Illinois Law Changes in Care of Sexual Assault Patients – 2019
Last year brought significant changes to Illinois laws governing the treatment of sexual assault survivors. In August, House Bill 5245, initiated by Illinois Attorney General Lisa Madigan and developed by combined efforts of multiple entities (including, among others, the Office of Attorney General (OAG), Illinois Department of Public Health (IDPH), sexual assault nurse examiners (SANEs), child abuse pediatricians, and rape crisis advocates) passed in the Illinois House and Senate and was signed off by the governor, becoming Public Act 100-0775.
This act expands the Sexual Assault Survivors Emergency Treatment Act (SASETA) with the goal of improving care of sexual assault survivors. Public Act 100-0775 also established the Sexual Assault Medical Forensic Services Implementation Task Force and set numerous goals to accomplish before December 31, 2023. Some of the initial goals are the development and distribution of educational materials to all parties involved in the care of sexual assault survivors including medical providers, hospitals, rape crisis centers and state attorneys.
Summarized here are some of the points of Public Act 100-0775 that are most relevant to emergency physicians, as well as links to full documents released by OAG and IDPH. Full text of Public Act 100-0775 and SASETA, a list of Implementation Task Force members, and all of the education materials released before January 1, 2019, are available from OAG at
www.illinoisattorneygeneral.gov/victims/saimplementationtaskforce.html.
Direct links to each document are also included below.
Qualified medical provider requirement (QMP) starting January 1, 2022
A very significant change is the new requirement that every survivor of a sexual assault that occurred within the last 7 days will undergo a medical forensic exam done by a medical professional trained in sexual assault forensic examination (“Qualified Medical Provider” or QMP). For adult and adolescent patients, the QMP must be a SANE or a sexual assault forensic examiner (SAFE), which could be a physician or physician’s assistant. SANE training for the nurses is provided free of charge by OAG. Training requirements for SAFEs are not established yet and will be determined by the end of 2019, but likely will include education similar to SANE training. For pediatric patients (under 13) QMPs must be child abuse pediatricians or pediatric SANEs. A Qualified Medical Provider must be available within 90 minutes from a patient’s arrival to the facility. For Illinois hospitals the requirement for a QMP starts January 1, 2022.
The bottom line is – if you want to be able to continue doing kits on sexual assault patients after that date, you will have to go through the appropriate training and certification process.
Alternatively, emergency departments will have to have sufficient number of SANE nurses available 24/7. Only SAFEs and SANEs will be able to collect the evidence using the sexual assault kit.
Hospital designation
Every hospital in Illinois must choose a classification under SASETA regarding the treatment of sexual assault survivors presenting at the hospital. Hospital designations are as follows:
- Treatment hospital (providing medical forensic services to both adult and pediatric sexual assault survivors)
- Treatment hospital with approved pediatric transfer (providing medical forensic services to adults and adolescents and transferring pediatric patients after a screening exam and stabilization if needed)
- Transfer hospital (providing medical screening exam and appropriate stabilization, but patients are transferred for forensic medical exam to a treatment hospital or APHCF).
Additionally, in counties with population less than 1,000,000 (all counties except Cook), at least one hospital located within a 20-mile radius from a 4-year public university must provide medical forensic services. Hospitals can already submit treatment/transfer plans for approval to IDPH. More detailed information is available in Educational Materials for Hospitals and Approved Pediatric Health Care Facilities
Read Educational Materials for Hospital and Approved Pediatric Health Care Facility document
Training requirements for (non-trained) staff
This law applies to clinical staff in treatment hospitals and treatment hospitals with approved pediatric transfer. “Clinical staff” in this case includes non-SAFE attending physicians and advance practice providers, and non-SANE registered nurses working in the emergency department. Every clinical provider will need to do 2 hours of training regarding care of sexual assault survivors. The training will need to be repeated every 2 years, and it can be online or in person. By March of 2019, OAG will provide online training that can be used to partially fulfill this requirement, with supplementation by the hospital’s own treatment policies and procedures. More details on page 17 in Educational Materials for Health Care Providers
Read Educational Materials for Health Care Providers document
Photography requirement
On or before July 1, 2019, every provider doing a medical forensic exam needs to offer photo documentation of injuries. Photos will become part of the patient’s medical records and need to be retained for a period of 20 years for adults and for 60 years from the date of the 18th birthday for pediatric survivors. The access to the genital photographs should be limited and regulated by hospital policy in order to maximally protect the patient’s privacy. Every hospital needs to develop a protocol addressing the collection and backup of photo documentation. To facilitate the change, OAG released a sample photography policy that can be obtained in a Word format and adapted by individual institutions.
View Sample Photography Policy (PDF)
Download Sample Photography Policy Template (Word)
Additional Resources
Educational Materials for Health Care Providers
Educational Materials for Hospitals and Approved Pediatric Health Care Facilities
Educational Materials for Rape Crisis Centers
Educational Materials for Children’s Advocacy Centers
Educational Materials for State’s Attorney’s Offices
Photo Documentation and Sample Digital Photography Policy (PDF)
Sample Photography Policy Template (Word)
Sample Agreement between Hospital and Rape Crisis Center (PDF)
Sample Agreement between Hospital and Rape Crisis Center Template (Word)