Amends the Program of All-Inclusive Care for the Elderly Act. Provides that to ensure that organizations contracted to implement the Program of All-Inclusive Care for the Elderly (PACE) program meet the needs of PACE participants, the Department of Healthcare and Family Services shall reform the rate-setting methodology for the PACE program by establishing a blended rate structure based on a 30% Home and Community-Based Services and 70% Skilled Nursing Facility case-mix which is a more accurate proportion of the comparable population expected to reside in an institution or the community if not enrolled in PACE. Requires the blended rate structure to more accurately reflect the comprehensive nature of care provided by PACE organizations and address the unique needs of PACE participants as a higher risk/acuity population with expected higher costs and frailty than comparable populations. Provides that when developing rates under the blended rate structure, the Department must consider not only the standard cost experiences of PACE participants but also the unique characteristics and specific care needs of the PACE population as well as any additional State plan services or populations that are not included in the State's Medicaid managed care contracts but are required under the PACE program.
Amends the Assisted Living and Shared Housing Act. Makes changes to assessments for admission to establishments and service plan requirements. Requires an establishment to notify the resident and the resident's representative when there is a significant change in the resident's condition that affects the establishment's ability to meet the resident's needs. Prohibits an establishment from terminating or reducing any service without the consent of the resident or the resident's representative for the purpose of making it more difficult or impossible for the resident to remain in the establishment. Adds new requirements for establishments and the Department of Public Health regarding the involuntary termination of residency. Provides that a resident has the right to not be unlawfully transferred or discharged. Makes other changes. Amends the Nursing Home Care Act. Prohibits a resident from being transferred or discharged in violation of the Act. Provides that a resident has the right not to be unlawfully transferred or discharged. Provides for the assessment of a $2,500 fine for a facility that fails to comply with an order to readmit a resident who wishes to return to the facility and is appropriate for that level of care and services provided. Requires a facility that complies with an order to readmit a resident that has been deemed to have been unlawfully discharged to notify the Department within 10 business days after the resident has been readmitted to the facility. Provides that a facility may involuntarily transfer or discharge a resident because the facility is unable to meet the medical needs of the resident, as documented in the resident's clinical record by the resident's physician. Provides that the Department maintains jurisdiction over the transfer or discharge irrespective of the timing of the notice and discharge. Provides that if the Department determines that a transfer or discharge is not authorized, then the Department shall issue a written decision stating that the transfer or discharge is denied. Makes other changes. Effective immediately.
Amends the Nursing Home Care Act. In provisions concerning required posting of information, provides that the posting of information is not required if staffing was at 90% staffing of the minimum staffing requirements or if a facility has corrected the minimum staffing requirements before the posting deadline.
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions listing the classes of persons eligible for medical assistance, provides that, to the extent permitted by federal law, the Department of Healthcare and Family Services shall by rule eliminate the consideration of assets when determining eligibility for any program of medical assistance. Requires the Department to seek federal authority to disregard all resources, including real and personal property, as authorized by the flexibilities provided under a specified federal law or other available authorities. Provides that if adjustment or elimination of the asset limit results in any disadvantage to receiving medical assistance in a community setting, the Department shall adopt rules rebalancing the programs so that, where medical assistance is available in a community setting, a medical assistance beneficiary has free choice between receiving those services in the community or in a long-term care facility. Makes conforming changes by: (i) removing a provision that requires the Department to establish, by rule, the amounts of assets to be disregarded in determining eligibility for medical assistance; (ii) removing a provision that permits the Department to establish resource standards for pregnant individuals applying for medical assistance that are more restrictive than those resource standards established under the Temporary Assistance for Needy Families program; and (iii) removing a provision that permits the Department to allow non-exempt assets up to $25,000 during periods of medical assistance eligibility for employed persons with disabilities and employed persons with a medically improved disability.
Amends the Criminal Code of 2012. Provides for enhanced penalties for aggravated assault or aggravated battery of emergency department staff of a health care facility. Defines "emergency department staff" as any clinical or nonclinical staff present in the emergency department or emergency room of a health care facility who may come in contact with patients, including, but not limited to, physicians, nurses, nonphysician providers, technicians, security staff, patient transporters, respiratory therapists, housekeeping personnel, secretaries, and pharmacists. Defines "health care facility" as a facility, hospital, or establishment licensed or organized under the Ambulatory Surgical Treatment Center Act, the University of Illinois Hospital Act, the Hospital Licensing Act, the Nursing Home Care Act, the Assisted Living and Shared Housing Act, or the Community Living Facilities Licensing Act. Effective immediately.
Amends the Nursing Home Care Act and the Assisted Living and Shared Housing Act. Requires the Department of Public Health to hold semiannual joint training sessions for surveyors, nursing home providers, and assisted living establishment providers. Provides that the Department shall include the State long-term care ombudsman, or the State long-term care ombudsman's designee, and representatives of each nursing home provider association and assisted living provider association in the State in the planning process to create the topics and content of the joint training sessions as well as the coordination and presentations for the joint training sessions. Provides that, at least annually, a joint training session shall include, but not be limited to, regional citation patterns relating to complaints, standards, and outcomes in the nursing home and assisted living survey process. Requires the Department to develop standardized training for establishments to prevent common citations in the assisted living survey process.
Amends the Assisted Living and Shared Housing Act. Makes changes to assessments for admission to establishments and service plan requirements. Requires an establishment to notify the resident and the resident's representative when there is a significant change in the resident's condition that affects the establishment's ability to meet the resident's needs. Prohibits an establishment from terminating or reducing any service without the consent of the resident or the resident's representative for the purpose of making it more difficult or impossible for the resident to remain in the establishment. Adds new requirements for establishments and the Department of Public Health regarding the involuntary termination of residency. Provides that a resident has the right to not be unlawfully transferred or discharged. Makes other changes. Amends the Nursing Home Care Act. Prohibits a resident from being transferred or discharged in violation of the Act. Provides that a resident has the right not to be unlawfully transferred or discharged. Provides for the assessment of a $2,500 fine for a facility that fails to comply with an order to readmit a resident who wishes to return to the facility and is appropriate for that level of care and services provided. Requires a facility that complies with an order to readmit a resident that has been deemed to have been unlawfully discharged to notify the Department within 10 business days after the resident has been readmitted to the facility. Provides that a facility may involuntarily transfer or discharge a resident because the facility is unable to meet the medical needs of the resident, as documented in the resident's clinical record by the resident's physician. Provides that the Department maintains jurisdiction over the transfer or discharge irrespective of the timing of the notice and discharge. Provides that if the Department determines that a transfer or discharge is not authorized, then the Department shall issue a written decision stating that the transfer or discharge is denied. Makes other changes. Effective immediately.
Amends the Consumer Fraud and Deceptive Business Practices Act. Provides that it is an unlawful practice for any seller of accident insurance or health insurance to solicit individuals who are residents of a nursing home or long-term care facility or individuals who are over the age of 65, unless the seller: (1) does not require a purchasing decision in the first communication to the potential enrollee; (2) advises the potential enrollee of the benefit of examining the potential enrollee's current insurance plan and discussing any changes with a family member, friend, or other advisor before making any decisions; (3) provides a phone number that may be called if the potential enrollee or the potential enrollee's family members, friends, or other advisors have any questions; and (4) allows the potential enrollee to opt out of any future communications with the seller. Provides that it is also an unlawful practice for any seller or provider of accident insurance or health insurance to enter into or amend an insurance policy with a person who: (1) is over the age of 65 and who has executed a power of attorney to give another person authority over medical decisions; or (2) has a medical condition, such as dementia, that would reduce the person's capacity to make informed decisions independently. Provides that the provision does not apply to a new insurance policy or an amendment to an insurance policy that is agreed to by a person with a lawfully executed power of attorney relating to the enrollee or potential enrollee's health or financial matters.
Amends the Illinois Insurance Code. Requires a group or individual policy of accident and health insurance or a managed care plan to provide coverage for at least one early egg allergen introduction dietary supplement and one early peanut allergen introduction dietary supplement. Provides that the required coverage shall be provided at no cost to a covered individual, including deductible payments and cost-sharing amounts charged once a deductible is met. Except as otherwise provided, nothing in the provisions prevents the operation of such a policy provision as a deductible, coinsurance, allowable charge limitation, coordination of benefits, or a provision restricting coverage to services by a licensed, certified, or carrier-approved provider or facility. Provides that the required coverage does not apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policies, and that the cost-sharing limitation does not apply to a catastrophic health plan to the extent the cost-sharing limitation would cause the plan to fail to be treated as a catastrophic plan under federal law. Provides that the cost-sharing limitation does not apply to a high deductible health plan to the extent this cost-sharing limitation would cause the plan to fail to be treated as a high deductible health plan under specified provisions of the Internal Revenue Code. Provides that, if the cost-sharing limitation would result in an enrollee becoming ineligible for a health savings account under federal law, the cost-sharing limitation only applies to a qualified high deductible health plan after the enrollee's deductible has been met. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions.
Amends the Nursing Home Care Act. In provisions concerning monetary penalties for noncompliance with minimum staffing standards, provides that monetary penalties shall be established based on a formula that calculates on a quarterly basis (instead of a daily basis). Provides that the monetary penalty may not be waived, except where there is no more than a 10% deviation from the staffing requirements, in which case the facility shall not receive a penalty. Makes changes regarding the notice that a facility that has received a notice of violation for a violation of the minimum staffing requirements shall display. Effective immediately.
