HB 5492 — HOSPITAL-ABUSE/NEGLECT REPORTS

(o) All patient identifiable information in any report or investigation under this Section shall be confidential and shall not be disclosed except as authorized by this Act or other applicable law.

(p) Nothing in this Section relieves an FEC administrator, employee, agent, or medical staff member from contacting appropriate law enforcement authorities as required by law.

(q) Nothing in this Section shall be construed to mean that a patient is a victim of abuse because of health care services provided or not provided by health care professionals.

(r) Nothing in this Section shall require an FEC, including HB5492 Engrossed - 5 - LRB095 15957 DRJ 41967 b its employees, agents, and medical staff members, to provide any services to a patient in contravention of his or her stated or implied objection thereto upon grounds that such services conflict with his or her religious beliefs or practices, nor shall such a patient be considered abused under this Section for the exercise of such beliefs or practices.

(s) As used in this Section, the following terms have the following meanings:

"Abuse" means any physical or mental injury or sexual abuse intentionally inflicted by an FEC employee, agent, or medical staff member on a patient of the FEC and does not include any FEC, medical, health care, or other personal care services done in good faith in the interest of the patient according to established medical and clinical standards of care.

"Neglect""Mental injury" means aintentionally failurecaused inemotional andistress FECin toa providepatient adequatefrom medicalwords or othergestures care,that whichwould failurebe resultsconsidered inby physicala orreasonable mentalperson injury to abe patienthumiliating, harassing, or inthreatening theand deteriorationwhich ofcauses aobservable patient’sand physicalsubstantial orimpairment. mental condition.

"Vulnerable"Sexual adult"abuse" means anany individualintentional whoact (i) is at least 18 years of agesexual butcontact less than 60 years of age, (ii) regardless of his or hersexual mentalpenetration capacity, has or is suspected of having a HB5492patient - 2 - LRB095 15957 DRJ 41967 b physical, mental, or developmental impairment, and (iii) is receiving, is requesting, or may be in needthe ofhospital. emergency treatment services, including evaluation for a determination of service needs.

(b)"Substantiated", Nowith administrator,respect agent,to ora employeereport of anabuse, FECmeans maythat abuse or neglect a vulnerablepreponderance adultof whothe isevidence aindicates patientthat inabuse theoccurred. FEC.

(c)HB5492 TheEngrossed following- persons6 shall- beLRB095 required15957 toDRJ report41967 allb allegations(t) Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of abusethe andGovernor neglecthas any authority to make or promulgate rules to implement or enforce the provisions of vulnerablethis adults:Section.

anyIf, FEChowever, administrator,the agent,Governor orbelieves employee,that andrules anyare physician,necessary surgeon,to dentist,implement osteopath, chiropractor, podiatrist, EMT/paramedic, nurse, aide, social worker, social services administrator, coroner, law enforcement or securityenforce personnel, religious practitioner, field personnel from a hospital accreditation agency, personnel of the Illinoisprovisions Department of Healthcarethis andSection, Family Services or the IllinoisGovernor Departmentmay ofsuggest Publicrules Healthto orthe anyGeneral countyAssembly orby municipalfiling healththem orwith human services department, personnel of the IllinoisClerk Department of Human Services, the IllinoisHouse Guardianship and Advocacy Commission, the IllinoisSecretary Departmentof onthe AgingSenate orand itsby subsidiaryrequesting Agenciesthat onthe Aging,General orAssembly theauthorize Illinoissuch Departmentrulemaking ofby Financiallaw, andenact Professionalthose Regulation,suggested andrules personnelinto law, or agentstake of any other agencyappropriate thataction isin conductingthe aGeneral healthAssembly’s ordiscretion. disability-related service.

RequiredNothing reporters include all employees of the State of Illinois who are involved in providingthis servicesSection toshall vulnerablebe adults,interpreted including professionals providing medical, rehabilitative, or dental HB5492 - 3 - LRB095 15957 DRJ 41967 b services to vulnerablegrant adults,rulemaking andauthority allunder employeesany ofother communityIllinois servicestatute agencieswhere whosuch provideauthority servicesis tonot vulnerableotherwise adultsexplicitly ingiven. a setting outside that FEC.

(d)For Anythe personpurposes requiredof tothis reportSection, under"rules" subsectionis (c)given whothe witnesses,meaning discovers,contained orin isSection told1-70 of possiblethe abuseIllinois orAdministrative neglectProcedure ofAct, aand vulnerable"agency" adult,and or"agency whohead" hasare reasongiven tothe believemeanings thatcontained ain vulnerableSections adult1-20 mayand have1-25 beenof abusedthe orIllinois neglectedAdministrative withinProcedure anAct FEC,to shallthe immediatelyextent reportthat thosesuch allegationsdefinitions apply to agencies and agency heads under the Department.jurisdiction of the Governor.

FEC employees shall immediately report all allegations to the FEC administrator according to the facility’s procedures.

All reports from FECs to the Department must be made by telephone and in writing.

No FEC administrator, agent, or employee, nor any other person, may screen reports or otherwise withhold reports from the Department, and no FEC shall establish criteria, guidelines, rules, procedures, or policies that alter or unreasonably delay reports to the Department.

The Department shall investigate every allegation of abuse or neglect of a vulnerable adult received by the Department.

Under no circumstances may an FEC’s internal review of an allegation of abuse or neglect of a vulnerable adult under subsection (e) replace an investigation of the allegation by the Department.

(e) In every event the FEC must, upon receipt of any allegation, promptly conduct an internal review to ensure the alleged victim’s safety.

Measures to protect an alleged victim HB5492 - 4 - LRB095 15957 DRJ 41967 b shall be taken as deemed necessary by the facility’s administrator and may include, but are not limited to, removing suspected violators from further patient contact during the internal review.

All internal reviews are to be conducted by a designated FEC employee or agent who is qualified to detect abuse and neglect and is not involved in the alleged victim’s treatment.

All internal review findings must be documented and filed according to facility procedures and shall be made available to the Department.

All internal review files, including information regarding the disposition of each report, shall also be made available, subject to confidentiality requirements, to the Illinois Guardianship and Advocacy Commission and any other agency or legal representative in the course of monitoring or investigating rights protections for recipients of services.

(f) Every FEC shall regularly train all employees in the detection and reporting of abuse and neglect of vulnerable adults.

(g) Retaliation in any form against a person who lawfully and in good faith makes report of abuse or neglect to an FEC administrator or to the Department is prohibited.

(h) The provisions of this Section do not relieve any FEC administrator, agent, or employee from making contact with appropriate law enforcement authorities as required by law.

The Hospital Licensing Act is amended by HB5492 - 5 - LRB095 15957 DRJ 41967 b changing Section 9 and by adding Section 9.6 as follows:

150) HB5492 Engrossed - 7 - LRB095 15957 DRJ 41967 b Sec.

The Department shall make or cause to be made such inspections and investigations as it deems necessary,necessary , except that the Department shall investigate every allegation of abuse or neglect of a vulnerablepatient adult received by the Department.

Under no circumstances may a hospital’s internal review of an allegation of abuse or neglect of a vulnerable adult under subsection (e) of Section 9.6 replace an investigation of the allegation by the Department.

1-1-00.) HB5492 - 6 - LRB095 15957 DRJ 41967 b (210 ILCS 85/9.6 new) Sec.

AbusePatient orprotection neglectfrom ofabuse. vulnerable adult.

(a) InNo thisadministrator, Section:agent, or employee of a hospital or a member of its medical staff may abuse a patient in the hospital.

"Abuse"(b) meansAny hospital administrator, agent, employee, or HB5492 Engrossed - 8 - LRB095 15957 DRJ 41967 b medical staff member who has reasonable cause to believe that any physicalpatient with whom he or mentalshe injuryhas direct contact has been subjected to abuse in the hospital shall promptly report or sexualcause assaulta inflictedreport onto be made to a vulnerabledesignated adult,hospital otheradministrator thanresponsible byfor accidentalproviding means,such inreports ato hospital.the Department as required by this Section.

"Allegation"(c) meansRetaliation anyagainst assertion,a complaint,person orwho suspicionlawfully thatand abusein orgood neglectfaith ofmakes a vulnerablereport adultunder maythis haveSection occurred.is prohibited.

"Neglect"(d) meansUpon areceiving failure in a hospitalreport tounder providesubsection adequate(b) medicalof orthis otherSection, care,the whichhospital failureshall resultssubmit inthe physicalreport or mental injury to athe patientDepartment orwithin in24 thehours deterioration of aobtaining patient’ssuch physicalreport. or mental condition.

"VulnerableIn adult"the meansevent anthat individualthe whohospital (i)receives ismultiple atreports leastinvolving 18a yearssingle ofalleged ageinstance but less than 60 years of age,abuse, (ii)the regardless of his or her mental capacity, has or is suspected of having a physical, mental, or developmental impairment, and (iii) is receiving, is requesting, or may be in need of hospital services,shall includingsubmit evaluationone forreport ato determinationthe ofDepartment. service needs.

(b)(e) NoUpon administrator,receiving agent,a orreport employeeunder ofthis aSection, the hospital mayshall abusepromptly orconduct neglectan ainternal vulnerablereview adultto whoensure isthe aalleged patientvictim’s insafety. the hospital.

(c)Measures Theto followingprotect personsthe alleged victim shall be requiredtaken toas reportdeemed allnecessary allegationsby ofthe abusehospital’s administrator and neglectmay ofinclude, vulnerablebut adults:are not limited to, removing suspected violators from further patient contact during the hospital’s internal review.

anyIf hospital administrator, agent, or employee, and any physician, HB5492 - 7 - LRB095 15957 DRJ 41967 b surgeon, dentist, osteopath, chiropractor, podiatrist, EMT/paramedic, nurse, aide, social worker, social services administrator, coroner, law enforcement or security personnel, religious practitioner, field personnel from a hospital accreditation agency, personnel of the Illinoisalleged Departmentvictim oflacks Healthcaredecision-making andcapacity Familyunder Services or the Illinois Department of Public Health orCare anySurrogate countyAct orand municipalno health orcare humansurrogate servicesis department,available, personnel of the Illinoishospital Departmentmay ofcontact Human Services, the Illinois Guardianship and Advocacy Commission,Commission theto Illinoisdetermine Department on Aging or its subsidiary Agencies on Aging, or the Illinoisneed Departmentfor ofa Financialtemporary andguardian Professional Regulation, and personnel of any other agency that isperson. conducting a health or disability-related service.

Required(f) reportersAll includeinternal allhospital employeesreviews ofshall thebe Stateconducted ofby Illinoisa whoHB5492 areEngrossed involved- in9 providing- servicesLRB095 to15957 vulnerableDRJ adults,41967 includingb professionalsdesignated providinghospital medical,employee rehabilitative, or dentalagent serviceswho is qualified to vulnerabledetect adults,abuse and allis employeesnot ofinvolved community service agencies who provide services to vulnerable adults in athe settingalleged outsidevictim’s thattreatment. hospital.

(d)All Anyinternal personreview requiredfindings tomust reportbe underdocumented subsectionand (c)filed whoaccording witnesses, discovers, or is told of possible abuse or neglect of a vulnerable adult, or who has reason to believehospital thatprocedures aand vulnerable adult may have been abused or neglected within a hospital, shall immediatelybe reportmade suchavailable allegations to the Department.Department upon request.

Hospital(g) employeesAny shallother immediatelyperson may make a report allof allegationspatient abuse to the hospitalDepartment administratorif accordingthat toperson thehas HB5492reasonable -cause 8to -believe LRB095that 15957a DRJpatient 41967has bbeen facility’sabused procedures.in the hospital.

All(h) reportsThe fromreport hospitalsrequired tounder thethis DepartmentSection mustshall beinclude: made by telephone and in writing.

No hospital administrator, agent, or employee, nor any other person, may screen reports or otherwise withhold reports from the Department,name andof no hospital shall establish criteria, guidelines, rules, procedures, or policies that alter or unreasonably delay reports to the Department.patient;

Thethe Departmentname shalland investigateaddress every allegation of abusethe orhospital neglecttreating of a vulnerable adult received by the Department.patient;

Underthe noage circumstances may a hospital’s internal review of an allegation of abuse or neglect of a vulnerable adult under subsection (e) replace an investigation of the allegationpatient; by the Department.

(e)the Innature everyof event the hospitalpatient’s must,condition, uponincluding receipt of any allegation,evidence promptlyof conductprevious aninjuries internalor reviewdisabilities; to ensure the alleged victim’s safety.

Measuresand toany protectother aninformation allegedthat victimthe shallreporter bebelieves takenmight asbe deemedhelpful necessaryin byestablishing the facility’scause administratorof andthe mayreported include,abuse butand arethe notidentity limitedof to,the removingperson suspectedbelieved violatorsto fromhave furthercaused patient contact during the internalabuse. review.

All(i) internalAny reviewsindividual, areperson, toinstitution, beor conductedagency byparticipating in good faith in the making of a designatedreport hospitalunder employeethis Section, or agentin whothe isinvestigation qualifiedof tosuch detecta report or in making a disclosure of information concerning reports of abuse andunder neglectthis andSection, isshall nothave involvedimmunity infrom theany allegedliability, victim’swhether treatment.civil, professional, or criminal, that otherwise might result by reason of such actions.

AllFor internalthe reviewpurpose findingsof mustany beproceedings, documentedwhether andcivil, filedprofessional, accordingor tocriminal, facilitythe proceduresgood andfaith shallof beany madepersons availablerequired to thereport Department.cases of suspected abuse under this Section or who disclose information concerning HB5492 Engrossed - 10 - LRB095 15957 DRJ 41967 b reports of abuse in compliance with this Section, shall be presumed.

All(j) internalNo reviewadministrator, files,agent, includingor informationemployee regarding the disposition of eacha HB5492hospital - 9 - LRB095 15957 DRJ 41967 b report, shall alsoadopt beor madeemploy available,practices subjector toprocedures confidentialitydesigned requirements, to thediscourage Illinoisgood Guardianshipfaith andreporting Advocacy Commission and any other agency or legal representative in the course of monitoringpatient orabuse investigatingunder rightsthis protectionsSection. for recipients of services.

(f)(k) Every hospital shall regularlyensure trainthat all new and existing employees are trained in the detection and reporting of abuse of patients and neglectretrained ofat vulnerableleast adults.every 2 years thereafter.

(g)(l) RetaliationThe inDepartment anyshall forminvestigate againsteach areport personof whopatient lawfullyabuse andmade inunder goodthis faithSection makesaccording to the procedures of the Department, except that a report of abuse orwhich neglectindicates tothat a hospitalpatient’s administratorlife or tosafety theis Departmentin isimminent prohibited.danger shall be investigated within 24 hours of such report.

(h)Under Theno provisionscircumstances ofmay thisa Sectionhospital’s dointernal notreview relieveof anyan hospitalallegation administrator,of agent,abuse orreplace employeean frominvestigation makingof contactthe withallegation appropriate law enforcement authorities as required by law.the Department.

(m) The Department shall keep a continuing record of all reports made pursuant to this Section, including indications of the final determination of any investigation and the final disposition of all reports.

The Department shall inform the investigated hospital and any other person making a report under subsection (g) of its final determination or disposition in writing.

(n) The Department shall not disclose to the public any information regarding any reports and investigations under HB5492 Engrossed - 11 - LRB095 15957 DRJ 41967 b this Section unless and until the report of abuse is substantiated following a full and proper investigation.

(o) All patient identifiable information in any report or investigation under this Section shall be confidential and shall not be disclosed except as authorized by this Act or other applicable law.

(p) Nothing in this Section relieves a hospital administrator, employee, agent, or medical staff member from contacting appropriate law enforcement authorities as required by law.

(q) Nothing in this Section shall be construed to mean that a patient is a victim of abuse because of health care services provided or not provided by health care professionals.

(r) Nothing in this Section shall require a hospital, including its employees, agents, and medical staff members, to provide any services to a patient in contravention of his or her stated or implied objection thereto upon grounds that such services conflict with his or her religious beliefs or practices, nor shall such a patient be considered abused under this Section for the exercise of such beliefs or practices.

(s) As used in this Section, the following terms have the following meanings:

"Abuse" means any physical or mental injury or sexual abuse intentionally inflicted by a hospital employee, agent, or medical staff member on a patient of the hospital and does not include any hospital, medical, health care, or other personal HB5492 Engrossed - 12 - LRB095 15957 DRJ 41967 b care services done in good faith in the interest of the patient according to established medical and clinical standards of care.

"Mental injury" means intentionally caused emotional distress in a patient from words or gestures that would be considered by a reasonable person to be humiliating, harassing, or threatening and which causes observable and substantial impairment.

"Sexual abuse" means any intentional act of sexual contact or sexual penetration of a patient in the hospital.

"Substantiated", with respect to a report of abuse, means that a preponderance of the evidence indicates that abuse occurred.

(t) Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this Section.

If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this Section, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and the Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly’s discretion.

Nothing in this Section shall be interpreted to grant rulemaking authority under any other HB5492 Engrossed - 13 - LRB095 15957 DRJ 41967 b Illinois statute where such authority is not otherwise explicitly given.

For the purposes of this Section, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies and agency heads under the jurisdiction of the Governor.