A law recently signed by Gov. JB Pritzker would extend the state’s deadline for transferring criminal defendants deemed mentally incapacitated from prison to psychiatric facilities to stand trial.
The same bill, House Bill 240, also gives Illinois nursing homes two years to comply with minimum staffing levels in place in 2022 before being fined by the Department of Public Health.
Those are just two parts of the 67-page “comprehensive” health care bill that passed the Assembly on the last day of the recent lame-duck session.
While some parts of the bill have been criticized, many lawmakers who opposed those elements said they felt compelled to vote for it anyway because other parts of the bill were so important. These necessary provisions include enabling certain rural hospitals to tap more federal funding, allocating federal disaster relief aid to ambulance services impacted by the COVID-19 pandemic, and extending the reopening of a closed hospital in Chicago’s western suburbs under new ownership deadline.
“I think there are some important changes in the bill, and I certainly disagree with the process of putting together some things that I really support and some that I don’t,” said the then-Rep. Avery Byrne, R-Morrisonville, at a committee hearing on the bill.
Byrne lost his bid for lieutenant governor in 2022, forgoing a fifth term in the House of Representatives.
extended jail term
Previous standards under Illinois law required DHS to provide custody of criminal defendants who were found incapable of trial or acquitted of insanity within a 20-day period. DHS would then be required to place them in a mental institution.
The new law extends the prison term for defendants to 60 days. And, if DHS is unable to house a defendant in a facility within the allotted time, it can ask the court for a 30-day extension until space becomes available.
Officials in the Pritzker administration have testified that DHS is often unable to do so, either because the agency has not been notified from the courts that defendants need to be transferred or because Illinois simply does not have enough staff beds. Seven state mental hospitals.
“I think it’s really just an attempt to be realistic,” Pritzker’s general counsel, Ann Spillane, said in committee testimony earlier this month. “We’re not meeting in 20 days. We haven’t been in a long time.”
State officials estimate that more than 200 people are currently in county jails awaiting transfer to state mental institutions for 60 days or more.
Spillane said the Department of Homeland Security is working to expand the number of psychiatric hospital beds in the state, but there has been a “significant increase” in the past year in the number of people found unfit to stand trial or exonerated on grounds of insanity.
But the sheriff, who oversees the county jail, argues that they too are understaffed and that they don’t have the capacity to house and treat people with serious mental illness.
Jim Kechuk, executive director of the Illinois Sheriff’s Association, said the problem is especially acute in southern Illinois, where there is already a lack of community-based mental health services. He noted that attorneys in some states are suing the Department of Homeland Security for failing to remove people from county jails in a timely manner.
“We certainly understand the plight of the Department of Public Services in recruiting these staff,” he said. “The problem is, at the local level, we have the same problem. So we can’t maintain the staffing levels, the numbers and the beds that the county jails need.”
He also said many counties lack community services to provide treatment for individuals.
During a House debate earlier this month, Rep. Jim Durkin, the now-retired House Republican leader of West Springs, said he understood the sheriff’s concerns but said the rest of the bill was too important, Cannot be put aside by this question.
“Don’t let this rule kill or change your position or change your vote on this,” he said. “It’s a really good bill.”
Durkin suggested that lawmakers should continue negotiations on that specific issue in the new session of the General Assembly, which begins on Jan. 11.
Other lawmakers have similar issues, including 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 nation’s most understaffed nursing homes, and last year lawmakers passed an overhaul of how Medicaid is reimbursed, including up to $700 million in annual incentives to boost nursing home staffing and raise wages for workers.
But nursing home industry lobbyists say many facilities are still feeling the financial impact of the COVID-19 pandemic, and statewide, nursing home employment remains below pre-pandemic levels.
“The pandemic has caused thousands of nursing home workers to resign and has strained the long-term care labor market,” Ron Nunziato, director of policy and regulatory affairs at the Illinois Health Care Commission, said in a statement.
Nursing homes face the same hiring hurdles as the rest of the health care industry, he said.
“The workforce development pipeline is slow in many parts of the state, and it will take years for nursing homes to recover from staffing challenges,” Nunziato said.
Rep. Lakesia Collins, D-Chicago, a former nursing home worker, spoke on the floor against the provision, but said her opposition was not strong enough to veto the entire bill.
“I’m not going to sink the ship on this because these other measures are very important,” she said. “But as a former nursing home worker, if I don’t talk about the importance of the staffing shortage and the provision in the bill to defer penalties for another two years , I will lose my job.”
The bill passed the Senate on Jan. 6 with a 32-15 vote. It passed the House on Jan. 10 by a vote of 85-24.
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