Illinois General Assembly - Full Text of SR0098
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Full Text of SR0098  101st General Assembly




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2    WHEREAS, The Illinois Constitution reads, in SECTION 2. DUE
3PROCESS AND EQUAL PROTECTION, "No person shall be deprived of
4life, liberty or property without due process of law nor be
5denied the equal protection of the laws"; and
6    WHEREAS, The November 2018 Summary Report of the Second
7Court Appointed Expert Filed in the District Court for the
8Northern District Court of Illinois finds that 1/3 of the
9deaths occurring at the Illinois Department of Corrections were
10preventable; and
11    WHEREAS, Illinois has averaged 19 healthcare professionals
12for every 1,000 inmates, compared to the national average of 40
13healthcare professionals for every 1,000 inmates, ranking
14seventh lowest in the United States in terms of per capita
15spending per year; and
16    WHEREAS, The 2018 Summary Report finds that the conditions
17of the healthcare provided in the Illinois Department of
18Corrections have not improved or have become far worse since
192015; the report reads, in part, "Overall, the health program
20is not significantly improved since the First Court Expert's
21report. Based on record reviews, we found that clinical care
22was extremely poor and resulted in preventable morbidity and



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1mortality that appeared worse than that uncovered by the First
2Court Expert"; and
3    WHEREAS, The 2018 Summary Report finds staffing to be a
4major issue in providing necessary and adequate care to stop
5preventable deaths at the Illinois Department of Corrections
6and states, "The IDOC does not have a staffing plan that is
7sufficient to implement IDOC policies and procedures. The
8staffing plan does not incorporate a staff relief factor.
9Custody staffing has also not been analyzed relative to health
10care delivery to determine if there are sufficient custody
11staff to deliver adequate medical care. Staff vacancy rates are
12very high"; and
13    WHEREAS, The 2018 Summary Report finds lack of hiring of
14properly-licensed physicians to provide the necessary care
15needed and links it to preventable deaths impacting monitoring
16of sanitation, management of chronic disease, infection
17control, necessity of specialty care, and periodic
18examination; in this case, "The vendor, fails to hire properly
19credentialed and privileged physicians. This appears to be a
20major factor in preventable morbidity and mortality, and
21significantly increases risk of harm to patients with the
22IDOC...It is our opinion that the quality of physicians in the
23IDOC is the single most important variable in preventable
24morbidity and mortality, which is substantial"; and



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1    WHEREAS, The 2018 Summary Report finds inadequate
2accommodation for the elderly and the disabled and states,
3"Housing of the elderly and disabled is inadequate"; and
4    WHEREAS, The 2018 Summary Report finds the dental care
5below adequate, noting, "Dental care continues to be below
6accepted professional standards and is not minimally
7adequate...There is no dentist on staff"; and
8    WHEREAS, The 2018 Summary Report finds the lack of
9authority given to the Illinois Department of Corrections
10Agency Medical Director is a critical issue that correlates
11with the overall monitoring of quality of care; it was noted
12that "The Agency Medical Director has limited responsibility
13with respect to the health program. He is responsible for
14formulation of statewide health care policy and chronic care
15guidelines. Through subordinates, he monitors and reviews
16medical services, but he has insufficient physician staff to
17perform adequate monitoring, especially for physician care. He
18has no authority to manage operations of the health program. He
19has no responsibility for the budget except in a consultative
20role. He participates in scoring prospective vendors of the
21medical contract and in reviewing staffing recommendations in
22the contract. But this is mostly an advisory and consultative
23role. According to his job description and interview, he does



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1not function as the authority in establishing budgets, staffing
2levels, or equipment purchases. Although he appears to be the
3final clinical medical decision maker, one has to infer this
4responsibility because it is nowhere stated in his job
5description"; and
6    WHEREAS, The 2018 Summary Report finds the impact of
7vendors hired by the Illinois Department of Corrections
8self-monitoring their services is an impediment of improvement
9of healthcare provided at IDOC facilities; the report states,
10"The Wexford Regional Medical Directors are responsible for
11ensuring that direct patient care is consistent with community
12standards and with contract requirements. They supervise the
13facility Medical Directors and are responsible for peer reviews
14of Medical Directors, and must ensure and/or conduct death
15reviews. Since there is inadequate oversight by the IDOC over
16physicians, the supervision of Wexford Regional Medical
17Directors is the only oversight of physicians. Wexford is
18thereby evaluating its own performance and does this extremely
19poorly"; and
20    WHEREAS, The 2018 Summary Report finds the same conditions
21in clinical space as the First Summary Report of 2015; the
22report notes, "In the final report, the First Court Expert
23noted that clinical space, sanitation, and equipment were
24problematic at virtually every facility...Overall, we found



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1problems with nurse sick call rooms, infirmary spaces, and
2examination rooms in all facilities we visited. The dialysis
3unit at SCC is inadequate and needs renovation. These problems
4detracted from the ability to provide care"; therefore, be it
6ASSEMBLY OF THE STATE OF ILLINOIS, that we urge the Illinois
7Department of Corrections to put in place processes and
8measures to implement the recommendations of the November 2018
9Summary Report of the Second Court Appointed Expert filed in
10the District Court for the Northern District Court of Illinois
11and to provide this General Assembly with a written report of
12its initiatives and impact by the end of the 2019 Legislative