Full Text of SB1445 102nd General Assembly
SB1445sam001 102ND GENERAL ASSEMBLY | Sen. Sue Rezin Filed: 5/7/2021
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| 1 | | AMENDMENT TO SENATE BILL 1445
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1445 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The State Officials and Employees Ethics Act | 5 | | is amended by changing Sections 25-20 and 25-70 as follows: | 6 | | (5 ILCS 430/25-20)
| 7 | | Sec. 25-20. Duties of the Legislative Inspector
General. | 8 | | In addition to duties otherwise assigned by law,
the | 9 | | Legislative Inspector General shall have the following duties:
| 10 | | (1) To receive and investigate allegations of | 11 | | violations of this
Act. Except as otherwise provided in | 12 | | paragraph (1.5), an investigation may not be initiated
| 13 | | more than one year after the most recent act of the alleged | 14 | | violation or of a
series of alleged violations except | 15 | | where there is reasonable cause to believe
that fraudulent | 16 | | concealment has occurred. To constitute fraudulent |
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| 1 | | concealment
sufficient to toll this limitations period, | 2 | | there must be an affirmative act or
representation | 3 | | calculated to prevent discovery of the fact that a | 4 | | violation
has occurred. The
Legislative Inspector General | 5 | | shall have the discretion to determine the
appropriate | 6 | | means of investigation as permitted by law. | 7 | | (1.5) Notwithstanding any provision of law to the | 8 | | contrary, the Legislative Inspector General, whether | 9 | | appointed by the Legislative Ethics Commission or the | 10 | | General Assembly, may initiate an investigation based on | 11 | | information provided to the Office of the Legislative | 12 | | Inspector General or the Legislative Ethics Commission | 13 | | during the period from December 1, 2014 through November | 14 | | 3, 2017. Any investigation initiated under this paragraph | 15 | | (1.5) must be initiated within one year after the | 16 | | effective date of this amendatory Act of the 100th General | 17 | | Assembly.
| 18 | | Notwithstanding any provision of law to the contrary, | 19 | | the Legislative Inspector General, through the Attorney | 20 | | General, shall have the authority to file a complaint | 21 | | related to any founded violations that occurred during the | 22 | | period December 1, 2014 through November 3, 2017 to the | 23 | | Legislative Ethics Commission, and the Commission shall | 24 | | have jurisdiction to conduct administrative hearings | 25 | | related to any pleadings filed by the Legislative | 26 | | Inspector General, provided the complaint is filed with |
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| 1 | | the Commission no later than 6 months after the summary | 2 | | report is provided to the Attorney General in accordance | 3 | | with subsection (c) of Section 25-50. | 4 | | (2) To request information relating to an | 5 | | investigation from any
person when the Legislative | 6 | | Inspector General deems that information necessary
in
| 7 | | conducting an investigation.
| 8 | | (3) To issue subpoenas, with the advance approval of | 9 | | the Commission,
to compel the attendance of witnesses for | 10 | | the
purposes of testimony and production of documents and | 11 | | other items for
inspection and copying and to make service | 12 | | of those subpoenas and subpoenas
issued under item (7) of | 13 | | Section 25-15. The Legislative Inspector General shall | 14 | | have the power to subpoena a former State employee as | 15 | | described in subsection (d) of Section 25-5 to correct a | 16 | | systemic issue, problem, or deficiency identified during | 17 | | an investigation authorized by this Article.
| 18 | | (4) To submit reports as required by this Act.
| 19 | | (5) To file
pleadings in the name of
the Legislative | 20 | | Inspector General with the Legislative Ethics
Commission, | 21 | | through the Attorney General, as provided in this Article | 22 | | if the
Attorney General finds that reasonable cause exists | 23 | | to believe that a violation
has
occurred.
| 24 | | (6) To assist and coordinate the ethics officers
for | 25 | | State agencies under the jurisdiction of the
Legislative | 26 | | Inspector General and to work with those ethics officers.
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| 1 | | (7) To participate in or conduct, when appropriate, | 2 | | multi-jurisdictional
investigations.
| 3 | | (8) To request, as the Legislative Inspector General | 4 | | deems appropriate,
from ethics officers
of State agencies | 5 | | under his or her jurisdiction, reports or information
on | 6 | | (i) the content of a State agency's ethics
training | 7 | | program and (ii) the percentage of new officers and
| 8 | | employees who have completed ethics training.
| 9 | | (9) To establish a policy that ensures the appropriate | 10 | | handling and correct recording of all investigations of | 11 | | allegations and to ensure that the policy is accessible | 12 | | via the Internet in order that those seeking to report | 13 | | those allegations are familiar with the process and that | 14 | | the subjects of those allegations are treated fairly. | 15 | | (10) To post information to the Legislative Inspector | 16 | | General's website explaining to complainants and subjects | 17 | | of an investigation the legal limitations on the | 18 | | Legislative Inspector General's ability to provide | 19 | | information to them and a general overview of the | 20 | | investigation process. | 21 | | (Source: P.A. 100-553, eff. 11-16-17; 100-588, eff. 6-8-18.) | 22 | | (5 ILCS 430/25-70)
| 23 | | Sec. 25-70. Cooperation in investigations. It is the duty | 24 | | of
every officer , and employee , and former State employee | 25 | | under the jurisdiction of the Legislative
Inspector General, |
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| 1 | | including any inspector general serving in any
State agency | 2 | | under the jurisdiction of the Legislative Inspector
General, | 3 | | to cooperate with the Legislative Inspector General and the | 4 | | Attorney General in any
investigation undertaken pursuant to | 5 | | this Act. Failure to cooperate includes, but is not limited | 6 | | to, intentional omissions and knowing false statements. | 7 | | Failure to cooperate
with an investigation of the Legislative | 8 | | Inspector General or the Attorney General is grounds
for | 9 | | disciplinary action, including dismissal. Nothing in this | 10 | | Section limits or
alters a person's existing rights or | 11 | | privileges under State or federal law.
| 12 | | (Source: P.A. 100-588, eff. 6-8-18.) | 13 | | Section 10. The Children and Family Services Act is | 14 | | amended by changing Section 35.5 as follows:
| 15 | | (20 ILCS 505/35.5)
| 16 | | Sec. 35.5. Inspector General.
| 17 | | (a) The Governor shall appoint, and the Senate shall | 18 | | confirm, an Inspector
General who shall
have the authority to | 19 | | conduct investigations into allegations of or incidents
of | 20 | | possible misconduct, misfeasance, malfeasance, or violations | 21 | | of rules,
procedures, or laws by any employee, former employee | 22 | | as defined in subsection (f-5), foster parent, service | 23 | | provider, or
contractor of the Department of Children and | 24 | | Family Services, except for allegations of violations of the |
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| 1 | | State Officials and Employees Ethics Act which shall be | 2 | | referred to the Office of the Governor's Executive Inspector | 3 | | General for investigation. The Inspector
General shall make | 4 | | recommendations
to the Director of Children and Family | 5 | | Services concerning sanctions or
disciplinary actions against | 6 | | Department
employees or providers of service under contract to | 7 | | the Department. The Director of Children and Family Services | 8 | | shall provide the Inspector General with an implementation | 9 | | report on the status of any corrective actions taken on | 10 | | recommendations under review and shall continue sending | 11 | | updated reports until the corrective action is completed. The | 12 | | Director shall provide a written response to the Inspector | 13 | | General indicating the status of any sanctions or disciplinary | 14 | | actions against employees or providers of service involving | 15 | | any investigation subject to review. In any case, information | 16 | | included in the reports to the Inspector General and | 17 | | Department responses shall be subject to the public disclosure | 18 | | requirements of the Abused and Neglected Child Reporting Act.
| 19 | | Any
investigation
conducted by the Inspector General shall be | 20 | | independent and separate from the
investigation mandated by | 21 | | the Abused and Neglected Child Reporting Act. The
Inspector | 22 | | General shall be appointed for a term of 4 years. The Inspector
| 23 | | General shall function independently within the Department of | 24 | | Children and Family Services with respect to the operations of | 25 | | the Office of Inspector General, including the performance of | 26 | | investigations and issuance of findings and recommendations, |
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| 1 | | and shall
report to the Director of Children and Family | 2 | | Services and the Governor and
perform other
duties the | 3 | | Director may designate. The Inspector General shall adopt | 4 | | rules
as necessary to carry out the
functions, purposes, and | 5 | | duties of the office of Inspector General in the
Department of | 6 | | Children and Family Services, in accordance with the Illinois
| 7 | | Administrative Procedure Act and any other applicable law.
| 8 | | (b) The Inspector
General shall have access to all | 9 | | information and personnel necessary to perform
the duties of | 10 | | the office. To minimize duplication of efforts, and to assure
| 11 | | consistency and conformance with the requirements and | 12 | | procedures established in
the B.H. v. Suter consent decree and | 13 | | to share resources
when appropriate, the Inspector General | 14 | | shall coordinate his or her
activities with the Bureau of | 15 | | Quality Assurance within the Department.
| 16 | | (c) The Inspector General shall be the primary liaison | 17 | | between the
Department and the Department of State Police with | 18 | | regard to investigations
conducted under the Inspector | 19 | | General's auspices.
If the Inspector General determines that a | 20 | | possible criminal act
has been committed,
or that special | 21 | | expertise is required in the investigation, he or she shall
| 22 | | immediately notify the Department of State Police.
All | 23 | | investigations conducted by the Inspector General shall be
| 24 | | conducted in a manner designed to ensure the preservation of | 25 | | evidence for
possible use in a criminal prosecution.
| 26 | | (d) The Inspector General may recommend to the Department |
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| 1 | | of Children and
Family Services, the Department of Public | 2 | | Health, or any other appropriate
agency, sanctions to be | 3 | | imposed against service providers under the
jurisdiction of or | 4 | | under contract with the Department for the protection of
| 5 | | children in the custody or under the guardianship of the | 6 | | Department who
received services from those providers. The | 7 | | Inspector General may seek the
assistance of the Attorney | 8 | | General or any of the several State's Attorneys in
imposing | 9 | | sanctions.
| 10 | | (e) The Inspector General shall at all times be granted | 11 | | access to any foster
home, facility, or program operated for | 12 | | or licensed or funded by the
Department.
| 13 | | (f) Nothing in this Section shall limit investigations by | 14 | | the Department of
Children and Family Services that may | 15 | | otherwise be required by law or that may
be necessary in that | 16 | | Department's capacity as the central administrative
authority | 17 | | for child welfare.
| 18 | | (f-5) It is the duty of every employee and former employee | 19 | | to cooperate with the Inspector General in any investigation | 20 | | undertaken in accordance with this Act. For purposes of this | 21 | | Section, "former employee" means a former agency director, | 22 | | senior administrator, or any other individual who, while | 23 | | employed at the Department, had the authority to implement | 24 | | policy action for (i) the Department, (ii) an agency under | 25 | | contract with the Department, or (iii) any facility or program | 26 | | operated for or licensed or funded by the
Department. |
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| 1 | | (g) The Inspector General shall have the power to subpoena | 2 | | witnesses and
compel the production of books and papers | 3 | | pertinent to an investigation
authorized by this Act. The | 4 | | Inspector General shall have the power to subpoena a former | 5 | | employee as defined in subsection (f-5) to correct a systemic | 6 | | issue, problem, or deficiency identified during an | 7 | | investigation authorized by this Act. The power to subpoena or | 8 | | to compel the
production of books and papers, however, shall | 9 | | not extend to the person or
documents of a
labor organization | 10 | | or its representatives insofar as the person or documents of
a | 11 | | labor organization relate to the function of representing an | 12 | | employee subject
to investigation under this Act. Any person | 13 | | who fails to appear in response to
a subpoena or to answer any | 14 | | question or produce any books or papers pertinent
to an | 15 | | investigation under this Act, except as otherwise provided in | 16 | | this
Section, or who knowingly gives false testimony in | 17 | | relation to an investigation
under this Act is guilty of a | 18 | | Class A misdemeanor.
| 19 | | (h) The Inspector General shall provide to the General | 20 | | Assembly and the
Governor, no later than January 1 of each | 21 | | year, a summary of reports and
investigations made under this | 22 | | Section for the prior fiscal year. The
summaries shall detail | 23 | | the imposition of sanctions and the final disposition
of those | 24 | | recommendations. The summaries shall not contain any | 25 | | confidential or
identifying information concerning the | 26 | | subjects of the reports and
investigations. The summaries also |
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| 1 | | shall include detailed recommended
administrative actions and | 2 | | matters for consideration by the General Assembly.
| 3 | | (Source: P.A. 95-527, eff. 6-1-08; 96-555, eff. 8-18-09.)
| 4 | | Section 15. The Department of Human Services Act is | 5 | | amended 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 | | "Adult student with a disability" means an adult student, | 24 | | age 18 through 21, inclusive, with an Individual Education |
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| 1 | | Program, other than a resident of a facility licensed by the | 2 | | Department of Children and Family Services in accordance with | 3 | | the Child Care Act of 1969. For purposes of this definition, | 4 | | "through age 21, inclusive", means through the day before the | 5 | | student's 22nd birthday. | 6 | | "Agency" or "community agency" means (i) a community | 7 | | agency licensed, funded, or certified by the Department, but | 8 | | not licensed or certified by any other human services agency | 9 | | of the State, to provide mental health service or | 10 | | developmental disabilities service, or (ii) a program | 11 | | licensed, funded, or certified by the Department, but not | 12 | | licensed or certified by any other human services agency of | 13 | | the State, to provide mental health service or developmental | 14 | | disabilities service. | 15 | | "Aggravating circumstance" means a factor that is | 16 | | attendant to a finding and that tends to compound or increase | 17 | | the culpability of the accused. | 18 | | "Allegation" means an assertion, complaint, suspicion, or | 19 | | incident involving any of the following conduct by an | 20 | | employee, facility, or agency against an individual or | 21 | | individuals: mental abuse, physical abuse, sexual abuse, | 22 | | neglect, or financial exploitation. | 23 | | "Day" means working day, unless otherwise specified. | 24 | | "Deflection" means a situation in which an individual is | 25 | | presented for admission to a facility or agency, and the | 26 | | facility staff or agency staff do not admit the individual. |
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| 1 | | "Deflection" includes triage, redirection, and denial of | 2 | | admission. | 3 | | "Department" means the Department of Human Services. | 4 | | "Developmental disability" means "developmental | 5 | | disability" as defined in the Mental Health and Developmental | 6 | | Disabilities Code. | 7 | | "Egregious neglect" means a finding of neglect as | 8 | | determined by the Inspector General that (i) represents a | 9 | | gross failure to adequately provide for, or a callused | 10 | | indifference to, the health, safety, or medical needs of an | 11 | | individual and (ii) results in an individual's death or other | 12 | | serious deterioration of an individual's physical condition or | 13 | | mental condition. | 14 | | "Employee" means any person who provides services at the | 15 | | facility or agency on-site or off-site. The service | 16 | | relationship can be with the individual or with the facility | 17 | | or agency. Also, "employee" includes any employee or | 18 | | contractual agent of the Department of Human Services or the | 19 | | community agency involved in providing or monitoring or | 20 | | administering mental health or developmental disability | 21 | | services. This includes but is not limited to: owners, | 22 | | operators, payroll personnel, contractors, subcontractors, and | 23 | | volunteers. | 24 | | "Facility" or "State-operated facility" means a mental | 25 | | health facility or developmental disabilities facility | 26 | | operated by the Department. |
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| 1 | | "Financial exploitation" means taking unjust advantage of | 2 | | an individual's assets, property, or financial resources | 3 | | through deception, intimidation, or conversion for the | 4 | | employee's, facility's, or agency's own advantage or benefit. | 5 | | "Finding" means the Office of Inspector General's | 6 | | determination regarding whether an allegation is | 7 | | substantiated, unsubstantiated, or unfounded. | 8 | | "Former employee" means a former agency director, senior | 9 | | administrator, or any other individual who, while employed at | 10 | | the Department, had the authority to implement policy action | 11 | | for the Department, a facility, or an agency. | 12 | | "Health Care Worker Registry" or "Registry" means the | 13 | | Health Care Worker Registry under the Health Care Worker | 14 | | Background Check Act. | 15 | | "Individual" means any person receiving mental health | 16 | | service, developmental disabilities service, or both from a | 17 | | facility or agency, while either on-site or off-site. | 18 | | "Mental abuse" means the use of demeaning, intimidating, | 19 | | or threatening words, signs, gestures, or other actions by an | 20 | | employee about an individual and in the presence of an | 21 | | individual or individuals that results in emotional distress | 22 | | or maladaptive behavior, or could have resulted in emotional | 23 | | distress or maladaptive behavior, for any individual present. | 24 | | "Mental illness" means "mental illness" as defined in the | 25 | | Mental Health and Developmental Disabilities Code. | 26 | | "Mentally ill" means having a mental illness. |
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| 1 | | "Mitigating circumstance" means a condition that (i) is | 2 | | attendant to a finding, (ii) does not excuse or justify the | 3 | | conduct in question, but (iii) may be considered in evaluating | 4 | | the severity of the conduct, the culpability of the accused, | 5 | | or both the severity of the conduct and the culpability of the | 6 | | accused. | 7 | | "Neglect" means an employee's, agency's, or facility's | 8 | | failure to provide adequate medical care, personal care, or | 9 | | maintenance and that, as a consequence, (i) causes an | 10 | | individual pain, injury, or emotional distress, (ii) results | 11 | | in either an individual's maladaptive behavior or the | 12 | | deterioration of an individual's physical condition or mental | 13 | | condition, or (iii) places the individual's health or safety | 14 | | at substantial risk. | 15 | | "Person with a developmental disability" means a person | 16 | | having a developmental disability. | 17 | | "Physical abuse" means an employee's non-accidental and | 18 | | inappropriate contact with an individual that causes bodily | 19 | | harm. "Physical abuse" includes actions that cause bodily harm | 20 | | as a result of an employee directing an individual or person to | 21 | | physically abuse another individual. | 22 | | "Recommendation" means an admonition, separate from a | 23 | | finding, that requires action by the facility, agency, or | 24 | | Department to correct a systemic issue, problem, or deficiency | 25 | | identified during an investigation. | 26 | | "Required reporter" means any employee who suspects, |
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| 1 | | witnesses, or is informed of an allegation of any one or more | 2 | | of the following: mental abuse, physical abuse, sexual abuse, | 3 | | neglect, or financial exploitation. | 4 | | "Secretary" means the Chief Administrative Officer of the | 5 | | Department. | 6 | | "Sexual abuse" means any sexual contact or intimate | 7 | | physical contact between an employee and an individual, | 8 | | including an employee's coercion or encouragement of an | 9 | | individual to engage in sexual behavior that results in sexual | 10 | | contact, intimate physical contact, sexual behavior, or | 11 | | intimate physical behavior. Sexual abuse also includes (i) an | 12 | | employee's actions that result in the sending or showing of | 13 | | sexually explicit images to an individual via computer, | 14 | | cellular phone, electronic mail, portable electronic device, | 15 | | or other media with or without contact with the individual or | 16 | | (ii) an employee's posting of sexually explicit images of an | 17 | | individual online or elsewhere whether or not there is contact | 18 | | with the individual. | 19 | | "Sexually explicit images" includes, but is not limited | 20 | | to, any material which depicts nudity, sexual conduct, or | 21 | | sado-masochistic abuse, or which contains explicit and | 22 | | detailed verbal descriptions or narrative accounts of sexual | 23 | | excitement, sexual conduct, or sado-masochistic abuse. | 24 | | "Substantiated" means there is a preponderance of the | 25 | | evidence to support the allegation. | 26 | | "Unfounded" means there is no credible evidence to support |
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| 1 | | the allegation. | 2 | | "Unsubstantiated" means there is credible evidence, but | 3 | | less than a preponderance of evidence to support the | 4 | | allegation. | 5 | | (c) Appointment. The Governor shall appoint, and the | 6 | | Senate shall confirm, an Inspector General. The Inspector | 7 | | General shall be appointed for a term of 4 years and shall | 8 | | function within the Department of Human Services and report to | 9 | | the Secretary and the Governor. | 10 | | (d) Operation and appropriation. The Inspector General | 11 | | shall function independently within the Department with | 12 | | respect to the operations of the Office, including the | 13 | | performance of investigations and issuance of findings and | 14 | | recommendations. The appropriation for the Office of Inspector | 15 | | General shall be separate from the overall appropriation for | 16 | | the Department. | 17 | | (e) Powers and duties. The Inspector General shall | 18 | | investigate reports of suspected mental abuse, physical abuse, | 19 | | sexual abuse, neglect, or financial exploitation of | 20 | | individuals in any mental health or developmental disabilities | 21 | | facility or agency and shall have authority to take immediate | 22 | | action to prevent any one or more of the following from | 23 | | happening to individuals under its jurisdiction: mental abuse, | 24 | | physical abuse, sexual abuse, neglect, or financial | 25 | | exploitation. Upon written request of an agency of this State, | 26 | | the Inspector General may assist another agency of the State |
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| 1 | | in investigating reports of the abuse, neglect, or abuse and | 2 | | neglect of persons with mental illness, persons with | 3 | | developmental disabilities, or persons with both. To comply | 4 | | with the requirements of subsection (k) of this Section, the | 5 | | Inspector General shall also review all reportable deaths for | 6 | | which there is no allegation of abuse or neglect. Nothing in | 7 | | this Section shall preempt any duties of the Medical Review | 8 | | Board set forth in the Mental Health and Developmental | 9 | | Disabilities Code. The Inspector General shall have no | 10 | | authority to investigate alleged violations of the State | 11 | | Officials and Employees Ethics Act. Allegations of misconduct | 12 | | under the State Officials and Employees Ethics Act shall be | 13 | | referred to the Office of the Governor's Executive Inspector | 14 | | General for investigation. | 15 | | (f) Limitations. The Inspector General shall not conduct | 16 | | an investigation within an agency or facility if that | 17 | | investigation would be redundant to or interfere with an | 18 | | investigation conducted by another State agency. The Inspector | 19 | | General shall have no supervision over, or involvement in, the | 20 | | routine programmatic, licensing, funding, or certification | 21 | | operations of the Department. Nothing in this subsection | 22 | | limits investigations by the Department that may otherwise be | 23 | | required by law or that may be necessary in the Department's | 24 | | capacity as central administrative authority responsible for | 25 | | the operation of the State's mental health and developmental | 26 | | disabilities facilities. |
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| 1 | | (g) Rulemaking authority. The Inspector General shall | 2 | | promulgate rules establishing minimum requirements for | 3 | | reporting allegations as well as for initiating, conducting, | 4 | | and completing investigations based upon the nature of the | 5 | | allegation or allegations. The rules shall clearly establish | 6 | | that if 2 or more State agencies could investigate an | 7 | | allegation, the Inspector General shall not conduct an | 8 | | investigation that would be redundant to, or interfere with, | 9 | | an investigation conducted by another State agency. The rules | 10 | | shall further clarify the method and circumstances under which | 11 | | the Office of Inspector General may interact with the | 12 | | licensing, funding, or certification units of the Department | 13 | | in preventing further occurrences of mental abuse, physical | 14 | | abuse, sexual abuse, neglect, egregious neglect, and financial | 15 | | exploitation. | 16 | | (h) Training programs. The Inspector General shall (i) | 17 | | establish a comprehensive program to ensure that every person | 18 | | authorized to conduct investigations receives ongoing training | 19 | | relative to investigation techniques, communication skills, | 20 | | and the appropriate means of interacting with persons | 21 | | receiving treatment for mental illness, developmental | 22 | | disability, or both mental illness and developmental | 23 | | disability, and (ii) establish and conduct periodic training | 24 | | programs for facility and agency employees concerning the | 25 | | prevention and reporting of any one or more of the following: | 26 | | mental abuse, physical abuse, sexual abuse, neglect, egregious |
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| 1 | | neglect, or financial exploitation. The Inspector General | 2 | | shall further ensure (i) every person authorized to conduct | 3 | | investigations at community agencies receives ongoing training | 4 | | in Title 59, Parts 115, 116, and 119 of the Illinois | 5 | | Administrative Code, and (ii) every person authorized to | 6 | | conduct investigations shall receive ongoing training in Title | 7 | | 59, Part 50 of the Illinois Administrative Code. Nothing in | 8 | | this Section shall be deemed to prevent the Office of | 9 | | Inspector General from conducting any other training as | 10 | | determined by the Inspector General to be necessary or | 11 | | helpful. | 12 | | (i) Duty to cooperate. | 13 | | (1) The Inspector General shall at all times be | 14 | | granted access to any facility or agency for the purpose | 15 | | of investigating any allegation, conducting unannounced | 16 | | site visits, monitoring compliance with a written | 17 | | response, or completing any other statutorily assigned | 18 | | duty. The Inspector General shall conduct unannounced site | 19 | | visits to each facility at least annually for the purpose | 20 | | of reviewing and making recommendations on systemic issues | 21 | | relative to preventing, reporting, investigating, and | 22 | | responding to all of the following: mental abuse, physical | 23 | | abuse, sexual abuse, neglect, egregious neglect, or | 24 | | financial exploitation. | 25 | | (2) Any employee or former employee who fails to | 26 | | cooperate with an Office of the Inspector General |
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| 1 | | investigation is in violation of this Act. Failure to | 2 | | cooperate with an investigation includes, but is not | 3 | | limited to, any one or more of the following: (i) creating | 4 | | and transmitting a false report to the Office of the | 5 | | Inspector General hotline, (ii) providing false | 6 | | information to an Office of the Inspector General | 7 | | Investigator during an investigation, (iii) colluding with | 8 | | other employees or former employees to cover up evidence, | 9 | | (iv) colluding with other employees or former employees to | 10 | | provide false information to an Office of the Inspector | 11 | | General investigator, (v) destroying evidence, (vi) | 12 | | withholding evidence, or (vii) otherwise obstructing an | 13 | | Office of the Inspector General investigation. | 14 | | Additionally, any employee who, during an unannounced site | 15 | | visit or written response compliance check, fails to | 16 | | cooperate with requests from the Office of the Inspector | 17 | | General is in violation of this Act. | 18 | | (j) Subpoena powers. The Inspector General shall have the | 19 | | power to subpoena witnesses and compel the production of all | 20 | | documents and physical evidence relating to his or her | 21 | | investigations and any hearings authorized by this Act. The | 22 | | Inspector General shall have the power to subpoena a former | 23 | | employee in order to correct a systemic issue, problem, or | 24 | | deficiency identified during an investigation authorized by | 25 | | this Act. This subpoena power shall not extend to persons or | 26 | | documents of a labor organization or its representatives |
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| 1 | | insofar as the persons are acting in a representative capacity | 2 | | to an employee whose conduct is the subject of an | 3 | | investigation or the documents relate to that representation. | 4 | | Any person who otherwise fails to respond to a subpoena or who | 5 | | knowingly provides false information to the Office of the | 6 | | Inspector General by subpoena during an investigation is | 7 | | guilty of a Class A misdemeanor. | 8 | | (k) Reporting allegations and deaths. | 9 | | (1) Allegations. If an employee witnesses, is told of, | 10 | | or has reason to believe an incident of mental abuse, | 11 | | physical abuse, sexual abuse, neglect, or financial | 12 | | exploitation has occurred, the employee, agency, or | 13 | | facility shall report the allegation by phone to the | 14 | | Office of the Inspector General hotline according to the | 15 | | agency's or facility's procedures, but in no event later | 16 | | than 4 hours after the initial discovery of the incident, | 17 | | allegation, or suspicion of any one or more of the | 18 | | following: mental abuse, physical abuse, sexual abuse, | 19 | | neglect, or financial exploitation. A required reporter as | 20 | | defined in subsection (b) of this Section who knowingly or | 21 | | intentionally fails to comply with these reporting | 22 | | requirements is guilty of a Class A misdemeanor. | 23 | | (2) Deaths. Absent an allegation, a required reporter | 24 | | shall, within 24 hours after initial discovery, report by | 25 | | phone to the Office of the Inspector General hotline each | 26 | | of the following: |
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| 1 | | (i) Any death of an individual occurring within 14 | 2 | | calendar days after discharge or transfer of the | 3 | | individual from a residential program or facility. | 4 | | (ii) Any death of an individual occurring within | 5 | | 24 hours after deflection from a residential program | 6 | | or facility. | 7 | | (iii) Any other death of an individual occurring | 8 | | at an agency or facility or at any Department-funded | 9 | | site. | 10 | | (3) Retaliation. It is a violation of this Act for any | 11 | | employee or administrator of an agency or facility to take | 12 | | retaliatory action against an employee who acts in good | 13 | | faith in conformance with his or her duties as a required | 14 | | reporter. | 15 | | (l) Reporting to law enforcement. | 16 | | (1) Reporting criminal acts. Within 24 hours after | 17 | | determining that there is credible evidence indicating | 18 | | that a criminal act may have been committed or that | 19 | | special expertise may be required in an investigation, the | 20 | | Inspector General shall notify the Department of State | 21 | | Police or other appropriate law enforcement authority, or | 22 | | ensure that such notification is made. The Department of | 23 | | State Police shall investigate any report from a | 24 | | State-operated facility indicating a possible murder, | 25 | | sexual assault, or other felony by an employee. All | 26 | | investigations conducted by the Inspector General shall be |
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| 1 | | conducted in a manner designed to ensure the preservation | 2 | | of evidence for possible use in a criminal prosecution. | 3 | | (2) Reporting allegations of adult students with | 4 | | disabilities. Upon receipt of a reportable allegation | 5 | | regarding an adult student with a disability, the | 6 | | Department's Office of the Inspector General shall | 7 | | determine whether the allegation meets the criteria for | 8 | | the Domestic Abuse Program under the Abuse of Adults with | 9 | | Disabilities Intervention Act. If the allegation is | 10 | | reportable to that program, the Office of the Inspector | 11 | | General shall initiate an investigation. If the allegation | 12 | | is not reportable to the Domestic Abuse Program, the | 13 | | Office of the Inspector General shall make an expeditious | 14 | | referral to the respective law enforcement entity. If the | 15 | | alleged victim is already receiving services from the | 16 | | Department, the Office of the Inspector General shall also | 17 | | make a referral to the respective Department of Human | 18 | | Services' Division or Bureau. | 19 | | (m) Investigative reports. Upon completion of an | 20 | | investigation, the Office of Inspector General shall issue an | 21 | | investigative report identifying whether the allegations are | 22 | | substantiated, unsubstantiated, or unfounded. Within 10 | 23 | | business days after the transmittal of a completed | 24 | | investigative report substantiating an allegation, finding an | 25 | | allegation is unsubstantiated, or if a recommendation is made, | 26 | | the Inspector General shall provide the investigative report |
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| 1 | | on the case to the Secretary and to the director of the | 2 | | facility or agency where any one or more of the following | 3 | | occurred: mental abuse, physical abuse, sexual abuse, neglect, | 4 | | egregious neglect, or financial exploitation. The director of | 5 | | the facility or agency shall be responsible for maintaining | 6 | | the confidentiality of the investigative report consistent | 7 | | with State and federal law. In a substantiated case, the | 8 | | investigative report shall include any mitigating or | 9 | | aggravating circumstances that were identified during the | 10 | | investigation. If the case involves substantiated neglect, the | 11 | | investigative report shall also state whether egregious | 12 | | neglect was found. An investigative report may also set forth | 13 | | recommendations. All investigative reports prepared by the | 14 | | Office of the Inspector General shall be considered | 15 | | confidential and shall not be released except as provided by | 16 | | the law of this State or as required under applicable federal | 17 | | law. Unsubstantiated and unfounded reports shall not be | 18 | | disclosed except as allowed under Section 6 of the Abused and | 19 | | Neglected Long Term Care Facility Residents Reporting Act. Raw | 20 | | data used to compile the investigative report shall not be | 21 | | subject to release unless required by law or a court order. | 22 | | "Raw data used to compile the investigative report" includes, | 23 | | but is not limited to, any one or more of the following: the | 24 | | initial complaint, witness statements, photographs, | 25 | | investigator's notes, police reports, or incident reports. If | 26 | | the allegations are substantiated, the victim, the victim's |
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| 1 | | guardian, and the accused shall be provided with a redacted | 2 | | copy of the investigative report. Death reports where there | 3 | | was no allegation of abuse or neglect shall only be released | 4 | | pursuant to applicable State or federal law or a valid court | 5 | | order. Unredacted investigative reports, as well as raw data, | 6 | | may be shared with a local law enforcement entity, a State's | 7 | | Attorney's office, or a county coroner's office upon written | 8 | | request. | 9 | | (n) Written responses, clarification requests, and | 10 | | reconsideration requests. | 11 | | (1) Written responses. Within 30 calendar days from | 12 | | receipt of a substantiated investigative report or an | 13 | | investigative report which contains recommendations, | 14 | | absent a reconsideration request, the facility or agency | 15 | | shall file a written response that addresses, in a concise | 16 | | and reasoned manner, the actions taken to: (i) protect the | 17 | | individual; (ii) prevent recurrences; and (iii) eliminate | 18 | | the problems identified. The response shall include the | 19 | | implementation and completion dates of such actions. If | 20 | | the written response is not filed within the allotted 30 | 21 | | calendar day period, the Secretary shall determine the | 22 | | appropriate corrective action to be taken. | 23 | | (2) Requests for clarification. The facility, agency, | 24 | | victim or guardian, or the subject employee may request | 25 | | that the Office of Inspector General clarify the finding | 26 | | or findings for which clarification is sought. |
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| 1 | | (3) Requests for reconsideration. The facility, | 2 | | agency, victim or guardian, or the subject employee may | 3 | | request that the Office of the Inspector General | 4 | | reconsider the finding or findings or the recommendations. | 5 | | A request for reconsideration shall be subject to a | 6 | | multi-layer review and shall include at least one reviewer | 7 | | who did not participate in the investigation or approval | 8 | | of the original investigative report. After the | 9 | | multi-layer review process has been completed, the | 10 | | Inspector General shall make the final determination on | 11 | | the reconsideration request. The investigation shall be | 12 | | reopened if the reconsideration determination finds that | 13 | | additional information is needed to complete the | 14 | | investigative record. | 15 | | (o) Disclosure of the finding by the Inspector General. | 16 | | The Inspector General shall disclose the finding of an | 17 | | investigation to the following persons: (i) the Governor, (ii) | 18 | | the Secretary, (iii) the director of the facility or agency, | 19 | | (iv) the alleged victims and their guardians, (v) the | 20 | | complainant, and (vi) the accused. This information shall | 21 | | include whether the allegations were deemed substantiated, | 22 | | unsubstantiated, or unfounded. | 23 | | (p) Secretary review. Upon review of the Inspector | 24 | | General's investigative report and any agency's or facility's | 25 | | written response, the Secretary shall accept or reject the | 26 | | written response and notify the Inspector General of that |
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| 1 | | determination. The Secretary may further direct that other | 2 | | administrative action be taken, including, but not limited to, | 3 | | any one or more of the following: (i) additional site visits, | 4 | | (ii) training, (iii) provision of technical assistance | 5 | | relative to administrative needs, licensure, or certification, | 6 | | or (iv) the imposition of appropriate sanctions. | 7 | | (q) Action by facility or agency. Within 30 days of the | 8 | | date the Secretary approves the written response or directs | 9 | | that further administrative action be taken, the facility or | 10 | | agency shall provide an implementation report to the Inspector | 11 | | General that provides the status of the action taken. The | 12 | | facility or agency shall be allowed an additional 30 days to | 13 | | send notice of completion of the action or to send an updated | 14 | | implementation report. If the action has not been completed | 15 | | within the additional 30-day period, the facility or agency | 16 | | shall send updated implementation reports every 60 days until | 17 | | completion. The Inspector General shall conduct a review of | 18 | | any implementation plan that takes more than 120 days after | 19 | | approval to complete, and shall monitor compliance through a | 20 | | random review of approved written responses, which may | 21 | | include, but are not limited to: (i) site visits, (ii) | 22 | | telephone contact, and (iii) requests for additional | 23 | | documentation evidencing compliance. | 24 | | (r) Sanctions. Sanctions, if imposed by the Secretary | 25 | | under Subdivision (p)(iv) of this Section, shall be designed | 26 | | to prevent further acts of mental abuse, physical abuse, |
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| 1 | | sexual abuse, neglect, egregious neglect, or financial | 2 | | exploitation or some combination of one or more of those acts | 3 | | at a facility or agency, and may include any one or more of the | 4 | | following: | 5 | | (1) Appointment of on-site monitors. | 6 | | (2) Transfer or relocation of an individual or | 7 | | individuals. | 8 | | (3) Closure of units. | 9 | | (4) Termination of any one or more of the following: | 10 | | (i) Department licensing, (ii) funding, or (iii) | 11 | | certification. | 12 | | The Inspector General may seek the assistance of the | 13 | | Illinois Attorney General or the office of any State's | 14 | | Attorney in implementing sanctions. | 15 | | (s) Health Care Worker Registry. | 16 | | (1) Reporting to the Registry. The Inspector General | 17 | | shall report to the Department of Public Health's Health | 18 | | Care Worker Registry, a public registry, the identity and | 19 | | finding of each employee of a facility or agency against | 20 | | whom there is a final investigative report containing a | 21 | | substantiated allegation of physical or sexual abuse, | 22 | | financial exploitation, or egregious neglect of an | 23 | | individual. | 24 | | (2) Notice to employee. Prior to reporting the name of | 25 | | an employee, the employee shall be notified of the | 26 | | Department's obligation to report and shall be granted an |
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| 1 | | opportunity to request an administrative hearing, the sole | 2 | | purpose of which is to determine if the substantiated | 3 | | finding warrants reporting to the Registry. Notice to the | 4 | | employee shall contain a clear and concise statement of | 5 | | the grounds on which the report to the Registry is based, | 6 | | offer the employee an opportunity for a hearing, and | 7 | | identify the process for requesting such a hearing. Notice | 8 | | is sufficient if provided by certified mail to the | 9 | | employee's last known address. If the employee fails to | 10 | | request a hearing within 30 days from the date of the | 11 | | notice, the Inspector General shall report the name of the | 12 | | employee to the Registry. Nothing in this subdivision | 13 | | (s)(2) shall diminish or impair the rights of a person who | 14 | | is a member of a collective bargaining unit under the | 15 | | Illinois Public Labor Relations Act or under any other | 16 | | federal labor statute. | 17 | | (3) Registry hearings. If the employee requests an | 18 | | administrative hearing, the employee shall be granted an | 19 | | opportunity to appear before an administrative law judge | 20 | | to present reasons why the employee's name should not be | 21 | | reported to the Registry. The Department shall bear the | 22 | | burden of presenting evidence that establishes, by a | 23 | | preponderance of the evidence, that the substantiated | 24 | | finding warrants reporting to the Registry. After | 25 | | considering all the evidence presented, the administrative | 26 | | law judge shall make a recommendation to the Secretary as |
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| 1 | | to whether the substantiated finding warrants reporting | 2 | | the name of the employee to the Registry. The Secretary | 3 | | shall render the final decision. The Department and the | 4 | | employee shall have the right to request that the | 5 | | administrative law judge consider a stipulated disposition | 6 | | of these proceedings. | 7 | | (4) Testimony at Registry hearings. A person who makes | 8 | | a report or who investigates a report under this Act shall | 9 | | testify fully in any judicial proceeding resulting from | 10 | | such a report, as to any evidence of abuse or neglect, or | 11 | | the cause thereof. No evidence shall be excluded by reason | 12 | | of any common law or statutory privilege relating to | 13 | | communications between the alleged perpetrator of abuse or | 14 | | neglect, or the individual alleged as the victim in the | 15 | | report, and the person making or investigating the report. | 16 | | Testimony at hearings is exempt from the confidentiality | 17 | | requirements of subsection (f) of Section 10 of the Mental | 18 | | Health and Developmental Disabilities Confidentiality Act. | 19 | | (5) Employee's rights to collateral action. No | 20 | | reporting to the Registry shall occur and no hearing shall | 21 | | be set or proceed if an employee notifies the Inspector | 22 | | General in writing, including any supporting | 23 | | documentation, that he or she is formally contesting an | 24 | | adverse employment action resulting from a substantiated | 25 | | finding by complaint filed with the Illinois Civil Service | 26 | | Commission, or which otherwise seeks to enforce the |
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| 1 | | employee's rights pursuant to any applicable collective | 2 | | bargaining agreement. If an action taken by an employer | 3 | | against an employee as a result of a finding of physical | 4 | | abuse, sexual abuse, or egregious neglect is overturned | 5 | | through an action filed with the Illinois Civil Service | 6 | | Commission or under any applicable collective bargaining | 7 | | agreement and if that employee's name has already been | 8 | | sent to the Registry, the employee's name shall be removed | 9 | | from the Registry. | 10 | | (6) Removal from Registry. At any time after the | 11 | | report to the Registry, but no more than once in any | 12 | | 12-month period, an employee may petition the Department | 13 | | in writing to remove his or her name from the Registry. | 14 | | Upon receiving notice of such request, the Inspector | 15 | | General shall conduct an investigation into the petition. | 16 | | Upon receipt of such request, an administrative hearing | 17 | | will be set by the Department. At the hearing, the | 18 | | employee shall bear the burden of presenting evidence that | 19 | | establishes, by a preponderance of the evidence, that | 20 | | removal of the name from the Registry is in the public | 21 | | interest. The parties may jointly request that the | 22 | | administrative law judge consider a stipulated disposition | 23 | | of these proceedings. | 24 | | (t) Review of Administrative Decisions. The Department | 25 | | shall preserve a record of all proceedings at any formal | 26 | | hearing conducted by the Department involving Health Care |
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| 1 | | Worker Registry hearings. Final administrative decisions of | 2 | | the Department are subject to judicial review pursuant to | 3 | | provisions of the Administrative Review Law. | 4 | | (u) Quality Care Board. There is created, within the | 5 | | Office of the Inspector General, a Quality Care Board to be | 6 | | composed of 7 members appointed by the Governor with the | 7 | | advice and consent of the Senate. One of the members shall be | 8 | | designated as chairman by the Governor. Of the initial | 9 | | appointments made by the Governor, 4 Board members shall each | 10 | | be appointed for a term of 4 years and 3 members shall each be | 11 | | appointed for a term of 2 years. Upon the expiration of each | 12 | | member's term, a successor shall be appointed for a term of 4 | 13 | | years. In the case of a vacancy in the office of any member, | 14 | | the Governor shall appoint a successor for the remainder of | 15 | | the unexpired term. | 16 | | Members appointed by the Governor shall be qualified by | 17 | | professional knowledge or experience in the area of law, | 18 | | investigatory techniques, or in the area of care of the | 19 | | mentally ill or care of persons with developmental | 20 | | disabilities. Two members appointed by the Governor shall be | 21 | | persons with a disability or parents of persons with a | 22 | | disability. Members shall serve without compensation, but | 23 | | shall be reimbursed for expenses incurred in connection with | 24 | | the performance of their duties as members. | 25 | | The Board shall meet quarterly, and may hold other | 26 | | meetings on the call of the chairman. Four members shall |
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| 1 | | constitute a quorum allowing the Board to conduct its | 2 | | business. The Board may adopt rules and regulations it deems | 3 | | necessary to govern its own procedures. | 4 | | The Board shall monitor and oversee the operations, | 5 | | policies, and procedures of the Inspector General to ensure | 6 | | the prompt and thorough investigation of allegations of | 7 | | neglect and abuse. In fulfilling these responsibilities, the | 8 | | Board may do the following: | 9 | | (1) Provide independent, expert consultation to the | 10 | | Inspector General on policies and protocols for | 11 | | investigations of alleged abuse, neglect, or both abuse | 12 | | and neglect. | 13 | | (2) Review existing regulations relating to the | 14 | | operation of facilities. | 15 | | (3) Advise the Inspector General as to the content of | 16 | | training activities authorized under this Section. | 17 | | (4) Recommend policies concerning methods for | 18 | | improving the intergovernmental relationships between the | 19 | | Office of the Inspector General and other State or federal | 20 | | offices. | 21 | | (v) Annual report. The Inspector General shall provide to | 22 | | the General Assembly and the Governor, no later than January 1 | 23 | | of each year, a summary of reports and investigations made | 24 | | under this Act for the prior fiscal year with respect to | 25 | | individuals receiving mental health or developmental | 26 | | disabilities services. The report shall detail the imposition |
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| 1 | | of sanctions, if any, and the final disposition of any | 2 | | corrective or administrative action directed by the Secretary. | 3 | | The summaries shall not contain any confidential or | 4 | | identifying information of any individual, but shall include | 5 | | objective data identifying any trends in the number of | 6 | | reported allegations, the timeliness of the Office of the | 7 | | Inspector General's investigations, and their disposition, for | 8 | | each facility and Department-wide, for the most recent 3-year | 9 | | time period. The report shall also identify, by facility, the | 10 | | staff-to-patient ratios taking account of direct care staff | 11 | | only. The report shall also include detailed recommended | 12 | | administrative actions and matters for consideration by the | 13 | | General Assembly. | 14 | | (w) Program audit. The Auditor General shall conduct a | 15 | | program audit of the Office of the Inspector General on an | 16 | | as-needed basis, as determined by the Auditor General. The | 17 | | audit shall specifically include the Inspector General's | 18 | | compliance with the Act and effectiveness in investigating | 19 | | reports of allegations occurring in any facility or agency. | 20 | | The Auditor General shall conduct the program audit according | 21 | | to the provisions of the Illinois State Auditing Act and shall | 22 | | report its findings to the General Assembly no later than | 23 | | January 1 following the audit period.
| 24 | | (x) Nothing in this Section shall be construed to mean | 25 | | that an individual is a victim of abuse or neglect because of | 26 | | health care services appropriately provided or not provided by |
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| 1 | | health care professionals. | 2 | | (y) Nothing in this Section shall require a facility, | 3 | | including its employees, agents, medical staff members, and | 4 | | health care professionals, to provide a service to an | 5 | | individual in contravention of that individual's stated or | 6 | | implied objection to the provision of that service on the | 7 | | ground that that service conflicts with the individual's | 8 | | religious beliefs or practices, nor shall the failure to | 9 | | provide a service to an individual be considered abuse under | 10 | | this Section if the individual has objected to the provision | 11 | | of that service based on his or her religious beliefs or | 12 | | practices.
| 13 | | (Source: P.A. 100-313, eff. 8-24-17; 100-432, eff. 8-25-17; | 14 | | 100-863, eff. 8-14-18; 100-943, eff. 1-1-19; 100-991, eff. | 15 | | 8-20-18; 100-1098, eff. 8-26-18; 101-81, eff. 7-12-19.)
| 16 | | Section 20. The Illinois Public Aid Code is amended by | 17 | | changing Section 12-13.1 as follows:
| 18 | | (305 ILCS 5/12-13.1)
| 19 | | Sec. 12-13.1. Inspector General.
| 20 | | (a) The Governor shall appoint, and the Senate shall | 21 | | confirm, an Inspector
General who shall function within the | 22 | | Illinois Department of Public Aid (now Healthcare and Family | 23 | | Services) and
report to the Governor. The term of the | 24 | | Inspector General shall expire on the
third Monday of January, |
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| 1 | | 1997 and every 4 years thereafter.
| 2 | | (b) In order to prevent, detect, and eliminate fraud, | 3 | | waste, abuse,
mismanagement, and misconduct, the Inspector | 4 | | General shall oversee the
Department of Healthcare and Family | 5 | | Services' and the Department on Aging's integrity
functions, | 6 | | which include, but are not limited to, the following:
| 7 | | (1) Investigation of misconduct by employees, former | 8 | | employees as defined in subsection (e-5), vendors, | 9 | | contractors and
medical providers, except for allegations | 10 | | of violations of the State Officials and Employees Ethics | 11 | | Act which shall be referred to the Office of the | 12 | | Governor's Executive Inspector General for investigation.
| 13 | | (2) Prepayment and post-payment audits of medical | 14 | | providers related to ensuring that appropriate
payments | 15 | | are made for services rendered and to the prevention and | 16 | | recovery of overpayments.
| 17 | | (3) Monitoring of quality assurance programs | 18 | | administered by the Department of Healthcare and Family
| 19 | | Services and the Community Care Program administered by | 20 | | the Department on Aging.
| 21 | | (4) Quality control measurements of the programs | 22 | | administered by the
Department of Healthcare and Family | 23 | | Services and the Community Care Program administered by | 24 | | the Department on Aging.
| 25 | | (5) Investigations of fraud or intentional program | 26 | | violations committed by
clients of the Department of |
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| 1 | | Healthcare and Family Services and the Community Care | 2 | | Program administered by the Department on Aging.
| 3 | | (6) Actions initiated against contractors, vendors, or | 4 | | medical providers for any of
the following reasons:
| 5 | | (A) Violations of the medical assistance program | 6 | | and the Community Care Program administered by the | 7 | | Department on Aging.
| 8 | | (B) Sanctions against providers brought in | 9 | | conjunction with the
Department of Public Health or | 10 | | the Department of Human Services (as successor
to the | 11 | | Department of Mental Health and Developmental | 12 | | Disabilities).
| 13 | | (C) Recoveries of assessments against hospitals | 14 | | and long-term care
facilities.
| 15 | | (D) Sanctions mandated by the United States | 16 | | Department of Health and
Human Services against | 17 | | medical providers.
| 18 | | (E) Violations of contracts related to any | 19 | | programs administered by the Department of Healthcare
| 20 | | and Family Services and the Community Care Program | 21 | | administered by the Department on Aging.
| 22 | | (7) Representation of the Department of Healthcare and | 23 | | Family Services at
hearings with the Illinois Department | 24 | | of Financial and Professional Regulation in actions
taken | 25 | | against professional licenses held by persons who are in | 26 | | violation of
orders for child support payments.
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| 1 | | (b-5) At the request of the Secretary of Human Services, | 2 | | the Inspector
General shall, in relation to any function | 3 | | performed by the Department of Human
Services as successor to | 4 | | the Department of Public Aid, exercise one or more
of the | 5 | | powers provided under this Section as if those powers related | 6 | | to the
Department of Human Services; in such matters, the | 7 | | Inspector General shall
report his or her findings to the | 8 | | Secretary of Human Services.
| 9 | | (c) Notwithstanding, and in addition to, any other
| 10 | | provision of law, the Inspector General shall have access to | 11 | | all information, personnel
and facilities of the
Department of | 12 | | Healthcare and Family Services and the Department of
Human | 13 | | Services (as successor to the Department of Public Aid), their | 14 | | employees, vendors, contractors and medical providers and any | 15 | | federal,
State or local governmental agency that are necessary | 16 | | to perform the duties of
the Office as directly related to | 17 | | public assistance programs administered by
those departments. | 18 | | No medical provider shall
be compelled, however, to provide | 19 | | individual medical records of patients who
are not clients of | 20 | | the programs administered by the Department of Healthcare and
| 21 | | Family Services. State and local
governmental agencies are | 22 | | authorized and directed to provide the requested
information, | 23 | | assistance or cooperation.
| 24 | | For purposes of enhanced program integrity functions and
| 25 | | oversight, and to the extent consistent with applicable
| 26 | | information and privacy, security, and disclosure laws, State
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| 1 | | agencies and departments shall provide the Office of Inspector | 2 | | General access to confidential and other information and data, | 3 | | and the Inspector General is authorized to enter into | 4 | | agreements with appropriate federal agencies and departments | 5 | | to secure similar data. This includes, but is not limited to, | 6 | | information pertaining to: licensure; certification; earnings; | 7 | | immigration status; citizenship; wage reporting; unearned and | 8 | | earned income; pension income;
employment; supplemental | 9 | | security income; social security
numbers; National Provider | 10 | | Identifier (NPI) numbers; the
National Practitioner Data Bank | 11 | | (NPDB); program and agency
exclusions; taxpayer identification | 12 | | numbers; tax delinquency;
corporate information; and death | 13 | | records. | 14 | | The Inspector General shall enter into agreements with | 15 | | State agencies and departments, and is authorized to enter | 16 | | into agreements with federal agencies and departments, under | 17 | | which such agencies and departments shall share data necessary | 18 | | for medical assistance program integrity functions and | 19 | | oversight. The Inspector General shall enter into agreements | 20 | | with State agencies and departments, and is authorized to | 21 | | enter into agreements with federal agencies and departments, | 22 | | under which such agencies shall share data necessary for | 23 | | recipient and vendor screening, review, and investigation, | 24 | | including but not limited to vendor payment and recipient | 25 | | eligibility verification. The Inspector General shall develop, | 26 | | in cooperation with other State and federal agencies and |
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| 1 | | departments, and in compliance with applicable federal laws | 2 | | and regulations, appropriate and effective
methods to share | 3 | | such data. The Inspector General shall enter into agreements | 4 | | with State agencies and departments, and is authorized to | 5 | | enter into agreements with federal agencies and departments, | 6 | | including, but not limited to: the Secretary of State; the
| 7 | | Department of Revenue; the Department of Public Health; the
| 8 | | Department of Human Services; and the Department of Financial | 9 | | and Professional Regulation. | 10 | | The Inspector General shall have the authority to deny | 11 | | payment, prevent overpayments, and recover overpayments. | 12 | | The Inspector General shall have the authority to deny or
| 13 | | suspend payment to, and deny, terminate, or suspend the
| 14 | | eligibility of, any vendor who fails to grant the Inspector
| 15 | | General timely access to full and complete records, including | 16 | | records of recipients under the medical assistance program for | 17 | | the most recent 6 years, in accordance with Section 140.28 of | 18 | | Title 89 of the Illinois Administrative Code, and other | 19 | | information for the purpose of audits, investigations, or | 20 | | other program integrity functions, after reasonable written | 21 | | request by the Inspector General. | 22 | | (d) The Inspector General shall serve as the
Department of | 23 | | Healthcare and Family Services'
primary liaison with law | 24 | | enforcement,
investigatory and prosecutorial agencies, | 25 | | including but not limited to the
following:
| 26 | | (1) The Department of State Police.
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| 1 | | (2) The Federal Bureau of Investigation and other | 2 | | federal law enforcement
agencies.
| 3 | | (3) The various Inspectors General of federal agencies | 4 | | overseeing the
programs administered by the
Department of | 5 | | Healthcare and Family Services.
| 6 | | (4) The various Inspectors General of any other State | 7 | | agencies with
responsibilities for portions of programs | 8 | | primarily administered by the
Department of Healthcare and | 9 | | Family Services.
| 10 | | (5) The Offices of the several United States Attorneys | 11 | | in Illinois.
| 12 | | (6) The several State's Attorneys.
| 13 | | (7) The offices of the Centers for Medicare and | 14 | | Medicaid Services that administer the Medicare and | 15 | | Medicaid integrity programs. | 16 | | The Inspector General shall meet on a regular basis with | 17 | | these entities to
share information regarding possible | 18 | | misconduct by any persons or entities
involved with the public | 19 | | aid programs administered by the Department
of Healthcare and | 20 | | Family Services.
| 21 | | (e) All investigations conducted by the Inspector General | 22 | | shall be conducted
in a manner that ensures the preservation | 23 | | of evidence for use in criminal
prosecutions. If the Inspector | 24 | | General determines that a possible criminal act
relating to | 25 | | fraud in the provision or administration of the medical | 26 | | assistance
program has been committed, the Inspector General |
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| 1 | | shall immediately notify the
Medicaid Fraud Control Unit. If | 2 | | the Inspector General determines that a
possible criminal act | 3 | | has been committed within the jurisdiction of the Office,
the | 4 | | Inspector General may request the special expertise of the | 5 | | Department of
State Police. The Inspector General may present | 6 | | for prosecution the findings
of any criminal investigation to | 7 | | the Office of the Attorney General, the
Offices of the several | 8 | | United States Attorneys in Illinois or the several
State's | 9 | | Attorneys.
| 10 | | (e-5) It is the duty of every employee and former employee | 11 | | to cooperate with the Inspector General in any investigation | 12 | | undertaken in accordance with this Code. For purposes of this | 13 | | Section, "former employee" means a former agency director, | 14 | | senior administrator, or any other individual who, while | 15 | | employed at the Department of Healthcare and Family Services | 16 | | or the Department of Human Services, had the authority to | 17 | | implement policy action concerning the public assistance | 18 | | programs established under this Code for (i) the Department of | 19 | | Healthcare and Family Services or the Department of Human | 20 | | Services, (ii) an agency under contract with the Department of | 21 | | Healthcare and Family Services or the Department of Human | 22 | | Services, or (iii) any facility or program operated for or | 23 | | licensed or funded by the Department of Healthcare and Family | 24 | | Services or the Department of Human Services. | 25 | | (f) To carry out his or her duties as described in this | 26 | | Section, the
Inspector General and his or her designees shall |
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| 1 | | have the power to compel
by subpoena the attendance and | 2 | | testimony of witnesses and the production
of books, electronic | 3 | | records and papers as directly related to public
assistance | 4 | | programs administered by the Department of Healthcare and | 5 | | Family Services or
the Department of Human Services (as | 6 | | successor to the Department of Public
Aid). The Inspector | 7 | | General shall have the power to subpoena a former employee, as | 8 | | defined in subsection (e-5), of the Department of Healthcare | 9 | | and Family Services or the Department of Human Services to | 10 | | correct a systemic issue, problem, or deficiency identified | 11 | | during an investigation authorized by this Section. No medical | 12 | | provider shall be compelled, however, to provide individual
| 13 | | medical records of patients who are not clients of the Medical | 14 | | Assistance
Program.
| 15 | | (g) The Inspector General shall report all convictions, | 16 | | terminations, and
suspensions taken against vendors, | 17 | | contractors and medical providers to the
Department of | 18 | | Healthcare and Family Services and to any agency responsible | 19 | | for
licensing or regulating those persons or entities.
| 20 | | (h) The Inspector General shall make annual
reports, | 21 | | findings, and recommendations regarding the Office's | 22 | | investigations
into reports of fraud, waste, abuse, | 23 | | mismanagement, or misconduct relating to
any programs | 24 | | administered by the Department
of Healthcare and Family | 25 | | Services or the Department of Human Services (as successor to | 26 | | the
Department of Public Aid) to the General Assembly and the |
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| 1 | | Governor. These
reports shall include, but not be limited to, | 2 | | the following information:
| 3 | | (1) Aggregate provider billing and payment | 4 | | information, including the
number of providers at various | 5 | | Medicaid earning levels.
| 6 | | (2) The number of audits of the medical assistance
| 7 | | program and the dollar savings resulting from those | 8 | | audits.
| 9 | | (3) The number of prescriptions rejected annually | 10 | | under the
Department of Healthcare and Family Services' | 11 | | Refill Too Soon program and the
dollar savings resulting | 12 | | from that program.
| 13 | | (4) Provider sanctions, in the aggregate, including | 14 | | terminations and
suspensions.
| 15 | | (5) A detailed summary of the investigations | 16 | | undertaken in the previous
fiscal year. These summaries | 17 | | shall comply with all laws and rules regarding
maintaining | 18 | | confidentiality in the public aid programs.
| 19 | | (i) Nothing in this Section shall limit investigations by | 20 | | the
Department of Healthcare and Family Services or the | 21 | | Department of Human Services that may
otherwise be required by | 22 | | law or that may be necessary in their capacity as the
central | 23 | | administrative authorities responsible for administration of | 24 | | their agency's
programs in this
State.
| 25 | | (j) The Inspector General may issue shields or other | 26 | | distinctive identification to his or her employees not |
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| 1 | | exercising the powers of a peace officer if the Inspector | 2 | | General determines that a shield or distinctive identification | 3 | | is needed by an employee to carry out his or her | 4 | | responsibilities. | 5 | | (Source: P.A. 97-689, eff. 6-14-12; 98-8, eff. 5-3-13.)".
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