A law recently signed by Gov. JB Pritzker would extend the deadline for the state to transfer felony defendants deemed mentally incompetent to stand trial from prison to a mental hospital.
The same bill, House Bill 240, also gives nursing homes in Illinois two more years to comply with minimum staffing levels implemented in 2022 before being fined by the Department of Public Health.
These are just two parts of a 67-page “omnibus” health care bill that made its way through the General Assembly on the final day of the recent lame duck session.
And while parts of the bill drew criticism, many lawmakers who opposed those elements said they felt compelled to vote for it anyway because other parts of the bill were too important. Those necessary provisions include allowing certain rural hospitals to draw more federal funds, allocating federal disaster aid to ambulance services affected by the COVID-19 pandemic and extending a deadline to reopen a closed hospital in Chicago’s western suburbs under a new owner.
“I think there are some important changes in this bill, and I certainly don’t agree with the process of putting things together, where some I really support and some I don’t,” said then-Rep. Avery Bourne, R-Morrisonville, during a committee hearing on the bill.
Bourne ran unsuccessfully for lieutenant governor in 2022, giving up the possibility of a fifth term in the House of Representatives.
Extended stay in prison
Previous standards set out in Illinois law set a 20-day deadline for the Department of Human Services to take custody of a criminal defendant deemed incompetent to stand trial or found not guilty by reason of insanity. DHS would then be required to place them in a mental institution.
The new law extends the length of time a defendant can be incarcerated to 60 days. And if DHS can’t place the defendant in a facility for that period of time, it can ask the court for a 30-day extension until space becomes available.
Officials in the Pritzker administration testified that DHS is often unable to do this, either because the agency does not receive notice from the court that the accused must be transferred or because there simply are not enough staffed beds in Illinois. seven state mental institutions.
“I think it was really just an attempt to try to be realistic,” Ann Spillane, Pritzker’s general counsel, said in committee testimony earlier this month. “We won’t meet in 20 days. We haven’t been in a long time.”
State officials estimate there are currently more than 200 people in county jails awaiting transfer to a state mental hospital for 60 days or more.
Spillane said DHS is working to expand the number of psychiatric hospital beds in the state, but there has been a “huge increase” in the past year in the number of people found unfit to stand trial or not guilty by reason of insanity.
But county sheriffs who oversee county jails say they, too, are understaffed and that they are not equipped to house and treat people with severe mental illness.
Jim Kaichuk, executive director of the Illinois Sheriffs’ Association, said the problem is particularly acute in southern Illinois, where there is a shortage of community mental health services. He pointed to ongoing lawsuits filed by a number of state attorneys general over DHS’s failure to promptly take people into custody from county jails.
“We certainly understand the dilemma that the Department of Human Services has in hiring these personnel,” he said. “The problem is that locally we have the same problem. So we are unable to maintain the staffing level and the number of people and beds that we need in our county jails.”
He also said that many counties do not have the public services to provide treatment for people.
During a House debate earlier this month, now-retired House Republican Leader Jim Durkin of Western Springs said he understood the county sheriffs’ concerns, but said the rest of the bill was too important to be held up by this a question.
“Don’t let this provision kill or change your position or change your vote on this issue,” he said. “It’s a really good bill.”
Durkin suggested that lawmakers continue to negotiate on this particular issue in the new General Assembly, which began on January 11.
Nursing homes
Other lawmakers had similar problems with a provision that gives nursing homes two more years — until 2025 — to meet minimum staffing requirements before facing fines from the Department of Public Health.
Illinois has some of the most understaffed nursing homes in the country, and last year lawmakers passed a sweeping overhaul of how they are reimbursed through Medicaid that included up to $700 million a year in incentive payments to increase their staff and increase salaries for nursing home workers.
But nursing home industry lobbyists said many facilities are still struggling from the financial impact of the COVID-19 pandemic and that nationwide nursing home occupancy is still below pre-pandemic levels.
“Pandemic attrition has led to the resignation of thousands of nursing home employees and strained the long-term care labor market,” Ron Nunziato, director of policy and regulatory affairs for the Illinois Board of Health Care, said in a statement.
He said nursing homes face the same hiring hurdles as the rest of the healthcare industry.
“Workforce development has been slow in many areas of the state, and it will take years for nursing homes to recover from staffing challenges,” Nunciato said.
Rep. Lakecia Collins, D-Chicago, a former nursing home worker, spoke out against the provision on the floor, but said her objections to it were not enough to defeat the entire bill.
“I’m not going to sink the ship with this because these other measures are very important,” she said. “But as a former nursing home worker, I would be remiss not to talk about the importance of short staffing and the provision in the bill to hold for another two years because of the penalties.”
The bill passed the Senate on January 6 by a margin of 32-15. It passed the House on January 10, 85-24.
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