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Sen. William Delgado
Filed: 5/17/2013
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1 | | AMENDMENT TO HOUSE BILL 1191
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2 | | AMENDMENT NO. ______. Amend House Bill 1191 as follows:
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3 | | on page 1, line 5, by replacing "Section 4.01" with "Sections |
4 | | 4.01 and 4.04"; and |
5 | | on page 8, immediately after line 1, by inserting the |
6 | | following:
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7 | | "(20 ILCS 105/4.04) (from Ch. 23, par. 6104.04)
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8 | | Sec. 4.04. Long Term Care Ombudsman Program. The purpose of |
9 | | the Long Term Care Ombudsman Program is to ensure that older |
10 | | persons and persons with disabilities receive quality |
11 | | services. This is accomplished by providing advocacy services |
12 | | for residents of long term care facilities and participants |
13 | | receiving home care and community-based care. Managed care is |
14 | | increasingly becoming the vehicle for delivering health and |
15 | | long-term services and supports to seniors and persons with |
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1 | | disabilities, including dual eligible participants. The |
2 | | additional ombudsman authority will allow advocacy services to |
3 | | be provided to Illinois participants for the first time and |
4 | | will produce a cost savings for the State of Illinois by |
5 | | supporting the rebalancing efforts of the Patient Protection |
6 | | and Affordable Care Act.
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7 | | (a) Long Term Care Ombudsman Program. The Department shall
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8 | | establish a Long Term Care Ombudsman Program, through the |
9 | | Office of State
Long Term Care Ombudsman ("the Office"), in |
10 | | accordance with the provisions of
the Older Americans Act of |
11 | | 1965, as now or hereafter amended. The Long Term Care Ombudsman |
12 | | Program is authorized, subject to sufficient appropriations, |
13 | | to advocate on behalf of older persons and persons with |
14 | | disabilities residing in their own homes or community-based |
15 | | settings, relating to matters which may adversely affect the |
16 | | health, safety, welfare, or rights of such individuals.
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17 | | (b) Definitions. As used in this Section, unless the |
18 | | context requires
otherwise:
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19 | | (1) "Access" has the same meaning as in Section 1-104 |
20 | | of the Nursing
Home Care Act, as now or hereafter amended; |
21 | | that is, it means the right to:
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22 | | (i) Enter any long term care facility or assisted |
23 | | living or shared
housing establishment or supportive |
24 | | living facility;
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25 | | (ii) Communicate privately and without restriction |
26 | | with any resident, regardless of age,
who consents to |
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1 | | the communication;
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2 | | (iii) Seek consent to communicate privately and |
3 | | without restriction
with any participant or resident, |
4 | | regardless of age;
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5 | | (iv) Inspect the clinical and other records of a |
6 | | participant or resident, regardless of age, with the
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7 | | express written consent of the participant or |
8 | | resident;
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9 | | (v) Observe all areas of the long term care |
10 | | facility or supportive
living facilities, assisted |
11 | | living or shared housing establishment except the
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12 | | living area of any resident who protests the |
13 | | observation ; and .
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14 | | (vi) Subject to permission of the participant or |
15 | | resident requesting services or his or her |
16 | | representative, enter a home or community-based |
17 | | setting.
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18 | | (2) "Long Term Care Facility" means (i) any facility as |
19 | | defined by Section
1-113 of the Nursing Home Care Act, as |
20 | | now or hereafter amended; and (ii) any
skilled nursing |
21 | | facility or a nursing facility which meets the
requirements |
22 | | of Section 1819(a), (b), (c), and (d) or Section 1919(a), |
23 | | (b),
(c), and (d) of the Social Security Act, as now or |
24 | | hereafter amended (42
U.S.C. 1395i-3(a), (b), (c), and (d) |
25 | | and 42 U.S.C. 1396r(a), (b), (c), and
(d)); and any |
26 | | facility as defined by Section 1-113 of the MR/DD Community |
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1 | | Care Act, as now or hereafter amended.
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2 | | (2.5) "Assisted living establishment" and "shared |
3 | | housing establishment"
have the meanings given those terms |
4 | | in Section 10 of the Assisted Living and
Shared Housing |
5 | | Act.
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6 | | (2.7) "Supportive living facility" means a facility |
7 | | established under
Section 5-5.01a of the Illinois Public |
8 | | Aid Code.
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9 | | (2.8) "Community-based setting" means any place of |
10 | | abode other than an individual's private home.
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11 | | (3) "State Long Term Care Ombudsman" means any person |
12 | | employed by the
Department to fulfill
the requirements of |
13 | | the Office of State Long Term Care Ombudsman as
required |
14 | | under the Older Americans Act of 1965, as now or hereafter |
15 | | amended,
and Departmental policy.
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16 | | (3.1) "Ombudsman" means any designated representative |
17 | | of the State Long Term Care Ombudsman Program a regional |
18 | | long
term care ombudsman program ; provided that the |
19 | | representative, whether he is
paid for or volunteers his |
20 | | ombudsman services, shall be qualified and
designated by |
21 | | the Office to perform the duties of an ombudsman as |
22 | | specified by
the Department in rules and in accordance with |
23 | | the provisions of
the Older Americans Act of 1965, as now |
24 | | or hereafter amended.
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25 | | (4) "Participant" means an older person or persons with |
26 | | disabilities who are eligible for services under any of the |
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1 | | following: |
2 | | (i) A medical assistance waiver administered by |
3 | | the State. |
4 | | (ii) A managed care organization providing care |
5 | | coordination and other services to seniors and persons |
6 | | with disabilities. |
7 | | (5) "Resident" means an older individual who resides in |
8 | | a long-term care facility. |
9 | | (c) Ombudsman; rules. The Office of State Long Term Care |
10 | | Ombudsman shall
be composed of at least one full-time ombudsman |
11 | | and shall include a system of
designated regional long term |
12 | | care ombudsman programs. Each regional program
shall be |
13 | | designated by the State Long Term Care Ombudsman as a |
14 | | subdivision of
the Office and any representative of a regional |
15 | | program shall be treated as a
representative of the Office.
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16 | | The Department, in consultation with the Office, shall |
17 | | promulgate
administrative rules in accordance with the |
18 | | provisions of the Older Americans
Act of 1965, as now or |
19 | | hereafter amended, to establish the responsibilities of
the |
20 | | Department and the Office of State Long Term Care Ombudsman and |
21 | | the
designated regional Ombudsman programs. The administrative |
22 | | rules shall include
the responsibility of the Office and |
23 | | designated regional programs to
investigate and resolve |
24 | | complaints made by or on behalf of residents of long
term care |
25 | | facilities, supportive living facilities, and assisted living |
26 | | and
shared housing establishments, and participants residing |
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1 | | in their own homes or community-based settings, including the |
2 | | option to serve residents and participants under the age of 60, |
3 | | relating to actions, inaction, or
decisions of providers, or |
4 | | their representatives, of such long term care
facilities , of |
5 | | supported living facilities, of assisted living and shared
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6 | | housing establishments, of public agencies, or of social |
7 | | services agencies,
which may adversely affect the health, |
8 | | safety, welfare, or rights of such
residents and participants . |
9 | | The Office and designated regional programs may represent all |
10 | | residents and participants , but are not required by this Act to |
11 | | represent persons under 60 years of age, except to the extent |
12 | | required by federal law.
When necessary and appropriate, |
13 | | representatives of the Office shall refer
complaints to the |
14 | | appropriate regulatory State agency.
The Department, in |
15 | | consultation with the Office, shall cooperate with the
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16 | | Department of Human Services and other State agencies in |
17 | | providing information and training to
designated regional long |
18 | | term care ombudsman programs about the appropriate
assessment |
19 | | and treatment (including information about appropriate |
20 | | supportive
services, treatment options, and assessment of |
21 | | rehabilitation potential) of the participants residents they |
22 | | serve , including children,
persons with mental illness (other |
23 | | than Alzheimer's disease and related
disorders), and persons |
24 | | with developmental disabilities . |
25 | | The State Long Term Care Ombudsman and all other ombudsmen, |
26 | | as defined in paragraph (3.1) of subsection (b) must submit to |
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1 | | background checks under the Health Care Worker Background Check |
2 | | Act and receive training, as prescribed by the Illinois |
3 | | Department on Aging, before visiting facilities , private |
4 | | homes, or community-based settings . The training must include |
5 | | information specific to assisted living establishments, |
6 | | supportive living facilities, and shared housing |
7 | | establishments , private homes, and community-based settings |
8 | | and to the rights of residents and participants guaranteed |
9 | | under the corresponding Acts and administrative rules.
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10 | | (c-5) Consumer Choice Information Reports. The Office |
11 | | shall: |
12 | | (1) In collaboration with the Attorney General, create |
13 | | a Consumer Choice Information Report form to be completed |
14 | | by all licensed long term care facilities to aid |
15 | | Illinoisans and their families in making informed choices |
16 | | about long term care. The Office shall create a Consumer |
17 | | Choice Information Report for each type of licensed long |
18 | | term care facility. The Office shall collaborate with the |
19 | | Attorney General and the Department of Human Services to |
20 | | create a Consumer Choice Information Report form for |
21 | | facilities licensed under the MR/DD Community Care Act. |
22 | | (2) Develop a database of Consumer Choice Information |
23 | | Reports completed by licensed long term care facilities |
24 | | that includes information in the following consumer |
25 | | categories: |
26 | | (A) Medical Care, Services, and Treatment. |
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1 | | (B) Special Services and Amenities. |
2 | | (C) Staffing. |
3 | | (D) Facility Statistics and Resident Demographics. |
4 | | (E) Ownership and Administration. |
5 | | (F) Safety and Security. |
6 | | (G) Meals and Nutrition. |
7 | | (H) Rooms, Furnishings, and Equipment. |
8 | | (I) Family, Volunteer, and Visitation Provisions. |
9 | | (3) Make this information accessible to the public, |
10 | | including on the Internet by means of a hyperlink labeled |
11 | | "Resident's Right to Know" on the Office's World Wide Web |
12 | | home page. Information about facilities licensed under the |
13 | | MR/DD Community Care Act shall be made accessible to the |
14 | | public by the Department of Human Services, including on |
15 | | the Internet by means of a hyperlink labeled "Resident's |
16 | | and Families' Right to Know" on the Department of Human |
17 | | Services' "For Customers" website. |
18 | | (4) Have the authority, with the Attorney General, to |
19 | | verify that information provided by a facility is accurate. |
20 | | (5) Request a new report from any licensed facility |
21 | | whenever it deems necessary.
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22 | | (6) Include in the Office's Consumer Choice
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23 | | Information Report for each type of licensed long term care
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24 | | facility additional information on each licensed long term
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25 | | care facility in the State of Illinois, including
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26 | | information regarding each facility's compliance with the
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1 | | relevant State and federal statutes, rules, and standards;
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2 | | customer satisfaction surveys; and information generated
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3 | | from quality measures developed by the Centers for Medicare
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4 | | and Medicaid Services. |
5 | | (d) Access and visitation rights.
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6 | | (1) In accordance with subparagraphs (A) and (E) of |
7 | | paragraph (3) of
subsection (c) of Section 1819
and |
8 | | subparagraphs (A) and (E) of paragraph (3) of subsection |
9 | | (c) of Section
1919 of the Social Security Act, as now or |
10 | | hereafter amended (42 U.S.C.
1395i-3 (c)(3)(A) and (E) and |
11 | | 42 U.S.C. 1396r (c)(3)(A) and (E)), and
Section
712 of the |
12 | | Older Americans Act of 1965, as now or hereafter
amended |
13 | | (42 U.S.C. 3058f), a long term care facility, supportive |
14 | | living
facility, assisted living
establishment, and shared |
15 | | housing establishment must:
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16 | | (i) permit immediate access to any resident, |
17 | | regardless of age, by a designated
ombudsman; and
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18 | | (ii) permit representatives of the Office, with |
19 | | the permission of the
resident's legal representative |
20 | | or legal guardian, to examine a resident's
clinical and |
21 | | other records, regardless of the age of the resident, |
22 | | and if a resident is unable to consent to such
review, |
23 | | and has no legal guardian, permit representatives of |
24 | | the Office
appropriate access, as defined by the |
25 | | Department, in consultation with the
Office, in |
26 | | administrative rules, to the resident's records.
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1 | | (2) Each long term care facility, supportive living |
2 | | facility, assisted
living establishment, and
shared |
3 | | housing establishment shall display, in multiple, |
4 | | conspicuous
public places within the facility accessible |
5 | | to both visitors and residents and
in an easily readable |
6 | | format, the address and phone number of the Office of the
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7 | | Long Term Care Ombudsman, in a manner prescribed by the |
8 | | Office.
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9 | | (e) Immunity. An ombudsman or any representative of the |
10 | | Office participating
in the good faith performance of his or |
11 | | her official duties
shall have immunity from any liability |
12 | | (civil, criminal or otherwise) in
any proceedings (civil, |
13 | | criminal or otherwise) brought as a consequence of
the |
14 | | performance of his official duties.
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15 | | (f) Business offenses.
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16 | | (1) No person shall:
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17 | | (i) Intentionally prevent, interfere with, or |
18 | | attempt to impede in any
way any representative of the |
19 | | Office in the performance of his
official
duties under |
20 | | this Act and the Older Americans Act of 1965; or
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21 | | (ii) Intentionally retaliate, discriminate |
22 | | against, or effect reprisals
against any long term care |
23 | | facility resident or employee for contacting or
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24 | | providing information to any representative of the |
25 | | Office.
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26 | | (2) A violation of this Section is a business offense, |
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1 | | punishable by a
fine not to exceed $501.
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2 | | (3) The Director of Aging, in consultation with the |
3 | | Office, shall
notify the State's Attorney of the
county in |
4 | | which the long term care facility, supportive living |
5 | | facility, or
assisted living or shared housing |
6 | | establishment is located,
or the Attorney General, of any |
7 | | violations of this Section.
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8 | | (g) Confidentiality of records and identities. The |
9 | | Department shall
establish procedures for the disclosure by the |
10 | | State Ombudsman or the regional
ombudsmen
entities of files |
11 | | maintained by the program. The procedures shall provide that
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12 | | the files and records may be disclosed only at the discretion |
13 | | of the State Long
Term Care
Ombudsman or the person designated |
14 | | by the State Ombudsman to disclose the files
and records, and |
15 | | the procedures shall prohibit the disclosure of the identity
of |
16 | | any complainant, resident, participant, witness, or employee |
17 | | of a long term care provider
unless:
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18 | | (1) the complainant, resident, participant, witness, |
19 | | or employee of a long term care
provider or his or her |
20 | | legal representative consents to the disclosure and the
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21 | | consent is in writing;
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22 | | (2) the complainant, resident, participant, witness, |
23 | | or employee of a long term care
provider gives consent |
24 | | orally; and the consent is documented contemporaneously
in |
25 | | writing in
accordance with such requirements as the |
26 | | Department shall establish; or
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1 | | (3) the disclosure is required by court order.
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2 | | (h) Legal representation. The Attorney General shall
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3 | | provide legal representation to any representative of the |
4 | | Office
against
whom suit or other legal action is brought in |
5 | | connection with the
performance of the representative's |
6 | | official duties, in accordance with the
State Employee |
7 | | Indemnification Act.
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8 | | (i) Treatment by prayer and spiritual means. Nothing in |
9 | | this Act shall
be construed to authorize or require the medical |
10 | | supervision, regulation
or control of remedial care or |
11 | | treatment of any resident in a long term
care facility operated |
12 | | exclusively by and for members or adherents of any
church or |
13 | | religious denomination the tenets and practices of which |
14 | | include
reliance solely upon spiritual means through prayer for |
15 | | healing.
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16 | | (j) The Long Term Care Ombudsman Fund is created as a |
17 | | special fund in the State treasury to receive moneys for the |
18 | | express purposes of this Section. All interest earned on moneys |
19 | | in the fund shall be credited to the fund. Moneys contained in |
20 | | the fund shall be used to support the purposes of this Section. |
21 | | (Source: P.A. 96-328, eff. 8-11-09; 96-758, eff. 8-25-09; |
22 | | 96-1372, eff. 7-29-10; 97-38, eff. 6-28-11.)".
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