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HomeMy WebLinkAboutORDINANCES-1984-091-O-842/7/85 91-0-84 iai� v �u iivhI i 11V t1L - )/ 11/ OJ Amending Title 8 of the City Code of the City of Evanston, 1979, as Amended, Providing for the Licensing of Residential Care Homes and Group Care Homes WHEREAS, the City of Evanston as a home rule unit • may exercise powers and perform functions pertaining to its government and affairs; and WHEREAS, effective local licensing, regulation and enforcement of minimum standards for Residential and Group Care Homes located within Evanston is a matter directly relating to the affairs of the City of Evanston; and WHEREAS, a demonstrated need exists in Evanston for such Homes to accommodate certain Evanston residents currently unable to find appropriate living arrangements within the City of Evanston; and WHEREAS, expeditious evaluation and processing of applications for such licensing is deemed sound and appropriate; and WHEREAS, the City Council of the City of Evanston on November 21, 1983, adopted Ordinance 88-0-83 providing for the establishment of Residential Care Homes and Group Care Homes, and included the provision that the City Council will promulgate such standards, rules and regulations regarding the licensing and operation of Residential Care and Group Care Homes as it shall deem necessary to implement the Ordinance and provide due process; NOW, THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF EVANSTON, COOK COUNTY, ILLINOIS: SECTION 1: That Title 8, Chapter 19, entitled "Residential Care Homes and Group • Care Homes", of the City Code of the City of Evanston, 1979, as amended, be further amended to read as follows: CHAPTER 19 RESIDENTIAL CARE AND GROUP CARE HOMES SECTION: PAGE 8-19-1 GENERAL PROVISIONS AND DEFINITIONS 4 8-19-1-1 DECLARATION OF POLICY 4 • 8-19-1-2 DEFINITIONS 5 8-19-1-3 ADMINISTRATION 14 8-19-1-4 EXEMPTIONS 14 8-19-2 RUUIREMENTS FOR LICENSURE 15 8-19-2-1 LICENSE REQUIRED; APPLICATION FEE 15 8-19-2-2 LICENSE APPLICATION REQUIREMENTS 15 8-19-3 LICENSING AND ENFORCEMENT PROCEDURES 20 8-19-3-1 LICENSE APPLICATION REVIEW 20 8-19-3-2 ISSUANCE OF LICENSE 21 8-19-3-3 DENIAL OF LICENSE 21 8-19-3-4 LICENSE CATEGORIES; TERMS, FEES 22 8-19-3-5 TRANSFER OF OWNERSHIP 23 8-19-3-6 ANNUAL INSPECTION 24 8-19-3-7 LICENSE REVOCATION 24 • 25 8-19-3-8 NOTICE OF LICENSE REVOCATION 8-19-3-9 VOLUNTARY CLOSING 26 8-19-3-10 DEPARTMENT ENFORCEMENT RIGHTS AND RESPONSIBILITIES 26 8-19-4 COMPLAINT PROCEDURES 30 8-19-4-1 COMPLAINTS; INVESTIGATION 30 8-19-4-2 CONFIDENTIALITY 31 8-19-4-3 FINDINGS: NOTICE TO LICENSEE 31 8-19-5 HEARINGS 31 8-19-5-1 HEARING PROCEDURES 31 8-19-5-2 HEARING OFFICER TO MAKE FINDINGS 34 8-19-6 WAIVERS 35 8-19-6-1 RELIEF REQUESTED 35 • 8-19-6-2 CONTINUATION OF RELIEF 36 8-19-6-3 APPEAL OF WAIVER DETERMINATION 36 8-19-7 PENALTIES 37 -2- 8-19-7-1 INJUNCTIVE RELIEF 37 8-19-7-2 FINES 37 8-19-8 SPECIFIC OPERATING REOUIREMENTS FOR HOMES SERVING ELDERLY 37 8-19-8-1 PROGRAM PRINCIPLES 37 • 8-19-8-2 ADMISSION AND DISCHARGE 39 8-19-8-3 RESIDENT TRANSFER 41 8-19-8-4 CONTRACT 41 8-19-8-5 RESIDENT RIGHTS 42 8-19-8-6 FAMILY AND COMMUNITY RELATIONS 45 8-19-8-7 STAFF 45 8-19-8-8 EMERGENCY AND UNUSUAL OCCURRENCE PROCEDURES 47 8-19-8-9 RECORDS 50 8-19-8-10 MAINTENANCE AND HOUSEKEEPING 51 8-19-9 SPECIFIC OPERATING REQUIREMENTS FOR HOMES SERVING THE DEVELOPMENTALLY, DISABLED 54 8-19-9-1 ADOPTION OF STATE RULES AND REGULATIONS 54 • 55 8-19-9-2 PROGRAM PRINCIPLES 8-19-9-3 MONITORING 55 8-19-9-4 ADMISSION AND DISCHARGE 56 8-19-9-5 CONTRACT 60 8-19-9-6 RESIDENT RIGHTS 61 8-19-9-7 FAMILY AND COMMUNITY RELATIONS 63 8-19-9-8 STAFF 63 8-19-9-9 INDIVIDUAL CARE PLAN 65 8-19-9-10 SELF ADMINISTRATION OF PRESCRIBED MEDICATION 67 8-19-9-11 EMERGENCY AND UNUSUAL OCCURRENC PROCEDURES 65 8-19-9-12 RECORDS 71 • 8-19-9-13 MAINTENANCE AND HOUSEKEEPING 71 8-19-9-14 FOOD SERVICE 73 1wil 8-19-10 SPECIFIC OPERATING REQUIREMENTS FOR HOMES SERVING THE MENTALLY ILL 74 8-19-10-1 PROGRAM PRINCIPLES 74 8-19-10-2 MONITORING 74 8-19-10-3 ADMISSION AND DISCHARGE 75 8-19-10-4 CONTRACT 80 8-19-10-5 RESIDENT RIGHTS 81 8-19-10-6 FAMILY AND COMMUNITY RELATIONS 83 8-19-10-7 STAFF 83 8-19-10-8 INDIVIDUAL CARE PLAN 85 8-19-10-9 SELF ADMINISTRATION OF PRESCRIBED MEDICATIONS 87 8-19-10-10 EMERGENCY AND UNUSUAL OCCURRENCE PROCEDURES 88 8719-10-11 RECORDS 90 8-19-10-12 MAINTENANCE AND HOUSEKEEPING 91 8-19-10-13 FOOD SERVICE 92 It 8-19-1 GENERAL PROVISIONS AND DEFINITIONS 8-19-1-1 DECLARATION OF POLICY: It is the purpose of this Chapter and the policy of the City to support, foster and establish standards for the creation, licensing and regulation of facilities designed to care for four specific groups with special housing needs, the elderly, youth, the mentally ill, and the developmentally disabled, who will benefit from the security and support of a group, and who may need limited supervision from others, but who do not need the services usually provided in a long • term care facility. All residents admitted to and residing in a Home shall be of the same specific group identified above (elderly, youth, mentally ill or developmentally disabled. -4- 8-19-1-2 DEFINITIONS ABUSE: Any physical, emotional, social or mental injury inflicted on a resident other than by accidental means. AGGRIEVED PARTY: For purposes of this Chapter, license applicants, licensees, residents and legal representatives of residents whose legal rights, duties or privileges created under this Chapter are adversely affected by a decision rendered in a particular case by the Director of the Department of Health and Human Services. ANNUAL LICENSE: A License issued to a Home after the period of provisional licenseee and annually thereafter, when a Home is in substantial compliance with this Chapter and other applicable City ordinances. APPLICANT: Any person, agency, association, corporation, partnership, or organization proposing to operate a Home and making application for a license. APPROPRIATE: With respect to a program, that the program has the type and quality of staff, services, and enivronment which are sufficient to meet the objectives assigned to it in a resident's Individual Care Plan. -5- CALL TO CONFERENCE: A meeting which may be called • 0- by the Director, attendance at which is mandatory, when the Director determines that a Home is not in compliance with this Chapter, that a complaint can best be resolved by negotiation, that a service or action of the Home requires discussion and evaluation to determine the best way to provide for the needs of residents or when a Hearing has been requested by the Licensee. CASE MANAGER: In Homes for the Mentally Ill, a certified Social Worker, licensed by the State of Illinois (Certified by the Illinois Department of Registration and Education) and is a Masters Degree graduate of a School of Social Work approved by the Council on Social Work Education, and has two years of clinical experience in a mental health setting, who is designated by the licensee for the monitoring of Individual care Plans. In Homes for the Developmentally Disabled, a qualified mental retardation professional as defined herein who is designated by the licensee for the monitoring of Individual Care Plans. DEPARTMENT: Services. The City of Evanston's Department of Health and Human DEVELOPMENTAL DISABILITY: A severe chronic disability of a person which: (3) is attributable to a ruental or physical impairment or combination of mental and physical impairments; (b) is manifested before such person attains age twenty-two; (c) is likely to continue indefinitely; (d) results in substantial functional limitations in three or more of the following areas of major life activity: ( i ) self care (ii) receptive and expressive language (III) learning (iv) mobility (v) self -direction (vi) capacity for independent living, and (vii) economic sufficiency; and (e) reflects the person's need for a combination and sequence of special, interdisciplinary or • generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated. DIRECTOR: The Director of the City of Evanston's Department of Health and Human Services or his/her designee. ELDERLY: Those impaired by chronic illness and/or mobility limitations associated with the aging process. These individuals are capable of independent living, will benefit from the security and support of a group, and may need some supervision from others; but do not regularly need the services usually obtained in a long term care facility. -7- • n LJ • ENTRANCE CRITERIA: Any criteria or characteristic required by this Ordinance and/or by the Home for admission. GROUP CARE HOME: A residential facility housing from nine (9) to fifteen (15) persons, including any resident supervisory personnel, residing together in a family environment, each of whom is capable of independent living with support services, but who may need a substitute Home and are developmentally disabled, mentally ill, or impaired by chronic illness and/or mobility limitations associated with the aging process, or are between nine (9) and eighteen (18) years of age and are unable to live with their parents or guardians. Excluded from this definition are homes, any residents of which are currently addicted to or recovering from addiction to alcohol or narcotic drugs or are criminal offenders serving on work release or probationary programs. All Group Care Homes shall be licensed pursuant to the provisions as set forth herein. GUARDIAN: A person appointed as a guardian of the person and/or estate under the Probate Act of 1975 (Illinois Revised Statuates. 1983, Chapter 110 1/2. Paragraph 1-1 et seq.) HOME: A Residential Care Home or Group Care Home as defined herein. INDIVIDUAL CARE PLAN: An individual written plan of intervention and action for a resident that is developed on the basis of the results of the Service Needs Assessment and modified at frequent intervals, with the participation of all concerned. The Plan specifies measurable goals and objectives and a timetable for the achievement of such goals, identifies a continuum of development, and projects progressive steps and developmental consequences of services, including the assignment of persons responsible for providing and overseeing such services. LICENSEE: A person, agency, association, corporation, partnership or organization which has been issued a license to operate a Residential Care or Group Care Home. MENTAL ILLNESS: A disability attributable to the residual effects of a • mental disorder or emotional disturbance that causes some functional impairment and that alone or in connection with social, legal, or economic constraints, requires the provision of specialized services over an extended period of time directed toward the individual's social, personal, physical and/or economical habilitation or rehabilitation. For purposes of this Chapter, the term mental illness does not include individuals who are currently acutely psychotic, individuals with a history within the past three years of violent, destructive or criminal behavior, individuals who are determined at the point of application to be currently at risk of posing a threat to themselves or others, or individuals who are currently am addicted to or recovering from addictions to alcohol or narcotic drugs. NEGLECT: An act without care or attention or the omission of an act which results • in physical or mental injury to a resident or the deterioration of a resident's physical or mental condition. Also, a failure to note changes in residents condition requiring that person to receive additional services or a failure to initiate actions to help the person secure any needed assistance and/or to make a change in their living arrangements. PHYSICIAN: Any person licensed by the State of Illinois to practice medicine in all its branches. PROVISIONAL LICENSE: A License issued to'a new applicant and whenever the ownership of the Home is transferred by sale of stock or otherwise from the licensee to another person, agency or entity. A provisional license is issued for a period of six months, unless extended by the Director for good cause. PSYCHIATRIC NURSE: A registered nurse as defined in the Illinois Nursing Act (Illinois Revised Statuates. 1983, Chapter 111, paragraphs 3401 et seq.) who is specially prepared by education to practice as a clinical specialist in adult psychiatric and mental health nursing or has a Masters Degree in psychiatric or mental health nursing. -10- r� • PSYCHIATRIST: A physician as defined herein who is board eligible or board certified in psychiatry. PSYCHOLOGIST: A person registered with the Illinois Department of Regirstration and Education as a psychologist under the Psychologist Registration Act (Illinois Revised Statuates. 1983, Chapter 11, paragraphs 5301 et seq.) QUALIFIED MENTAL RETARDATION PROFESSIONAL: A' person who is: An educator with a bachelor's degree in education from an accredited program and with either specialized training in working with the mentally retarded or one year of experience in working with the mentally retarded. A physical therapist or occupational therapist with either specialized training in working with the mentally retarded or one year of experience in working with the mentally retarded. A physician licensed by the State of Illinois to practice medicine or osteopathy with either specialized training in working with the mentally retarded or one year of experience in working with the mentally retarded. A psychologist registered with the State of Illinois Department of Registration and Education in accordance with the "Psychologist's Licensing Act" and with either specialized training in -11- working with the mentally retarded or one (1) year of experience in working with the mentally retarded. A registered nurse with a valid current Illinois registration to practice as a registered professional nurse with either specialized training in working with the mentally retarded or one year of experience in working with the mentally retarded. A speech pathologist or audiologist with either specialized training in working with the mentally retarded or one year of experience in working with the mentally retarded. A registered social worker with a bachelor's degree in social work from an accredited program, • or a bachelor's degree in a field other than social work and at least three years social work experience under the supervision of a qualified social worker, and with either specialized training in working with the mentally retarded or one year of experience in working with the mentally retarded. A therapeutic recreation specialist who is a graduate of an accredited program and eligible for registration in the National Therapeutic Recreation Society, and with either specialized training in working with the mentally retarded or one year of experience in working with the • mentally retarded. -12- A rehabilitation counselor who is certified by the Commission on Rehabilitation Counselor Certification and with either specialized training in working with the mentally retarded or one year of experience in working with the mentally • retarded. RESIDENTIAL CARE HOME: A residential facility housing four (4) to eight (8) persons, including any resident supervisory personnel, residing together in a family environment, each of whom is capable of independent living with support services, but who may need a substitute Home and are developmentally disabled, mentally ill, or impaired by chronic illness and/or mobility limitations associated with the aging process, or are between nine (9) and eighteen (18) years of age and are unable to • live with their parents or guardians. Excluded from this definition are homes, any residents of which are currently addicted to or recovering from addiction to alcohol or narcotic drugs or are criminal offenders serving on work release or probationary programs. All Residential Care Homes shall be licensed pursuant to the provisions as set forth herein. SCREENING PROCEDURE: The process which the Residential Care or Group Care Home utilizes to determine whether an applicant for residence meets the entrance criteria. • SERVICE NEEDS ASSESSMENT: The procedure for determining the functioning level -13- • • • and services needed for each individual at the time of admission and periodically thereafter, including the assessment of physical, mental, emotional and social capacities and the ability to respond to emergency situations appropriately. The Services Needs Assessment is completed by a team including at least one (1) professional designated by either the Commission on Aging or the Mental Health Board, as appropriate. SUPPORT SERVICES: Those services provided to residents to facilitate their Integration into the community and to improve their level of functioning, independence and self-respect. YOUTH: Those individuals between nine (9) and eighteen (18) years of age unable to live with their parents or guardians. 8-19-1-3 ADMINISTRATION : The City Manager, or his designee, shall administer this Chapter and may, with the approval of the City Council, promulgate regulations to carry out Its enforcement. 8-19-1-4 EXEMPTIONS : Any Residential Care or Group Care Home currently licensed by the State of Illinois or previously approved by the City of Evanston's Building and Zoning Department for zoning code compliance is hereby exempted from provisions of this Chapter. Such exemption shall apply only so long as the Home maintains its State license and shall -14- terminate whenever the original licensee is no longer operating the Home. Such exemption shall not apply to any currently existing Home which is neither licensed by the State nor approved for • zoning code compliance by the Building and Zoning Department. 8-19-2 REQUIREMENTS FOR LICENSURE 8-19-2-1 LICENSE REQUIRED: APPLICATION FEE: No person, firm, corporation, association, partnership or religious or other organization may establish, operate, maintain, offer, or advertise a Residential Care or Group Care Home within the Cty unless that person or entity obtains a valid License as provided herein. Application to conduct and operate a Home shall be made to the Director on forms furnished by the Department, and a nonrefundable application fee of $300.00 shall accompany the application. The application shall be under oath and shall contain all the information required in Section 8-19-2-2. 8-19-2-2 LICENSE APPLICATION REQUIREMENTS: Each initial application and renewal application shall contain the following: (A) The name and address of the applicant if an • individual; the name and address of every -15- member, if a firm, partnership or association; and in the case of a corporation, the name and address thereof and of its officers and its registered ,agent. (B) The name and location of the Home; (C) Applicant information (1) List of other programs, services, institutions, facilities and activities operated by the applicant; (2) Current and previous experience with residential programs and/or a specific plan for developing and securing expertise in the management of a Residential Care or Group Care Home. Applicant must demonstrate • current ability for programming and services appropriate for the group to be served, ability to monitor individual functioning, and ability to assist individual residents to make appropriate changes consistent with individual needs. (3) Evidence of financial responsibility and capacity. Proof shall include an audited financial statement setting forth the financial condition of the applicant, proposed construction, acquisition and operating budget for the first year and a • statement of the funds that have been or are projected to be committed to the project and the source(s) of those funds. -16- (D) Community Relations and Involvement • (1) A specific plan for educating and being responsive to the community on the nature of the proposed Home; (2) Data demonstrating existence of a need in Evanston for the proposed Home; (3) Agreement that the property remain on the tax rolls or that the Home will make equivalent annual payment in lieu of taxes. The payment shall be in an amount equal to the proportionate share of taxes which the City would receive if the property were subject to taxation. (E) Resident Population to be Served • (1) Identification of resident target group; (2) Proposed minimum and maximum number, functioning level, and needs of residents to be served in Home consistent with entrance criteria required by this Chapter; (3) Statement of policy of priority for Evanston residents; (4) Resident entrance criteria and screening procedures; .0 -17- t (F) Program (1) Administrative procedures to make available to residents programs and services as required in 8-19-8,.8-19-9 and 0 8-19-10. (2) Staffing, service and supervision plans to meet the needs of residents. At least one staff person shall be available, by phone or on -premises, twenty-four hours every day. The Home shall determine,'by appropriate procedures, that staff possess the skills and moral character to perform their respective duties. (3) Plans to inform and assist residents in the meaningful use of community services. Periodic resident meetings • which include staff of community services agencies are required. (4) Plans for the instruction of residents in correct emergency procedures. (5) Plans for staff orientation and ongoing inservice training to make staff aware of community resources, emergency procedures and evidences of changing resident needs. (G) Site Location and Building Specific plans for physical structure including at least: -18- (1) Details of site location, including zoning district requirements and assurance that the Home is not or will not. be within a two thousand five hundred foot (2,500') radius, determined by a straight line and not street distances, of another Residential Care or Group Care Home, or within two hundred and fifty feet (250') of a boarding house, rooming house, sheltered care home, nursing home (skilled or intermediate) or other residential facility, the occupation of which is limited by income, age or medical status. (2) Details of building design, location and dimension. Each bedroom in a Residential Care or Group Care Home shall contain at least seventy (7-0) square feet for one occupant and at least one hundred twenty • (120 ) square feet for two ( 2 ) occupants. No bedroom shall be used for more than two (2) residents. There must be at least one bath for every five residents and one lavatory and toilet for every four. (3) Evidence of compliance with parking requirements. A Residential Care or Group Care Home shall not allow the keeping or storage of more than one motor vehicle for each off-street parking space lawfully existing in connection with such dwelling unit. If more than one staff car is • to be parked at the Home, there must be off-street parking for such cars. -19- (4) In the case of new construction or the conversion of an existing structure, preliminary plans and specifications. (H) Such other data and information as the • Department may reasonably require as necessary to its evaluation. ' 8-19-3 LICENSING AND ENFORCEMENT PROCEDURES 5-19-3-1 LICENSE APPLICATION REVIEW : The Director of Health and Human Services, in conjunction with the appropriate Department staff, will review the application and request additional information as needed. • (A) The Director of the Department of Housing and Property Services shall determine that the building or structure occupied by the Home complies with the applicable provisions of the Evanston Housing, Building and Zoning Codes. (B) The Fire Chief shall determine that the building and premises meet the minimum applicable life safety standards established by the State Standards and Evanston City Code. (C) The Chief of Police shall determine that the applicant or officers and stockholders of the • applicant if a corporation, are of good moral character. The conviction of any party of a Federal offense, State felony or misdemeanor -20- involving moral turpitude shall be prima facie • • • evidence of lack of good moral character. (D) The person or group of persons designated by the Mental Health Board or Commission on Aging shall advise on the appropriateness of the program plans for the relevant.resident target population. 8-19-3-2 ISSUANCE OF LICENSE : The Director shall determine whether the specific licensing and other Chapter requirements have been met, and will grant a license upon finding of compliance with this and other applicable City ordinances.. No license shall be granted unless the Director determines that the proposed Home meets all applicable requirements of those ordinances of the City and the statutes of the State and finds that a need exists in the City for such a Home and that any other facilities, programs, institutions or activities operated by the applicant have been in compliance with federal, state and local regulations. Any License granted by the Director shall state the category of residents for which the license is being issued, the maximum number of persons to reside in the Home, the date of license issuance and the date of license expiration. -21- 8-19-3-3 DENIAL OF LICENSE : (A) Notice of Denial: The Director shall notify the applicant in writing of license denial. Notice of denial shall include a clear and . concise statement of the reasons upon which denial is based and notice of the opportunity for a hearing under Section 8-19-5. (B) Denial Contested: If the applicant desires to contest the denial of a license, it shall provide written notice to the Director requesting a hearing within ten (10) days after receipt of notice of denial. The Hearing shall be conducted pursuant to Section 8-19-5. The denial shall thereafter be reviewed by the City Manager, as provided by Section 8-19-5-2. 8-19-3-4 LICENSE CATEGORIES: TERMS, FEES : • The following license categories and corresponding terms and fees are established. All licenses shall be prominently displayed in the Home. (A) Provisional License Each initial license granted shall be provisional. A provisional license shall be valid for six (6) months, unless extended by the Director for good cause shown. No fee in addition to application fee shall be required. If the Home fails to open within • six (6) months of provisional licensing or extension for good cause granted by the Director, said license shall expire and the -22- Home must reapply for licensing and pay a new license application fee. No less than five (5) days prior to occupancy by the first resident, the Licensee shall • notify the Director. When the Director determines that a sufficient number of residents is occupying the Home to permit an evaluation of its operations, the Director shall initiate an inspection of the Home for compliance with this Chapter and with the plans originally submitted by the applicant. The Director shall issue a written report of inspection to the Licensee pursuant to Section 8-19-3-10(B). (B) Annual License: When the Director has found the Licensee to be in substantial compliance, he/she shall issue an Annual License • to said Licensee upon payment by the Licensee of a license fee equivalent to Twenty Dollars ($20.00) per resident allowed. The License shall be valid for a period of one (1) year, unless otherwise revoked or terminated as a result of transfer of ownership. 8-19-3-5 TRANSFER OF OWNERSHIP (A) Whenever the ownership of the Home is to be transferred by sale of stock or otherwise from the licensed person, agency or entity to • another person, agency or entity, the transferee shall obtain a Provisional License. The transferor and transferee must -23- • • notify the Department of the intended transfer and apply for a new license at least thirty (30) days prior to transfer. The procedures and fees for new applicants as set forth in Section 8-19-2 above shall apply to all transferees. (B) The transferor shall remain responsible for operation of the Home until such time as a Provisional License is issued to the transferee, and shall remain liable for all penalties assessed against the Home prior to transfer of ownership. (C) Director shall review the license application in accordance with Section 8-19-3-1 and will make a determination to issue or deny a license pursuant to Section 8-19-3-2. 8-19-3-6 ANNUAL INSPECTION : No less than sixty (60) days prior to expiration of an annual license, an inspection of the Home will be conducted by a staff team appointed by the Director to evaluate continued compliance with all licensing requirements in this Chapter. The Director shall mail a report of inspection pursuant to Section 8-19-3-10(B). After the time period allowed for correction the Director will make a determination to renew or revoke or not renew the license pursuant to Section 8-19-3-7 below. Notice of the intent to revoke or not renew a license shall be sent by Certified Mail to the licensee and published in accordance with Section 8-19-3-8 below. -24- 8-19-3-7 LICENSE REVOCATION The Director may revoke or refuse to renew the License of a Home on the following grounds: • (A) a violation of any part of this Chapter or other applicable ordinances of the City of Evanston or the Statutes of the State of Illinois by the licensee or any agent or employee thereof; (B) a conviction of the licensee for any Federal offense, state felony or misdemeanor involving moral turpitude; (C) obtaining or attempting to obtain or retain a license by fradulent means, misrepresentation, or by submitting false information; • (D) insolvency of the Home, or filing of a petition in bankruptcy or for receivership, or an assignment for the benefit of creditors; 8-19-3-8 NOTICE OF LICENSE REVOCATION (A) The Director shall send by Certified Mail a written notice of a determination to revoke or not renew a license. The notice shall contain a clear and concise statement of the violations upon which the revocation or non -renewal is based and notice of the right • to contest the Director's decision under Section 8-19-5. -25- (B) If a Licensee desires to contest the revocation or non -renewal oL a license, the Licensee shall, within ten (10) days after receipt of notice, notify the Director in writing of its request for a hearing under Section 8-19-5. Upon • receipt of the request, the Director shall send notice to the Licensee and hold a hearing as provided under Section 8-19-5. Notice of Hearing regarding a license revocation or non -renewal shall be published in a newspaper of general circulation within the City at least ten (10) days in advance of the hearing. 8-19-3-9 VOLUNTARY CLOSING : Any licensee shall give ninety (90) days notice prior to closing a Home voluntarily. The notice shall state the proposed date of closing. Such notice shall be given to the Director, to every Aresident and guardian, and, if practicable, to a member of the resident's family. The Home shall comply with all applicable laws and regulations until the date of closing, including those related to transfer or discharge of residents. 8-19-3-10 DEPARTMENT ENFORCEMENT RIGHTS AND RESPONSIBILITIES : The Director of the Department of Health and Human Services shall have the primary authority and responsibility for enforcing all requirements in this Chapter. ` In addition to the responsibilities specified elsewhere in this Chapter, the Department has the following specific rights and responsibilities: -26- (A) Inspections: The Director or his/her designee, whenever he/she deems necessary, but not less than annually, shall inspect every Home to determine compliance with applicable license requirements and standards. The Director • or his/her designee may periodically visit a Home for the purpose of consultation. Inspections and visits may be conducted without notice to the Licensee. (B) Report of Inspection: If upon inspection, the Director determines that a Home is in violation of this Chapter or other applicable ordinances, lie/she shall promptly mail a report of Inspection to the licensee. The report shall specify the nature of the violation and the time allowed to correct the violation not to exceed sixty (60) days. • (C) Right of Entry: Any holder of a license or applicant for a license shall be deemed to have given consent to any authorized officer, employee or agent of the City, or any other licensing agent to enter and inspect the Home. Refusal to permit such entry or inspection shall constitute grounds for denial, nonrenewal or revocation of a license. (D) Records: The Director shall have access to any books, records and other documents maintained by the licensee necessary to carry out this Chapter. • (E) In addition to the requirements set forth herein, the Director may require additional -27- • • 0 staff, .specific staff qualifications, services, and/or facilities to meet the needs of the residents as determined by the Service Needs Assessments and the Individual Care Plans of the individuals residing in the Home. (C) The staff of the Department of health and human Services shall have responsibilities for enforcement of this Chapter as follows: ( 1 ) The Public Health Director: shall review the license application and shall inspect every Home as required by the Director to determine compliance with all health and sanitation codes of the City and to determine compliance with any provisions of this Chapter.. The Public Health Director shall. forward written reports of all inspections to the Director, who shall determine compliance with this Chapter.. (2) The Executive Director of the Evanston Mental. Health Board shall review the license application for any Home making application to serve the Mentally Ill and any home making application to serve tide Developmentally Disabled. He/she shall inspect on at least a quarterly basis each Home serving the Mentally Ill pursuant to Section 8-19-10-1 and each Home serving the Developmentally Disabled pursuant to Section 3-19-9-3. He/she shall forward written reports of these inspections to the Director, who shall determine compliance with this Chapter. -20- (3) The Executive Director of the Evanston Commission on Aging shall review the application of any Home making application to serve the elderly. He/she shall inspect at least annually each Home serving the elderly • and shall forward written reports of these inspections to the Director, who shall determine compliance with this Chapter. (G) Call to Conference: The Director may issue a Call to Conference to the licensee, attendance at which is mandatory, in the following instances: when the Home is not in compliance with this Chapter, when the Director determines that a complaint can best be resolved by negotiation, when a service or action of the Home requires discussion and evaluation to determine the best way to provide for the needs of the residents, and when a Hearing has been requested • by the licensee. The Mental Health Board and the Commission on Aging may establish procedures for participation of the Board or Commission, as appropriate, in the conference. The purpose of the Conference is to resolve differences which may arise between the Department and the licensee or between the licensee and a complainant prior to or in the place of legal action. At the Director's request and with their consent, complainants may be included in such conferences. The decisions reached at the Conference shall be reduced to writing and forwarded to all concerned parties. If a resolution deemed satisfactory by the Director is not reached, the Home may be cited in violation of this Chapter and the citation may be considered grounds for denial, revocation or -29- non -renewal of the license. If a resolution deemed satisfactory to the licensee or a complainant is not reached, each has the right to appeal the decision pursuant to Section 8-19-5. • (H) Cooperation with Other Agencies: The Department shall cooperate with units of State Government, including the Department of Public Health, the Department of Public Aid, The Department of Children and Family Services, and the Department of Mental Health and Developmental Disabilities in monitoring Homes with the goal of assuring necessary, equitable and consistent supervision of Homes. 8-19-4 COMPLAINT PROCEDURES : The Director shall investigate all complaints thoroughly and promptly. Such • investigation shall be carried out according to the following procedures. 8-19-4-1 COMPLAINT; INVESTIGATION : Any person who believes that any provision of this Chapter may have been violated may request an investigation. The request may be submitted to the Department in writing, by telephone, or by personal visit. An oral complaint shall be reduced to writing by the Director. Within ten (10) days of receipt of a complaint the Director shall initiate an investigation. Within thirty (30) days of initiation of investigation, the Department shall • complete the investigation and determine whether any provision of this Chapter has been violated. -30- Investigations of complaints of suspected abuse shall be initiated within twenty-four (24) hours. 8-19-4-2 CONFIDENTIALITY : The complaint, a copy of the complaint, or a record • published, released or otherwise disclosed to the Home shall not disclose the name of the complainant unless the complainant consents in writing to the disclosure, or the investigation results in a judicial proceeding or unless disclosure is essential to the investigation, in which case the complainant shall be given the opportunity to withdraw the complaint before disclosure. Upon the request of the complainant, the Director may permit the complainant or a representative of the complainant to accompany the person making the on -site inspection of the Home. 8-19-4-3 FINDINGS; NOTICE TO LICENSEE The • Director shall inform the • complainant and the Licensee of its findings within ten (10) days of its determination. The notice of such findings shall include a copy of the written determination and the report of inspection pursuant to Section 8-19-3-10(B). 8-19-5 HEARINGS : 8-19-5-1 HEARING PROCEDURES : An aggrieved party may appeal the decision of the Director rendered in a particular case. The appeal shall comply with the following procedures: (A) An appeal shall be made in writing to the Director within ten (10) days of notification -31- by the Director of the decision to be appealed. The appeal shall include the mailing address and telephone number of the grievant. (B) Within five ( 5 ) days after receipt of an • appeal, the Director may issue a "Call to Conference" pursuant to Section 8-19-3-10(G). The Conference shall be held within fifteen (15 ) days after receipt of appeal. (C) The Hearing shall commence no later than " thirty (30) days after the receipt by the Director of the appeal, or after the conference held pursuant to Section 8-19-5-1(B), whichever is later, and shall end no later than ninety (90) days after the commencement unless justice requires otherwise. (D) The City Manager shall designate a person to • serve as Hearing Officer to conduct a hearing to review the decision. After notice of hearing, the Hearing Officer shall not communicate, directly or indirectly, in connection with any issue of fact in that case or hearing with any person or party except upon notice and opportunity for all parties to participate. (E) At least ten (10) days prior to the Hearing, the Director shall send notice of the Hearing to all parties. The notice shall specify the date, time and place of the hearing and the purpose of the Hearing. The notice to the • aggrieved party shall be sent to the address set forth in the request for hearing by certified mail, or by personal service. -32- (F) The Hearing Officer may compel by subpoena or • • subpoena duces tecum the attendance and testimony of witnesses and the -production of books and papers, and may administer oaths to witnesses. (G) The Hearing Officer shall.permit the aggrieved party to appear in person and to be represented by counsel at the hearing at which time he shall be afforded an opportunity to present all relevant matter in support of his position. In the event of the inability of either the aggrieved party, or the Director to procure the attendance of witnesses to give testimony or produce books and papers, either the aggrieved party or the Director may take the deposition of witnesses in accordance with the provisions of the laws of this State. All testimony taken at a hearing shall be recorded and all such testimony and other evidence introduced at the hearing shall be a part of the record of the hearing. (H) The Hearing Officer shall be bound by the Administrative Procedures Act of the State of Illinois in so far as tht Act requires the technical rules of evidence. All hearings shall be conducted in a manner sufficient to afford all parties full opportunity to be heard, to be represented by counsel, to present complete evidence to the end of securing substantial justice. (I) All subpoenas issued by the Hearing Officer shall be served as provided for in civil -33- • • • actions. The fees of witnesses for attendance and travel shall be the same as the fees for witnesses before the Circuit Court and shall be paid by the party at whose request the subpoena is issued. If such subpoena is issued at the request of the Director or by a person proceeding in forma pauperis, the witness fees shall be paid by the Department as an administrative expense. (J) In case of refusal of a witness to attend or testify or to produce books or papers concerning any matter upon which he might be lawfully examined, the Circuit Court of the county wherein the hearing is held, upon application of any party to the proceeding, may compel obedience by a proceeding for contempt as in cases of a like refusal to obey a similar order of the court. (K) The Department, at its expense, shall record the testimony and preserve a record of all proceedings under this Secton. The notice of hearing, the complaint and all other documents in the nature of pleadings and written motions filed in the proceedings, the transcript of testimony, and the findings and decision shall be the record of the proceedings. The Director shall make available such record. 8-19-5-2 HEARING OFFICER TO MAKE FINDINGS : The Hearing Officer shall make findings of fact in such hearing and shall make a recommendation for a decision to the City Manager. The City Manager shall render his decision within thirty (30) days after termination -34- of the hearing, unless additional time not to exceed ninety (90) days is required by him for a proper disposition of the matter. The City Manager shall review the record and findings of fact before rendering a decision. All decisions is rendered by the City Manager shall be binding upon and complied with by the Director, the Department, the Home, or the persons involved in the hearing, as appropriate. 8-19-6 WAIVERS : 8-19-6-1 RELIEF REQUESTED : A Licensee may seek relief from the provisions of this Chapter when a specific or peculiar situation exists which makes compliance a practical impossibility or extreme hardship. A Licensee requesting relief shall submit to the Director in • writing a detailed explanation of why compliance with the provisions of this Chapter would create a practical impossibility or extreme hardship, and a plan for how an alternative method of service provision appropriate to the needs of the residents of the Home will be implemented. Upon receipt of such request, the Director shall determine whether the Home has provided evidence of these conditions. A decision to grant relief from a provision of this Chapter shall be made only where the Director has found that a practical impossibility or • extreme hardship exists in complying with the provision for which a waiver is sought and that an acceptable alternative method of service provision -35- appropriate to the needs of the residents will be implemented. Written notice of the decision shall be sent by certified mail to the Licensee within thirty (30) days of receipt of the request, and shall be prominently displayed in the Home, unless the waiver pertains to an individual resident, in • which case a copy of the notice of the decision shall be given to the resident. No waiver shall be granted from any requirements of this Chapter relating to licensing and inspection provided in Sections 8-19-1 through 8-19-6. 8-19-6-2 CONTINUATION OF RELIEF : A Licensee which has been granted relief from a provision of this Chapter may request the continuation of such relief by a letter to the Director when the Annual License renewal application is filed. The Director shall grant • such relief if the Licensee has submitted an adequate showing that the same conditions exist at the time of license renewal as existed when the relief was originally granted. Without said request, such relief terminates at the end of the license year. 8-19-6-3 APPEAL OF WAIVER DETERMINATION : An aggrieved party may appeal the Director's determination by requesting a hearing under Section 8-19-5. The request for hearing shall be submitted in writing to the Director within ten (10) days after receipt of the Director's determination. Upon receipt of the • request, a hearing shall be conducted as provided under Section 8-19-5. -36- 8-19-7 PENALTIES : 8-19-7-1 INJUNCTIVE RELIEF If, in the judgement of the Director, • immediate Court action is necessary, he may at any time direct the Corporation Counsel to file a complaint in any court of competent jurisdiction for a fine, injunction, or other appropriate relief. Such action may be taken even though administrative hearings are still pending. 8-19-7-2 FINES Any person, agency, association, corporation, partnership, organization or licensee violating the provisions of this Chapter shall be fined not less than one hundred dollars ($100) nor more than five hundred dollars ($500) for each such offense. Every day a violation continues may be • deemed a separate offense by appropriate finding. 8-19-8 REQUIREMENTS FOR RESIDENTIAL CARE AND GROUP CARE HOMES FOR THE ELDERLY : 8-19-8.1 PROGRAM PRINCIPLES (A) All programs shall be based on the following: (1) The group is the basic support for the • individuals. (2) Within the structure of the group, individuals are to be encouraged -37- and aided to remain as independent as possible and to have their individual differences respected. (3) Residents plan for and implement as much • of the activities and operation of the Home as possible. (B) There shall be a written procedure for ongoing evaluation of resident needs, and residents shall be part of this process. This procedure shall include a method for noting changes in physical or mental condition and responding to these. (C) The Home shall provide or assist with at least the following services: (1) At least one hot meal per'day, providing • at least one-half of the daily minimum • nutritional needs, planned with input from residents, and meeting medically prescribed special dietary requirements; all foods shall be stored, prepared and served in a clean, nutritious and appetizing manner. Staff shall assist in meal preparation to the extent necessary. (2) Regular resident meetings; (3) Information and/or assistance to residents in using community services. -38- (D) There shall be proof of agreement for services and advocacy for residents from community agencies. The licensee shall have a written plan to inform residents of community services and shall maintain awareness of changes 0 necessitating such services. 8-19-8-2 ADMISSION AND DISCHARGE : (A) All required policies and procedures for admission and discharge of residents as set forth below shall be in writing, approved by the Director and given to applicants for residence prior to admission and to residents at the time contracts are executed. (B) Eligibility • (1) No resident may be admitted without evidence of completion of a physical and mental status assessment within the six months prior to admission. The assessment shall include documentation of the presence or absence of tuberculosis infection by tuberculin skin test or chest x-ray. No person with a communicable disease shall knowingly be admitted into the Home. (2) Each resident to be admitted shall be capable of self -medication as attested by a physician. • (3) Each resident to be admitted shall be capable of taking appropriate actions unassisted in an emergency. -39- (4) Reasons for non -acceptance of resident • applicant must be recorded. Records shall be subject to inspection. (C) Admission (1) Homes shall not discriminate on the basis of race, creed, religion. (2) No resident shall be admitted without a Service Needs Assessment and a plan designed to provide the resident with information and, if necessary, assistance in obtaining services to meet the needs. No resident shall be admitted whose Service Needs Assessment indicates service needs which would require professional nursing supervision or care or whose needs cannot be met within the context of the group supports, • community resources and the staffing plan proposed. (D) Involuntary Discharge Except where a resident is an immediate danger to himself or herself or others, a Licensee must provide a resident with twenty-one days written notice before requiring him/her to leave the Home. The licensee must offer assistance to the resident and, if the resident wishes, to the resident's family in locating another place • to live. A social worker or a nurse, as appropriate, who is staff to the licensee or from a community service agency shall be -40- involved in the decision and in discussions with the resident. The resident, and,if the resident wishes the family, shall be informed. of the right to contest the discharge. Hospitalization is not discharge and all • discharge procedures must be followed if a resident is not to return to the Home from a hospital. 8-19-8-3 RESIDENT TRANSFER The Department shall assist residents in finding other places to live should any of the following conditions exist: (A) The Home is operating without a license; (B) The Director has revoked or refused to renew the license of the Home as provided • under Sections 8-19-3-7 and 8-10-3-8; 8-19-8-4 CONTRACT (A) The written annual contract entered into by the resident and the Licensee shall specify at a minimum: (1) The parties; (2) All services which the Licensee will provide and any specific items for which • there Is a charge in addition to the base rate; -41- (3) The monthly charges and the amount of the deposit, andcharges for any extra services; and (4) A listing of which services and items • are provided by the Licensee and which services and items the resident shall be • responsible for providing for himself or herself . (5) Provisions for contract te4mination. (B) The contract shall provide that if a resident chooses to leave the Home, the resident may terminate the contract, and shall not be liable for any penalty or damages in excess of thirty days, or one month's charge. The contract shall include resident discharge rights as provided in Section 8-19-8-3(D). (C) The contract shall include as an attachment a copy of the resident rights and "House Rules". 8-19-8-5 RESIDENT RIGHTS (A) Residents shall be treated with respect, dignity, consideration and as persons capable of growth, development and full citizenship rights. Physical and psychological abuse are prohibited. • (B) No resident shall be deprived of any rights, benefits or privileges guaranteed by law, the Constitution of Illinois or the Constitution of the United States. -42- (C) Unless each resident is provided with a room which he or she can lock, each room shall have a private locked space available to him/her in his/her room large enough to secure valuables. • (D) Each Home shall have periodic meetings of staff and residents and shall include community agency personnel from time to time so that residents will become familiar with resources to whom they may turn for advocacy and assistance. (E) No resident's room shall have as its sole means of access a door to another resident's room. (F) Neither staff nor visitors shall enter a resident room without permission except in an emergency. • (G) Residents have the right to free exercise of religion. (H) Residents have the right to receive health, social and other services from the provider of his or her choice. (I) Residents shall plan day to day activities operations of the Home with staff. (J) Residents' confidentiality shall be maintained. Residents and staff shall • determine what information may be given out, to whom, and under what circumstances. Any release of information shall be in accord with applicable laws. -43- (K) Residents have the right to visitors. Residents have the right to unimpeded, private and uncensored communication by mail, and by public phone subject to reasonable time limitations and the rights of fellow residents. • Mail must not be delayed. A public phone shall be accessible and available. There shall be space to meet privately with visitors. (L) The resident has the right to decide how and by whom the resident's funds may be spent. (M) Residents shall be informed of their rights in the case of involuntary discharge as delineated in Section 8-19-8-1(D). (N) Residents shall be informed of their right to communicate with advocates including the appropriate Board, Commission or Committee related • to the Department. • (P) Residents shall be given a copy of all resident rights and shall sign a document stating that they have been given a copy and have understood it or have had it read to them. (Q) Residents shall be given a copy of all resident responsibilities and house rules established by the Home, including requirements for continued residence, and shall sign a document stating that they have been given a copy and have understood it or have had it read to them. (R) Residents shall be given a copy of the Contract. -44- U • 8-19-8-6 FAMILY AND COMMUNITY RELATIONS (A) The Home shall assist in maintaining close relationships with family members of each resident for the benefit of the resident and with the knowledge, participation and consent of the resident. (B) The Home shall make efforts to establish a friendly relationship with the surrounding neighborhood and community, such as providing opportunities for social interaction between residents and neighbors, providing opportunities for residents to provide volunteer services in the neighborhood, and establishing liaison with organized neighborhood groups. (C) The Home shall make efforts designed to provide residents with information and shall make efforts to assist residents in obtaining benefits available from the community, such as opportunities for participation in recreational, social, cultural, and religious programs and services. 8-19-8-7 STAFF (A) There shall be one individual designated who is ultimately responsible for the day to day operation of the Home and for delivery of programs required to meet needs of residents. At least one staff person, designated by management, shall be present some part of every day, time of availability to be convenient for residents and -45- times of availability shall be posted. This individual shall have skills to enable him/her to assess changes in residents and assist in appropriate referrals. • (B) There shall be at least one staff person, designated by management, on call twenty-four (24) hours a day, consistent with resident needs and approval of the Director. On -call staff shall have direct access to all community emergency services. (C) All direct care staff shall be at least twenty-one (21) years of age. (D) The number and qualifications of staff shall be adequate to provide that residents have assistance needed in planning for their own needs and for the smooth operation of the group within isand Home, and to respond appropriately to emergency situations. The numbers and type of staff must also be adequate to observe and assess changes in resident needs and assist residents in making changes in the services they receive or in their living arrangements if so required. The staffing plan and continuing staff coverage must be approved by the Director. Residents who have needs which may adversely affect them or others if services are not obtained must arrange for these services through the provider of their choice or be discharged if • unable to make such arrangements. However, the Licensee is responsible for offering the resident assistance and advice in determining what services are needed. -46- (E) Each employee shall have a physical examination which has been conducted within ten (10 ) days before or after the first day of employment. This examination shall include findings that permit certification that the • employee is free from communicable disease, and shall include documentation of a•tuberculin skin test or chest x-ray within one (1) year before employment. (F) There shall be an ongoing written planned inservice education program and orientation to enable all personnel including volunteers to perform their duties effectively and to have the knowledge defined in Section 8-19-2-2(F). 8-19-8-8 EMIRGENCY AND UNUSUAL OCCURRENCE • PROCEDURES • (A) Emergency Procedures (1) The Home shall implement effective written emergency procedures, including: (a) at least two fire drills each year; (b) maintenance of a Red Cross approved first aid kit on each floor; (c) education of all residents and orientation of new residents regarding emergency procedures. -47- (d) any other procedure required by City ordinances. (2) If the Home does not have twenty-four (24) hour staff on the premises, the • Home shall provide an emergency contact at all times and the residents must know how to reach that person. (3) The Home shall immediately notify the Director of any emergency affecting a resident. The resident's family shall also be notified unless the resident requests otherwise. Police or other agencies shall be notified as appropriate. Records of such events shall be kept for review by the Department. Such emergencies include, but are not limited to: • (a) death, or imminent death; (b) suspected or alleged neglect, or physical/sexual abuse of or by a resident or employee; (c) any accident requiring medical care outside the Home; (d) any newly diagnosed serious illness or disease; (e) unexplained absence. House rules • shall establish procedures for -48- announcing intended absence, for informal efforts to locate, and for informing appropriate agencies when these are not successful. • (B) Unusual Occurrence Procedures (1) The Home shall implement procedures for responding to unusual occurrences and shall inform the residents of these procedures. Such unusual occurrences 1. include, but are not limited to: (a) loss of utilities; (b) severe weather conditions (e.g., tornado warning); • (c) major damage to Home or personal property; (d) any activity related to the Home leading to a police report; (e) involuntary discharge. (2) The Licensee shall notify the Director, the appropriate state agency, and Evanston Police Department (where appropriate) of any unusual occurrences. Records shall be kept of any unusual occurrence. 0 -49- 8-19-8-9 RECORDS (A) There shall be a current record of each resident which gives all pertinent information needed for emergency care and for • continuity of services. The following constitutes a minimum requirement for record keeping: Name Age Person to be notified in an emergency and family contacts, as appropriate Medical history, including regularly updated medication list and any drug allergies Identifying data such as sex, height, weight, or other data (Photo) for emergency identification. Any special problems which must be considered • in providing service to the individual Physician name, address and phone number. Service Needs Assessment • (B) In the event of discharge, the reason or reasons must be recorded in the resident record. (C) The Service Needs Assessment shall be updated every six months or more frequently if resident circumstances require a change. (D) All information in the record shall be confidential and any other personal -50- • information is available only to the resident, the licensee and the licensing body unless release is authorized in writing by the resident or the resident's guardian. Any release of information shall be in accord with applicable law. 8-19-8-10 MAINTENANCE AND HOUSEKEEPING (A) There shall be a plan for maintenance, repairs and exterminating, including a schedule. (B) Grounds shall be maintained in a safe, sanitary condition. The building shall be kept clean and in good repair. All building codes and sanitation codes shall be complied with at all times. • (C) All systems and equipment shall be maintained in good working condition, including electrical, plumbing, mechanical, heating, fire protection, sewage disposal, fixtures, piping and appliances. • (D) All furniture shall be maintained in a clean, attractive, safe condition. (E) Floors shall be clean, as non -slip as possible and free from hazards. (F) Odors shall be controlled and not covered. (G) Refuse shall not be allowed to accumulate and shall be properly disposed of. -51- • (H) Food and food materials shall be stored appropriately and in a sanitary fashion. (I) Hazardous compounds or solutions shall be kept in a safe place. (J) The laundry areas shall be kept clean. (K) There must be a plan stating what furniture Is provided by the licensee and what by the residents. Homes must contain furniture and equipment usual and customary in residences. There must be assurance that at least the following shall be available: (1) Common areas: Sufficient and suitable chairs for all residents Table space sufficient and • suitable for all residents to eat at the same time Sufficient and suitable appliances for the efficient and attractive preparation of meals Sufficient and suitable utensils, dishes, and serving materials to serve meals attractively and in a sanitary fashion. Sufficient and suitable furniture to provide an attractive, home -like • atmosphere -52- Sufficient and suitable lights and lamps for reading and carrying out activities (2) Resident rooms: One bed with good mattress and springs for each resident Sufficient and suitable storage furniture, such as a chest of drawers Sufficient and suitable furniture to give an attractive, home -like appearance Locked storage space, if necessary Sufficient linen in good condition to ensure that there are always clean linens available; window shades, • blinds, or other privacy devices unless obviated by • design Lamp or other illumination for reading -53- 8-19-9 SPECIFIC OPERATING REQUIREMENTS FOR HOMES SERVING THE DEVELOPMENTALLY DISABLED 8-19-9-1 ADOPTION OF STATE RTJ[T-S AND REGlJLATIONS (A) There is hereby adopted by reference the follow- ing Minimum Standards, Rules and Regulations for classification, licensure and regulation • of Residential and Group Care Hanes for the Developmentally Disabled. Where any con- flict occurs between the State standards adopted by reference herein and the standards set forth elsewhere in this chapter, the most stringent standard shall apply. (1) Minimum Standards for Licensure of Community 1! Residential Alternatives, Part 113 of Chapter 1 of Title 59 of the Illinois Administrative Code, as promulgated by the Illinois Department of Mental Health and Developmental Diisabilities pursuant to the Community Residential Alternatives Licensing Act of 1981, in • effect June 8, 1982, and as may from time to time thereunder be amended. These standards shall also apply to programs defined as Supportive Living Arrangements by the Illinois Depart- ment of Mental Health and Develop- mental Disabilities and that are subject by definition to the require- ments of this Chapter. (2) Minimum Standards, Rules and Regulations for classification and Licensure of Community Living Facilities as pro- mulgated by the Illinois Department of Public Health, pursuant to the Com- munity Living Facilities Licensing Act of 1981, in effect May 7, 1982, and as may from time to time thereunder be amended. -54- (B) At least one copy of said Standards, Rules and Regulations shall be available for public inspection in the Office of the Director. (C) Homes serving the developmentally disabled shall comply with sections 8-19-1 through • 8-19-7 and section 8-19-9. 8-19-9-2 PROGRAM PRINCIPLES (A) All programs shall be based on the following: (1) The group is the basic support for the individuals. (2) Within the structure of the group, individuals are to be encouraged and aided in remaining as independent as possible and individual differences are respected. (3) Residents plan for and implement as much of the activities and operation of the Home as possible. • (B) There shall be a written procedure for ongoing evaluation of resident needs, and residents shall be part of this procedure. This procedure shall include a method for noting changes in physical or mental condition and responding to these. (C) There shall be proof of agreement for services and advocacy for residents from community agencies. The licensee shall have and execute a plan to inform residents of cor unity ser- vices. (D) Services shall be provided to each resident in accordance with his/her individual care plan. 8-19-9-3 MONITORING • (A) The Executive Director of the Mental Health Board (or his/her staff designee), shall make on -site inspections to any Home for the de- velopmentally disabled on at least a quarterly basis. -55- (B) The Executive Director of the Mental Health Board shall submit written reports of all inspections to the Director of Health and Human Services. The Director shall consider these reports to determine compliance with this Chapter and and shall send notice to the licensee • pursuant to Section 8-19-3-10 (B). 8-19-9-4 ADMISSION AND DISCHARGE (A) All policies and procedures for admission and discharge of residents as set forth below shall be in writing, approved by the Director, and given to applicants for residence prior to admission and to residents at the time contracts are executed. (B) Eligibility (1) The individual shall be at least eighteen (18) years of age. (2) The individual shall have the ability to self administer medications. At the time • of admission, the individual's personal physician shall provide in writing a statement that the individual is either capable of self administration of medication or will be capable with training within three months. (3) The individual shall be capable of taking appropriate actions unassisted in an emergency- (4) All applicants for residency shall meet the following entrance criteria: (a) The individual shall, on a commonly accepted standardized test that measures cognitive development or • adaptive behavior, demonstrate functioning in the mild or moderate range, or (b) if test results are not available, the individual shall meet the -56- following criteria: Independent functioning: Demonstrate ability to feed self, clothe self, and bathe self. Is toilet trained. De- monstrates understanding of basic sur- vival skills (e.g., responds appropriately • to fire alarm). Physical Capability: Demonstrates ability of self,mobilization. Demonstrates capability of making a timely exit in case of emergency. Communication Skills: Demonstrates ability to communicate basic needs (by speech, signing, or other communicative device). Demonstrates ability to follow three step directions. Has ability to recognize survival words (e.g., fire, exit, stop). Social Skills: Has ability to manage and control behavior generally, and has aware- ness of socially appropriate behavior in varying situations. Has ability to leave or seek help in threatening public situation that is beyond his/her control (e.g., harrassment, severe weather con- ditions, etc). Economic Activitv: Understands purpose of money (i.e., knows money has value but does not necessarily know values) Home Living: Has ability to prepare simple foods (e.g., sandwiches); to help with simple household tasks (e.g., bedmaking, sweeping, vacuuming); to set and clear table. Vocational: Meets admissions standards of school, day program, sheltered work- shop, or competitive employment. -57- (5) No individual shall be admitted without evidence of completion of a physical and mental status assessment within the six months prior to admission. The assess- ment shall include documentation of the • presence or absence of tuberculosis in- fection by tuberculin skin test or chest x-ray. No individual with a communicable disease shall knowingly be admitted into the home. (6) No individual requiring continuous and constant professional nursing supervision or care shall be accommodated in a Home. (C) Admission (1) Homes shall not discriminate on the basis of race, creed, or religion. (2) No individual shall be admitted without a Service Needs Assessment as defined herein and a plan to ensure that the • individual is provided with services to meet his/her needs. No individual shall be admitted whose Service Needs Assess- ment indicates service needs which would require professional nursing supervision or care or whose needs cannot be met within the context of the group supports, ccmmmty resources, and the staffing plan proposed. (3) No individual shall be admitted without execution of a written contract conforming to the requirements in Section 8-19-8-5 setting forth the base rates, services • provided by the Home, admission and dis- charge rules and requirements, and resident rights and house rules. (4) The licensee shall form a screening committee that shall include at least one qualified mental retardation pro- fessional as defined herein. The con - position of the screening committee shall be approved by the Director. • No person shall be admitted without the recommendation of the screening committee. The licensee is responsible for final admission decisions. (D) Discharge and Discharge Planning (1) If a resident no longer wishes to live in a Home, a voluntary discharge shall be granted. The Home shall offer counseling to the resident's guardian or representative and to the resident him/herself, concerning the advantages and disadvantages of dis- charge. (2) The Hone shall provide discharge planning. • The discharge planning team (including the qualified mental retardation professional, • resident staff, and relevant community services providers) shall invite the resident, Director, receiving agency (if applicable), the -legal guardian (if applicable), and resident representative if applicable to review discharge plans. ( 3 ) At the time of discharge, a sunsnary of pertinent information from the resident's record must be transmitted to the receiving residential facility (if any and if appro- priate). Any release of information shall be made in accordance with applicable law. -59- (a) Involuntary Discharge (a) Except where a resident is an immediate danger to himself/herself or others, the licensee shall provide a resident with twenty-one days written notice be- fore discharge. The licensee shall offer assistance to the resident, resident's guardian, or represenative, in locating another place to live. (b) Involuntary discharge may result from chronic violation of program and/or "house rules" or the development of a psychological or physical condition which cannot be appropriately managed in a residential setting. (c) Hospitalization is not discharge and all discharge procedures shall be followed if a resident is not to return to the Home from a hospital. • (E) Resident Transfer: The Director shall assist residents in finding other places to live should any of the following conditions exist: (a) The Home is operating without a license; (b) The Director has revoked or refused to renew the license of the Home as provided under Section 8-19-3-8. 8-19-9-5 CONTRACT (A) The written annual contract entered into by the resident, resident's guardian, and the licensee shall specify at a minimum: (1) The parties, including the name and address • of resident's legal guardian where applicable; a resident's representative may be designated by the resident or guardian. (2) All services which the licensee will provide. (3) The monthly charges and the amount of the deposit; and (4) Provisions for contract termination. The contract shall provide that if a resident chooses to leave the Home, the • resident may terminate the contract, and shall not be liable for any penalty or damages in excess of thirty days, or one month's charge. The contract shall inlude a statement of the resident dis- charge rights provided in section 8-19-9-4(D). (B) The contract shall include as an attachment a copy of the Home's resident rights and "house rules". 8-19-9-6 RESIDENT RIGHTS (A) Residents shall be treated with respect, dignity, consideration and as persons capable of growth, development and full citizenship rights. Physical and psychological abuse are prohibited. (B) No resident shall be deprived of any rights, benefits or privileges guaranteed by law, the Constitution of Illinois or the Constitution of the United States. (C) Unless each resident is provided with a room which he or she can lock, each resident shall have a private locked space available large enough to secure valuables (except for those for wham a physician specifically states a reason not to allow this right). (D) Each Hone shall have periodic meetings of staff and residents which shall include community agency personnel from time to time so residents will become familiar with resources to whom they may turn for advocacy and assistance. (E) No resident's room shall have as its sole means of access a door to another resident's room. (F) Neither staff nor visitors shall enter a resident's room without permission except in an emergency. -61- (G) Residents have the right to free exercise of religion. (H) Residents have the right to receive.health, social, and other services from the provider of their choice. • (I) Residents shall be included in planning day to day activities and operations of the Home with staf f . (J) Residents' confidentiality shall be maintained. Residents and staff shall determine what in- formation may be given out, to whom, and under what circumstances. Any release of information shall be.made in accordance with applicable law. (K) Residents have the right to visitors. Residents have the right to unimpeded, private and uncensored communication by mail, and by public phone subject to reasonable time limitations and the rights of fellow residents. • Mail must not be delayed. A public phone shall be accessible and available. There shall be space to meet privately with visitors. (L) The resident or the resident's guardian or resident's representative has the right to decide how and by whom the resident's funds may be spent. (M) Residents and guardians of residents and resident's representatives shall be informed of their rights in the case of involuntary discharge as delineated in Section 8-19-9-4 (D) 4. (N) Residents, guardians of residents, and resident representatives shall be informed of their rights to communicate with advocates, including the Mental Health Board. • (0) Residents, guardians of residents, and resident representatives shall be given a copy of all resident rights and shall sign a document stating that they have been given a copy and have understood it or have had it read to them. -62- (P) Residents, guardians of residents, and resident representatives shall be given a ccpl' cf -I' resident responsibilities established by the Home, including behaviors that are defined as inappropriate and unacceptable by the Home, and shall sign a document stating that they have been given a copy and have understood it or have had it read to them. (Q) Residents and guardians of residents and resident representatives shall be given a copy of the contract and the house rules. 8-19-9-7 FAMILY AND COMMUNITY RELATIONS (A) The Home shall assist in maintaining close relationships with family members of each resident for the benefit of the resident and with the knowledge, participation and consent of the resident. (B) The Home shall maintain regular contact with the legally appointed guardian or resident repre- sentative of any resident, and provide verbal status reports on at least a quarterly basis. (C) The Home shall make efforts to establish a friendly relationship with the surrounding neighborhood and cammunity, such as providing opportunities for social interaction between residents and neighbors, providing opportunities for residents to provide volunteer services in the neighborhood, and establishing liaison with or- ganized neighborhood groups. (D) The Home shall make efforts designed to provide that residents are informed of and receive the benefits available from the community, such as opportunities for participation in recreational, social, cultural, and religious programs and services. 8-19-9-8 STAFF (A) There shall be one individual designated who is ultimately responsible for the day to day operation of the Home and for delivery of programs -63- required to meet needs of residents. This in- dividual shall be a qualified mental retardation professional as defined herein, and as approved by the Director. (B) There shall be at least one staff person on the premises at all times when residents are present, consistent with all federal and state requirements, resident needs and Depart- mental approval. Staff shall have direct access to all community emergency services. (C) The licensee shall designate a case manager for every resident admitted to a Residential Care or Group Care Hane. The designated case manager may or may not be a staff member of the licensee. The case manager shall participate in making the Individual Care Plan, and shall be responsible for coordinating services between the Home and the appropriate community resources. The case manager shall • periodically review with the resident and with the relevant service providers (including physician) the provided services (including the appropriateness and effectiveness of prescribed medication and any side effects). The case manger shall be a qualified mental retardation professional. (D) All direct care staff shall be at least twenty-one (21) years of age. (E) The number and qualifications of staff shall be adequate to meet the needs of residents as determined by the Service Needs Assessment and Individual Care Plan�to respond appropriately in emergency situations, and to carry out • responsibilities defined in these standards and as further required in this Chapter. There shall be trained staff or contractual arrangements to meet all resident needs determined by the Service Needs Assessments and Individual Care Plans. The -64- capacity to observe and to assess changes in resident needs, and to provide that changes in the services provided or in living arrangements (if so required) are made. The staffing plan and continuing staff coverage shall be approved by the Director. • (E) Each employee shall have a physical examination which has been conducted within ten (10) days before or after the first day of employment. This examination shall include findings that permit certification that the employee is free from communicable disease, and shall include documentation of a tuberculin skin test or chest x-ray within one (1) year before employment. (G) No employee or representative of the licensee may act as guardian for a resident of the Home. (H) There shall be an ongoing written planned in- service education program or orientation, skill training and related education to enable all personnel including.volunteers to perform their duties effectively. The agency's staff training program shall meet both staff training needs and service needs of the residents. 8-19-9-9 INDIVIDUAL CARE PLAN: The licensee shall provide an appropriate Individual Care Plan based upon the Service Needs Assessment and consistent with individual capacity for in- dependent functioning. The Individual Care Plan shall be written, in consultation with the resident, by a staff team that includes a designated case manager. The resident's guardian, resident's representative, and/or relevant service providers shall be included • in the process whenever feasible and/or appropriate. (A) The Individual Care Plan shall include the following written elements and be incor- porated into the resident's record: (1) Resident identification information -65- and assessment summary; (2) Service needs; (3) Measurable goals and objectives for the resident with specified timeframes; (4) Services to be provided including type, frequency, duration and availability; • (5) Identification of resident's case manager; (6) Effective date of service implementation; (7) Termination summary, when appropriate. (B) The individual care plan shall be reviewed at least quarterly by the case manager and resident, and amended as necessary. A written summary of the review shall be entered into the record. The written review shall note any changes in the resident's needs or progress made in reaching established goals. Reviews shall take place more frequently if the resident's circumstances require a change in the Care Plan. (C) All Individual Care Plans shall be based on . the following: (1) Resident programs shall concentrate upon areas designed to increase the residents' ability to take responsibility for themselves. (2) Residents shall be involved in programs that develop skills required to move toward greater personal independence. (3) There shall be agreed upon goals between the residential staff and each resident. (D) Each resident shall be linked to the network of existing mental health, educational, vocational, social, recreational and other community re- sources as outlined in the Individual Care Plan. (E) A case manager shall be designated by the licensee for every resident admitted to a Home. The designated case manager may or may not be a staff member of licensee. The designated case manager shall participate in making the Individual Care plan, and shall be responsible for coordinating services between the Home and the appropriate community resources, including ensuring that residents keep appointments for • medication review and management. (F) A detailed case history shall be maintained and kept current for every resident. 8-19-9-10 SELF ADMINISTRATION OF PRESCRIBED MEDICATIONS (A) No person shall be admitted who is not capable of self-administering his/her own medications, except that staff may guide new residents in the self -administration of medication for a training period not to exceed three (3) months. At the time of admission, the resident's personal physician shall provide in writing a statement that the resident is either capable of self administration of medications or will be capable with training • of self administration of medication within three months. Staff may also guide a resident in the self -administration of medication for a period not to exceed thirty (30) days following a change in the resident's medication regimen by the physician. A resident capable of self-administering his/her own medications shall, at a minimum, be able to identify his/her medication by size, shape, color, etc., and know when he/she is to take it, and the amount to be taken each.time. (B) If a person is not at the time of admission capable of self-administering his/her own • medications, the licensee shall provide personnel on the premises to supervise medication administration. Such personnel shall be licensed by the State of Illinois to administer medications. (C) Staff may assist a resident in the self- -67- administration of medications by taking the medication from the locked area where it is stored and handing it to the resident. If the resident is physically unable to open the container, a staff member may open the container for the resident. • (D) Staff shall monitor the self-administraztion of medication as necessary and appropriate and ordered by the person's physician. Staff monitoring responsibility shall in- clude informing the case manager and/or physician of changes in the resident's ability to self-administer medications. (E) Medication management shall be recorded in each resident's case record. (F) The responsibilities of the case manager shall include periodic review with the resident and with the physician prescribing medication the -appropriateness, effectiveness, is and side effects, if any, of the medication. (G) All medication shall be secured. (H) Information relating to common risks and side effects of the medication, the procedures to be taken to minimize such risks, and a description of any clinical indication that might require suspension or termination of the drug therapy shall be available to residents and staff in every program. Such information shall also be available to parents and guardians upon request. 8-19-9-11 EMERGENCY AND UNUSUAL OCCURENCE PROCEDURES (A) Emergency Procedures (1) The licensee shall implement effective • emergency procedures, including: (a) At least two fire drills each year; (b) maintenance of a Red Cross approved first aid kit on each floor; (c) education of all residents and orientation of new residents re- garding emergency procedures; (d) any other procedures required by City ordinance. • (2) The licensee shall immediately notify the resident's guardian or resident re- presentative and the Director of any emergency affecting a resident. Police or other agencies shall also be notified as appropriate. Records of such events shall be kept for re- view by the Director. Such emergencies include but are not limited to: (a) death, or imminent death; (b) suspected or alleged neglect, or physical/sexual abuse of or by a resident or employee; (c) any accident requiring medical care • outside the Home; (d) any newly diagnosed serious illness or disease; (e) unexplained absence (based on the guidelines and procedures established by the Hone) (B) Unusual Occurrence Procedures (1) The licensee shall implement procedures to manage unusual occurrences and shall in- form the residents of these procedures. Such unusual occurrences include, but are not limited to: (a) loss of utilities; (b) severe weather conditions (e.g., • tornado warning); (c) any activity related to the Home leading to a police report; (d) involuntary discharge. (2) The licensee shall notify the Department, the appropriate State age__ncy, and E anst^ o Police Department (where appropriate) of any unusual occurences. Records shall be kept of any unusual occurences. • (3) The licensee shall notify the Department, the appropriate state agency, and Evanston Police Department (where appropriate) of any unusual occurrences. Records shall be kept of any unusual occurences. (C) Plan for Unannounced Absences (1) Every licensee shall prepare, update as often as necessary, and have readily accessible at the Home, a plan for searching for residents; (a) Who are not in compliance with the Home's policy and procedures for announcing intended absences; and (b) Who remain unaccounted for after • informal attempts to locate them have been ineffective; or (c) Whose special needs are such as to create risk of harm. (2) Every licensee shall maintain an "Emergency Fact Sheet" for each resident which shall be immediately accessible to program staff and which shall include a current photograph and the following information: name, age, general physical charateristics, including sex, weight, height, build, hair and eye color, any physical handicaps; and any special • medical problems, including allergies and medication needs; addresses of family members, work, school, or day programs and places frequented; and name, telephone, and addresses of the resident's treating physician. -70- 8-19-9-12 RBCORDS The following constit,_ites a minimtn .rern1ireiment for record keeping: (A) There shall be a current record for each resident which gives all pertinent information • needed for emergency care and for continuity of services. The following shall be included: Name, age, person to be notified in an emergency, and family contacts as appropriate, medical history, including regularly updated medication list and any -drug allergies. Identifying data such as sex, height, weight, or other data (photo) for emergency identifi- cation. Any special problems which must be considered in providing service to the individual. Legal compentency status and name of guardian (if any). Physician name, address and phone number. Service needs assessment. • (B) In the event of discharge, the reason or reasons shall be recorded in the resident record. (C) All information in the record shall be confidential and any other personal infor- mation is available only to the resident, the licensee and the licensing body unless release is authorized in writing by the resident or the resident's guardian. Any release of information shall be in accordance with applicable laws. 8-19-9-13 MAINTENANCE AND HOUSEKEEPING (A) There shall be a plan for maintenance, repairs and exterminating, including a schedule. • (B) Grounds shall be maintained in a safe, sanitary condition. The building shall be kept clean and in good repair. All building codes and sanitation codes shall be complied with at all times. -71- (C) All systems and equipment shall be maintained in good working condition, including electrical, plumbing, mechanical, heating, fire protection, sewage disposal, fixtures, piping and appliances. (D) All furniture shall be maintained in a clean • attractive, safe,.condition. (E) Floors shall be clean, as non -slip as possible and free from hazards. (F) Odors shall be controlled and not covered. (G) Refuse shall not be allowed to ac=late and shall be properly disposed of. (H) Food and food materials shall be stored apapropriately and in a sanitary fashion. (I) Hazardous compounds or solutions shall be kept in a safe place, and marked with suitable and universal hazard warnings. (J) The laundry areas shall be kept clean. (K) There must be a plan stating what furniture is provided by the licensee and what by the residents. Homes must contain furniture and equipment usual and customary in residences. Furniture and equipment such as stereos, T.V.'s, radios, cameras, sporting equipment must be marked inconspicuously with the resident's name. A record of all furniture and equipment owned by an individual resident or jointly by two or more residents must be kept in the resident's file in close proximity to the resident's fact sheet. There shall be assurance that at least the following shall be available: (1) Common Areas: Sufficient and suitable chairs for all residents. Table space . sufficient for all residents to eat at the same time. Sufficient and suitable applicances for the efficient and attractive preparation of meals. Adaptive kitchen equipment shall be provided to facilitate -72- a resident's safety and maximum functioning indicated in the Individual Care Plan. Sufficient and suitable utensils, dishes, and serving materials to serve meals attractively and in a sanitary fashion. Sufficient and suitable furni- ture to provide an attractive, home -like atmosphere. Sufficient and suitable lights and lamps for reading and carrying out activities. (2) Resident Rooms: One bed with good mattress and springs for each resident. Sufficient and suitable storage furniture, such as a chest of drawers. Suffficient and suitable furniture to provide an attractive, home -like appearance. Locked storage space if necessary. Sufficient linen in good con- dition to ensure that there are always • clean linens available; window shades, blinds, or other privacy devices unless obviated by design. Larp or other illumination for reading. 8-19-9-14 FOOD SERVICE (A) The Home shall provide or arrange for a nourishing and well-balanced diet for all residents and shall assist residents with meal preparation to the extent necessary. This shall include at least one hot meal provided at the Home each day. This meal shall provide at least one-half of the daily minimal nutritional needs, shall be planned with input from residents, and shall meet any medically prescribed dietary • requirements. Each resident's Individual Care Plan shall specify how his/her dietary needs shall be met. (B) All foods shall be stored, prepared and served in a clean, nutritious and appetizing manner. -73- 8-19-10 SPECIFIC OPERATING REQUIREMENTS FOR HOMES SERVING THE MENTALLY ILL 8-19_10_1 PROGRAM PRINCIPLES (A) All programs shall be based on the following: (1) The group is the basic support for the individuals. (2) Within the structure of the group, is individuals are to be encouraged and aided in remaining as independent as possible and individual differences are respected. (3) Residents plan for and implement as much of the activities and operation of the Home as possible. (B) There shall be a written procedure for ongoing evaluation of resident needs, and residents shall be part of this procedure. This procedure shall include a method for noting changes in physical or mental condition and responding to these. (C) There shall be proof of agreement for services and advocacy for residents from community • agencies. The licensee shall have and execute a plan to inform residents of community services. (D) Services shall be provided to each resident in accordance with his/her individual care plan. 8-19-10-2 MONITORING (A) The Executive Director of the Mental Health Board (or his/her staff designee), shall meet with each designated case manager on at least a quarterly basis to review Individual Care Plans and the provision of prescribed services. (B) The Executive Director of the Mental Health Board (or his/her staff designee), shall make on -site • inspections to any Home for the mentally ill on at least a quarterly basis. -74- (C) The Executive Director of the Mental Health Board shall suhmit writtan reports of all in- spections to the Director of Health and Human Services. The Director shall consider these reports to determine compliance with this • Chapter and shall send notice to the licensee suant to Section 8-19-3-10(B). 8-19-10-3 ADMISSION AND DISCHARGE (A) All policies and procedures for admission and discharge of residents as set forth below shall be in writing, approved by the Director and given to applicants for residence prior to admission and to residents at the time contracts are executed. (B) Eligibility (1) The individual shall be at least eighteen (18) years of age. (2) The individual shall have the ability to self administer medications.$t the time oF" • admission, the individual's personal physician shall provide in writing a statement that Ihc individual is capable of self administration of medication. (3) The individual shall be capable of taking appropriate actions unassisted in an emergency. (4) All applicants for residency shall meet the following entrance criteria: (a) The individual shall demonstrate the following: Assessed capacity for independent functioning, based on the individual's wish to live independently and de- monstrated capacity to function in a socially appropriate manner and to manage his/her own needs and care -75- (e.g., personal care, health management, hcusehold maintenance); deronstrated - willingness and capacity to learn and/or to refine additional independent living skills if needed (e.g., vocational training, develop- ment of own social network). (b) The individual shall demonstrate mastery of the following skills: In Home Skills: Cares for personal hygiene; takes own medications as prescribed (if any); perceives common dangers (e.g., locks doors, turns off gas), capable of exiting Home unassisted in an emergency. In the Community Skills: Has basic understanding of community expecta- tions and awareness of appropriate social behavior. • Social and motional Skills: Maintains contact with a clinic, other social agency; or private practitioner (c) The individual shall have or demonstrate the potential to master the following skills, which should be developed through support services available to residents of the Home: In Home Skills: Performs routine household chores; does laundry; prepares own meals; budgets own money. In the Community Skills: Schedules and keeps own therapy and medical appointments; uses public transporta- • tion; shops on own; attends school, workshop, job; has awareness of public welfare and other bureau- cratic systems (may need help to negotiate these systems). -76- Social and Emotional Skills: Monitors eT etional needs (e.g., need for more medications, extra attention, quiet time); has some ability to problem solve, ver- balize and negotiate with others in the environment. (5) No individual shall be admitted without evidence of completion of a physical and mental status assessment within the six months prior to admission. The assess- ment shall include documentation of the presence or absence of tuberculosis in- fection by tuberculin skin test or chest x-ray. No individual with a communicable disease shall knowingly be admitted into the home. (6) No individual requiring continuous and constant professional nursing super- vision or care shall be accommodated in a Home. (C) ADMISSION (1) Hones shall not discriminate on the basis of race, creed, or religion. (2) No individual shall be admitted without a Service Needs Assessment as defined herein and a plan to ensure that the resident is provided with services to meet his/her needs. No individual shall be admitted whose Service Needs Assessment indicates service needs which would re- quire professional nursing supervision or care or whose needs cannot be met within • the context of the group supports, com- munity resources, and the staffing plan proposed. (3) No individual shall be admitted without execution of a written contract -77- conforming to the requirements in Section 8-19-8-5 setting forth the base rates, services provided by the Home, admission and discharge rules and requirements, and resident rights and house rules. (4) The licensee shall have on staff, or by written consultation agreement, a psychiatrist, psychologist, psychiatric nurse, or case manager (qualified social worker) designated to assess the suita- bility of applicants for residence in a Hone, according to the entrance criteria as defined in this Chapter. The licensee shall form a screening committee that will include at least one clinical staff person from a community agency other than the agency sponsoring the Herne. The com- position of the screening ccnnittee • shall be approved by the Director. The designated clinician and the screening committee shall each make admission re- commendations to the licensee. No person shall be admitted without the recom- mendation of both the designated clinician and the screening committee. The licensee is responsible for admission decisions. (D) DISCHARGE AND DISCHARGE PLANNING (1) If a resident no longer wishes to live in the Home, a voluntary discharge shall be granted. The Home shall offer counsel- ing to the resident's guardian or re- presentative and to the resident • him/herself, concerning advantages and disadvantages of discharge. (2) The Hone shall provide discharge planning. The discharge planning team (including the designated case manager, residential staff, and relevant community service 111-IM providers) shall invite the resident, • • Director, receiving agenc- ( i f applicable), the legal guardian (if applicable), and resident representative (if applicable) to review discharge plans. (3) At the time of discharge, a summary of pertinent information from the resident's record must be transmitted to the receiving residential facility (if any and if appropriate). Any release of information shall be made in accordance with applicable law. ( 4 ) IWOLUNrARY DISCHARGE (a) Except where a resident is an immediate danger to himself/herself or others, the licensee shall provide a resident with twenty-one (21) days written notice before discharge. The Licensee shall offer assistance to the resident, and to the resident's guardian or representative in locating another place to live. (b) Involuntary discharge may result from chronic violation of program and/or "house rules" or the development of a psychological or physical condition which cannot be appropriately managed in a residential setting. (c) If a resident, following admission, begins to demonstrate a disintegration in functioning level (as manifested by thought disorders, impaired judgment, negative changes in sleeping and eating patterns, changes in ideas of reference, and/or refusal of medication), the Hone shall convene a team meeting (including the de- signated case manager, residential staff, and relevant community services -'7Q- providers) to evaluate the appropriateness of the resident remaining in the Home. At all times, a resident shall at a minimum meet the entrance criteria set forth in section 8-19-10-3-(B). (d) Hospitalization is not discharge and • all discharge procedures shall be followed if a resident is not to return to the Home from a hospital. (E) RESIDENT TRANSFER: The Director shall assist residents in finding other places to live should any of the following conditions exist: (a) The Home is operating without a license; (b) The Director has revoked or refused to renew the license of the Home as provided under Section 8-19-3-8. 8-19-10-4 CONTRACT • (A) The written annual contract entered into by the resident, resident's guardian, and the licensee shall specify at a minimum: (1) The parties, including the name and addresses of resident's legal guardian where applicable; a resident's re- presentative may be designated by the resident or guardian. (2) All services which the licensee will provide. (3) The monthly charges and the amount of the deposit; and (4) Provisions for contract termination. The contract shall provide that if a resident chooses to leave the Home, the • resident may terminate the contract, and shall not be liable for any penalty or damages in excess of thirty days, or one month's charge. The contract shall in- clude a statment of the resident dis- charge rights provided in section :m 8-19-10-3 (D). (B) The contract shall include as an attachment a copy of the Home's resident rights and house rules. 8-19-10-5 RESIDENT RIGHTS (A) Residents shall be treated with respect, dignity, consideration and as persons capable • of growth, development and full citizenship rights. Physical and psychological abuse are prohibited. (B) No resident shall be deprived of any rights, benefits or privileges guaranteed by law, the Constitution of Illinois or the Constitution of the United States. (C) Unless each resident is provided with a roan which he or she can lock, each resident shall have a private locked space available large enough to secure valuables (except for those for whom a physician specifically states a reason not to allow this right). (D) Each Hone shall have periodic meetings of staff and residents which shall include community agency personnel from time to time so that residents will became familiar with resources to whom they may turn for advocacy and assistance. (E) No resident's room shall have as its sole means of access a door to another resident's M Neither staff nor visitors shall enter a residents roan without permission except in an emergency. (G) Residents have the right to free exercise of religion. • (H) Residents have the right to receive health, social, and other services from the provider of their choice. (I) Residents shall plan day to day activities and operations of the Home with staff. (J) Residents' confidentiality shall be maintained. M Residents and staff shall determine what in- formation may be given out, to whom, and under what circumstances. Any release of information shall be made in accordance with applicable law. (K) Residents have the right to visitors. Residents have the right to unimpeded, private and uncensored communication by is mail, and by public phone subject to reasonable time limitations'and the rights of fellow residents. Mail must not be delayed. A public phone shall be accessible and available. There shall be space to meet privately with visitors. (L) The resident or the resident's guardian or resident representative has the right to decide how and by whom the resident's funds may be spent. (M) Residents and guardians of residents and resident representative shall be informed of their rights in the case of involuntary discharge as delineated in Section 8-19-10-3(D). (N) Residents, guardians of residents, and resident representatives shall be informed of their right to communicate with advocates, inlcuding the Mental Health Board. (0) Residents, guardians of residents, and resident representatives shall be given a copy of all resident rights and shall sign a document stating that they have been given a copy and have understood it or have had it read to them. (P) Residents, guardians of residents, and resident representatives shall be given a copy of all resident responsibilities established by the Home, including behaviors that are defined as • inappropriate and unacceptable by the Home, and shall sign a document stating that they have been given a copy and have understood it or have it read to them. (0) Residents and guardians of residents and resident representatives shall be given a copy -82- of the Contract and the house rules. 8-19-10-6 FAMILY AND COMMUNITY RELATIONS (A) The Fome shall. assist it maintaining close relationships with family members of each resident for the benefit of the resident and with the knowledge, participation and • consent of the resident. (B) The Home shall maintain regular contact with the legally appointed guardian or resident representative of any resident, and provide verbal status reports on at least a quarterly basis. (C) The Home shall make efforts to establish a friendly relationship with the surrounding neighborhood and cormtunity, such as providing opportunities for social interaction between residents and neighbors, providing opportunities for residents to provide volunteer services in the neighborhood, and establishing liaison with organized neighborhood groups. • (D) The Home shall make efforts designed to provide that residents are informed of and receive the benefits available from the community, such as opportunities for participation in re- creational, social, cultural, and religious programs and services. 8-19-10-7 STAFF (A) There shall be one individual designated who is ultimately responsible for the day to day operation of the Home and for delivery of programs required to meet needs of residents. This individual shall have a masters degree in a mental health discipline as approved by the Director. • (B) There shall be at least one staff person on the premises at all times when residents are present, consistent with all federal and state requirements resident needs and Departmental approval. Staff shall have direct access to all ccm-unity emergency services. • • 11 (C) The licensee shall designate a case manager for every resident admitted to a Residential Care or Group Care Home. The designated case manager may or may not be a staff member of the licensee The case manager shall particiapte in making the Individual Care Plan, and shall be responsible for coordinating services between the Home and the appropriate community resources. This includes ensuring that residents keep appointments for medication review and management. The case manager shall periodically review with the resident and with the relevant service providers (including physician) the provided services plan (including the appropriateness and effectiveness of prescribed medication and any side effects). (D) The licensee shall have on staff, or by written consultation agreement, a psychiatrist, psychologist, psychiatric nurse or a case manager (qualified social worker) designated to assess the suitability of applicants for residence in a Home, according to the criteria as defined in this Chapter. (E) All direct care staff shall be at least twenty-one (2) years of age. M The number and qualifications of staff shall be adequate to meet the needs of residents as determined by the Service Needs Assessment and Individual Care Plans, to respond appropriately in emergency situations, and to carry out res- ponsibilities defined in these standards and as further required in this Chapter. There shall be tra ined staff or contractual arrangements to meet all resident needs determined by the Service Needs Assessment and Individual Care Plans. The numbers and type of staff shall also provide the capacity to observe and tc assess changes in resident needs, and to provide that changes in the services provided or in their living arrangements (if so required) • are made. The staffing, plan and continuing staff coverage shall be approved by the Director. (G) Each employee shall have a physical examination which has been conducted within ten days before or after the first day of employemnt. This examination shall include findings that permit certification that the employee is free from communicable disease, and shall include do- cumentation of a tuberculin skin test or chest x-ray within one (1) year before employment. (H) No employee or representative of the licensee may act as guardian for a resident of the Home. • (I) There shall be an ongoing written planned in- service education program or orientation, skill training and related education to enable all personnel including volunteers to perform their duties effectively. The agency's staff training program shall meet both staff training needs and service needs of the residents. 8-19-10-8 INDIVIDUAL CARE PLAN The licensee shall provide an appropriate Individual Care Plan based upon the Service Needs Assessment and consistent with individual capacity for independent functioning. The Individual Care Plan shall be written, in consultation with the resident, by a staff team that includes a de- signated case manager. The resident's guardian, resident's representative, and/or relevant service providers shall be included in the process whenever feasible and/or appropriate. (A) The Individual Care Plan shall include the following written elements and be incor- n C porated in the resident's record: (1) Resident identification information and assessment summary; (2) Service needs; (3) Measurable goals and objectives for the resident with specified timeframes; (4) Services to be provided including type, frequency, duration and availability; (5) Identification of resident's case manager; (6) Effective date of service implementation; (7) Termination summary, when appropriate. (B) The individual care plan shall be reviewed at least quarterly by the case manager and resident, and amended as necessary. A written summary of the review shall be entered into the record. The written review shall rote any changes in the resident's needs or progress made in reaching established goals. Review shall take place more frequently if the • resident's circumstances require a change in the care plan. (C) All Individual Care Plans shall be based on the following: (1) Resident programs shall concentrate upon areas designed to increase the residents' ability to take responsibility for themselves. (2) Residents shall be involved in programs that develop skills required to move toward greater personal independence. (3) There shall be agreed upon goals between the residential staff and each resident. • (D) Each resident shall be linked to the network of existing mental health, educational, vocational, social, recreational and other community resources as outlined in the In- dividual Care Plan. (E) A case manager shall be designated by the oc licensee for every resident admitted to a Home. The designated case manager may or may not be a staff member of the licensee: The designated case manager shall participate in making Individual Care Plan, and shall be responsible for coordinating services between the Home and the appropriate community resources, including ensuring that residents keep appointments for medication review and management. The case manager shall meet with the Executive Director of the Evanston Mental Health Board (or his/her staff designee) on at least a quarteriyi"basis to review Individual Care Plans. (F) A detailed case history shall be maintained and kept current for every resident. 8-19-10-9 SELF ADMINISTRATION OF PRESCRIBED MEDICATIONS (A) No person shall be admitted who is not capable of self administering his/her own medications. At the time of admission, • the resident's personal physician shall provide in writing a statement that the resident is capable of self administration of medications. A resident capable of self- administering his/her own medications shall at a minimum, be able to identify his/her medications by size, shape, color, etc. and know when he/she is to take it, and the amount to be taken each time. (B) Staff shall monitor the self -administration of medication as necessary and appropriate and ordered by the person's physician. Staff monitoring responsibility shall include in- forming the case manager and/or physician of • changes in the resident's ability to self- administer medications. (C) Medication management shall be recorded in each resident's case record. (D) Psychotropic medication shall be prescribed by a licensed physician who has evaluated -87- the resident and is familiar with the case history, or in an emergency, is at least familiar with the case history. Medication and dosage shall be monitored by a Psychiatric out -patient facility or a psychiatrist in private practice. (E) Each resident receiving psychotropic • medication shall receive a yearly physical examination. The results of the examination shall be reviewed by the physician prescribing psychotropic medication. (F) The responsibilities of the case manager shall include periodic review with the resident and with the physician prescribing medication the appropriateness, effectiveness, and side effects, if any, of the medication. (G) No person shall be admitted to a Hone for the mentally ill without the execution of a written contract that includes the agreement of the prospective resident • to conply with his/her prescribed medication regimen. (H) All medication shall be secured. (I) Information relating to common risks and side effects of the medication, the procedures to be taken to minimize such risks, and a des- cription of any clinical indications -hat might require suspension or termination of the drug therapy shall be available to residents and staff in every program. Such information shall also be available to parents and guardians upon request; 8-19-10-10 EMERGENCY AND UNUSUAL OCCURENCE PROCEDURES (A) Emergency Procedures i 1 (1) The licensee,,nimplement effective emergency procedures, including: (a) At least two fire drills each year; (b) maintenance of a Red Cross approved first aid kit on each floor; (c) education of all residents and orientation of new residents re- garding emergency procedures. (d) any other procedures required by City ordinance. • (2) The licensee shall immediately notify the resident's guardian or -resident re- presentative and the Director of any emergency affecting a resident. Police or other agencies shall also be notified as appropriate. Records of such events shall be kept for review by the Director. Such emergencies include, but are not limited to: (a) death, or imminent death; (b) suspected or alleged neglect, or physical/sexual abuse of or by a resident or employee; (c) Any accident requiring medical • care outside the Home; (d) any newly diagnosed serious illness or disease; (e) unexplained absence (based on the guidelines and procedures established by the Home). (B) Unusual Occurrence Procedures (1) The licensee shall implement procedures to manage unusual occurrences and shall inform the residents of these procedures. Such unusual occurrences include, but are not limited to: (a) loss of utilities; (b) severe weather conditions (e.g., • tornado warning) ; (c) any activity related to the Home leading to a police report; (d) involuntary discharge. -89- (2) The licensee shall notify the Department, the appropriate state agency, and Evansston Police Department (where appropriate) of any unusual occurences. Records shall be kept of any unusual occurences. (C) Plan for Unannounced Absences (1) Every licensee shall prepare, update as • often as necessary, and have readily accessible at the Home,, a plan for searching for residents; (a) Who are not in compliance with the Home's policy and procedure for announcing intended absences; and (b) Who remain unaccounted for after informal attempts to locate them have been ineffective; or (c) Whose special needs are such as to create a risk of harm; (2) Every licensee shall maintain an "Emergency Fact Sheet" for each resident which shall be immediately accessible to program staff • and which shall include a current photograph and the following information: name, age, general physical characteristics including sex, weight, height, build, hair and eye color; any physical handicaps; and any special medical problems, including allergies and medication needs; addresses of family members, work, school, or day programs and places frequented; and name, telephone, and addresses of the resident's treating physician. 8-19-10-11 RECORDS The following constitutes a minimum requirement for • record keeping: (A) There shall be a current record for each resident which gives all pertinent information needed for emergency care and for continuity of services. The following shall be included: Name, age, person to be notified in an .M emergency, and family contacts as appropriate, medical history, including regularly updated medication list and any drug allergies. Identifying data such as sex, height, weight, or other data (photo) for emergency identification. Any special problems which must be considered in providing service to the individual. Legal is competency status and name of guardian (if any). Physician name, address and phone number. Service Needs Assessment. (B) In the event of discharge, the reason or reasons shall be recorded in the resident record. (C) All information in the record shall be confidential and any other personal in- formation is available only to the resident, the licensee and the licensing body unless release is authorized in writing by the resident or the resident's guardian. Any release of information shall be in accordance 0 with applicable law. 8-19-10-12 MAINTENANCE AND HOUSE=PING (A) There shall be a plan for maintenance, re- pairs and exterminating, including a schedule. (B) Grounds shall be maintained in a safe, sanitary condition. The building shall be kept clean and in good repair. All building codes and sanitation codes shall be complied with at all times. (C) All systems and equipment shall be maintained in good working condition, including electrical, plumbing, mechanical, heating, fire protection, sewage disposal, fixtures, piping • and appliances. (D) All furniture shall be maintained in a clean, attractive, safe condition. (E) Floors shall be clean, as non -slip as possible and free from hazards. (F) Odors shall be controlled and not covered. -91- (G) Refuse shall not be allowed to accumulate • U • and shall be properly disposed of. (H) food and food materials shall be stored appropriately and in a sanitary fashion. (I) Hazardous compunds or solutions shall be kept in a safe place, and marked with suitable and universal hazard warnings. (J) The laundry areas shall be kept clean. (K) There must be a plan stating what furniture is provided by the licensee and what by the residents. Homes must contain furniture and equipment usual and customary in residences. Furniture and. equipment such as stereos, T.M s, radios, cameras, sporting equipment must be marked inconspicously with the resident's name. A record of all furniture and equipment owned by an individual resident or jointly by two or more residents must be kept in the resident's file in close proximity to the resident's fact sheet. There shall be assurance that at least the following shall be available: (1) Common areas: Sufficient and suitable chairs for all residents. Table space sufficient and suitable for all residents to eat at the same time. Sufficient and suitable appliances for the efficient and attractive preparation of meals. Adaptive kitchen equipment shall be provided to facilitate a resident's safety and maximum functioning as indicated in the individual care plan. Sufficient and suitable utensils, dishes, and serving materials to serve meals attractively and and in a sanitary fashion. Sufficient and suitable furniture to provide an attractive, home -like atmosphere. Sufficient and suitable lights and lamps for reading and carrying out activities. -92- (2) Resident Rooms: One bed with good • • mattress and springs for each resident. Sufficient and suitable storage furniture, such as a chest of drawers. Sufficient and suitable furniture to give an attractive, home -like appearance. Locked storage space if necessary. Sufficient linen in good condition to ensure that there are always clean linens available; window shades, blinds, or other privacy devices unless obviated by design. Lamp or other illumination for reading . 8-19-10-13 FOOD SERVICES (A) The Home shall provide or arrange for a nourishing and well-balanced diet for all residents and shall assist residents with meal preparation to the extent necessary. This shall include at least one hot meal eaten at the home each day. This meal shall provide at least one-half of the daily minimal nutritional needs; shall be planned with input from residents, and shall meet any medically prescribed dietary requirements. Each resident's Individual Care Plan shall specify how his/her dietary needs shall be met. (B) All foods shall be stored, prepared and served in a clean, nutritious and appetizing manner. -92- • • SECTION 2: No residential or group care home for youth shall be issued a license unless and until the City Council enacts specific rules, reg- ulations and standards regarding the licensing and operation of such youth home. SECTION 3: This ordinance, by its terms, is severable if any court of competent jurisdiction should determine any paragraph, subparagraph or clause unconstitutional or invalid. Such declaration should be determined to be excised and the remainder of this or- dinance shall be in full force and effect. SECTION 4: All ordinances or parts of or- dinances in conflict herewith are hereby repealed. SECTION 5: This ordinance shall be in full force and effect from and after its passage, approval and publication in the manner provided by law. Introduced: Jr4u 4 -y l� 0 Adopted: VAd,� /( ATTEST: City Clerk Approved as to form: Corporation Cdunsel , 1985 , 1985 Approved: /Z-C l ,� 198,5— Mr - Mayo 93