Public Act 103-0767
 
SB2957 EnrolledLRB103 38874 KTG 69011 b

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