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Public Act 102-1033 | ||||
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AN ACT concerning State government.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Act on the Aging is amended by | ||||
changing Section 4.04 as follows:
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(20 ILCS 105/4.04) (from Ch. 23, par. 6104.04)
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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.
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(a) Long Term Care Ombudsman Program. The Department shall
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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.
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(b) Definitions. As used in this Section, unless the | ||
context requires
otherwise:
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(1) "Access" means the right to:
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(i) Enter any long term care facility or assisted | ||
living or shared
housing establishment or supportive | ||
living facility;
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(ii) Communicate privately and without restriction | ||
with any resident, regardless of age,
who consents to | ||
the communication;
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(iii) Seek consent to communicate privately and | ||
without restriction
with any participant or resident, | ||
regardless of age;
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(iv) Inspect the clinical and other records of a | ||
participant or resident, regardless of age, with the
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express written consent of the participant or | ||
resident;
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(v) Observe all areas of the long term care | ||
facility or supportive
living facilities, assisted |
living or shared housing establishment except the
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living area of any resident who protests the | ||
observation; and
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(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
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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
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(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.
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(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.
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(2.7) "Supportive living facility" means a facility | ||
established under
Section 5-5.01a of the Illinois Public | ||
Aid Code.
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(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.
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(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
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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.
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(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.
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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
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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
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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
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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.
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(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 labeled | ||
"Resident's Right to Know" 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 labeled "Resident's and Families' Right to Know" | ||
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.
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(6) Include in the Office's Consumer Choice
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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
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information regarding each facility's compliance with the
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relevant State and federal statutes, rules, and standards;
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customer satisfaction surveys; and information generated
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from quality measures developed by the Centers for | ||
Medicare
and Medicaid Services. | ||
(d) Access and visitation rights.
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(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:
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(i) permit immediate access to any resident, | ||
regardless of age, by a designated
ombudsman;
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(ii) permit representatives of the Office, with | ||
the permission of the
resident's legal representative | ||
or legal guardian, to examine a resident's
clinical | ||
and other records, 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
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Office, in administrative rules, to the resident's | ||
records; and
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(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
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Long Term Care Ombudsman, in a manner prescribed by the | ||
Office.
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(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.
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(f) Business offenses.
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(1) No person shall:
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(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
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(ii) Intentionally retaliate, discriminate | ||
against, or effect reprisals
against any long term | ||
care facility resident or employee for contacting or
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providing information to any representative of the |
Office.
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(2) A violation of this Section is a business offense, | ||
punishable by a
fine not to exceed $501.
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(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.
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(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:
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(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
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consent is in writing;
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(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
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(3) the disclosure is required by court order.
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(h) Legal representation. The Attorney General shall
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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.
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(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
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church or religious denomination the tenets and practices of | ||
which include
reliance solely upon spiritual means through | ||
prayer for healing.
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(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. 98-380, eff. 8-16-13; 98-989, eff. 1-1-15; | ||
99-180, eff. 7-29-15; 99-712, eff. 8-5-16.)
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