Illinois to relocate at least half of current residents at Choate
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[March 08, 2023]
By BETH HUNDSDORFER
Capitol News Illinois
& MOLLY PARKER
Lee Enterprises Midwest
news@capitolnewsillinois.com
This article was produced for ProPublica’s Local Reporting Network in
partnership with Lee Enterprises, along with Capitol News Illinois.
The Illinois Department of Human Services plans to dramatically reduce
the number of patients with developmental disabilities who live at the
embattled state-run Choate Mental Health and Developmental Center.
In an exclusive interview before an expected Wednesday announcement,
IDHS Secretary Grace Hou outlined a “repurposing and restructuring” of
Choate, located in rural Anna, about 120 miles southeast of St. Louis.
That process will start with the relocation of 123 residents with
developmental disabilities who entered the facility voluntarily —
roughly half the current population.
In a separate interview with reporters, Democratic Gov. J.B. Pritzker
said that IDHS has been working on improvements at Choate since he first
took office in January 2019. But he said “it became clear, I would say
certainly over the last year — and, in part, because of your reporting —
that there were more significant changes that needed to be made.”
The announcement — which the governor’s office billed as a
“transformational” behavioral health initiative in southern Illinois —
comes after months of reporting by Capitol News Illinois, Lee
Enterprises and ProPublica that detailed the beatings of patients, a
concerted effort by some staff members to cover up abuse and serious
neglect, the intimidation of employees who reported it and the attempt
to coerce new employees into participating in the abuse or being silent
about it. Local prosecutors have filed felony charges against at least
49 people, both residents and employees, since 2015, a review of court
records by reporters showed.
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Hou also said the reporting played into the timing of the announcement
because it has “brought a lot of this to light and I think forced the
conversation into the public discourse.”
The agency will help residents relocate from Choate, and it will give
them two to three years to move, Hou said. She said some will likely
move into state-supported centers and others will go to community
settings.
IDHS will also develop a plan for an additional 112 residents with
developmental disabilities who currently live in its so-called specialty
units, Hou said. The group includes some people who were sent to Choate
by a criminal court judge after they were found unfit to stand trial or
not guilty by reason of insanity. Hou said that the state is likely to
move a “significant portion” of those residents, but that the agency
does not want to rush the decision before it is able to determine “what
capacity we have to serve those individuals in a different setting.”
In the interviews and news release, Hou, IDHS and the governor’s office
did not label their plans for Choate as a closure, and no layoffs were
included in the announcement. The facility’s 49-bed psychiatric hospital
will remain open and may expand, Hou said. They’ve tapped the Southern
Illinois University School of Medicine to determine the best path
forward for the institution.
The restructuring of Choate, she said, is part of a broader goal for
Illinois to expand services for people with developmental disabilities
who are receiving state funding and want to live in the community; the
aim is ultimately to reduce the number of people living at its seven
developmental centers.
Advocacy and legal organizations that represent people with disabilities
have long criticized the state for its heavy reliance on large public
and private institutions to house people with disabilities, and for its
lack of adequate funding for community-based options such as group homes
or supports to keep people at home with loved ones.
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Spurred by a slew of lawsuits across the country, states have reduced
the number of people with developmental disabilities in state-operated
institutions by more than 90% over the past half century, according to a
2022 study by the University of Minnesota. As of 2018, only four states
— Illinois, Texas, North Carolina and New Jersey — had 1,000 or more
state-operated beds open, the Minnesota study found.
Closures of large institutions accelerated with the U.S. Supreme Court’s
1999 Olmstead decision, which found it unconstitutional to segregate
people with disabilities from the rest of society. Seventeen states no
longer operate developmental centers at all, and others have
dramatically reduced the number of beds they operate.
Illinois has shuttered some of its large institutions over the past two
decades, but it has been slow to transition compared with other states.
It houses more people with developmental disabilities in large
institutions and spends more to operate those institutions relative to
statewide personal income than almost every other state in the nation,
according to a review of data compiled by researchers with the
University of Kansas. The number of people, nearly 15,000, on its
waitlist for community-based services for people with intellectual and
developmental disabilities is one of the largest in the country.
In addition, a 2005 lawsuit brought on behalf of residents living in
large privately operated state-funded centers argued the state had
failed to live up to the mandates of Olmstead. As a result, Illinois
currently operates under the terms of a federal consent decree to ensure
that people with developmental disabilities get sufficient support from
the state in their homes and community settings.
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In an exclusive interview, IDHS
Secretary Grace Hou discussed impending changes to the state’s
system that serves developmentally disabled individuals. (Jerry
Nowicki/Capitol News Illinois)
![](http://archives.lincolndailynews.com/2019/Sep/05/images/ads/current/stclara_lda_SPONSOR_090519.png)
Hou said this week that when Pritzker appointed her to lead IDHS
after he took office in 2019, the state’s poor record was common
knowledge. “I think all of us leaders knew that Illinois was a
laggard as it relates to prioritizing community-based care,” she
said.
But Hou said that back then, the provider network that serves people
in the community was not in a place to handle a large influx of
people. Then COVID-19 hit the following year, putting significant
changes on hold. “We’ve taken the opportunity over the course of the
past four years to build up the community-based system,” she said,
including increasing pay for direct service professionals, the
front-line caretakers.
Hou said the state has made significant new investments in its
community-based system since Pritzker took office, but it has so far
failed to make the improvements needed to bring the consent decree
to a close.
Pritzker, who just won a second term, has faced numerous challenges
with the large state agencies that provide social and human
services. Advocates for people with disabilities have praised the
administration’s expansion of services, but they argued it hasn’t
been enough to correct decades-old problems. Pritzker said the
budget crisis under his predecessor “hollowed out” social service
agencies; the pandemic further caused a labor shortage, he said.
“Rebuilding takes time, and we’re proud of the progress that we’ve
made so far,” he said.
The plan Hou put forth also signaled changes for all state-operated
developmental centers, including safety enhancements, and expanding
support for community-based living.
The agency also created a new position of chief resident safety
officer to oversee security at all residential centers. Ryan Thomas,
a former compliance officer for a Chicago community health
organization, will fill that role. In addition, the agency announced
it would be adding 10 investigators to its Office of Inspector
General, which investigates allegations of patient maltreatment.
This week’s decision to repurpose Choate “advances the State’s
commitment to equity and the civil rights of people with
disabilities,” IDHS said in its news release about its planned
announcement. “It also reflects the State’s legal duty to ensure
residents with disabilities have a full opportunity to live in the
least restrictive environment of their choosing.”
In its news release, IDHS noted that Choate had been heavily
scrutinized by state and federal overseers, as well as Equip for
Equality, a legal advocacy organization appointed to monitor
conditions inside Choate, for at least the past 20 years.
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In a 2005 report, Equip for Equality detailed cases of patient abuse
and neglect, poor medical and mental health care and an excessive
use of restraints; it said that an “archaic system” had resulted in
“tragic consequences for people with disabilities.” A U.S. Justice
Department investigation had similar findings in a report four years
later. At the time, IDHS promised to improve conditions, but the
news organizations’ reporting uncovered that strikingly similar
patient mistreatment and poor care persisted long after the Justice
Department closed its case in 2013.
Past governors have closed facilities, but Illinois has a poor
record when it comes to ensuring that the community-based system has
the proper oversight and staffing to provide safe care for those who
move. In 2011, then-Gov. Pat Quinn, a Democrat, announced plans to
close several state-operated facilities under a plan he called a
“rebalancing initiative.” Those included Jacksonville Developmental
Center, about 35 miles southwest of the capital, Springfield, and
the Warren G. Murray Developmental Center in the southern Illinois
city of Centralia.
Some residents moved out of Murray, but ultimately it was not closed
after parents, the union and local leaders opposed the plan and
Quinn lost his reelection bid. Jacksonville was. Four years later, a
Chicago Tribune investigation documented the state’s botched
transition efforts, resulting in horrifying mistreatment and tragic
deaths across the state.
Hou, in the interview, acknowledged the difficulty of closing
facilities. “The one thing that is common throughout those closures
is that it tears communities apart. And it pits people against each
other,” she said, adding that it was her hope to avoid past
mistakes.
Hou also said there would be no change in the administration at
Choate. Bryant Davis, the facility manager, and Gary Goins, the
quality manager, were both indicted by a Union County grand jury in
2021 on charges of felony official misconduct in connection with a
patient abuse case. After the charges were issued, they were
relieved of their duties at the facility. They pleaded not guilty,
the charges were later dismissed and they returned to work.
“We’ve weighed a lot of different perspectives, but I think we need
a leader who knows Choate inside and out, who has relationships with
the residents and the parents and the staff to lead us through this
challenging transition. I think to put someone new in there, I think
would be very disruptive and even further unsettling,” Hou said.
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