Bill Text: IL HB4249 | 2023-2024 | 103rd General Assembly | Engrossed

---

Bill Title: Amends the Illinois Act on the Aging. In provisions concerning the Long Term Care Ombudsman Program, expands the definition of "access" to means the right to 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 of State Long Term Care Ombudsman. In provisions requiring long term care facilities, supportive living facilities, assisted living establishments, and shared housing establishments to permit Office representatives to examine and copy a resident's clinical and other reports, includes reports of incidents or occurrences involving the resident that were made to other State agencies.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-04-19 - Rule 19(a) / Re-referred to Rules Committee [HB4249 Detail]

Download: Illinois-2023-HB4249-Engrossed.html

---

HB4249 Engrossed LRB103 35290 KTG 65324 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

HB4249 Engrossed - 2 - LRB103 35290 KTG 65324 b
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

HB4249 Engrossed - 3 - LRB103 35290 KTG 65324 b
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.

HB4249 Engrossed - 4 - LRB103 35290 KTG 65324 b
(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

HB4249 Engrossed - 5 - LRB103 35290 KTG 65324 b
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

HB4249 Engrossed - 6 - LRB103 35290 KTG 65324 b
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

HB4249 Engrossed - 7 - LRB103 35290 KTG 65324 b
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.

HB4249 Engrossed - 8 - LRB103 35290 KTG 65324 b
(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

HB4249 Engrossed - 9 - LRB103 35290 KTG 65324 b
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 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

HB4249 Engrossed - 10 - LRB103 35290 KTG 65324 b
(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

HB4249 Engrossed - 11 - LRB103 35290 KTG 65324 b
(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;

HB4249 Engrossed - 12 - LRB103 35290 KTG 65324 b
(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.

HB4249 Engrossed - 13 - LRB103 35290 KTG 65324 b