Full Text of SB2957 103rd General Assembly
SB2957eng 103RD GENERAL ASSEMBLY | | | SB2957 Engrossed | | LRB103 38874 KTG 69011 b |
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| 1 | | AN ACT concerning State government. | 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly: | 4 | | Section 5. The Illinois Act on the Aging is amended by | 5 | | changing Section 4.04 as follows: | 6 | | (20 ILCS 105/4.04) (from Ch. 23, par. 6104.04) | 7 | | Sec. 4.04. Long Term Care Ombudsman Program. The purpose | 8 | | of the Long Term Care Ombudsman Program is to ensure that older | 9 | | persons and persons with disabilities receive quality | 10 | | services. This is accomplished by providing advocacy services | 11 | | for residents of long term care facilities and participants | 12 | | receiving home care and community-based care. Managed care is | 13 | | increasingly becoming the vehicle for delivering health and | 14 | | long-term services and supports to seniors and persons with | 15 | | disabilities, including dual eligible participants. The | 16 | | additional ombudsman authority will allow advocacy services to | 17 | | be provided to Illinois participants for the first time and | 18 | | will produce a cost savings for the State of Illinois by | 19 | | supporting the rebalancing efforts of the Patient Protection | 20 | | and Affordable Care Act. | 21 | | (a) Long Term Care Ombudsman Program. The Department shall | 22 | | establish a Long Term Care Ombudsman Program, through the | 23 | | Office of State Long Term Care Ombudsman ("the Office"), in |
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| 1 | | accordance with the provisions of the Older Americans Act of | 2 | | 1965, as now or hereafter amended. The Long Term Care | 3 | | Ombudsman Program is authorized, subject to sufficient | 4 | | appropriations, to advocate on behalf of older persons and | 5 | | persons with disabilities residing in their own homes or | 6 | | community-based settings, relating to matters which may | 7 | | adversely affect the health, safety, welfare, or rights of | 8 | | such individuals. | 9 | | (b) Definitions. As used in this Section, unless the | 10 | | context requires otherwise: | 11 | | (1) "Access" means the right to: | 12 | | (i) Enter any long term care facility or assisted | 13 | | living or shared housing establishment or supportive | 14 | | living facility; | 15 | | (ii) Communicate privately and without restriction | 16 | | with any resident, regardless of age, who consents to | 17 | | the communication; | 18 | | (iii) Seek consent to communicate privately and | 19 | | without restriction with any participant or resident, | 20 | | regardless of age; | 21 | | (iv) Inspect and copy the clinical and other | 22 | | records of a participant or resident, regardless of | 23 | | age, with the express written consent of the | 24 | | participant or resident , or if consent is given | 25 | | orally, visually, or through the use of auxiliary aids | 26 | | and services, such consent is documented |
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| 1 | | contemporaneously by a representative of the Office in | 2 | | accordance with such procedures ; | 3 | | (v) Observe all areas of the long term care | 4 | | facility or supportive living facilities, assisted | 5 | | living or shared housing establishment except the | 6 | | living area of any resident who protests the | 7 | | observation; and | 8 | | (vi) Subject to permission of the participant or | 9 | | resident requesting services or his or her | 10 | | representative, enter a home or community-based | 11 | | setting. | 12 | | (2) "Long Term Care Facility" means (i) any facility | 13 | | as defined by Section 1-113 of the Nursing Home Care Act, | 14 | | as now or hereafter amended; (ii) any skilled nursing | 15 | | facility or a nursing facility which meets the | 16 | | requirements of Section 1819(a), (b), (c), and (d) or | 17 | | Section 1919(a), (b), (c), and (d) of the Social Security | 18 | | Act, as now or hereafter amended (42 U.S.C. 1395i-3(a), | 19 | | (b), (c), and (d) and 42 U.S.C. 1396r(a), (b), (c), and | 20 | | (d)); (iii) any facility as defined by Section 1-113 of | 21 | | the ID/DD Community Care Act, as now or hereafter amended; | 22 | | (iv) any facility as defined by Section 1-113 of MC/DD | 23 | | Act, as now or hereafter amended; and (v) any facility | 24 | | licensed under Section 4-105 or 4-201 of the Specialized | 25 | | Mental Health Rehabilitation Act of 2013, as now or | 26 | | hereafter amended. |
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| 1 | | (2.5) "Assisted living establishment" and "shared | 2 | | housing establishment" have the meanings given those terms | 3 | | in Section 10 of the Assisted Living and Shared Housing | 4 | | Act. | 5 | | (2.7) "Supportive living facility" means a facility | 6 | | established under Section 5-5.01a of the Illinois Public | 7 | | Aid Code. | 8 | | (2.8) "Community-based setting" means any place of | 9 | | abode other than an individual's private home. | 10 | | (3) "State Long Term Care Ombudsman" means any person | 11 | | employed by the Department to fulfill the requirements of | 12 | | the Office of State Long Term Care Ombudsman as required | 13 | | under the Older Americans Act of 1965, as now or hereafter | 14 | | amended, and Departmental policy. | 15 | | (3.1) "Ombudsman" means any designated representative | 16 | | of the State Long Term Care Ombudsman Program; provided | 17 | | that the representative, whether he is paid for or | 18 | | volunteers his ombudsman services, shall be qualified and | 19 | | designated by the Office to perform the duties of an | 20 | | ombudsman as specified by the Department in rules and in | 21 | | accordance with the provisions of the Older Americans Act | 22 | | of 1965, as now or hereafter amended. | 23 | | (4) "Participant" means an older person aged 60 or | 24 | | over or an adult with a disability aged 18 through 59 who | 25 | | is eligible for services under any of the following: | 26 | | (i) A medical assistance waiver administered by |
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| 1 | | the State. | 2 | | (ii) A managed care organization providing care | 3 | | coordination and other services to seniors and persons | 4 | | with disabilities. | 5 | | (5) "Resident" means an older person aged 60 or over | 6 | | or an adult with a disability aged 18 through 59 who | 7 | | resides in a long-term care facility. | 8 | | (c) Ombudsman; rules. The Office of State Long Term Care | 9 | | Ombudsman shall be composed of at least one full-time | 10 | | ombudsman and shall include a system of designated regional | 11 | | long term care ombudsman programs. Each regional program shall | 12 | | be designated by the State Long Term Care Ombudsman as a | 13 | | subdivision of the Office and any representative of a regional | 14 | | program shall be treated as a representative of the Office. | 15 | | The Department, in consultation with the Office, shall | 16 | | promulgate administrative rules in accordance with the | 17 | | provisions of the Older Americans Act of 1965, as now or | 18 | | hereafter amended, to establish the responsibilities of the | 19 | | Department and the Office of State Long Term Care Ombudsman | 20 | | and the designated regional Ombudsman programs. The | 21 | | administrative rules shall include the responsibility of the | 22 | | Office and designated regional programs to investigate and | 23 | | resolve complaints made by or on behalf of residents of long | 24 | | term care facilities, supportive living facilities, and | 25 | | assisted living and shared housing establishments, and | 26 | | participants residing in their own homes or community-based |
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| 1 | | settings, including the option to serve residents and | 2 | | participants under the age of 60, relating to actions, | 3 | | inaction, or decisions of providers, or their representatives, | 4 | | of such facilities and establishments, of public agencies, or | 5 | | of social services agencies, which may adversely affect the | 6 | | health, safety, welfare, or rights of such residents and | 7 | | participants. The Office and designated regional programs may | 8 | | represent all residents and participants, but are not required | 9 | | by this Act to represent persons under 60 years of age, except | 10 | | to the extent required by federal law. When necessary and | 11 | | appropriate, representatives of the Office shall refer | 12 | | complaints to the appropriate regulatory State agency. The | 13 | | Department, in consultation with the Office, shall cooperate | 14 | | with the Department of Human Services and other State agencies | 15 | | in providing information and training to designated regional | 16 | | long term care ombudsman programs about the appropriate | 17 | | assessment and treatment (including information about | 18 | | appropriate supportive services, treatment options, and | 19 | | assessment of rehabilitation potential) of the participants | 20 | | they serve. | 21 | | The State Long Term Care Ombudsman and all other | 22 | | ombudsmen, as defined in paragraph (3.1) of subsection (b) | 23 | | must submit to background checks under the Health Care Worker | 24 | | Background Check Act and receive training, as prescribed by | 25 | | the Illinois Department on Aging, before visiting facilities, | 26 | | private homes, or community-based settings. The training must |
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| 1 | | include information specific to assisted living | 2 | | establishments, supportive living facilities, shared housing | 3 | | establishments, private homes, and community-based settings | 4 | | and to the rights of residents and participants guaranteed | 5 | | under the corresponding Acts and administrative rules. | 6 | | (c-5) Consumer Choice Information Reports. The Office | 7 | | shall: | 8 | | (1) In collaboration with the Attorney General, create | 9 | | a Consumer Choice Information Report form to be completed | 10 | | by all licensed long term care facilities to aid | 11 | | Illinoisans and their families in making informed choices | 12 | | about long term care. The Office shall create a Consumer | 13 | | Choice Information Report for each type of licensed long | 14 | | term care facility. The Office shall collaborate with the | 15 | | Attorney General and the Department of Human Services to | 16 | | create a Consumer Choice Information Report form for | 17 | | facilities licensed under the ID/DD Community Care Act or | 18 | | the MC/DD Act. | 19 | | (2) Develop a database of Consumer Choice Information | 20 | | Reports completed by licensed long term care facilities | 21 | | that includes information in the following consumer | 22 | | categories: | 23 | | (A) Medical Care, Services, and Treatment. | 24 | | (B) Special Services and Amenities. | 25 | | (C) Staffing. | 26 | | (D) Facility Statistics and Resident Demographics. |
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| 1 | | (E) Ownership and Administration. | 2 | | (F) Safety and Security. | 3 | | (G) Meals and Nutrition. | 4 | | (H) Rooms, Furnishings, and Equipment. | 5 | | (I) Family, Volunteer, and Visitation Provisions. | 6 | | (3) Make this information accessible to the public, | 7 | | including on the Internet by means of a hyperlink on the | 8 | | Office's World Wide Web home page. Information about | 9 | | facilities licensed under the ID/DD Community Care Act or | 10 | | the MC/DD Act shall be made accessible to the public by the | 11 | | Department of Human Services, including on the Internet by | 12 | | means of a hyperlink on the Department of Human Services' | 13 | | "For Customers" website. | 14 | | (4) Have the authority, with the Attorney General, to | 15 | | verify that information provided by a facility is | 16 | | accurate. | 17 | | (5) Request a new report from any licensed facility | 18 | | whenever it deems necessary. | 19 | | (6) Include in the Office's Consumer Choice | 20 | | Information Report for each type of licensed long term | 21 | | care facility additional information on each licensed long | 22 | | term care facility in the State of Illinois, including | 23 | | information regarding each facility's compliance with the | 24 | | relevant State and federal statutes, rules, and standards; | 25 | | customer satisfaction surveys; and information generated | 26 | | from quality measures developed by the Centers for |
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| 1 | | Medicare and Medicaid Services. | 2 | | (d) Access and visitation rights. | 3 | | (1) In accordance with subparagraphs (A) and (E) of | 4 | | paragraph (3) of subsection (c) of Section 1819 and | 5 | | subparagraphs (A) and (E) of paragraph (3) of subsection | 6 | | (c) of Section 1919 of the Social Security Act, as now or | 7 | | hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and | 8 | | 42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the | 9 | | Older Americans Act of 1965, as now or hereafter amended | 10 | | (42 U.S.C. 3058f), a long term care facility, supportive | 11 | | living facility, assisted living establishment, and shared | 12 | | housing establishment must: | 13 | | (i) permit immediate access to any resident, | 14 | | regardless of age, by a designated ombudsman; | 15 | | (ii) permit representatives of the Office, with | 16 | | the permission of the resident, the resident's legal | 17 | | representative, or the resident's legal guardian, to | 18 | | examine and copy a resident's clinical and other | 19 | | records, including facility reports of incidents or | 20 | | occurrences made to State agencies, regardless of the | 21 | | age of the resident, and if a resident is unable to | 22 | | consent to such review, and has no legal guardian, | 23 | | permit representatives of the Office appropriate | 24 | | access, as defined by the Department, in consultation | 25 | | with the Office, in administrative rules, to the | 26 | | resident's records; and |
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| 1 | | (iii) permit a representative of the Program to | 2 | | communicate privately and without restriction with any | 3 | | participant who consents to the communication | 4 | | regardless of the consent of, or withholding of | 5 | | consent by, a legal guardian or an agent named in a | 6 | | power of attorney executed by the participant. | 7 | | (2) Each long term care facility, supportive living | 8 | | facility, assisted living establishment, and shared | 9 | | housing establishment shall display, in multiple, | 10 | | conspicuous public places within the facility accessible | 11 | | to both visitors and residents and in an easily readable | 12 | | format, the address and phone number of the Office of the | 13 | | Long Term Care Ombudsman, in a manner prescribed by the | 14 | | Office. | 15 | | (e) Immunity. An ombudsman or any representative of the | 16 | | Office participating in the good faith performance of his or | 17 | | her official duties shall have immunity from any liability | 18 | | (civil, criminal or otherwise) in any proceedings (civil, | 19 | | criminal or otherwise) brought as a consequence of the | 20 | | performance of his official duties. | 21 | | (f) Business offenses. | 22 | | (1) No person shall: | 23 | | (i) Intentionally prevent, interfere with, or | 24 | | attempt to impede in any way any representative of the | 25 | | Office in the performance of his official duties under | 26 | | this Act and the Older Americans Act of 1965; or |
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| 1 | | (ii) Intentionally retaliate, discriminate | 2 | | against, or effect reprisals against any long term | 3 | | care facility resident or employee for contacting or | 4 | | providing information to any representative of the | 5 | | Office. | 6 | | (2) A violation of this Section is a business offense, | 7 | | punishable by a fine not to exceed $501. | 8 | | (3) The State Long Term Care Ombudsman shall notify | 9 | | the State's Attorney of the county in which the long term | 10 | | care facility, supportive living facility, or assisted | 11 | | living or shared housing establishment is located, or the | 12 | | Attorney General, of any violations of this Section. | 13 | | (g) Confidentiality of records and identities. The | 14 | | Department shall establish procedures for the disclosure by | 15 | | the State Ombudsman or the regional ombudsmen entities of | 16 | | files maintained by the program. The procedures shall provide | 17 | | that the files and records may be disclosed only at the | 18 | | discretion of the State Long Term Care Ombudsman or the person | 19 | | designated by the State Ombudsman to disclose the files and | 20 | | records, and the procedures shall prohibit the disclosure of | 21 | | the identity of any complainant, resident, participant, | 22 | | witness, or employee of a long term care provider unless: | 23 | | (1) the complainant, resident, participant, witness, | 24 | | or employee of a long term care provider or his or her | 25 | | legal representative consents to the disclosure and the | 26 | | consent is in writing; |
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| 1 | | (2) the complainant, resident, participant, witness, | 2 | | or employee of a long term care provider gives consent | 3 | | orally; and the consent is documented contemporaneously in | 4 | | writing in accordance with such requirements as the | 5 | | Department shall establish; or | 6 | | (3) the disclosure is required by court order. | 7 | | (h) Legal representation. The Attorney General shall | 8 | | provide legal representation to any representative of the | 9 | | Office against whom suit or other legal action is brought in | 10 | | connection with the performance of the representative's | 11 | | official duties, in accordance with the State Employee | 12 | | Indemnification Act. | 13 | | (i) Treatment by prayer and spiritual means. Nothing in | 14 | | this Act shall be construed to authorize or require the | 15 | | medical supervision, regulation or control of remedial care or | 16 | | treatment of any resident in a long term care facility | 17 | | operated exclusively by and for members or adherents of any | 18 | | church or religious denomination the tenets and practices of | 19 | | which include reliance solely upon spiritual means through | 20 | | prayer for healing. | 21 | | (j) The Long Term Care Ombudsman Fund is created as a | 22 | | special fund in the State treasury to receive moneys for the | 23 | | express purposes of this Section. All interest earned on | 24 | | moneys in the fund shall be credited to the fund. Moneys | 25 | | contained in the fund shall be used to support the purposes of | 26 | | this Section. |
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| 1 | | (k) Each Regional Ombudsman may, in accordance with rules | 2 | | promulgated by the Office, establish a multi-disciplinary team | 3 | | to act in an advisory role for the purpose of providing | 4 | | professional knowledge and expertise in handling complex | 5 | | abuse, neglect, and advocacy issues involving participants. | 6 | | Each multi-disciplinary team may consist of one or more | 7 | | volunteer representatives from any combination of at least 7 | 8 | | members from the following professions: banking or finance; | 9 | | disability care; health care; pharmacology; law; law | 10 | | enforcement; emergency responder; mental health care; clergy; | 11 | | coroner or medical examiner; substance abuse; domestic | 12 | | violence; sexual assault; or other related fields. To support | 13 | | multi-disciplinary teams in this role, law enforcement | 14 | | agencies and coroners or medical examiners shall supply | 15 | | records as may be requested in particular cases. The Regional | 16 | | Ombudsman, or his or her designee, of the area in which the | 17 | | multi-disciplinary team is created shall be the facilitator of | 18 | | the multi-disciplinary team. | 19 | | (Source: P.A. 102-1033, eff. 1-1-23; 103-329, eff. 1-1-24 .) |
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