Starting next year, Illinois will have new safeguards in place to prevent parents from being wrongly accused of child abuse or neglect when their children visit a doctor or hospital emergency room for unexplained injuries or ailments.

For advocates, the law speaks to the horrific circumstances families can endure when a medical issue is misconstrued as abuse.

Gov. JB Pritzker signed the bill in July after it passed the Democratic-controlled General Assembly without opposition — 110-0 in the House and 59-0 in the Senate, with three Senate Republicans from the legislative superminority among its co-sponsors. But behind that vote was a yearslong debate between family-rights advocates and doctors that had exposed hard feelings on both sides.

Family rights advocates, including the Family Justice Resource Center, which pushed for the law, were perceived by some as not taking a strong enough stand against child abuse, while the medical community was tagged as requiring families to prove their innocence from the outset.

For Tara Crady and her husband, that scare happened more than a decade ago. Crady said courts ordered their then-infant son temporarily placed with her parents after she had medical personnel examine a spot on his ankle that turned out to be from healed fractures.

Crady, who has a background in child advocacy, said she and her husband eventually learned their son had a metabolic bone disease. But a child protection case was filed, and it took well over a year for them to be cleared of wrongdoing by child welfare officials.

“I fought against child abuse. So the fact that anybody would look at us like we would hurt our child was tragic,” said Crady, now the treasurer of the resource center. “We had to live with my parents under a safety plan. So his first birthday, his first Christmas, everything, we were watched. We couldn’t be alone with him.”

Under the new law, when the Illinois Department of Children and Family Services requests a professional’s “medical or forensic opinion” during an investigation into whether a child’s injury or illness may stem from abuse or neglect, DCFS must make reasonable efforts within 24 hours to tell the child’s parent or guardian that the opinion will be weighed in the case, and disclose “the professional’s specialty and any subspecialty.”

The agency must also inform the parent or guardian that they may seek, at their own expense, a second medical or forensic opinion at any point before the case is completed and submit it to DCFS for consideration — though they must be told that opinion will be treated as evidence, for or against them, in the investigation. Parents and guardians also have the right to request and “timely receive” a copy of any professional’s written opinion.

By July 1, 2027, DCFS must post an “informational document” on its website explaining how the agency responds to allegations of abuse and neglect, why children may receive medical evaluations in such cases, which types of medical professionals are involved, and who at a healthcare facility qualifies as a mandated reporter. The posting must also spell out parents’ right to seek a second opinion, access their child’s medical records and retain legal counsel — and must be published in English, Spanish, Polish, Chinese and Arabic, with other languages available on request.

Once a minor is in a healthcare professional’s care, that employee — whether a doctor, nurse or social worker — must identify themselves to the parent or guardian, along with their specialty or subspecialty and their role in treating the child, according to the law.

At an event celebrating the signing last week, Democratic state Rep. Mary Beth Canty of Arlington Heights, the bill’s main House sponsor, recalled hearing about early opposition from doctors who said, “We want to catch criminals” — a goal she said she shared. But she said she also sought balance, along with a requirement that doctors be transparent with families about who they are, their specialty, and their purpose in evaluating a child.

“I’m a lawyer, and I believe in due process,” Canty told an audience in a small banquet room at a restaurant in Chicago’s Gold Coast. “And I also believe in our ability to hear each other and to accomplish both goals of protecting families, protecting children and also making sure that people and families get to stay together, that they are not swallowed up whole by a system that is overworked and overrun and looking for the worst in people.”

In a prepared statement, DCFS acknowledged the role child abuse pediatricians play in its abuse and neglect investigations.

“DCFS relies on the medical expertise and clinical judgment of physicians when assessing reports of suspected child abuse or neglect,” the agency said. “Pediatricians who are board certified in child abuse pediatrics and medical experts regarding the medical aspects of child abuse/neglect are a helpful resource to our child protection specialists who respond to reports of child abuse and neglect.”

The Family Justice Resource Center has paid particular attention to the role of child abuse pediatricians, who specialize in identifying whether children have been victims of abuse or neglect, even though the new law as written pertains more broadly to the medical community.

Dr. Veena Ramaiah, who represents the Illinois Chapter of the American Academy of Pediatrics as a co-chair of its committee on child abuse and neglect, said the committee moved from opposing the measure to not opposing it — though stopping short of endorsing it — after it was stripped of language the committee felt dictated too strongly how doctors should deal with patients.

“At the end of the day, we’re not looking for abuse. We’re looking for the truth about what happened to a child,” said Ramaiah, who is also a child abuse pediatrician. “You know, we do thorough evaluations. We do thorough consultations. We talk to our colleagues. … Are we missing anything? Are there any other diagnoses we need to consider?”

The office of Democratic Cook County State’s Attorney Eileen O’Neill Burke also opposed the bill’s early version, filed in February 2025, before settling into a neutral position by the time Pritzker signed it.

“The bill’s initial language created significant burdens for child abuse pediatricians and other medical professionals that may have interfered with our ability to seek justice,” O’Neill Burke’s office said in a statement. “Through our Legislative Advisory Council, practitioners with specific expertise in child protection matters provided feedback that was reflected in the final bill, addressing our concerns and leading us to a neutral position.”

The Family Justice Resource Center has argued that child abuse pediatricians’ opinions can carry significant consequences for families, as findings consistent with abuse can also result from complex medical conditions or common household accidents.

“When a child abuse pediatrician interprets those findings as abuse before the child’s full medical history is reviewed, treating physicians are consulted, and plausible accidental or medical explanations are considered, that conclusion can redirect the child’s care and have undue influence on DCFS, law enforcement, prosecutors, and the courts as though it has been independently confirmed,” the resource center said in a news release in late July about Pritzker’s signing of the law.

To back its position, the resource center also shared with the Tribune a 2024 Journal of the American Medical Association opinion piece from two doctors and a law professor arguing that child abuse pediatricians “have an ethical and professional duty to disclose their role within and outside the medical center and to inform families how their opinion might be used outside of the direct patient care team.”

“We make no claim that failure to introduce the (child abuse pediatrician) role is a pervasive problem, as many CAPs likely are transparent about their role,” the article states. “Rather, we suggest that professional societies develop clear guidelines for clinician disclosure. This would help to promote the ethical principle of autonomy, which includes a commitment to informed consent and truth telling.”

Ramaiah noted that only a small percentage of cases reported to DCFS involve child abuse pediatricians, of which she said there are about a dozen statewide, and that investigators typically get medical input from other doctors as well, not only from a specialist in abuse and neglect.

“This kind of focus, almost like a vendetta on child abuse pediatricians, is puzzling to us because we’re not involved in the majority of cases,” she said. “We are involved in more serious abuse. … I’m not going to pretend that we’re not. Of course, when DCFS is very worried about abuse, they may be bringing cases to us, or they may already be coming to us because … we all work at major medical centers.”

Even though she doesn’t oppose the law, Ramaiah still questioned its purpose, saying DCFS “informs families or should have always been informing families where their information is coming from.”

“But as far as I’m concerned, the way cases are investigated, the way outcomes are determined, the way information is gathered, will continue as it has always continued,” she said. “We will continue to introduce ourselves when we go in. We will continue to do thorough assessments.”