State Reports                                                      

DMHDD inspector general progress report:
Steps in the right direction

State of Care Report (FY94 Annual Report), Office of the Inspector General, Illinois Department of Mental Health and Developmental Disabilities, 401 Stratton Bidg., Springfield 62765 (1994), 216 pp.

Given the state and national attention focused on all aspects of health care, this annual report by Inspector General Cathleen J. "C.J." Dombrowski is useful. It offers a status report on the reform efforts undertaken about three years ago to increase public accountability of the DMHDD system and to clean up the department's facilities.

The report is divided into three sections, each dealing with a different set of facilities: those serving individuals with developmental disabilities; those serving both individuals with mental illness and individuals with developmental disabilities; and those serving individuals with mental illness. For each facility listed, the report includes information on its background and mission, its census and staffing levels, summaries of surveys with affected agencies and organizations, pending litigation, and reported incidents during FY94. The concluding section of the report provides comparisons among the facilities in various areas, including funding, staffing and injuries, as well as abuse/neglect.

In her introductory comments Dombrowski makes clear that while her office acknowledges that great improvements have been made, much remains to be done. For instance, injuries to staff and individuals have been reduced, the staff-to-individual ratio has increased, and new cases are being completed in an average of 71 days (rather than 204).

The most significant problem facing the department is the "failure to invest in clinical leadership." According to Dombrowski, an aggressive clinical director is needed in addition to the department director so the agency can establish a clear direction for client care as reforms progress from institutionalization to a community-based service system.