State may end reliance on nursing homes for disabled adults

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State may end reliance on nursing homes for disabled adults



WGN news reported the following story: http://www.wgntv.com/news/local/breaking/chi-state-may-end-reliance-on-nursing-homes-for-young-disabled-adults-20110829,0,6186374.story

By David Jackson Tribune reporter
6:39 p.m. CDT, August 29, 2011

State officials on Monday moved a step closer to ending Illinois' long-standing reliance on large nursing facilities to house adults who have physical and mental disabilities.

A proposed settlement to a class-action lawsuit was filed in federal court Monday evening. It would require state agencies to offer subsidized apartments to thousands of Cook County nursing home residents who can function independently and want to move out of the institutions.

Before it becomes state policy, Monday's settlement still requires court approval and a "fairness hearing" to consider the comments and objections of interested parties. But the agreement was hailed as a civil rights victory by advocates for low-income people with disabilities who say the new settlement would bolster other recent court agreements and legislative reforms aimed at reshaping Illinois' troubled long-term care system.

"Institutions foster dependency. It is actually harmful to people to live in nursing homes when they could be better served in the community," said Patricia Werner, an attorney for the nonprofit Access Living, which filed a 2007 federal lawsuit that paved the way for the settlement agreement.

Officials for the administration of Gov. Pat Quinn say the new agreement would not burden Illinois taxpayers because the debt-ravaged state would recoup Medicaid dollars as it offers apartments and community housing to the former nursing home residents. In other states, they say, such subsidized dwellings have proved less costly to taxpayers than nursing facilities. Under the court agreement, the new housing plan must be implemented in a way that costs the state no more than its current use of nursing homes.

The agreement would require state agencies to offer so-called supportive housing to as many as 20,000 Medicaid recipients who currently reside in Cook County nursing facilities. The plan would be rolled out cautiously, with some 1,100 nursing home residents moved into apartments and group homes during an initial 30-month period.

Quinn and state officials worked to settle three linked disability-rights lawsuits and reform Illinois nursing homes following a 2009 Chicago Tribune investigation that detailed numerous reports of sexual assault, violence and drug abuse in the state's most troubled facilities.

While some Cook County nursing home residents receive excellent treatment, others find themselves trapped in a subset of grim, profit-making institutions that provide little therapy or discharge planning, the Tribune investigation of court records and interviews found.

Cook County nursing homes often take direct control of residents' disability checks, which typically total about $700 a month, and allot each resident just $30 per month in spending money — far too little to amass an apartment security deposit or build a life beyond the institution.

Advocates for the elderly and disabled in 2005 filed the first of three linked lawsuits demanding that Illinois abide by a 1999 Supreme Court decision known as Olmstead, which requires government agencies to place people with disabilities in the least restrictive setting appropriate to their needs.

Newspaper investigations around the country have shown that supportive living arrangements are not an automatic cure for the abuse and neglect found in nursing facilities.

"We have to be vigilant in making sure the people who move are prepared and the places are safe. We're dealing with the most vulnerable people in society, which gives us a special obligation to make sure wherever they live is as safe as it can be," said state Department on Aging acting Director Michael Gelder.

Under Monday's court settlement, Cook County nursing home residents can be evaluated by state-supervised professionals to determine whether they are eligible to be moved into a less restrictive setting and what is needed to thrive there. The evaluation is voluntary, and residents can decline to take part and remain where they are.

Those who opt to move would be offered rental assistance that in many cases would total roughly $700 per month, as well up to $4,000 in transitional funds to equip and furnish their apartments. This money will not be handed to the clients but will be distributed to their landlords using a method akin to Section 8 Housing Choice Vouchers.

Community-based organizations would provide on-site or off-site services, including mental health treatment, life-skills training, personal attendant services and case management that includes linking clients with medical providers.


Editor's note: Unfortunately, while this is a step in the right direction, it does nothing to help the elderly disabled wards in the Cook County Probate Court. Wards in Cook County are being victimized by their guardians through the use of OBRA Special Needs Pooled Trusts. These trusts are created, with the approval of certain judges, for the sole purpose of allowing the ward to qualify for Medicaid. Once a ward qualifies for Medicaid, they can no longer stay in private pay housing. These wards are then moved from their high quality private pay nursing homes and are immediately moved to public aid facilities at the cost of the taxpayer; this is done as soon as their funds are placed into the OBRA trust by the guardian. This is done because of a legal loophole in the OBRA laws. While the wards' OBRA funds (their entire estates) cannot be used on housing or food per OBRA laws, the wards' estate funds CAN be used on administrative fees (legal fees and guardian's fees). Thus, the wards are placed into public aid facilities, and their estates are depleted by the attorneys and guardians. A review of the wards of the Public Guardian shows that over 50% of the wards estates are placed into these trusts, the wards are moved to public aid facilities, and the estates are depleted with legal and guardian fees. There is a shortage of public aid nursing home beds for those truly in need. The abuse of the Medicaid system by the guardians in the Cook County Probate Courts needs to come to an end