In Crisis, She Went to an Illinois Facility. Two Years Later, She Still Isn’t Able to Leave.

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Series: Culture of Cruelty:Inside Illinois’ Mental Health System

State-run facilities in Illinois are supposed to care for people with mental and developmental disabilities. But patients have been subjected to abuse, neglect and staff misconduct for decades, despite calls for change.

Kaleigh Rogers was in crisis when she checked into a state-run institution on Illinois’ northern border two years ago. Rogers, who has cerebral palsy, had a mental health breakdown during the pandemic and was acting aggressively toward herself and others.

Before COVID-19, she had been living in a small group home; she had been taking college classes online and enjoyed going out with friends, volunteering and going to church. But when her aggression escalated, she needed more medical help than her community setting could provide.

With few viable options for intervention, she moved into Kiley Developmental Center in Waukegan, a much larger facility. There, she says she has fewer freedoms and almost nothing to do, and was placed in a unit with six other residents, all of whom are unable to speak. Although the stay was meant to be short term, she’s been there for two years.

The predicament facing Rogers and others like her is proof, advocates say, that the state is failing to live up to the promise it made in a 13-year-old federal consent decree to serve people in the community.

Rogers, 26, said she has lost so much at Kiley: her privacy, her autonomy and her purpose. During dark times, she cries on the phone to her mom, who has reduced the frequency of her visits because it is so upsetting for Rogers when her mom has to leave.

The 220-bed developmental center about an hour north of Chicago is one of seven in the state that have been plagued by allegations of abuse and other staff misconduct. The facilities have been the subject of a monthslong investigation by Capitol News Illinois and ProPublica about the state’s failures to correct poor conditions for people with intellectual and developmental disabilities. The news organizations uncovered instances of staff who had beaten, choked, thrown, dragged and humiliated residents inside the state-run facilities.

Advocates hoped the state would become less reliant on large institutions like these when they filed a lawsuit in 2005, alleging that Illinois’ failure to adequately fund community living options ended up segregating people with intellectual and developmental disabilities from society by forcing them to live in institutions. The suit claimed Illinois was in direct violation of a 1999 U.S. Supreme Court decision in another case, which found that states had to serve people in the most integrated setting of their choosing.

Negotiations resulted in a consent decree, a court-supervised improvement plan. The state agreed to find and fund community placements and services for individuals covered by the consent decree, thousands of adults with intellectual and developmental disabilities across Illinois who have put their names on waiting lists to receive them.

Now, the state has asked a judge to consider ending the consent decree, citing significant increases in the number of people receiving community-based services. In a court filing in December, Illinois argued that while its system is “not and never will be perfect,” it is “much more than legally adequate.”

But advocates say the consent decree should not be considered fulfilled as long as people with disabilities continue to live without the services and choices that the state promised.

Across the country, states have significantly downsized or closed their large-scale institutions for people with developmental and intellectual disabilities in favor of smaller, more integrated and more homelike settings.

But in Illinois, a national outlier, such efforts have foundered. Efforts to close state-operated developmental centers have been met with strong opposition from labor unions, the communities where the centers are located, local politicians and some parents.

U.S. District Judge Sharon Johnson Coleman in Chicago is scheduled in late summer to decide whether the state has made enough progress in building up community supports to end the court’s oversight.

For some individuals like Rogers, who are in crisis or have higher medical or behavioral challenges, the state itself acknowledges that it has struggled to serve them in community settings. Rogers said she’d like to send this message on behalf of those in state-operated developmental centers: “Please, please get us out once and for all.”

“Living Inside a Box”

Without a robust system of community-based resources and living arrangements to intervene during a crisis, state-operated developmental centers become a last resort for people with disabilities. But under the consent decree agreement, the state, Equip for Equality argues, is expected to offer sufficient alternative crisis supports to keep people who want them out of these institutions.

In a written response to questions, Rachel Otwell, a spokesperson for the Illinois Department of Human Services, said the state has sought to expand the menu of services it offers people experiencing a crisis, in an effort to keep them from going into institutions. But Andrea Rizor, a lawyer with Equip for Equality, said, “They just don’t have enough to meet the demand.”

For example, the state offers stabilization homes where people can live for 90 days while they receive more intensive support from staff serving the homes, including medication reviews and behavioral interventions. But there are only 32 placements available — only four of them for women — and the beds are always full, Rizor said.

Too many people, she said, enter a state-run institution for short-term treatment and end up stuck there for years for various reasons, including shortcomings with the state’s discharge planning and concerns from providers who may assume those residents to be disruptive or difficult to serve without adequate resources.

That’s what happened to Rogers. Interruptions to her routine and isolation during the pandemic sent her anxiety and aggressive behaviors into overdrive. The staff at her community group home in Machesney Park, unsure of what to do when she acted out, had called the police on several occasions.

Doctors also tried to intervene, but the cocktail of medications she was prescribed turned her into a “zombie,” Rogers said. Stacey Rogers, her mom and legal guardian, said she didn’t know where else to turn for help. Kiley, she said, “was pretty much the last resort for us,” but she never intended for her daughter to be there for this long. She’s helped her daughter apply to dozens of group homes over the past year. A few put her on waitlists; most have turned her down.

“Right now, all she’s doing is living inside a box,” Stacey Rogers said.

Although Rogers gave the news organizations permission to ask about her situation, IDHS declined to comment, citing privacy restrictions. In general, the IDHS spokesperson said that timelines for leaving institutions are “specific to each individual” and their unique preferences, such as where they want to live and speciality services they may require in a group home.

Equip for Equality points to people like Rogers to argue that the consent decree has not been sufficiently fulfilled. She’s one of several hundred in that predicament, the organization said.

“If the state doesn’t have capacity to serve folks in the community, then the time is not right to terminate this consent decree, which requires community capacity,” Rizor said.

Equip for Equality has said that ongoing safety issues in these facilities make it even more important that people covered by the consent decree not be placed in state-run institutions. In an October court brief, citing the news organizations’ reporting, Equip for Equality said that individuals with disabilities who were transferred from community to institutional care in crisis have “died, been raped, and been physically and mentally abused.”

Over the summer, an independent court monitor assigned to provide expert opinions in the consent decree, in a memo to the court, asked a judge to bar the state from admitting those individuals into its institutions.

In its December court filing, the state acknowledged that there are some safety concerns inside its state-run centers, “which the state is diligently working on,” as well as conditions inside privately operated facilities and group homes “that need to be addressed.” But it also argued that conditions inside its facilities are outside the scope of the consent decree. The lawsuit and consent decree specifically aimed to help people who wanted to move out of large private institutions, but plaintiffs’ attorneys argue that the consent decree prohibits the state from using state-run institutions as backup crisis centers.

In arguing to end the consent decree, the state pointed to significant increases in the number of people served since it went into effect. There were about 13,500 people receiving home- and community-based services in 2011 compared with more than 23,000 in 2023, it told the court.

The state also said it has significantly increased funding that is earmarked to pay front-line direct support professionals who assist individuals with daily living needs in the community, such as eating and grooming.

In a statement to reporters, the human services department called these and other improvements to the system “extraordinary.”

Lawyers for the state argued that those improvements are enough to end court oversight.

“The systemic barriers that were in place in 2011 no longer exist,” the state’s court filing said.

Among those who were able to find homes in the community is Stanley Ligas, the lead plaintiff in the lawsuit that led to the consent decree. When it was filed in 2005, he was living in a roughly 100-bed private facility but wanted to move into a community home closer to his sister. The state refused to fund his move.

Today, the 56-year-old lives in Oswego with three roommates in a house they rent. All of them receive services to help their daily living needs through a nonprofit, and Ligas has held jobs in the community: He previously worked in a bowling alley and is now paid to make public appearances to advocate for others with disabilities. He lives near his sister, says he goes on family beach vacations and enjoys watching professional wrestling with friends. During an interview with reporters, Ligas hugged his caregiver and said he’s “very happy” and hopes others can receive the same opportunities he’s been given.

While much of that progress has come only in recent years, under Gov. JB Pritzker’s administration, it has proven to be vulnerable to political and economic changes. After a prolonged budget stalemate, the court in 2017 found Illinois out of compliance with the Ligas consent decree.

At the time, late and insufficient payments from the state had resulted in a staffing crisis inside community group homes, leading to escalating claims of abuse and neglect and failures to provide routine services that residents relied on, such as help getting to work, social engagements and medical appointments in the community. Advocates worry about what could happen under a different administration, or this one, if Illinois’ finances continue to decline as projected.

“I acknowledge the commitments that this administration has made. However, because we had so far to come, we still have far to go,” said Kathy Carmody, chief executive of The Institute on Public Policy for People with Disabilities, which represents providers.

While the wait for services is significantly shorter than it was when the consent decree went into effect in 2011, there are still more than 5,000 adults who have told the state they want community services but have yet to receive them, most of them in a family home. Most people spend about five years waiting to get the services they request. And Illinois continues to rank near the bottom in terms of the investment it makes in community-based services, according to a University of Kansas analysis of states’ spending on services for people with intellectual and developmental disabilities.

Advocates who believe the consent decree has not been fulfilled contend that Illinois’ continued reliance on congregate settings has tied up funds that could go into building up more community living options. Each year, Illinois spends about $347,000 per person to care for those in state-run institutions compared with roughly $91,000 per person spent to support those living in the community.

For Rogers, the days inside Kiley are long, tedious and sometimes chaotic. It can be stressful, but Rogers told reporters that she uses soothing self-talk to calm herself when she feels sad or anxious.

“I tell myself: ‘You are doing good. You are doing great. You have people outside of here that care about you and cherish you.’”

This article is republished from ProPublica under a Creative Commons license. Read the original article.

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  • Solitary Fitness – by Charles Bronson

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    Sometimes it can seem that every new diet and/or exercise regime you want to try will change your life, if just you first max out your credit card on restocking your kitchen and refurbishing your home gym, not to mention buying all the best supplements, enjoying the latest medical gadgets, and so on and so forth.

    And often… Most of those things genuinely are good! And it’s great that such things are becoming more accessible and available.

    But… Wouldn’t it be nice to know how to have excellent strength and fitness without any of that, even if just as a “bare bones” protocol to fall back on? That’s what Manson provides in this book.

    The writing style is casual and friendly; Manson is not exactly an academic, but he knows his stuff when it comes to what works. And a good general rule of thumb is: if it’s something that he can do in his jail cell, we can surely do it in the comfort of our homes.

    Bottom line: if you want functional strength and fitness with zero gimmicks, this is the book for you (as an aside, it’s also simply an interesting and recommendable read, sociologically speaking, but that’s another matter entirely).

    Click here to check out Solitary Fitness, and get good functional strength and fitness with nothing fancy!

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  • Foods For Managing Hypothyroidism (incl. Hashimoto’s)

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    Foods for Managing Hypothyroidism

    For any unfamiliar, hypothyroidism is the condition of having an underactive thyroid gland. The thyroid gland lives at the base of the front of your neck, and, as the name suggests, it makes and stores thyroid hormones. Those are important for many systems in the body, and a shortage typically causes fatigue, weight gain, and other symptoms.

    What causes it?

    This makes a difference in some cases to how it can be treated/managed. Causes include:

    • Hashimoto’s thyroiditis, an autoimmune condition
    • Severe inflammation (end result is similar to the above, but more treatable)
    • Dietary deficiencies, especially iodine deficiency
    • Secondary endocrine issues, e.g. pituitary gland didn’t make enough TSH for the thyroid gland to do its thing
    • Some medications (ask your pharmacist)

    We can’t do a lot about those last two by leveraging diet alone, but we can make a big difference to the others.

    What to eat (and what to avoid)

    There is nuance here, which we’ll go into a bit, but let’s start by giving the one-line two-line summary that tends to be the dietary advice for most things:

    • Eat a nutrient-dense whole-foods diet (shocking, we know)
    • Avoid sugar, alcohol, flour, processed foods (ditto)

    What’s the deal with meat and dairy?

    • Meat: avoid red and processed meats; poultry and fish are fine or even good (unless fried; don’t do that)
    • Dairy: limit/avoid milk; but unsweetened yogurt and cheese are fine or even good

    What’s the deal with plants?

    First, get plenty of fiber, because that’s important to ease almost any inflammation-related condition, and for general good health for most people (an exception is if you have Crohn’s Disease, for example).

    If you have Hashimoto’s, then gluten (as found in wheat, barley, and rye) may be an issue, but the jury is still out, science-wise. Here’s an example study for “avoid gluten” and “don’t worry about gluten”, respectively:

    So, you might want to skip it, to be on the safe side, but that’s up to you (and the advice of your nutritionist/doctor, as applicable).

    A word on goitrogens…

    Goitrogens are found in cruciferous vegetables and soy, both of which are very healthy foods for most people, but need some extra awareness in the case of hypothyroidism. This means there’s no need to abstain completely, but:

    • Keep serving sizes small, for example a 100g serving only
    • Cook goitrogenic foods before eating them, to greatly reduce goitrogenic activity

    For more details, reading even just the abstract (intro summary) of this paper will help you get healthy cruciferous veg content without having a goitrogenic effect.

    (as for soy, consider just skipping that if you suffer from hypothyroidism)

    What nutrients to focus on getting?

    • Top tier nutrients: iodine, selenium, zinc
    • Also important: vitamin B12, vitamin D, magnesium, iron

    Enjoy!

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  • The Best Kind Of Fiber For Overall Health?

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    The Fiber Of Good Health

    We’ve written before about how most people in industrialized nations in general, and N. America in particular, do not get nearly enough fiber:

    Why You’re Probably Not Getting Enough Fiber (And How To Fix It)

    Fiber’s important for many aspects of health, not least of all the heart:

    What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure

    As well, of course, as being critical for gut health:

    Gut Health 101: Making Friends With Your Gut (You Can Thank Us Later)

    But is all fiber “prebiotic fiber”, and/or are some better than others?

    Beta-glucan

    A recent study (it’s a mouse study, but promising in its applicability for humans) examined the health impacts of 5 different fiber types:

    • pectin
    • β-glucan
    • wheat dextrin
    • resistant starch
    • cellulose (control)

    As for health metrics, they measured:

    • body weight
    • adiposity
    • indirect calorimetry
    • glucose tolerance
    • gut microbiota
    • metabolites thereof

    What they found was…

    ❝Only β-glucan supplementation during HFD-feeding decreased adiposity and body weight gain and improved glucose tolerance compared with HFD-cellulose, whereas all other fibers had no effect. This was associated with increased energy expenditure and locomotor activity in mice compared with HFD-cellulose.

    All fibers supplemented into an HFD uniquely shifted the intestinal microbiota and cecal short-chain fatty acids; however, only β-glucan supplementation increased cecal butyrate concentrations. Lastly, all fibers altered the small-intestinal microbiota and portal bile acid composition. ❞

    ~ Dr. Elizabeth Howard et al.

    If you’d like to read more, the study itself is here:

    Impact of Plant-Based Dietary Fibers on Metabolic Homeostasis in High-Fat Diet Mice via Alterations in the Gut Microbiota and Metabolites

    If you’d like to read less, the short version is that they are all good but β-glucan scored best in several metrics.

    It also acts indirectly as a GLP-1 agonist, by the way:

    The right fiber may help you lose weight

    You may be wondering: what is β-glucan found in?

    It’s found in many (non-animal product) foods, but oats, barley, mushrooms, and yeasts are all good sources.

    Is it available as a supplement?

    More or less; there are supplements that contain it generously, here’s an example product on Amazon, a cordyceps extract, of which >30% is β-glucan.

    As an aside, cordyceps itself has many other healthful properties too:

    Cordyceps: Friend Or Foe? ← the answer is, it depends! If you’re human, it’s a friend.

    Enjoy!

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  • How To Plan For The Unplannable

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    How To Always Follow Through

    ❝Two roads diverged in a wood, and I—
    I took the one less traveled by,
    And that has made all the difference:
    Now my socks are wet.❞

    ~ with apologies to Robert Frost

    The thing is, much like a different Robert wrote, “The best-laid schemes o’ mice an’ men gang aft agley”, and when we have a plan and the unexpected occurs, we often find ourselves in a position of “well then, now what?”

    This goes for New Year’s Resolutions that lasted until around January the 4th, and it goes for “xyz in a month” plans of diet, exercise, or so forth.

    We’ve written before on bolstering flagging motivation when all is as expected but we just need an extra boost:

    How To Keep On Keeping On… Long Term!

    …but what about when the unexpected happens?

    First rule: wear a belt and suspenders

    Not literally, unless that’s your thing. But you might have heard this phrase from the business world, and it applies to healthful practices too:

    If your primary plan fails, you need a second one already in place.

    In business, we see this as “business continuity management”. For example, your writer here, I have backups for every important piece of tech I own, Internet connections from two different companies in case one goes down, and if there’s a power cut, I have everything accessible and sync’d on a fully-charged tablet so I can complete my work there if necessary. And yes, I have low-tech coffee-brewing equipment too.

    In health, we should be as serious. We all learned back in 2020 that grocery stores and supply chains can fail; how do we eat healthily when all that is on sale is an assortment of random odds and ends? The answer, as we now know because hindsight really is 2020 in this case, is to keep a well-stocked pantry of healthy things with a long shelf life. Also a good stock of whatever supplements we take, and medicines, and water. And maintain them and rotate the stock!

    And what of exercise? We must not rely on gyms, we can use and enjoy them sure, but we should have at least one good go-to routine for which we need nothing more than a bit of floorspace at home.

    If you’re unsure where to start with that one, we strongly recommend this book that we reviewed recently:

    Science of Pilates: Understand the Anatomy and Physiology to Perfect Your Practice – by Tracy Ward

    Second rule: troubleshoot up front

    With any given intended diet or exercise regime or other endeavor, we must ask ourselves: what could prevent me from doing this? Set a timer for at least 10 minutes, and write down as many things as possible. Then plan for those.

    You can read a bit more about some of this here, the below article was written about facing depression and anxiety, but if you can enact your plans when unmotivated and fearful, then you will surely be able to enact them when not, so this information is good anyway:

    When You Know What You “Should” Do (But Knowing Isn’t The Problem)

    Third rule: don’t err the same way twice

    We all screw up sometimes. To err is, indeed, human. So to errantly eat the wrong food, or do so at the wrong time, or miss a day’s exercise session etc, these things happen.

    Just, don’t let it happen twice.

    Once is an outlier; twice is starting to look like a pattern.

    How To Break Out Of Cycles Of Self-Sabotage, And Stop Making The Same Mistakes

    Enjoy!

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  • Olive Oil vs Coconut Oil – Which is Healthier?

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    Our Verdict

    When comparing extra virgin olive oil to cold-pressed coconut oil, we picked the olive oil.

    Why?

    While the cold-pressed coconut oil may offer some health benefits due to its lauric acid content, its 80–90% saturated fat content isn’t great for most people. It’s a great oil when applied topically for healthy skin and hair, though!

    The extra virgin olive oil has a much more uncontroversially healthy blend of triglycerides, and (in moderation) is universally recognized as very heart-healthy.

    Your local supermarket, most likely, has a good extra virgin olive oil, but if you’d like to get some online, here’s an example product on Amazon for your convenience.

    Don’t Forget…

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  • Diet Tips for Crohn’s Disease

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Doctors are great at saving lives like mine. I’m a two time survivor of colon cancer and have recently been diagnosed with Chron’s disease at 62. No one is the health system can or is prepared to tell me an appropriate diet to follow or what to avoid. Can you?❞

    Congratulations on the survivorship!

    As to Crohn’s, that’s indeed quite a pain, isn’t it? In some ways, a good diet for Crohn’s is the same as a good diet for most other people, with one major exception: fiber

    …and unfortunately, that changes everything, in terms of a whole-foods majority plant-based diet.

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    • You still ideally want to eat a lot of plants
    • You definitely want to avoid meat and dairy in general
    • Eating fish is still usually* fine, same with eggs
    • Get plenty of water

    What needs to change:

    • Consider swapping grains for potatoes or pasta (at least: avoid grains)
    • Peel vegetables that are peelable; discard the peel or use it to make stock
    • Consider steaming fruit and veg for easier digestion
    • Skip spicy foods (moderate spices, like ginger, turmeric, and black pepper, are usually fine in moderation)

    Much of this latter list is opposite to the advice for people without Crohn’s Disease.

    *A good practice, by the way, is to keep a food journal. There are apps that you can get for free, or you can do it the old-fashioned way on paper if prefer.

    But the important part is: make a note not just of what you ate, but also of how you felt afterwards. That way, you can start to get a picture of patterns, and what’s working (or not) for you, and build up a more personalized set of guidelines than anyone else could give to you.

    We hope the above pointers at least help you get going on the right foot, though!

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    Learn to Age Gracefully

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