Choate Mental Health & Developmental Center Transformation
Families & Guardians FAQ #2 (March 28, 2023)
What document placed individuals on the list of 30 to be the moved in the first year? How long have those individuals been on the list?
BACKGROUND FROM MARCH 14 Q&A: "The first set of moves will likely be the group of roughly 30 residents who, with their families and guardians, have already indicated that they would like to reside in a different location outside of the Choate Mental Health and Developmental Center. We anticipate these first moves will take approximately one year to complete. Following that, we hope to move a small number of residents, on average, per month for two more years."
Residents, families, and guardians indicate their interest in placement exploration outside of Choate (or any SODC) by notifying their Inter-Disciplinary Team (IDT) or their local Independent Service Coordination (ISC) agency. As of March 8, 32 Choate residents (or guardians) were currently interested in exploring community placement.
Those who request placement exploration can be added or removed at any time, on a rolling basis.
Note: An IDT includes the onsite Habilitation Program Coordinator (sometimes also called a case manager or Qualified Intellectual Disabilities Professional/QIDP), along with the resident, residents' family/guardian, nurses, social workers, and/or physicians. A map and contact listing of ISC agencies is included in the appendix at the bottom of this Q&A.
Does the paper that is included with the annual Individual Service Plan (ISP) that says you would be interested in discussion of alternative placement in the future put your ward on that list if you indicate yes and sign it?
No, not by itself. To be counted among those "interested in placement exploration," a resident, their family, or guardian needs to notify a member of the resident's Inter-Disciplinary Team (IDT) or they can independently contact the ISC agency.
It's important to know that, ultimately, the sequence and timing of moves will be highly individualized, affected by a variety of factors, and driven by the preferences of residents, families, and guardians.
IDHS will make every reasonable effort to carry out and support the requests of residents, families, and guardians who may request to move at a particular time, and to a particular place.
Can you explain the difference between the tier placements and the new standard of "guardian consent" to make an individual ready to move?
The "tier process" has been discontinued. IDHS-DDD now details the number (not the names) of SODC residents and families/guardians who indicate that they are interested in exploring community-based living arrangements, by facility, online. The information is posted online at SODC Transition Reports.
Can you provide the names of community placements, both CILA and private ICF, that have been approved for placement of Choate residents?
Any CILA or private ICF provider appropriately licensed (by IDHS' Bureau of Accreditation, Licensure and Certification, for CILAs, and by IDPH, for ICFs) can admit residents from State Developmental Centers. Residents and families/guardians decide which placement(s) they would like to consider.
The CILA provider list is posted here: CILA Provider List
The ICF-DD provider list is posted here: ICF-DD Provider List
Support for reviewing potential living arrangements is available from several staff resources, including the Choate Social Workers, IDHS DDD's Bureau of Transition Services (BTS) staff (phone: 815-288-8337), the Family & Resident Liaison Team (phone: 815-677-0107), and the Independent Service Coordination (ISC) agencies (listed at the bottom of this Q&A document).
Does the expansion of the Public Aid offices require the removal of DD residents from the Cypress or Cedar buildings?
No. The current IDHS "Public Aid" case processing unit is housed in Oak Hall. The IDHS Family & Community Resource Center (FCRC) is at Willow Hall, and most of the staff assigned there are working remotely. The FCRC is scheduled to move to the first floor of Oak Hall, eventually.
Is there a concrete, written plan as to how, as DD numbers dwindle by removal to other settings, the remaining residents will be consolidated? Will units close? Will they be populated by MI residents?
Not yet. Advice on unit repurposing and space allocation is part of the request to the SIU School of Medicine. More 3-year transformation details, including plans for individual buildings and units, will be shared on at least a monthly basis, as all of these efforts are even further established. Related information will be posted regularly at DD Transformation.
Will campus work and recreational activities continue as the numbers get smaller?
Yes, there will be continued recreational and work activities for every eligible resident on the Choate campus. These crucial services will not be diminished, but rather should be enhanced as the transformation process unfolds.
IDHS welcomes ideas for new and/or improved work and recreational activities. Please send any related suggestions about this - or about the transformation process including space allocation plans to DHS.DDD.Transformation@Illinois.gov.
If a guardian resists transitioning to another setting, will they be advised that as time goes on, their choices of a new placement will be limited (even as to another SODC)? Utilization review?
No. All available placement and living arrangement options will remain and be offered throughout the entire transformation process.
A "Utilization Review" process exists, towards the end of the Choate transformation, to support residents and families/guardians who are undecided about or unwilling to change their living arrangement. The process is outlined in Illinois statute (Mental Health Code: 405 ILCS 5/4-707 and 405 ILCS 5/4-709) and administrative code (59 Illinois Admin. Code 112.10).
The utilization review involves a review and binding recommendation (appealable to the IDHS Secretary) by a group of 3-7 people with training and expertise in clinical and treatment needs of residents served in State Psychiatric Hospitals and Developmental Centers. It asks the group to decide if the reasons for resident transfer are compelling, appropriate, and consistent with the habilitation needs of the individual.
Even more details on the Utilization Review process will be posted online at DD Transformation
If a resident tries a CILA placement and it does not work out (in my judgment), can he/she return to Choate? To another SODC?
Yes, they could return temporarily to Choate or move to another SODC, but a goal of the transformation effort is to safely transition all 123 general DD population residents out of Choate. We are committed to a careful, thoughtful approach to all transitions to ensure that they are successful and to minimize related stress and disruption.
The IDHS DD Division's Bureau of Transition Services (BTS) staff routinely helps SODC residents transition into non-institutional, community-based placements. The BTS staff works hard to ensure successful transitions but understands that sometimes new living arrangements do not work out. In these cases, BTS staff works with all relevant parties -- most importantly the person and their family/guardian -- to transition into an appropriate placement, either in an SODC, or in another setting.
Should we have a "safety net" letter signed by DHS?
A letter has historically been provided to some community-based providers to offer assurance that individuals exiting SODCs may return to an SODC if their community placement does not work out. However, it is not required for those who find that they need wish to return to an SODC.
What is the guarantee that [individuals under guardianship] can return to an SODC if I, as the guardian, am the only one who believes the placement is not working out? Does guardian opinion outweigh the rest of the transition team?
IDHS will work with families/guardians on a case-by-case basis and respect, to the maximum possible extent, individual preferences.
If there is a disagreement between a guardian, parent, resident, and/or transition team about individual long-term care needs, there are several options to help achieve safe, positive resolutions.
These options include additional support provided by Support Service Teams (SST), on-site technical assistance from SODC employees, and conflict resolution support from ISC agencies.
Will some of the new MI population come from prisons due to a lawsuit for their inappropriate placements in jail? Are staff ready for that change in service paradigm?
For many years, I/DD patients deemed unfit to stand trial (UST) or not guilty by reason of insanity (NGRI) have resided at Choate. These I/DD patients are served by the Division of Developmental Disabilities. "Sycamore Lower" houses medium security DD forensic USTs and NGRIs, and "Sycamore Upper" houses Forensic Minimum Security "stepdowns" - including former NGRIs and Extended USTs.
Before their transfer to Choate, some of these individuals were placed in county jails and not receiving any remediation, restoration or mental health support. These populations will continue to be served at Choate for the immediate future. The SIU School of Medicine team will be working with IDHS to make recommendations as to whether these populations should continue to receive services at Choate or at another IDHS facility.
Currently, the Division of Mental Health only serves a "civil" mental health population (that is, not "forensic" individuals, or those found UST or NGRI). The SIU School of Medicine team will, similarly, provide recommendations regarding whether other patient populations might be served on the Choate campus and to what potentially increased capacity.
Staff who work in the Choate Developmental Center will not experience job description changes - or be transferred to different positions in the Choate Mental Health Center without significant notice, appropriate training, and "impact bargaining" with the relevant employee unions (such as AFSCME or the Illinois Nurses Association).
According to the Choate repurposing plan, will the MI population mingle with the DD population on units or work or recreational sites as MI numbers grow and DD numbers diminish?
No
