Illinois General Assembly - Full Text of HB5544
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Full Text of HB5544  99th General Assembly




State of Illinois
2015 and 2016


Introduced , by Rep. Carol Ammons


210 ILCS 9/90
210 ILCS 9/150

    Amends the Assisted Living and Shared Housing Act. Requires assisted living and shared housing establishment's service delivery contracts to include a copy of the establishment's emergency involuntary termination of residency plan and the establishment's discharge protocol. Requires establishments covered by the Act to develop a discharge protocol and an emergency involuntary termination plan. Defines "emergency involuntary termination of residency plan" and "discharge protocol". Requires establishments that accept Alzheimer's and dementia patients within 30 days of admission or 30 days after an establishment's existing resident is diagnosed with Alzheimer's or dementia to develop a pre-emptive plan of discharge for the resident. Contains requirements for emergency involuntary termination of residency plans and discharge protocols. Effective immediately.

LRB099 18954 MJP 43343 b





HB5544LRB099 18954 MJP 43343 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Assisted Living and Shared Housing Act is
5amended by changing Sections 90 and 150 as follows:
6    (210 ILCS 9/90)
7    Sec. 90. Contents of service delivery contract. A contract
8between an establishment and a resident must be entitled
9"assisted living establishment contract" or "shared housing
10establishment contract" as applicable, shall be printed in no
11less than 12 point type, and shall include at least the
12following elements in the body or through supporting documents
13or attachments:
14        (1) the name, street address, and mailing address of
15    the establishment;
16        (2) the name and mailing address of the owner or owners
17    of the establishment and, if the owner or owners are not
18    natural persons, the type of business entity of the owner
19    or owners;
20        (3) the name and mailing address of the managing agent
21    of the establishment, whether hired under a management
22    agreement or lease agreement, if the managing agent is
23    different from the owner or owners;



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1        (4) the name and address of at least one natural person
2    who is authorized to accept service on behalf of the owners
3    and managing agent;
4        (5) a statement describing the license status of the
5    establishment and the license status of all providers of
6    health-related or supportive services to a resident under
7    arrangement with the establishment;
8        (6) the duration of the contract;
9        (7) the base rate to be paid by the resident and a
10    description of the services to be provided as part of this
11    rate;
12        (8) a description of any additional services to be
13    provided for an additional fee by the establishment
14    directly or by a third party provider under arrangement
15    with the establishment;
16        (9) the fee schedules outlining the cost of any
17    additional services;
18        (10) a description of the process through which the
19    contract may be modified, amended, or terminated;
20        (11) a description of the establishment's complaint
21    resolution process available to residents and notice of the
22    availability of the Department on Aging's Senior Helpline
23    for complaints;
24        (12) the name of the resident's designated
25    representative, if any;
26        (13) the resident's obligations in order to maintain



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1    residency and receive services including compliance with
2    all assessments required under Section 15;
3        (14) the billing and payment procedures and
4    requirements;
5        (15) a statement affirming the resident's freedom to
6    receive services from service providers with whom the
7    establishment does not have a contractual arrangement,
8    which may also disclaim liability on the part of the
9    establishment for those services;
10        (16) a statement that medical assistance under Article
11    V or Article VI of the Illinois Public Aid Code is not
12    available for payment for services provided in an
13    establishment, excluding contracts executed with residents
14    residing in licensed establishments participating in the
15    Department on Aging's Comprehensive Care in Residential
16    Settings Demonstration Project;
17        (17) a statement detailing the admission, risk
18    management, and residency termination criteria and
19    procedures;
20        (18) a statement listing the rights specified in
21    Section 95 and acknowledging that, by contracting with the
22    assisted living or shared housing establishment, the
23    resident does not forfeit those rights;
24        (19) a statement detailing the Department's annual
25    on-site review process including what documents contained
26    in a resident's personal file shall be reviewed by the



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1    on-site reviewer as defined by rule; and
2        (20) a statement outlining whether the establishment
3    charges a community fee and, if so, the amount of the fee
4    and whether it is refundable; if the fee is refundable, the
5    contract must describe the conditions under which it is
6    refundable and how the amount of the refund is determined;
7    and .
8        (21) a copy of the establishment's emergency
9    involuntary termination of residency plan and the
10    establishment's discharge protocol, as defined in Section
11    150 of this Act.
12(Source: P.A. 93-775, eff. 1-1-05; 94-256, eff. 7-19-05.)
13    (210 ILCS 9/150)
14    Sec. 150. Alzheimer and dementia programs.
15    (a) In addition to this Section, Alzheimer and dementia
16programs shall comply with all of the other provisions of this
18    (b) No person shall be admitted or retained if the assisted
19living or shared housing establishment cannot provide or secure
20appropriate care, if the resident requires a level of service
21or type of service for which the establishment is not licensed
22or which the establishment does not provide, or if the
23establishment does not have the staff appropriate in numbers
24and with appropriate skill to provide such services.
25    (c) No person shall be accepted for residency or remain in



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1residence if the person's mental or physical condition has so
2deteriorated to render residency in such a program to be
3detrimental to the health, welfare or safety of the person or
4of other residents of the establishment. The Department by rule
5shall identify a validated dementia-specific standard with
6inter-rater reliability that will be used to assess individual
7residents. The assessment must be approved by the resident's
8physician and shall occur prior to acceptance for residency,
9annually, and at such time that a change in the resident's
10condition is identified by a family member, staff of the
11establishment, or the resident's physician.
12    (d) No person shall be accepted for residency or remain in
13residence if the person is dangerous to self or others and the
14establishment would be unable to eliminate the danger through
15the use of appropriate treatment modalities.
16    (e) No person shall be accepted for residency or remain in
17residence if the person meets the criteria provided in
18subsections (b) through (g) of Section 75 of this Act.
19    (f) An establishment that offers to provide a special
20program or unit for persons with Alzheimer's disease and
21related disorders shall:
22        (1) disclose to the Department and to a potential or
23    actual resident of the establishment information as
24    specified under the Alzheimer's Disease and Related
25    Dementias Special Care Disclosure Act;
26        (2) ensure that a resident's representative is



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1    designated for the resident;
2        (3) develop and implement policies and procedures that
3    ensure the continued safety of all residents in the
4    establishment including, but not limited to, those who:
5            (A) may wander; and
6            (B) may need supervision and assistance when
7        evacuating the building in an emergency;
8        (4) provide coordination of communications with each
9    resident, resident's representative, relatives and other
10    persons identified in the resident's service plan;
11        (5) provide cognitive stimulation and activities to
12    maximize functioning;
13        (6) provide an appropriate number of staff for its
14    resident population, as established by rule;
15        (7) require the director or administrator and direct
16    care staff to complete sufficient comprehensive and
17    ongoing dementia and cognitive deficit training, the
18    content of which shall be established by rule; and
19        (8) develop emergency procedures, a discharge
20    protocol, an emergency involuntary termination plan, and
21    staffing patterns to respond to the needs of residents.
22    (g) For the purposes of this Section, an emergency
23involuntary termination of residency plan applies only to
24residents with Alzheimer's disease or a related dementia. In
25this Section, "emergency involuntary termination of residency
26plan" means a plan to better inform individuals being admitted,



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1caregivers, legal guardians, health care power of attorneys, or
2family members who are seeking to place an individual with
3Alzheimer's disease or related dementias, of the discharge
4process. Some individuals with Alzheimer's disease or related
5dementias may be at risk of dangerous behavior due to their
6cognitive impairment and difficulty understanding and
7adjusting to a new environment, particularly if that
8environment is not structured to meet their needs. This Section
9serves to ensure that the establishment has developed and
10communicates to individuals served, legal representatives, and
11family members their strategy for preventing discharge, and
12their discharge protocol. In this Section, "discharge
13protocol" means the involuntary discharge procedures of the
14applicable facility. The discharge protocol includes resources
15that would potentially be accessed should discharge be
16considered and the rights and responsibilities of the
17individuals being served and their representatives.
18    Within 30 days of admission, an establishment that accepts
19Alzheimer's and dementia patients is required to develop a
20pre-emptive plan of discharge to be used should an involuntary
21discharge occur based on disruptive behavior or physical harm
22to themselves or others housed in the establishment.
23    If an individual is diagnosed while a resident of an
24establishment, the establishment has 30 days after the official
25diagnosis date to develop a pre-emptive plan of discharge to be
26used should an involuntary discharge occur.



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1    The emergency involuntary termination of residency plan
2shall include the following:
3        (1) An inventory of the individual's interests and
4    preferences.
5        (2) An inventory of the individual's dislikes,
6    triggers, and early warning signs.
7        (3) Strategies tailored to the individual's interests
8    and preferences designed to prevent disruptive or harmful
9    behavior or to aid the individual in calming when they are
10    upset. Best practice examples include access to the
11    individual's music preferences or engaging in an activity
12    that they enjoy.
13        (4) A method of educating care staff about the items
14    (1) through (3) and verifying their competence to carry out
15    the strategies.
16    The establishment's discharge protocol is a description of
17the procedures to prevent and respond to dangerous behavior and
18includes the following:
19        (A) The establishment's strategy for identifying
20    warning signs of dangerous behavior.
21        (B) The establishment's strategy for creating a
22    calming environment to decrease common triggers such as
23    noise levels, over-stimulus from televisions, and lack of a
24    comfortable quiet space.
25        (C) The establishment's strategy for responding to
26    warning signs to prevent escalation.



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1        (D) After the occurrence of a dangerous behavior, the
2    establishment's strategy for preventing additional
3    dangerous behaviors such as a time-limited assignment of
4    extra staff to assist in engaging the individual in
5    positive behaviors.
6        (E) Resources that would be used by the establishment
7    as a temporary measure to assure safety such as evaluation
8    by a dementia expert, respite in a more structured
9    facility, and evaluation in a hospital or geriatric
10    psychiatry unit.
11        (F) The individual, family, and legal representative's
12    rights and responsibilities in these situations, including
13    the process for appeal or providing feedback.
14        (G) A list of facilities that are potential placement
15    resources should discharge be needed.
16(Source: P.A. 96-990, eff. 7-2-10.)
17    Section 99. Effective date. This Act takes effect upon
18becoming law.