
25        orally, visually, or through the use of auxiliary aids
26        and services, such consent is documented

 

 

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1        contemporaneously by a representative of the Office in
2        accordance with such procedures;
3            (v) Observe all areas of the long term care
4        facility or supportive living facilities, assisted
5        living or shared housing establishment except the
6        living area of any resident who protests the
7        observation; and
8            (vi) Subject to permission of the participant or
9        resident requesting services or his or her
10        representative, enter a home or community-based
11        setting.
12        (2) "Long Term Care Facility" means (i) any facility
13    as defined by Section 1-113 of the Nursing Home Care Act,
14    as now or hereafter amended; (ii) any skilled nursing
15    facility or a nursing facility which meets the
16    requirements of Section 1819(a), (b), (c), and (d) or
17    Section 1919(a), (b), (c), and (d) of the Social Security
18    Act, as now or hereafter amended (42 U.S.C. 1395i-3(a),
19    (b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and
20    (d)); (iii) any facility as defined by Section 1-113 of
21    the ID/DD Community Care Act, as now or hereafter amended;
22    (iv) any facility as defined by Section 1-113 of MC/DD
23    Act, as now or hereafter amended; and (v) any facility
24    licensed under Section 4-105 or 4-201 of the Specialized
25    Mental Health Rehabilitation Act of 2013, as now or
26    hereafter amended.

 

 

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1        (2.5) "Assisted living establishment" and "shared
2    housing establishment" have the meanings given those terms
3    in Section 10 of the Assisted Living and Shared Housing
4    Act.
5        (2.7) "Supportive living facility" means a facility
6    established under Section 5-5.01a of the Illinois Public
7    Aid Code.
8        (2.8) "Community-based setting" means any place of
9    abode other than an individual's private home.
10        (3) "State Long Term Care Ombudsman" means any person
11    employed by the Department to fulfill the requirements of
12    the Office of State Long Term Care Ombudsman as required
13    under the Older Americans Act of 1965, as now or hereafter
14    amended, and Departmental policy.
15        (3.1) "Ombudsman" means any designated representative
16    of the State Long Term Care Ombudsman Program; provided
17    that the representative, whether he is paid for or
18    volunteers his ombudsman services, shall be qualified and
19    designated by the Office to perform the duties of an
20    ombudsman as specified by the Department in rules and in
21    accordance with the provisions of the Older Americans Act
22    of 1965, as now or hereafter amended.
23        (4) "Participant" means an older person aged 60 or
24    over or an adult with a disability aged 18 through 59 who
25    is eligible for services under any of the following:
26            (i) A medical assistance waiver administered by

 

 

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

 

 

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

 

 

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1include information specific to assisted living
2establishments, supportive living facilities, shared housing
3establishments, private homes, and community-based settings
4and to the rights of residents and participants guaranteed
5under the corresponding Acts and administrative rules.
6    (c-5) Consumer Choice Information Reports. The Office
7shall:
8        (1) In collaboration with the Attorney General, create
9    a Consumer Choice Information Report form to be completed
10    by all licensed long term care facilities to aid
11    Illinoisans and their families in making informed choices
12    about long term care. The Office shall create a Consumer
13    Choice Information Report for each type of licensed long
14    term care facility. The Office shall collaborate with the
15    Attorney General and the Department of Human Services to
16    create a Consumer Choice Information Report form for
17    facilities licensed under the ID/DD Community Care Act or
18    the MC/DD Act.
19        (2) Develop a database of Consumer Choice Information
20    Reports completed by licensed long term care facilities
21    that includes information in the following consumer
22    categories:
23            (A) Medical Care, Services, and Treatment.
24            (B) Special Services and Amenities.
25            (C) Staffing.
26            (D) Facility Statistics and Resident Demographics.

 

 

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

 

 

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1    Medicare and Medicaid Services.
2    (d) Access and visitation rights.
3        (1) In accordance with subparagraphs (A) and (E) of
4    paragraph (3) of subsection (c) of Section 1819 and
5    subparagraphs (A) and (E) of paragraph (3) of subsection
6    (c) of Section 1919 of the Social Security Act, as now or
7    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
8    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
9    Older Americans Act of 1965, as now or hereafter amended
10    (42 U.S.C. 3058f), a long term care facility, supportive
11    living facility, assisted living establishment, and shared
12    housing establishment must:
13            (i) permit immediate access to any resident,
14        regardless of age, by a designated ombudsman;
15            (ii) permit representatives of the Office, with
16        the permission of the resident, the resident's legal
17        representative, or the resident's legal guardian, to
18        examine and copy a resident's clinical and other
19        records, including facility reports of incidents or
20        occurrences made to State agencies, regardless of the
21        age of the resident, and if a resident is unable to
22        consent to such review, and has no legal guardian,
23        permit representatives of the Office appropriate
24        access, as defined by the Department, in consultation
25        with the Office, in administrative rules, to the
26        resident's records; and

 

 

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1            (iii) permit a representative of the Program to
2        communicate privately and without restriction with any
3        participant who consents to the communication
4        regardless of the consent of, or withholding of
5        consent by, a legal guardian or an agent named in a
6        power of attorney executed by the participant.
7        (2) Each long term care facility, supportive living
8    facility, assisted living establishment, and shared
9    housing establishment shall display, in multiple,
10    conspicuous public places within the facility accessible
11    to both visitors and residents and in an easily readable
12    format, the address and phone number of the Office of the
13    Long Term Care Ombudsman, in a manner prescribed by the
14    Office.
15    (e) Immunity. An ombudsman or any representative of the
16Office participating in the good faith performance of his or
17her official duties shall have immunity from any liability
18(civil, criminal or otherwise) in any proceedings (civil,
19criminal or otherwise) brought as a consequence of the
20performance of his official duties.
21    (f) Business offenses.
22        (1) No person shall:
23            (i) Intentionally prevent, interfere with, or
24        attempt to impede in any way any representative of the
25        Office in the performance of his official duties under
26        this Act and the Older Americans Act of 1965; or

 

 

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

 

 

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

 

 

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1    (k) Each Regional Ombudsman may, in accordance with rules
2promulgated by the Office, establish a multi-disciplinary team
3to act in an advisory role for the purpose of providing
4professional knowledge and expertise in handling complex
5abuse, neglect, and advocacy issues involving participants.
6Each multi-disciplinary team may consist of one or more
7volunteer representatives from any combination of at least 7
8members from the following professions: banking or finance;
9disability care; health care; pharmacology; law; law
10enforcement; emergency responder; mental health care; clergy;
11coroner or medical examiner; substance abuse; domestic
12violence; sexual assault; or other related fields. To support
13multi-disciplinary teams in this role, law enforcement
14agencies and coroners or medical examiners shall supply
15records as may be requested in particular cases. The Regional
16Ombudsman, or his or her designee, of the area in which the
17multi-disciplinary team is created shall be the facilitator of
18the multi-disciplinary team.
19(Source: P.A. 102-1033, eff. 1-1-23; 103-329, eff. 1-1-24.)