Tuesday, July 31, 2012

Quinn adviser sees "serious problems" with how DHS handled abuse and neglect allegations

By Jamey Dunn

A House panel took members of Gov. Pat Quinn’s administration to task today over recent reports that the Illinois Department of Human Services did not follow up on allegations of abuse and neglect after the deaths of several developmentally disabled adults.

The Belleville News-Democrat reported in June that the DHS inspector general, who is tasked with looking into reports of neglect, was not pursuing complaints after the alleged victims had died. The agency reportedly deemed those who had died “ineligible for service.”  The paper found 53 deaths since 2003 that the department did not investigate or list in its annual report. In most cases, the individuals were brought into the hospital near death, and health care professionals raised the possibility of potential abuse or neglect, but the patient died before an investigation began.

 “We’re here today for a particularly sad reason because our state failed to detect abuse and neglect of adults with disabilities. We failed to adequately investigate complaints and failed to protect those who were abused and failed to help bring their abusers to justice,” said Rep. Greg Harris, chair of the House Human Services Committee. “Fifty-three deaths occurred, and there were none, no, absolutely zero felony convictions for that abuse and neglect. ... These men and women passed away and suffered in very horrible ways.”

Harris described some of the conditions the disabled adults had faced as “living in filth” and “covered in bedsores.” He said that some had “become emaciated skeletons.” Some “might have been saved if the system had performed batter or even had responded at all to their appalling circumstances instead of parsing legal language,” Harris said.

Michael Gelder, Quinn’s senior adviser on health policy, agreed that there were “serious problems” and “deficiencies” with the way the inspector general’s office handled the cases. “We can’t undo what’s been done, but we can do better,” he told the committee at the Chicago hearing. “The gaps and mistakes in our system are deplorable, and the governor responded as quickly as he could.”

He added, “I think that there’s no question that certain job responsibilities were not fulfilled.”

Since the report, Quinn has restructured the inspector general’s office and issued an executive order meant to address the problems. Former inspector general William Davis' resignation becomes effective on Aug. 1. Quinn named Daniel Dyslin as acting inspector general for DHS. Dyslin previously served as senior deputy general council at the department. Quinn also appointed Michael McCotter, who has a background in law enforcement, as a special investigator for the office. McCotter is tasked with looking into the cases that the department failed to investigate previously.

DHS Secretary Michelle Saddler said that the inspector general’s office refers such cases to local law enforcement authority. However, she said the office lacked the proper documentation to prove that all of the cases in questions had been referred. “When a person passes away before we can complete or even initiate an investigation, we appropriately refer these results to local law enforcement agencies,” she told the committee. “But as the days progressed, we found that we had inadequately documented our referrals to law enforcement authorities, and in fact, there was no evidence in many cases of our having made those referrals.”

She added that the department made a “very poor choice of words” when it declared the deceased  “ineligible for services” in its paperwork.  She said the decision “raised concerns about our commitment to adults with disabilities.”

The executive order requires the department to refer suspect cases of neglect or abuse when the alleged victim dies to local law enforcement, to document the referral and to follow up with law enforcement to see what action was taken. “The executive order [and] the investigative team will allow us not only to look back and find out exactly what went wrong but also begin that conversation of how we can make this a better system with the resources we have.”

Rep. Mary Flowers DHS bears the responsibility for abuse cases slipping through the cracks. “The law is the law, and your agency failed to protect the people,” she said. “It is not about the police. It is about your agency failing to do what it’s supposed to do." Flowers, a Democrat from Chicago, argued that low staffing numbers set the office up for a fall. “This program was doomed for failure from the very beginning,” she said.

Saddler said that the DHS inspector general’s office only has five investigators and one supervisor who handle reports of potential abuse or neglect. However, she said the department is working to find solutions without adding staff. “The reality that all of us are dealing with at each of our levels is that there are only a certain number of resources to go around. There were a tremendous number of unspeakably difficult decisions that were made at every single level of the budget process.”

Rep. Sandy Cole, a Republican from Grayslake, said that budget cuts are no excuse for the department’s shortfalls. “I’m kind of amazed at how we are equating incompetence with the fact that the state has a budget crisis. I found that [to be] such a scapegoat.”

Both Saddler and Gelder agreed that streamlining the process for reporting abuse — regardless if the victim is developmentally disabled, a child or elderly — might help make the system function more smoothly. They noted that many of the calls that come into the DHS hot line for reporting neglect or abuse of the developmentally disabled are not for cases covered by the department. They are instead cases that involve children or the elderly, or they are reports of suspected fraud in programs, such as Medicaid. “If we seriously consider combining these hot lines, we would be doing the public a great service so there wouldn’t be a wrong number,” Gelder said. According to Saddler, the DHS hot line received 1,438 calls in Fiscal Year 2011. 

Ann Spillane, chief of staff for Attorney General Lisa Madigan, suggested setting up training programs specific to investigating abuse and neglect allegations for local law enforcement units. “We want to make sure that local law enforcement feel like they’re supported in this effort.” She said local police should also be connected to experts in their area for assistance.

Lawmakers argued that the intent of the law was clear, and they felt that the inspector general disregarded that intent, but they also said that it may be time to rewrite the statute in a way that leaves no room for confusion and considers the needs of the developmentally disabled and those who would utilize the system to report neglect and abuse cases. While some proposed sweeping changes, such as the merger of functions across agencies, others suggested smaller ideas, such as putting the abuse hot line number on the homepage of the DHS website. “We really need to look at the consumer as we design these systems,” Harris said.


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