103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2246

 

Introduced 2/10/2023, by Sen. Kimberly A. Lightford

 

SYNOPSIS AS INTRODUCED:
 
325 ILCS 5/6  from Ch. 23, par. 2056
325 ILCS 5/7.4  from Ch. 23, par. 2057.4

    Sets forth certain protections that must be provided to any subject of an abuse or neglect investigation whenever the Department of Children and Family Services consults with and relies upon the opinion of a medically trained professional as to whether there is evidence of abuse or neglect. Provides that no child or family member of a child who is the subject of an investigation shall be required to submit to additional medical tests, for investigation purposes only, during the investigation. Requires a consulting medical professional who is employed or under contract with the Department to identify himself or herself as a forensic consultant, rather than as a member of the child's treatment team, whenever the individual has direct contact with the child or the family of the child. Provides that the subject of a report shall have the opportunity to submit a second medical opinion as to whether there is evidence of abuse or neglect. Requires the Department to annually prepare and make available on the Department's Reports and Statistics webpage a report on the number of children referred to a consulting medical professional for forensic opinion. Provides that the first report must be posted by March 31, 2024. Sets forth certain data and information that must be contained in the annual report.


LRB103 30764 KTG 57248 b

 

 

A BILL FOR

 

SB2246LRB103 30764 KTG 57248 b

1    AN ACT concerning children.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Findings. The General Assembly finds as
5follows:
6    (1) Any case involving allegations of child abuse or
7neglect raise the potential for risk of error and trauma if the
8determination made at the conclusion of the investigation is
9incorrect.
10    (2) The Department relies on the expertise of medical
11professional consultants in order to understand and assess the
12validity of hotline calls reporting abuse or neglect. The
13Department has established contracts and consultations with
14doctors and other medical professionals for the purpose of
15obtaining their opinion during child abuse and neglect
16investigations conducted throughout Illinois in accordance
17with this Act.
18    (3) Such contracts and consultations, as currently
19constituted, include input from law enforcement, county
20state's attorneys, and other local agencies. A balance of
21consideration of alternative explanations and information from
22independent sources has not been developed in Illinois.
23Consequently, parents, guardians, and others do not have equal
24access and an ability to contribute potentially dispositive

 

 

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1information during a child abuse or neglect investigations.
2    (4) There is extensive controversy over whether medical
3conclusions such as "shaken baby syndrome", metaphyseal
4fractures, Ehlers Danlos syndrome, rickets and Vitamin D
5deficiency, and Munchausen's Syndrome by Proxy are the causes
6or contributors to children's reported injuries, symptoms, or
7conditions. There are many conditions that mimic child abuse.
8Some common beliefs about child abuse being idiopathic to
9certain conditions have been shown to be demonstrably false
10(such as that a triad of conditions necessarily means that a
11child must have been shaken or that the last person with the
12child must have been the person who injured the child).
13    (5) Children with rare diseases and disabilities are
14particularly at risk of having medical conditions overlooked
15or misunderstood as child abuse.
16    (6) As a result of these medical misunderstandings and the
17lack of up-to-date information grounded in science, innocent
18parents have been targeted as child abusers and child
19neglectors, and have been imprisoned, fired, or had their
20children taken into state custody or their rights of access to
21their children restricted whenever a person with the title
22"child abuse pediatrician" contends that the parent's child is
23abused, even when that opinion is erroneous.
24    (7) A right as basic as the right to consent to the release
25of medical records is not adequately protected in the context
26of any hotline call investigation.

 

 

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1    (8) There is currently no limitation on a medical
2professional's participation in a child abuse or neglect
3investigation even when the medical professional, or the
4medical professional's colleague or employment institution,
5directly participated in the making of the hotline call that
6triggered the abuse or neglect investigation.
7    (9) The interest of truth in science, common sense, and
8justice require that access to objective scientific
9information should not be the privilege of one side to a
10reasonable dispute as to medical science.
11    (10) The State of Illinois currently has no system of
12independent review of the accuracy of the forensic opinions
13rendered by child abuse pediatricians who hold contracts
14through child advocacy centers and hospitals.
15    (11) Parents report being blindsided and misinformed as to
16the role of the child abuse pediatrician in many cases,
17including ones where no abuse was ultimately found.
18    (12) News reports by NBC News have highlighted cases in
19which grievous errors in medical opinions rendered by child
20abuse pediatricians, and relied upon by state agencies during
21child abuse and neglect investigations, have led to grave
22injustices that could be remedied with modest procedural
23protections for the fairness of such investigations.
24    (13) Doctors take an oath to "first do no harm" but there
25is no system in the State of Illinois for redressing and
26mitigating the harm to families who have been the victims of

 

 

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1wrongful child abuse or neglect allegations.
 
2    Section 5. The Abused and Neglected Child Reporting Act is
3amended by changing Sections 6 and 7.4 as follows:
 
4    (325 ILCS 5/6)  (from Ch. 23, par. 2056)
5    Sec. 6. Any person required to investigate cases of
6suspected child abuse or neglect may not take or cause to be
7taken, at Department expense, color photographs and x-rays of
8the child who is the subject of a report, and color photographs
9of the physical environment in which the alleged abuse or
10neglect has taken place, except if there are exigent
11circumstances, or if there is a need for such photographs or
12x-rays for emergency treatment of the child, or if the person
13responsible for the child's welfare gives consent to the
14taking of such photographs or x-rays. The person seeking to
15take such photographs or x-rays shall make every reasonable
16effort to notify the person responsible for the child's
17welfare. The person required to investigate cases of suspected
18child abuse or neglect shall not threaten removal of a child or
19other legal action if the person reasonable for the child's
20welfare refuses to consent to the taking of photographs or
21x-rays.
22(Source: P.A. 84-611.)
 
23    (325 ILCS 5/7.4)  (from Ch. 23, par. 2057.4)

 

 

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1    Sec. 7.4. (a) The Department shall be capable of receiving
2reports of suspected child abuse or neglect 24 hours a day, 7
3days a week. Whenever the Department receives a report
4alleging that a child is a truant as defined in Section 26-2a
5of the School Code, as now or hereafter amended, the
6Department shall notify the superintendent of the school
7district in which the child resides and the appropriate
8superintendent of the educational service region. The
9notification to the appropriate officials by the Department
10shall not be considered an allegation of abuse or neglect
11under this Act.
12    (a-5) The Department of Children and Family Services may
13implement a "differential response program" in accordance with
14criteria, standards, and procedures prescribed by rule. The
15program may provide that, upon receiving a report, the
16Department shall determine whether to conduct a family
17assessment or an investigation as appropriate to prevent or
18provide a remedy for child abuse or neglect.
19    For purposes of this subsection (a-5), "family assessment"
20means a comprehensive assessment of child safety, risk of
21subsequent child maltreatment, and family strengths and needs
22that is applied to a child maltreatment report that does not
23allege substantial child endangerment. "Family assessment"
24does not include a determination as to whether child
25maltreatment occurred but does determine the need for services
26to address the safety of family members and the risk of

 

 

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1subsequent maltreatment.
2    For purposes of this subsection (a-5), "investigation"
3means fact-gathering related to the current safety of a child
4and the risk of subsequent abuse or neglect that determines
5whether a report of suspected child abuse or neglect should be
6indicated or unfounded and whether child protective services
7are needed.
8    Under the "differential response program" implemented
9under this subsection (a-5), the Department:
10        (1) Shall conduct an investigation on reports
11    involving substantial child abuse or neglect.
12        (2) Shall begin an immediate investigation if, at any
13    time when it is using a family assessment response, it
14    determines that there is reason to believe that
15    substantial child abuse or neglect or a serious threat to
16    the child's safety exists.
17        (3) May conduct a family assessment for reports that
18    do not allege substantial child endangerment. In
19    determining that a family assessment is appropriate, the
20    Department may consider issues, including, but not limited
21    to, child safety, parental cooperation, and the need for
22    an immediate response.
23        (4) Shall promulgate criteria, standards, and
24    procedures that shall be applied in making this
25    determination, taking into consideration the Child
26    Endangerment Risk Assessment Protocol of the Department.

 

 

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1        (5) May conduct a family assessment on a report that
2    was initially screened and assigned for an investigation.
3    In determining that a complete investigation is not
4required, the Department must document the reason for
5terminating the investigation and notify the local law
6enforcement agency or the Illinois State Police if the local
7law enforcement agency or Illinois State Police is conducting
8a joint investigation.
9    Once it is determined that a "family assessment" will be
10implemented, the case shall not be reported to the central
11register of abuse and neglect reports.
12    During a family assessment, the Department shall collect
13any available and relevant information to determine child
14safety, risk of subsequent abuse or neglect, and family
15strengths.
16    Information collected includes, but is not limited to,
17when relevant: information with regard to the person reporting
18the alleged abuse or neglect, including the nature of the
19reporter's relationship to the child and to the alleged
20offender, and the basis of the reporter's knowledge for the
21report; the child allegedly being abused or neglected; the
22alleged offender; the child's caretaker; and other collateral
23sources having relevant information related to the alleged
24abuse or neglect. Information relevant to the assessment must
25be asked for, and may include:
26        (A) The child's sex and age, prior reports of abuse or

 

 

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1    neglect, information relating to developmental
2    functioning, credibility of the child's statement, and
3    whether the information provided under this paragraph (A)
4    is consistent with other information collected during the
5    course of the assessment or investigation.
6        (B) The alleged offender's age, a record check for
7    prior reports of abuse or neglect, and criminal charges
8    and convictions. The alleged offender may submit
9    supporting documentation relevant to the assessment.
10        (C) Collateral source information regarding the
11    alleged abuse or neglect and care of the child. Collateral
12    information includes, when relevant: (i) a medical
13    examination of the child; (ii) prior medical records
14    relating to the alleged maltreatment or care of the child
15    maintained by any facility, clinic, or health care
16    professional, and an interview with the treating
17    professionals; and (iii) interviews with the child's
18    caretakers, including the child's parent, guardian, foster
19    parent, child care provider, teachers, counselors, family
20    members, relatives, and other persons who may have
21    knowledge regarding the alleged maltreatment and the care
22    of the child.
23        (D) Information on the existence of domestic abuse and
24    violence in the home of the child, and substance abuse.
25    Nothing in this subsection (a-5) precludes the Department
26from collecting other relevant information necessary to

 

 

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1conduct the assessment or investigation. Nothing in this
2subsection (a-5) shall be construed to allow the name or
3identity of a reporter to be disclosed in violation of the
4protections afforded under Section 7.19 of this Act.
5    After conducting the family assessment, the Department
6shall determine whether services are needed to address the
7safety of the child and other family members and the risk of
8subsequent abuse or neglect.
9    Upon completion of the family assessment, if the
10Department concludes that no services shall be offered, then
11the case shall be closed. If the Department concludes that
12services shall be offered, the Department shall develop a
13family preservation plan and offer or refer services to the
14family.
15    At any time during a family assessment, if the Department
16believes there is any reason to stop the assessment and
17conduct an investigation based on the information discovered,
18the Department shall do so.
19    The procedures available to the Department in conducting
20investigations under this Act shall be followed as appropriate
21during a family assessment.
22    If the Department implements a differential response
23program authorized under this subsection (a-5), the Department
24shall arrange for an independent evaluation of the program for
25at least the first 3 years of implementation to determine
26whether it is meeting the goals in accordance with Section 2 of

 

 

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1this Act.
2    The Department may adopt administrative rules necessary
3for the execution of this Section, in accordance with Section
44 of the Children and Family Services Act.
5    The Department shall submit a report to the General
6Assembly by January 15, 2018 on the implementation progress
7and recommendations for additional needed legislative changes.
8    (b)(1) The following procedures shall be followed in the
9investigation of all reports of suspected abuse or neglect of
10a child, except as provided in subsection (c) of this Section.
11    (2) If, during a family assessment authorized by
12subsection (a-5) or an investigation, it appears that the
13immediate safety or well-being of a child is endangered, that
14the family may flee or the child disappear, or that the facts
15otherwise so warrant, the Child Protective Service Unit shall
16commence an investigation immediately, regardless of the time
17of day or night. All other investigations shall be commenced
18within 24 hours of receipt of the report. Upon receipt of a
19report, the Child Protective Service Unit shall conduct a
20family assessment authorized by subsection (a-5) or begin an
21initial investigation and make an initial determination
22whether the report is a good faith indication of alleged child
23abuse or neglect.
24    (3) Based on an initial investigation, if the Unit
25determines the report is a good faith indication of alleged
26child abuse or neglect, then a formal investigation shall

 

 

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1commence and, pursuant to Section 7.12 of this Act, may or may
2not result in an indicated report. The formal investigation
3shall include: direct contact with the subject or subjects of
4the report as soon as possible after the report is received; an
5evaluation of the environment of the child named in the report
6and any other children in the same environment; a
7determination of the risk to such children if they continue to
8remain in the existing environments, as well as a
9determination of the nature, extent and cause of any condition
10enumerated in such report; the name, age and condition of
11other children in the environment; and an evaluation as to
12whether there would be an immediate and urgent necessity to
13remove the child from the environment if appropriate family
14preservation services were provided. After seeing to the
15safety of the child or children, the Department shall
16forthwith notify the subjects of the report in writing, of the
17existence of the report and their rights existing under this
18Act in regard to amendment or expungement. To fulfill the
19requirements of this Section, the Child Protective Service
20Unit shall have the capability of providing or arranging for
21comprehensive emergency services to children and families at
22all times of the day or night.
23    (4) If (i) at the conclusion of the Unit's initial
24investigation of a report, the Unit determines the report to
25be a good faith indication of alleged child abuse or neglect
26that warrants a formal investigation by the Unit, the

 

 

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1Department, any law enforcement agency or any other
2responsible agency and (ii) the person who is alleged to have
3caused the abuse or neglect is employed or otherwise engaged
4in an activity resulting in frequent contact with children and
5the alleged abuse or neglect are in the course of such
6employment or activity, then the Department shall, except in
7investigations where the Director determines that such
8notification would be detrimental to the Department's
9investigation, inform the appropriate supervisor or
10administrator of that employment or activity that the Unit has
11commenced a formal investigation pursuant to this Act, which
12may or may not result in an indicated report. The Department
13shall also notify the person being investigated, unless the
14Director determines that such notification would be
15detrimental to the Department's investigation.
16    (c) In an investigation of a report of suspected abuse or
17neglect of a child by a school employee at a school or on
18school grounds, the Department shall make reasonable efforts
19to follow the following procedures:
20        (1) Investigations involving teachers shall not, to
21    the extent possible, be conducted when the teacher is
22    scheduled to conduct classes. Investigations involving
23    other school employees shall be conducted so as to
24    minimize disruption of the school day. The school employee
25    accused of child abuse or neglect may have his superior,
26    his association or union representative and his attorney

 

 

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1    present at any interview or meeting at which the teacher
2    or administrator is present. The accused school employee
3    shall be informed by a representative of the Department,
4    at any interview or meeting, of the accused school
5    employee's due process rights and of the steps in the
6    investigation process. These due process rights shall also
7    include the right of the school employee to present
8    countervailing evidence regarding the accusations. In an
9    investigation in which the alleged perpetrator of abuse or
10    neglect is a school employee, including, but not limited
11    to, a school teacher or administrator, and the
12    recommendation is to determine the report to be indicated,
13    in addition to other procedures as set forth and defined
14    in Department rules and procedures, the employee's due
15    process rights shall also include: (i) the right to a copy
16    of the investigation summary; (ii) the right to review the
17    specific allegations which gave rise to the investigation;
18    and (iii) the right to an administrator's teleconference
19    which shall be convened to provide the school employee
20    with the opportunity to present documentary evidence or
21    other information that supports his or her position and to
22    provide information before a final finding is entered.
23        (2) If a report of neglect or abuse of a child by a
24    teacher or administrator does not involve allegations of
25    sexual abuse or extreme physical abuse, the Child
26    Protective Service Unit shall make reasonable efforts to

 

 

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1    conduct the initial investigation in coordination with the
2    employee's supervisor.
3        If the Unit determines that the report is a good faith
4    indication of potential child abuse or neglect, it shall
5    then commence a formal investigation under paragraph (3)
6    of subsection (b) of this Section.
7        (3) If a report of neglect or abuse of a child by a
8    teacher or administrator involves an allegation of sexual
9    abuse or extreme physical abuse, the Child Protective Unit
10    shall commence an investigation under paragraph (2) of
11    subsection (b) of this Section.
12    (c-5) In any instance in which a report is made or caused
13to made by a school district employee involving the conduct of
14a person employed by the school district, at the time the
15report was made, as required under Section 4 of this Act, the
16Child Protective Service Unit shall send a copy of its final
17finding report to the general superintendent of that school
18district.
19    (c-10) The Department may recommend that a school district
20remove a school employee who is the subject of an
21investigation from his or her employment position pending the
22outcome of the investigation; however, all employment
23decisions regarding school personnel shall be the sole
24responsibility of the school district or employer. The
25Department may not require a school district to remove a
26school employee from his or her employment position or limit

 

 

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1the school employee's duties pending the outcome of an
2investigation.
3    (d) If the Department has contact with an employer, or
4with a religious institution or religious official having
5supervisory or hierarchical authority over a member of the
6clergy accused of the abuse of a child, in the course of its
7investigation, the Department shall notify the employer or the
8religious institution or religious official, in writing, when
9a report is unfounded so that any record of the investigation
10can be expunged from the employee's or member of the clergy's
11personnel or other records. The Department shall also notify
12the employee or the member of the clergy, in writing, that
13notification has been sent to the employer or to the
14appropriate religious institution or religious official
15informing the employer or religious institution or religious
16official that the Department's investigation has resulted in
17an unfounded report.
18    (d-1) Whenever a report alleges that a child was abused or
19neglected while receiving care in a hospital, including a
20freestanding psychiatric hospital licensed by the Department
21of Public Health, the Department shall send a copy of its final
22finding to the Director of Public Health and the Director of
23Healthcare and Family Services.
24    (d-2) In any investigation conducted in accordance with
25this Act during which the Department consults with and relies
26upon a medically trained professional as to whether abuse or

 

 

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1neglect is considered likely, to a reasonable degree of
2medical certainty, the following protections shall be provided
3to any subject of the investigation:
4        (A) No child or family member of a child who is the
5    subject of an investigation shall be required to submit to
6    additional medical tests, for investigation purposes only,
7    during the investigation. The risks associated with any
8    recommended test must be fully disclosed to the child's
9    custodial parent or guardian during the investigation.
10    Nothing in this paragraph shall be read to preclude those
11    medical tests that are medically necessary for the child's
12    treatment.
13        (B) If a consulting medical professional is employed,
14    in whole or in part, by the Department or receives
15    referrals in the course of an investigation pursuant to
16    any contract, memorandum of understanding, or direct
17    request by an investigator, such individual must identify
18    himself or herself as a forensic consultant, rather than
19    as a member of the child's treatment team, whenever the
20    individual has direct contact with the child or the family
21    of the child. The individual must also provide the child's
22    guardian with accurate information about the medical
23    specialties that the individual holds.
24        (C) The subject of the investigation shall be afforded
25    the opportunity to identify all medical professionals who
26    have examined or treated the child during the previous

 

 

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1    12-month period prior to the hotline call and, with the
2    subject's consent, such medical professionals shall be
3    afforded the opportunity to submit information for
4    consideration by the Department prior to the conclusion of
5    the investigation.
6        (D) The subject of the investigation shall be afforded
7    the reasonable opportunity to submit a second medical
8    opinion to the Department or to request that the
9    Department allow time for the subject to obtain and submit
10    second independent opinions from medical professionals. A
11    request for a second medical opinion shall be considered
12    good cause to toll deadlines for completion of an
13    investigation.
14        (E) Except if there are exigent circumstances, the
15    subject of the investigation shall be provided the
16    identity, credentials, and opinions of other professionals
17    the consulted medical professional relies upon in
18    rendering an opinion as to the likelihood of abuse or
19    neglect, and the written opinion of such person shall be
20    provided, upon the conclusion of the investigation (with
21    due allowance for redactions as otherwise provided under
22    this Act).
23        (F) The Department shall annually prepare and make
24    available on the Department's Reports and Statistics
25    webpage a report on the number of children referred to a
26    consulting medical professional for forensic opinion. The

 

 

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1    first report must be posted by March 31, 2024. The report
2    shall contain the following information:
3            (i) Total number of abuse or neglect cases that
4        were substantiated by the court.
5            (ii) Total number of abuse or neglect cases that
6        the Department determined were unfounded.
7            (iii) Total number of abuse or neglect cases that
8        the Department determined were indicated, but were not
9        sent to the court.
10                (I) Data on the subset of those indicated
11            cases that were appealed and the outcomes of those
12            appeals.
13                (II) Data on the subset of those cases that
14            the Department determined were indicated but with
15            an unknown perpetrator.
16            (iv) Compile the information collected under items
17        (i) through (iii) by individual provider.
18            (v) Compile the information collected under items
19        (i) through (iii) by medical diagnosis.
20            (vi) Compile the information collected under items
21        (i) through (iii) by county.
22            (vii) Compile the information collected under
23        items (i) through (iii) by race.
24            (viii) Compile the information collected under
25        items (i) through (iii) by gender (of the child).
26            (ix) Compile the information collected under items

 

 

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1        (i) through (iii) by children with safety plans and
2        children put in protective custody.
3    (e) Upon request by the Department, the Illinois State
4Police and law enforcement agencies are authorized to provide
5criminal history record information as defined in the Illinois
6Uniform Conviction Information Act and information maintained
7in the adjudicatory and dispositional record system as defined
8in Section 2605-355 of the Illinois State Police Law to
9properly designated employees of the Department of Children
10and Family Services if the Department determines the
11information is necessary to perform its duties under the
12Abused and Neglected Child Reporting Act, the Child Care Act
13of 1969, and the Children and Family Services Act. The request
14shall be in the form and manner required by the Illinois State
15Police. Any information obtained by the Department of Children
16and Family Services under this Section is confidential and may
17not be transmitted outside the Department of Children and
18Family Services other than to a court of competent
19jurisdiction or unless otherwise authorized by law. Any
20employee of the Department of Children and Family Services who
21transmits confidential information in violation of this
22Section or causes the information to be transmitted in
23violation of this Section is guilty of a Class A misdemeanor
24unless the transmittal of the information is authorized by
25this Section or otherwise authorized by law.
26    (f) For purposes of this Section, "child abuse or neglect"

 

 

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1includes abuse or neglect of an adult resident as defined in
2this Act.
3(Source: P.A. 101-43, eff. 1-1-20; 102-538, eff. 8-20-21.)