HB 4643

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Full Text of HB4643
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	HB4643 - 104th General Assembly
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			House Amendment 001
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		HB4643 Enrolled		LRB104 17702 KTG 31133 b
1    AN ACT concerning State government.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Department of Human Services Act is amended
5by changing Section 1-17 as follows:
6    (20 ILCS 1305/1-17)
7    Sec. 1-17. Inspector General.
8    (a) Nature and purpose. It is the express intent of the
9General Assembly to ensure the health, safety, and financial
10condition of individuals receiving services in this State due
11to mental illness, developmental disability, or both by
12protecting those persons from acts of abuse, neglect, or both
13by service providers. To that end, the Office of the Inspector
14General for the Department of Human Services is created to
15investigate and report upon allegations of the abuse, neglect,
16or financial exploitation of individuals receiving services
17within mental health facilities, developmental disabilities
18facilities, and community agencies operated, licensed, funded,
19or certified by the Department of Human Services, but not
20licensed or certified by any other State agency.
21    (b) Definitions. The following definitions apply to this
22Section:
23    "Agency" or "community agency" means (i) a community
		HB4643 Enrolled	- 2 -	LRB104 17702 KTG 31133 b
1agency licensed, funded, or certified by the Department, but
2not licensed or certified by any other human services agency
3of the State, to provide mental health service or
4developmental disabilities service, or (ii) a program
5licensed, funded, or certified by the Department, but not
6licensed or certified by any other human services agency of
7the State, to provide mental health service or developmental
8disabilities service.
9    "Aggravating circumstance" means a factor that is
10attendant to a finding and that tends to compound or increase
11the culpability of the accused.
12    "Allegation" means an assertion, complaint, suspicion, or
13incident involving any of the following conduct by an
14employee, facility, or agency against an individual or
15individuals: mental abuse, physical abuse, sexual abuse,
16neglect, financial exploitation, or material obstruction of an
17investigation.
18    "Day" means working day, unless otherwise specified.
19    "Deflection" means a situation in which an individual is
20presented for admission to a facility or agency, and the
21facility staff or agency staff do not admit the individual.
22"Deflection" includes triage, redirection, and denial of
23admission.
24    "Department" means the Department of Human Services.
25    "Developmental disability" means "developmental
26disability" as defined in the Mental Health and Developmental
		HB4643 Enrolled	- 3 -	LRB104 17702 KTG 31133 b
1Disabilities Code.
2    "Egregious neglect" means a finding of neglect as
3determined by the Inspector General that (i) represents a
4gross failure to adequately provide for, or a callous [callused]
5indifference to, the health, safety, or medical needs of an
6individual and (ii) results in an individual's death or other
7serious deterioration of an individual's physical condition or
8mental condition.
9    "Employee" means any person who provides services at the
10facility or agency on-site or off-site. The service
11relationship can be with the individual or with the facility
12or agency. Also, "employee" includes any employee or
13contractual agent of the Department of Human Services or the
14community agency involved in providing or monitoring or
15administering mental health or developmental disability
16services. This includes but is not limited to: owners,
17operators, payroll personnel, contractors, subcontractors, and
18volunteers.
19    "Facility" or "State-operated facility" means a mental
20health facility or developmental disabilities facility
21operated by the Department.
22    "Financial exploitation" means taking unjust advantage of
23an individual's assets, property, or financial resources
24through deception, intimidation, or conversion for the
25employee's, facility's, or agency's own advantage or benefit.
26    "Finding" means the Office of Inspector General's
		HB4643 Enrolled	- 4 -	LRB104 17702 KTG 31133 b
1determination regarding whether an allegation is
2substantiated, unsubstantiated, or unfounded.
3    "Health Care Worker Registry" or "Registry" means the
4Health Care Worker Registry under the Health Care Worker
5Background Check Act.
6    "Individual" means any person receiving mental health
7service, developmental disabilities service, or both from a
8facility or agency, while either on-site or off-site.
9    "Material obstruction of an investigation" means the
10intentional failure to timely report an allegation to the 
11hotline or the [purposeful] interference with an investigation
12of physical abuse, sexual abuse, mental abuse, neglect, or
13financial exploitation for the purpose of obstructing an 
14Office of the Inspector General investigation. This may 
15include [and includes], but is not limited to, delaying or 
16withholding reports of allegations to the hotline for the 
17purpose of obstructing an Office of the Inspector General 
18investigation; the withholding or altering of documentation or
19recorded evidence during an investigation; influencing,
20threatening, or impeding a victim's, complainant's, or 
21required reporter's report of an allegation to the hotline or
22witness testimony during an investigation; presenting
23untruthful information to the hotline or during an
24investigatory interview; or failing to cooperate with an
25investigation conducted by the Office of the Inspector
26General. Violation of paragraph (2) of subsection (i) may also 
		HB4643 Enrolled	- 5 -	LRB104 17702 KTG 31133 b
1result in a finding of material obstruction of an 
2investigation. If an employee, following a criminal
3investigation of physical abuse, sexual abuse, mental abuse,
4neglect, or financial exploitation, is convicted of an offense
5that is factually predicated on the employee presenting
6untruthful information during the course of the investigation,
7that offense constitutes obstruction of an investigation.
8Obstruction of an investigation does not include: an
9employee's lawful exercising of his or her constitutional
10right against self-incrimination, an employee invoking his or
11her lawful rights to union representation as provided by a
12collective bargaining agreement or the Illinois Public Labor
13Relations Act, or a union representative's lawful activities
14providing representation under a collective bargaining
15agreement or the Illinois Public Labor Relations Act.
16Obstruction of an investigation is considered material when it
17could significantly impair the Office of the Inspector 
18General's [an investigator's] ability to gather all relevant
19facts. An employee shall not be placed on the Health Care
20Worker Registry for presenting untruthful information during
21an interview conducted by the Office of the Inspector General,
22unless, prior to the interview, the employee was provided with
23any previous signed statements he or she made during the
24course of the investigation.
25    "Mental abuse" means the use of demeaning, intimidating,
26or threatening words, signs, gestures, or other actions by an
		HB4643 Enrolled	- 6 -	LRB104 17702 KTG 31133 b
1employee about an individual and in the presence of an
2individual or individuals that results in emotional distress
3or maladaptive behavior, or could have resulted in emotional
4distress or maladaptive behavior, for any individual present.
5    "Mental illness" means "mental illness" as defined in the
6Mental Health and Developmental Disabilities Code.
7    "Mentally ill" means having a mental illness.
8    "Mitigating circumstance" means a condition that (i) is
9attendant to a finding, (ii) does not excuse or justify the
10conduct in question, but (iii) may be considered in evaluating
11the severity of the conduct, the culpability of the accused,
12or both the severity of the conduct and the culpability of the
13accused.
14    "Neglect" means an employee's, agency's, or facility's
15failure to provide adequate medical care, personal care, or
16maintenance and that, as a consequence, (i) causes an
17individual pain, injury, or emotional distress, (ii) results
18in either an individual's maladaptive behavior or the
19deterioration of an individual's physical condition or mental
20condition, or (iii) places the individual's health or safety
21at substantial risk.
22    "Person with a developmental disability" means a person
23having a developmental disability.
24    "Physical abuse" means an employee's non-accidental and
25inappropriate contact with an individual that causes bodily
26harm. "Physical abuse" includes actions that cause bodily harm
		HB4643 Enrolled	- 7 -	LRB104 17702 KTG 31133 b
1as a result of an employee directing an individual or person to
2physically abuse another individual.
3    "Presenting untruthful information" means making a false
4statement, material to the report of an allegation to the 
5hotline or during an investigation of physical abuse, sexual
6abuse, mental abuse, neglect, or financial exploitation,
7knowing the statement is false.
8    "Recommendation" means an admonition, separate from a
9finding, that requires action by the facility, agency, or
10Department to correct a systemic issue, problem, or deficiency
11identified during an investigation. "Recommendation" can also
12mean an admonition to correct a systemic issue, problem or
13deficiency during a review.
14    "Required reporter" means any employee who suspects,
15witnesses, or is informed of an allegation of any one or more
16of the following: mental abuse, physical abuse, sexual abuse,
17neglect, or financial exploitation.
18    "Secretary" means the Chief Administrative Officer of the
19Department.
20    "Sexual abuse" means any sexual contact or intimate
21physical contact between an employee and an individual,
22including an employee's coercion or encouragement of an
23individual to engage in sexual behavior that results in sexual
24contact, intimate physical contact, sexual behavior, or
25intimate physical behavior. Sexual abuse also includes (i) an
26employee's actions that result in the sending or showing of
		HB4643 Enrolled	- 8 -	LRB104 17702 KTG 31133 b
1sexually explicit images to an individual via computer,
2cellular phone, electronic mail, portable electronic device,
3or other media with or without contact with the individual or
4(ii) an employee's posting of sexually explicit images of an
5individual online or elsewhere whether or not there is contact
6with the individual.
7    "Sexually explicit images" includes, but is not limited
8to, any material which depicts nudity, sexual conduct, or
9sado-masochistic abuse, or which contains explicit and
10detailed verbal descriptions or narrative accounts of sexual
11excitement, sexual conduct, or sado-masochistic abuse.
12    "Substantiated" means there is a preponderance of the
13evidence to support the allegation.
14    "Unfounded" means there is no credible evidence to support
15the allegation.
16    "Unsubstantiated" means there is credible evidence, but
17less than a preponderance of evidence to support the
18allegation.
19    (c) Appointment. The Governor shall appoint, and the
20Senate shall confirm, an Inspector General. The Inspector
21General shall be appointed for a term of 4 years and shall
22function within the Department of Human Services and report to
23the Secretary and the Governor.
24    (d) Operation and appropriation. The Inspector General
25shall function independently within the Department with
26respect to the operations of the Office, including the
		HB4643 Enrolled	- 9 -	LRB104 17702 KTG 31133 b
1performance of investigations and issuance of findings and
2recommendations and the performance of site visits and reviews
3of facilities and community agencies. The appropriation for
4the Office of Inspector General shall be separate from the
5overall appropriation for the Department.
6    (e) Powers and duties. The Inspector General shall
7investigate reports of suspected mental abuse, physical abuse,
8sexual abuse, neglect, or financial exploitation of
9individuals in any mental health or developmental disabilities
10facility or agency and shall have authority to take immediate
11action to prevent any one or more of the following from
12happening to individuals under its jurisdiction: mental abuse,
13physical abuse, sexual abuse, neglect, or financial
14exploitation. The Inspector General shall also investigate
15allegations of material obstruction of an investigation by an
16employee. Upon written request of an agency of this State, the
17Inspector General may assist another agency of the State in
18investigating reports of the abuse, neglect, or abuse and
19neglect of persons with mental illness, persons with
20developmental disabilities, or persons with both. The
21Inspector General shall conduct annual site visits of each
22facility and may conduct reviews of facilities and community
23agencies. To comply with the requirements of subsection (k) of
24this Section, the Inspector General shall also review all
25reportable deaths for which there is no allegation of abuse or
26neglect. Nothing in this Section shall preempt any duties of
		HB4643 Enrolled	- 10 -	LRB104 17702 KTG 31133 b
1the Medical Review Board set forth in the Mental Health and
2Developmental Disabilities Code. The Inspector General shall
3have no authority to investigate alleged violations of the
4State Officials and Employees Ethics Act. Allegations of
5misconduct under the State Officials and Employees Ethics Act
6shall be referred to the Office of the Governor's Executive
7Inspector General for investigation.
8    (f) Limitations. The Inspector General shall not conduct
9an investigation within an agency or facility if that
10investigation would be redundant to or interfere with an
11investigation conducted by another State agency. The Inspector
12General shall have no supervision over, or involvement in, the
13routine programmatic, licensing, funding, or certification
14operations of the Department. Nothing in this subsection
15limits investigations by the Department that may otherwise be
16required by law or that may be necessary in the Department's
17capacity as central administrative authority responsible for
18the operation of the State's mental health and developmental
19disabilities facilities.
20    (g) Rulemaking authority. The Inspector General shall
21promulgate rules establishing minimum requirements for
22reporting allegations as well as for initiating, conducting,
23and completing investigations based upon the nature of the
24allegation or allegations. The rules shall clearly establish
25that if 2 or more State agencies could investigate an
26allegation, the Inspector General shall not conduct an
		HB4643 Enrolled	- 11 -	LRB104 17702 KTG 31133 b
1investigation that would be redundant to, or interfere with,
2an investigation conducted by another State agency. The rules
3shall further clarify the method and circumstances under which
4the Office of Inspector General may interact with the
5licensing, funding, or certification units of the Department
6in preventing further occurrences of mental abuse, physical
7abuse, sexual abuse, neglect, egregious neglect, financial
8exploitation, and material obstruction of an investigation.
9    (g-5) Site visits and review authority.
10        (1) Site visits. The Inspector General shall conduct
11    unannounced site visits to each facility at least annually
12    for the purpose of reviewing and making recommendations on
13    systemic issues relative to preventing, reporting,
14    investigating, and responding to all of the following:
15    mental abuse, physical abuse, sexual abuse, neglect,
16    egregious neglect, financial exploitation, or material
17    obstruction of an investigation.
18        (2) Review authority. In response to complaints or
19    information gathered from investigations, the Inspector
20    General shall have and may exercise the authority to
21    initiate reviews of facilities and agencies related to
22    preventing, reporting, investigating, and responding to
23    all of the following: mental abuse, physical abuse, sexual
24    abuse, neglect, egregious neglect, financial exploitation,
25    or material obstruction of an investigation. Upon
26    concluding a review, the Inspector General shall issue a
		HB4643 Enrolled	- 12 -	LRB104 17702 KTG 31133 b
1    written report setting forth its conclusions and
2    recommendations. The report shall be distributed to the
3    Secretary and to the director of the facility or agency
4    that was the subject of review. Within 45 calendar days,
5    the facility or agency shall submit a written response
6    addressing the Inspector General's conclusions and
7    recommendations and, in a concise and reasoned manner, the
8    actions taken, if applicable, to: (i) protect the
9    individual or individuals; (ii) prevent recurrences; and
10    (iii) eliminate the problems identified. The response
11    shall include the implementation and completion dates of
12    such actions.
13    (h) Training programs. The Inspector General shall (i)
14establish a comprehensive program to ensure that every person
15authorized to conduct investigations receives ongoing training
16relative to investigation techniques, communication skills,
17and the appropriate means of interacting with persons
18receiving treatment for mental illness, developmental
19disability, or both mental illness and developmental
20disability, and (ii) establish and conduct periodic training
21programs for facility and agency employees concerning the
22prevention and reporting of any one or more of the following:
23mental abuse, physical abuse, sexual abuse, neglect, egregious
24neglect, financial exploitation, or material obstruction of an
25investigation. The Inspector General shall further ensure (i)
26every person authorized to conduct investigations at community
		HB4643 Enrolled	- 13 -	LRB104 17702 KTG 31133 b
1agencies receives ongoing training in Title 59, Parts 115,
2116, and 119 of the Illinois Administrative Code, and (ii)
3every person authorized to conduct investigations shall
4receive ongoing training in Title 59, Part 50 of the Illinois
5Administrative Code. Nothing in this Section shall be deemed
6to prevent the Office of Inspector General from conducting any
7other training as determined by the Inspector General to be
8necessary or helpful.
9    (i) Duty to cooperate.
10        (1) The Inspector General shall at all times be
11    granted access to any facility or agency for the purpose
12    of investigating any allegation, conducting unannounced
13    site visits, monitoring compliance with a written
14    response, conducting reviews of facilities and agencies,
15    or completing any other statutorily assigned duty.
16        (2) Any employee who fails to cooperate with an Office
17    of the Inspector General investigation is in violation of
18    this Act. Failure to cooperate with an investigation
19    includes, but is not limited to, any one or more of the
20    following: (i) creating and transmitting a false report to
21    the Office of the Inspector General hotline, (ii)
22    providing false information to an Office of the Inspector
23    General Investigator during an investigation, (iii)
24    colluding with other employees to cover up evidence, (iv)
25    colluding with other employees to provide false
26    information to the [an] Office of the Inspector General
		HB4643 Enrolled	- 14 -	LRB104 17702 KTG 31133 b
1    hotline or an investigator, (v) destroying evidence, (vi)
2    withholding evidence, (vii) influencing, threatening, or 
3    impeding a victim's, complainant's, or required reporter's 
4    report of an allegation to the hotline or witness 
5    testimony during an investigation, or (viii) [(vii)]
6    otherwise obstructing a report to the [an] Office of the
7    Inspector General hotline or investigation. Additionally,
8    any employee who, during an unannounced site visit,
9    written response compliance check, or review fails to
10    cooperate with requests from the Office of the Inspector
11    General is in violation of this Act.
12    (j) Subpoena powers. The Inspector General shall have the
13power to subpoena witnesses and compel the production of all
14documents and physical evidence relating to his or her
15investigations and reviews and any hearings authorized by this
16Act. This subpoena power shall not extend to persons or
17documents of a labor organization or its representatives
18insofar as the persons are acting in a representative capacity
19to an employee whose conduct is the subject of an
20investigation or the documents relate to that representation.
21Any person who otherwise fails to respond to a subpoena or who
22knowingly provides false information to the Office of the
23Inspector General by subpoena during an investigation is
24guilty of a Class A misdemeanor.
25    (k) Reporting allegations and deaths.
26        (1) Allegations. If an employee witnesses, is told of,
		HB4643 Enrolled	- 15 -	LRB104 17702 KTG 31133 b
1    or has reason to believe an incident of mental abuse,
2    physical abuse, sexual abuse, neglect, financial
3    exploitation, or material obstruction of an investigation
4    has occurred, the employee, agency, or facility shall
5    report the allegation by phone to the Office of the
6    Inspector General hotline according to the agency's or
7    facility's procedures, but in no event later than 4 hours
8    after the initial discovery of the incident, allegation,
9    or suspicion of any one or more of the following: mental
10    abuse, physical abuse, sexual abuse, neglect, financial
11    exploitation, or material obstruction of an investigation.
12    A required reporter as defined in subsection (b) of this
13    Section who knowingly or intentionally fails to comply
14    with these reporting requirements or who knowingly or 
15    intentionally delays or withholds reports of allegations 
16    for the purpose of obstructing an investigation is guilty
17    of a Class A misdemeanor.
18        (2) Deaths. Absent an allegation, a required reporter
19    shall, within 24 hours after initial discovery, report by
20    phone to the Office of the Inspector General hotline each
21    of the following:
22            (i) Any death of an individual occurring within 14
23        calendar days after discharge or transfer of the
24        individual from a residential program or facility.
25            (ii) Any death of an individual occurring within
26        24 hours after deflection from a residential program
		HB4643 Enrolled	- 16 -	LRB104 17702 KTG 31133 b
1        or facility.
2            (iii) Any other death of an individual occurring
3        at an agency or facility or at any Department-funded
4        site.
5        (3) Retaliation. It is a violation of this Act for any
6    employee or administrator of an agency or facility to take
7    retaliatory action against an employee who acts in good
8    faith in conformance with his or her duties as a required
9    reporter.
10    (l) Reporting to law enforcement. Reporting criminal acts.
11Within 24 hours after determining that there is credible
12evidence indicating that a criminal act may have been
13committed or that special expertise may be required in an
14investigation, the Inspector General shall notify the Illinois
15State Police or other appropriate law enforcement authority,
16or ensure that such notification is made. The Illinois State
17Police shall investigate any report from a State-operated
18facility indicating a possible murder, sexual assault, or
19other felony by an employee. All investigations conducted by
20the Inspector General shall be conducted in a manner designed
21to ensure the preservation of evidence for possible use in a
22criminal prosecution.
23    (m) Investigative reports. Upon completion of an
24investigation, the Office of Inspector General shall issue an
25investigative report identifying whether the allegations are
26substantiated, unsubstantiated, or unfounded. Within 10
		HB4643 Enrolled	- 17 -	LRB104 17702 KTG 31133 b
1business days after the transmittal of a completed
2investigative report substantiating an allegation, finding an
3allegation is unsubstantiated, or if a recommendation is made,
4the Inspector General shall provide the investigative report
5on the case to the Secretary and to the director of the
6facility or agency where any one or more of the following
7occurred: mental abuse, physical abuse, sexual abuse, neglect,
8egregious neglect, financial exploitation, or material
9obstruction of an investigation. The director of the facility
10or agency shall be responsible for maintaining the
11confidentiality of the investigative report consistent with
12State and federal law. In a substantiated case, the
13investigative report shall include any mitigating or
14aggravating circumstances that were identified during the
15investigation. If the case involves substantiated neglect, the
16investigative report shall also state whether egregious
17neglect was found. An investigative report may also set forth
18recommendations. All investigative reports prepared by the
19Office of the Inspector General shall be considered
20confidential and shall not be released except as provided by
21the law of this State or as required under applicable federal
22law. Unsubstantiated and unfounded reports shall not be
23disclosed except as allowed under Section 6 of the Abused and
24Neglected Long Term Care Facility Residents Reporting Act. Raw
25data used to compile the investigative report shall not be
26subject to release unless required by law or a court order.
		HB4643 Enrolled	- 18 -	LRB104 17702 KTG 31133 b
1"Raw data used to compile the investigative report" includes,
2but is not limited to, any one or more of the following: the
3initial complaint, witness statements, photographs,
4investigator's notes, police reports, or incident reports. If
5the allegations are substantiated, the victim, the victim's
6guardian, and the accused shall be provided with a redacted
7copy of the investigative report. Death reports where there
8was no allegation of abuse or neglect shall only be released to
9the Secretary, or the Secretary's designee, and to the
10director of the facility or agency when a recommendation is
11made and pursuant to applicable State or federal law or a valid
12court order. Unredacted investigative reports, as well as raw
13data, may be shared with a local law enforcement entity, a
14State's Attorney's office, or a county coroner's office upon
15written request. Unredacted investigative reports, as well as
16raw data, may be shared with the Department of Financial and
17Professional Regulation when there is a substantiated finding
18against a person licensed by the Department of Financial and
19Professional Regulation who is within the Office of the
20Inspector General's jurisdiction, upon written request. If,
21during its investigation, the Office of the Inspector General
22found credible evidence of neglect by a person licensed by the
23Department of Financial and Professional Regulation who is not
24within the Office's jurisdiction, the Office may provide an
25unfounded or unsubstantiated investigative report or death
26report, as well as raw data, with the Department of Financial
		HB4643 Enrolled	- 19 -	LRB104 17702 KTG 31133 b
1and Professional Regulation, upon written request.
2    (n) Written responses, clarification requests, and
3reconsideration requests.
4        (1) Written responses. Within 30 calendar days from
5    receipt of a substantiated investigative report or an
6    investigative report which contains recommendations,
7    absent a reconsideration request, the facility or agency
8    shall file a written response that addresses, in a concise
9    and reasoned manner, the actions taken to: (i) protect the
10    individual; (ii) prevent recurrences; and (iii) eliminate
11    the problems identified. The response shall include the
12    implementation and completion dates of such actions. If
13    the written response is not filed within the allotted 30
14    calendar day period, the Secretary, or the Secretary's
15    designee, shall determine the appropriate corrective
16    action to be taken.
17        (2) Requests for clarification. The facility, agency,
18    victim or guardian, or the subject employee may request
19    that the Office of Inspector General clarify the finding
20    or findings for which clarification is sought.
21        (3) Requests for reconsideration. The facility,
22    agency, victim or guardian, or the subject employee may
23    request that the Office of the Inspector General
24    reconsider the finding or findings or the recommendations.
25    A request for reconsideration shall be subject to a
26    multi-layer review and shall include at least one reviewer
		HB4643 Enrolled	- 20 -	LRB104 17702 KTG 31133 b
1    who did not participate in the investigation or approval
2    of the original investigative report. After the
3    multi-layer review process has been completed, the
4    Inspector General shall make the final determination on
5    the reconsideration request. The investigation shall be
6    reopened if the reconsideration determination finds that
7    additional information is needed to complete the
8    investigative record.
9    (o) Disclosure of the finding by the Inspector General.
10The Inspector General shall disclose the finding of an
11investigation to the following persons: (i) the Governor, (ii)
12the Secretary, (iii) the director of the facility or agency,
13(iv) the alleged victims and their guardians, (v) the
14complainant, and (vi) the accused. This information shall
15include whether the allegations were deemed substantiated,
16unsubstantiated, or unfounded.
17    (p) Secretary review. Upon review of the Inspector
18General's investigative report and any agency's or facility's
19written response, the Secretary, or the Secretary's designee,
20shall accept or reject the written response and notify the
21Inspector General of that determination. The Secretary, or the
22Secretary's designee, may further direct that other
23administrative action be taken, including, but not limited to,
24any one or more of the following: (i) additional site visits,
25(ii) training, (iii) provision of technical assistance
26relative to administrative needs, licensure, or certification,
		HB4643 Enrolled	- 21 -	LRB104 17702 KTG 31133 b
1or (iv) the imposition of appropriate sanctions.
2    (q) Action by facility or agency. Within 30 days of the
3date the Secretary, or the Secretary's designee, approves the
4written response or directs that further administrative action
5be taken, the facility or agency shall provide an
6implementation report to the Inspector General that provides
7the status of the action taken. The facility or agency shall be
8allowed an additional 30 days to send notice of completion of
9the action or to send an updated implementation report. If the
10action has not been completed within the additional 30-day
11period, the facility or agency shall send updated
12implementation reports every 60 days until completion. The
13Inspector General shall conduct a review of any implementation
14plan that takes more than 120 days after approval to complete,
15and shall monitor compliance through a random review of
16approved written responses, which may include, but are not
17limited to: (i) site visits, (ii) telephone contact, and (iii)
18requests for additional documentation evidencing compliance.
19    (r) Sanctions. Sanctions, if imposed by the Secretary
20under Subdivision (p)(iv) of this Section, shall be designed
21to prevent further acts of mental abuse, physical abuse,
22sexual abuse, neglect, egregious neglect, or financial
23exploitation or some combination of one or more of those acts
24at a facility or agency, and may include any one or more of the
25following:
26        (1) Appointment of on-site monitors.
		HB4643 Enrolled	- 22 -	LRB104 17702 KTG 31133 b
1        (2) Transfer or relocation of an individual or
2    individuals.
3        (3) Closure of units.
4        (4) Termination of any one or more of the following:
5    (i) Department licensing, (ii) funding, or (iii)
6    certification.
7    The Inspector General may seek the assistance of the
8Illinois Attorney General or the office of any State's
9Attorney in implementing sanctions.
10    (s) Health Care Worker Registry.
11        (1) Reporting to the Registry. The Inspector General
12    shall report to the Department of Public Health's Health
13    Care Worker Registry, a public registry, the identity and
14    finding of each employee of a facility or agency against
15    whom there is a final investigative report prepared by the
16    Office of the Inspector General containing a substantiated
17    allegation of physical or sexual abuse, financial
18    exploitation, egregious neglect of an individual, or
19    material obstruction of an investigation, unless the
20    Inspector General requests a stipulated disposition of the
21    investigative report that does not include the reporting
22    of the employee's name to the Health Care Worker Registry
23    and the Secretary of Human Services agrees with the
24    requested stipulated disposition.
25        (2) Notice to employee. Prior to reporting the name of
26    an employee, the employee shall be notified of the
		HB4643 Enrolled	- 23 -	LRB104 17702 KTG 31133 b
1    Department's obligation to report and shall be granted an
2    opportunity to request an administrative hearing, the sole
3    purpose of which is to determine if the substantiated
4    finding warrants reporting to the Registry. Notice to the
5    employee shall contain a clear and concise statement of
6    the grounds on which the report to the Registry is based,
7    offer the employee an opportunity for a hearing, and
8    identify the process for requesting such a hearing. Notice
9    is sufficient if provided by certified mail to the
10    employee's last known address. If the employee fails to
11    request a hearing within 30 days from the date of the
12    notice, the Inspector General shall report the name of the
13    employee to the Registry. Nothing in this subdivision
14    (s)(2) shall diminish or impair the rights of a person who
15    is a member of a collective bargaining unit under the
16    Illinois Public Labor Relations Act or under any other
17    federal labor statute.
18        (3) Registry hearings. If the employee requests an
19    administrative hearing, the employee shall be granted an
20    opportunity to appear before an administrative law judge
21    to present reasons why the employee's name should not be
22    reported to the Registry. The Department shall bear the
23    burden of presenting evidence that establishes, by a
24    preponderance of the evidence, that the substantiated
25    finding warrants reporting to the Registry. After
26    considering all the evidence presented, the administrative
		HB4643 Enrolled	- 24 -	LRB104 17702 KTG 31133 b
1    law judge shall make a recommendation to the Secretary as
2    to whether the substantiated finding warrants reporting
3    the name of the employee to the Registry. The Secretary
4    shall render the final decision. The Department and the
5    employee shall have the right to request that the
6    administrative law judge consider a stipulated disposition
7    of these proceedings.
8        (4) Testimony at Registry hearings. A person who makes
9    a report or who investigates a report under this Act shall
10    testify fully in any judicial proceeding resulting from
11    such a report, as to any evidence of physical abuse,
12    sexual abuse, egregious neglect, financial exploitation,
13    or material obstruction of an investigation, or the cause
14    thereof. No evidence shall be excluded by reason of any
15    common law or statutory privilege relating to
16    communications between the alleged perpetrator of abuse or
17    neglect, or the individual alleged as the victim in the
18    report, and the person making or investigating the report.
19    Testimony at hearings is exempt from the confidentiality
20    requirements of subsection (f) of Section 10 of the Mental
21    Health and Developmental Disabilities Confidentiality Act.
22        (5) Employee's rights to collateral action. No
23    reporting to the Registry shall occur and no hearing shall
24    be set or proceed if an employee notifies the Inspector
25    General in writing, including any supporting
26    documentation, that he or she is formally contesting an
		HB4643 Enrolled	- 25 -	LRB104 17702 KTG 31133 b
1    adverse employment action resulting from a substantiated
2    finding by complaint filed with the Illinois Civil Service
3    Commission, or which otherwise seeks to enforce the
4    employee's rights pursuant to any applicable collective
5    bargaining agreement. If an action taken by an employer
6    against an employee as a result of a finding of physical
7    abuse, sexual abuse, egregious neglect, financial
8    exploitation, or material obstruction of an investigation
9    is overturned through an action filed with the Illinois
10    Civil Service Commission or under any applicable
11    collective bargaining agreement and if that employee's
12    name has already been sent to the Registry, the employee's
13    name shall be removed from the Registry.
14        (6) Removal from Registry. At any time after the
15    report to the Registry, but no more than once in any
16    12-month period, an employee may petition the Department
17    in writing to remove his or her name from the Registry.
18    Upon receiving notice of such request, the Inspector
19    General shall conduct an investigation into the petition.
20    Upon receipt of such request, an administrative hearing
21    will be set by the Department. At the hearing, the
22    employee shall bear the burden of presenting evidence that
23    establishes, by a preponderance of the evidence, that
24    removal of the name from the Registry is in the public
25    interest. The parties may jointly request that the
26    administrative law judge consider a stipulated disposition
		HB4643 Enrolled	- 26 -	LRB104 17702 KTG 31133 b
1    of these proceedings.
2    (t) Review of Administrative Decisions. The Department
3shall preserve a record of all proceedings at any formal
4hearing conducted by the Department involving Health Care
5Worker Registry hearings. Final administrative decisions of
6the Department are subject to judicial review pursuant to
7provisions of the Administrative Review Law.
8    (u) Quality Care Board. There is created, within the
9Office of the Inspector General, a Quality Care Board to be
10composed of 7 members appointed by the Governor with the
11advice and consent of the Senate. One of the members shall be
12designated as chairman by the Governor. Of the initial
13appointments made by the Governor, 4 Board members shall each
14be appointed for a term of 4 years and 3 members shall each be
15appointed for a term of 2 years. Upon the expiration of each
16member's term, a successor shall be appointed for a term of 4
17years. In the case of a vacancy in the office of any member,
18the Governor shall appoint a successor for the remainder of
19the unexpired term.
20    Members appointed by the Governor shall be qualified by
21professional knowledge or experience in the area of law,
22investigatory techniques, or in the area of care of the
23mentally ill or care of persons with developmental
24disabilities. Two members appointed by the Governor shall be
25persons with a disability or parents of persons with a
26disability. Members shall serve without compensation, but
		HB4643 Enrolled	- 27 -	LRB104 17702 KTG 31133 b
1shall be reimbursed for expenses incurred in connection with
2the performance of their duties as members.
3    The Board shall meet quarterly, and may hold other
4meetings on the call of the chairman. Four members shall
5constitute a quorum allowing the Board to conduct its
6business. The Board may adopt rules and regulations it deems
7necessary to govern its own procedures.
8    The Board shall monitor and oversee the operations,
9policies, and procedures of the Inspector General to ensure
10the prompt and thorough investigation of allegations of
11neglect and abuse. In fulfilling these responsibilities, the
12Board may do the following:
13        (1) Provide independent, expert consultation to the
14    Inspector General on policies and protocols for
15    investigations of alleged abuse, neglect, or both abuse
16    and neglect.
17        (2) Review existing regulations relating to the
18    operation of facilities.
19        (3) Advise the Inspector General as to the content of
20    training activities authorized under this Section.
21        (4) Recommend policies concerning methods for
22    improving the intergovernmental relationships between the
23    Office of the Inspector General and other State or federal
24    offices.
25    (v) Annual report. The Inspector General shall provide to
26the General Assembly and the Governor, no later than January 1
		HB4643 Enrolled	- 28 -	LRB104 17702 KTG 31133 b
1of each year, a summary of reports and investigations made
2under this Act for the prior fiscal year with respect to
3individuals receiving mental health or developmental
4disabilities services. The report shall detail the imposition
5of sanctions, if any, and the final disposition of any
6corrective or administrative action directed by the Secretary.
7The summaries shall not contain any confidential or
8identifying information of any individual, but shall include
9objective data identifying any trends in the number of
10reported allegations, the timeliness of the Office of the
11Inspector General's investigations, and their disposition, for
12each facility and Department-wide, for the most recent 3-year
13time period. The report shall also identify, by facility, the
14staff-to-patient ratios taking account of direct care staff
15only. The report shall also include detailed recommended
16administrative actions and matters for consideration by the
17General Assembly.
18    (w) Program audit. The Auditor General shall conduct a
19program audit of the Office of the Inspector General on an
20as-needed basis, as determined by the Auditor General. The
21audit shall specifically include the Inspector General's
22compliance with the Act and effectiveness in investigating
23reports of allegations occurring in any facility or agency.
24The Auditor General shall conduct the program audit according
25to the provisions of the Illinois State Auditing Act and shall
26report its findings to the General Assembly no later than
		HB4643 Enrolled	- 29 -	LRB104 17702 KTG 31133 b
1January 1 following the audit period.
2    (x) Nothing in this Section shall be construed to mean
3that an individual is a victim of abuse or neglect because of
4health care services appropriately provided or not provided by
5health care professionals.
6    (y) Nothing in this Section shall require a facility,
7including its employees, agents, medical staff members, and
8health care professionals, to provide a service to an
9individual in contravention of that individual's stated or
10implied objection to the provision of that service on the
11ground that that service conflicts with the individual's
12religious beliefs or practices, nor shall the failure to
13provide a service to an individual be considered abuse under
14this Section if the individual has objected to the provision
15of that service based on his or her religious beliefs or
16practices.
17(Source: P.A. 103-76, eff. 6-9-23; 103-154, eff. 6-30-23;
18103-752, eff. 1-1-25; 104-270, eff. 8-15-25; revised
1912-12-25.)