State of Illinois
90th General Assembly
Legislation

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[ Introduced ][ Senate Amendment 002 ][ Senate Amendment 003 ]

90_SB0743eng

      New Act
      20 ILCS 3960/3            from Ch. 111 1/2, par. 1153
      210 ILCS 45/1-113         from Ch. 111 1/2, par. 4151-113
          Creates the Assisted Living Establishment Act to  require
      the  registration  of assisted living establishments with the
      Department  on  Aging.  Provides  that  an  assisted   living
      establishment  must  execute  a  written  contract  with each
      tenant  or  his  or  her   representative.   Authorizes   the
      Department to oversee and coordinate the enforcement of State
      consumer  protection  policies  affecting tenants of assisted
      living  establishments.  Provides  for  the  creation  of  an
      Assisted Living Advisory Commission to assist the  Department
      with   registration  and  disciplinary  actions.  Amends  the
      Illinois Health Facilities Planning Act and the Nursing  Home
      Care  Act  to  exempt assisted living establishments from the
      licensing requirements of those Acts.  Effective  January  1,
      1998.
                                                    LRB9000385DPccC
SB743 Engrossed                               LRB9000385DPccC
 1        AN  ACT  to  create the Senior Housing with Services Act,
 2    amending named Acts.
 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:
 5        Section  1.   Short  title.  This Act may be cited as the
 6    Senior Housing with Services Act.
 7        Section 5.  Legislative purpose.   The  purpose  of  this
 8    Act  is  to  promote the availability of appropriate services
 9    for  elderly  persons  in  the  least  restrictive  and  most
10    homelike  environment;   to  encourage  the  development   of
11    assisted  living and shared housing arrangements that promote
12    the dignity, individuality, privacy, independence,  autonomy,
13    and  decision-making ability and the right to negotiated risk
14    of those persons;  to provide for  the  health,  safety,  and
15    welfare  of  those  residents residing in assisted living and
16    shared housing establishments  in  this  State;   to  promote
17    continuous  quality  improvement  in assisted living;  and to
18    encourage  the  development  of  innovative  and   affordable
19    assisted   living  establishments  and  shared  housing  with
20    service establishments for  elderly  persons  of  all  income
21    levels.   It is the public policy of this State that assisted
22    living is an important part of  the  continuum  of  long-term
23    care.   In  support  of  the goal of aging in place, assisted
24    living establishments and shared housing establishments shall
25    be  operated  as  residential  environments  with  supportive
26    services designed to meet the individual residents'  changing
27    needs  and preferences.  The residential environment shall be
28    designed to encourage family and community involvement.   The
29    services  available  to residents, either directly or through
30    contracts or  agreements,  are  intended  to  help  residents
31    remain  as  independent  as  possible. Assisted living, which
SB743 Engrossed             -2-               LRB9000385DPccC
 1    promotes resident choice autonomy and decision making, should
 2    be based  on  a  contract  model  designed  to  result  in  a
 3    negotiated  agreement between the resident or a family member
 4    of the resident and the  provider,  clearly  identifying  the
 5    services  to  be provided.  This model supports the principle
 6    that  there  is  an  acceptable  balance   between   consumer
 7    protection  and  resident willingness to accept risk and that
 8    most consumers are competent  to  make  their  own  judgments
 9    about  the services they are obtaining. Oversight of assisted
10    living establishments and shared housing establishments  must
11    be sufficiently flexible to allow  residents to age in place.
12        Section 10.  Definitions.  For purposes of this Act:
13        "Activity   of  daily  living"  means  eating,  dressing,
14    bathing,  toileting,  transferring,  ambulating,   or   other
15    grooming.
16        "Assisted  living establishment" or "establishment" means
17    a home, building, residence, or any  other  place  where  the
18    following  services are provided consistent with the purposes
19    of this Act:
20             (1)  community-based residential  care  for  persons
21        who  need  assistance  with  activities  of daily living,
22        including   housing   and   personal,   supportive,   and
23        intermittent health-related services available  24  hours
24        per day, if needed, to meet the scheduled and unscheduled
25        needs of a resident in a way that promotes self-direction
26        and    participation    in   decisions   that   emphasize
27        independence, individuality, privacy, and  dignity  in  a
28        residential surrounding;
29             (2)  mandatory  services,  whether provided directly
30        by the establishment or by another entity arranged for by
31        the establishment, with the consent of  the  resident  or
32        resident's  representative;
33             (3)  physical   environment  standards  that,  at  a
SB743 Engrossed             -3-               LRB9000385DPccC
 1        minimum, require a homelike  setting  that  includes  the
 2        following  and  such other elements as established by the
 3        Department in conjunction with the  Senior  Housing  with
 4        Services Advisory Board:  individual living units each of
 5        which  shall  accommodate  small  kitchen  appliances and
 6        contain private bathing, washing, and toilet  facilities,
 7        or  private  washing  and toilet facilities with a common
 8        bathing room readily accessible to each resident.   Units
 9        shall  be maintained for single occupancy except in cases
10        in which 2 residents choose to share a unit.   Sufficient
11        common  space  shall exist to permit individual and group
12        activities.  An  assisted  living  establishment provides
13        sleeping accommodations to  3  or  more  unrelated  adult
14        residents,   at  least 80% of whom are 55 years of age or
15        older.
16        "Assisted living establishment" or  "establishment"  does
17    not mean any of the following:
18             (1)  A  home, institution, or similar place operated
19        by the federal government or the State of Illinois.
20             (2)  A long-term care facility  licensed  under  the
21        Nursing  Home  Care  Act.   However,  a  long  term  care
22        facility may convert sections of the facility to assisted
23        living.  If the long-term care  facility elects to do so,
24        the facility shall retain the  Certificate  of  Need  for
25        its nursing beds that were converted.
26             (3)  A  hospital,  sanitarium, or other institution,
27        the principal activity  or  business  of  which  is   the
28        diagnosis,  care, and treatment of human illness and that
29        is  required  to  be   licensed   under    the   Hospital
30        Licensing Act.
31             (4)  A  facility  for  child  care as defined in the
32        Child Care Act of 1969.
33             (5)  A community living facility as defined  in  the
34        Community Living Facilities Licensing Act.
SB743 Engrossed             -4-               LRB9000385DPccC
 1             (6)  A  community residential alternative as defined
 2        in the Community  Residential Alternatives Licensing Act.
 3             (7)  A nursing home or sanitarium operated solely by
 4        and for persons who rely exclusively  upon  treatment  by
 5        spiritual means through prayer in  accordance  with   the
 6        creed    or   tenants  of  a  well-recognized  church  or
 7        religious denomination.
 8             (8)  A facility licensed by the Department of  Human
 9        Services  as a community-integrated living arrangement as
10        defined in the  Community-Integrated Living  Arrangements
11        Licensure and Certification Act.
12             (9)  A   supportive  residence  licensed  under  the
13        Supportive  Residences  Licensing Act.
14             (10)  A life care facility as defined  in  the  Life
15        Care Facilities Act; a life care facility may apply under
16        this Act to convert sections of the community to assisted
17        living.
18             (11)  A free-standing hospice facility.
19             (12)  A shared housing establishment.
20             (13)  A  supportive  living facility as described in
21        Section 5-5.01a of the Illinois Public Aid Code.
22        "Department" means the Department on Aging.
23        "Director" means the Director of Aging.
24        "Mandatory services" include the following:
25             (1)  meals  provided  in  a  dining  room  or    the
26        resident's  own room and prepared by the establishment or
27        an outside contractor;
28             (2)  housekeeping  services   including,   but   not
29        limited  to, vacuuming, dusting, and cleaning the kitchen
30        and bathrooms of the resident's unit;
31             (3)  security provided 24 hours each day  including,
32        but  not  limited  to,  locked  entrances  or building or
33        contract security personnel;
34             (4)  either  an  emergency  communication   response
SB743 Engrossed             -5-               LRB9000385DPccC
 1        system, which is a procedure in place 24  hours  each day
 2        by  which  a  resident can notify building management, an
 3        emergency response  vendor, or others able to respond  to
 4        his  or  her  need  for  assistance   or  a procedure and
 5        staffing pattern designed to meet the intention  of  this
 6        clause  to  respond to the needs of residents who are not
 7        capable of communicating their needs for  assistance  due
 8        to cognitive impairment; and
 9             (5)  personal  care  including,  but not limited to,
10        assistance   with   bathing,      dressing,     grooming,
11        ambulating,   toileting,   transferring,  meal  planning,
12        personal laundry.
13        "Shared housing establishment" or "establishment" means a
14    publicly or privately operated residence for  fewer  than  12
15    persons,  at  least  80% of whom are 55 years of age or older
16    and who are unrelated to the owners and one  manager  of  the
17    residence,  that  directly provides or contracts with another
18    entity  with  the  consent  of  the  resident  or  resident's
19    representative for the provision of mandatory services.
20        "Resident" means a person residing in an assisted  living
21    or shared housing establishment.
22        Section  15. Service plan requirement. Prior to admission
23    to any establishment covered by  this  Act,  a  comprehensive
24    assessment  that  includes  an  evaluation of the prospective
25    resident's physical, cognitive,  and  psychosocial  condition
26    shall   be   completed.    At   least   annually,   and  upon
27    identification of a  significant  change  in  the  resident's
28    condition,  a  comprehensive  assessment  shall be completed.
29    The initial physical  assessment  shall  be  completed  by  a
30    physician  licensed to practice medicine in all its branches.
31    Based on the assessment, a  written  service  plan  shall  be
32    developed  and  mutually  agreed upon by the provider and the
33    resident. The service plan, which shall be reviewed annually,
SB743 Engrossed             -6-               LRB9000385DPccC
 1    or more often as the resident's  condition,  preferences,  or
 2    care  needs  change,  shall serve as a basis for the contract
 3    between  the  provider  and  the  resident.   Based  on   the
 4    assessment,   the   service   plan   may   provide   for  the
 5    disconnection or removal of any kitchen appliance.
 6        Section 20.  Staffing and management requirements.
 7        (a)  A facility licensed under this Act must employ:
 8             (1)  a full-time administrator who must be at  least
 9        21  years  of  age  with ability, training, and education
10        appropriate to meet the needs of  the  residents  and  to
11        manage   the   operations   of   the   facility  and  who
12        participates in on-going training for those purposes;
13             (2)  staff sufficient in number with qualifications,
14        adequate skills, education, and experience to meet the 24
15        hour scheduled and unscheduled needs of residents and who
16        participate in on-going training to  serve  the  resident
17        populations in a manner consistent with the philosophy of
18        assisted living.
19        (b)  The  administrator  and  all  individuals  providing
20    direct  care  to  residents  of  the  establishment,  whether
21    employed or contracted by the establishment, shall be subject
22    to the Health Care Worker Background Check Act.
23        Section    25.   License   requirement.   No  entity  may
24    establish, operate, conduct, or  maintain   an  establishment
25    registered  under  this  Act  in this State without a license
26    issued by the Department under this  Act.    An  entity  that
27    violates  the requirement of this Section shall be subject to
28    corrective action as established by rule of the Department in
29    collaboration with the Senior Housing with Services  Advisory
30    Board.
31        Section 30.  Licensing.
SB743 Engrossed             -7-               LRB9000385DPccC
 1        (a)  The  Department,  in  consultation  with  the Senior
 2    Housing with Services Advisory Board, shall establish by rule
 3    forms, procedures, and  fees  for  the  annual  licensing  of
 4    assisted  living and shared housing establishments, sanctions
 5    and penalties for operating in violation of this Act, and  an
 6    annual  on-site  review  requirement  for  each establishment
 7    covered by this Act, the scope of which shall  be  set  forth
 8    within the rule.
 9        (b)  Within 30 days after any change in the business name
10    or  address of the establishment or of pending closure of the
11    facility,  a  licensed   establishment   shall   notify   the
12    Department  of  the  name  or mailing address of the owner or
13    owners, the name or mailing address of the managing agent, or
14    of the pending closure.   There  shall  be  no  fee  for  the
15    submission  of any such notification.  An establishment shall
16    provide the following information to  the  Department  to  be
17    licensed:
18             (1)  the  business  name,  street  address,  mailing
19        address, and telephone number of the establishment;
20             (2)  the   name  and mailing address of the owner or
21        owners of  the  establishment and if the owner or  owners
22        are  not  natural  persons, identification of the type of
23        business entity  of   the   owners,  and  the  names  and
24        addresses of the officers and  members  of  the governing
25        body,  or  comparable  persons  for partnerships, limited
26        liability   corporations,  or  other  types  of  business
27        organizations;
28             (3)  the   name   and   mailing  address   of    the
29        managing   agent  of  the  establishment,  whether  hired
30        under a management  agreement   or  lease  agreement,  if
31        different  from  the owner or owners, and the name of the
32        on-site manager, if any;
33             (4)  verification    that   the   establishment  has
34        entered or will enter into a service delivery contract as
SB743 Engrossed             -8-               LRB9000385DPccC
 1        described  in Section 55, as  required  under  this  Act,
 2        with each resident or resident's representative;
 3             (5)  the  name  and  address of at least one natural
 4        person who shall be responsible  for   dealing  with  the
 5        Department  on  all  matters provided for in this Act, on
 6        whom personal service of all notices and orders shall  be
 7        made,  and  who  shall be authorized to accept service on
 8        behalf of the owner or owners  and  the  managing  agent.
 9        Notwithstanding a contrary provision of the Code of Civil
10        Procedure,  personal  service  on  the  person identified
11        pursuant to this subsection shall be  considered  service
12        on  the  owner  or  owners and the managing agent, and it
13        shall not be a defense  to  any  action    that  personal
14        service was not made on each individual or entity;
15             (6)  the  signature of the authorized representative
16        of the owner or owners;
17             (7)  proof of an ongoing quality  assurance  program
18        in  accordance   with  rules adopted by the Department in
19        collaboration  with  the  Senior  Housing  with  Services
20        Advisory Board;
21             (8)  information  about  the  number  and  types  of
22        units,  the  maximum  census,  and  the  services  to  be
23        provided at the establishment, proof of  compliance  with
24        applicable  State  and local residential standards, and a
25        copy of the standard contract offered to residents; and
26             (9)  documentation of adequate liability insurance.
27        Section 35.  Service requirements. An assisted living  or
28    shared  housing  establishment  must  provide  all  mandatory
29    services  and  may  provide additional services as defined by
30    rule including, but not limited  to,  medication  management,
31    intermittent  health-related services, transportation, health
32    assessment, counseling, and social or educational activities,
33    whether provided directly by the establishment or by  another
SB743 Engrossed             -9-               LRB9000385DPccC
 1    entity  arranged for by the establishment with the consent of
 2    the resident or the resident's representative.
 3        Section 40.  Admission and discharge criteria.
 4        (a)  A person shall be ineligible to be admitted as or to
 5    continue   as   an    assisted  living  or   shared   housing
 6    establishment  resident  for any one or more of the following
 7    reasons:
 8             (1)  the person poses a serious threat to himself or
 9        herself or to others;
10             (2)  the person is not able to  communicate  his  or
11        her needs;
12             (3)  the  person requires total assistance with 2 or
13        more   activities   of   daily   living    (except    for
14        quadraplegics,   paraplegics,  and  victims  of  muscular
15        dystrophy, multiple sclerosis, and  other  neuro-muscular
16        diseases  if  the  resident is able to communicate his or
17        her needs and does not require  assistance  with  complex
18        medical problems);
19             (4)  the person requires the assistance of more than
20        one  paid  caregiver  with  an  activity  of daily living
21        (except for quadraplegics, paraplegics,  and  victims  of
22        muscular   dystrophy,   multiple   sclerosis,  and  other
23        neuro-muscular  diseases  if  the  resident  is  able  to
24        communicate  his  or  her  needs  and  does  not  require
25        assistance with complex medical problems);
26             (5)  the person  requires  24-hour  skilled  nursing
27        care or supervision;
28             (6)  the   person   requires  intravenous  or  daily
29        intramuscular injections or intravenous feedings that are
30        not self-administered;
31             (7)  the person requires gastromy feedings that  are
32        not self-administered;
33             (8)  the    person   requires   insertion,   sterile
SB743 Engrossed             -10-              LRB9000385DPccC
 1        irrigation,  and  replacement  of  catheter,  except  for
 2        routine maintenance of Foley catheters;
 3             (9)  the person requires sterile wound care;
 4             (10)  the person requires treatment of  stage  3  or
 5        stage 4 decubitus ulcers or exfoliative dermatitis; or
 6             (11)  other reasons prescribed  by the Department by
 7        rule.
 8        (b)  Except  as provided in subsection (e), a person with
 9    a condition listed in items (6) through  (11)  of  subsection
10    (a)  for  a period of 21 consecutive days shall be ineligible
11    to continue as a resident.
12        (c)  A person  shall  be  ineligible  to  continue  as  a
13    resident if the individual requires 5 or more skilled nursing
14    visits   per   week for conditions other than those listed in
15    items (6) through (11) of subsection (a) for a period of   21
16    consecutive days or more.
17        (d)  A  resident  shall  be  discharged from the facility
18    when, in the opinion of the  resident's  treating  physician,
19    services  available to the resident  in the establishment are
20    no longer adequate for  the  care  of  the  resident.    This
21    provision    shall   not   be  interpreted  as  limiting  the
22    authority of the Department  to  require   the  discharge  of
23    individuals.
24        (e)  Terminally ill residents may continue residing in an
25    establishment if a hospice licensed under the Hospice Program
26    Licensing  Act  coordinates services and all parties agree to
27    the continued residency.
28        (f)  The Department,  in  consultation  with  the  Senior
29    Housing  with  Services Advisory Board, shall develop by rule
30    the procedures by  which  residents  shall  be  involuntarily
31    discharged under this Section.
32        Section 45.  Involuntary discharge.
33        (a)  No  resident may be involuntarily discharged from an
SB743 Engrossed             -11-              LRB9000385DPccC
 1    assisted living or shared housing  establishment  except  for
 2    the following reasons:
 3             (1)  for  the reasons outlined in Section 40 of this
 4        Act;
 5             (2)  for non-payment of  justifiable  charges  after
 6        the  resident  and  the  resident's  representative  have
 7        received  30  days  written notice of the delinquency and
 8        the resident or the resident's representative has had  at
 9        least 15 days to cure the deficiency; or
10             (3)  for  failure  to  negotiate a service agreement
11        where applicable.
12        (b)  Prior to an involuntary discharge, the establishment
13    shall give the resident or the resident's representative,  or
14    both,  a  30-day  written notice setting forth the reason and
15    proposed date for the move and notifying the resident of  the
16    right  to file a complaint with the Department.  In emergency
17    situations, notice may be waived.
18        Section 50.  Issuance of license.  The  Department  shall
19    issue  a license to an applicant who has met the requirements
20    of Section 25 and paid the required fee.
21        Section 55.    Contract   requirements.   No  entity  may
22    establish,  operate,  conduct, or maintain an assisted living
23    or shared housing establishment  in  this   State  unless   a
24    written   service  delivery  contract   is  executed  between
25    the  establishment    and   each   resident   or   resident's
26    representative  in accordance with Section 55, and unless the
27    establishment  operates in accordance with the terms  of  the
28    contract.   The  resident  or  the  resident's representative
29    shall  be given  a  complete copy of  the  contract  and  all
30    supporting   documents  and  attachments   and   any  changes
31    whenever changes are made.
SB743 Engrossed             -12-              LRB9000385DPccC
 1        Section 60.  Contents of  service  delivery  contract.  A
 2    contract   between  an  assisted  living  or  shared  housing
 3    establishment and  a  resident  must  be  entitled  "assisted
 4    living    establishment   contract"    or   "shared   housing
 5    establishment contract" as applicable, shall be printed in no
 6    less than 12 point type,  and  shall  include  at  least  the
 7    following   elements   in  the  body  or  through  supporting
 8    documents or attachments:
 9        (1)  name, street address, and  mailing  address  of  the
10    establishment;
11        (2)  the  name and mailing address of the owner or owners
12    of   the    establishment  and, if the owner or owners is not
13    natural persons, the type of  business entity of the owner or
14    owners;
15        (3)  the  name and mailing address of the managing  agent
16    of  the  establishment,   whether  hired  under  a management
17    agreement  or  lease  agreement,  if the  managing  agent  is
18    different  from  the  owner  or owners;
19        (4)  the   name   and   address  of  at least one natural
20    person  who  is  authorized  to accept service on  behalf  of
21    the owners and managing agent;
22        (5)  a  statement   describing  the license status of the
23    establishment and the license  status  of  all  providers  of
24    health-related  or  supportive  services  to a resident under
25    arrangement with the establishment;
26        (6)  the duration of the contract;
27        (7)  the base rate to be  paid  by  the  resident  and  a
28    description  of  the  services to be provided as part of this
29    rate;
30        (8)  description   of   any  additional  services  to  be
31    provided for an additional fee by the establishment  directly
32    or  by  a  third  party  provider  under arrangement with the
33    establishment;
34        (9)  fee schedules outlining the cost of  any  additional
SB743 Engrossed             -13-              LRB9000385DPccC
 1    services;
 2        (10)  a  description   of   the process through which the
 3    contract  may  be  modified, amended, or terminated;
 4        (11)  a  description  of  the  establishment's  complaint
 5    resolution process available  to residents and notice of  the
 6    availability   of   the   Department's  Senior  Helpline  for
 7    complaints;
 8        (12)  the resident's designated representative, if any;
 9        (13)  the resident's obligations  in  order  to  maintain
10    residency and receive services;
11        (14)  billing and payment procedures and requirements;
12        (15)  a  statement  affirming  the  resident's freedom to
13    receive  services  from  service  providers  with  whom   the
14    establishment  does not have a contractual arrangement, which
15    may also disclaim liability  on  the  part  of  the  assisted
16    living or shared housing establishment for those services;
17        (16)  a statement that medical assistance under Article V
18    or  Article  VI  of  the  Illinois  Public  Aid  Code  is not
19    available for payment for services provided  in  an  assisted
20    living or shared housing establishment;
21        (17)  a   statement   detailing   the   admission,   risk
22    management, and discharge criteria and procedures;
23        (18)  a statement acknowledging that, by contracting with
24    the  assisted  living  or  shared  housing establishment, the
25    resident does not forfeit the following rights:
26             (A)  federal and State constitutional rights;
27             (B)  the   right   to   retain  and   use   personal
28        property  and  a  place  to  store personal items that is
29        locked and secure;
30             (C)  the  right to refuse services and to be advised
31        of the  consequences  of that refusal;
32             (D)  the right to respect  for  bodily  privacy  and
33        dignity  at  all  times,    especially  during  care  and
34        treatment;
SB743 Engrossed             -14-              LRB9000385DPccC
 1             (E)  the right to privacy with regard to mail, phone
 2        calls, and visitors;
 3             (F)  the   right  to  be  free  of  retaliation  for
 4        criticizing   the  establishment  or making complaints to
 5        appropriate agencies;
 6             (G)  the right to be free of restraints;
 7             (H)  the right to be free of abuse or neglect;
 8             (I)  the  right to confidentiality of the resident's
 9        personal files maintained by the   establishment,  except
10        as specified in item (19) of this Section;
11             (J)  the  right  of access and the right to copy the
12        resident's    personal   files    maintained    by    the
13        establishment;
14             (K)  the   right   to   24   hours   access  to  the
15        establishment; and
16             (L)  the right to a  minimum  30  day  notice  of  a
17        planned establishment closure.
18        (19)  A   statement  detailing  the  Department's  annual
19    on-site review process  including  what  documents  shall  be
20    reviewed by the on-site reviewer as defined by rule.
21        Section   65.    Record   retention.    Service  delivery
22    contracts and related documents executed by each resident  or
23    resident's   representative   shall   be   maintained  by  an
24    establishment covered by this Act from the date of  execution
25    until   3  years  after  the  contract  is  terminated.   The
26    establishment shall  also  maintain  and  retain  records  to
27    residents  to  support  compliance  with  individual contract
28    and  with  applicable   State   and    federal   regulations.
29    The   records   and   supporting  documents  other  than  the
30    resident's  personal  files  shall   be  made  available  for
31    on-site  inspection  by  the Department upon request  at  any
32    time.
SB743 Engrossed             -15-              LRB9000385DPccC
 1        Section  70.  Powers and duties of the Department.
 2        (a)  The Department shall conduct an annual on-site visit
 3    at each assisted living and shared housing establishment.
 4        (b)  Upon receipt of information that  may  indicate  the
 5    failure   of    the     assisted  living  or  shared  housing
 6    establishment  or  a  service  provider  to  comply  with   a
 7    provision  of  this Act, the Department shall investigate the
 8    matter or make  appropriate  referrals  to  other  government
 9    agencies  and  entities  having jurisdiction over the subject
10    matter of the possible violation.  The  Department  may  also
11    make  referrals   to  any  public  or private agency that the
12    Department considers available for appropriate assistance  to
13    those involved. The Department may oversee and coordinate the
14    enforcement  of  State consumer protection policies affecting
15    residents residing in an establishment  licensed  under  this
16    Act.
17        (c)  The   Department  shall  establish by rule complaint
18    receipt,   investigation,    and    resolution    procedures.
19    Resolution  procedures  shall  provide for on-site review and
20    evaluation  of  an  assisted   living   or   shared   housing
21    establishment  found  to be in violation of this Act within a
22    specified period of time based on the gravity and severity of
23    the violation and any pervasive pattern of occurrences of the
24    same or similar violations.
25        (d)  The Director shall establish a Senior  Housing  with
26    Services Advisory Board.
27        (e)  The   Department   shall  mandate   compliance  with
28    the National Fire    Protection  Association's   Life  Safety
29    Code.
30        (f)  The  Department  shall,  beginning  January 1, 1999,
31    promulgate rules necessary for  the  administration  of  this
32    Act.
33        Section 75.  Senior Housing with Services Advisory Board.
SB743 Engrossed             -16-              LRB9000385DPccC
 1        (a)  The  Director  shall appoint the Senior Housing with
 2    Services  Advisory  Board  which  shall  be  responsible  for
 3    advising the Director in all aspects of the administration of
 4    the Act.
 5        (b)  The  Board  shall  be  comprised  of  the  following
 6    persons:
 7             (1)  the Director  who  shall  serve  as  chair,  ex
 8        officio and nonvoting;
 9             (2)  one  representative  each of the Departments of
10        Public Health,  Public  Aid,  and  the  Illinois  Housing
11        Development Authority, all nonvoting members;
12             (3)  the State ombudsman or his designee;
13             (4)  one  member of to be appointed by the President
14        of the Senate;
15             (5)  one member to  be  appointed  by  the  Minority
16        Leader of the Senate;
17             (6)  one  member  to  be appointed by the Speaker of
18        the House of Representatives;
19             (7)  one member to  be  appointed  by  the  Minority
20        Leader of the House of Representatives;
21             (8)  one  representative  of the Association of Area
22        Agencies on Aging;
23             (9)  four members selected from the  recommendations
24        by  provider  organizations  whose  membership consist of
25        nursing care or assisted living facilities;
26             (10)  two residents of assisted living facilities;
27             (11)  three    members     selected     from     the
28        recommendations  of  consumer  organizations which engage
29        solely in advocacy or legal representation on  behalf  of
30        the senior population;
31             (12)  two  representatives of the medical profession
32        of the State of Illinois; and
33             (13)  two citizen members with expertise in the area
34        of gerontology research.
SB743 Engrossed             -17-              LRB9000385DPccC
 1        (c)  Members of the Board created by this  Act  shall  be
 2    appointed to serve for terms of 3 years.  All members will be
 3    appointed  no  later  than January 1, 1999.  One third of the
 4    Board member's initial terms will expire  in  one  year;  one
 5    third in 2 years, and one third in 3 years.   A member's term
 6    does  not  expire  until  a  successor  is  appointed  by the
 7    Director.  The Board shall meet at the call of the  Director.
 8    A member of the Board can designate a replacement to serve at
 9    the  Board  meeting  and  vote  in  place  of  the  member by
10    submitting a letter of designation to the chair prior  to  or
11    at the Board meeting.  Members of this Board shall receive no
12    compensation  for  their  services; however, resident members
13    shall be reimbursed for their actual expenses.
14        Section 80.  Operation without a license. An entity  that
15    provides  assisted  living  or  shared  housing establishment
16    services without a license issued under  this  Act  shall  be
17    subject  to  the  provisions,  including  penalties,  of  the
18    Nursing Home Care Act.
19        Section 85.  Civil penalties.
20        (a)  The  Department  may  assess  a civil penalty not to
21    exceed $5,000 against any establishment  covered  under  this
22    Act for violations of this Act. Each day of such operation is
23    a separate violation.
24        (b)  Beginning  180  days after the promulgation of rules
25    under this Act by  the Department, the Department may  assess
26    a   civil   penalty   not   to   exceed  $3,000  against  any
27    establishment  covered  under  this  Act  for  caring  for  a
28    resident who exceeds the care  needs  defined  in  this  Act.
29    Each day shall constitute a separate violation.
30        (c)  The  Department  is   authorized to hold hearings in
31    contested cases regarding appeals of the  penalties  assessed
32    pursuant to this subsection.
SB743 Engrossed             -18-              LRB9000385DPccC
 1        Section 90.  State and private funding. Nothing  in  this
 2    Act shall:
 3        (1)  require  or  authorize  the State agency responsible
 4    for the administration  of  the  medical  assistance  program
 5    established  under  Article  V and Article VI of the Illinois
 6    Public Aid Code to approve, supply or cover services provided
 7    in an assisted living or shared housing establishment;
 8        (2)  require an agency or  a  managed  care  organization
 9    to approve, supply, or cover services provided in an assisted
10    living or shared housing establishment; or
11        (3)  require  any  other  third  party  payer to approve,
12    supply  or  cover  medically  necessary  home  care  services
13    provided in an assisted living establishment.
14        Section  95.   Conversion  of  sheltered care facilities.
15    Entities licensed as  sheltered  care  facilities  under  the
16    Nursing  Home  Care  Act may elect to convert their sheltered
17    care license to a license under this Act.
18        Section 100.   Application of  Act.   All  establishments
19    licensed  under this Act shall obtain and maintain  all other
20    licenses,  permits,  certificates,  and  other   governmental
21    approvals  required  of  it,  except that a licensed assisted
22    living or shared housing establishment  is  exempt  from  the
23    provisions of the Illinois Health Facilities Planning Act and
24    the Nursing Home Care Act.  All establishments licensed under
25    this  Act shall  comply  with  the requirements of all local,
26    State,  federal,  and  other  applicable  laws,  rules,   and
27    ordinances  and  the  National  Fire Protection Association's
28    Life Safety Code.
29        Section 105. Senior Housing Regulatory  Fund.   There  is
30    created  in  the State treasury a special fund to be known as
31    the Senior Housing Regulatory Fund.  All moneys  received  by
SB743 Engrossed             -19-              LRB9000385DPccC
 1    the  Department  under  this  Act shall be deposited into the
 2    Fund.  Subject to appropriation, moneys in the Fund shall  be
 3    used  for the administration of this Act.  Interest earned on
 4    moneys in the Fund shall be deposited into the Fund.
 5        Section 110.  Report of the Department.
 6        (a)  The Department shall conduct a study or contract for
 7    the conducting of a study to review the effects of  this  Act
 8    on  the availability of housing for seniors.  The study shall
 9    evaluate whether (i) sufficient housing exists  to  meet  the
10    needs  of  Illinois  seniors  for  housing, (ii) the services
11    available under this Act meet the needs of Illinois  seniors,
12    (iii)  the private sector marketplace is an adequate supplier
13    of housing with services for  seniors,  and  (iv)  any  other
14    consideration the Department deems relevant.
15        (b)  The  study  shall  be completed and its findings and
16    recommendations reported to the  General  Assembly  no  later
17    than January 1, 2005.
18        Section  115.  Severability.   The provisions of this Act
19    are severable under Section 1.31 of the Statute on Statutes.
20        Section 190.  The Illinois Health Facilities Planning Act
21    is amended by changing Section 3 as follows:
22        (20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
23        Sec. 3.  As used in this Act:
24        "Health care facilities" means and includes the following
25    facilities and organizations:
26             1.  An ambulatory surgical treatment center required
27        to  be  licensed  pursuant  to  the  Ambulatory  Surgical
28        Treatment Center Act;
29             2.  An  institution,  place,  building,  or   agency
30        required   to   be  licensed  pursuant  to  the  Hospital
SB743 Engrossed             -20-              LRB9000385DPccC
 1        Licensing Act;
 2             3.  Any institution required to be licensed pursuant
 3        to the Nursing Home Care Act;
 4             4.  Hospitals, nursing  homes,  ambulatory  surgical
 5        treatment  centers,  or  kidney disease treatment centers
 6        maintained by the  State  or  any  department  or  agency
 7        thereof; and
 8             5.  Skilled    and   intermediate   long-term   care
 9        facilities licensed under the Nursing Home Care Act; and
10             6.  Kidney disease treatment  centers,  including  a
11        free-standing hemodialysis unit.
12        No  federally  owned  facility  shall  be  subject to the
13    provisions of  this  Act,  nor  facilities  used  solely  for
14    healing by prayer or spiritual means.
15        No  facility  licensed  under  the  Supportive Residences
16    Licensing Act or  licensed  under  the  Senior  Housing  with
17    Services Act shall be subject to the provisions of this Act.
18        A  facility  designated  as  a supportive living facility
19    that is in  good  standing  with  the  demonstration  project
20    established  under Section 5-5.01a of the Illinois Public Aid
21    Code shall not be subject to the provisions of this Act.
22        This Act does not apply  to  facilities  granted  waivers
23    under Section 3-102.2 of the Nursing Home Care Act.  However,
24    if  a  demonstration  project  under  that  Act applies for a
25    certificate of need to convert  to  a  nursing  facility,  it
26    shall meet the licensure and certificate of need requirements
27    in effect as of the date of application.
28        With  the  exception  of  those  health  care  facilities
29    specifically  included  in  this Section, nothing in this Act
30    shall be intended to include facilities operated as a part of
31    the practice of a physician or  other  licensed  health  care
32    professional,  whether  practicing in his individual capacity
33    or within the legal structure of any partnership, medical  or
34    professional   corporation,   or  unincorporated  medical  or
SB743 Engrossed             -21-              LRB9000385DPccC
 1    professional group. Further, this  Act  shall  not  apply  to
 2    physicians  or  other  licensed  health  care  professional's
 3    practices  where  such practices are carried out in a portion
 4    of a health care facility under  contract  with  such  health
 5    care facility by a physician or by other licensed health care
 6    professionals,  whether practicing in his individual capacity
 7    or within the legal structure of any partnership, medical  or
 8    professional   corporation,   or  unincorporated  medical  or
 9    professional groups.  This Act shall apply to construction or
10    modification  and  to  establishment  by  such  health   care
11    facility  of  such  contracted  portion  which  is subject to
12    facility licensing requirements, irrespective  of  the  party
13    responsible   for   such   action   or   attendant  financial
14    obligation.
15        "Person" means any one or  more  natural  persons,  legal
16    entities,  governmental  bodies  other  than  federal, or any
17    combination thereof.
18        "Consumer" means any person other than a person (a) whose
19    major  occupation  currently  involves  or   whose   official
20    capacity   within   the  last  12  months  has  involved  the
21    providing, administering or financing of any type  of  health
22    care  facility,  (b) who is engaged in health research or the
23    teaching of health, (c) who has a material financial interest
24    in any activity which involves the  providing,  administering
25    or  financing of any type of health care facility, or (d) who
26    is or ever has been a member of the immediate family  of  the
27    person defined by (a), (b), or (c).
28        "State Board" means the Health Facilities Planning Board.
29        "Construction  or  modification" means the establishment,
30    erection,     building,      alteration,      reconstruction,
31    modernization,   improvement,   extension,   discontinuation,
32    change  of ownership, of or by a health care facility, or the
33    purchase or acquisition by or through a health care  facility
34    of   equipment  or  service  for  diagnostic  or  therapeutic
SB743 Engrossed             -22-              LRB9000385DPccC
 1    purposes or for facility administration or operation, or  any
 2    capital  expenditure  made  by  or on behalf of a health care
 3    facility which exceeds the capital expenditure minimum.
 4        "Establish" means  the  construction  of  a  health  care
 5    facility  or  the  replacement  of  an  existing  facility on
 6    another site.
 7        "Major medical equipment" means medical  equipment  which
 8    is  used  for  the  provision  of  medical  and  other health
 9    services and which costs in excess of the capital expenditure
10    minimum, except that  such  term  does  not  include  medical
11    equipment  acquired  by or on behalf of a clinical laboratory
12    to provide  clinical  laboratory  services  if  the  clinical
13    laboratory  is  independent  of  a  physician's  office and a
14    hospital and it has been determined under Title XVIII of  the
15    Social  Security  Act  to meet the requirements of paragraphs
16    (10) and (11) of Section 1861(s) of such Act.  In determining
17    whether medical equipment  has  a  value  in  excess  of  the
18    capital  expenditure  minimum, the value of studies, surveys,
19    designs, plans, working drawings, specifications,  and  other
20    activities  essential  to  the  acquisition of such equipment
21    shall be included.
22        "Capital Expenditure" means an expenditure:  (A) made  by
23    or on behalf of a health care facility (as such a facility is
24    defined  in this Act); and (B) which under generally accepted
25    accounting  principles  is  not  properly  chargeable  as  an
26    expense of operation and maintenance, or is made to obtain by
27    lease or comparable arrangement any facility or part  thereof
28    or  any  equipment  for a facility or part; and which exceeds
29    the capital expenditure minimum.
30        For the purpose  of  this  paragraph,  the  cost  of  any
31    studies,   surveys,   designs,   plans,   working   drawings,
32    specifications,   and   other  activities  essential  to  the
33    acquisition, improvement, expansion, or  replacement  of  any
34    plant  or  equipment  with respect to which an expenditure is
SB743 Engrossed             -23-              LRB9000385DPccC
 1    made shall be included in  determining  if  such  expenditure
 2    exceeds   the  capital  expenditures  minimum.  Donations  of
 3    equipment or facilities to a health care  facility  which  if
 4    acquired directly by such facility would be subject to review
 5    under  this Act shall be considered capital expenditures, and
 6    a transfer of equipment or  facilities  for  less  than  fair
 7    market  value  shall  be considered a capital expenditure for
 8    purposes of this Act  if  a  transfer  of  the  equipment  or
 9    facilities at fair market value would be subject to review.
10        "Capital  expenditure minimum" means $1,000,000 for major
11    medical  equipment  and  $2,000,000  for  all  other  capital
12    expenditures, both of which shall  be  annually  adjusted  to
13    reflect the increase in construction costs due to inflation.
14        "Areawide"  means a major area of the State delineated on
15    a geographic, demographic, and functional  basis  for  health
16    planning  and  for health service and having within it one or
17    more local areas for health planning and health service.  The
18    term "region", as contrasted with the term  "subregion",  and
19    the  word  "area"  may  be  used  synonymously  with the term
20    "areawide".
21        "Local" means a subarea of a delineated major  area  that
22    on  a  geographic,  demographic,  and functional basis may be
23    considered  to  be  part  of  such  major  area.   The   term
24    "subregion" may be used synonymously with the term "local".
25        "Areawide health planning organization" or "Comprehensive
26    health planning organization" means the health systems agency
27    designated  by  the Secretary, Department of Health and Human
28    Services or any successor agency.
29        "Local health planning organization"  means  those  local
30    health  planning organizations that are designated as such by
31    the areawide health planning organization of the  appropriate
32    area.
33        "Physician"  means  a  person  licensed  to  practice  in
34    accordance with the Medical Practice Act of 1987, as amended.
SB743 Engrossed             -24-              LRB9000385DPccC
 1        "Licensed   health  care  professional"  means  a  person
 2    licensed to practice  a  health  profession  under  pertinent
 3    licensing statutes of the State of Illinois.
 4        "Director" means the  Director of the Illinois Department
 5    of Public Health.
 6        "Agency" means the Illinois Department of Public Health.
 7        "Comprehensive  health  planning"  means  health planning
 8    concerned with  the  total  population  and  all  health  and
 9    associated  problems that affect the well-being of people and
10    that encompasses health services, health manpower, and health
11    facilities; and the coordination among these and  with  those
12    social,  economic,  and  environmental  factors  that  affect
13    health.
14        "Alternative  health  care  model"  means  a  facility or
15    program authorized under the Alternative Health Care Delivery
16    Act.
17    (Source: P.A. 89-499, eff.  6-28-96;  89-530,  eff.  7-19-96;
18    90-14, eff. 7-1-97.)
19        Section  191.  The State Finance Act is amended by adding
20    Section 5.480 as follows:
21        (30 ILCS 105/5.480 new)
22        Sec. 5.480.  The Senior Housing Regulatory Fund.
23        Section  192.  The Nursing Home Care Act  is  amended  by
24    changing Section 1-113 as follows:
25        (210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113)
26        Sec.  1-113.   "Facility"  or  "long-term  care facility"
27    means a private home, institution,  building,  residence,  or
28    any  other  place,  whether  operated for profit or not, or a
29    county home for  the  infirm  and  chronically  ill  operated
30    pursuant  to  Division  5-21 or 5-22 of the Counties Code, or
SB743 Engrossed             -25-              LRB9000385DPccC
 1    any similar institution operated by a  political  subdivision
 2    of  the  State  of  Illinois,  which  provides,  through  its
 3    ownership  or  management,  personal  care, sheltered care or
 4    nursing for 3 or more persons, not related to  the  applicant
 5    or  owner  by blood or marriage.  It includes skilled nursing
 6    facilities and intermediate care facilities  as  those  terms
 7    are  defined  in  Title  XVIII  and  Title XIX of the Federal
 8    Social Security Act.
 9        "Facility" does not include the following:
10        (1)  A home, institution, or other place operated by  the
11    federal  government  or  agency  thereof,  or by the State of
12    Illinois;
13        (2)  A hospital, sanitarium, or other  institution  whose
14    principal  activity  or  business is the diagnosis, care, and
15    treatment  of  human  illness  through  the  maintenance  and
16    operation as organized facilities therefor, which is required
17    to be licensed under the Hospital Licensing Act;
18        (3)  Any "facility for child  care"  as  defined  in  the
19    Child Care Act of 1969;
20        (4)  Any  "Community  Living  Facility" as defined in the
21    Community Living Facilities Licensing Act;
22        (5)  Any "community residential alternative"  as  defined
23    in the Community Residential Alternatives Licensing Act;
24        (6)  Any  nursing  home  or sanatorium operated solely by
25    and for  persons  who  rely  exclusively  upon  treatment  by
26    spiritual  means through prayer, in accordance with the creed
27    or  tenets  of  any  well-recognized  church   or   religious
28    denomination.  However, such nursing home or sanatorium shall
29    comply with all local laws and rules relating  to  sanitation
30    and safety;
31        (7)  Any  facility  licensed  by  the Department of Human
32    Services as  a  community-integrated  living  arrangement  as
33    defined   in  the  Community-Integrated  Living  Arrangements
34    Licensure and Certification Act;
SB743 Engrossed             -26-              LRB9000385DPccC
 1        (8)  Any  "Supportive  Residence"  licensed   under   the
 2    Supportive Residences Licensing Act; or
 3        (9)  Any  "supportive  living  facility" in good standing
 4    with the  demonstration  project  established  under  Section
 5    5-5.01a of the Illinois Public Aid Code; or.
 6        (10)  Any assisted living or shared housing establishment
 7    licensed under the Senior Housing with Services Act.
 8    (Source:  P.A.  89-499,  eff.  6-28-96;  89-507, eff. 7-1-97;
 9    90-14, eff. 7-1-97.)
10        Section 193.  The Health Care Worker Background Check Act
11    is amended by changing Section 15 as follows:
12        (225 ILCS 46/15)
13        Sec. 15.  Definitions.  For the purposes of this Act, the
14    following definitions apply:
15        "Applicant" means an individual seeking employment with a
16    health care employer who has received a bona fide conditional
17    offer of employment.
18        "Conditional offer of employment" means a bona fide offer
19    of employment by a health  care  employer  to  an  applicant,
20    which  is  contingent  upon  the receipt of a report from the
21    Department of State Police indicating that the applicant does
22    not have a record  of  conviction  of  any  of  the  criminal
23    offenses enumerated in Section 25.
24        "Direct  care"  means  the  provision  of nursing care or
25    assistance with meals, dressing, movement, bathing, or  other
26    personal  needs  or  maintenance,  or general supervision and
27    oversight  of  the  physical  and  mental  well-being  of  an
28    individual who is incapable of managing  his  or  her  person
29    whether  or  not  a  guardian  has  been  appointed  for that
30    individual.
31        "Health care employer" means:
32        (1)  the owner or licensee of any of the following:
SB743 Engrossed             -27-              LRB9000385DPccC
 1             (i)  a community living facility, as defined in  the
 2        Community Living Facilities Act;
 3             (ii)  a  life  care facility, as defined in the Life
 4        Care Facilities Act;
 5             (iii)  a long-term care facility, as defined in  the
 6        Nursing Home Care Act;
 7             (iv)  a  home  health agency, as defined in the Home
 8        Health Agency Licensing Act;
 9             (v)  a full  hospice,  as  defined  in  the  Hospice
10        Program Licensing Act;
11             (vi)  a   hospital,   as  defined  in  the  Hospital
12        Licensing Act;
13             (vii)  a  community  residential   alternative,   as
14        defined   in   the   Community  Residential  Alternatives
15        Licensing Act;
16             (viii)  a nurse agency,  as  defined  in  the  Nurse
17        Agency Licensing Act;
18             (ix)  a  respite  care  provider,  as defined in the
19        Respite Program Act;
20             (x)  an  establishment  licensed  under  the  Senior
21        Housing with Services Act;
22        (2)  a day training program certified by  the  Department
23    of Human Services;  or
24        (3)  a  community  integrated living arrangement operated
25    by  a  community  mental  health  and  developmental  service
26    agency,  as  defined  in  the   Community-Integrated   Living
27    Arrangements Licensing and Certification Act.
28        "Initiate" means the obtaining of the authorization for a
29    record  check  from  a  student, applicant, or employee.  The
30    educational entity or health care employer  or  its  designee
31    shall  transmit  all  necessary  information  and fees to the
32    Illinois State Police within 10 working days after receipt of
33    the authorization.
34    (Source: P.A. 89-197,  eff.  7-21-95;  89-507,  eff.  7-1-97;
SB743 Engrossed             -28-              LRB9000385DPccC
 1    89-674, eff. 8-14-96; 90-14, eff. 7-1-97.)
 2        Section  199.   Effective date.  This Section, Section 1,
 3    Section 10, Section 70, and  Section  75  of  this  Act  take
 4    effect  upon  becoming  law; the remaining provisions of this
 5    Act take effect January 1, 2000.

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