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Ugh

Wednesday, Mar 21, 2007 - Posted by Rich Miller

The loss of federal funding isn’t permanent and may be reversed, but it looks like the state really needs to clean up this place

The Howe Developmental Center in Tinley Park has lost its Medicaid funding, which provides half of its $53 million budget.

The state-run center, home to about 400 disabled adults, failed in a scramble to fix problems in the three months since it was warned its federal certification was at risk. […]

In one case, a woman who was supposed to be under close and constant supervision was able to swallow a coin and a paper clip and insert a pen in her genitals.

As the Medicaid status was in limbo, a state watchdog group called Equip for Equality called on the governor to close Howe, angering residents’ families who say the center is the best possible home for their loved ones.

Under a federal law, Equip for Equality has authority to visit facilities and review records.

The group issued press releases in February and March alleging that poor care at Howe contributed to 11 deaths since 2005.

This is a state mismanagement open thread. Be advised, though, that over the top personal insults and the like will be deleted. So, please, follow the rules.

       

17 Comments
  1. - Dan B-R - Wednesday, Mar 21, 07 @ 10:11 am:

    What we really need to do is to close down these huge institutions which are more like prisons than a place to receive care and transition to a community based services system. Small group homes in the commuinty are smaller with better staff to client ratios. Plus people are happier and more successful in community based settings. Indiana just closed the last of their institutions for people with disabilites early this year. It time for Illinois to catch up with the times and do the same.


  2. - VanillaMan - Wednesday, Mar 21, 07 @ 10:12 am:

    It is horrible to move a loved one unable to understand why their world is being changed. We had to move a 48 year old friend who has the intelligence of an 18 month old from a center closed under Ryan. Although the move was for the better, and he now receives better care, the change nearly killed him.

    I completely understand why a family would rather keep their loved ones in a dumpy dangerous center than move them. These special people do not understand what is happening to them, and it is devastating to their world.

    This is a case of mismanagement, and cutting funds shouldn’t be the means of changing it.

    And I figured it out for those shocked at the price - $53,000,000 sounds fair when caring for 400 developmentally disabled Illinoians.


  3. - VanillaMan - Wednesday, Mar 21, 07 @ 10:17 am:

    Dan is right, but we are discussing SEVERELY disabled Illinoians unable to be moved to a group home. We have thousands of loved ones mentally disabled to the point where group homes are not an option.

    Just closing the centers and putting these people in group homes is not a solution. I don’t know what Indiana is doing, but it is impossible for them to be warehousing their severely disabled citizens in group homes - it would kill them.


  4. - Dan B-R - Wednesday, Mar 21, 07 @ 10:24 am:

    Everyone can live in the community which means different things for different people with different needs. We don’t know the potential of people in an institutional setting. People tend to take on the negative behaviors that they are surrounded with plus they are often unhappy and neglected. Staff are also burned out and unhappy. However, for 53 millions we can definately provide better care that is more humane and personalized. That is my main point. Other states have deinstitutionalized, in fact to my knowledge all of the other midwestern states have. Illinois is way behind in this area. We can do better.


  5. - Reality Check - Wednesday, Mar 21, 07 @ 11:01 am:

    In fact Illinois is way behind in adequately funding care for individuals with developmental disabilities in both state-operated centers like Howe and community-based agencies under state contract.

    Both parts of the system are integral to a continuum of care that serves all Illinoisans regardless of the severity of their needs - and both parts are woefully neglected by the proposed 08 budget (as they were this year as well).

    Anyone concerned about this matter should push their lawmakers to (1) provide a cost-of-doing-business rate increase for community providers AND (2) direct DHS to preserve access to care in state-operated centers by rejecting the administration’s push to close needed beds and improve quality of care by hiring adequate staff. Caregivers today are being forced to work crushing amounts of overtime, which hurts residents, staff and taxpayers alike.


  6. - Reality Check - Wednesday, Mar 21, 07 @ 11:08 am:

    And the problems are not just at Howe. See this recent piece on the harm done by starvation budgets at another state center for individuals with severe developmental disabilities - Kiley, where the immensely well-respected director recently resigned amid great frustration over the center’s lack of staff and resources: http://www.suburbanchicagonews.com/newssun/news/293089,5_1_WA12_KILEY_S1.article


  7. - i d - Wednesday, Mar 21, 07 @ 12:25 pm:

    I did not know any of this and I’m nearly speechless. When do we stop worrying about the needs of people in other countries and take care of our own. Who are we to tell any other country that it is not taking care of its’ citizens.


  8. - Anonymous - Wednesday, Mar 21, 07 @ 1:16 pm:

    DHS is doing an outstanding job. We know this because Carole Adams told us so a couple of weeks ago at the Pajamagate hearing. What’s the big deal about lost federal subsidies of $26 million?


  9. - Gathers No - Wednesday, Mar 21, 07 @ 1:37 pm:

    Although I took part in drafting and lobbying the bills that created Howe, Ludeman and Waukegan institutions 30 years ago, it’s now time they were phased out. At that time, they were considered radically small compared to the 5,500 bed facilities at both Dixon and Lincoln. Regardlesss of the severity one’s disability, he or she can learn to reach their potential more successfully in small residential homes integrated into the community. However, those needing more supports have to be provided with adequate funding from the Department of Human Services. Somewhere between the $50,000 a year that the rates are now set at, and the $145,000 it costs to maintain someone each year in the outmoded state institutions. Institutions are as outdated as the orphanages of the past.


  10. - Larry Mulholland - Wednesday, Mar 21, 07 @ 1:41 pm:

    It is sad day when patients are at risk.

    Loss of federal funding has been happening very frequently under the BLAGO Administration. I think I have heard a story at nearly every state agency that has, in one form or another, lost a significant $revenue$ stream from federal sources because of lack of proper oversight by this administration.

    Perhaps other readers have heard similar bad news for Illinois taxpayers??

    I was going to suggest that DHS quickly send a couple of drivers over to Howe Developmental Center to lend a hand but I do not want to be cencured :-)


  11. - Belle - Wednesday, Mar 21, 07 @ 1:44 pm:

    Maybe it wouldn’t have taken so long to get the problem noticed if these people could vote. Cynical, but sadly true.


  12. - Oldtimer - Wednesday, Mar 21, 07 @ 2:01 pm:

    I have been involved with providing services for citizens with disabilities for over 35 years and it has been decades since the state was worried about the quality of care that it provides. State institutions are about jobs for members of the state employees’ union, political endorsements, and political donations not about care. Illinois under-funds services for its citizens with disabilities but the bulk of the money goes to the state institutions. Community programs are not considered important by our state leaders. No wonder parents are reluctant to have their children leave the state institution.


  13. - Tessa - Wednesday, Mar 21, 07 @ 6:12 pm:

    Okay, I have worked for both the community and the state providing services to individuals who have developmental disabilities. There is still a need for both at this time in this state. The state, and this Governor, are not providing adequate funding in the budget for community operated agencies to provide appropriate services to many of the individuals still living in state centers. With appropriate support, a great many people with severe disabilities, including those with dual sensory impairments, other medical issues, psychiatric diagnoses (dual diagnoses), etc., could live successfully in less restrictive private sector homes. However, the pay is low and the turnover rate for staff in these homes is high, there aren’t professional staff on duty 24 hours a day at most places to deal with medical or behavioral concerns. The money just isn’t there. And the state isn’t willing to put the money into the budget to help the community agencies out.

    Until that happens, there is going to continue to be a need for state operated centers. If people would look harder istead of complaining about staff there just being there for the “good” paychecks, they’d find longterm dedicated staff who care about the jobs they do. People who have stuck around after failed placements, medication changes, behavior plans that didn’t work, family and guardianship changes. Direct contact and professional staff in these centers frequently don’t leave shortly after training is over. They stay, even after being berated by upper management and surveying people who tell them how bad they are. Hmmm. Have they worked many 60-80 hour weeks of mandatory overtime and not seen their kids play a home game in two years? What about missing parent/teacher conference again? That’s a normal life at a state center these days.

    Truth be told, the Gov would be happy to have Howe close. Remember, he wants Tinley Parks land. He tried to close that a few years back and they are on the same land. Tinley just lost it’s federal funding last week. Any coincidence here folks? He could have a two for one deal. Big bucks. Super huge money. It doesn’t take a rocket scientist. If Tinley goes down and he can sell that land, and Howe closes and he can sell that land, he stands to make multiple millions and still look like a good guy, because he “saved” these people.

    But ask the community agencies if they are ready to take on any of the people with mental illnesses from Tinley right now? Or the people who have developmental disabilities from Howe? Not gonna happen.

    Reality check. And a sad one at that.


  14. - Decatur Dave - Wednesday, Mar 21, 07 @ 7:44 pm:

    The name, once again, is Carol Adams, Secretary of DHS for the last four years, who is ultimately responsible for what happened at Howe Developmental Center. Carol Adams. Don’t forget. No time for driver jokes — remember who is responsible for something really, seriously, bad with state government.


  15. - Nostradamus - Wednesday, Mar 21, 07 @ 8:22 pm:

    I worked for Mental Health, now DHS. There are
    numerous things wrong. First, the people who are
    responsible for the patients care is called a
    mental health technician. This is probably the
    lowest paying job of all state job positions. This
    is one of the toughest jobsto have. When a recipient “acts out” or attacks a care giver, they
    have to be sure they don’t violate the patients
    rights. Some of these workers are really injured
    badly. Another problem that DHS has is, they use
    part time workers. The pay is less than someone
    working in a part time job at a fast food restaurant. Next, a person working part time in
    a state facility must agree to stay at their job,
    if the relief fails to show. They have a tremendous turn over in staff because of the
    mandatory overtime they are forced to accept. If
    a MHTech that is supposed to be off at 7 am, they
    may have another pt job that they need to be at
    by 8 am. If the relieving worker does not report,
    the tech that was to be off at 7 will have to
    stay until 3 pm, and to hell with the other job
    they have. The people that get hired at these
    facilities are usually the rejects of all other
    employers. This is mainly in the Chicago area.
    At the other facilities, Dixon, Anna, Kankakee ect
    there is a much higher standard of worker. A BIG
    BIG problem at DHS is, the Social Workers, Physicians, Psychologists, Psychiatrists, Facility Directors, Chauffeurs all make the Big
    Big bucks. The person with the hardest and more
    dangerous job makes the least. The wife of the
    Illinois Senate President, Mrs. Emil Jones makes
    OVER $200,000.00 a year!! Then you have people
    like the agency director, that knows little about
    running such a large organization. But she be the
    big woman. Also, you don’t want the facilities
    to close, some of those people “Don’t Belong” on
    the streets. The state should hire full time
    employees and pay them a decent salary.


  16. - Cassandra - Wednesday, Mar 21, 07 @ 9:31 pm:

    Just as we recently got a DCFS Oversight Committee in the Illinois House, it looks like we need a DHS Oversight Committee. Federal standards aren’t all that high….Howe must be in really bad shape to fail them.

    One of the recommendations for DCFS is that the DCFS Inspector General be empowered to send its crisis teams into failing DCFS offices to turn them around. Perhaps similar recommendations should be made for the DHS Inspector General to send in a similar team to figure out what can be salvaged at Howe and whether at least some of the residents could tolerate moving to a community based setting pronto. And that should be done sooner rather than later.


  17. - Tessa - Thursday, Mar 22, 07 @ 6:50 am:

    Cassandra, who told you Federal standards aren’t that high? Been through a federal survey lately? I doubt it. They aren’t fun, and not easy to pass. Been there, done that. We kept our federal funding, by the way, at a state center in Illinois. And we continue to be under scrutiny.

    And Cassandra, like I said, the community agencies aren’t ready to take everyone. Get on the phone and ask. You’ll be surprised.

    I’m not a tech, but I work side by side with them, every day. I put in over 40 hours OT last week to help out. That was voluntary, not mandatory. Every day that I worked over, every staff person there got mandated to work. That should say something about how bad the staffing levels are.

    Right now, DHS has a consulting firm going through every state operated center looking for ways to cut money. The way they are doing it - looking at ways to cut more staff. It’s crazy. Frontline staff are pushed to the limits already, both in the physical and mental sense. Staff want to do the best they can, but with what they are given, they can’t do it. Do more with a whole lot less. And kick us in the teeth because we can’t do more. No one’s listening to the staff doing the work.

    It’s not right. I wonder how much the Harvey Rose firm is making off this contract?

    And before anyone suggests I just want state op centers to stay open forever, I am for placement when it’s the right option, but it’s not for everyone. I’ve seen successful placements, and I’ve seen people return after placements gone bad, and I’ve had people who’ve been in the community their whole lives had to come in because their community or home placement can’t be done anymore. It takes a world to help a person. Let’s do it together.


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