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90_HB2540
210 ILCS 30/3 from Ch. 111 1/2, par. 4163
320 ILCS 20/2 from Ch. 23, par. 6602
Amends the Abused and Neglected Long Term Care Facility
Residents Reporting Act and the Elder Abuse and Neglect Act.
Replaces the definition of "abuse" in each Act with similar
provisions in both Acts defining abuse to include physical
abuse, sexual abuse, and emotional or psychological abuse,
explaining each term, and giving signs and symptoms of each
type of abuse. Replaces the definition of "neglect" in each
Act with similar provisions in both Acts defining neglect to
include abandonment, financial or material exploitation, and
self-neglect, explaining each term, and giving signs and
symptoms of each type of abuse.
LRB9008343SMpk
LRB9008343SMpk
1 AN ACT regarding abuse and neglect of the elderly and
2 disabled.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Abused and Neglected Long Term Care
6 Facility Residents Reporting Act is amended by changing
7 Section 3 as follows:
8 (210 ILCS 30/3) (from Ch. 111 1/2, par. 4163)
9 Sec. 3. As used in this Act unless the context otherwise
10 requires:
11 a. "Department" means the Department of Public Health of
12 the State of Illinois.
13 b. "Resident" means a person residing in and receiving
14 personal care from a long term care facility, or residing in
15 a mental health facility or developmental disability facility
16 as defined in the Mental Health and Developmental
17 Disabilities Code.
18 c. "Long term care facility" has the same meaning
19 ascribed to such term in the Nursing Home Care Act, except
20 that the term as used in this Act shall include any mental
21 health facility or developmental disability facility as
22 defined in the Mental Health and Developmental Disabilities
23 Code.
24 d. "Abuse" means physical abuse, sexual abuse, and
25 emotional or psychological abuse any physical injury, sexual
26 abuse or mental injury inflicted on a resident other than by
27 accidental means.
28 e. "Neglect" means the refusal or failure to fulfill any
29 part of a person's obligations or duties to a resident.
30 Neglect may also include failure of a person who has
31 fiduciary responsibilities to provide care for a resident.
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1 Neglect typically means the refusal or failure to provide a
2 resident with such life necessities as food, water, clothing,
3 shelter, personal hygiene, medicine, comfort, personal
4 safety, and other essentials included in an implied or
5 agreed-upon responsibility to a resident.
6 Signs and symptoms of neglect include but are not limited
7 to: dehydration, malnutrition, untreated bed sores, and
8 poor personal hygiene; unattended or untreated health
9 problems; hazardous or unsafe living condition or
10 arrangements (for example, improper wiring, no heat, or no
11 running water); unsanitary and unclean living conditions (for
12 example, dirt, fleas, lice on the person, soiled bedding,
13 fecal or urine smell, or inadequate clothing); and a
14 resident's report of being mistreated.
15 "Neglect" also means abandonment, financial or material
16 exploitation, and self-neglect. a failure in a long term care
17 facility to provide adequate medical or personal care or
18 maintenance, which failure results in physical or mental
19 injury to a resident or in the deterioration of a resident's
20 physical or mental condition.
21 f. "Protective services" means services provided to a
22 resident who has been abused or neglected, which may include,
23 but are not limited to alternative temporary institutional
24 placement, nursing care, counseling, other social services
25 provided at the nursing home where the resident resides or at
26 some other facility, personal care and such protective
27 services of voluntary agencies as are available.
28 g. Unless the context otherwise requires, direct or
29 indirect references in this Act to the programs, personnel,
30 facilities, services, service providers, or service
31 recipients of the Department of Human Services shall be
32 construed to refer only to those programs, personnel,
33 facilities, services, service providers, or service
34 recipients that pertain to the Department of Human Services'
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1 mental health and developmental disabilities functions.
2 h. "Physical abuse" means the use of physical force that
3 may result in bodily injury, physical pain, or impairment.
4 Physical abuse may include but is not limited to such acts
5 of violence as striking (with or without an object), hitting,
6 beating, pushing, shoving, shaking, slapping, kicking,
7 pinching, and burning. In addition, the inappropriate use of
8 drugs and physical restraints, force-feeding, and physical
9 punishment of any kind also are examples of physical abuse.
10 Signs and symptoms of physical abuse include but are not
11 limited to: bruises, black eyes, welts, lacerations, and
12 rope marks; bone fractures, broken bones, and skull
13 fractures; open wounds, cuts, punctures, and untreated
14 injuries in various stages of healing; sprains, dislocations,
15 and internal injuries or bleeding; broken eyeglasses or
16 frames, physical signs of being subjected to punishment, and
17 signs of being restrained; laboratory findings of medication
18 overdose or under-utilization of prescribed drugs; a
19 resident's report of being hit, slapped, kicked, or
20 mistreated; a resident's sudden change in behavior; and the
21 long term care facility's refusal to allow visitors to see a
22 resident alone.
23 i. "Sexual abuse" means nonconsensual sexual contact of
24 any kind with a resident. Sexual contact with any person
25 incapable of giving consent is also considered sexual abuse.
26 It includes but is not limited to unwanted touching and all
27 types of sexual assault or battery, such as rape, sodomy,
28 coerced nudity, and sexually explicit photographing.
29 Signs and symptoms of sexual abuse include but are not
30 limited to: bruises around the breasts or genital area;
31 unexplained venereal disease or genital infections;
32 unexplained vaginal or anal bleeding; torn, stained, or
33 bloody underclothing; and a resident's report of being
34 sexually assaulted or raped.
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1 j. "Emotional abuse" or "psychological abuse" means the
2 infliction of anguish, pain, or distress through verbal or
3 nonverbal acts. Emotional or psychological abuse includes
4 but is not limited to verbal assaults, insults, threats,
5 intimidation, humiliation, and harassment. In addition,
6 treating a resident like an infant; isolating a resident from
7 his or her family, friends, or regular activities; giving a
8 resident the "silent treatment"; and enforced social
9 isolation are examples of emotional or psychological abuse.
10 Signs and symptoms of emotional or psychological abuse
11 include but are not limited to: being emotionally upset or
12 agitated; being extremely withdrawn and noncommunicative or
13 nonresponsive; unusual behavior usually attributed to
14 dementia (for example, sucking, biting, or rocking); and a
15 resident's report of being verbally or emotionally
16 mistreated.
17 k. "Abandonment" means the desertion of a resident by an
18 individual who has assumed responsibility for providing care
19 for a resident, or by a person with physical custody of a
20 resident.
21 Signs and symptoms of abandonment include but are not
22 limited to: the desertion of a resident at a hospital or
23 other similar institution; the desertion of a resident at a
24 shopping center or other public location; and a resident's
25 own report of being abandoned.
26 l. "Financial exploitation" or "material exploitation"
27 means the illegal or improper use of a resident's funds,
28 property, or assets. Examples include but are not limited to
29 cashing a resident's checks without authorization or
30 permission; forging a resident's signature; misusing or
31 stealing a resident's money or possessions; coercing or
32 deceiving a resident into signing any document (for example,
33 a contract or a will); and the improper use of
34 conservatorship, guardianship, or power of attorney.
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1 Signs and symptoms of financial or material exploitation
2 include but are not limited to: sudden changes in bank
3 account or banking practice, including an unexplained
4 withdrawal of large sums of money by a person accompanying
5 the resident; the inclusion of additional names on a
6 resident's bank signature card; unauthorized withdrawal of
7 the resident's funds using the resident's ATM card; abrupt
8 changes in a will or other financial documents; unexplained
9 disappearance of funds or valuable possessions; substandard
10 care being provided for bills unpaid despite the
11 availability of adequate financial resources; discovery of a
12 resident's signature being forged for financial transactions
13 and for the titles of his or her possessions; sudden
14 appearance of previously uninvolved relatives claiming their
15 rights to a resident's affairs and possessions; unexplained
16 sudden transfer of assets to a family member or someone
17 outside the family; the provision of services that are not
18 necessary; and a resident's report of financial exploitation.
19 m. "Self-neglect" means the behavior of a resident that
20 threatens his or her own health or safety. Self-neglect
21 generally manifests itself in a resident as a refusal or
22 failure to provide himself or herself with adequate food,
23 water, clothing, shelter, personal hygiene, medication (when
24 indicated), and safety precautions. The definition of
25 self-neglect excludes a situation in which a mentally
26 competent resident, who understands the consequences of his
27 or her decisions, makes a conscious and voluntary decision to
28 engage in acts that threaten his or her health or safety as a
29 matter of personal choice.
30 Signs and symptoms of self-neglect include but are not
31 limited to: dehydration, malnutrition, untreated or
32 improperly attended medical conditions, and poor personal
33 hygiene; hazardous or unsafe living conditions or
34 arrangements; unsanitary or unclean living quarters (for
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1 example, animal or insect infestation, no functioning toilet,
2 or fecal or urine smell); inappropriate or inadequate
3 clothing; and lack of the necessary medical aids (for
4 example, eyeglasses, hearing aids, or dentures).
5 (Source: P.A. 89-507, eff. 7-1-97.)
6 Section 10. The Elder Abuse and Neglect Act is amended
7 by changing Section 2 as follows:
8 (320 ILCS 20/2) (from Ch. 23, par. 6602)
9 Sec. 2. Definitions. As used in this Act, unless the
10 context requires otherwise:
11 (a) "Abuse" means physical abuse, sexual abuse, and
12 emotional or psychological abuse causing any physical, mental
13 or sexual injury to an eligible adult, including exploitation
14 of such adult's financial resources. Nothing in this Act
15 shall be construed to mean that an eligible adult is a victim
16 of abuse or neglect for the sole reason that he or she is
17 being furnished with or relies upon treatment by spiritual
18 means through prayer alone, in accordance with the tenets and
19 practices of a recognized church or religious denomination.
20 (b) "Department" means the Department on Aging of the
21 State of Illinois.
22 (c) "Director" means the Director of the Department.
23 (d) "Domestic living situation" means a residence where
24 the eligible adult lives alone or with his or her family or a
25 caretaker, or others, but is not:
26 (1) A licensed facility as defined in Section
27 1-113 of the Nursing Home Care Act;
28 (2) A "life care facility" as defined in the Life
29 Care Facilities Act;
30 (3) A home, institution, or other place operated by
31 the federal government or agency thereof or by the State
32 of Illinois;
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1 (4) A hospital, sanitarium, or other institution,
2 the principal activity or business of which is the
3 diagnosis, care, and treatment of human illness through
4 the maintenance and operation of organized facilities
5 therefor, which is required to be licensed under the
6 Hospital Licensing Act;
7 (5) A "community living facility" as defined in the
8 Community Living Facilities Licensing Act;
9 (6) A "community residential alternative" as
10 defined in the Community Residential Alternatives
11 Licensing Act; and
12 (7) A "community-integrated living arrangement" as
13 defined in the Community-Integrated Living Arrangements
14 Licensure and Certification Act.
15 (e) "Eligible adult" means a person 60 years of age or
16 older who resides in a domestic setting and is abused or
17 neglected by another individual.
18 (f) "Emergency" means a situation in which an eligible
19 adult is living in conditions presenting a risk of death or
20 physical, mental or sexual injury and is unable to consent to
21 services which would alleviate that risk.
22 (g) "Neglect" means the refusal or failure to fulfill
23 any part of a person's obligations or duties to an eligible
24 adult. Neglect may also include failure of a person who has
25 fiduciary responsibilities to provide care for an eligible
26 adult (for example, pay for necessary home care service) or
27 the failure on the part of an in-home service provider to
28 provide necessary care. Neglect typically means the refusal
29 or failure to provide an eligible adult with such life
30 necessities as food, water, clothing, shelter, personal
31 hygiene, medicine, comfort, personal safety, and other
32 essentials included in an implied or agreed-upon
33 responsibility to an eligible adult.
34 Signs and symptoms of neglect include but are not limited
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1 to: dehydration, malnutrition, untreated bed sores, and
2 poor personal hygiene; unattended or untreated health
3 problems; hazardous or unsafe living condition or
4 arrangements (for example, improper wiring, no heat, or no
5 running water); unsanitary and unclean living conditions
6 (for example, dirt, fleas, lice on the person, soiled
7 bedding, fecal or urine smell, or inadequate clothing); and
8 an eligible adult's report of being mistreated.
9 "Neglect" also means abandonment, financial or material
10 exploitation, and self-neglect. another individual's failure
11 to provide an eligible adult with or willful withholding from
12 an eligible adult the necessities of life including, but not
13 limited to, food, clothing, shelter or medical care. This
14 subsection does not create any new affirmative duty to
15 provide support to eligible adults.
16 (h) "Provider agency" means any public or nonprofit
17 agency in a planning and service area appointed by the
18 regional administrative agency with prior approval by the
19 Department on Aging to receive and assess reports of alleged
20 or suspected abuse or neglect.
21 (i) "Regional administrative agency" means any public or
22 nonprofit agency in a planning and service area so designated
23 by the Department, provided that the designated Area Agency
24 on Aging shall be designated the regional administrative
25 agency if it so requests.
26 (j) "Substantiated case" means a reported case of
27 alleged or suspected abuse or neglect in which a provider
28 agency, after assessment, determines that there is reason to
29 believe abuse or neglect has occurred.
30 (k) "Physical abuse" means the use of physical force
31 that may result in bodily injury, physical pain, or
32 impairment. Physical abuse may include but is not limited to
33 such acts of violence as striking (with or without an
34 object), hitting, beating, pushing, shoving, shaking,
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1 slapping, kicking, pinching, and burning. In addition, the
2 inappropriate use of drugs and physical restraints,
3 force-feeding, and physical punishment of any kind also are
4 examples of physical abuse.
5 Signs and symptoms of physical abuse include but are not
6 limited to: bruises, black eyes, welts, lacerations, and
7 rope marks; bone fractures, broken bones, and skull
8 fractures; open wounds, cuts, punctures, and untreated
9 injuries in various stages of healing; sprains, dislocations,
10 and internal injuries or bleeding; broken eyeglasses or
11 frames, physical signs of being subjected to punishment, and
12 signs of being restrained; laboratory findings of medication
13 overdose or under-utilization of prescribed drugs; an
14 eligible adult's report of being hit, slapped, kicked, or
15 mistreated; an eligible adult's sudden change in behavior;
16 and the caregiver's refusal to allow visitors to see an
17 eligible adult alone.
18 (l) "Sexual abuse" means nonconsensual sexual contact of
19 any kind with an eligible adult. Sexual contact with any
20 person incapable of giving consent is also considered sexual
21 abuse. It includes but is not limited to unwanted touching
22 and all types of sexual assault or battery, such as rape,
23 sodomy, coerced nudity, and sexually explicit photographing.
24 Signs and symptoms of sexual abuse include but are not
25 limited to: bruises around the breasts or genital area;
26 unexplained venereal disease or genital infections;
27 unexplained vaginal or anal bleeding; torn, stained, or
28 bloody underclothing; and an eligible adult's report of
29 being sexually assaulted or raped.
30 (m) "Emotional abuse" or "psychological abuse" means the
31 infliction of anguish, pain, or distress through verbal or
32 nonverbal acts. Emotional or psychological abuse includes
33 but is not limited to verbal assaults, insults, threats,
34 intimidation, humiliation, and harassment. In addition,
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1 treating an eligible adult like an infant; isolating an
2 eligible adult from his or her family, friends, or regular
3 activities; giving an eligible adult the "silent treatment";
4 and enforced social isolation are examples of emotional or
5 psychological abuse.
6 Signs and symptoms of emotional or psychological abuse
7 include but are not limited to: being emotionally upset or
8 agitated; being extremely withdrawn and noncommunicative or
9 nonresponsive; unusual behavior usually attributed to
10 dementia (for example, sucking, biting, or rocking); and an
11 eligible adult's report of being verbally or emotionally
12 mistreated.
13 (n) "Abandonment" means the desertion of an eligible
14 adult by an individual who has assumed responsibility for
15 providing care for an eligible adult, or by a person with
16 physical custody of an eligible adult.
17 Signs and symptoms of abandonment include but are not
18 limited to: the desertion of an eligible adult at a
19 hospital, a nursing facility, or other similar institution;
20 the desertion of an eligible adult at a shopping center or
21 other public location; and an eligible adult's own report of
22 being abandoned.
23 (o) "Financial exploitation" or "material exploitation"
24 means the illegal or improper use of an eligible adult's
25 funds, property, or assets. Examples include but are not
26 limited to cashing an eligible adult's checks without
27 authorization or permission; forging an eligible adult's
28 signature; misusing or stealing an eligible adult's money or
29 possessions; coercing or deceiving an eligible adult into
30 signing any document (for example, a contract or a will);
31 and the improper use of conservatorship, guardianship, or
32 power of attorney.
33 Signs and symptoms of financial or material exploitation
34 include but are not limited to: sudden changes in bank
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1 account or banking practice, including an unexplained
2 withdrawal of large sums of money by a person accompanying
3 the eligible adult; the inclusion of additional names on an
4 eligible adult's bank signature card; unauthorized
5 withdrawal of the eligible adult's funds using the eligible
6 adult's ATM card; abrupt changes in a will or other financial
7 documents; unexplained disappearance of funds or valuable
8 possessions; substandard care being provided for bills
9 unpaid despite the availability of adequate financial
10 resources; discovery of an eligible adult's signature being
11 forged for financial transactions and for the titles of his
12 or her possessions; sudden appearance of previously
13 uninvolved relatives claiming their rights to an eligible
14 adult's affairs and possessions; unexplained sudden transfer
15 of assets to a family member or someone outside the family;
16 the provision of services that are not necessary; and an
17 eligible adult's report of financial exploitation.
18 (p) "Self-neglect" means the behavior of an elderly
19 person that threatens his or her own health or safety.
20 Self-neglect generally manifests itself in an eligible adult
21 as a refusal or failure to provide himself or herself with
22 adequate food, water, clothing, shelter, personal hygiene,
23 medication (when indicated), and safety precautions. The
24 definition of self-neglect excludes a situation in which a
25 mentally competent eligible adult, who understands the
26 consequences of his or her decisions, makes a conscious and
27 voluntary decision to engage in acts that threaten his or her
28 health or safety as a matter of personal choice.
29 Signs and symptoms of self-neglect include but are not
30 limited to: dehydration, malnutrition, untreated or
31 improperly attended medical conditions, and poor personal
32 hygiene; hazardous or unsafe living conditions or
33 arrangements (for example, improper wiring, no indoor
34 plumbing, no heat, or no running water); unsanitary or
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1 unclean living quarters (for example, animal or insect
2 infestation, no functioning toilet, or fecal or urine
3 smell); inappropriate or inadequate clothing or lack of the
4 necessary medical aids (for example, eyeglasses, hearing
5 aids, or dentures); and grossly inadequate housing or
6 homelessness.
7 (Source: P.A. 86-820; 87-264.)