CENTRALIA, Ill. -- Like most of the severely disabled residents at the Warren G. Murray Developmental Center in southern Illinois, Todd Clementz stuck to a routine: Deaf, blind and requiring constant supervision, he passed his days with meals, therapy and an evening bath.
But in late March, Clementz's routine was disrupted when a worker at the state institution gave him an unscheduled shower, during which the 46-year-old man choked to death. A jury in a coroner's inquest last month ruled his death a homicide.
Clinton County State's Attorney John Hudspeth told The Associated Press on Tuesday that he expects to decide soon whether to file criminal charges. The AP is not naming the former employee of the facility in Centralia. He was initially placed on administrative leave but later was fired for seeking work at another state agency during an internal investigation, according to Veronica Vera, a spokeswoman for the Illinois Department of Human Services, which oversees the developmental center.
Tom Hatley, a state police investigator, testified at the coroner's inquest that the mental health technician who gave Clementz the shower told him that Clementz had missed his regularly scheduled bath "because he was exhibiting a behavior." Other workers testified that the forced shower was meant to help keep Clementz from going to sleep earlier than scheduled.
Within minutes, Clementz began choking on the cold water being sprayed from a hand-held shower wand, the trooper testified. His lips turned blue as he became unconscious and went into cardiac arrest. An autopsy determined Clementz died from choking on cold water as well as regurgitated food.
"This gentleman was waterboarded," said Tony Pauluski, executive director of The ARC of Illinois, an advocacy group that wants the state to close all of its developmental centers by 2020.
Hatley said several co-workers of the technician -- who is at least 6 feet tall and about 250 pounds -- said he had previously given forced showers to discipline uncooperative residents. The trooper said he wasn't able to independently corroborate those accounts.
Vera said Clementz's death led to increased staff training and supervision, among other changes, including the replacement of suctioning machines designed to stop patients from choking.
But the death has ramped up pressure on the state to close the facility and six others that remain open. Other states are increasingly turning to smaller, community-based treatment options spurred by an evolving consensus on treatment and a series of federal court rulings.
Only Texas and New Jersey house more adults with mental or physical disabilities in state institutions. Thirteen states, including neighboring Indiana and Michigan, have closed all such facilities. At least 1,700 Illinois residents call the state developmental centers home.
Then-Gov. Pat Quinn targeted the Murray Center for closure in a 2012 cost-cutting move. But parents and guardians of patients at the institution and others like it sued in federal court, alleging it would violate the Americans with Disabilities Act.
In October, a three-judge panel of the 7th U.S. Circuit Court of Appeals upheld a district court ruling that sided with the state. The ruling deemed Illinois a "laggard outlier" in the national move away from institutionalization.
Rita Winkeler, a retired third-grade teacher who heads the Murray Parents Association, called Clementz's death an anomaly.
She says her son and others with severe disabilities would not be able to receive adequate treatment at smaller facilities. Mark Winkeler, 31, is a 20-year Murray Center resident with an IQ of 12, who can't speak and is unable to feed, dress or bathe himself, or use the bathroom on his own.
At 6-foot-3, but with severe osteoporosis, he walks haltingly with a pronounced hunch, his feet turned inward while navigating a living area where most other residents are bedridden or use wheelchairs.
"These parents -- I think everyone would dream that their kids can live in the community," his mother said. "But one size doesn't fit all."