.png "Call Us")
The Williams Consent Decree
In 2005, a class-action lawsuit was filed on behalf of Illinois residents living in Institutions for Mental Diseases (IMDs). The lawsuit alleged that Illinois was in violation of Title II of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act by "needlessly segregating" individuals with a serious mental illness who were living in these institutional settings and denying them opportunities to receive services in more integrated settings.
The lawsuit said that more than 5,000 people were residing in privately-owned Illinois IMDs. “The nursing home structure of the IMDs deprives residents of countless liberties and choices most people take for granted, such as the opportunity to read a book in private, to choose what to have for dinner, to decide when to wake up in the morning, and to come and go when desired.” These IMDs, the lawsuit said “range from cold and institutional to chaotic, unclean, and unsafe. Few provide adequate staffing, psychiatric treatment, therapeutic activities, or social rehabilitation.”
Representing the plaintiffs were attorneys from Equip for Equality, the Protection and Advocacy agency in Illinois; the American Civil Liberties Union of Illinois, the law firm of Kirkland & Ellis (pro bono) and the Judge David L. Bazelon Center for Mental Health Law. The lead plaintiff was Ethel Williams, who lived in an IMD for 13 years. She, like the other three named plaintiffs, had repeatedly expressed a desire to live in a community setting.
On September 29, 2010, the State of Illinois entered into a Consent Decree, settling the Williams v Quinn class action lawsuit. The settlement requires that all Illinois IMD residents and all those being admitted into an IMD in the future be informed of their right to seek community placement and offered an evaluation to determine if that option is right for them.
Multiple Agencies Work Together in Chicago to Implement the Williams Consent Decree
Moving people with mental illnesses from the IMDs into the community is complex, but there are two main aspects: the financial component and the actual transition into the community. The Division of Mental Health (DMH) of the Illinois Department of Human Services contracts with Chicago's Catholic Charities to manage the financial component of moving people into the community. Thresholds is one of numerous community mental health providers that contract with DMH to assist with the transition. Established in 1959, Thresholds provides healthcare, housing and other services, and support for persons with mental illnesses and substance use disorders in Illinois.
Thresholds staff works with the IMD residents to get them to the point where they are ready to move out, such as helping them prepare for acquiring and taking their own medications. Much like Access Living does for people moving out under the Colbert Consent Decree, Thresholds helps those it serves locate housing. The Williams settlement also provides the same rent subsidy vouchers.
Thresholds staff also assist in purchasing furniture, appliances, household goods and food. Only $2,800 per person is allocated to cover these costs under the Williams settlement. However, if the first attempt at moving out fails and the person returns to the IMD, they may make another attempt to move out and more funds can be budgeted.
Once Thresholds becomes involved, it usually takes three months to a year to move someone out of an IMD. But the story doesn’t end there. It’s important for those who move out to have places to go and people to see that offer companionship and support. That’s why Thresholds operates four New Freedom Centers, which are funded by the DMH. These are community centers which are run and staffed by people with mental health disabilities.
As of February 2019, Thresholds helped 900 people move out of IMDs under the William Consent Decree. Throughout Illinois, 2,376 IMD residents moved into the community as of December 2018.
How the Williams Consent Decree has helped Angela
Angela’s medication was becoming oppressive. “I couldn’t go to sleep. It seemed like time was moving so slow. I was shaking.” So she stopped taking it. But then she started hallucinating and hearing voices. So she checked into a hospital.
This was in 2008. She spent about a week in the hospital. They put her on another medication which turned out to be a much better fit for her. But Angela was afraid that if left to her own resources, she wouldn’t take the medication regularly and she would again relapse. She was told at the hospital that if she went to an IMD, nurses would dispense her medication for her.
So that’s what Angela did. What was it like living there? Angela says, “Some people make you laugh. Some people you feel scared of. I said, ‘Make the best of it. Take your medication.’”
Her new medication was working well and nurses brought it to her regularly. Slowly the dosage decreased. Angela felt steady. But the isolation was hard on her. She didn’t want to just sit around the IMD all day. “That makes me more depressed. You wanna keep in contact with the outside world.”
Angela was fortunate that her sister came around regularly and brought her things like pajamas and a warm winter coat. She often stayed with her sister and other family on weekends.
But then Angela’s mother was diagnosed with brain cancer and her life steadily slipped away. It was hard on Angela that she couldn’t be around her mother as much as she wanted to be.
After her mother died, Angela’s sister suggested that she move out of the IMD and into her mother’s apartment. An IMD social worker put Angela in touch with Catholic Charities and they, with the help of Thresholds, helped her move into her mother’s apartment within a few months.
That was 2012. Angela kept her mother’s queen-size bed and some of her furniture but she purchased some new furniture using Williams funds. Family visits often. Her brother brings his kids. Angela says, “I made one of the bedrooms into a little den so kids could watch TV.”
Angela pays 30 percent of her monthly income from SSI for rent and the rest is covered by her Williams subsidy. She has to manage her own medication and do other things she didn’t have to do for herself in the IMD. But she does what she has to do and she hasn’t had a relapse since she went to the hospital in 2008. And she loves having her own home. “It’s quiet and peaceful. Nobody cussing and fussing.”
She attends church in her neighborhood every Sunday and she spends most every weekday at her local Thresholds New Freedom Center. There she enjoys attending group sessions on a variety of topics, particularly nutrition. “You gotta take care of yourself and love yourself. And eat right. Eat the healthy food your mother told you to eat when you were a kid.”
