Quinn for Illinois

By David Jackson and Gary Marx

A top aide to Gov. Pat Quinn is proposing an array of sweeping reforms that could dramatically restructure how Illinois cares for nursing home residents and the mentally ill.

The initiatives, proposed today by Quinn's Nursing Home Safety Task Force, are designed to end the chronic violence and abuse that plague some facilities, and to foster better treatment for people with serious mental illness, according to task force chairman Michael Gelder.

In draft recommendations obtained by the Tribune -- prepared for a task force hearing this morning -- Gelder outlined 27 "preliminary recommendations" that will be refined during the next three weeks before a final report to the governor.

Quinn's task force was formed in response to a series of Tribune reports on assaults, rapes and murders in Illinois nursing homes.

The state is unique in mixing geriatric and mentally ill nursing home residents. Understaffed facilities have failed to treat and monitor their most violent patients, government records show.

The proposed initiatives address shortfalls identified in the Tribune stories.

Among them are steps that might be put into place fairly rapidly, including a tightening of criminal background checks and the screening of people entering nursing homes. The checks should be started before people are admitted to facilities, according to Gelder's preliminary recommendations. He proposes the state should sanction homes that do not immediately complete the screening reports.

Under the current system, Gelder has said, it takes too long to get too little information.

The governor should direct the state police to begin searching nursing homes for residents with outstanding warrants, and to ensure nursing homes are complying with a tighter criminal backgrounds checks of new residents, according to Gelder's recommendations.

The administration should create new compliance and training standards for facilities that serve people with severe psychiatric disorders, the recommendations said.

Gelder also is recommending that the administration hire additional nursing home inspectors and retrain its existing inspectors to better understand issues involving the mentally ill.

Illinois has a deficit of more than $12 billion. But Gelder has said these reforms can be achieved by redirecting current spending and will not require any additional general revenue funds.

In addition, the proposals give the state Department of Public Health greater authority to revoke the licenses of nursing homes that repeatedly violate state regulations. Other proposals strengthen the government's response to misconduct by nursing home administrators.

Gelder recommends that the state increase minimum staffing requirements of nursing homes to bring them up to standards recommended in federal government studies on nursing home care.

The most ambitious set of proposals may take several years to implement but would end the  decades-old practice of shuttling mentally people into nursing homes from psychiatric wards, jail cells and homeless shelters.

For the vast majority of mentally ill people who can work toward independence if given proper treatment and support, the administration is proposing to expand Illinois' home- and community-based housing programs.