Federal judge gives preliminary nod to disabilities deal (UPDATE)

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By CARLA K. JOHNSON
AP Medical Writer

CHICAGO (AP) – A federal judge on Tuesday gave her preliminary approval to a settlement that could eventually help thousands of disabled, low-income Illinois residents live more independently while saving the state money in the process.

State officials and advocates for the disabled lauded their agreement as a money-saving milestone after U.S. District Judge Joan Humphrey Lefkow gave it her initial backing and set a Dec. 20 hearing for fielding comments and objections.

If the judge gives the deal her final approval, it could affect not only 20,000 low-income people with physical disabilities and mental illnesses living in Cook County nursing homes, but also thousands more nursing home residents throughout Illinois.

Illinois could save $2,320 per person annually by housing Medicaid-eligible people with disabilities in houses and apartments with community services instead of in nursing homes, advocates and state officials agreed.

Michael Gelder, Gov. Pat Quinn’s senior health adviser who helped guide the settlement negotiations, said Cook County would be “a demonstration project” for the rest of the state.

“We’re shaping government services to the way people want to be served and in a way that should be less costly,” Gelder told The Associated Press. The settlement, also called a consent decree, requires that the new housing arrangements cost the state the same amount of money or less than if the disabled residents had remained in nursing homes, Gelder said.

“We built into this consent decree some special protections for the state to make sure that after 2½ years if it’s more expensive than what we’re paying in nursing homes, we can adjust that,” Gelder said.

The amount of housing assistance could be reduced, for example, if the net cost is more than the state was paying for nursing homes, he said. Gelder said evidence from other states suggests that savings are the more likely scenario.

The proposed settlement outlines how Illinois will provide housing assistance and other money to help with security deposits, to build wheelchair ramps and to make other modifications to homes to make them more accessible to the disabled.

In Illinois, housing assistance has been available to people with developmental disabilities and mental illnesses, but hasn’t generally been available to people with physical disabilities in the past.

In the deal’s first phase, the state would spend $10 million to help at least 1,100 nursing home residents move into houses or apartments. More people would be helped in the second phase.

Nursing home residents would be evaluated by qualified professionals to determine what help they would need to live more independently.

Pat Comstock of the Health Care Council of Illinois, the state’s largest nursing home trade group, said it’s too early to tell whether the settlement could cause some facilities to close as the state shifts resources to community housing.

Comstock said the safety of disabled residents should be considered along with their wishes for where to live.

“We need to make sure we aren’t putting individuals at risk by rushing to move them out just for the sake of moving them out,” Comstock said.

Lenil Colbert, 39, a named plaintiff in the case, had a stroke in 2005 that left him partially paralyzed. The former delivery driver lived with his mother for a while, then was transferred from a hospital to an Oak Park nursing home in 2006. He had three roommates, a curfew and little privacy, although the help he received in the nursing home could have been provided in the community, according to the lawsuit.

Since the case was filed, Colbert has moved out of the nursing home and now lives in his own apartment. A personal assistant helps him about five hours a day, he said.

“Nursing homes may work for some people, but I think everyone in nursing homes should have the option to move out,” Colbert said at a news conference Tuesday.

The settlement would resolve a 2007 lawsuit filed by Access Living, an advocacy group for the disabled, and other groups. Their lawsuit claimed that Illinois violates the civil rights of people with disabilities by not giving them housing choices.

“Here in Illinois, people with disabilities have been institutionalized for way too long,” said Access Living President and CEO Marca Bristo. “In fact, we institutionalize the non-elderly disability community in nursing homes more than any other state in the nation.”

The lawsuit is one of three similar class-action lawsuits involving housing for mentally ill and disabled adults.

Earlier this year, a judge approved a similar deal affecting 6,000 disabled adults living in privately operated care facilities and 3,000 adults living at home with aging parents and other family members.

Last year, in the first of the three cases to be settled, a judge approved an agreement involving 4,500 people with mental illness who live in specialized nursing homes.