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Today’s number: 47

Tuesday, Jul 7, 2015 - Posted by Rich Miller

* Tribune

State general fund spending on the three main agencies that handle the safety net has hovered around $5 billion for much of the past decade, which critics say is not enough to keep up with inflation.

Currently, Illinois has 22,000 people waiting for help and ranks 47th in funding those services, which can range from housing to medication management and transportation assistance, according to the State of the States, a project of the University of Colorado that tracks public spending for programs to address intellectual and developmental disabilities.

Illinois also ranks third nationwide for number of people living in state institutions, despite the fact that community care is more cost-effective: $53,000 per person annually vs. $248,000 per year for institutionalization, according to the Department of Human Services.

Carl LaMell, CEO of Clearbrook, said state support for programs like his Arlington Heights facility, which houses about 340 residents with disabilities, has been steadily chipped away.

“Every year, we’re pawns in this game,” said LaMell, noting that this will be the 10th consecutive year without a rate or cost of living increase.

       

30 Comments
  1. - Nickname #2 - Tuesday, Jul 7, 15 @ 9:16 am:

    What happens if they just decide to shut down? Can the state force them to stay open? The state has an obligation to care for some people, and if fiscal choices lead to closings, what happens then?


  2. - Wordslinger - Tuesday, Jul 7, 15 @ 9:18 am:

    Sounds like an area in need of a shake up and gubernatorial leadership.


  3. - Bob the Slob with a Cushy State Job - Tuesday, Jul 7, 15 @ 9:22 am:

    The solution here is to make all the employees and residents of these facilities state employees. That way they get an automatic 3% increase per year in salary, a pension and health insurance.


  4. - Downstate - Tuesday, Jul 7, 15 @ 9:24 am:

    Nick,
    Many of these private agencies, in addition to operating at a deficit, already have debt on their books (in hopes that private or public dollars will eventually appear).
    It will be tough for the state to “force them” to stay open, when they can’t meet payroll obligations.


  5. - Give Me A Break - Tuesday, Jul 7, 15 @ 9:25 am:

    Compounding the issue of reduced funding, is the fact that Illinois has, and continues to operate a system of care that is both an institutional and community based model and both models have been cut to the bone in the last ten years.

    Illinois needs to decide what it wants to be, trying to continue operate two types of service delivery models is not only expensive but does not allow for a fully funded quality product.

    All that being said, here in Illinois, the DHS state operated MH and DD centers are often the largest employers in their regions and lawmakers will fight to the death to keep them open.

    Illinois has a long history of underfunding human service programs which is illustrated by the number consent decrees DHS and DCFS currently operate under.


  6. - Linus - Tuesday, Jul 7, 15 @ 9:26 am:

    It might go without saying, but here goes anyhow: That 22,000 figure for unmet needs is specific to the DD and intellectual-disabilities population. When you consider other populations as well, the number has got to be astronomical. In day care, reports state the Governor now has instituted a new waiting list that means hundreds of working households will now be turned away from services each month - just one of many examples of still other unmet needs, which our budget problems are exacerbating rapidly.


  7. - Arizona Bob - Tuesday, Jul 7, 15 @ 9:26 am:

    That $248K per institutionalized person pays for a lot of patronage, health care workers, custodial staff, no-bid contracts for construction and maintenance and other services provision. Those receiving those dollars spend it in those communities as well as in campaign contributions. Anyone know if what they’re calling “community care” is outpatient vs inpatient with institutionalized care?

    Isn’t it curious how none of these “professionals” providing services in institutions were calling for less expensive community care until their programs were in funding jeopardy? That’s one of the benefits of the “show cause” approach by cutting then making those in charge justify the quality and cost effectiveness of what they’re doing…it doesn’t happen unless they’re given no alternative.


  8. - Cassandra - Tuesday, Jul 7, 15 @ 9:26 am:

    Well, while this dispute gets worked out, and it will work out eventually, one hopes that our well-paid state bureaucrats, with leadership from the guv, are working hard to increase the number of recipients of community vs. institutional care, as well as to reduce the prison population and the state’s foster care population. Over the long term, this will improve the quality of these services-yes, prison is a service, and save taxpayer money. Unfortunately, a great many comfortable government livelihoods, not to mention local economies, depend on keeping the populations of these institutions as high as possible for as long as possible.So more likely, reform, to the extent that it is happening at all, will stop while everyone awaits the results of the Rauner-Madigan battle. Because nobody is watching.


  9. - Anonymous - Tuesday, Jul 7, 15 @ 9:31 am:

    The turn around agenda will take care of all of that. snark.


  10. - A Jack - Tuesday, Jul 7, 15 @ 9:32 am:

    I couldn’t find the editorial on the Tribune site. Did they offer any solutions? They don’t want tax increases and we have already seen that pension tinkering is unconstitutional. So where are they suggesting that the state find the money?


  11. - illinifan - Tuesday, Jul 7, 15 @ 9:33 am:

    Many of these agencies received contracts for the upcoming year but the contracts include a clause that says the contract can be canceled retroactively. If they sign and still provide the service and then their program is eliminated they are taking a risk that they will not be reimbursed for services provided. Really puts them in a bind as well as the people they serve.


  12. - Give Me A Break - Tuesday, Jul 7, 15 @ 9:50 am:

    Bob: When the human service world refers to something as community care, for the most part, they are talking about Group Homes on the MH side and CILAs on the DD side.

    If you recall the bitter fights over the closures of JDC, TPMHC and Murray, the entire human service delivery systems has been moving away from institutional care for the last two decades. The closure fights are always nasty, bitter and involve members of the General Assembly and local officials who see well paying jobs being lost.

    And it doesn’t help when the State promises to provide better care at the community level then proceeds to gut the funding for that level of care.


  13. - Mokenavince - Tuesday, Jul 7, 15 @ 9:52 am:

    Home care by loving friends and relatives is the most economical way to go. Yet the pols like to always cut here first. The person receiving the care I’m sure would prefer it. No one would make a nursing home their 1st choice.


  14. - Anonymous - Tuesday, Jul 7, 15 @ 9:55 am:

    I know this after this year there will be a lot less community care and that means he better beef up hospitals or prisons one. Good money for all the lawyers once again corporate welfare when.


  15. - Grandson of Man - Tuesday, Jul 7, 15 @ 10:07 am:

    “So where are they suggesting that the state find the money?”

    One of the Republican legislators last night on TV said that the Democrats should throw Rauner a bone in exchange for more revenue. I wonder what the final deal will look like, and when it will come. This is a perilous time for so many.


  16. - Bystander - Tuesday, Jul 7, 15 @ 10:09 am:

    - A Jack - Tuesday, Jul 7, 15 @ 9:32 am:

    Here’s the article, not an editorial.

    http://www.chicagotribune.com/news/local/politics/ct-state-budget-social-service-worries-20150707-story.html#page=1


  17. - carbaby - Tuesday, Jul 7, 15 @ 10:09 am:

    There are very few nonprofit social service agencies that will be able to sustain services and make payroll this month and more will drop off next month if there is no revenue/budget appropriations. Yes you can sign those contracts and grants so you can continue services- but the State has made it clear that having a contract/grant does not equate to payment for those services you’ve provided. In fact, there is no guarantee that payment for those contracts/grants will be retroactive to July 1st- so you are providing services at your own peril.
    This is especially concerning for those programs that were eliminated in the proposed budget back in February. Many agencies are still operating as if that was a figment of imagination.


  18. - #5 - Tuesday, Jul 7, 15 @ 10:10 am:

    @A Jack
    I didn’t read any. If you want to get around the pay wall, just put Rich’s link into Google search and then use Google’s result.


  19. - Arizona Bob - Tuesday, Jul 7, 15 @ 10:14 am:

    Thanks, Give me a break. From what I’ve seen over the years, the biggest that SHOULD be fought are between the those receiving the services and those providing them, for a fee of course. Too often their interests conflict. The one place where this conflict rarely exists is familial home health care. For minimal selective family support, the caring services are provided, and the taxpayers save big time. I personally think forcing these folks to pay union dues for support taking care of their family members is incredibly abusive. Just my two cents worth…


  20. - VanillaMan - Tuesday, Jul 7, 15 @ 10:19 am:

    We must remind ourselves of what happened to Illinois during the past decade. It wasn’t just inflation that our state fell behind. It was a lack of a governor, as well.

    Lets not kid ourselves. Having two criminals for governor, then Pat Quinn, set us back in more ways than political. An effective governor would have at least helped Illinois keep pace with costs and maintenance. An effective governor would have done what was needed to move Illinois towards more cost efficient and sustainable programs.

    So, what we will be witnessing, and will be experiencing is partly due to having elected incompetent crooks as governors. A lot of today’s politics and government frustrations are due to having had Ryan, Blagojevich and Quinn - (and Rauner, sad to include), as our governors.

    What Illinois has been going through over the past decade has harmed us institutionally. Our citizens are very frustrated. Whatever is the mood of the electorate across the US, is magnified here in Illinois.

    We have experienced a governmental nightmare and we cannot merely blame the General Assembly for not being an executive branch of our state government, while also being our legislative branch. Without a governor, we have seen legislators step into roles they weren’t fully empowered to take. Blaming them now for our current government plight isn’t putting it upon the real people who harmed Illinois.

    Illinois lost a decade. We are not trying to catch up with where we needed to have been. Rauner’s political attacks would not hold any merit here, had it not been for the Three Stooges of Governors.

    The most effective way of blunting Governor CEO would have been good government. Now we have a governor who feels empowered to blow everything up and an important segment of our citizenry feeling the same. Had we had good governors, Rauner would not be governor, and we would not be seeing Illinois government being convulsed.


  21. - Anonymous - Tuesday, Jul 7, 15 @ 10:27 am:

    PLEASE……do not use the figures comparing community care and institutional care. You are comparing apples and oranges. In a meeting last summer with Kevin Casey, then head of DHS, and Michelle Saddler, they agreed that they actually had no idea how much it costs to keep someone in the community and someone in a state center. The cost for community care ONLY includes room and board, not medical care, transportation, cost for workshops for residents, does not include medication, dental care, etc. etc. etc. Please get your facts straight. DHS may say that, but behind closed doors they will tell you something totally different. Also, federal law under Olmstead Ruling say that the disabled have the federal right to large care facilities. Community care is a CHOICE, just as state centers are a choice. If people want to move from state centers they will. Most people who live in state centers live there because they have CHOSEN to live there, which is their right.


  22. - Chicago Hack - Tuesday, Jul 7, 15 @ 10:41 am:

    Anonymous - Let’s be clear that when someone “chooses” to live in a state institution, it’s really a false choice, made by someone other than the individual. Many families are told their child can’t live in the community with supports, that only a state institution can provide the care they need. So the “choice” is, have your child fail in the community or live in a state institution. That’s a “choice” based on a false premise.


  23. - Logic not emotion - Tuesday, Jul 7, 15 @ 11:07 am:

    I struggle to get past the “$248,000 per year for institutionalization”. On average, how many taxpayers does it take to generate the $248,000? There simply has to be a better, more affordable option.


  24. - Pacman - Tuesday, Jul 7, 15 @ 11:24 am:

    Murray is still open. The Murray Parents Association put up a heck of a fight. During the Gov. Campaign, now Gov. Rauner pledged to keep Murray open. He even included the MPA president on his transition team.


  25. - Michael Westen - Tuesday, Jul 7, 15 @ 11:45 am:

    Who cares if 22,000 people are waiting for needed services? The genius Ron Sandack said, “The sun will rise tomorrow.” This is the modern day version of “Let them eat cake.”

    Except for some Illinois residents, in the event of a government shutdown, the sun may not rise tomorrow.


  26. - Mama - Tuesday, Jul 7, 15 @ 11:51 am:

    It is my understanding that “community care” does accept people with mental health issues.


  27. - Arizona Bob - Tuesday, Jul 7, 15 @ 12:45 pm:

    Michael, maybe those services are “needed” for 22,000, or maybe they’re not.

    A lot of people get on these lists who, in good conscience, really didn’t need the services, but would like to get them for free.

    Case in point..my late father. He was miffed when his town would no longer provide personal pick and service through PACE for $2 per round trip. The cost was well over $50 per trip, and the town couldn’t afford it. My Dad lived 15 minutes away from me, and we’d take him anywhere he wanted to go just about any day of the week. That didn’t keep him from complaining long and hard that being a “senior” he was entitled to have taxpayers subsidize $48 for each ride he really didn’t need from them.

    I wonder how many of those 22,000 have other options to meet their needs, but would much rather have the state pay for it.

    Ya hate to think that way, but in our entitlement society…..


  28. - Truthteller - Tuesday, Jul 7, 15 @ 1:24 pm:

    Why is no one taking about the best way to come up with revenue to fund these programs adequately? Passing a budget, while necessary, is not adequate.Do folks think if we got tort reform and eliminated the prevailing rate, this problem would be solved?


  29. - Arizona Bob - Tuesday, Jul 7, 15 @ 3:28 pm:

    @Truthteller

    =Do folks think if we got tort reform and eliminated the prevailing rate, this problem would be solved?=

    Nope, but it would be a good start. Add prohibiting public employee strikes, cost shifting to schools for their unconscionable “spiking” of salaries to boost pension benefits unfairly, , and excessive salaries like in New Trier where the AVERAGE teacher salary is over $103K, ending “double dipping” pensions for new employees in their second (or third) “public” careers, cutting the unnecessary and excessive education and municipal capital work state subsidies, and providing TEMPORARY tax increases until the full force of these reforms can take hold, and I think you’re pretty much there.

    At the same time you look at economies for program consolidation and programs that are “wants” rather than “needs” and I think you’re pretty much there. It’s just that changing the direction of the Titanic will take more than a few minutes….but if we don’t change direction, that iceberg is out there waiting for us. We’re already scraping our bow.


  30. - Triple fat - Tuesday, Jul 7, 15 @ 10:07 pm:

    So lei me get this straight Arizons Bob - because your Daddy was one of those takers who didn’t really need help, anyone needing help is part of an entitlement society? Like the businesses that want taxpayers to build them facilities and grant them their own special tax breaks? You know I personally feel better when my tax dollars help people in need rather than businesses extorting my tax dollars with threats of leaving or just because they have a strong lobby. Many of this entitled class are posting their best earnings yet they need my tax dollars? I bet your Daddy benefited from the Gi bill too. That is some hardy stock you come from selfish opportunist benefitting from socialism. By chance do you own a business receiving subsidies from the government?


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