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Heng v. Foster





APPEAL from the Circuit Court of Cook County; the Hon. ARTHUR L. DUNNE, Judge, presiding.


Plaintiff, N. Jean Heng, appeals from an order of the circuit court of Cook County entered under the Administrative Review Act. That order affirmed the decision of the Illinois Civil Service Commission (Commission) discharging plaintiff for cause from her certified position as Nurse III with the Department of Mental Health and Developmental Disabilities (DMH). On appeal, plaintiff presents several questions for review, including: (1) whether the discharge order is contrary to the manifest weight of the evidence; and, (2) whether her failure to report certain information regarding the theft of patient files from her place of employment was justified by rules governing patient confidentiality.

We reverse the order of the circuit court and the decision of the Commission discharging plaintiff.

Plaintiff, as a nurse employed by DMH, was assigned to the Little Village Mental Health Center, a community mental health center. At the same time plaintiff was assigned as a consultant to Exit House, a separate facility providing services to former substance abusers. In December 1974, approximately 200 active patient files containing confidential information were taken from Little Village. In April 1975, Roger Dvorak, an employee of Little Village and board member at Exit House, admitted at an Exit House emergency meeting, in plaintiff's presence, that he had taken the files. Thereafter, written charges were filed by DMH against the plaintiff alleging the following acts of misconduct:

"1. Conduct unbecoming a State employee in that Ms. Heng failed to notify her supervisor or any other person within the Department of Mental Health of the stolen records.

2. Respondent allowed the destruction of approximately 160 patient files by failing to prohibit the destruction of the files by Roger Dvorak, in violation of Mental Health regulations."

At the administrative hearing requested by plaintiff in defense of these charges, Pablo Holquin, the administrator of Little Village, testified that Little Village receives Federal funds and is required by the Federal government to maintain a record system. Records containing personal information and clinical data are also maintained for DMH. In December 1974, approximately 200 active patient files were taken from a filing cabinet at Little Village. The files were reconstructed and Little Village continued to operate.

On the morning of April 11, 1975, Holquin received a call from Roger Dvorak, a mental health specialist at Little Village. Holquin testified that Dvorak was under a great deal of stress; Dvorak said he was on drugs. As a result of this conversation Holquin immediately went to Dvorak's home, where Dvorak admitted to Holquin that he had stolen the patient files. Holquin saw a suitcase containing 37 of the original files which had been taken from Little Village. The suitcase also contained prescription pads and psychotropic drugs. Holquin advised Dvorak to get legal counseling and psychiatric treatment. He asked Dvorak to resign his position at Little Village, which Dvorak did on April 15, 1975. At the time the subsequent administrative hearing was held, Dvorak was under treatment at Michael Reese Hospital and unavailable to testify.

Holquin stated that Little Village and Exit House are separate agencies that have a working relationship outlined in a written agreement. Under this agreement Little Village provides some training and consultative services to Exit House staff members. In addition, plaintiff had been assigned to divide her time evenly between the Exit House program and Little Village. Holquin testified that plaintiff's responsibilities at Exit House included consulting and planning but not necessarily participation in clinical services. However, he acknowledged that plaintiff had begun her relationship with Exit House pursuant to an agreement entered into under his predecessor at Little Village. He accepted and continued the relationship but never observed plaintiff in the performance of her duties at Exit House. Holquin stated that Exit House is partially funded by the Federal government and is guided by Federal guidelines, including the requirements of patient confidentiality.

Plaintiff testified that her duties at Little Village included being co-leader of a therapy group and carrying a regular patient caseload. At Exit House plaintiff had direct contact with Exit House patients. A memorandum describing her duties at Exit House stated "[her] role is broadly defined * * * as a fully paid staff resource for the project; her role is not * * * limited to those behaviors and responsibilities of the `consultant' model."

Plaintiff related that she met with Holquin on the evening of April 10, 1975. After that meeting she received a message to attend a meeting at Exit House. When she arrived at Exit House later that evening, a staff meeting was in progress. Roger Dvorak, with whom she was acquainted, was present, as well as Shirley Fedder, plaintiff's supervisor at Exit House, and several members of the staff. Fedder, Dvorak and plaintiff went into Fedder's office. Plaintiff stated that Dvorak appeared distraught and under stress. Dvorak indicated that he had stolen the files from Little Village and stated "I'm a liar, I'm a fraud." Plaintiff responded, "Roger, are you saying you want me for therapy?" Dvorak answered in the affirmative.

Plaintiff then continued the discussion with Dvorak using therapy techniques. Dvorak stated he had several remaining files that he wanted to destroy. Plaintiff suggested that he return the files but Dvorak rejected this suggestion. She asked "Do you want us to turn you in?" But Dvorak insisted they could not because their conversation had been made a therapy session. He indicated that he had been taking several valium and librium daily.

After Dvorak obtained a ride home from a staff member, plaintiff and Fedder checked the Federal guidelines concerning the rules of patient confidentiality. These guidelines, they determined, prevented them from discussing Dvorak's confession with anyone. Plaintiff stated that she viewed her consultation with Dvorak as within her role at Exit House and that she did not notify Holquin or any member of the Little Village staff of Dvorak's confession.

Ruth Charles Edwards, clinical director at Little Village, testified that, to her knowledge, in order for an individual to become a patient at Exit House it was necessary to open a patient file and register the person with a hospital in Springfield. She also stated that rules of confidentiality applicable to Little Village ...

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