Public Act 103-0767
 
SB2957 EnrolledLRB103 38874 KTG 69011 b

    AN ACT concerning State government.
 
    Be it enacted by the People of the State of Illinois, 
represented in the General Assembly:
 
    Section 5. The Illinois Act on the Aging is amended by 
changing Section 4.04 as follows:
 
    (20 ILCS 105/4.04)  (from Ch. 23, par. 6104.04)
    Sec. 4.04. Long Term Care Ombudsman Program. The purpose 
of the Long Term Care Ombudsman Program is to ensure that older 
persons and persons with disabilities receive quality 
services. This is accomplished by providing advocacy services 
for residents of long term care facilities and participants 
receiving home care and community-based care. Managed care is 
increasingly becoming the vehicle for delivering health and 
long-term services and supports to seniors and persons with 
disabilities, including dual eligible participants. The 
additional ombudsman authority will allow advocacy services to 
be provided to Illinois participants for the first time and 
will produce a cost savings for the State of Illinois by 
supporting the rebalancing efforts of the Patient Protection 
and Affordable Care Act. 
    (a) Long Term Care Ombudsman Program. The Department shall 
establish a Long Term Care Ombudsman Program, through the 
Office of State Long Term Care Ombudsman ("the Office"), in 
accordance with the provisions of the Older Americans Act of 
1965, as now or hereafter amended. The Long Term Care 
Ombudsman Program is authorized, subject to sufficient 
appropriations, to advocate on behalf of older persons and 
persons with disabilities residing in their own homes or 
community-based settings, relating to matters which may 
adversely affect the health, safety, welfare, or rights of 
such individuals. 
    (b) Definitions. As used in this Section, unless the 
context requires otherwise:
        (1) "Access" means the right to:
            (i) Enter any long term care facility or assisted 
        living or shared housing establishment or supportive 
        living facility;
            (ii) Communicate privately and without restriction 
        with any resident, regardless of age, who consents to 
        the communication;
            (iii) Seek consent to communicate privately and 
        without restriction with any participant or resident, 
        regardless of age;
            (iv) Inspect and copy the clinical and other 
        records of a participant or resident, regardless of 
        age, with the express written consent of the 
        participant or resident, or if consent is given 
        orally, visually, or through the use of auxiliary aids 
        and services, such consent is documented 
        contemporaneously by a representative of the Office in 
        accordance with such procedures;
            (v) Observe all areas of the long term care 
        facility or supportive living facilities, assisted 
        living or shared housing establishment except the 
        living area of any resident who protests the 
        observation; and
            (vi) Subject to permission of the participant or 
        resident requesting services or his or her 
        representative, enter a home or community-based 
        setting. 
        (2) "Long Term Care Facility" means (i) any facility 
    as defined by Section 1-113 of the Nursing Home Care Act, 
    as now or hereafter amended; (ii) any skilled nursing 
    facility or a nursing facility which meets the 
    requirements of Section 1819(a), (b), (c), and (d) or 
    Section 1919(a), (b), (c), and (d) of the Social Security 
    Act, as now or hereafter amended (42 U.S.C. 1395i-3(a), 
    (b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and 
    (d)); (iii) any facility as defined by Section 1-113 of 
    the ID/DD Community Care Act, as now or hereafter amended; 
    (iv) any facility as defined by Section 1-113 of MC/DD 
    Act, as now or hereafter amended; and (v) any facility 
    licensed under Section 4-105 or 4-201 of the Specialized 
    Mental Health Rehabilitation Act of 2013, as now or 
    hereafter amended.
        (2.5) "Assisted living establishment" and "shared 
    housing establishment" have the meanings given those terms 
    in Section 10 of the Assisted Living and Shared Housing 
    Act.
        (2.7) "Supportive living facility" means a facility 
    established under Section 5-5.01a of the Illinois Public 
    Aid Code.
        (2.8) "Community-based setting" means any place of 
    abode other than an individual's private home. 
        (3) "State Long Term Care Ombudsman" means any person 
    employed by the Department to fulfill the requirements of 
    the Office of State Long Term Care Ombudsman as required 
    under the Older Americans Act of 1965, as now or hereafter 
    amended, and Departmental policy.
        (3.1) "Ombudsman" means any designated representative 
    of the State Long Term Care Ombudsman Program; provided 
    that the representative, whether he is paid for or 
    volunteers his ombudsman services, shall be qualified and 
    designated by the Office to perform the duties of an 
    ombudsman as specified by the Department in rules and in 
    accordance with the provisions of the Older Americans Act 
    of 1965, as now or hereafter amended.
        (4) "Participant" means an older person aged 60 or 
    over or an adult with a disability aged 18 through 59 who 
    is eligible for services under any of the following: 
            (i) A medical assistance waiver administered by 
        the State. 
            (ii) A managed care organization providing care 
        coordination and other services to seniors and persons 
        with disabilities. 
        (5) "Resident" means an older person aged 60 or over 
    or an adult with a disability aged 18 through 59 who 
    resides in a long-term care facility. 
    (c) Ombudsman; rules. The Office of State Long Term Care 
Ombudsman shall be composed of at least one full-time 
ombudsman and shall include a system of designated regional 
long term care ombudsman programs. Each regional program shall 
be designated by the State Long Term Care Ombudsman as a 
subdivision of the Office and any representative of a regional 
program shall be treated as a representative of the Office.
    The Department, in consultation with the Office, shall 
promulgate administrative rules in accordance with the 
provisions of the Older Americans Act of 1965, as now or 
hereafter amended, to establish the responsibilities of the 
Department and the Office of State Long Term Care Ombudsman 
and the designated regional Ombudsman programs. The 
administrative rules shall include the responsibility of the 
Office and designated regional programs to investigate and 
resolve complaints made by or on behalf of residents of long 
term care facilities, supportive living facilities, and 
assisted living and shared housing establishments, and 
participants residing in their own homes or community-based 
settings, including the option to serve residents and 
participants under the age of 60, relating to actions, 
inaction, or decisions of providers, or their representatives, 
of such facilities and establishments, of public agencies, or 
of social services agencies, which may adversely affect the 
health, safety, welfare, or rights of such residents and 
participants. The Office and designated regional programs may 
represent all residents and participants, but are not required 
by this Act to represent persons under 60 years of age, except 
to the extent required by federal law. When necessary and 
appropriate, representatives of the Office shall refer 
complaints to the appropriate regulatory State agency. The 
Department, in consultation with the Office, shall cooperate 
with the Department of Human Services and other State agencies 
in providing information and training to designated regional 
long term care ombudsman programs about the appropriate 
assessment and treatment (including information about 
appropriate supportive services, treatment options, and 
assessment of rehabilitation potential) of the participants 
they serve.
    The State Long Term Care Ombudsman and all other 
ombudsmen, as defined in paragraph (3.1) of subsection (b) 
must submit to background checks under the Health Care Worker 
Background Check Act and receive training, as prescribed by 
the Illinois Department on Aging, before visiting facilities, 
private homes, or community-based settings. The training must 
include information specific to assisted living 
establishments, supportive living facilities, shared housing 
establishments, private homes, and community-based settings 
and to the rights of residents and participants guaranteed 
under the corresponding Acts and administrative rules. 
    (c-5) Consumer Choice Information Reports. The Office 
shall:
        (1) In collaboration with the Attorney General, create 
    a Consumer Choice Information Report form to be completed 
    by all licensed long term care facilities to aid 
    Illinoisans and their families in making informed choices 
    about long term care. The Office shall create a Consumer 
    Choice Information Report for each type of licensed long 
    term care facility. The Office shall collaborate with the 
    Attorney General and the Department of Human Services to 
    create a Consumer Choice Information Report form for 
    facilities licensed under the ID/DD Community Care Act or 
    the MC/DD Act. 
        (2) Develop a database of Consumer Choice Information 
    Reports completed by licensed long term care facilities 
    that includes information in the following consumer 
    categories:
            (A) Medical Care, Services, and Treatment.
            (B) Special Services and Amenities.
            (C) Staffing.
            (D) Facility Statistics and Resident Demographics.
            (E) Ownership and Administration.
            (F) Safety and Security.
            (G) Meals and Nutrition.
            (H) Rooms, Furnishings, and Equipment.
            (I) Family, Volunteer, and Visitation Provisions.
        (3) Make this information accessible to the public, 
    including on the Internet by means of a hyperlink on the 
    Office's World Wide Web home page. Information about 
    facilities licensed under the ID/DD Community Care Act or 
    the MC/DD Act shall be made accessible to the public by the 
    Department of Human Services, including on the Internet by 
    means of a hyperlink on the Department of Human Services' 
    "For Customers" website. 
        (4) Have the authority, with the Attorney General, to 
    verify that information provided by a facility is 
    accurate.
        (5) Request a new report from any licensed facility 
    whenever it deems necessary. 
        (6) Include in the Office's Consumer Choice 
    Information Report for each type of licensed long term 
    care facility additional information on each licensed long 
    term care facility in the State of Illinois, including 
    information regarding each facility's compliance with the 
    relevant State and federal statutes, rules, and standards; 
    customer satisfaction surveys; and information generated 
    from quality measures developed by the Centers for 
    Medicare and Medicaid Services.
    (d) Access and visitation rights.
        (1) In accordance with subparagraphs (A) and (E) of 
    paragraph (3) of subsection (c) of Section 1819 and 
    subparagraphs (A) and (E) of paragraph (3) of subsection 
    (c) of Section 1919 of the Social Security Act, as now or 
    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and 
    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the 
    Older Americans Act of 1965, as now or hereafter amended 
    (42 U.S.C. 3058f), a long term care facility, supportive 
    living facility, assisted living establishment, and shared 
    housing establishment must:
            (i) permit immediate access to any resident, 
        regardless of age, by a designated ombudsman;
            (ii) permit representatives of the Office, with 
        the permission of the resident, the resident's legal 
        representative, or the resident's legal guardian, to 
        examine and copy a resident's clinical and other 
        records, including facility reports of incidents or 
        occurrences made to State agencies, regardless of the 
        age of the resident, and if a resident is unable to 
        consent to such review, and has no legal guardian, 
        permit representatives of the Office appropriate 
        access, as defined by the Department, in consultation 
        with the Office, in administrative rules, to the 
        resident's records; and
            (iii) permit a representative of the Program to 
        communicate privately and without restriction with any 
        participant who consents to the communication 
        regardless of the consent of, or withholding of 
        consent by, a legal guardian or an agent named in a 
        power of attorney executed by the participant.
        (2) Each long term care facility, supportive living 
    facility, assisted living establishment, and shared 
    housing establishment shall display, in multiple, 
    conspicuous public places within the facility accessible 
    to both visitors and residents and in an easily readable 
    format, the address and phone number of the Office of the 
    Long Term Care Ombudsman, in a manner prescribed by the 
    Office.
    (e) Immunity. An ombudsman or any representative of the 
Office participating in the good faith performance of his or 
her official duties shall have immunity from any liability 
(civil, criminal or otherwise) in any proceedings (civil, 
criminal or otherwise) brought as a consequence of the 
performance of his official duties.
    (f) Business offenses.
        (1) No person shall:
            (i) Intentionally prevent, interfere with, or 
        attempt to impede in any way any representative of the 
        Office in the performance of his official duties under 
        this Act and the Older Americans Act of 1965; or
            (ii) Intentionally retaliate, discriminate 
        against, or effect reprisals against any long term 
        care facility resident or employee for contacting or 
        providing information to any representative of the 
        Office.
        (2) A violation of this Section is a business offense, 
    punishable by a fine not to exceed $501.
        (3) The State Long Term Care Ombudsman shall notify 
    the State's Attorney of the county in which the long term 
    care facility, supportive living facility, or assisted 
    living or shared housing establishment is located, or the 
    Attorney General, of any violations of this Section.
    (g) Confidentiality of records and identities. The 
Department shall establish procedures for the disclosure by 
the State Ombudsman or the regional ombudsmen entities of 
files maintained by the program. The procedures shall provide 
that the files and records may be disclosed only at the 
discretion of the State Long Term Care Ombudsman or the person 
designated by the State Ombudsman to disclose the files and 
records, and the procedures shall prohibit the disclosure of 
the identity of any complainant, resident, participant, 
witness, or employee of a long term care provider unless:
        (1) the complainant, resident, participant, witness, 
    or employee of a long term care provider or his or her 
    legal representative consents to the disclosure and the 
    consent is in writing;
        (2) the complainant, resident, participant, witness, 
    or employee of a long term care provider gives consent 
    orally; and the consent is documented contemporaneously in 
    writing in accordance with such requirements as the 
    Department shall establish; or
        (3) the disclosure is required by court order.
    (h) Legal representation. The Attorney General shall 
provide legal representation to any representative of the 
Office against whom suit or other legal action is brought in 
connection with the performance of the representative's 
official duties, in accordance with the State Employee 
Indemnification Act.
    (i) Treatment by prayer and spiritual means. Nothing in 
this Act shall be construed to authorize or require the 
medical supervision, regulation or control of remedial care or 
treatment of any resident in a long term care facility 
operated exclusively by and for members or adherents of any 
church or religious denomination the tenets and practices of 
which include reliance solely upon spiritual means through 
prayer for healing.
    (j) The Long Term Care Ombudsman Fund is created as a 
special fund in the State treasury to receive moneys for the 
express purposes of this Section. All interest earned on 
moneys in the fund shall be credited to the fund. Moneys 
contained in the fund shall be used to support the purposes of 
this Section. 
    (k) Each Regional Ombudsman may, in accordance with rules 
promulgated by the Office, establish a multi-disciplinary team 
to act in an advisory role for the purpose of providing 
professional knowledge and expertise in handling complex 
abuse, neglect, and advocacy issues involving participants. 
Each multi-disciplinary team may consist of one or more 
volunteer representatives from any combination of at least 7 
members from the following professions: banking or finance; 
disability care; health care; pharmacology; law; law 
enforcement; emergency responder; mental health care; clergy; 
coroner or medical examiner; substance abuse; domestic 
violence; sexual assault; or other related fields. To support 
multi-disciplinary teams in this role, law enforcement 
agencies and coroners or medical examiners shall supply 
records as may be requested in particular cases. The Regional 
Ombudsman, or his or her designee, of the area in which the 
multi-disciplinary team is created shall be the facilitator of 
the multi-disciplinary team. 
(Source: P.A. 102-1033, eff. 1-1-23; 103-329, eff. 1-1-24.)