Illinois House Bill 5245

On August 10, 2018 a bill regarding improving the care of sexual assault survivors in Illinois was signed into law. House Bill 5245 was initiated by IL Attorney General Lisa Madigan, passed in the Illinois House and Senate and was signed off on by the governor. The law will expand the Sexual Assault Survivors Emergency Treatment Act (SASETA) to ensure that the survivors of sexual assault will receive specialized sexual assault care in the Emergency Department.

The law requires that hospitals licensed under the Hospital Licensing Act (or operated under the University of Illinois Hospital Act), which provide general medical and surgical hospital services, will provide either medical forensic services by trained providers, or transfer services to all sexual assault survivors.  Pediatric health care facilities may accept transfers from other facilities and provide medical forensic services to pediatric sexual assault survivors, with exams done by pediatric SANEs or physicians trained in pediatric sexual assault care. The hospital may become a treatment facility for teenage and adult sexual survivors (13 and older) but choose to become a transfer facility for pediatric sexual assault survivors. Transfer protocols will be approved by the Illinois Department of Public Health. Additionally, at least one hospital located within a 20-mile radius from a 4-year public university must provide medical forensic services. Photo documentation will be required and retained indefinitely for sexual assault survivors under 18 years of age, and for 20 years for survivors 18 and older.

The provision includes the requirement that each health care provider (physician, physician assistant or nurse) be trained and familiar with the sexual assault exam, trauma focused care, and proper techniques of evidence collection. Although Sexual Assault Nurse Examiners (SANEs) training in Illinois has been provided for approximately 15 years free of charge by the Office of the Attorney General, less than 200 SANE nurses are currently practicing in emergency departments in IL, and there are no 24/7 SANE programs. Physicians and physician assistants, in order to become sexual assault forensic examiners as required to care for the survivors, must now provide documentation of training and clinical experience meeting specific guidelines. The deadline for the changes is January 1, 2022. Currently a Sexual Assault Medical Forensic Services Implementation Task Force is being created to assist hospitals with implementation of the changes and to define guidelines necessary for provider training. Illinois College of Emergency Physicians (ICEP) initially opposed the early versions of the bill due to concerns of imposing significant burden on practicing physicians from an excessive amount of required (and possibly redundant) training. However, since emergency physicians are represented on the Task Force, the implementation of the law can be done in a way that benefits the patients and efficiently complements the training that emergency physicians already have.

References

1. IL House Bill 5245
2. MADIGAN: NEW LAW WILL IMPROVE MEDICAL CARE FOR SEXUAL ASSAULT SURVIVORS IN ILLINOIS

Monika Pitzele, MD, PhD
Mount Sinai Hospital and Community First Medical Center, Chicago