Controlling growth or a drastic cut?
Thursday, Feb 18, 2016 - Posted by Rich Miller
* From the Illinois Department on Aging’s budget book…
Enrollment in the Department on Aging’s Community Care Program (CCP) has significantly grown over the past 10 years, from 40,965 enrollees in 2005 to 83,787 enrollees in 2015, a 105% increase over a decade. Looking forward, the growth in Illinois’ aging population will also more than double by 2030, with an expected 57 percent increase in individuals aged 60 plus over the next 15 years. Sustaining CCP as it exists today will cost an additional $93.3 million in the next six years assuming the completion of the managed care transition by FY2018.
* The Community Reinvestment Program is a new initiative targeted to older adults who are not eligible for CCP who need assistance to live independently in the community.
* The initiative represents a long term strategy to maintain community-based supports for our current aging population as well to address the anticipated growth in the population its first year at a funding level of $225 Million.
* Transition individuals who are non-Medicaid eligible to a new Community Reinvestment Program (“CRP”).
– Non-Medicaid eligible clients will have their DON score applied to the new service cost maximum table to derive a new individual spending allocation.
– CRP will provide greater flexibility of services. The AAA Network (Area Agency on Aging) will be utilized as the mechanism for the coordination of preventative services.
– Similar to other states, Illinois’ approach will maintain a service package for individuals that do not meet Medicaid eligibility requirements.
– This approach will maintain the Department’s commitment to maintaining individuals in their own home and community and delay the number of admissions in nursing facilities, which is currently a large portion of the Medicaid budget at $1,583,008,257 per year out of the total spending for Medicaid Long Term Care.
* SEIU Healthcare is calling this an almost $200 million budget cut for 44,000 seniors…
1) The Bruce Rauner proposed FY17 budget dramatically cuts home care for seniors through a $197.6 million cut to the Illinois Department on Aging budget.
2) The Rauner budget would do this by splitting the Community Care Program (CCP), which currently provides home care services for roughly 84,000 seniors, into two programs: one for those covered by Medicaid, and a new “Community Reinvestment Program” for seniors not in Medicaid.
3) This proposal, if implemented, would have a substantial negative impact on the 43,700 seniors who the Rauner budget indicates would be moved to the “Community Reinvestment Program”
· The $197.6 million cut represents average cut of $4,520 in services annually per affected senior
· $4,520 is a 43% cut in services compared with the average amount of services seniors receive currently.
4) In CCP right now, the average cost of care per senior per year is roughly $10,430. The average cost to Medicaid of a nursing home is around $52,000 a year, or about five times as much.
5) The Rauner budget gives NO DETAILS about the nature of these cuts. The Illinois Department on Aging Budget presentation indicates that for seniors moved to the “CRP”
· There would be a different set of services available than those available to them now
· There would be different set of service cost maximums their services could not cost above.
- Liberty - Thursday, Feb 18, 16 @ 1:30 pm:
Won’t this keep Illinois as one of the lowest spending states per person on medicare? Rauner doesn’t seem to care about prevention.
- 47th Ward - Thursday, Feb 18, 16 @ 1:37 pm:
===Rauner doesn’t seem to care about prevention===
He wants Illinois to be average. He aspires to mediocrity. Apparently, that’s all we can afford.
- Miami - Thursday, Feb 18, 16 @ 1:39 pm:
47th - average is above where we are now. Unfortunately, average is improvement. Catch up.
- Demoralized - Thursday, Feb 18, 16 @ 1:55 pm:
So basically if you aren’t eligible for Medicaid then the state is reducing your services.
==Similar to other states, Illinois’ approach will maintain a service package for individuals that do not meet Medicaid eligibility requirements.==
This obsession with other states amazes me especially when what other states are doing is crappier than what we are doing. I do not understand why the Governor seems to want to make sure we aren’t better than other states when it comes to services provided by the state.
- PublicServant - Thursday, Feb 18, 16 @ 1:56 pm:
#winning (unless, of course, you’re a senior needing some state assistance.)
- Ghost - Thursday, Feb 18, 16 @ 1:56 pm:
there are sta dards of care set up by the feds for teceipt of fed money. States however are free to offer more generous coverage the. the federal minimium. The short version, Rauner is saying we cant afford the enhanced benefits, so we need to drip down to the minimium standard set by the feds.
Rauner is right that we can not w/ our current budget afford the enhanced program. But I think a better approach would be to talk to people about revenue enhancements to support the program. (i.e what does the tax rate need to look like on a permanent basis to fully fund enhanced benefits as people using the services increase over the next decade).
We need to start discussing what programs people want to keep and what they are willing to pay to keep them. a discussion that should come from the gov office IMHO
- Juvenal - Thursday, Feb 18, 16 @ 2:06 pm:
@Ghost -
Part of the strategy is to make public services so awful that nobody would be willing to pay more for them.
He is aiming for a different price point. Think Ramen noodles instead of P F Chang’s.
It is a price point that many in his tax bracket will love, it is not a service level that is going to have regular families flocking to Illinois.
- HangingOn - Thursday, Feb 18, 16 @ 2:11 pm:
==This obsession with other states ==
I guess it could be worse. We could be hearing “compared to Nigeria…”
- Ghost - Thursday, Feb 18, 16 @ 2:16 pm:
the other states reference is a veiled reference to states who do not offer enhanced care. often these are little states that are not comporable to the 5 th largest State.
- Anon221 - Thursday, Feb 18, 16 @ 2:19 pm:
Seriously… CRP as an acronym for this program???
- AlabamaShake - Thursday, Feb 18, 16 @ 2:31 pm:
Some seniors get Community Care, the rest get CRaP.
- Miami - Thursday, Feb 18, 16 @ 2:48 pm:
Juvenal,
Are there big numbers migrating into Illinois for the Community Care Program services? Is the CCP program supposed to be a resident recruitment tool?
Seems like a goofy comment.
- Albany Park Patriot - Thursday, Feb 18, 16 @ 3:13 pm:
Cutting four grand per senior is not going to improve the program, any more than the cuts he made at his nursing homes improved the outcomes there.
- Anonymous - Thursday, Feb 18, 16 @ 3:15 pm:
It’s home care or a nursing home.
Which does the Governor think would be cheaper?
- LTSW - Thursday, Feb 18, 16 @ 3:30 pm:
The Medicaid eligible seniors will be covered under managed care plans that are paid from HFS’ budget.
- Elo Kiddies - Thursday, Feb 18, 16 @ 3:52 pm:
Who are these “community based supports?” Are they nonprofit service providers? I sure hope not, because there are fewer of those willing to work on state contracts than there were a year ago.
- Muscular - Thursday, Feb 18, 16 @ 4:06 pm:
Might Governor Rauner want the feds to pick up more of the reimbursement tab for these services? If Illinois has the same rate of nursing home admissions with enhanced services as other states do with basic services, why not shift people over to Medicaid to achieve the same outcome and get a better deal for taxpayers? For once, we have a governor who puts the interest of the taxpayer first.
- AlabamaShake - Thursday, Feb 18, 16 @ 4:25 pm:
**If Illinois has the same rate of nursing home admissions with enhanced services as other states do with basic services, why not shift people over to Medicaid to achieve the same outcome and get a better deal for taxpayers?**
Come on, muscular, keep up. The seniors that Rauner wants to cut 40+% of their services are not Medicaid eligible.
**For once, we have a governor who puts the interest of the taxpayer first.**
Well, he sure isn’t putting the interests of seniors first.
**The Medicaid eligible seniors will be covered under managed care plans that are paid from HFS’ budget.**
The Medicaid eligible seniors are not being cut, so this isn’t relevant.
- PENSIONS ARE OFF LIMITS - Thursday, Feb 18, 16 @ 5:19 pm:
Surely he has severed all ties from the nursing care business….or else this appears to be criminal. Might still be if any relatives are involved in nursing/long term care.
- LTSW - Thursday, Feb 18, 16 @ 6:43 pm:
AlabamaShake, Aging used to have the funding for both Medicaid and non-Medicaid seniors. The Medicaid eligibles will be paid from HFS’ budget so there is no longer a need to have that funding in Aging’s budget.