* WBBM Radio…
Chicagoland advocates for the disability community said they hope Gov. J.B. Pritzker’s recent decision to start moving residents out of the state-run Choate institutional living center will signal a shift toward community-based living for all Illinois residents.
“It’s really something the leadership—both the governor and, hopefully, the Legislature—will embrace, which is, the rights of people to live with their families and in their communities,” said Zena Naiditch, the President and CEO of Equip for Equality in Chicago.
Naiditch said Equip has served as the federally mandated protection and advocacy system for people with disabilities for 38 years. That means it’s held special authority to make both announced and unannounced visits to state-run institutions as part of its watchdog efforts. […]
While Pritzker announced the transition of Choate residents, though, he also promised to fund improvements at state-run facilities and expand support for those residents. Naiditch, who praised the decision to move residents out of Choate, said no state in the country can afford to fund both institutional and community-based living.
“Other states have chosen to focus their investments heavily on home- and community-based services, and that’s a direction Illinois is struggling to do because of the fact that they’re trying to fund, essentially, a dual-system,” she said. […]
“We need to understand that there are consent decrees in place, such as Olmstead, Ligas, Williams, and Colbert, that assure people with developmental disabilities the right to live in the least restrictive setting,” [Going Home Coalition Manager Carole Rosen] said.
I spoke with Sen. Terri Bryant the other day and she said one of her top priorities is making sure that Choate residents with nearby families would be able to stay there and not be moved elsewhere.
* Meanwhile, on the other side of the coin, here’s Center Square’s take…
Illinois lawmakers are coming together to call for an audit into ongoing issues at group homes for those with disabilities.
A Community Integrated Living Arrangement, or CILA, is a group home where eight or fewer unrelated adults with developmental disabilities live under the supervision of the community developmental services agency.
State Rep. Charlie Meier, R-Okawville, has previously shared examples of problems at some of these facilities.
“You have heard from the first responders about the incidents of rape, sexual abuse, the neglect of residents, and even starvations that we can document in the state of Illinois that have taken place in CILAs,” Meier said.
Meier’s House Bill 1298 would require the Department of Human Services to establish a system of sight inspections at the facilities.
On Tuesday, the Legislative Audit Commission approved a resolution to trigger an Auditor General Performance Audit. […]
The issue has been a bipartisan one in Springfield. State Rep. LaShawn Ford, D-Chicago, said doing nothing is a misuse of their power.
“They [the state] just got notice there is a problem,” Ford told The Center Square. “To ignore it and to do nothing, I think, is a dereliction of duty on our part.” […]
There wasn’t an immediate timetable offered for when the audit will be started and finished before the findings are released. However, on March 15, 2017, the House adopted a similar resolution calling for an audit of CILA homes. That report was released in July 2018.
The audit wasn’t about CILA homes, it was about the Department of Human Services’ oversight of those homes. From the report…
During the period FY12-FY16, DHS transitioned 408 individuals from the eight State- Operated Developmental Centers (SODCs) to CILA living arrangements. The responsibility for providing follow-up service visits to individuals who transition from an SODC to the community is performed by several entities. These entities are the Independent Service Coordinators (ISCs), the Bureau of Transitional Services (BTS) within DHS, SODC staff, and a vendor (Community Resource Associates (CRA)) that DHS contracted with for SODC closure activities.
DHS contracted with 17 ISCs whose primary role is to work with the individual, family, and/or guardian to identify the most appropriate living arrangement, be it State-operated facility or CILA. The 17 ISCs received over $28 million for these services during the audit period.
During audit testing of available documentation we found:
• DHS failed to ensure that Independent Service Coordinators (ISCs) maintained documentation on all required visits to individuals that transitioned from an SODC to a CILA.
• ISCs only conducted 62 percent of the required weekly visits to the individuals in CILAs. Additionally, ISCs only conducted 82 percent of the required monthly visits to the individuals in CILAs. However, ISCs did conduct 91 percent of the required quarterly visits to the individuals in CILAs.
DHS, through BTS, failed to conduct follow up visits with individuals that transitioned from SODCs to CILAs. Our sample testing found that BTS only conducted 45 percent of the required weekly visits to the individuals in CILAs. Additionally, BTS only conducted 51 percent of the required monthly visits to the individuals in CILAs.
- Give Me A Break - Wednesday, Mar 15, 23 @ 9:42 am:
As with too many issues, the sides want to run to the extremes. You can’t simply shift everyone into CILA care, there is going to have be some form of institutional care for extreme cases. But keeping the large number of people in “state ops” that Illinois does has to end.
At the same time, if the GA wants to start discussing community care, maybe they should start with their history of underfunding both the private providers and the state agencies charged with their oversight.
Charlie Meier and his GOP friends stood by cheering on Rauner while he refused to pay providers and slashed and burned their budgets. But good ole Charlie, front and center with his moral outrage now.
- The Young Gov - Wednesday, Mar 15, 23 @ 9:50 am:
Naiditch makes a good point by bringing up our dual system and last I checked it cost $48M/year to run Choate. We can seriously scale down our insitutional system and seriously scale up our community based system. Several other states have no large insitutions for thier DD population. The community system is endemically underfunded and we today we have a about 14k people on our waiting list for services in the community (PUNS). The Pritzker Administration has has made some seriouS investments in the community-based system, amping up since 2019, although we still have a long way to go. Given all this, scrutinizing state overssight of CILASs during a time period of SFY12-SFY16 is not how I will be spending my time.
- We’ll See - Wednesday, Mar 15, 23 @ 10:18 am:
Rep Meier is always quick to point out issues in community settings but somehow fails to acknowledge issues at his in-district SODC.
https://www.bnd.com/news/local/article44769120.html
- Give Us Barabbas - Wednesday, Mar 15, 23 @ 11:10 am:
I think there will always be some individual cases out there where the non-residential type facility will be needed, so I disagree that it must be an all-one-way deals with only CILAs. Places like Choate will need to exist but they can be scaled-down to give better care to fewer of these edge cases, with a goal of perhaps eventually transitioning some of them to CILA care arrangements. But there will never be a one-size-fits-all approach.
The CILA’s need to have regular inspections, weekly, at random. What I’d envision is an inspector assigned to three such facilities, randomly visiting each one twice a week, in a circuit. This way bad practices can’t get a foothold out of sight, families and residents will have easier communication about needs or problems.
- Friendly Bob Adams - Wednesday, Mar 15, 23 @ 11:25 am:
Lots of information online at the DHS web site. This chart shows that the number served in community settings is going up and the number served in more institutional settings is going down. So the trend is positive overall.
https://www.dhs.state.il.us/page.aspx?item=137738
- PoliticIL Scientist - Wednesday, Mar 15, 23 @ 11:37 am:
You can increase the inspections and oversight of community settings all you want, but if you do not address the ROOT cause, you will continue to find the same problems. What Illinois needs is a fully funded and staffed community system, with limited state operated facilities acting as a fail safe for some of the most acute patients who may not be able to live in a community setting. There is a roadmap for what this is supposed to look like and it is called the DHS Guidehouse Rate Study, which remains underfunded by the state. Operating a large state operated system in conjunction with a community system is duplicative and is not a cost-effective use of state resources. Young Gov at 9:50 is right.
- Grateful Gail - Wednesday, Mar 15, 23 @ 12:15 pm:
Rep. Meier has always fought for QUALITY care, and does not support abuse and neglect in either CILAs or SODCs. There will always be the need for large centers and CILAs, but all need to be funded There ARE good CILA providers who do a great job with the funding they have, and make it work. There are also CILA providers who are only concerned about making a profit. I get calls every week from families who want the care of an ICF or state center. It cannot be a “one size fits all” system. The needs of all need to be met. I also get calls from families in other states every week trying to get services in an SODC in Illinois. Many people who have said to close all the SODCs have never been to one, and never to a good one. When Gov. Quinn tried to close Murray Developmental Center in Centralia he had never visited it. He was taking the word of so called advocates who also had financial interest in CILAs. I applaud Rep. Meier for fighting for quality care. DHS has hidden the abuse in CILAs for years. Time to make ALL care good, and money isn’t just the issue. It is the expectation of quality care.
- thoughts matter - Wednesday, Mar 15, 23 @ 1:04 pm:
This can’t be a one size fits all solution. There will always be people that need care other than at home or in a small group home. Either additional supervision needs, medication needs, behavioral needs or medical care. Or the simple lack of family that can oversee them. We do not want to end up with developmentally disabled people out on the street. This has already happened with the mentally ill and could be happening with dementia patients. We cannot dismantle larger facilities just because some people feel that they shouldn’t exist.
In addition we do need oversight of both home based and group home care for all three categories I mention above.
- Candy Dogood - Wednesday, Mar 15, 23 @ 9:21 pm:
There’s thousands and thousands of funded vacancies in state government. Perhaps we should start considering what those vacancies are at DHS and what role the state’s hiring failures have played in DHS’ ability to actually achieve its mission. The agencies have failed to hire the positions that the legislature has appropriated to such an extent there’s no way they’re achieving 100% of what the legislature intended.
=== it cost $48M/year to run Choate. We can seriously scale down our insitutional system and seriously scale up our community based system.===
Does that $48 million include the forensic unit? So far that forensic unit is staying in place and probably needs to be expanded. The funds for the forensic unit aren’t really something that can be cut because all of those people absolutely have to be kept somewhere.
What’s being discussed or considered right now is evicting the people who are in the broadest terms there voluntarily. Never mind the happy fiction people like to paint about the community based system, those patients are there because they, their families, and or guardians want to be there.
We’re discussing closing the facility because Bruce Rauner is a piece of absolute garbage and Governor Pritzker left the wrong people in charge at Choate and brought some people back at DHS who should have never worked in state Government again.
We’re treating Choate like it’s a lame horse and not a vital public service that hundreds of people depend on and seem to be pretending that we can just go out and get another horse.
This is without even attempting to address that the Illinois Department of Corrections has categorically failed to acknowledge the rights that inmates have to mental health services on top of just regular healthcare in general. There are tens of thousands of people in this state that the State government is failing.
But — thank God for Governor Pritzker who has actually unveiled something that might be part of a long term solution. It just isn’t going to solve the problems we have right now.
Thousands of vacancies. Thousands of job duties being undone. There’s consequences to that and we’re living them.