Bill Amendment: IL HB5000 | 2023-2024 | 103rd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: ASSISTED LIVING CATHETER CARE

Status: 2024-08-09 - Public Act . . . . . . . . . 103-0844 [HB5000 Detail]

Download: Illinois-2023-HB5000-Senate_Amendment_001.html

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Sen. Dave Syverson

Filed: 5/17/2024

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AMENDMENT TO HOUSE BILL 5000
AMENDMENT NO. ______. Amend House Bill 5000 by replacing
everything after the enacting clause with the following:
"Section 5. The Assisted Living and Shared Housing Act is
amended by changing Sections 10, 75, and 76 as follows:
(210 ILCS 9/10)
Sec. 10. Definitions. For purposes of this Act:
"Activities of daily living" means eating, dressing,
bathing, toileting, transferring, or personal hygiene.
"Assisted living establishment" or "establishment" means a
home, building, residence, or any other place where sleeping
accommodations are provided for at least 3 unrelated adults,
at least 80% of whom are 55 years of age or older and where the
following are provided consistent with the purposes of this
Act:
(1) services consistent with a social model that is

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based on the premise that the resident's unit in assisted
living and shared housing is his or her own home;
(2) community-based residential care for persons who
need assistance with activities of daily living, including
personal, supportive, and intermittent health-related
services available 24 hours per day, if needed, to meet
the scheduled and unscheduled needs of a resident;
(3) mandatory services, whether provided directly by
the establishment or by another entity arranged for by the
establishment, with the consent of the resident or
resident's representative; and
(4) a physical environment that is a homelike setting
that includes the following and such other elements as
established by the Department: individual living units
each of which shall accommodate small kitchen appliances
and contain private bathing, washing, and toilet
facilities, or private washing and toilet facilities with
a common bathing room readily accessible to each resident.
Units shall be maintained for single occupancy except in
cases in which 2 residents choose to share a unit.
Sufficient common space shall exist to permit individual
and group activities.
"Assisted living establishment" or "establishment" does
not mean any of the following:
(1) A home, institution, or similar place operated by
the federal government or the State of Illinois.

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(2) A long term care facility licensed under the
Nursing Home Care Act, a facility licensed under the
Specialized Mental Health Rehabilitation Act of 2013, a
facility licensed under the ID/DD Community Care Act, or a
facility licensed under the MC/DD Act. However, a facility
licensed under any of those Acts may convert distinct
parts of the facility to assisted living. If the facility
elects to do so, the facility shall retain the Certificate
of Need for its nursing and sheltered care beds that were
converted.
(3) A hospital, sanitarium, or other institution, the
principal activity or business of which is the diagnosis,
care, and treatment of human illness and that is required
to be licensed under the Hospital Licensing Act.
(4) A facility for child care as defined in the Child
Care Act of 1969.
(5) A community living facility as defined in the
Community Living Facilities Licensing Act.
(6) A nursing home or sanitarium operated solely by
and for persons who rely exclusively upon treatment by
spiritual means through prayer in accordance with the
creed or tenants of a well-recognized church or religious
denomination.
(7) A facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements

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Licensure and Certification Act.
(8) A supportive residence licensed under the
Supportive Residences Licensing Act.
(9) The portion of a life care facility as defined in
the Life Care Facilities Act not licensed as an assisted
living establishment under this Act; a life care facility
may apply under this Act to convert sections of the
community to assisted living.
(10) A free-standing hospice facility licensed under
the Hospice Program Licensing Act.
(11) A shared housing establishment.
(12) A supportive living facility as described in
Section 5-5.01a of the Illinois Public Aid Code.
"Department" means the Department of Public Health.
"Director" means the Director of Public Health.
"Emergency situation" means imminent danger of death or
serious physical harm to a resident of an establishment.
"Infection control committee" means persons, including an
infection preventionist, who develop and implement policies
governing control of infections and communicable diseases and
are qualified through education, training, experience, or
certification or a combination of such qualifications.
"Infection preventionist" means a registered nurse who
develops and implements policies governing control of
infections and communicable diseases and is qualified through
education, training, experience, or certification or a

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combination of such qualifications.
"License" means any of the following types of licenses
issued to an applicant or licensee by the Department:
(1) "Probationary license" means a license issued to
an applicant or licensee that has not held a license under
this Act prior to its application or pursuant to a license
transfer in accordance with Section 50 of this Act.
(2) "Regular license" means a license issued by the
Department to an applicant or licensee that is in
substantial compliance with this Act and any rules
promulgated under this Act.
"Licensee" means a person, agency, association,
corporation, partnership, or organization that has been issued
a license to operate an assisted living or shared housing
establishment.
"Licensed health care professional" means a registered
professional nurse, an advanced practice registered nurse, a
physician assistant, and a licensed practical nurse.
"Mandatory services" include the following:
(1) 3 meals per day available to the residents
prepared by the establishment or an outside contractor;
(2) housekeeping services including, but not limited
to, vacuuming, dusting, and cleaning the resident's unit;
(3) personal laundry and linen services available to
the residents provided or arranged for by the
establishment;

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(4) security provided 24 hours each day including, but
not limited to, locked entrances or building or contract
security personnel;
(5) an emergency communication response system, which
is a procedure in place 24 hours each day by which a
resident can notify building management, an emergency
response vendor, or others able to respond to his or her
need for assistance; and
(6) assistance with activities of daily living as
required by each resident.
"Negotiated risk" is the process by which a resident, or
his or her representative, may formally negotiate with
providers what risks each are willing and unwilling to assume
in service provision and the resident's living environment.
The provider assures that the resident and the resident's
representative, if any, are informed of the risks of these
decisions and of the potential consequences of assuming these
risks.
"Owner" means the individual, partnership, corporation,
association, or other person who owns an assisted living or
shared housing establishment. In the event an assisted living
or shared housing establishment is operated by a person who
leases or manages the physical plant, which is owned by
another person, "owner" means the person who operates the
assisted living or shared housing establishment, except that
if the person who owns the physical plant is an affiliate of

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the person who operates the assisted living or shared housing
establishment and has significant control over the day to day
operations of the assisted living or shared housing
establishment, the person who owns the physical plant shall
incur jointly and severally with the owner all liabilities
imposed on an owner under this Act.
"Physician" means a person licensed under the Medical
Practice Act of 1987 to practice medicine in all of its
branches.
"Resident" means a person residing in an assisted living
or shared housing establishment.
"Resident's representative" means a person, other than the
owner, agent, or employee of an establishment or of the health
care provider unless related to the resident, designated in
writing by a resident to be his or her representative. This
designation may be accomplished through the Illinois Power of
Attorney Act, pursuant to the guardianship process under the
Probate Act of 1975, or pursuant to an executed designation of
representative form specified by the Department.
"Self" means the individual or the individual's designated
representative.
"Shared housing establishment" or "establishment" means a
publicly or privately operated free-standing residence for 16
or fewer persons, at least 80% of whom are 55 years of age or
older and who are unrelated to the owners and one manager of
the residence, where the following are provided:

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(1) services consistent with a social model that is
based on the premise that the resident's unit is his or her
own home;
(2) community-based residential care for persons who
need assistance with activities of daily living, including
housing and personal, supportive, and intermittent
health-related services available 24 hours per day, if
needed, to meet the scheduled and unscheduled needs of a
resident; and
(3) mandatory services, whether provided directly by
the establishment or by another entity arranged for by the
establishment, with the consent of the resident or the
resident's representative.
"Shared housing establishment" or "establishment" does not
mean any of the following:
(1) A home, institution, or similar place operated by
the federal government or the State of Illinois.
(2) A long term care facility licensed under the
Nursing Home Care Act, a facility licensed under the
Specialized Mental Health Rehabilitation Act of 2013, a
facility licensed under the ID/DD Community Care Act, or a
facility licensed under the MC/DD Act. A facility licensed
under any of those Acts may, however, convert sections of
the facility to assisted living. If the facility elects to
do so, the facility shall retain the Certificate of Need
for its nursing beds that were converted.

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(3) A hospital, sanitarium, or other institution, the
principal activity or business of which is the diagnosis,
care, and treatment of human illness and that is required
to be licensed under the Hospital Licensing Act.
(4) A facility for child care as defined in the Child
Care Act of 1969.
(5) A community living facility as defined in the
Community Living Facilities Licensing Act.
(6) A nursing home or sanitarium operated solely by
and for persons who rely exclusively upon treatment by
spiritual means through prayer in accordance with the
creed or tenants of a well-recognized church or religious
denomination.
(7) A facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements
Licensure and Certification Act.
(8) A supportive residence licensed under the
Supportive Residences Licensing Act.
(9) A life care facility as defined in the Life Care
Facilities Act; a life care facility may apply under this
Act to convert sections of the community to assisted
living.
(10) A free-standing hospice facility licensed under
the Hospice Program Licensing Act.
(11) An assisted living establishment.

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(12) A supportive living facility as described in
Section 5-5.01a of the Illinois Public Aid Code.
"Total assistance" means that staff or another individual
performs the entire activity of daily living without
participation by the resident.
(Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18.)
(210 ILCS 9/75)
Sec. 75. Residency requirements.
(a) No individual shall be accepted for residency or
remain in residence if the establishment cannot provide or
secure appropriate services, if the individual requires a
level of service or type of service for which the
establishment is not licensed or which the establishment does
not provide, or if the establishment does not have the staff
appropriate in numbers and with appropriate skill to provide
such services.
(b) Only adults may be accepted for residency.
(c) A person shall not be accepted for residency if:
(1) the person poses a serious threat to himself or
herself or to others;
(2) the person is not able to communicate his or her
needs and no resident representative residing in the
establishment, and with a prior relationship to the
person, has been appointed to direct the provision of
services;

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(3) the person requires total assistance with 2 or
more activities of daily living;
(4) the person requires the assistance of more than
one paid caregiver at any given time with an activity of
daily living;
(5) the person requires more than minimal assistance
in moving to a safe area in an emergency;
(6) the person has a severe mental illness, which for
the purposes of this Section means a condition that is
characterized by the presence of a major mental disorder
as classified in the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV) (American
Psychiatric Association, 1994), where the individual is a
person with a substantial disability due to mental illness
in the areas of self-maintenance, social functioning,
activities of community living and work skills, and the
disability specified is expected to be present for a
period of not less than one year, but does not mean
Alzheimer's disease and other forms of dementia based on
organic or physical disorders;
(7) the person requires intravenous therapy or
intravenous feedings unless self-administered or
administered by a qualified, licensed health care
professional;
(8) the person requires gastrostomy feedings unless
self-administered or administered by a licensed health

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care professional;
(9) the person requires insertion, sterile irrigation,
and replacement of catheter, except for routine
maintenance of urinary catheters, unless the catheter care
is self-administered or administered by a licensed health
care professional or a nurse in compliance with education,
certification, and training in catheter care or infection
control by the Centers for Disease Control and Prevention
with oversight from an infection preventionist or
infection control committee;
(10) the person requires sterile wound care unless
care is self-administered or administered by a licensed
health care professional;
(11) (blank);
(12) the person is a diabetic requiring routine
insulin injections unless the injections are
self-administered or administered by a licensed health
care professional;
(13) the person requires treatment of stage 3 or stage
4 decubitus ulcers or exfoliative dermatitis;
(14) the person requires 5 or more skilled nursing
visits per week for conditions other than those listed in
items (13) and (15) of this subsection for a period of 3
consecutive weeks or more except when the course of
treatment is expected to extend beyond a 3 week period for
rehabilitative purposes and is certified as temporary by a

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physician; or
(15) other reasons prescribed by the Department by
rule.
(d) A resident with a condition listed in items (1)
through (15) of subsection (c) shall have his or her residency
terminated.
(e) Residency shall be terminated when services available
to the resident in the establishment are no longer adequate to
meet the needs of the resident. This provision shall not be
interpreted as limiting the authority of the Department to
require the residency termination of individuals.
(f) Subsection (d) of this Section shall not apply to
terminally ill residents who receive or would qualify for
hospice care and such care is coordinated by a hospice program
licensed under the Hospice Program Licensing Act or other
licensed health care professional employed by a licensed home
health agency and the establishment and all parties agree to
the continued residency.
(g) Items (3), (4), (5), and (9) of subsection (c) shall
not apply to a quadriplegic, paraplegic, or individual with
neuro-muscular diseases, such as muscular dystrophy and
multiple sclerosis, or other chronic diseases and conditions
as defined by rule if the individual is able to communicate his
or her needs and does not require assistance with complex
medical problems, and the establishment is able to accommodate
the individual's needs. The Department shall prescribe rules

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pursuant to this Section that address special safety and
service needs of these individuals.
(h) For the purposes of items (7) through (10) of
subsection (c), a licensed health care professional may not be
employed by the owner or operator of the establishment, its
parent entity, or any other entity with ownership common to
either the owner or operator of the establishment or parent
entity, including but not limited to an affiliate of the owner
or operator of the establishment. Nothing in this Section is
meant to limit a resident's right to choose his or her health
care provider.
(i) Subsection (h) is not applicable to residents admitted
to an assisted living establishment under a life care contract
as defined in the Life Care Facilities Act if the life care
facility has both an assisted living establishment and a
skilled nursing facility. A licensed health care professional
providing health-related or supportive services at a life care
assisted living or shared housing establishment must be
employed by an entity licensed by the Department under the
Nursing Home Care Act or the Home Health, Home Services, and
Home Nursing Agency Licensing Act.
(Source: P.A. 103-444, eff. 1-1-24.)
(210 ILCS 9/76)
Sec. 76. Vaccinations.
(a) Before a prospective resident's admission to an

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assisted living establishment or shared housing establishment
that does not provide medication administration as an optional
service, the establishment shall advise the prospective
resident to consult a physician to determine whether the
prospective resident should obtain a vaccination against
pneumococcal pneumonia or influenza, or both.
(b) An assisted living establishment or shared housing
establishment that provides medication administration as an
optional service shall annually administer or arrange for
administration of a vaccination against influenza to each
resident, in accordance with the recommendations of the
Advisory Committee on Immunization Practices of the Centers
for Disease Control and Prevention that are most recent to the
time of vaccination, unless the vaccination is medically
contraindicated or the resident has refused the vaccine.
Influenza vaccinations for all residents age 65 or over shall
be completed by November 30 of each year or as soon as
practicable if vaccine supplies are not available before
November 1. Residents admitted after November 30, during the
flu season, and until February 1 shall, as medically
appropriate, receive an influenza vaccination prior to or upon
admission or as soon as practicable if vaccine supplies are
not available at the time of the admission, unless the vaccine
is medically contraindicated or the resident has refused the
vaccine. In the event that the Advisory Committee on
Immunization Practices of the Centers for Disease Control and

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Prevention determines that dates of administration other than
those stated in this Section are optimal to protect the health
of residents, the Department is authorized to adopt rules to
require vaccinations at those times rather than the times
stated in this Section. An establishment shall document in the
resident's medication record that an annual vaccination
against influenza was administered, arranged, refused, or
medically contraindicated.
An assisted living establishment or shared housing
establishment that provides medication administration as an
optional service shall administer or arrange for
administration of a pneumococcal vaccination to each resident
who is age 65 or over, in accordance with the recommendations
of the Advisory Committee on Immunization Practices of the
Centers for Disease Control and Prevention, who has not
received this immunization prior to or upon admission to the
establishment, unless the resident refuses the offer for
vaccination or the vaccination is medically contraindicated.
An establishment shall document in each resident's medication
record that a vaccination against pneumococcal pneumonia was
offered and administered, arranged, refused, or medically
contraindicated.
An assisted living establishment or shared housing
establishment that provides catheter care to one or more
residents shall designate at least one person as an Infection
Prevention and Control Professional to develop and implement

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policies governing control of infections and communicable
diseases. The Infection Prevention and Control Professionals
shall be qualified through education, training, experience, or
certification or a combination of such qualifications. The
Infection Prevention and Control Professional's qualifications
shall be documented and shall be made available for inspection
by the Department. The Department shall adopt rules to
implement the changes made by this amendatory Act of the 103rd
General Assembly.
(Source: P.A. 93-1003, eff. 8-23-04; 94-429, eff. 8-2-05.)