Pritzker’s oversight of social services questioned amid abuse allegations at Choate mental health facility

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In a small southern Illinois town earlier this year, a 58-year-old employee at the Choate Mental Health and Developmental Center was accused of sexually assaulting a person with a “severe or profound intellectual disability.”

The victim, who was unable to give consent, was only identified in court records with the initials “E.K.” and the alleged assailant was later identified as a mental health technician at the 270-bed, state-run home who also was accused of a separate sexual assault of a girl under 13.

The shocking charges against Charles Mills this March were the latest in a string of scandals at Choate, a home in downstate Anna for people with developmental disabilities and mental illnesses, though few significant reforms at the home had been taken.

But on the same day Mills was charged, Gov. J.B. Pritzker’s chief counsel sent an email to the governor with the subject line: “choate — privileged and confidential,” emails obtained by the Chicago Tribune through a public records request show. A few months later, Pritzker administration officials finally announced increased training and staffing at Choate, in addition to outside monitoring and the installation of new cameras to monitor conditions there.

Administration officials have refused to detail the contents of the email sent to Pritzker or the single-line reply he also sent to other top aides. But critics say the reaction from the governor and his administration was too little too late.

While problems at the Illinois Department of Human Services facility had existed for years, employees at Choate have been charged 14 times since Pritzker became governor. The accusations have included employees abusing residents, obstructing investigations or participating in other misconduct. The state’s watchdog cited dozens of other incidents of abuse and neglect in the same timespan.

The ongoing problems at Choate also raise questions about the Pritzker administration’s oversight of social service agencies in general during his first term in office as he runs for reelection against GOP nominee Darren Bailey.

The state auditor general has blamed Pritzker’s Public Health Department for failing to adequately respond to a COVID-19 outbreak at a state home for veterans that led to the deaths of 36 residents. And child-welfare advocates have repeatedly hammered the administration’s oversight of the Department of Children and Family Services that resulted in a judge ordering Pritzker’s hand-picked DCFS director to be held in contempt of court a dozen times for failing to find appropriate placements for children.

“I have to lay it at the feet of the governor because the buck stops with him,” state Sen. Terri Bryant of Murphysboro said of the incidents at Choate, which is just west of her district. The Republican minority spokesperson for the Senate’s Committee on Behavioral and Mental Health added: “The things that are a priority, you put all hands on deck.”

Audit blasts Pritzker administration for failed response to LaSalle Veterans’ Home COVID-19 outbreak that killed 36 ]

The criminal charges at Choate have ranged from residents being beaten to a resident being forced to drink a cup of hot sauce to employees not reporting abuse, as well as obstruction of investigations or lying to state police. A recent joint investigation by ProPublica, Capitol News Illinois and Lee Enterprises found state police have launched at least 40 criminal investigations over the past decade into alleged employee misconduct at Choate.

Illinois state Sen. Terri Bryant, R-Murphysboro, on the floor of the Illinois Senate at the Illinois State Capitol in Springfield on Sept. 13, 2021. Bryant's district is just west of the Choate Mental Health and Developmental Center.

Illinois state Sen. Terri Bryant, R-Murphysboro, on the floor of the Illinois Senate at the Illinois State Capitol in Springfield on Sept. 13, 2021. Bryant’s district is just west of the Choate Mental Health and Developmental Center. (Justin L. Fowler/The State Journal-Register)

Since Pritzker took office in 2019, the inspector general for the Human Services Department has issued 41 reports substantiating other troubling incidents of abuse and neglect, including one employee punching a resident so hard it broke the resident’s ribs, another employee grabbing a resident by the throat and slamming that person to the ground, and yet another employee threatening to smother a resident with a pillow if the resident failed to stop talking.

Officials with Pritzker’s administration say the problems at Choate are long-standing and are taking time to address while also laying blame on the previous Republican administration for budget cuts to social services.

“Any allegation of abuse or neglect is taken seriously and thoroughly investigated working in close partnership with the IDHS office of inspector general, the Illinois State Police and the Illinois Department of Public Health,” Pritzker spokesperson Jordan Abudayyeh said in an emailed statement. “As we work to ensure the safety of those who reside at Choate, continuing to address these deeply entrenched challenges and make positive steps forward is a top priority for this administration.”

But some advocates for people with developmental disabilities question whether Pritzker’s reforms are enough and why Choate continues to operate. Experts who’ve studied and monitored residential services in Illinois and nationally say harmful conditions can flourish in large, state-run homes for people with developmental disabilities — of which Choate is one of seven in Illinois. Federally funded research shows 16 other states and the District of Columbia had “closed, downsized, privatized or converted” all of their similar facilities as of 2018.

“Look at your neighbors in Michigan and in Indiana. They’re serving the same people with the same characteristics” in smaller settings, said Steven Eidelman, a professor of human services policy at the University of Delaware and past president of the American Association on Intellectual and Developmental Disabilities. “We know how to do this.”

Indeed, one group of experts called for Choate’s closure years ago.

Following a damning 2005 report from the independent advocacy group Equip for Equality that called for the center’s closure, the U.S. Department of Justice found Choate had failed to provide its residents with adequate protection from harm, had a “critical lack of oversight and supervision” and “substantial underreporting of incidents.” The DOJ later declined to intervene because, by 2013, Illinois had “significantly expanded its commitment to community-based services.”

By then, Gov. Pat Quinn had set out to scale back the state’s network of such facilities — closing one in 2012 and planning to close others before organized family groups pushed back. His successor, Gov. Bruce Rauner, kept open the next state home slated to be shuttered, then engaged in a yearslong budget battle that left the state’s social service agencies tattered.

While serious issues at group homes can be found systemwide, some of the problems at Choate are acute — and since Pritzker has taken office his administration has been made aware of them.

Among those who rang alarm bells was Barry Smoot, a former security chief at Choate who emailed the head of IDHS with an urgent message in late May 2021.

“What I am presently seeing occur at Choate and hearing occur at other facilities concerns me more than it has my entire career in relation to the safety of the vulnerable populations that we serve,” he wrote to IDHS Secretary Grace Hou.

Smoot had worked for IDHS for decades, including as the statewide training coordinator for the office’s inspector general and as head of security at the Chester Mental Health Center. In the email, he requested an in-person meeting with Hou to “discuss possible solutions that will greatly reduce instances of abuse and neglect.”

A Pritzker appointee to the role, Hou was formerly IDHS assistant secretary between 2003 and 2012, when both the Equip for Equality and DOJ reports landed. Hou replied to Smoot within hours, offering a meeting with her chief of staff and the director of the division that oversees state-operated developmental centers, known as SODCs.

IDHS Secretary Grace Hou speaks alongside Gov. J.B. Pritzker during a news conference in Chicago on Sept. 14, 2022.

IDHS Secretary Grace Hou speaks alongside Gov. J.B. Pritzker during a news conference in Chicago on Sept. 14, 2022. (Antonio Perez / Chicago Tribune)

But seven months later, on his last day of work with the state in December 2021, Smoot wrote again to tell Hou no one in her office had ever reached out or met with him about the issues he raised in his earlier email.

Earlier this month, IDHS spokesperson Marisa Kollias said in a statement that the agency had “determined, based on information gathered after the Secretary’s message was sent to Mr. Smoot, that it was inadvisable for IDHS management staff to communicate with him any further.”

Kollias added that Smoot was in regular contact with other leaders at IDHS and “had several other avenues to raise any concerns,” including with state police and the watchdog that oversees executive offices across the state. Smoot told the Tribune he wrote to Hou directly because going up IDHS’ chain of command had been unsuccessful.

Kollias declined to elaborate on the department’s decision to not meet with Smoot. IDHS personnel records do not indicate any reprimands. He is named among multiple defendants in a pending civil suit brought by a former Chester resident alleging that Smoot “turned a blind eye” to a culture of intimidation, harassment and retaliation.

Smoot has denied any wrongdoing and said during his years of service he had “a history of showing that I didn’t cover anything up … I did everything by the book and what was required.”

Gov. J.B. Pritzker vowed to overhaul state’s child welfare system. Despite additional funding, some say it’s in worse shape than ever. ]

This March, Smoot self-published a book titled “Failure to Protect,” which detailed a code of silence at Choate and scant reporting of abuse and intimidation. In an email to officials in the governor’s office, an official from the state Guardianship and Advocacy Commission said Smoot’s accounts “jive with” many of the reports released by the Illinois Human Rights Authority. The GAC provides legal representation and guardianship to those with disabilities and investigates complaints of rights violations.

Bryant, the state senator from Murphysboro, also reached out to IDHS leadership after hearing a resident had been beaten by an employee with a belt and that the incident had been seen through a window from outside. The employee, Kevin Jackson, was one of five Choate employees arrested in October 2020.

“When I first brought this to (IDHS’) attention, I believed that they were doing something about it,” Bryant, a former Department of Corrections employee who knows two families with adult children at Choate, told the Tribune.

She later learned that paper was placed over the upstairs windows. After driving to Choate to confirm it, Bryant called an IDHS legislative liaison “and said, ‘I think you guys need to check this out.’ He called back and said, ‘That’s not the case.’ I said, ‘I’m sitting outside the facility, the paper’s on the windows.’ ”

Bryant said she was taken aback by the denial, and the presence of the paper at all. “Their response to someone saying I’m standing outside and seeing someone getting whipped with a belt is to put butcher paper over the windows,” she said.

IDHS said the paper was put up for residents’ privacy after curtains were damaged and removed. “When the use of paper was brought to the attention of Choate administration, it was investigated, removed and new window fixtures were purchased and put in place,” Kollias said.

Three top administrators at the facility were later charged with official misconduct and interfering in a state police investigation of the alleged belt beating. Bryant and others in Springfield pushed publicly to have the accused administrators fired or placed on leave until the allegations were fully investigated. State officials later opted to reassign them. Charges against all three were later dropped, though the Union County state’s attorney has left the door open to recharging them.

Dozens of heavily redacted communications obtained through an open records request show several people in the governor’s immediate orbit were aware of those arrests and other issues dating back to January 2020.

Sol Flores, Pritzker’s deputy governor for Human Services, approved hiring a replacement interim director at Choate after the accused administrators were reassigned, emails show.

Flores also was sent at least 20 e-newsletters from a disability industry insider with blaring headlines about the facility last year. The author of those newsletters, Ed McManus, has a daughter with a disability and works as a consultant for disability agencies, law firms and families. A former Chicago Tribune editor and reporter who later worked at DCFS and IDHS, McManus began sharing details of the criminal cases with clients and others in March 2021.

Though he applauds the reforms, McManus was disappointed they took so long.

“I found out about this in March of last year,” he told the Tribune in July. “They never lifted a finger — to my knowledge, at least they certainly didn’t make it public — to do anything about it.”

Pritzker’s office said the June memo announcing interventions at Choate “documented several years of reviews and work,” and that “robust internal policy improvements are ongoing,” including training and administrative oversight.

The governor’s general counsel, Ann Spillane, was in frequent contact with IDHS attorneys about Choate dating back to at least October 2020. Emails indicate she was kept apprised of legal developments surrounding the administrators’ arrests, policies around facility leadership access to investigatory files and a separate whistleblower suit.

Spillane’s monitoring was not unusual, a Pritzker spokesperson said. She oversees the attorneys at all executive agencies and is “regularly updated on all legal matters throughout agencies and works closely” with other attorneys “to respond to critical issues.”

Media questions about Charles Mills’ employment at Choate made their way to Flores and Pritzker’s communications staff and soon thereafter Spillane, her deputy and IDHS counsel John Schomberg drafted the “email to the governor to give him some background,” titled “choate — privileged and confidential.”

Pritzker’s spokesperson declined to say whether that email was the first time the governor was made aware of issues at Choate.

She similarly did not disclose the nature of the other redacted discussions, saying they contain attorney-client privileged discussions, and that it is “important to ensure staff can freely express opinions and make recommendations.”

Mills, who was charged two years after he allegedly orally penetrated “E.K.” in 2020, is scheduled to go on trial later this year. He’s pleaded not guilty.

The changes at Choate that Hou and IDHS announced in June included independent monitoring from Equip for Equality, increasing security staff by four positions, boosting afterhours staffing and monitoring from regional developmental center personnel, and temporarily assigning a psychologist “to provide staff support.”

They also announced they would install 10 cameras at the facility, which advocates and the GAC had sought. In addition, the IDHS inspector general repeatedly recommended cameras be installed at Choate between 2015 and 2021, according to the ProPublica investigation.

Aside from helping to quickly rule out false allegations, cameras can serve as eyes and ears for residents who could not advocate for themselves, some advocates argue. Of Choate’s roughly 230 current residents, 10% are nonverbal.

Four months after the June announcements, however, cameras have yet to be installed at Choate. A contract to buy them “is being finalized,” IDHS’ Kollias said, and they will be put “in public locations where there is a low, or no reasonable expectation for privacy.”

Specifically, the cameras will be placed outside, which critics like Smoot say defeats their purpose. While cameras can’t catch everything, the critics say surveillance of hallways and common areas in other state-run residential facilities has improved the quality and speed of some investigations.

But some parents and guardians have pushed back on installing them at all. Liz Gersbacher, a guardian of two Choate residents, said it is debatable whether cameras deter abuse and could make the facility feel less like a home to residents.

Beyond cameras and extra security, experts and advocates say, the Pritzker administration has not addressed the larger problem of whether the state continues investing in Choate and places like it. Pritzker has faced criticism for not fully funding disability services in past budgets, and the state remains under a federal consent decree that seeks to make community services more accessible to those with disabilities.

It’s “disappointing” many of the problematic conditions Equip for Equality and the Justice Department identified more than a decade ago still exist, Equip’s Program Vice President Stacey Aschemann told the Tribune. That includes a lack of adequate programming and resident engagement as well as psychiatric and psychological treatment. Creating long-term improvement is “going to require a lot of attention by the state to get things where they need to be,” she said.

As part of the Choate reforms, the Illinois Crisis Prevention Network has been brought in to train staff on topics such as de-escalation, and to counsel residents who want to successfully transition into a smaller community home.

But there often isn’t enough capacity, according to Caitlin Crabb, a researcher with the University of Illinois Chicago’s Institute on Disability and Human Development, which helps evaluate certain IDHS services and has been contracted by IDHS to study barriers to access.

“People in SODCs are living in SODCs because there’s not really a lot of other places to go,” she said. A lot of the problems at Choate stem from the lack of community-based options, Crabb said.

Best practices equate to supporting people with disabilities to live like people who don’t — from having locks on doors to the ability to host guests and hold jobs, according to Crabb.

Community-based settings also aren’t perfect. Illinois has its own troubled track record of transitioning residents to group homes, and supply remains low.

Dozens of Choate residents would transition out of the facility if they could, according to state data. As of the beginning of October, 32 people or guardians were pursuing a move to a community provider, while another 156 can’t pursue a transition because community providers can’t currently meet certain medical or behavioral needs, an IDHS report shows.

A sign outside the Choate Mental Health and Developmental Center in downstate Anna.

A sign outside the Choate Mental Health and Developmental Center in downstate Anna. (Armando L. Sanchez / Chicago Tribune)

Eidelman said “the small percentage of people whose needs are extraordinary” should not stop Illinois from keeping up with the quality of care provided elsewhere. He and other experts acknowledged some family members oppose a transition to smaller-scale, community settings. After the most recent Illinois closure, of the Jacksonville Developmental Center in 2012, a follow-up study with residents’ relatives showed most saw in community settings an improved quality of life and health outcomes for their loved ones.

Officials in the governor’s office and IDHS say Pritzker’s last two budgets made major investments in the Division of Developmental Disabilities that helped pay for wage hikes for front-line workers and direct support professionals, and added staff to help individuals transition out of SODCs like Choate. The pandemic also delayed community transitions.

According to Amie Lulinski, executive director of The Arc of Illinois, a statewide advocacy organization serving people with disabilities and their parents, the budget increases were still only about half what a study for IDHS deemed necessary. She hopes to see Pritzker’s administration plan a thoughtful closure of Choate and for Illinois to follow suit with other states in providing more alternatives to SODCs.

“Are we so broken that we can’t do it? Or is it just the fact that we haven’t put enough resources into the (community) system?” Lulinski asked.

Choate’s closure is “not something that we’re looking at right now,” the governor said on Sept. 6. “The question is, can we prevent that (abuse) in the future and if not, then obviously that’s not a facility that should remain open.”

Yet even when an election isn’t looming, political tension surrounds the issue of jobs at scandal-tainted centers like Choate, according to Eidelman and other experts.

Bryant, the state senator, doesn’t want to see the facility close. She and others acknowledged the good employees doing tough work at Choate. “Even legislators who work around this a lot, we’re sensitive to the fact that if we raise too much of a stink,” that a closure could threaten some of the area’s best-paying jobs.

But in the face of mounting claims of abuse, Eidelman said the Pritzker administration and legislators need to step up.

“This isn’t supposed to be a jobs program or a funding program,” he said. “It’s supposed to be services for people who are vulnerable. It’s about quality of care and people’s lives.”

adquig@chicagotribune.com

smacaraeg@chicagotribune.com

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October 21, 2022 at 05:15AM

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