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#IllinoisFail: 12-18 month delay to process medical licenses

Thursday, Jan 10, 2013

* More massive fail from the Illinois General Assembly

The Illinois government agency that looks into complaints against doctors announced it will lay off investigators starting Tuesday and warned of yearlong delays in physician licensing because the Legislature didn’t act to bail out the medical watchdog unit.

In a letter being sent to doctors Thursday, officials from Illinois Department of Financial and Professional Regulation pin the blame on the Illinois State Medical Society for lobbying against legislation to transfer $9.6 million to keep the program going. The Associated Press obtained a copy of the letter on Wednesday.

The letter details “calamitous consequences,” including “delays between 12 and 18 months to process a medical license and severe constraints to the Department’s ability to prosecute physicians who pose a risk to the health and safety of Illinois citizens.”

The letter is signed by department Director Jay Stewart and Acting Secretary Manuel Flores. “As a direct result of (the medical society’s) actions, the layoffs will occur,” the letter says.

Medical society president Dr. William Werner said the legislation that stalled in the just-finished lame duck session required borrowing against future money collected by the fund that supports the medical watchdog unit. He said it’s time to restore money that was raided from the fund by previous legislatures.

OK, so the docs worked against it. No other solution could be found?

- Posted by Rich Miller        


35 Comments
  1. - 47th Ward - Thursday, Jan 10, 13 @ 12:54 pm:

    This is what cuts look like.

    On the other hand, desperate times call for desperate measures. Seems like IDFPR managers ought to, you know, manage this new reality. Reassign some staff, make suggestions for streamlining the process and the workload, put in longer hours, etc.

    When the money runs out, you get creative with your management or you go out of business. Since going out of business isn’t an option…

    Hopefully this is just temporary, but it sure seems like licensing physicians and checking out reports of bad doctors ought to be a higher priority than licensing barbers.


  2. - Fight for the Bureaucrats - Thursday, Jan 10, 13 @ 1:00 pm:

    Right… when Deja Vu goes out of business, I’ll believe there are real cuts in Springfield.


  3. - Give Me A Break - Thursday, Jan 10, 13 @ 1:02 pm:

    “Fight for the Bureaucrats” you might want to ask a Human Service Provider of a DHS staff member if there have been any “real cuts in Springfield”.


  4. - Fans Of Squeezy - Thursday, Jan 10, 13 @ 1:12 pm:

    Well you know the doctors at a level have a point.

    Your license fees are supposed to cover this regulation, that is supposed to be the point of your license fees, to pay for this sort of thing. But when you use licensing fees to pay for scholarships (in the case of nursing) as well as doing fund raids, this is what happens.


  5. - sal-says - Thursday, Jan 10, 13 @ 1:16 pm:

    Sometimes you gotta be careful what you ask for?


  6. - Norseman - Thursday, Jan 10, 13 @ 1:17 pm:

    Failure is the norm for state government and it’s going to get worse. The mantra to reduce government jobs has led to the steady reduction in the quality of services. The governors and legislators have naively or perhaps arrogantly continued to create or enact new programs while not sufficiently funding existing ones. All this with the dismissive argument that public employees can handle the additional responsiblities by becoming more efficient.

    We all know the horrible state of the budget, yet a quick review of yesterday’s bill introductions shows the solons still want more programs. It would be nice to see more legislation to eliminate programs.


  7. - Michelle Flaherty - Thursday, Jan 10, 13 @ 1:19 pm:

    C’mon, this is an administration that closed prisons to save DCFS. Suddenly it’s powerless to protect society from docs gone wild? This is a problem only because the administration wants it to be a problem.


  8. - Abe the Babe - Thursday, Jan 10, 13 @ 1:20 pm:

    @fan

    You also have to consider that doc fees haven’t been raised in decades and numerous laws have been passed requiring greater oversight over the industry not to mention just a general increase in the number of those practicing. $100 bucks a year is pretty small pittance one of the more lucrative professions. The med society has some points but they also need to realize that their fund is at a structural deficit even when you factor in sweeps/borrowing.


  9. - Huh? - Thursday, Jan 10, 13 @ 1:21 pm:

    “… The letter details “calamitous consequences,” including “delays between 12 and 18 months to process a medical license …”

    This appears that Illinois is going to force doctors to practice medicine without a license. It also means that doctors will not be able to prescribe medicine if they can’t get their controlled substance license renewed.

    How long until the first doctor gets arrested for practing medicine without a license or a pharmacy refuses to fill a prescription from a doctor with a lapsed license?


  10. - wishbone - Thursday, Jan 10, 13 @ 1:32 pm:

    It’s called the Washington Monument Syndrome. In 1969 following some minor cuts in its budget, the National Park Service decided to close the Washington Monument two days a week rather than try to save the money in a less disruptive way. The agency’s director was fired which should be the case here.


  11. - Fans Of Squeezy - Thursday, Jan 10, 13 @ 1:41 pm:

    @Abe the Babe

    It’s the fund sweeps, not the license fees that are the issue. If you are going to stop using license fees.

    I am curious how much the MD license fee (there are two) is vs the three fees my wife has to pay for her medical license fees (APN).


  12. - Fight for the Bureaucrats - Thursday, Jan 10, 13 @ 1:45 pm:

    Wishbone has it exactly right. Quinn cuts for pain, not the fat. That way everyone is scared of this nefarious cuts that means everyone is going to die.

    How many of the state’s executive aircraft have been sold? Should I go over other luxury expenses?


  13. - wordslinger - Thursday, Jan 10, 13 @ 1:57 pm:

    C’mon, $9.6 million is keeping you from licensing doctors and oversight? That sounds like a management problem to me.


  14. - Endangered Moderate Species - Thursday, Jan 10, 13 @ 2:06 pm:

    I am beginning to wonder who really makes decisions regarding the business of this State; the State employees and the agencies or the voters and the elected officials? In the business world, people work everyday to figure out how to produce a better product for less money. Those who are successful, thrive and prosper. In Illinois, the government seems to work everyday to produce a worse product that costs more money and we all know how this is working for us.


  15. - Abe the Babe - Thursday, Jan 10, 13 @ 2:16 pm:

    @ Fan

    Two words: structural deficit.

    Like I said sweeps are a problem but a structural deficit which means your annual revenues are exceeded by the annual expenses indicates you need to either raise revenues or start making cuts. looks like dfpr went the cut route. Putting the money back from the sweeps won’t solve the longer term problem. Fee increases and better management could.


  16. - OneMan - Thursday, Jan 10, 13 @ 2:41 pm:

    Abe The Babe…

    If you didn’t sweep the fund they would have the money, it’s as simple as that.

    If you want to treat licensing fees as general revenue, go ahead and do so, but stop saying the fees are to cover the regulatory costs.

    The idea is/was your license fees cover the cost of regulating your industry.

    If you show me those fees were insufficient, then yeah raise the fees. If the fees were/are sufficient but were used for other things (fund sweep) then you either cover the regulatory costs via general revenue (since you are treating the license fees as general revenue) or you don’t spend so much regulating.

    What I suspect the doctors are worried about (and more than doctors should worry about this, everyone regulated by the state is going to face this issue) is if license fees are basically going to be just general revenue, then it is going to be easy to start raising fees on some professions since after all Doctors, Nurses, etc.. can afford it.

    It becomes a backdoor tax, not just a fee to cover regulating your industry.

    Heck, they did this already to some extent by using RN license fees to pay for scholarships to try and increase the number of nurses.

    Not sure if it is good state policy to use money from people in a profession to add more people to the profession so in part everyone can make less in said profession.


  17. - Anonymous - Thursday, Jan 10, 13 @ 2:41 pm:

    Lots of state government is funded out of “special funds.”. If there are no dollars left in the fund supporting the doctor licensing program, then it doesn’t really matter whether there is money somewhere else, unless the GA moves it into the special fund. That is apparently what ISMS blocked. If their beef is that the special fund was raided in the past, join the club.


  18. - RetiredStateEmployee - Thursday, Jan 10, 13 @ 2:56 pm:

    What fund are they using and how much was swept?


  19. - Confused - Thursday, Jan 10, 13 @ 2:59 pm:

    Seems like the residents of the state get significant benefit out of having a functional IDFPR. So maybe they should pay for it. As opposed to - via fund sweeps - having physicians pay not only for the IDFPR but for other GA goodies as well. Or heck, be honest and start calling a doctor tax. At least Blago’s was honest when he proposed taxing doctors for a universal Medicaid system.


  20. - OneMan - Thursday, Jan 10, 13 @ 2:59 pm:

    Also Abe..

    Just to give you an idea, my wife has to have 4 licenses 3 from the state, RN, APN and Controlled Substance as well as one from the feds to do her job. All of these licenses have fees (the state controlled substance is only $5, the others do have a cost)

    That is just her regulatory costs for licensing that does not include her continuing education costs (also not trivial) because X amount of it has to be, for want of a better term, hard and not inexpensive (she can’t read a magazine article and answer a quiz at the end). I know it’s the same for doctors.

    So if you want to use fees as general revenue, fine. But it isn’t going to stop at the doctors and the lawyers, lets not kid ourselves. It is going to go to the alarm guys, nail techs and everyone else who they regulate.

    Also keep in mind, you want to raise their their license fees at the same time the same state takes forever to pay them and/or their employers for services rendered. That’s freakin rich…

    So don’t complain you don’t have any money in the beer fund, when you took money I put in the beer fund to pay for window treatments.


  21. - OneMan - Thursday, Jan 10, 13 @ 3:01 pm:

    RetiredStateEmployee

    generally each license (or license group) has it’s own fund within the department. They have done general department sweeps of most if not all of the funds if I am not mistaken.

    Also generally the funds get flush when everyone renews (varies by license, nurses it is even numbered years)


  22. - Abe the Babe - Thursday, Jan 10, 13 @ 3:04 pm:

    “If you show me those fees were insufficient, then yeah raise the fees. If the fees were/are sufficient but were used for other things (fund sweep) ”

    It’s both in this case. There were sweeps and there is a structural deficit. I’m not sure why this is hard to understand. Even if you pay back the sweeps you will have the same problem. I’m not an apologist for the sweepers I just think raising fees for the first time since the 80s is not a bad idea. I probably would demand assurances against future sweeps if I was the med society too but everyone knows those promises can’t be made when you are in the budget situation we are in. Plus madigan likely wont go along either.


  23. - RetiredStateEmployee - Thursday, Jan 10, 13 @ 3:08 pm:

    Without a fund number (or funds?) I can’t search the comptroller’s website, but this letter from 2010 http://www.isms.org/NewsRoom/letters/Pages/StopRaidingIllinoisMedicalDisciplineFund.aspx claims $18.9 mil was swept. Clearly, the fund sweep caused the problem. (pending further clarification)

    As always with these issues, there are so few facts to base an opinion on. Even though I know how to use the comptroller’s website, without knowing the correct codes, it is hard to find the information. A lay person could never make sense of it.


  24. - Skeptic - Thursday, Jan 10, 13 @ 3:28 pm:

    “Reassign some staff, make suggestions for streamlining the process and the workload, put in longer hours, etc.” Mandatory overtime (time and a half at that)? Assigning a job to someone not necessarily qualified to do it or outside their job title? Put office people on the road full-time? And yet people wonder why State employees flocked to AFSCME.


  25. - Original Rambler - Thursday, Jan 10, 13 @ 3:31 pm:

    Norseman is spot on. I keep getting more bureaucratic mandates which take time and manpower to complete (lest the Auditor whack me) while demands for budget cuts continue. Just get out of our way and let us do our jobs.

    Related, just once I’d like to see a GA member tout legislation they passed killing an unnecessary program as opposed to always creating new ones.


  26. - 47th Ward - Thursday, Jan 10, 13 @ 3:43 pm:

    ===And yet people wonder why State employees flocked to AFSCME.===

    Skeptic, if you’re suggesting that AFSCME’s work rules help protect its members from doing actual work, you’ve made a good argument. I guess you prefer layoffs. To each his own.


  27. - I don't want to live in Teabagistan - Thursday, Jan 10, 13 @ 3:58 pm:

    $100 a year

    That is what doctors pay to be doctors in the State of Illinois–$300 for a 3-year license. What do you lawyers, accountants, engineers, plumbers and other licensed professionals think about that.

    The doctors don’t want the State to have the money to investigate them.


  28. - Sgtstu - Thursday, Jan 10, 13 @ 4:22 pm:

    Fans Of Squeezy - Thursday, Jan 10, 13 @ 1:12 pm

    Kind of like the pension funds ?


  29. - walkinfool - Thursday, Jan 10, 13 @ 4:40 pm:

    Yep: Cuts are easy to ask for, hard to manage.

    They can have serious impacts all around the system. Some are not so obvious. Identifying the risks and managing for them is the Executive’s challenge. This looks more like sloppiness, than like any deliberate tactic.


  30. - Norseman - Thursday, Jan 10, 13 @ 4:58 pm:

    === C’mon, $9.6 million is keeping you from licensing doctors and oversight? That sounds like a management problem to me. ===

    You would think in a efficiently managed organization. Illinois government is not that.

    Without the funding, the administration will do something half-$##*@ to avert some of the heat without really ensuring that all the necessary services to be provided by the agency are getting done. The balloon analogy where you push-in a balloon in one place it will pop-out another is perfect example of government management.

    What needs to be done during this budget crisis is for managers to be empowered to eliminate programs that are unnecessary and ineffective. But lo and behold, this won’t happen because there’s always a constiuency group that believes their programs are more essential than everybody else’s programs.


  31. - martalli - Thursday, Jan 10, 13 @ 5:18 pm:

    They needed over half a million dollars per employee? How much are these people making, and are their keyboards gold plated? Blaming it on the ISMS implies that the ISMS gets whatever it asks for in the General Assembly, which is surely pure fantasy. Otherwise, we would have achieved some decent malpractice reform in Illinois.


  32. - Bigtiwch - Thursday, Jan 10, 13 @ 5:20 pm:

    It looks like the divisions of this Department are funded by user fees. If that is the case then there would have to be a fund sweep done to take money from another division to fund this one. AS for putting the money swept back, well that is about the same argument the various beneficiaries of pension funds are making. Ok by me but I do not see it being done.


  33. - DuPage Dave - Thursday, Jan 10, 13 @ 6:17 pm:

    This is exactly what happens with the short-term thinking of Blagojevich and Quinn in doing the “fund sweeps”. They saw dollar signs and didn’t think through what would happen when those “excess funds” were needed to accomplish their original purposes.

    I doubt this staff reduction strategy will go through as planned. But it’s galling to have people like the last couple of Governors come along and pretend that people who actually know what they are doing are obstructionists.


  34. - Oneman - Thursday, Jan 10, 13 @ 8:38 pm:

    Abe, it is easy to understand…

    The thing I don’t get, is how you can say.

    There was a structural deficit, so there were fund sweeps.

    And seem to be cool with that….

    It seems the role of professional registration fees, be they for a Nurse, Doctor, Nail Tech or Locksmith should cover the cost of regulating/investigating and licensing the given field and that is it.

    So if the state took the road fund and used it for general revenue then raised gas taxes, you would be cool with that as well?

    It’s a bit like if I paid my kids fee for drivers ed to the school district and they said, well we had to use the money for other stuff so for your next kid we are going to double the fee. It’s wrong.

    Also 6.9 Million seems illogical on multiple levels.

    Using numbers from the ITLA, there were 40,000 doctors (roughly) in Illinois in 2008.

    So 100 a year, so $1.2 Million a year or $3.6 million over three years.

    Doesn’t add up to $6.9 million… So either it is a significant undercharge for the doctors, or they want the doctors to cover other stuff as well.


  35. - Yossarian Lives - Thursday, Jan 10, 13 @ 11:45 pm:

    Retired State Employee - On the Comptroller’s website you can search by fund name as well as by fund number.

    Michelle Flaherty - I might find that line of reasoning more plausible if closing prisons had, in fact, saved DCFS. Instead, the legislature couldn’t manager to pass the necessary supplemental appropriation, so now that money’s in limbo.


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