RALNA Illinois Legislative Update January 17, 2022


Medically Complex for the Developmentally Disabled Facilities (MC/DD)

Significant rulemaking activity is occurring by the Illinois Department of Public Health pertaining to Medically Complex[1] for the Developmentally Disabled Facilities (MC/DD). Updates relate to 77 Ill. Adm. Code 390.

MC/DD is a specific licensing category under Illinois law and does not include assisted living facilities. However, because the definition of MC/DD facilities includes any facility with three or more residents not related to the owner, it may apply to RALNA members and is included here for the benefit of those serving this population.

Some changes include:

  • Facilities can only refer residents to a home health agency, home services agency, or home nursing agency if the agency is licensed under the Home Health, Home Services, and Home Nursing Agency Licensing Act. 
  • Creates specific standards for designation of distressed facilities, with identified standards for labeling a facility as “distressed.”
  • Certain municipal licensing must be coordinated with the Act and this regulation.
  • Additional provisions are added regarding assessment of penalties.
  • Substantial revisions are made to pre-admission determination of need screening requirements.
  • Facilities must check to see if any current resident is a registered sex offender, and if they are, the regulation sets out details steps for how to handle the situation.
  • A facility shall be used exclusively for medically complex and developmentally disabled persons.
  • Residents can choose to be discharged from a facility by giving the administrator, a physician, or a nurse of the facility written notice of his or her desire to be discharged.  If a guardian has been appointed for a resident or if the resident is a minor, the resident shall be discharged upon written consent of his or her guardian or if the resident is a minor, his or her parent unless there is a
    court order to the contrary.
  • Nursing assistants, home health aides, Direct Support Persons (DSP), or newly hired employees who may have access to a resident, a resident’s living quarters, or a resident’s personal,
    financial, or medical records must be listed in the Health Care Worker Registry as eligible to work for a health care employer.
  • Sets new infection control procedures
  • Requires that facilities provide each resident, regardless of age, no less than 4.0 hours of nursing and personal care time each day.
  • Establishes greater restrictions on the use of antipsychotic drugs

As mentioned, this is a substantial revision, so facilities licensed under this regulation should carefully review the prosed changes – not all of which are listed here.

Comments can be sent by February 17, 2022 to:
Department of Public Health
Attention:  Tracey Trigillo, Rules Coordinator
Lincoln Plaza
524 South 2nd Street, 6th Floor
Springfield, IL 62701
[email protected]

[1] Medically complex – a term used when a child has a medical condition, or multiple medical conditions, that require ongoing specialized care.  The medical condition may vary from rare illnesses, to premature birth, or incidents involving physical trauma.

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