The Illinois Department of Public Health (IDPH) clarifies that health care facilities (including hospitals) should allow patients with intellectual and/or developmental disabilities or cognitive impairments to be accompanied by a support person determined to be essential to their care. Persons with disabilities should be provided reasonable accommodations that afford meaningful access to information and an equal opportunity to benefit from the treatment. Individuals with intellectual and/or developmental disabilities (I/DD) may require accommodations in a health care facility that include permitting the presence of a support person, such as a guardian, family member, caregiver, or paid support worker, provided that essential precautions can be taken to contain the spread of infection.
The use of effective communication is critical to a patient's autonomy and ability to participate in their care. Otherwise, medical providers risk substituting misplaced assumptions and potential biases about the person with a disability for verifiable information and medical history. In addition, effective communication leads to better transparency in process and protocols, which helps to ensure that the medical provider and the person with a disability understand each other and agree.
The patient's support person may be necessary to:
- facilitate communication between the individual and hospital personnel;
- ascertain the individual's pertinent medical history;
- secure from the individual "informed consent" for treatment;
- ensure the individual's participation in care planning;
- provide emotional and sensory supports; and
- provide the individual with specialized strategies to reduce anxiety and the incidence of harmful behaviors.
Health care facilities (including hospitals), therefore, should establish a protocol that allows at least one identified support person to be present with any individual with I/DD in an emergency room and to accompany those admitted to the hospital. For hospitalized patients, especially those with prolonged hospitalizations, the patient or legal guardian should be allowed to designate two support people, but only one support person may be present at any given time. Hospital staff should explain this protocol to the individual needing the accommodation and to their caregivers upon arrival at the hospital, or ideally, prior to arriving at the hospital. The patient should be given the opportunity to make informed decisions as to whom they wish to identify as a support person.
Support persons should be screened for illness daily upon entry to the facility with a temperature check and symptom checklist. The facility may limit the support person's movement in the facility, including directing them to stay in the patient's room. The support person must adhere to facility policies, wear a designated identification tag provided by the facility, and comply with any instructions on personal protective equipment (PPE), also to be provided by the facility. Failure to comply with any of these measures may result in the support person being denied access to the patient, wherein the patient would be allowed to identify another support person.