State oversight failures exposed in a Tribune investigation drove a package of major changes to state law aimed at better protecting patients from sexual abuse or other inappropriate conduct by doctors, nurses and other healthcare workers.

State Rep. Kelly Cassidy, D-Chicago, who first proposed the legislation more than a year ago, called the final version of the bill, which the legislature approved late last session, “frankly revolutionary.”

The bill creates an obligation for healthcare businesses and individual healthcare workers to promptly report to the state if they witness or hear about allegations of sexual or intimate conduct involving healthcare professionals and patients. The state would be able to discipline licensed workers ranging from doctors and nurses to dentists and massage therapists for failing to report such incidents.

The bill also expands on previous reporting requirements for hospitals and allows the state to fine them for failing to properly report incidents where healthcare workers engaged in sexual or intimate conduct with patients. That money would go into the Sexual Assault Services and Prevention Fund. “Reckless failure to report” such incidents would also put healthcare organizations’ certificate to operate in jeopardy.

In addition, some healthcare workers — including doctors, midwives, nurses and physical therapists — could be disciplined if they conduct sensitive physical examinations alone after a patient requests that a third party be present, assuming the situation is not an emergency.

“Really, the teeth matter to me the most,” Cassidy told the Tribune in an interview. “… There are consequences.”

Gov. JB Pritzker plans to sign the bill, according to a spokesperson for his office.

If the bill becomes law, the state would require employers to notify all healthcare workers through training or other means of their reporting responsibilities and how to report patient sexual abuse to the Illinois Department of Financial and Professional Regulation, which is in charge of licensing and disciplining a wide array of healthcare professionals.

Although hospitals were already required to report allegations of patient abuse to the Illinois Department of Public Health, the bill sets out guidelines for hospitals’ internal investigations, including who is qualified to conduct them, what information should be sought and considered in determining whether an allegation is substantiated, and what information must be logged and submitted to the department, even if the hospital determines an allegation is unfounded.

The Tribune’s 2024 investigation exposed how Illinois healthcare systems failed to protect patients from abuse and how state government failed to hold them accountable. Reporters identified instances in which well-known health systems allowed healthcare workers accused of sexually abusing patients to continue providing care. In some cases, workers were not removed from patient care until additional patients came forward alleging similar abuse.

In one particularly troubling case, Chicago-area Endeavor Health continued to allow obstetrician and gynecologist Fabio Ortega access to patients despite receiving complaints. The doctor continued practicing even after the hospital system learned he was under criminal investigation following allegations of sexual abuse from a patient. The health system has since committed more than $450 million to settling patients’ claims that an unspecified former doctor sexually abused them, according to the system’s financial statements. Endeavor has settled more than 75 lawsuits brought by Ortega’s former patients, the Tribune reported last year.

The new bill identifies actions that qualify as sexual or intimate conduct, including engaging in seductive or sexually suggestive behaviors, neglecting draping practices that respect patient privacy, requesting details of a patient’s sexual likes or dislikes, and examining or touching a patient’s mucosal areas without wearing gloves.

Some women who filed lawsuits against Ortega reported they had been confused about whether demeaning or uncomfortable actions the doctor engaged in during exams was within the bounds of necessary medical behavior.

Attorney Tamara Holder, who, along with co-counsels Johanna Raimond and Stephan Blandin, represented most of the women who sued Ortega and Endeavor, said she likes that the new bill requires healthcare workers to report certain types of “conduct” rather than “misconduct.”

She said she thinks that will make it more likely that healthcare workers will report what they see and hear.

“It doesn’t require the holder of the information to define in their own mind what misconduct is,” Holder said.

She said she also appreciates that the bill gives hospitals 48 hours to conduct an internal review before they must report to the state health department and that hospitals can be fined for failing to follow the new rules. Under the bill, hospitals would have to report allegations to the state health department if their internal review finds that reasonable cause exists to support the allegations or if further investigation is needed.

The Illinois Health and Hospital Association felt at first that the bill, as introduced, “failed to address the law’s lack of a reasonable timeframe to undergo an appropriate investigation of alleged abuse” but ultimately supported the legislation after working on it with lawmakers and state agencies, spokesperson Paris Ervin said in a statement.

Ervin said the bill now “underscores the commitment by our membership to patient safety and ethical practices, while providing significant improvements to the current framework for compliance with the law’s requirements.”

Three months after the Tribune published its investigation, lawmakers passed legislation that requires hospitals to report sexual misconduct incidents that occur at affiliated doctors’ offices to the Illinois Department of Public Health, not just those inside the hospital’s walls. Cassidy, who also sponsored that bill, said the measure directly addressed Ortega’s situation but more work needed to be done.

The Tribune’s reporting revealed that, in one instance, a medical business did not look any further into patient abuse allegations after one of its employees resigned following an incident that resulted in battery and public indecency convictions. In another case, a nurse accused several times of patient abuse was able to secure a new job twice, with a clean nursing license, despite being fired from prior positions for his conduct. The Illinois Department of Financial and Professional Regulation did not file a complaint against the nurse until more than two years after he was first fired over his behavior.

The new bill requires healthcare organizations – including private businesses like doctors’ offices – to notify the department promptly if a healthcare worker resigns, is terminated or suspended or if their privileges are materially changed because of allegations concerning intimate or sexual conduct with patients.

The bill also allows for communication between the state’s health department and IDFPR involving patient abuse allegations, even those a hospital determines are unfounded. Hospitals must keep a log of allegations and make them available twice annually to the state’s health department, which can share them with IDFPR upon request.

“The unfounded reports that wouldn’t necessarily make it have to be logged, have to be examined, have to be searched for patterns,” Cassidy said. “Having that piece in there is huge.”

A spokesperson for IDFPR said in a statement that the agency was grateful legislators passed the measure and noted that the department relies on complaints from the public to take action.

“Too often our agency does not receive a complaint, and instead only learns about these horrible situations when an allegation or arrest is publicized in the news or on social media,” the statement said, adding later: “With this early reporting, IDFPR can open an investigation soon after the conduct occurred, suspend or otherwise discipline the health professional’s license and prevent the health professional from continuing to see and harm patients.”

The bill also expanded on the requirement that county prosecutors promptly notify IDFPR when healthcare workers are charged with certain offenses to include arrests or charges related to sexual or intimate conduct. The Tribune found there were sometimes delays between when a worker was charged and when doctors and other healthcare workers were required to provide care under the supervision of a medical chaperone.

Cassidy said the bill was complex and took many months of negotiating and hard conversations, but that supporters regularly recentered sexual abuse survivors as they moved the bill forward.

“We fundamentally have rewritten this entire process,” Cassidy said.