Fly on the wall: example of state mistreatment of residents

The HFS is responsible for much -if not all- of the chaos. They would come to the units and ask where residents were placed. Staff would tell them. They’d write in down on their lists. And then ignore it. Then they’d bring representatives of other facilities in and, without the residents agreement, give charts to the facility rep. to go through. And HFS would do this to residents already placed into appropriate facilities of the resident’s choice.

Example. Resident A wanted to go where his girlfriend was going. He was accepted into that facility, and HFS was informed of the resident’s choice and acceptance. A few days later, HFS brought a different facility’s rep to the unit, and gave them the resident’s chart. “I’m giving them charts of residents who haven’t been placed yet.” Staff explained that Resident A HAD been placed.  HFS said to have the resident come talk to the rep. anyway.  So Resident A came, sat down, and said he was going to facility X.  The rep flipped through his chart, and told HFS “we’ll take him”.  Resident A again said “no, I don’t want to go to your facility, I’m going to X with my girlfriend. I want to go to X.”, and staff again explained to HFS and rep. that the resident had been accepted at X.

The facility rep and HFS ignored both resident and staff, and sat there like they were bartering about a slave bought at market. And the next day Resident A’s name is on the HFS list to be picked up to go to this facility! OF COURSE HE REFUSED TO GO!

How many residents, who don’t have the wherewithal to do what Resident A did, are being railroaded into places they don’t want to go and aren’t best for them?

And HFS gets upset? Acts surprised? Throws a tantrum?
Well, maybe they should try listening to residents. Maybe they should try listening to staff.
Or maybe, instead of blaming others, they should have just done the whole damn thing themselves.

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HFS Meltdown! A glimmer of why the mental health system in this state is in shambles.

The Special Assistant to the Director of IL Dept. Healthcare & Family Services, Jean Summerfield unleashed a full-out verbal attack complete with clenched fists, eye rolling and flaring nostrils directed at the facility’s clinical consultant yesterday.  It’s like nothing I’ve ever seen before. She was screaming so loud she could be heard on the other side of the second floor. Actually, the outburst took place on the administrative wing of the second floor and the hallway quickly became filled with both facility and HFS staff. Initially, most facility staff thought that the commotion was due to a resident who was symptomatic and decompensating. Clearly that was not the case! No one would ever believe that an employee let alone a high ranking state employee would behave in such an unprofessional and abusive manner.  If that wasn’t bad enough the other HFS employees were (while in the presence of their supervisor Jean Summerfield) swearing “I’m not F- – – – -, Mother Theresa. . .”, and one HFS employee (a former IDPH surveyor) was saying “you people never did any kind of discharge planning with any of your residents before, now all of the sudden you act like you care, no one ever cared before, and that’s why you got decertified”.

What the hell happened? The HFS team has continually refused to work with the facility staff to locate appropriate placement for the residents. HFS makes placement decisions for the resident and apparently is not informing them of the decision. Then when the staff informs the resident that they are leaving the next day the residents refuses to go. I wonder why. “That’s not my problem” was the statement one HFS employee made after staff questioned the appropriateness of a placement decision they made for a DD resident. HFS is screaming that the facility is obstructing the process. Again, what process? They are herding cattle and being abusive and violating resident rights. Somerset Place reportedly was decertified because of abuse! Interesting.

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Fly on the wall: identified offenders screened for community living

Here is an update regarding the PasR screens that HFS has had conducted for residents at Somerset Place. Previously, it was reported that agencies were given the directive to score as many residents as possible for independent community living. For the most part this re-screening process has not included information or feedback from facility staff. There has been little if any collaboration with facility clinical staff.  Once a resident is re-screened for independent living they are referred to a community agency for linkage and community placement.  It is unclear if these agencies even review the clinical records before accepting the residents.

Consider the following case of resident X. Resident X was deemed appropriate for independent living in the community and linked with a community agency to find an apartment.  A quick review of the clinical record reveals that resident X has not lived outside of a structured supervised MI setting for over 28 years. More importantly, resident X has a significant history of substance abuse, medication non-compliance, and a violent criminal background, including a double homicide. This information was easily accessible in the clinical record and could have been elicited from the facility staff had the agencies involved  bothered to ask. An interview with resident X would have in itself created concern for this drastic shift in level of care.

What are the criteria for determining a resident’s appropriateness for independent living? What are the credentials and training of those making the determination? Many residents can present as higher functioning upon initial interview. However, after reviewing their history and risk behaviors it becomes apparent that a higher level of supervision/structure is necessary, not less or none.  Finally, there are several identified offenders that have been deemed appropriate for independent living.

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Fly on the wall 3/2/09

This week we experienced a very frightening situation, which was directly related to the  HFS process of relocating residents. HFS schedules when the residents are going to be transferred with the receiving facilities and then informs us the afternoon before.  The day of, HFS monitors the process and ensures transfer of the residents.

Yesterday, while they were monitoring the transfers, one HFS employee somehow allowed a resident to leave unnoticed. This was a 76-year-old woman, who is not allowed to leave the building without supervision due to being unsafe in the community. IDPH refers to such incidents as “elopements.”  The resident walked out the door the monitor was monitoring at about 1:30 pm and was wandering the community until the police found her outside, cold, at 4:00 am the next morning. Just to put this in perspective, this incident was more serious than any cited during the federal survey which decertified the facility.

Do they get cited? Lose their jobs? What?

Is the HSF supervisor on-site held responsible for the staff even though the employee acted independently, similarly to how administrators get cited when their employees act independently?

The reality of this situation is that good people make mistakes. No one is saying that the HFS worker wanted this to happen, is a bad person, or doesn’t know how to do her job. She is human and humans are not perfect.

Somerset was being held to the unrealistic standard of perfection during the last survey, which resulted in decertification. Substantial compliance was truly met by the facility. The Feds definition of substantial compliance was 100 % compliance. Really?? How many humans, businesses or even government agencies can meet that standard?

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A former case-manager shares his thoughts. . .

I fully believe that Somerset should have been shut down. As a PRSC in that facility my job was nearly impossible. It was very unorganized and suffered from a severe lack of communication between co-workers, various departments, and from administration down. Even when I started, the training I received was invalid by the end of the first month. Almost every day there was a new policy change without explanation. Add to this that the state was visiting regularly and constantly putting everyone on edge. I can say that, when it came down to it, the resident’s health and safety always came first. They always received any treatment we could provide. I blame everything else on politics and decisions made by people who weren’t there. That makes things hard real quick.

In the beginning state visits went very well and we received all kinds of praise, but something changed. All the sudden the state started visiting and citing us for things we didn’t even know we were supposed to be doing. How can you say a facility isn’t providing enough treatment and referrals to programs, while cutting the budget for treatment and day programs? Who was I supposed to refer a resident to if all the day programs in the city were cutting their hours and the number of residents admitted to their programs? What tools does the state think are appropriate when dealing with residents who are actively abusing substances? I had a “piss cup” and that was it. I knew all kinds of residents with substance abuse problems but I didn’t have any resources to help them. Sure, refer them to MISA and require them to go. Well, if they don’t want to go then they won’t. I couldn’t drag them. I couldn’t bribe them. I could counsel them and help them see the benefits of the MISA program, if I had time to sit. If I put them on restriction, ok great, leads me to my next point. Psychotic residents mixing with residents looking for their next fix…at least it was contained within the facility. It was all very frustrating. I have to give credit where it’s due, though. Some residents really made an effort to sober up. Most of them really understood and complied with what we were trying to do for them, and it helped.

My problem with Somerset closing is how and why they are doing it. The neighborhood complained that the residents were bringing everything down and people didn’t feel safe. I live in Uptown. If I had a problem with a resident while in the community then it was directed specifically toward me for something that happened within the facility. Most of the time, my run-ins with Somerset residents involved them working in the little food stores and helping the local businesses stock their shelves and what not. Others were just trying to go about their business like any other person in the city. The most complaints I ever received involving my residents were for panhandling and it was all just bitching. I’ve asked and been asked for cigarettes and change. You say no and you move on. I’m more afraid of the gangs in Uptown and the random drug deals going on. Seriously, almost every day I walked to work, at 7:45am, I would literally walk in between several drug deals on Argyle. I’ve clocked out of Somerset, crossed the street, and had to grab a resident and force them inside Quick-Stop because some kids were chasing each other and throwing glass bottles in the middle of the street. Local blogs informed me when I got home that those same kids shot somebody right down the street. How many out-right, in the middle of the street, middle of the day gang shootings were there last summer? You can find the answer by watching them on Youtube. I was happy to be in Somerset, safe. A Somerset resident did not murder Ms. Walker. She was killed by a member of the community. Residents did not grow weed and make crack in their rooms. They bought it from the community.

Somerset residents had a stigma attached to them that they could not escape from. It’s obvious that most members of the community are scared of the mentally ill. The infamous Alderwoman wants to get reelected and she’s not doing anything else. Why not take part in something easy, that she really has no control over, and take some credit for “making it better?” What she and everyone else who sit around and bitch do not seem to realize, nothing that is currently being done is going to make anything better. These residents are going to be lacking treatment everywhere you ship them. Those who’ve got a record will still have a record when they go to their new placement. They don’t just disappear because Somerset did. The neighborhood violence will continue. Somerset will probably become the next public urinal (Wilson/Broadway).

Somerset was a huge facility, governed by the state. Because of its size it was the easiest target. It should be considered the largest, most obvious example of what happens when politics govern treatment of the mentally ill. If Somerset needed to be closed, then so does every other psychiatric nursing facility everywhere.

Also, I feel like I do not understand something. Why does the Alderwoman think she has control of what happens to the building next? Why does the neighborhood think the same? No one came to my door and asked me what I thought? Isn’t that up to the person who owns it? How does all this work, really?

There is no next step though. There’s no plan. Actually providing the means for quality treatment of the mentally ill seems to be too much to ask. So, here’s to the next set of policies and propaganda that will serve to set up the next horrible failure. To those who actually cared and worked their asses into the ground, got hit and abused, cried to their families, were too tired for a social life, but loved their job anyway…all we can do is try again so that eventually someone in control sees the effort and does what needs to be done.

Ryan, former case-manager

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Why is the state so secretive and treating residents so poorly?

from a staff member:

“There are about 30 people a day scheduled to leave. The schedule is a state secret, with them saying late in the afternoon who leaves the next day. With all the uncertainty and upheaval, is that really necessary? Residents ask when they are leaving and staff have no idea.”

Well, so much for allowing a person time to say goodbye, process their moving away and so on.  The state will tell you the night before when you are going to leave. Nice.  Is there anyone among the state representatives with even an iota of clinical training? Oh, never mind that. . . what about basic human dignity and compassion? Apparently not.

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staff report 2/23/09

The ombudsman will be in tomorrow. Supposedly to let the residents know how their actual discharges are going to be handled. Our understanding is that the State remains in the dark about how massive logistically this all is. They are on the units each day asking who’s been placed where. If they are “helping” in this process, I sure don’t see it.

There are also A LOT of residents not yet placed. We got one of our identified offenders placed today- he’d originally been denied. We’re having trouble, as I’m sure you can imagine, with placing unsafe smokers.  Several residents continue in denial and refuse to give any input about where they’ll be placed.

On a personal level, we feel highly resentful that it’s the state that has done this, but we’re the ones doing their dirty work. The state engineered this situation, but it’s not a state rep. telling a resident they weren’t accepted at their first choice facility, we are.

I don’t want to sound melodramatic, but this is horrible. We’re sending people that we know and have been their advocates and care-givers off into we have no idea what. We have residents asking about everything from their money to what’ll happen if they don’t like their roommate. We’ve always been able to promise residents “we’ll figure it out,” and now we can’t… We know they’re not on their own, but it sure feels that way. We’re doing our best to get everyone placed somewhere perfect for them, and it’s impossible, and it’s frustrating and heartbreaking.

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