103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4261

 

Introduced 1/16/2024, by Rep. Kevin John Olickal

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.04  from Ch. 23, par. 6104.04

    Amends the Illinois Act on Aging. Provides that all records containing resident, participant, and complainant information collected by the Long Term Care Ombudsman Program are confidential and shall not be disclosed outside of the program without a lawful subpoena or the permission of the State Ombudsman. Permits the State Ombudsman, at his or her discretion, to disclose resident or participant information if it is in the best interest of the resident or participant. Requires the Department on Aging to establish procedures for the disclosure of program records by the State Ombudsman. Provides that the procedures shall prohibit disclosure of a resident's identity in case records unless the resident gives consent.


LRB103 35291 KTG 65325 b

 

 

A BILL FOR

 

HB4261LRB103 35291 KTG 65325 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Section 4.04 as follows:
 
6    (20 ILCS 105/4.04)  (from Ch. 23, par. 6104.04)
7    (Text of Section after amendment by P.A. 103-329)
8    Sec. 4.04. Long Term Care Ombudsman Program. The purpose
9of the Long Term Care Ombudsman Program is to ensure that older
10persons and persons with disabilities receive quality
11services. This is accomplished by providing advocacy services
12for residents of long term care facilities and participants
13receiving home care and community-based care. Managed care is
14increasingly becoming the vehicle for delivering health and
15long-term services and supports to seniors and persons with
16disabilities, including dual eligible participants. The
17additional ombudsman authority will allow advocacy services to
18be provided to Illinois participants for the first time and
19will produce a cost savings for the State of Illinois by
20supporting the rebalancing efforts of the Patient Protection
21and Affordable Care Act.
22    (a) Long Term Care Ombudsman Program. The Department shall
23establish a Long Term Care Ombudsman Program, through the

 

 

HB4261- 2 -LRB103 35291 KTG 65325 b

1Office of State Long Term Care Ombudsman ("the Office"), in
2accordance with the provisions of the Older Americans Act of
31965, as now or hereafter amended. The Long Term Care
4Ombudsman Program is authorized, subject to sufficient
5appropriations, to advocate on behalf of older persons and
6persons with disabilities residing in their own homes or
7community-based settings, relating to matters which may
8adversely affect the health, safety, welfare, or rights of
9such individuals.
10    (b) Definitions. As used in this Section, unless the
11context requires otherwise:
12        (1) "Access" means the right to:
13            (i) Enter any long term care facility or assisted
14        living or shared housing establishment or supportive
15        living facility;
16            (ii) Communicate privately and without restriction
17        with any resident, regardless of age, who consents to
18        the communication;
19            (iii) Seek consent to communicate privately and
20        without restriction with any participant or resident,
21        regardless of age;
22            (iv) Inspect and copy the clinical and other
23        records of a participant or resident, regardless of
24        age, with the express written consent of the
25        participant or resident;
26            (v) Observe all areas of the long term care

 

 

HB4261- 3 -LRB103 35291 KTG 65325 b

1        facility or supportive living facilities, assisted
2        living or shared housing establishment except the
3        living area of any resident who protests the
4        observation; and
5            (vi) Subject to permission of the participant or
6        resident requesting services or his or her
7        representative, enter a home or community-based
8        setting.
9        (2) "Long Term Care Facility" means (i) any facility
10    as defined by Section 1-113 of the Nursing Home Care Act,
11    as now or hereafter amended; (ii) any skilled nursing
12    facility or a nursing facility which meets the
13    requirements of Section 1819(a), (b), (c), and (d) or
14    Section 1919(a), (b), (c), and (d) of the Social Security
15    Act, as now or hereafter amended (42 U.S.C. 1395i-3(a),
16    (b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and
17    (d)); (iii) any facility as defined by Section 1-113 of
18    the ID/DD Community Care Act, as now or hereafter amended;
19    (iv) any facility as defined by Section 1-113 of MC/DD
20    Act, as now or hereafter amended; and (v) any facility
21    licensed under Section 4-105 or 4-201 of the Specialized
22    Mental Health Rehabilitation Act of 2013, as now or
23    hereafter amended.
24        (2.5) "Assisted living establishment" and "shared
25    housing establishment" have the meanings given those terms
26    in Section 10 of the Assisted Living and Shared Housing

 

 

HB4261- 4 -LRB103 35291 KTG 65325 b

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

 

 

HB4261- 5 -LRB103 35291 KTG 65325 b

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

 

 

HB4261- 6 -LRB103 35291 KTG 65325 b

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

 

 

HB4261- 7 -LRB103 35291 KTG 65325 b

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

 

 

HB4261- 8 -LRB103 35291 KTG 65325 b

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

 

 

HB4261- 9 -LRB103 35291 KTG 65325 b

1    paragraph (3) of subsection (c) of Section 1819 and
2    subparagraphs (A) and (E) of paragraph (3) of subsection
3    (c) of Section 1919 of the Social Security Act, as now or
4    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
5    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
6    Older Americans Act of 1965, as now or hereafter amended
7    (42 U.S.C. 3058f), a long term care facility, supportive
8    living facility, assisted living establishment, and shared
9    housing establishment must:
10            (i) permit immediate access to any resident,
11        regardless of age, by a designated ombudsman;
12            (ii) permit representatives of the Office, with
13        the permission of the resident, the resident's legal
14        representative, or the resident's legal guardian, to
15        examine and copy a resident's clinical and other
16        records, regardless of the age of the resident, and if
17        a resident is unable to consent to such review, and has
18        no legal guardian, permit representatives of the
19        Office appropriate access, as defined by the
20        Department, in consultation with the Office, in
21        administrative rules, to the resident's records; and
22            (iii) permit a representative of the Program to
23        communicate privately and without restriction with any
24        participant who consents to the communication
25        regardless of the consent of, or withholding of
26        consent by, a legal guardian or an agent named in a

 

 

HB4261- 10 -LRB103 35291 KTG 65325 b

1        power of attorney executed by the participant.
2        (2) Each long term care facility, supportive living
3    facility, assisted living establishment, and shared
4    housing establishment shall display, in multiple,
5    conspicuous public places within the facility accessible
6    to both visitors and residents and in an easily readable
7    format, the address and phone number of the Office of the
8    Long Term Care Ombudsman, in a manner prescribed by the
9    Office.
10    (e) Immunity. An ombudsman or any representative of the
11Office participating in the good faith performance of his or
12her official duties shall have immunity from any liability
13(civil, criminal or otherwise) in any proceedings (civil,
14criminal or otherwise) brought as a consequence of the
15performance of his official duties.
16    (f) Business offenses.
17        (1) No person shall:
18            (i) Intentionally prevent, interfere with, or
19        attempt to impede in any way any representative of the
20        Office in the performance of his official duties under
21        this Act and the Older Americans Act of 1965; or
22            (ii) Intentionally retaliate, discriminate
23        against, or effect reprisals against any long term
24        care facility resident or employee for contacting or
25        providing information to any representative of the
26        Office.

 

 

HB4261- 11 -LRB103 35291 KTG 65325 b

1        (2) A violation of this Section is a business offense,
2    punishable by a fine not to exceed $501.
3        (3) The State Long Term Care Ombudsman shall notify
4    the State's Attorney of the county in which the long term
5    care facility, supportive living facility, or assisted
6    living or shared housing establishment is located, or the
7    Attorney General, of any violations of this Section.
8    (g) Confidentiality of records and identities. All records
9containing resident, participant, and complainant information
10collected by the Long Term Care Ombudsman Program are
11confidential and shall not be disclosed outside of the program
12without a lawful subpoena or the permission of the State
13Ombudsman. The State Ombudsman, at his or her discretion, may
14disclose resident or participant information if it is in the
15best interest of the resident or participant. The Department
16shall establish procedures for the disclosure of program
17records by the State Ombudsman. The or the regional ombudsmen
18entities of files maintained by the program. The procedures
19shall provide that the files and records may be disclosed only
20at the discretion of the State Long Term Care Ombudsman or the
21person designated by the State Ombudsman to disclose the files
22and records, and the procedures shall prohibit the disclosure
23of the identity of any complainant, resident, participant,
24witness, or employee of a long term care provider in case
25records unless:
26        (1) the complainant, resident, participant, witness,

 

 

HB4261- 12 -LRB103 35291 KTG 65325 b

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

 

 

HB4261- 13 -LRB103 35291 KTG 65325 b

1express purposes of this Section. All interest earned on
2moneys in the fund shall be credited to the fund. Moneys
3contained in the fund shall be used to support the purposes of
4this Section.
5    (k) Each Regional Ombudsman may, in accordance with rules
6promulgated by the Office, establish a multi-disciplinary team
7to act in an advisory role for the purpose of providing
8professional knowledge and expertise in handling complex
9abuse, neglect, and advocacy issues involving participants.
10Each multi-disciplinary team may consist of one or more
11volunteer representatives from any combination of at least 7
12members from the following professions: banking or finance;
13disability care; health care; pharmacology; law; law
14enforcement; emergency responder; mental health care; clergy;
15coroner or medical examiner; substance abuse; domestic
16violence; sexual assault; or other related fields. To support
17multi-disciplinary teams in this role, law enforcement
18agencies and coroners or medical examiners shall supply
19records as may be requested in particular cases. The Regional
20Ombudsman, or his or her designee, of the area in which the
21multi-disciplinary team is created shall be the facilitator of
22the multi-disciplinary team.
23(Source: P.A. 102-1033, eff. 1-1-23; 103-329, eff. 1-1-24.)