093_HB1412

 
                                     LRB093 03446 AMC 08879 b

 1        AN ACT concerning assisted living.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The Assisted Living and Shared Housing Act is
 5    amended by changing Sections 25, 35, 75, and 150  and  adding
 6    Section 32 as follows:

 7        (210 ILCS 9/25)
 8        Sec.  25.  License requirement.  No person may establish,
 9    operate, maintain, or offer an establishment as  an  assisted
10    living  establishment  or  shared  housing  establishment  as
11    defined  by  the Act within this State unless and until he or
12    she obtains  a  valid  license,  which  remains  unsuspended,
13    unrevoked,  and  unexpired.    No  public official, agent, or
14    employee may place any  person  in,  or  recommend  that  any
15    person  be  placed  in,  or  directly or indirectly cause any
16    person to be placed  in  any  establishment  that  meets  the
17    definition  under  this  Act that is being operated without a
18    valid license.  No public official, agent,  or  employee  may
19    place  the  name  of  an  unlicensed  establishment  that  is
20    required to be licensed under this Act on a list of programs.
21    An  entity  that  operates  as  an  assisted living or shared
22    housing establishment  as  defined  by  this  Act  without  a
23    license   shall  be  subject  to  the  provisions,  including
24    penalties, of the Nursing Home Care Act.  No entity shall use
25    in its name or advertise "assisted living" unless licensed as
26    an assisted living establishment  under  this  Act  or  as  a
27    shelter  care  facility  under the Nursing Home Care Act that
28    also meets the definition of an assisted living establishment
29    under  this  Act,  except  a  shared  housing   establishment
30    licensed   under  this  Act  may  advertise  assisted  living
31    services.
 
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 1    (Source: P.A. 91-656, eff. 1-1-01.)

 2        (210 ILCS 9/32 new)
 3        Sec. 32.  Floating license.  An establishment may request
 4    a floating license for any number of individual living  units
 5    within  a  building  up  to  the  total  number of units.  An
 6    establishment requesting a floating license must specify  the
 7    number  of  individual  living  units within a building to be
 8    licensed.  An establishment utilizing a floating license must
 9    have staff adequate to meet  the  scheduled  and  unscheduled
10    needs  of  residents  residing  in designated licensed units.
11    All staff providing services to licensed units must meet  the
12    requirement  of this Act.  A unit may only be designated as a
13    licensed unit if the unit and the unit's  resident  meet  the
14    requirements  of this Act and its rules.  The resident of the
15    living units specified in  a  floating  license  may  receive
16    mandatory  and  optional  services  under the establishment's
17    license.  Establishments may only provide services under this
18    Act in the individual living  units  designated  as  licensed
19    units.    Designation  as a licensed unit may be temporary to
20    accommodate a resident's changing needs without requiring the
21    resident to move.
22        An establishment with a  floating  license  must  keep  a
23    current  written  list  of  those  units designated under the
24    floating license.  If a resident elects to  receive  services
25    in  a  unit  that  is not licensed and the unit qualifies for
26    licensure, the establishment must notify  the  resident  that
27    the  unit  must  be licensed and the requirements of this Act
28    must be met before services can be provided to  residents  in
29    that  unit.   Upon  the  initiation  of  an initial licensing
30    inspection, annual inspection,  or  complaint  investigation,
31    the  establishment  shall provide to the Department a list of
32    the units designated under  the  floating  license  in  which
33    residents are receiving services subject to this Act.
 
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 1        (210 ILCS 9/35)
 2        Sec. 35.  Issuance of license.
 3        (a)  Upon  receipt  and  review  of  an application for a
 4    license  and  review  of  the  applicant  establishment,  the
 5    Director  may issue a license if he or she finds:
 6             (1)  that   the   individual   applicant,   or   the
 7        corporation,  partnership,  or  other   entity   if   the
 8        applicant  is  not an individual, is a person responsible
 9        and suitable to operate or to direct  or  participate  in
10        the  operation of an establishment by virtue of financial
11        capacity,   appropriate    business    or    professional
12        experience,  a  record  of  lawful compliance with lawful
13        orders of the Department and  lack  of  revocation  of  a
14        license  issued  under  this Act or the Nursing Home Care
15        Act during the previous 5 years;
16             (2)  that the establishment is under the supervision
17        of a full-time director who is at least 21 years  of  age
18        with ability, training, and education appropriate to meet
19        the  needs  of the residents and to manage the operations
20        of the establishment  and  who  participates  in  ongoing
21        training for these purposes;
22             (3)  that  the establishment has staff sufficient in
23        number with qualifications, adequate  skills,  education,
24        and   experience  to  meet  the  24  hour  scheduled  and
25        unscheduled needs of residents  and  who  participate  in
26        ongoing training to serve the resident population;
27             (4)  that direct care staff meet the requirements of
28        the Health Care Worker Background Check Act;
29             (5)  that the applicant is in substantial compliance
30        with  this  Act and such other requirements for a license
31        as the Department by rule may establish under this Act;
32             (6)  that the applicant pays all required fees;
33             (7)  that  the  applicant  has   provided   to   the
34        Department  an accurate disclosure document in accordance
 
                            -4-      LRB093 03446 AMC 08879 b
 1        with the Alzheimer's Special Care Disclosure Act  and  in
 2        substantial compliance with Section 150 of this Act.
 3        Any  license  issued  by  the  Director  shall  state the
 4    physical location of the establishment, the date the  license
 5    was  issued,  and the expiration date.  All licenses shall be
 6    valid for one year, except as provided in Section  40.   Each
 7    license  shall  be  issued  only for the premises and persons
 8    named in the application, and shall not  be  transferable  or
 9    assignable.
10    (Source: P.A. 91-656, eff. 1-1-01.)

11        (210 ILCS 9/75)
12        Sec. 75.  Residency Requirements.
13        (a)  No  individual  shall  be  accepted for residency or
14    remain in residence if the establishment  cannot  provide  or
15    secure  appropriate  services,  if  the individual requires a
16    level  of  service  or  type  of  service   for   which   the
17    establishment is not licensed or which the establishment does
18    not  provide, or if the establishment does not have the staff
19    appropriate in numbers and with appropriate skill to  provide
20    such services.
21        (b)  Only adults may be accepted for residency.
22        (c)  A person shall not be accepted for residency if:
23             (1)  the person poses a serious threat to himself or
24        herself or to others;
25             (2)  the  person  is  not able to communicate his or
26        her needs and no resident representative residing in  the
27        establishment,  and  with  a  prior  relationship  to the
28        person, has been appointed to  direct  the  provision  of
29        services;
30             (3)  the  person requires total assistance with 2 or
31        more activities of daily living;
32             (4)  the person requires the assistance of more than
33        one paid caregiver at any given time with an activity  of
 
                            -5-      LRB093 03446 AMC 08879 b
 1        daily living;
 2             (5)  the   person   requires   more   than   minimal
 3        assistance in moving to a safe area in an emergency;
 4             (6)  the person has a severe mental  illness,  which
 5        for  the  purposes of this Section means a condition that
 6        is characterized  by  the  presence  of  a  major  mental
 7        disorder  as classified in the Diagnostic and Statistical
 8        Manual  of  Mental  Disorders,  Fourth  Edition  (DSM-IV)
 9        (American  Psychiatric  Association,  1994),  where   the
10        individual   is  substantially  disabled  due  to  mental
11        illness  in  the  areas   of   self-maintenance,   social
12        functioning,  activities  of  community  living  and work
13        skills, and the disability specified is  expected  to  be
14        present  for a period of not less than one year, but does
15        not mean  Alzheimer's disease and other forms of dementia
16        based on organic or physical disorders;
17             (7)  the  person  requires  intravenous  therapy  or
18        intravenous   feedings   unless   self-administered    or
19        administered   by   a  qualified,  licensed  health  care
20        professional;
21             (8)  the person requires gastrostomy feedings unless
22        self-administered  or administered by a  licensed  health
23        care professional;
24             (9)  the    person   requires   insertion,   sterile
25        irrigation,  and  replacement  of  catheter,  except  for
26        routine maintenance of  urinary  catheters,   unless  the
27        catheter  care  is self-administered or administered by a
28        licensed health care professional;
29             (10)  the person requires sterile wound care  unless
30        care  is  self-administered or administered by a licensed
31        health care professional;
32             (11)  the  person  requires  sliding  scale  insulin
33        administration unless self-performed or administered by a
34        licensed health care professional;
 
                            -6-      LRB093 03446 AMC 08879 b
 1             (12)  the person is  a  diabetic  requiring  routine
 2        insulin    injections    unless    the   injections   are
 3        self-administered or administered by  a  licensed  health
 4        care professional;
 5             (13)  the  person  requires  treatment of stage 3 or
 6        stage 4 decubitus ulcers or exfoliative dermatitis;
 7             (14)  the person requires 5 or more skilled  nursing
 8        visits per week for conditions other than those listed in
 9        items (13) and (15) of this subsection for a period of  3
10        consecutive  weeks  or  more  except  when  the course of
11        treatment is expected to extend beyond a  3  week  period
12        for rehabilitative purposes and is certified as temporary
13        by a physician; or
14             (15)  other  reasons prescribed by the Department by
15        rule.
16        (d)  A resident with a  condition  listed  in  items  (1)
17    through   (15)   of  subsection  (c)  shall  have  his or her
18    residency terminated.
19        (e)  Residency  shall   be   terminated   when   services
20    available  to the resident in the establishment are no longer
21    adequate to meet the needs of the resident.  This   provision
22    shall  not  be  interpreted  as limiting the authority of the
23    Department  to  require  the   residency  termination      of
24    individuals.
25        (f)  Subsection  (d)  of  this Section shall not apply to
26    terminally ill residents who receive  or  would  qualify  for
27    hospice  care  and  such  care  is  coordinated by  a hospice
28    licensed under the Hospice Program  Licensing Act   or  other
29    licensed health care professional employed by a licensed home
30    health  agency and the establishment and all parties agree to
31    the continued residency.
32        (g)  Items (3), (4), (5), and (9) of subsection (c) shall
33    not apply to a quadriplegic, paraplegic, or  individual  with
34    neuro-muscular  diseases,  such  as  muscular  dystrophy  and
 
                            -7-      LRB093 03446 AMC 08879 b
 1    multiple  sclerosis, or other chronic diseases and conditions
 2    as defined by rule if the individual is able  to  communicate
 3    his or her needs and does not require assistance with complex
 4    medical   problems,   and   the   establishment  is  able  to
 5    accommodate the individual's needs.    The  Department  shall
 6    prescribe rules pursuant to this Section that address special
 7    safety and service needs of these individuals.
 8        (h)  For  the  purposes  of  items  (7)  through  (11) of
 9    subsection (c), a licensed health care professional  may  not
10    be  employed  by  the owner or operator of the establishment,
11    its parent entity, or any other entity with ownership  common
12    to  either  the  owner  or  operator  of the establishment or
13    parent entity, including but not limited to an  affiliate  of
14    the  owner or operator of the establishment.  Nothing in this
15    Section is meant to limit a resident's right to choose his or
16    her health care provider.
17    (Source: P.A. 91-656, eff. 1-1-01.)

18        (210 ILCS 9/150)
19        Sec. 150.  Alzheimer and dementia programs.
20        (a)  In addition to Except as provided in  this  Section,
21    Alzheimer  and dementia programs shall comply with all of the
22    other provisions of this Act.
23        (b)  No person shall  be  admitted  or  retained  if  the
24    assisted   living  or  shared  housing  establishment  cannot
25    provide or secure appropriate care, if the resident  requires
26    a  level  of  service  or  type  of  service  for  which  the
27    establishment is not licensed or which the establishment does
28    not  provide, or if the establishment does not have the staff
29    appropriate in numbers and with appropriate skill to  provide
30    such services.
31        (c)  No  person shall be accepted for residency or remain
32    in residence if the person's mental or physical condition has
33    so deteriorated to render residency in such a program  to  be
 
                            -8-      LRB093 03446 AMC 08879 b
 1    detrimental to the health, welfare or safety of the person or
 2    of  other  residents of the establishment.  The Department by
 3    rule shall identify a  validated  dementia-specific  standard
 4    with  inter-rater  reliability  that  will  be used to assess
 5    individual residents. The assessment must be approved by  the
 6    resident's  physician and shall occur prior to acceptance for
 7    residency, annually, and at such time that a  change  in  the
 8    resident's  condition is identified by a family member, staff
 9    of the establishment, or the resident's physician.
10        (d)  No person shall be accepted for residency or  remain
11    in residence if the person is dangerous to self or others and
12    the  establishment  would  be  unable to eliminate the danger
13    through the use of appropriate treatment modalities.
14        (e)  No person shall be accepted for residency or  remain
15    in  residence  if  the  person meets the criteria provided in
16    subsections (b) through (g) of Section 75 of this Act.
17        (f)  An establishment that offers to  provide  a  special
18    program  or  unit  for  persons  with Alzheimer's disease and
19    related disorders shall:
20             (1)  disclose to the Department and to  a  potential
21        or  actual  resident  of the establishment information as
22        specified under the Alzheimer's Special  Care  Disclosure
23        Act;
24             (2)  ensure  that  a  resident's  representative  is
25        designated for the resident;
26             (3)  develop  and  implement policies and procedures
27        that ensure the continued safety of all residents in  the
28        establishment including, but not limited to, those who:
29                  (A)  may wander; and
30                  (B)  may  need  supervision and assistance when
31             evacuating the building in an emergency;
32             (4)  provide  coordination  of  communications  with
33        each resident, resident's representative,  relatives  and
34        other persons identified in the resident's service plan;
 
                            -9-      LRB093 03446 AMC 08879 b
 1             (5)  provide cognitive stimulation and activities to
 2        maximize functioning;
 3             (6)  provide  an appropriate number of staff for its
 4        resident population, as established by rule;
 5             (7)  require  the  director  or  administrator   and
 6        direct  care  staff  to complete sufficient comprehensive
 7        and ongoing dementia and cognitive deficit training,  the
 8        content of which shall be established by rule; and
 9             (8)  develop   emergency   procedures  and  staffing
10        patterns to respond to the needs of residents.
11    (Source: P.A. 91-656, eff. 1-1-01.)

12        Section 99.  Effective date.  This Act takes effect  upon
13    becoming law.