Chicago and Illinois officials are struggling to explain why they have allowed a state-funded city office that advocates for mistreated nursing-home residents to run at half-strength through the pandemic, a time when those residents have needed advocates like never before.
The Illinois Department on Aging funds Chicago’s Long-Term Care Ombudsman Program to employ 10 full-time “elder protective investigators,” as the city calls them, to take complaints from nursing home residents and advocate on their behalf. The issues range from allegations of elder abuse to more mundane but vital services such as helping residents enroll in Medicaid — the state and federal insurance program that provides the bulk of the industry’s funding.
Since last summer, the office has had just five investigators.
“That’s far from adequate to address the health-and-safety concerns of the city’s long-term care residents,” said Fran Tobin of the Institutional Rescue and Recovery Coalition, composed of senior and disability rights groups advocating for Chicago nursing-home residents during the pandemic. “It’s a failure of leadership to not staff up these positions.”
The Chicago program, housed in the city’s Department of Family and Support Services, is in charge of advocacy at 158 sites, according to DFSS spokeswoman Quenjana Olayeni. The program’s five remaining investigators each now handle 3,500 to 4,000 beds, nearly twice as many as allowed under the state grant conditions.
Chicago has fallen short of the 10-investigator minimum for at least a decade. The highpoint was 2015 to 2017, when there were eight. From there, Mayor Rahm Emanuel’s administration failed to fill openings, allowing the number of investigators to fall to six by the time Lori Lightfoot replaced him in May 2019.
Within months, Gov. JB Pritzker’s administration decided to move the program outside city government.
Lisa Morrison Butler, Chicago’s DFSS commissioner at the time, announced that planned change in a September 2019 email to her department’s employees and pointed to the city’s understaffing of the program: “The reason for the de-designation is that there is a required benchmark of minimum staffing as well as other benchmarks and the program’s overall performance.”
Last summer, another investigator left the program, leaving just five. The Lightfoot administration did not fill the opening.
Short-staffing that ombudsman’s office during the pandemic is anything but trivial.
Nursing facilities account for 48.2% of recorded Illinois deaths due to COVID-19, according to state public health data released Friday. Nursing home residents have also faced intense isolation through the pandemic — physically separated from loved ones who could otherwise advocate for them. For several months last year, even state public-health inspectors were not entering the nursing homes, leading to a shake-up in the Illinois Department of Public Health.
Kelly D. Richards, a Department on Aging official who coordinates 17 regional long-term care ombudsman offices around the state, did not answer whether she believes five investigators can provide the advocacy needed for Chicago nursing-home residents.
The Pritzker administration has left the search for an organization to replace the city in the hands of the Lightfoot administration.
A city request for proposals last year did not pan out. Olayeni said in a statement that the city is planning to issue another RFP this spring in hopes of finding a “qualified community-based organization” that could take over by October.
Olayeni wrote that the city’s ombudsman program “continues to be an integral part of DFSS senior services as we strive to represent and work on behalf of seniors living in long-term care facilities with integrity and high regard for the clients we serve.”