State of Illinois
90th General Assembly
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[ Introduced ][ Engrossed ][ Senate Amendment 002 ]

90_SB0743sam003

                                           LRB9000385JSgcam03
 1                    AMENDMENT TO SENATE BILL 743
 2        AMENDMENT NO.     .  Amend Senate Bill 743,  AS  AMENDED,
 3    by replacing the title with the following:
 4        "AN  ACT  to create the Senior Housing with Services Act,
 5    amending named Acts."; and
 6    by replacing everything after the enacting  clause  with  the
 7    following:
 8        "Section  1.   Short title.  This Act may be cited as the
 9    Senior Housing with Services Act.
10        Section 5.  Legislative purpose.   The  purpose  of  this
11    Act  is  to  promote the availability of appropriate services
12    for  elderly  persons  in  the  least  restrictive  and  most
13    homelike  environment;   to  encourage  the  development   of
14    assisted  living and shared housing arrangements that promote
15    the dignity, individuality, privacy, independence,  autonomy,
16    and  decision-making ability and the right to negotiated risk
17    of those persons;  to provide for  the  health,  safety,  and
18    welfare  of  those  residents residing in assisted living and
19    shared housing establishments  in  this  State;   to  promote
20    continuous  quality  improvement  in assisted living;  and to
21    encourage  the  development  of  innovative  and   affordable
                            -2-            LRB9000385JSgcam03
 1    assisted   living  establishments  and  shared  housing  with
 2    service establishments for  elderly  persons  of  all  income
 3    levels.   It is the public policy of this State that assisted
 4    living is an important part of  the  continuum  of  long-term
 5    care.   In  support  of  the goal of aging in place, assisted
 6    living establishments and shared housing establishments shall
 7    be  operated  as  residential  environments  with  supportive
 8    services designed to meet the individual residents'  changing
 9    needs  and preferences.  The residential environment shall be
10    designed to encourage family and community involvement.   The
11    services  available  to residents, either directly or through
12    contracts or  agreements,  are  intended  to  help  residents
13    remain  as  independent  as  possible. Assisted living, which
14    promotes resident choice autonomy and decision making, should
15    be based  on  a  contract  model  designed  to  result  in  a
16    negotiated  agreement between the resident or a family member
17    of the resident and the  provider,  clearly  identifying  the
18    services  to  be provided.  This model supports the principle
19    that  there  is  an  acceptable  balance   between   consumer
20    protection  and  resident willingness to accept risk and that
21    most consumers are competent  to  make  their  own  judgments
22    about  the services they are obtaining. Oversight of assisted
23    living establishments and shared housing establishments  must
24    be sufficiently flexible to allow  residents to age in place.
25        Section 10.  Definitions.  For purposes of this Act:
26        "Activity   of  daily  living"  means  eating,  dressing,
27    bathing,  toileting,  transferring,  ambulating,   or   other
28    grooming.
29        "Assisted  living establishment" or "establishment" means
30    a home, building, residence, or any  other  place  where  the
31    following  services are provided consistent with the purposes
32    of this Act:
33             (1)  community-based residential  care  for  persons
                            -3-            LRB9000385JSgcam03
 1        who  need  assistance  with  activities  of daily living,
 2        including   housing   and   personal,   supportive,   and
 3        intermittent health-related services available  24  hours
 4        per day, if needed, to meet the scheduled and unscheduled
 5        needs of a resident in a way that promotes self-direction
 6        and    participation    in   decisions   that   emphasize
 7        independence, individuality, privacy, and  dignity  in  a
 8        residential surrounding;
 9             (2)  mandatory  services,  whether provided directly
10        by the establishment or by another entity arranged for by
11        the establishment, with the consent of  the  resident  or
12        resident's  representative;
13             (3)  physical   environment  standards  that,  at  a
14        minimum, require a homelike  setting  that  includes  the
15        following  and  such other elements as established by the
16        Department in conjunction with the  Senior  Housing  with
17        Services Advisory Board:  individual living units each of
18        which  shall  accommodate  small  kitchen  appliances and
19        contain private bathing, washing, and toilet  facilities,
20        or  private  washing  and toilet facilities with a common
21        bathing room readily accessible to each resident.   Units
22        shall  be maintained for single occupancy except in cases
23        in which 2 residents choose to share a unit.   Sufficient
24        common  space  shall exist to permit individual and group
25        activities.  An  assisted  living  establishment provides
26        sleeping accommodations to  3  or  more  unrelated  adult
27        residents,   at  least 80% of whom are 55 years of age or
28        older.
29        "Assisted living establishment" or  "establishment"  does
30    not mean any of the following:
31             (1)  A  home, institution, or similar place operated
32        by the federal government or the State of Illinois.
33             (2)  A long-term care facility  licensed  under  the
34        Nursing  Home  Care  Act.   However,  a  long  term  care
                            -4-            LRB9000385JSgcam03
 1        facility may convert sections of the facility to assisted
 2        living.  If the long term care  facility elects to do so,
 3        the facility shall retain the  Certificate  of  Need  for
 4        its nursing beds that were converted.
 5             (3)  A  hospital,  sanitarium, or other institution,
 6        the principal activity  or  business  of  which  is   the
 7        diagnosis,  care, and treatment of human illness and that
 8        is  required  to  be   licensed   under    the   Hospital
 9        Licensing Act.
10             (4)  A  facility  for  child  care as defined in the
11        Child Care Act of 1969.
12             (5)  A community living facility as defined  in  the
13        Community Living Facilities Licensing Act.
14             (6)  A  community residential alternative as defined
15        in the Community  Residential Alternatives Licensing Act.
16             (7)  A nursing home or sanitarium operated solely by
17        and for persons who rely exclusively  upon  treatment  by
18        spiritual means through prayer in  accordance  with   the
19        creed    or   tenants  of  a  well-recognized  church  or
20        religious denomination.
21             (8)  A facility licensed by the Department of  Human
22        Services  as a community-integrated living arrangement as
23        defined in the  Community-Integrated Living  Arrangements
24        Licensure and Certification Act.
25             (9)  A   supportive  residence  licensed  under  the
26        Supportive  Residences  Licensing Act.
27             (10)  A life care facility as defined  in  the  Life
28        Care Facilities Act; a life care facility may apply under
29        this Act to convert sections of the community to assisted
30        living.
31             (11)  A free-standing hospice facility.
32             (12)  A shared housing establishment.
33             (13)  A  supportive  living facility as described in
34        Section 5-5.01a of the Illinois Public Aid Code.
                            -5-            LRB9000385JSgcam03
 1        "Department" means the Department on Aging.
 2        "Director" means the Director of Aging.
 3        "Mandatory services" include the following:
 4             (1)  meals  provided  in  a  dining  room  or    the
 5        resident's  own room and prepared by the establishment or
 6        an outside contractor;
 7             (2)  housekeeping  services   including,   but   not
 8        limited  to, vacuuming, dusting, and cleaning the kitchen
 9        and bathrooms of the resident's unit;
10             (3)  security provided 24 hours each day  including,
11        but  not  limited  to,  locked  entrances  or building or
12        contract security personnel;
13             (4)  either  an  emergency  communication   response
14        system, which is a procedure in place 24  hours  each day
15        by  which  a  resident can notify building management, an
16        emergency response  vendor, or others able to respond  to
17        his  or  her  need  for  assistance   or  a procedure and
18        staffing pattern designed to meet the intention  of  this
19        clause  to  respond to the needs of residents who are not
20        capable of communicating their needs for  assistance  due
21        to cognitive impairment; and
22             (5)  personal  care  including,  but not limited to,
23        assistance   with   bathing,      dressing,     grooming,
24        ambulating,   toileting,   transferring,  meal  planning,
25        personal laundry.
26        "Shared housing establishment" or "establishment" means a
27    publicly or privately operated residence for  fewer  than  12
28    persons,  at  least  80% of whom are 55 years of age or older
29    and who are unrelated to the owners and one  manager  of  the
30    residence,  that  directly provides or contracts with another
31    entity  with  the  consent  of  the  resident  or  resident's
32    representative for the provision of mandatory services.
33        "Resident" means a person residing in an assisted  living
34    or shared housing establishment.
                            -6-            LRB9000385JSgcam03
 1        Section  15. Service plan requirement. Prior to admission
 2    to any establishment covered by  this  Act,  a  comprehensive
 3    assessment  that  includes  an  evaluation of the prospective
 4    resident's physical, cognitive,  and  psychosocial  condition
 5    shall   be   completed.    At   least   annually,   and  upon
 6    identification of a  significant  change  in  the  resident's
 7    condition,  a  comprehensive  assessment  shall be completed.
 8    The initial physical  assessment  shall  be  completed  by  a
 9    physician  licensed to practice medicine in all its branches.
10    Based on the assessment, a  written  service  plan  shall  be
11    developed  and  mutually  agreed upon by the provider and the
12    resident. The service plan, which shall be reviewed annually,
13    or more often as the resident's  condition,  preferences,  or
14    care  needs  change,  shall serve as a basis for the contract
15    between  the  provider  and  the  resident.   Based  on   the
16    assessment,   the   service   plan   may   provide   for  the
17    disconnection or removal of any kitchen appliance.
18        Section 20.  Staffing and management requirements.
19        (a)  A facility licensed under this Act must employ:
20             (1)  a full-time administrator who must be at  least
21        21  years  of  age  with ability, training, and education
22        appropriate to meet the needs of  the  residents  and  to
23        manage   the   operations   of   the   facility  and  who
24        participates in on-going training for those purposes;
25             (2)  staff sufficient in number with qualifications,
26        adequate skills, education, and experience to meet the 24
27        hour scheduled and unscheduled needs of residents and who
28        participate in on-going training to  serve  the  resident
29        populations in a manner consistent with the philosophy of
30        assisted living.
31        (b)  The  administrator  and  all  individuals  providing
32    direct  care  to  residents  of  the  establishment,  whether
33    employed or contracted by the establishment, shall be subject
                            -7-            LRB9000385JSgcam03
 1    to the Health Care Worker Background Check Act.
 2        Section    25.   License   requirement.   No  entity  may
 3    establish, operate, conduct, or  maintain   an  establishment
 4    registered  under  this  Act  in this State without a license
 5    issued by the Department under this  Act.    An  entity  that
 6    violates  the requirement of this Section shall be subject to
 7    corrective action as established by rule of the Department in
 8    collaboration with the Senior Housing with Services  Advisory
 9    Board.
10        Section 30.  Licensing.
11        (a)  The  Department,  in  consultation  with  the Senior
12    Housing with Services Advisory Board, shall establish by rule
13    forms, procedures, and  fees  for  the  annual  licensing  of
14    assisted  living and shared housing establishments, sanctions
15    and penalties for operating in violation of this Act, and  an
16    annual  on-site  review  requirement  for  each establishment
17    covered by this Act, the scope of which shall  be  set  forth
18    within the rule.
19        (b)  Within 30 days after any change in the business name
20    or  address of the establishment or of pending closure of the
21    facility,  a  licensed   establishment   shall   notify   the
22    Department  of  the  name  or mailing address of the owner or
23    owners, the name or mailing address of the managing agent, or
24    of the pending closure.   There  shall  be  no  fee  for  the
25    submission  of any such notification.  An establishment shall
26    provide the following information to  the  Department  to  be
27    licensed:
28             (1)  the  business  name,  street  address,  mailing
29        address, and telephone number of the establishment;
30             (2)  the   name  and mailing address of the owner or
31        owners of  the  establishment and if the owner or  owners
32        are  not  natural  persons, identification of the type of
                            -8-            LRB9000385JSgcam03
 1        business entity  of   the   owners,  and  the  names  and
 2        addresses of the officers and  members  of  the governing
 3        body,  or  comparable  persons  for partnerships, limited
 4        liability   corporations,  or  other  types  of  business
 5        organizations;
 6             (3)  the   name   and   mailing  address   of    the
 7        managing   agent  of  the  establishment,  whether  hired
 8        under a management  agreement   or  lease  agreement,  if
 9        different  from  the owner or owners, and the name of the
10        on-site manager, if any;
11             (4)  verification    that   the   establishment  has
12        entered or will enter into a service delivery contract as
13        described  in Section 55, as  required  under  this  Act,
14        with each resident or resident's representative;
15             (5)  the  name  and  address of at least one natural
16        person who shall be responsible  for   dealing  with  the
17        Department  on  all  matters provided for in this Act, on
18        whom personal service of all notices and orders shall  be
19        made,  and  who  shall be authorized to accept service on
20        behalf of the owner or owners  and  the  managing  agent.
21        Notwithstanding a contrary provision of the Code of Civil
22        Procedure,  personal  service  on  the  person identified
23        pursuant to this subsection shall be  considered  service
24        on  the  owner  or  owners and the managing agent, and it
25        shall not be a defense  to  any  action    that  personal
26        service was not made on each individual or entity;
27             (6)  the  signature of the authorized representative
28        of the owner or owners;
29             (7)  proof of an ongoing quality  assurance  program
30        in  accordance   with  rules adopted by the Department in
31        collaboration  with  the  Senior  Housing  with  Services
32        Advisory Board;
33             (8)  information  about  the  number  and  types  of
34        units,  the  maximum  census,  and  the  services  to  be
                            -9-            LRB9000385JSgcam03
 1        provided at the establishment, proof of  compliance  with
 2        applicable  State  and local residential standards, and a
 3        copy of the standard contract offered to residents; and
 4             (9)  documentation of adequate liability insurance.
 5        Section 35.  Service requirements. An assisted living  or
 6    shared  housing  establishment  must  provide  all  mandatory
 7    services  and  may  provide additional services as defined by
 8    rule including, but not limited  to,  medication  management,
 9    intermittent  health-related services, transportation, health
10    assessment, counseling, and social or educational activities,
11    whether provided directly by the establishment or by  another
12    entity  arranged for by the establishment with the consent of
13    the resident or the resident's representative.
14        Section 40.  Admission and discharge criteria.
15        (a)  A person shall be ineligible to be admitted as or to
16    continue   as   an    assisted  living  or   shared   housing
17    establishment  resident  for any one or more of the following
18    reasons:
19             (1)  the person poses a serious threat to himself or
20        herself or to others;
21             (2)  the person is not able to  communicate  his  or
22        her needs;
23             (3)  the  person requires total assistance with 2 or
24        more   activities   of   daily   living    (except    for
25        quadraplegics,   paraplegics,  and  victims  of  muscular
26        dystrophy, multiple sclerosis, and  other  neuro-muscular
27        diseases  if  the  resident is able to communicate his or
28        her needs and does not require  assistance  with  complex
29        medical problems);
30             (4)  the person requires the assistance of more than
31        one  paid  caregiver  with  an  activity  of daily living
32        (except for quadraplegics, paraplegics,  and  victims  of
                            -10-           LRB9000385JSgcam03
 1        muscular   dystrophy,   multiple   sclerosis,  and  other
 2        neuro-muscular  diseases  if  the  resident  is  able  to
 3        communicate  his  or  her  needs  and  does  not  require
 4        assistance with complex medical problems);
 5             (5)  the person  requires  24-hour  skilled  nursing
 6        care or supervision;
 7             (6)  the   person   requires  intravenous  or  daily
 8        intramuscular injections or intravenous feedings that are
 9        not self-administered;
10             (7)  the person requires gastromy feedings that  are
11        not self-administered;
12             (8)  the    person   requires   insertion,   sterile
13        irrigation,  and  replacement  of  catheter,  except  for
14        routine maintenance of Foley catheters;
15             (9)  the person requires sterile wound care;
16             (10)  the person requires treatment of  stage  3  or
17        stage 4 decubitus ulcers or exfoliative dermatitis; or
18             (11)  other reasons prescribed  by the Department by
19        rule.
20        (b)  Except  as provided in subsection (e), a person with
21    a condition listed in items (6) through  (11)  of  subsection
22    (a)  for  a period of 21 consecutive days shall be ineligible
23    to continue as a resident.
24        (c)  A person  shall  be  ineligible  to  continue  as  a
25    resident if the individual requires 5 or more skilled nursing
26    visits   per   week for conditions other than those listed in
27    items (6) through (11) of subsection (a) for period  of    21
28    consecutive days or more.
29        (d)  A  resident  shall  be  discharged from the facility
30    when, in the opinion of the  resident's  treating  physician,
31    services  available to the resident  in the establishment are
32    no longer adequate for  the  care  of  the  resident.    This
33    provision    shall   not   be  interpreted  as  limiting  the
34    authority of the Department  to  require   the  discharge  of
                            -11-           LRB9000385JSgcam03
 1    individuals.
 2        (e)  Terminally ill residents may continue residing in an
 3    establishment if a hospice licensed under the Hospice Program
 4    Licensing  Act  coordinates services and all parties agree to
 5    the continued residency.
 6        (f)  The Department,  in  consultation  with  the  Senior
 7    Housing  with  Services Advisory Board, shall develop by rule
 8    the procedures by  which  residents  shall  be  involuntarily
 9    discharged under this Section.
10        Section 45.  Involuntary discharge.
11        (a)  No  resident may be involuntarily discharged from an
12    assisted living or shared housing  establishment  except  for
13    the following reasons:
14             (1)  for  the reasons outlined in Section 40 of this
15        Act;
16             (2)  for non-payment of  justifiable  charges  after
17        the  resident  and  the  resident's  representative  have
18        received  30  days  written notice of the delinquency and
19        the resident or the resident's representative has had  at
20        least 15 days to cure the deficiency; or
21             (3)  for  failure  to  negotiate a service agreement
22        where applicable.
23        (b)  Prior to an involuntary discharge, the establishment
24    shall give the resident or the resident's representative,  or
25    both,  a  30-day  written notice setting forth the reason and
26    proposed date for the move and notifying the resident of  the
27    right  to file a complaint with the Department.  In emergency
28    situations, notice may be waived.
29        Section 50.  Issuance of license.  The  Department  shall
30    issue  a license to an applicant who has met the requirements
31    of Section 25 and paid the required fee.
                            -12-           LRB9000385JSgcam03
 1        Section 55.    Contract   requirements.   No  entity  may
 2    establish,  operate,  conduct, or maintain an assisted living
 3    or shared housing establishment  in  this   State  unless   a
 4    written   service  delivery  contract   is  executed  between
 5    the  establishment    and   each   resident   or   resident's
 6    representative  in accordance with Section 55, and unless the
 7    establishment  operates in accordance with the terms  of  the
 8    contract.   The  resident  or  the  resident's representative
 9    shall  be given  a  complete copy of  the  contract  and  all
10    supporting   documents  and  attachments   and   any  changes
11    whenever changes are made.
12        Section 60.  Contents of  service  delivery  contract.  A
13    contract   between  an  assisted  living  or  shared  housing
14    establishment and  a  resident  must  be  entitled  "assisted
15    living    establishment   contract"    or   "shared   housing
16    establishment contract" as applicable, shall be printed in no
17    less than 12 point type,  and  shall  include  at  least  the
18    following   elements   in  the  body  or  through  supporting
19    documents or attachments:
20        (1)  name, street address, and  mailing  address  of  the
21    establishment;
22        (2)  the  name and mailing address of the owner or owners
23    of   the    establishment  and, if the owner or owners is not
24    natural persons, the type of  business entity of the owner or
25    owners;
26        (3)  the  name and mailing address of the managing  agent
27    of  the  establishment,   whether  hired  under  a management
28    agreement  or  lease  agreement,  if the  managing  agent  is
29    different  from  the  owner  or owners;
30        (4)  the   name   and   address  of  at least one natural
31    person  who  is  authorized  to accept service on  behalf  of
32    the owners and managing agent;
33        (5)  a  statement   describing  the license status of the
                            -13-           LRB9000385JSgcam03
 1    establishment and the license  status  of  all  providers  of
 2    health-related  or  supportive  services  to a resident under
 3    arrangement with the establishment;
 4        (6)  the duration of the contract;
 5        (7)  the base rate to be  paid  by  the  resident  and  a
 6    description  of  the  services to be provided as part of this
 7    rate;
 8        (8)  description   of   any  additional  services  to  be
 9    provided for an additional fee by the establishment  directly
10    or  by  a  third  party  provider  under arrangement with the
11    establishment;
12        (9)  fee schedules outlining the cost of  any  additional
13    services;
14        (10)  a  description   of   the process through which the
15    contract  may  be  modified, amended, or terminated;
16        (11)  a  description  of  the  establishment's  complaint
17    resolution process available  to residents and notice of  the
18    availability   of   the   Department's  Senior  Helpline  for
19    complaints;
20        (12)  the resident's designated representative, if any;
21        (13)  the resident's obligations  in  order  to  maintain
22    residency and receive services;
23        (14)  billing and payment procedures and requirements;
24        (15)  a  statement  affirming  the  resident's freedom to
25    receive  services  from  service  providers  with  whom   the
26    establishment  does not have a contractual arrangement, which
27    may also disclaim liability  on  the  part  of  the  assisted
28    living or shared housing establishment for those services;
29        (16)  a statement that medical assistance under Article V
30    or  Article  VI  of  the  Illinois  Public  Aid  Code  is not
31    available for payment for services provided  in  an  assisted
32    living or shared housing establishment;
33        (17)  a   statement   detailing   the   admission,   risk
34    management, and discharge criteria and procedures;
                            -14-           LRB9000385JSgcam03
 1        (18)  a statement acknowledging that, by contracting with
 2    the  assisted  living  or  shared  housing establishment, the
 3    resident does not forfeit the following rights:
 4             (A)  federal and State constitutional rights;
 5             (B)  the   right   to   retain  and   use   personal
 6        property  and  a  place  to  store personal items that is
 7        locked and secure;
 8             (C)  the  right to refuse services and to be advised
 9        of the  consequences  of that refusal;
10             (D)  the right to respect  for  bodily  privacy  and
11        dignity  at  all  times,    especially  during  care  and
12        treatment;
13             (E)  the right to privacy with regard to mail, phone
14        calls, and visitors;
15             (F)  the   right  to  be  free  of  retaliation  for
16        criticizing   the  establishment  or making complaints to
17        appropriate agencies;
18             (G)  the right to be free of restraints;
19             (H)  the right to be free of abuse or neglect;
20             (I)  the  right to confidentiality of the resident's
21        personal files maintained by the   establishment,  except
22        as specified in item (19) of this Section;
23             (J)  the  right  of access and the right to copy the
24        resident's    personal   files    maintained    by    the
25        establishment;
26             (K)  the   right   to   24   hours   access  to  the
27        establishment; and
28             (L)  the right to a  minimum  30  day  notice  of  a
29        planned establishment closure.
30        (19)  A   statement  detailing  the  Department's  annual
31    on-site review process  including  what  documents  shall  be
32    reviewed by the on-site reviewer as defined by rule.
33        Section   65.    Record   retention.    Service  delivery
                            -15-           LRB9000385JSgcam03
 1    contracts and related documents executed by each resident  or
 2    resident's   representative   shall   be   maintained  by  an
 3    establishment covered by this Act from the date of  execution
 4    until   3  years  after  the  contract  is  terminated.   The
 5    establishment shall  also  maintain  and  retain  records  to
 6    residents  to  support  compliance  with  individual contract
 7    and  with  applicable   State   and    federal   regulations.
 8    The   records   and   supporting  documents  other  than  the
 9    resident's  personal  files  shall   be  made  available  for
10    on-site  inspection  by  the Department upon request  at  any
11    time.
12        Section  70.  Powers and duties of the Department.
13        (a)  The Department shall conduct an annual on-site visit
14    at each assisted living and shared housing establishment.
15        (b)  Upon receipt of information that  may  indicate  the
16    failure   of    the     assisted  living  or  shared  housing
17    establishment  or  a  service  provider  to  comply  with   a
18    provision  of  this Act, the Department shall investigate the
19    matter or make  appropriate  referrals  to  other  government
20    agencies  and  entities  having jurisdiction over the subject
21    matter of the possible violation.  The  Department  may  also
22    make  referrals   to  any  public  or private agency that the
23    Department considers available for appropriate assistance  to
24    those involved. The Department may oversee and coordinate the
25    enforcement  of  State consumer protection policies affecting
26    residents residing in an establishment  licensed  under  this
27    Act.
28        (c)  The   Department  shall  establish by rule complaint
29    receipt,   investigation,    and    resolution    procedures.
30    Resolution  procedures  shall  provide for on-site review and
31    evaluation  of  an  assisted   living   or   shared   housing
32    establishment  found  to be in violation of this Act within a
33    specified period of time based on the gravity and severity of
                            -16-           LRB9000385JSgcam03
 1    the violation and any pervasive pattern of occurrences of the
 2    same or similar violations.
 3        (d)  The Director shall establish a Senior  Housing  with
 4    Services Advisory Board.
 5        (e)  The   Department   shall  mandate   compliance  with
 6    the National Fire    Protection  Association's   Life  Safety
 7    Code.
 8        (f)  The  Department  shall,  beginning  January 1, 1999,
 9    promulgate rules necessary for  the  administration  of  this
10    Act.
11        Section 75.  Senior Housing with Services Advisory Board.
12        (a)  The  Director  shall appoint the Senior Housing with
13    Services  Advisory  Board  which  shall  be  responsible  for
14    advising the Director in all aspects of the administration of
15    the Act.
16        (b)  The  Board  shall  be  comprised  of  the  following
17    persons:
18             (1)  the Director  who  shall  serve  as  chair,  ex
19        officio and nonvoting;
20             (2)  one  representative  each of the Departments of
21        Public Health,  Public  Aid,  and  the  Illinois  Housing
22        Development Authority, all nonvoting members;
23             (3)  the State ombudsman or his designee;
24             (4)  one  member of to be appointed by the President
25        of the Senate;
26             (5)  one member to  be  appointed  by  the  Minority
27        Leader of the Senate;
28             (6)  one  member  to  be appointed by the Speaker of
29        the House of Representatives;
30             (7)  one member to  be  appointed  by  the  Minority
31        Leader of the House of Representatives;
32             (8)  one  representative  of the Association of Area
33        Agencies on Aging;
                            -17-           LRB9000385JSgcam03
 1             (9)  four members selected from the  recommendations
 2        by  provider  organizations  whose  membership consist of
 3        nursing care or assisted living facilities;
 4             (10)  two residents of assisted living facilities;
 5             (11)  three    members     selected     from     the
 6        recommendations  of  consumer  organizations which engage
 7        solely in advocacy or legal representation on  behalf  of
 8        the senior population;
 9             (12)  two  representatives of the medical profession
10        of the State of Illinois; and
11             (13)  two citizen members with expertise in the area
12        of gerontology research.
13        (c)  Members of the Board created by this  Act  shall  be
14    appointed to serve for terms of 3 years.  All members will be
15    appointed  no  later  than January 1, 1999.  One third of the
16    Board member's initial terms will expire  in  one  year;  one
17    third in 2 years, and one third in 3 years.   A member's term
18    does  not  expire  until  a  successor  is  appointed  by the
19    Director.  The Board shall meet at the call of the  Director.
20    A member of the Board can designate a replacement to serve at
21    the  Board  meeting  and  vote  in  place  of  the  member by
22    submitting a letter of designation to the chair prior  to  or
23    at the Board meeting.  Members of this Board shall receive no
24    compensation  for  their  services; however, resident members
25    shall be reimbursed for their actual expenses.
26        Section 80.  Operation without a license. An entity  that
27    provides  assisted  living  or  shared  housing establishment
28    services without a license issued under  this  Act  shall  be
29    subject  to  the  provisions,  including  penalties,  of  the
30    Nursing Home Care Act.
31        Section 85.  Civil penalties.
32        (a)  The  Department  may  assess  a civil penalty not to
                            -18-           LRB9000385JSgcam03
 1    exceed $5,000 against any establishment  covered  under  this
 2    Act for violations of this Act. Each day of such operation is
 3    a separate violation.
 4        (b)  Beginning  180  days after the promulgation of rules
 5    under this Act by  the Department, the Department may  assess
 6    a   civil   penalty   not   to   exceed  $3,000  against  any
 7    establishment  covered  under  this  Act  for  caring  for  a
 8    resident who exceeds the care  needs  defined  in  this  Act.
 9    Each day shall constitute a separate violation.
10        (c)  The  Department  is   authorized to hold hearings in
11    contested cases regarding appeals of the  penalties  assessed
12    pursuant to this subsection.
13        Section 90.  State and private funding. Nothing  in  this
14    Act shall:
15        (1)  require  or  authorize  the State agency responsible
16    for the administration  of  the  medical  assistance  program
17    established  under  Article  V and Article VI of the Illinois
18    Public Aid Code to approve, supply or cover services provided
19    in an assisted living or shared housing establishment;
20        (2)  require an agency or  a  managed  care  organization
21    to approve, supply, or cover services provided in an assisted
22    living or shared housing establishment; or
23        (3)  require  any  other  third  party  payer to approve,
24    supply  or  cover  medically  necessary  home  care  services
25    provided in an assisted living establishment.
26        Section  95.   Conversion  of  sheltered care facilities.
27    Entities licensed as  sheltered  care  facilities  under  the
28    Nursing  Home  Care  Act may elect to convert their sheltered
29    care license to a license under this Act.
30        Section 100.   Application of  Act.   All  establishments
31    licensed  under this Act shall obtain and maintain  all other
                            -19-           LRB9000385JSgcam03
 1    licenses,  permits,  certificates,  and  other   governmental
 2    approvals  required  of  it,  except that a licensed assisted
 3    living or shared housing establishment  is  exempt  from  the
 4    provisions of the Illinois Health Facilities Planning Act and
 5    the Nursing Home Care Act.  All establishments licensed under
 6    this  Act shall  comply  with  the requirements of all local,
 7    State,  federal,  and  other  applicable  laws,  rules,   and
 8    ordinances  and  the  National  Fire Protection Association's
 9    Life Safety Code.
10        Section 105. Senior Housing Regulatory  Fund.   There  is
11    created  in  the State treasury a special fund to be known as
12    the Senior Housing Regulatory Fund.  All moneys  received  by
13    the  Department  under  this  Act shall be deposited into the
14    Fund.  Subject to appropriation, moneys in the Fund shall  be
15    used  for the administration of this Act.  Interest earned on
16    moneys in the Fund shall be deposited into the Fund.
17        Section 110.  Report of the Department.
18        (a)  The Department shall conduct a study or contract for
19    the conducting of a study to review the effects of  this  Act
20    on  the availability of housing for seniors.  The study shall
21    evaluate whether (i) sufficient housing exists  to  meet  the
22    needs  of  Illinois  seniors  for  housing, (ii) the services
23    available under this Act meet the needs of Illinois  seniors,
24    (iii)  the private sector marketplace is an adequate supplier
25    of housing with services for  seniors,  and  (iv)  any  other
26    consideration the Department deems relevant.
27        (b)  The  study  shall  be completed and its findings and
28    recommendations reported to the  General  Assembly  no  later
29    than January 1, 2005.
30        Section  115.  Severability.   The provisions of this Act
31    are severable under Section 1.31 of the Statute on Statutes.
                            -20-           LRB9000385JSgcam03
 1        Section 190.  The Illinois Health Facilities Planning Act
 2    is amended by changing Section 3 as follows:
 3        (20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
 4        Sec. 3.  As used in this Act:
 5        "Health care facilities" means and includes the following
 6    facilities and organizations:
 7             1.  An ambulatory surgical treatment center required
 8        to  be  licensed  pursuant  to  the  Ambulatory  Surgical
 9        Treatment Center Act;
10             2.  An  institution,  place,  building,  or   agency
11        required   to   be  licensed  pursuant  to  the  Hospital
12        Licensing Act;
13             3.  Any institution required to be licensed pursuant
14        to the Nursing Home Care Act;
15             4.  Hospitals, nursing  homes,  ambulatory  surgical
16        treatment  centers,  or  kidney disease treatment centers
17        maintained by the  State  or  any  department  or  agency
18        thereof; and
19             5.  Skilled   and   intermediate   long   term  care
20        facilities licensed under the Nursing Home Care Act; and
21             6.  Kidney disease treatment  centers,  including  a
22        free-standing hemodialysis unit.
23        No  federally  owned  facility  shall  be  subject to the
24    provisions of  this  Act,  nor  facilities  used  solely  for
25    healing by prayer or spiritual means.
26        No  facility  licensed  under  the  Supportive Residences
27    Licensing Act or  licensed  under  the  Senior  Housing  with
28    Services Act shall be subject to the provisions of this Act.
29        A  facility  designated  as  a supportive living facility
30    that is in  good  standing  with  the  demonstration  project
31    established  under Section 5-5.01a of the Illinois Public Aid
32    Code shall not be subject to the provisions of this Act.
33        This Act does not apply  to  facilities  granted  waivers
                            -21-           LRB9000385JSgcam03
 1    under Section 3-102.2 of the Nursing Home Care Act.  However,
 2    if  a  demonstration  project  under  that  Act applies for a
 3    certificate of need to convert  to  a  nursing  facility,  it
 4    shall meet the licensure and certificate of need requirements
 5    in effect as of the date of application.
 6        With  the  exception  of  those  health  care  facilities
 7    specifically  included  in  this Section, nothing in this Act
 8    shall be intended to include facilities operated as a part of
 9    the practice of a physician or  other  licensed  health  care
10    professional,  whether  practicing in his individual capacity
11    or within the legal structure of any partnership, medical  or
12    professional   corporation,   or  unincorporated  medical  or
13    professional group. Further, this  Act  shall  not  apply  to
14    physicians  or  other  licensed  health  care  professional's
15    practices  where  such practices are carried out in a portion
16    of a health care facility under  contract  with  such  health
17    care facility by a physician or by other licensed health care
18    professionals,  whether practicing in his individual capacity
19    or within the legal structure of any partnership, medical  or
20    professional   corporation,   or  unincorporated  medical  or
21    professional groups.  This Act shall apply to construction or
22    modification  and  to  establishment  by  such  health   care
23    facility  of  such  contracted  portion  which  is subject to
24    facility licensing requirements, irrespective  of  the  party
25    responsible   for   such   action   or   attendant  financial
26    obligation.
27        "Person" means any one or  more  natural  persons,  legal
28    entities,  governmental  bodies  other  than  federal, or any
29    combination thereof.
30        "Consumer" means any person other than a person (a) whose
31    major  occupation  currently  involves  or   whose   official
32    capacity   within   the  last  12  months  has  involved  the
33    providing, administering or financing of any type  of  health
34    care  facility,  (b) who is engaged in health research or the
                            -22-           LRB9000385JSgcam03
 1    teaching of health, (c) who has a material financial interest
 2    in any activity which involves the  providing,  administering
 3    or  financing of any type of health care facility, or (d) who
 4    is or ever has been a member of the immediate family  of  the
 5    person defined by (a), (b), or (c).
 6        "State Board" means the Health Facilities Planning Board.
 7        "Construction  or  modification" means the establishment,
 8    erection,     building,      alteration,      reconstruction,
 9    modernization,   improvement,   extension,   discontinuation,
10    change  of ownership, of or by a health care facility, or the
11    purchase or acquisition by or through a health care  facility
12    of   equipment  or  service  for  diagnostic  or  therapeutic
13    purposes or for facility administration or operation, or  any
14    capital  expenditure  made  by  or on behalf of a health care
15    facility which exceeds the capital expenditure minimum.
16        "Establish" means  the  construction  of  a  health  care
17    facility  or  the  replacement  of  an  existing  facility on
18    another site.
19        "Major medical equipment" means medical  equipment  which
20    is  used  for  the  provision  of  medical  and  other health
21    services and which costs in excess of the capital expenditure
22    minimum, except that  such  term  does  not  include  medical
23    equipment  acquired  by or on behalf of a clinical laboratory
24    to provide  clinical  laboratory  services  if  the  clinical
25    laboratory  is  independent  of  a  physician's  office and a
26    hospital and it has been determined under Title XVIII of  the
27    Social  Security  Act  to meet the requirements of paragraphs
28    (10) and (11) of Section 1861(s) of such Act.  In determining
29    whether medical equipment  has  a  value  in  excess  of  the
30    capital  expenditure  minimum, the value of studies, surveys,
31    designs, plans, working drawings, specifications,  and  other
32    activities  essential  to  the  acquisition of such equipment
33    shall be included.
34        "Capital Expenditure" means an expenditure:  (A) made  by
                            -23-           LRB9000385JSgcam03
 1    or on behalf of a health care facility (as such a facility is
 2    defined  in this Act); and (B) which under generally accepted
 3    accounting  principles  is  not  properly  chargeable  as  an
 4    expense of operation and maintenance, or is made to obtain by
 5    lease or comparable arrangement any facility or part  thereof
 6    or  any  equipment  for a facility or part; and which exceeds
 7    the capital expenditure minimum.
 8        For the purpose  of  this  paragraph,  the  cost  of  any
 9    studies,   surveys,   designs,   plans,   working   drawings,
10    specifications,   and   other  activities  essential  to  the
11    acquisition, improvement, expansion, or  replacement  of  any
12    plant  or  equipment  with respect to which an expenditure is
13    made shall be included in  determining  if  such  expenditure
14    exceeds   the  capital  expenditures  minimum.  Donations  of
15    equipment or facilities to a health care  facility  which  if
16    acquired directly by such facility would be subject to review
17    under  this Act shall be considered capital expenditures, and
18    a transfer of equipment or  facilities  for  less  than  fair
19    market  value  shall  be considered a capital expenditure for
20    purposes of this Act  if  a  transfer  of  the  equipment  or
21    facilities at fair market value would be subject to review.
22        "Capital  expenditure minimum" means $1,000,000 for major
23    medical  equipment  and  $2,000,000  for  all  other  capital
24    expenditures, both of which shall  be  annually  adjusted  to
25    reflect the increase in construction costs due to inflation.
26        "Areawide"  means a major area of the State delineated on
27    a geographic, demographic, and functional  basis  for  health
28    planning  and  for health service and having within it one or
29    more local areas for health planning and health service.  The
30    term "region", as contrasted with the term  "subregion",  and
31    the  word  "area"  may  be  used  synonymously  with the term
32    "areawide".
33        "Local" means a subarea of a delineated major  area  that
34    on  a  geographic,  demographic,  and functional basis may be
                            -24-           LRB9000385JSgcam03
 1    considered  to  be  part  of  such  major  area.   The   term
 2    "subregion" may be used synonymously with the term "local".
 3        "Areawide health planning organization" or "Comprehensive
 4    health planning organization" means the health systems agency
 5    designated  by  the Secretary, Department of Health and Human
 6    Services or any successor agency.
 7        "Local health planning organization"  means  those  local
 8    health  planning organizations that are designated as such by
 9    the areawide health planning organization of the  appropriate
10    area.
11        "Physician"  means  a  person  licensed  to  practice  in
12    accordance with the Medical Practice Act of 1987, as amended.
13        "Licensed   health  care  professional"  means  a  person
14    licensed to practice  a  health  profession  under  pertinent
15    licensing statutes of the State of Illinois.
16        "Director" means the  Director of the Illinois Department
17    of Public Health.
18        "Agency" means the Illinois Department of Public Health.
19        "Comprehensive  health  planning"  means  health planning
20    concerned with  the  total  population  and  all  health  and
21    associated  problems that affect the well-being of people and
22    that encompasses health services, health manpower, and health
23    facilities; and the coordination among these and  with  those
24    social,  economic,  and  environmental  factors  that  affect
25    health.
26        "Alternative  health  care  model"  means  a  facility or
27    program authorized under the Alternative Health Care Delivery
28    Act.
29    (Source: P.A. 89-499, eff.  6-28-96;  89-530,  eff.  7-19-96;
30    90-14, eff. 7-1-97.)
31        Section  191.  The State Finance Act is amended by adding
32    Section 5.480 as follows:
                            -25-           LRB9000385JSgcam03
 1        (30 ILCS 105/5.480 new)
 2        Sec. 5.480.  The Senior Housing Regulatory Fund.
 3        Section  192.  The Nursing Home Care Act  is  amended  by
 4    changing Section 1-113 as follows:
 5        (210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113)
 6        Sec.  1-113.   "Facility"  or  "long-term  care facility"
 7    means a private home, institution,  building,  residence,  or
 8    any  other  place,  whether  operated for profit or not, or a
 9    county home for  the  infirm  and  chronically  ill  operated
10    pursuant  to  Division  5-21 or 5-22 of the Counties Code, or
11    any similar institution operated by a  political  subdivision
12    of  the  State  of  Illinois,  which  provides,  through  its
13    ownership  or  management,  personal  care, sheltered care or
14    nursing for 3 or more persons, not related to  the  applicant
15    or  owner  by blood or marriage.  It includes skilled nursing
16    facilities and intermediate care facilities  as  those  terms
17    are  defined  in  Title  XVIII  and  Title XIX of the Federal
18    Social Security Act.
19        "Facility" does not include the following:
20        (1)  A home, institution, or other place operated by  the
21    federal  government  or  agency  thereof,  or by the State of
22    Illinois;
23        (2)  A hospital, sanitarium, or other  institution  whose
24    principal  activity  or  business is the diagnosis, care, and
25    treatment  of  human  illness  through  the  maintenance  and
26    operation as organized facilities therefor, which is required
27    to be licensed under the Hospital Licensing Act;
28        (3)  Any "facility for child  care"  as  defined  in  the
29    Child Care Act of 1969;
30        (4)  Any  "Community  Living  Facility" as defined in the
31    Community Living Facilities Licensing Act;
32        (5)  Any "community residential alternative"  as  defined
                            -26-           LRB9000385JSgcam03
 1    in the Community Residential Alternatives Licensing Act;
 2        (6)  Any  nursing  home  or sanatorium operated solely by
 3    and for  persons  who  rely  exclusively  upon  treatment  by
 4    spiritual  means through prayer, in accordance with the creed
 5    or  tenets  of  any  well-recognized  church   or   religious
 6    denomination.  However, such nursing home or sanatorium shall
 7    comply with all local laws and rules relating  to  sanitation
 8    and safety;
 9        (7)  Any  facility  licensed  by  the Department of Human
10    Services as  a  community-integrated  living  arrangement  as
11    defined   in  the  Community-Integrated  Living  Arrangements
12    Licensure and Certification Act;
13        (8)  Any  "Supportive  Residence"  licensed   under   the
14    Supportive Residences Licensing Act; or
15        (9)  Any  "supportive  living  facility" in good standing
16    with the  demonstration  project  established  under  Section
17    5-5.01a of the Illinois Public Aid Code; or.
18        (10)  Any assisted living or shared housing establishment
19    licensed under the Senior Housing with Services Act.
20    (Source:  P.A.  89-499,  eff.  6-28-96;  89-507, eff. 7-1-97;
21    90-14, eff. 7-1-97.)
22        Section 193.  The Health Care Worker Background Check Act
23    is amended by changing Section 15 as follows:
24        (225 ILCS 46/15)
25        Sec. 15.  Definitions.  For the purposes of this Act, the
26    following definitions apply:
27        "Applicant" means an individual seeking employment with a
28    health care employer who has received a bona fide conditional
29    offer of employment.
30        "Conditional offer of employment" means a bona fide offer
31    of employment by a health  care  employer  to  an  applicant,
32    which  is  contingent  upon  the receipt of a report from the
                            -27-           LRB9000385JSgcam03
 1    Department of State Police indicating that the applicant does
 2    not have a record  of  conviction  of  any  of  the  criminal
 3    offenses enumerated in Section 25.
 4        "Direct  care"  means  the  provision  of nursing care or
 5    assistance with meals, dressing, movement, bathing, or  other
 6    personal  needs  or  maintenance,  or general supervision and
 7    oversight  of  the  physical  and  mental  well-being  of  an
 8    individual who is incapable of managing  his  or  her  person
 9    whether  or  not  a  guardian  has  been  appointed  for that
10    individual.
11        "Health care employer" means:
12        (1)  the owner or licensee of any of the following:
13             (i)  a community living facility, as defined in  the
14        Community Living Facilities Act;
15             (ii)  a  life  care facility, as defined in the Life
16        Care Facilities Act;
17             (iii)  a long-term care facility, as defined in  the
18        Nursing Home Care Act;
19             (iv)  a  home  health agency, as defined in the Home
20        Health Agency Licensing Act;
21             (v)  a full  hospice,  as  defined  in  the  Hospice
22        Program Licensing Act;
23             (vi)  a   hospital,   as  defined  in  the  Hospital
24        Licensing Act;
25             (vii)  a  community  residential   alternative,   as
26        defined   in   the   Community  Residential  Alternatives
27        Licensing Act;
28             (viii)  a nurse agency,  as  defined  in  the  Nurse
29        Agency Licensing Act;
30             (ix)  a  respite  care  provider,  as defined in the
31        Respite Program Act;
32             (x)  an  establishment  licensed  under  the  Senior
33        Housing with Services Act;
34        (2)  a day training program certified by  the  Department
                            -28-           LRB9000385JSgcam03
 1    of Human Services;  or
 2        (3)  a  community  integrated living arrangement operated
 3    by  a  community  mental  health  and  developmental  service
 4    agency,  as  defined  in  the   Community-Integrated   Living
 5    Arrangements Licensing and Certification Act.
 6        "Initiate" means the obtaining of the authorization for a
 7    record  check  from  a  student, applicant, or employee.  The
 8    educational entity or health care employer  or  its  designee
 9    shall  transmit  all  necessary  information  and fees to the
10    Illinois State Police within 10 working days after receipt of
11    the authorization.
12    (Source: P.A. 89-197,  eff.  7-21-95;  89-507,  eff.  7-1-97;
13    89-674, eff. 8-14-96; 90-14, eff. 7-1-97.)
14        Section  199.   Effective date.  This Section, Section 1,
15    Section 10, Section 70, and  Section  75  of  this  Act  take
16    effect  upon  becoming  law; the remaining provisions of this
17    Act take effect January 1, 2000.".

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