A top adviser to Gov. Pat Quinn outlined Thursday for the first time some of the steps Illinois must take to end the warehousing of mentally ill adults in nursing homes, including violent felons who have victimized elderly and disabled residents.
And at the state Senate hearing in Chicago, legislators expressed outrage with the series of assaults, rapes and murders in nursing facilities, and called for a top-to-bottom overhaul of the state's inspections and safety monitoring, as well as more rigorous screenings of violent offenders who cycle into the homes from psychiatric wards, jail cells and shelters.
Many facilities are so dangerous, said state Sen. William Delgado, D-Chicago, that "I would be pushing very hard to have a federal monitor oversee what is happening in these nursing homes. ... Shame on us, all of the agencies. ... This is really, really scary to me."
The senators said they would seek to introduce reform legislation by February and signaled that they were contemplating more stringent safety enforcement as well as the development of a more robust system for serving psychiatric patients outside the nursing facilities.
"These nursing homes have really turned into dumping grounds for our most vulnerable citizens," said Sen. Susan Garrett, D- Lake Forest. "Year after year, nothing has really changed. The time has come where rubber has to meet the road."
Some 150 people crowded into the state hearing room, and more than two dozen offered testimony. No Republican lawmakers attended, but Sen. Dave Syverson, R-Rockford, said their absence was only due to scheduling conflicts.
"Our goal is to work with the administration and legislators to come up with affordable and realistic solutions," he said.
The hearing was prompted by a Tribune series on compromised care at nursing homes that house violent psychiatric patients and criminals.
"We have a big mess on our hands," said Sen. Mattie Hunter, D-Chicago, who chaired the joint hearing of the Senate Human Services and Public Health committees.
At the hearing, public health officials were pressed by Sen. Jacqueline Collins, D-Chicago, to recount how many times the license of an Illinois nursing home had been revoked because of patient abuse or neglect. The public health authorities said they would look into the matter but could recall only one such instance in more than a decade.
"This is the concern," Collins responded. "There's a yo-yo pattern -- they come into compliance and then fall back into noncompliance, [and] we see the egregious behavior and the problems still existing."
Michael Gelder, head of Quinn's Nursing Home Safety Task Force, offered a broad outline of steps his team is likely to recommend to end the volatile mix of high-risk psychiatric patients and felons with the elderly and disabled.
Illinois needs to create many more home- and community-based service options for psychiatric patients currently housed in nursing homes, Gelder said at the hearing.
"That's an important element of everything this administration is undertaking," Gelder elaborated in an interview outside the hearing room.
The state also needs better assessment techniques so that mentally ill people can be placed in settings where they can get proper therapy and supervision, he said.
Small group settings are less expensive and therapeutically better for the mentally ill patients, Gelder said, and they "eliminate the risk that the relatively few numbers of those people would pose to vulnerable older adults or younger people with disabilities" in nursing facilities.
Asked how much it would cost and how long it would take to move hundreds or even thousands of people out of nursing homes and into community-based settings, Gelder said: "We're reviewing that as we speak."
Gelder said Illinois authorities are now applying for a federal waiver that would allow the state to access federal funding to move mentally ill people from nursing homes to less institutional settings.
For now, he said, Illinois needs "higher standards and enforcement" to ensure the care of nursing home residents.