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HB4643 - 104th General Assembly

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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,
3
represented in the General Assembly:

4

Section 5.
The Department of Human Services Act is amended
5
by 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
9
General Assembly to ensure the health, safety, and financial
10
condition of individuals receiving services in this State due
11
to mental illness, developmental disability, or both by
12
protecting those persons from acts of abuse, neglect, or both
13
by service providers. To that end, the Office of the Inspector
14
General for the Department of Human Services is created to
15
investigate and report upon allegations of the abuse, neglect,
16
or financial exploitation of individuals receiving services
17
within mental health facilities, developmental disabilities
18
facilities, and community agencies operated, licensed, funded,
19
or certified by the Department of Human Services, but not
20
licensed or certified by any other State agency.
21

(b) Definitions. The following definitions apply to this
22
Section:
23

"Agency" or "community agency" means (i) a community

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
agency licensed, funded, or certified by the Department, but
2
not licensed or certified by any other human services agency
3
of the State, to provide mental health service or
4
developmental disabilities service, or (ii) a program
5
licensed, funded, or certified by the Department, but not
6
licensed or certified by any other human services agency of
7
the State, to provide mental health service or developmental
8
disabilities service.
9

"Aggravating circumstance" means a factor that is
10
attendant to a finding and that tends to compound or increase
11
the culpability of the accused.
12

"Allegation" means an assertion, complaint, suspicion, or
13
incident involving any of the following conduct by an
14
employee, facility, or agency against an individual or
15
individuals: mental abuse, physical abuse, sexual abuse,
16
neglect, financial exploitation, or material obstruction of an
17
investigation.
18

"Day" means working day, unless otherwise specified.
19

"Deflection" means a situation in which an individual is
20
presented for admission to a facility or agency, and the
21
facility staff or agency staff do not admit the individual.
22
"Deflection" includes triage, redirection, and denial of
23
admission.
24

"Department" means the Department of Human Services.
25

"Developmental disability" means "developmental
26
disability" as defined in the Mental Health and Developmental

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
Disabilities Code.
2

"Egregious neglect" means a finding of neglect as
3
determined by the Inspector General that (i) represents a
4
gross failure to adequately provide for, or a
callous

callused

5
indifference to, the health, safety, or medical needs of an
6
individual and (ii) results in an individual's death or other
7
serious deterioration of an individual's physical condition or
8
mental condition.
9

"Employee" means any person who provides services at the
10
facility or agency on-site or off-site. The service
11
relationship can be with the individual or with the facility
12
or agency. Also, "employee" includes any employee or
13
contractual agent of the Department of Human Services or the
14
community agency involved in providing or monitoring or
15
administering mental health or developmental disability
16
services. This includes but is not limited to: owners,
17
operators, payroll personnel, contractors, subcontractors, and
18
volunteers.
19

"Facility" or "State-operated facility" means a mental
20
health facility or developmental disabilities facility
21
operated by the Department.
22

"Financial exploitation" means taking unjust advantage of
23
an individual's assets, property, or financial resources
24
through deception, intimidation, or conversion for the
25
employee's, facility's, or agency's own advantage or benefit.
26

"Finding" means the Office of Inspector General's

HB4643 Enrolled
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1
determination regarding whether an allegation is
2
substantiated, unsubstantiated, or unfounded.
3

"Health Care Worker Registry" or "Registry" means the
4
Health Care Worker Registry under the Health Care Worker
5
Background Check Act.
6

"Individual" means any person receiving mental health
7
service, developmental disabilities service, or both from a
8
facility or agency, while either on-site or off-site.
9

"Material obstruction of an investigation" means the
10
intentional failure to timely report an allegation to the
11
hotline or the

purposeful
interference with an investigation
12
of physical abuse, sexual abuse, mental abuse, neglect, or
13
financial exploitation
for the purpose of obstructing an
14
Office of the Inspector General investigation. This may
15
include

and includes
, but is not limited to,
delaying or
16
withholding reports of allegations to the hotline for the
17
purpose of obstructing an Office of the Inspector General
18
investigation;
the withholding or altering of documentation or
19
recorded evidence
during an investigation
; influencing,
20
threatening, or impeding
a victim's, complainant's, or
21
required reporter's report of an allegation to the hotline or

22
witness testimony
during an investigation
; presenting
23
untruthful information
to the hotline or
during an
24
investigatory
interview;
or
failing to cooperate with an
25
investigation conducted by the Office of the Inspector
26
General.
Violation of paragraph (2) of subsection (i) may also

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
result in a finding of material obstruction of an
2
investigation.
If an employee, following a criminal
3
investigation of physical abuse, sexual abuse, mental abuse,
4
neglect, or financial exploitation, is convicted of an offense
5
that is factually predicated on the employee presenting
6
untruthful information during the course of the investigation,
7
that offense constitutes obstruction of an investigation.
8
Obstruction of an investigation does not include: an
9
employee's lawful exercising of his or her constitutional
10
right against self-incrimination, an employee invoking his or
11
her lawful rights to union representation as provided by a
12
collective bargaining agreement or the Illinois Public Labor
13
Relations Act, or a union representative's lawful activities
14
providing representation under a collective bargaining
15
agreement or the Illinois Public Labor Relations Act.
16
Obstruction of an investigation is considered material when it
17
could significantly impair
the Office of the Inspector
18
General's

an investigator's
ability to gather all relevant
19
facts. An employee shall not be placed on the Health Care
20
Worker Registry for presenting untruthful information during
21
an interview conducted by the Office of the Inspector General,
22
unless, prior to the interview, the employee was provided with
23
any previous signed statements he or she made during the
24
course of the investigation.
25

"Mental abuse" means the use of demeaning, intimidating,
26
or threatening words, signs, gestures, or other actions by an

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
employee about an individual and in the presence of an
2
individual or individuals that results in emotional distress
3
or maladaptive behavior, or could have resulted in emotional
4
distress or maladaptive behavior, for any individual present.
5

"Mental illness" means "mental illness" as defined in the
6
Mental Health and Developmental Disabilities Code.
7

"Mentally ill" means having a mental illness.
8

"Mitigating circumstance" means a condition that (i) is
9
attendant to a finding, (ii) does not excuse or justify the
10
conduct in question, but (iii) may be considered in evaluating
11
the severity of the conduct, the culpability of the accused,
12
or both the severity of the conduct and the culpability of the
13
accused.
14

"Neglect" means an employee's, agency's, or facility's
15
failure to provide adequate medical care, personal care, or
16
maintenance and that, as a consequence, (i) causes an
17
individual pain, injury, or emotional distress, (ii) results
18
in either an individual's maladaptive behavior or the
19
deterioration of an individual's physical condition or mental
20
condition, or (iii) places the individual's health or safety
21
at substantial risk.
22

"Person with a developmental disability" means a person
23
having a developmental disability.
24

"Physical abuse" means an employee's non-accidental and
25
inappropriate contact with an individual that causes bodily
26
harm. "Physical abuse" includes actions that cause bodily harm

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
as a result of an employee directing an individual or person to
2
physically abuse another individual.
3

"Presenting untruthful information" means making a false
4
statement, material to
the report of an allegation to the
5
hotline or during
an investigation of physical abuse, sexual
6
abuse, mental abuse, neglect, or financial exploitation,
7
knowing the statement is false.
8

"Recommendation" means an admonition, separate from a
9
finding, that requires action by the facility, agency, or
10
Department to correct a systemic issue, problem, or deficiency
11
identified during an investigation. "Recommendation" can also
12
mean an admonition to correct a systemic issue, problem or
13
deficiency during a review.
14

"Required reporter" means any employee who suspects,
15
witnesses, or is informed of an allegation of any one or more
16
of the following: mental abuse, physical abuse, sexual abuse,
17
neglect, or financial exploitation.
18

"Secretary" means the Chief Administrative Officer of the
19
Department.
20

"Sexual abuse" means any sexual contact or intimate
21
physical contact between an employee and an individual,
22
including an employee's coercion or encouragement of an
23
individual to engage in sexual behavior that results in sexual
24
contact, intimate physical contact, sexual behavior, or
25
intimate physical behavior. Sexual abuse also includes (i) an
26
employee's actions that result in the sending or showing of

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
sexually explicit images to an individual via computer,
2
cellular phone, electronic mail, portable electronic device,
3
or other media with or without contact with the individual or
4
(ii) an employee's posting of sexually explicit images of an
5
individual online or elsewhere whether or not there is contact
6
with the individual.
7

"Sexually explicit images" includes, but is not limited
8
to, any material which depicts nudity, sexual conduct, or
9
sado-masochistic abuse, or which contains explicit and
10
detailed verbal descriptions or narrative accounts of sexual
11
excitement, sexual conduct, or sado-masochistic abuse.
12

"Substantiated" means there is a preponderance of the
13
evidence to support the allegation.
14

"Unfounded" means there is no credible evidence to support
15
the allegation.
16

"Unsubstantiated" means there is credible evidence, but
17
less than a preponderance of evidence to support the
18
allegation.
19

(c) Appointment. The Governor shall appoint, and the
20
Senate shall confirm, an Inspector General. The Inspector
21
General shall be appointed for a term of 4 years and shall
22
function within the Department of Human Services and report to
23
the Secretary and the Governor.
24

(d) Operation and appropriation. The Inspector General
25
shall function independently within the Department with
26
respect to the operations of the Office, including the

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
performance of investigations and issuance of findings and
2
recommendations and the performance of site visits and reviews
3
of facilities and community agencies. The appropriation for
4
the Office of Inspector General shall be separate from the
5
overall appropriation for the Department.
6

(e) Powers and duties. The Inspector General shall
7
investigate reports of suspected mental abuse, physical abuse,
8
sexual abuse, neglect, or financial exploitation of
9
individuals in any mental health or developmental disabilities
10
facility or agency and shall have authority to take immediate
11
action to prevent any one or more of the following from
12
happening to individuals under its jurisdiction: mental abuse,
13
physical abuse, sexual abuse, neglect, or financial
14
exploitation. The Inspector General shall also investigate
15
allegations of material obstruction of an investigation by an
16
employee. Upon written request of an agency of this State, the
17
Inspector General may assist another agency of the State in
18
investigating reports of the abuse, neglect, or abuse and
19
neglect of persons with mental illness, persons with
20
developmental disabilities, or persons with both. The
21
Inspector General shall conduct annual site visits of each
22
facility and may conduct reviews of facilities and community
23
agencies. To comply with the requirements of subsection (k) of
24
this Section, the Inspector General shall also review all
25
reportable deaths for which there is no allegation of abuse or
26
neglect. Nothing in this Section shall preempt any duties of

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
the Medical Review Board set forth in the Mental Health and
2
Developmental Disabilities Code. The Inspector General shall
3
have no authority to investigate alleged violations of the
4
State Officials and Employees Ethics Act. Allegations of
5
misconduct under the State Officials and Employees Ethics Act
6
shall be referred to the Office of the Governor's Executive
7
Inspector General for investigation.
8

(f) Limitations. The Inspector General shall not conduct
9
an investigation within an agency or facility if that
10
investigation would be redundant to or interfere with an
11
investigation conducted by another State agency. The Inspector
12
General shall have no supervision over, or involvement in, the
13
routine programmatic, licensing, funding, or certification
14
operations of the Department. Nothing in this subsection
15
limits investigations by the Department that may otherwise be
16
required by law or that may be necessary in the Department's
17
capacity as central administrative authority responsible for
18
the operation of the State's mental health and developmental
19
disabilities facilities.
20

(g) Rulemaking authority. The Inspector General shall
21
promulgate rules establishing minimum requirements for
22
reporting allegations as well as for initiating, conducting,
23
and completing investigations based upon the nature of the
24
allegation or allegations. The rules shall clearly establish
25
that if 2 or more State agencies could investigate an
26
allegation, the Inspector General shall not conduct an

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
investigation that would be redundant to, or interfere with,
2
an investigation conducted by another State agency. The rules
3
shall further clarify the method and circumstances under which
4
the Office of Inspector General may interact with the
5
licensing, funding, or certification units of the Department
6
in preventing further occurrences of mental abuse, physical
7
abuse, sexual abuse, neglect, egregious neglect, financial
8
exploitation, 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
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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)
14
establish a comprehensive program to ensure that every person
15
authorized to conduct investigations receives ongoing training
16
relative to investigation techniques, communication skills,
17
and the appropriate means of interacting with persons
18
receiving treatment for mental illness, developmental
19
disability, or both mental illness and developmental
20
disability, and (ii) establish and conduct periodic training
21
programs for facility and agency employees concerning the
22
prevention and reporting of any one or more of the following:
23
mental abuse, physical abuse, sexual abuse, neglect, egregious
24
neglect, financial exploitation, or material obstruction of an
25
investigation. The Inspector General shall further ensure (i)
26
every person authorized to conduct investigations at community

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
agencies receives ongoing training in Title 59, Parts 115,
2
116, and 119 of the Illinois Administrative Code, and (ii)
3
every person authorized to conduct investigations shall
4
receive ongoing training in Title 59, Part 50 of the Illinois
5
Administrative Code. Nothing in this Section shall be deemed
6
to prevent the Office of Inspector General from conducting any
7
other training as determined by the Inspector General to be
8
necessary 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
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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
13
power to subpoena witnesses and compel the production of all
14
documents and physical evidence relating to his or her
15
investigations and reviews and any hearings authorized by this
16
Act. This subpoena power shall not extend to persons or
17
documents of a labor organization or its representatives
18
insofar as the persons are acting in a representative capacity
19
to an employee whose conduct is the subject of an
20
investigation or the documents relate to that representation.
21
Any person who otherwise fails to respond to a subpoena or who
22
knowingly provides false information to the Office of the
23
Inspector General by subpoena during an investigation is
24
guilty of a Class A misdemeanor.
25

(k) Reporting allegations and deaths.
26

(1) Allegations. If an employee witnesses, is told of,

HB4643 Enrolled
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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
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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.
11
Within 24 hours after determining that there is credible
12
evidence indicating that a criminal act may have been
13
committed or that special expertise may be required in an
14
investigation, the Inspector General shall notify the Illinois
15
State Police or other appropriate law enforcement authority,
16
or ensure that such notification is made. The Illinois State
17
Police shall investigate any report from a State-operated
18
facility indicating a possible murder, sexual assault, or
19
other felony by an employee. All investigations conducted by
20
the Inspector General shall be conducted in a manner designed
21
to ensure the preservation of evidence for possible use in a
22
criminal prosecution.
23

(m) Investigative reports. Upon completion of an
24
investigation, the Office of Inspector General shall issue an
25
investigative report identifying whether the allegations are
26
substantiated, unsubstantiated, or unfounded. Within 10

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
1
business days after the transmittal of a completed
2
investigative report substantiating an allegation, finding an
3
allegation is unsubstantiated, or if a recommendation is made,
4
the Inspector General shall provide the investigative report
5
on the case to the Secretary and to the director of the
6
facility or agency where any one or more of the following
7
occurred: mental abuse, physical abuse, sexual abuse, neglect,
8
egregious neglect, financial exploitation, or material
9
obstruction of an investigation. The director of the facility
10
or agency shall be responsible for maintaining the
11
confidentiality of the investigative report consistent with
12
State and federal law. In a substantiated case, the
13
investigative report shall include any mitigating or
14
aggravating circumstances that were identified during the
15
investigation. If the case involves substantiated neglect, the
16
investigative report shall also state whether egregious
17
neglect was found. An investigative report may also set forth
18
recommendations. All investigative reports prepared by the
19
Office of the Inspector General shall be considered
20
confidential and shall not be released except as provided by
21
the law of this State or as required under applicable federal
22
law. Unsubstantiated and unfounded reports shall not be
23
disclosed except as allowed under Section 6 of the Abused and
24
Neglected Long Term Care Facility Residents Reporting Act. Raw
25
data used to compile the investigative report shall not be
26
subject to release unless required by law or a court order.

HB4643 Enrolled
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LRB104 17702 KTG 31133 b
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"Raw data used to compile the investigative report" includes,
2
but is not limited to, any one or more of the following: the
3
initial complaint, witness statements, photographs,
4
investigator's notes, police reports, or incident reports. If
5
the allegations are substantiated, the victim, the victim's
6
guardian, and the accused shall be provided with a redacted
7
copy of the investigative report. Death reports where there
8
was no allegation of abuse or neglect shall only be released to
9
the Secretary, or the Secretary's designee, and to the
10
director of the facility or agency when a recommendation is
11
made and pursuant to applicable State or federal law or a valid
12
court order. Unredacted investigative reports, as well as raw
13
data, may be shared with a local law enforcement entity, a
14
State's Attorney's office, or a county coroner's office upon
15
written request. Unredacted investigative reports, as well as
16
raw data, may be shared with the Department of Financial and
17
Professional Regulation when there is a substantiated finding
18
against a person licensed by the Department of Financial and
19
Professional Regulation who is within the Office of the
20
Inspector General's jurisdiction, upon written request. If,
21
during its investigation, the Office of the Inspector General
22
found credible evidence of neglect by a person licensed by the
23
Department of Financial and Professional Regulation who is not
24
within the Office's jurisdiction, the Office may provide an
25
unfounded or unsubstantiated investigative report or death
26
report, as well as raw data, with the Department of Financial

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and Professional Regulation, upon written request.
2

(n) Written responses, clarification requests, and
3
reconsideration 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

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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.
10
The Inspector General shall disclose the finding of an
11
investigation to the following persons: (i) the Governor, (ii)
12
the Secretary, (iii) the director of the facility or agency,
13
(iv) the alleged victims and their guardians, (v) the
14
complainant, and (vi) the accused. This information shall
15
include whether the allegations were deemed substantiated,
16
unsubstantiated, or unfounded.
17

(p) Secretary review. Upon review of the Inspector
18
General's investigative report and any agency's or facility's
19
written response, the Secretary, or the Secretary's designee,
20
shall accept or reject the written response and notify the
21
Inspector General of that determination. The Secretary, or the
22
Secretary's designee, may further direct that other
23
administrative action be taken, including, but not limited to,
24
any one or more of the following: (i) additional site visits,
25
(ii) training, (iii) provision of technical assistance
26
relative to administrative needs, licensure, or certification,

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or (iv) the imposition of appropriate sanctions.
2

(q) Action by facility or agency. Within 30 days of the
3
date the Secretary, or the Secretary's designee, approves the
4
written response or directs that further administrative action
5
be taken, the facility or agency shall provide an
6
implementation report to the Inspector General that provides
7
the status of the action taken. The facility or agency shall be
8
allowed an additional 30 days to send notice of completion of
9
the action or to send an updated implementation report. If the
10
action has not been completed within the additional 30-day
11
period, the facility or agency shall send updated
12
implementation reports every 60 days until completion. The
13
Inspector General shall conduct a review of any implementation
14
plan that takes more than 120 days after approval to complete,
15
and shall monitor compliance through a random review of
16
approved written responses, which may include, but are not
17
limited to: (i) site visits, (ii) telephone contact, and (iii)
18
requests for additional documentation evidencing compliance.
19

(r) Sanctions. Sanctions, if imposed by the Secretary
20
under Subdivision (p)(iv) of this Section, shall be designed
21
to prevent further acts of mental abuse, physical abuse,
22
sexual abuse, neglect, egregious neglect, or financial
23
exploitation or some combination of one or more of those acts
24
at a facility or agency, and may include any one or more of the
25
following:
26

(1) Appointment of on-site monitors.

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(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
8
Illinois Attorney General or the office of any State's
9
Attorney 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

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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

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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

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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

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of these proceedings.
2

(t) Review of Administrative Decisions. The Department
3
shall preserve a record of all proceedings at any formal
4
hearing conducted by the Department involving Health Care
5
Worker Registry hearings. Final administrative decisions of
6
the Department are subject to judicial review pursuant to
7
provisions of the Administrative Review Law.
8

(u) Quality Care Board. There is created, within the
9
Office of the Inspector General, a Quality Care Board to be
10
composed of 7 members appointed by the Governor with the
11
advice and consent of the Senate. One of the members shall be
12
designated as chairman by the Governor. Of the initial
13
appointments made by the Governor, 4 Board members shall each
14
be appointed for a term of 4 years and 3 members shall each be
15
appointed for a term of 2 years. Upon the expiration of each
16
member's term, a successor shall be appointed for a term of 4
17
years. In the case of a vacancy in the office of any member,
18
the Governor shall appoint a successor for the remainder of
19
the unexpired term.
20

Members appointed by the Governor shall be qualified by
21
professional knowledge or experience in the area of law,
22
investigatory techniques, or in the area of care of the
23
mentally ill or care of persons with developmental
24
disabilities. Two members appointed by the Governor shall be
25
persons with a disability or parents of persons with a
26
disability. Members shall serve without compensation, but

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shall be reimbursed for expenses incurred in connection with
2
the performance of their duties as members.
3

The Board shall meet quarterly, and may hold other
4
meetings on the call of the chairman. Four members shall
5
constitute a quorum allowing the Board to conduct its
6
business. The Board may adopt rules and regulations it deems
7
necessary to govern its own procedures.
8

The Board shall monitor and oversee the operations,
9
policies, and procedures of the Inspector General to ensure
10
the prompt and thorough investigation of allegations of
11
neglect and abuse. In fulfilling these responsibilities, the
12
Board 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
26
the General Assembly and the Governor, no later than January 1

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of each year, a summary of reports and investigations made
2
under this Act for the prior fiscal year with respect to
3
individuals receiving mental health or developmental
4
disabilities services. The report shall detail the imposition
5
of sanctions, if any, and the final disposition of any
6
corrective or administrative action directed by the Secretary.
7
The summaries shall not contain any confidential or
8
identifying information of any individual, but shall include
9
objective data identifying any trends in the number of
10
reported allegations, the timeliness of the Office of the
11
Inspector General's investigations, and their disposition, for
12
each facility and Department-wide, for the most recent 3-year
13
time period. The report shall also identify, by facility, the
14
staff-to-patient ratios taking account of direct care staff
15
only. The report shall also include detailed recommended
16
administrative actions and matters for consideration by the
17
General Assembly.
18

(w) Program audit. The Auditor General shall conduct a
19
program audit of the Office of the Inspector General on an
20
as-needed basis, as determined by the Auditor General. The
21
audit shall specifically include the Inspector General's
22
compliance with the Act and effectiveness in investigating
23
reports of allegations occurring in any facility or agency.
24
The Auditor General shall conduct the program audit according
25
to the provisions of the Illinois State Auditing Act and shall
26
report its findings to the General Assembly no later than

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January 1 following the audit period.
2

(x) Nothing in this Section shall be construed to mean
3
that an individual is a victim of abuse or neglect because of
4
health care services appropriately provided or not provided by
5
health care professionals.
6

(y) Nothing in this Section shall require a facility,
7
including its employees, agents, medical staff members, and
8
health care professionals, to provide a service to an
9
individual in contravention of that individual's stated or
10
implied objection to the provision of that service on the
11
ground that that service conflicts with the individual's
12
religious beliefs or practices, nor shall the failure to
13
provide a service to an individual be considered abuse under
14
this Section if the individual has objected to the provision
15
of that service based on his or her religious beliefs or
16
practices.
17
(Source: P.A. 103-76, eff. 6-9-23; 103-154, eff. 6-30-23;
18
103-752, eff. 1-1-25; 104-270, eff. 8-15-25; revised
19
12-12-25.)

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