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The high price of deliberately doing nothing

Wednesday, May 17, 2017

* $142 million in past-due bills, services dying or dead on the vine and a patient waiting list of almost 13,000 people. But all is well. Right. Keep telling yourselves that.

From a press release…

A new survey by a top behavioral health advocate group reveals that the state of Illinois owes community mental health centers statewide a staggering $142 million in unpaid bills, a debt that is squeezing care for people struggling with mental illness and addiction.

The Community Behavioral Healthcare Association of Illinois released on Wednesday a survey of state community mental health providers that shows that these agencies are owed for fiscal year 2017 a total of $142,558,150 or nearly 90% of what has been budgeted for the current fiscal year that expires on June 30.

Moreover, the survey shows that, in Fiscal Year 2016, 73.5% of community agencies had reduced or eliminated behavioral health programs and that in Fiscal Year 2017 an additional 33.7% of agencies further cut or ended services.

“To say that community mental health providers are operating on fumes would be incorrect. They consumed the fumes long ago,” said Community Behavioral Healthcare Association of Illinois C.E.O. Marvin Lindsey. “The financial starvation of providers has shriveled our ability to serve an exploding need to the extent that Illinois is fast becoming a behavioral health system Potemkin Village.”

Lindsey also pointed to a survey finding that says that a psychiatrist wait time of one-to-two months at 40.6% of agencies in Fiscal Year 2016 has jumped to a one-to-two month wait at 64.0% of centers in Fiscal Year 2017. And a four-month wait or more at 25% of agencies has edged up to 28% of providers.

Overall, the survey estimates that waiting lists to access all sorts of behavioral health treatment has ballooned to 12,696 individuals.

“A mental health crisis can’t be scheduled three weeks from next Tuesday at 4:00 p.m.,” said Lindsey. “But that’s where we find ourselves, turning away mothers, children who need our help, today, not tomorrow, not next week, but today.”

* And check out the timeline…

Beyond the immediate budget impasse, Lindsey also cites the survey’s finding of a vast disinvestment in behavior health by the state over the last 10 years.

In Fiscal Year 2008, the state legislature authorized Mental Health grants from General Revenue Funds totaling $368,281,300 to community agencies. In Fiscal Year 2018, in Governor Bruce Rauner’s proposed budget, the number had fallen by more than half to $170,622,300. Addiction treatment money followed the same pattern, dropping from $165,602,200 to $78,633,500.

“Some of the GRF was transferred to cover the state’s Medicaid mental health and substance use services, which I estimate totals $40 million for mental health and $15 million for addiction treatment,” said Lindsey. “But that shifting of a small amount money in no way excuses shameful financial disinvestment in behavioral health that has occurred and is continuing to occur today despite the disingenuous promises being made.”

- Posted by Rich Miller        

55 Comments »
  1. - Blue Bayou - Wednesday, May 17, 17 @ 9:43 am:

    We need a progressive income tax and an infrastructure investment plan NOW.

    We need to invest in the future: transport, tech, education, social services.

    If you have benefited from the system and become wealthy you should want to see the state thrive. Why wouldn’t you want others to have access to opportunity?


  2. - Ron - Wednesday, May 17, 17 @ 9:52 am:

    Blue, too bad our constitution doesn’t allow for a progressive income tax.

    Somehow in your wish list you didn’t include eliminating public employee benefit protection from the Constitution. Why?


  3. - Honeybear - Wednesday, May 17, 17 @ 9:54 am:

    Willful immorality! The result of putting corporate profit over everything!

    1.4% economic benefit for “reforms”

    Is immorality itself

    When so much is being destroyed.

    The horror is that republicans have bet it all

    In Rauners gamble.


  4. - Downstate - Wednesday, May 17, 17 @ 10:05 am:

    What do the financial travails of Puerto Rico, Greece, Detroit and Orange County all have in common? Public Sector Pensions.

    They are not sustainable.
    When I read Rich’s headline “The high price of deliberately doing nothing” I thought it was a reference to the one state official who was warned about this impending train wreck for the last 20 years.


  5. - Saluki - Wednesday, May 17, 17 @ 10:14 am:

    Dear Ron,

    I hope you get better soon.

    Signed,

    Everyone.


  6. - Honeybear - Wednesday, May 17, 17 @ 10:28 am:

    So let’s just say Republicans win everything
    Rauners gamble pays off
    DEMS are defeated
    Unions destroyed
    The Left is driven before you and you hear the Lamentations of their women (to quote Conan)

    How will Republicans govern?
    How will they provide for citizens?

    Would we even be a democracy?
    Go ahead here’s your chance
    Lay out your vision

    I think it would be a fascist plutocracy so prove me wrong with your arguments


  7. - Economics 'R us - Wednesday, May 17, 17 @ 10:28 am:

    @Ron

    read Article I, section 10, clause 1

    @downstate

    The problem of Greece is that being on the Euro along with a country like Germany is that there were balance-of-trade issues which put economic pressures on them. To alleviate, either Germany would have to have inflation, or Greece severe deflation. If Greece had their own currency, they could devaluate. This would be helpful because as a wonderful vacation destination, the Germans could convert their Marks to cheap Drachmas which for Greece would be like income from exports.

    Other countries, like Spain and Ireland, which did not have the profligacy of Greece, ran into the same problems.

    This is ECON 101.


  8. - Downstate - Wednesday, May 17, 17 @ 10:36 am:

    Econ,
    You are correct. Greece’s spending habits were exacerbated by the handcuff of EU membership. But like Orange County, Puerto Rico & Detroit - public sector pensions couldn’t be sustained with increased taxes, while trying to attract new business.

    For those that think Illinois’ pension problems can be solved with higher taxes only need to ask, “If it was that easy, why didn’t Detroit, Orange County & Puerto Rico simply play the ‘higher taxes’ card?”


  9. - Cubs in '16 - Wednesday, May 17, 17 @ 10:38 am:

    ===Somehow in your wish list you didn’t include eliminating public employee benefit protection from the Constitution. Why?===

    Who do you think provides care for these folks with mental illness? The de-funding for services has pushed ‘care’ to corrections. As valuable as correctional officers are, they are not well equipped to deal with this population.


  10. - Earnest - Wednesday, May 17, 17 @ 11:00 am:

    On the one hand, it’s hard to imagine the cost in terms of quality of life for so many people who are suffering. On the other hand, it’s hard to imagine not doing what it takes to get a budget passed. Maybe those are the same hand?

    It’s not must behavioral health. The wage crisis for direct support staff continues to take its toll on people with developmental disabilities.

    http://www.theherald-news.com/2017/05/12/social-services-declining-joliet-mayor-notices/apl0yks/

    I can’t imagine how hard it must be for those four women to be leaving their home of 20 years. What a depressing choice the agency has been forced to.

    And then there’s the impact on the rest of the human services system….


  11. - Ron - Wednesday, May 17, 17 @ 11:01 am:

    Cubs, you didn’t answer the question.

    Times change so do benefits.


  12. - frank peabody - Wednesday, May 17, 17 @ 11:03 am:

    @downstate
    If Rauner and the Illinois Policy goons want to shove the public sector workers into 401Ks, let the state start paying FICA too. What will happen to the pension costs then?


  13. - Ron - Wednesday, May 17, 17 @ 11:06 am:

    Social security gets changed, why not Illinois state employee benefits?


  14. - Oswego Willy - Wednesday, May 17, 17 @ 11:06 am:

    ===include eliminating public employee benefit protection from the Constitution===

    You could be a state employee and get a pension too.

    Why won’t you?


  15. - Oswego Willy - Wednesday, May 17, 17 @ 11:09 am:

    ===Social security gets changed, why not Illinois state employee benefits?===

    Pensions are constitutionally guaranteed in Illinois

    I don’t think Social Security is a constitutional guarantee, is it?

    Keep up


  16. - zatoichi - Wednesday, May 17, 17 @ 11:10 am:

    Remember the Wells Center in Jacksonville? Very good organization that ran out of money that was owed to them due to no/very late payments. So mental health and drug funding has dropped 50% in the last several years and a previous story showed state bill backlog jumped $1B overnite with the state agencies holding $6.6B. What was that squeeze the beast mantra? As long as it does not affect me personally, what is the problem?


  17. - Ron - Wednesday, May 17, 17 @ 11:10 am:

    OW, thanks for pointing out the utter unfairness of the IL consitution.

    Change it.


  18. - Ron - Wednesday, May 17, 17 @ 11:13 am:

    Illinois is in a death spiral of out of control pensions and mass exodus of people.

    The continued insistence by the public sector goons on ever higher taxes will only quicken the demise of Illinois.


  19. - Cubs in '16 - Wednesday, May 17, 17 @ 11:18 am:

    Ron,

    State employees’ benefits have undergone numerous changes in the past several years. We’re contributing more towards those pensions you despise and we’re paying more out of pocket for deductibles and copays.

    With regard to your question, my point was if you keep taking away reasons for people to enter the mental health field the state won’t be able to hire competent individuals to care for persons with mental illness. Doesn’t that bother you?


  20. - Grandson of Man - Wednesday, May 17, 17 @ 11:19 am:

    “I think it would be a fascist plutocracy so prove me wrong with your arguments”

    And one in which the super-wealthy who bring this about gorge themselves at the public trough while millions of middle class workers, over the years, get pushed down economically and made powerless politically.

    That’s what privatization is about. The proponents love the Big Spigot of government money. Libertarians and conservatives my behind. They want as much of it as they can get.

    Rauner loves himself some public trough. It’s the height of hypocrisy to criticize government workers who live paycheck to paycheck but spare Bruce, who’s probably made many millions of dollars off of collectivism and off the backs of those who fight politically for government employees.


  21. - Ron - Wednesday, May 17, 17 @ 11:21 am:

    Not really. Illinois should not be in the mental health providing business.


  22. - Ron - Wednesday, May 17, 17 @ 11:22 am:

    We have very expensive pensions to pay.


  23. - Cubs in '16 - Wednesday, May 17, 17 @ 11:28 am:

    ===Illinois should not be in the mental health providing business.===

    I see. We should leave that to the vulture capitalists like Rauner since they ooze caring and compassion. Ask the families of those nursing home residents how that worked out for them and get back to me.


  24. - Ron - Wednesday, May 17, 17 @ 11:39 am:

    The state can’t afford to provide mental health services.


  25. - Henry R Bloch - Wednesday, May 17, 17 @ 11:43 am:

    “We have very expensive pensions to pay. ”

    A very shoddy statement. How expensive? Give me a figure, in terms of the employer’s cost as a percentage of the employee’s wages.


  26. - Crispycritter - Wednesday, May 17, 17 @ 11:45 am:

    Downstate == many states have well funded pensions, they are quite sustainable because they were funded. Let us say schools are not sustainable since they are not being funded. You need to rethink your logic.


  27. - titan - Wednesday, May 17, 17 @ 12:13 pm:

    +++ - Ron - Wednesday, May 17, 17 @ 11:39 am:
    The state can’t afford to provide mental health services. +++

    It is less expensive than putting mentally ill people in jail and prison (which is where they otherwise end up), not to mention the additional taxpayers that got killed having ben removed from the taxpayer pool.


  28. - wordslinger - Wednesday, May 17, 17 @ 12:58 pm:

    Titan, be aware when the sad lonely boy is just crying out for some attention.

    To the high cost of squeeze the beast in fiscal meltdown and human damage, have the Superstars worked up that revised ROI schedule on that turnaround agenda? When the nut would be covered?

    Are they too busy tossing invoices in dumpsters to get around to it?


  29. - Demoralized - Wednesday, May 17, 17 @ 1:04 pm:

    ==The state can’t afford to provide mental health services==

    I hope they can, for your sake.


  30. - Downstate - Wednesday, May 17, 17 @ 1:45 pm:

    Crispycritter,
    I’ll try again….
    If raising taxes will cure Illinois’ pension ills, why didn’t Detroit, Puerto Rico and Orange County simply do that?


  31. - Oswego Willy - Wednesday, May 17, 17 @ 1:51 pm:

    ===If raising taxes will cure Illinois’ pension ills, why didn’t Detroit, Puerto Rico and Orange County simply===

    - Downstate -

    In January 2015, income taxes were sunsetted.

    What judge is going to accept taxes are too high when the state just reduced income taxes.

    Are you willfully ignorant or blissfully unaware? lol


  32. - Downstate - Wednesday, May 17, 17 @ 2:29 pm:

    OW,
    Thanks for the (non)response.
    Seriously, if raising taxes was the answer to pension woes, why didn’t Detroit, Puerto Rico, and Orange County simply do that?

    Are you avoiding the question, or do you simply not know? LOL


  33. - Ron - Wednesday, May 17, 17 @ 2:33 pm:

    Illinois has the 4th highest state and local tax burden in the nation. Over 100,000 people left Illinois last year alone. Increasing taxes without massive spending cuts will destroy Illinois.


  34. - Ron - Wednesday, May 17, 17 @ 2:34 pm:

    We must eliminate the outrageous protections public workers receive in Illinois or the private sector will continue to bail.


  35. - Oswego Willy - Wednesday, May 17, 17 @ 2:35 pm:

    Oh - Downstate -

    You can’t have your argument that anyplace is exactly like Illinois and taxes are too high, including Illinois, especially when Illinois in 2015 had income tax reduced.

    You could raise the income tax 65% and it’s still lower then when Quinn was governor.

    No judge is going to allow an Illinois “bankruptcy” as Illinois is coming off an income tax cut, lol

    Keep up. This isn’t a dorm room.


  36. - wordslinger - Wednesday, May 17, 17 @ 2:38 pm:

    – Seriously, if raising taxes was the answer to pension woes, why didn’t Detroit, Puerto Rico, and Orange County simply do that?–

    Seriously, you seem confused.

    Raising taxes, cutting taxes, or keeping taxes the same will not change the unanimous Supreme Court decision that the pension liability must be paid.

    Did you miss that bit? It was in all the papers.


  37. - Demoralized - Wednesday, May 17, 17 @ 2:43 pm:

    Ron

    Grow up and get over it. Your daily diatribes about employee pensions are tiresome.


  38. - Demoralized - Wednesday, May 17, 17 @ 2:48 pm:

    I’m not sure you are aware of this but Illinois isn’t Detroit, Orange County or Puerto Rico. I’ll get you a map


  39. - RNUG - Wednesday, May 17, 17 @ 2:54 pm:

    When in comes to reducing existing benefits / pensions for state workers, only seven opinions count. And I don’t think any of those seven are commenting here … although they, or their clerk’s, might he reading this blog.

    Go read Kanerva and SB-1 in their entirity. The justices went into a lot of detail addressing the issues you keep raising, including the issue of a self-created fiscal “emergency”. They didn’t leave much, if any, wiggle room. And they even cited some case law from BEFORE the 1970 Pension Clause.

    The only loophole that they left open was consideration. And that has to be voluntary, which the Tier 1 Cullerton option isn’t … but we’re going to have to wait for the court to tell us that because, apparently, the members of the GA, don’t understand legal contract modification.


  40. - Ron - Wednesday, May 17, 17 @ 3:17 pm:

    Then layoff the entire state workforce and rehire at Tier 2.


  41. - Ron - Wednesday, May 17, 17 @ 3:18 pm:

    Illinois is in fiscal and demographic meltdown.


  42. - Ron - Wednesday, May 17, 17 @ 3:24 pm:

    I know all the public employee union supporters think all we need is higher taxes, but a poll from the Paul Simon Public Policy Institute found that 47% of registered voters in Illinois say they want to move out, with 27% of them citing taxes as their top reason.


  43. - titan - Wednesday, May 17, 17 @ 3:47 pm:

    There are other states with public pension benefits very similar to Illinois, and where the pension systems are well funded and the states are in sound fiscal condition. Those states didn’t in effect “borrow” from their pension systems to spend on other things.

    No one disputes that Illinois is in bad shape financially. The main cause is not the structure of the pension systems themselves (and the Tier 2 changes fixed the structural issues that did exist) - the main problem is that the money “borrowed” needs to be paid back 9as it would with bonds or other forms of debt).


  44. - VanillaMan - Wednesday, May 17, 17 @ 3:53 pm:

    See this smoldering wreckage?
    That ain’t doin’ NOTHING.


  45. - RNUG - Wednesday, May 17, 17 @ 3:55 pm:

    == Then layoff the entire state workforce and rehire at Tier 2. ==

    You’ve been told that isn’t legal. Once you are in the Tier 1 system, you are in it … even with a break in service.


  46. - Ron - Wednesday, May 17, 17 @ 4:02 pm:

    No, don’t rehire Tier 1 folks, they are too expensive.


  47. - Ron - Wednesday, May 17, 17 @ 4:03 pm:

    The goal is to reduce the cost of government.


  48. - Oswego Willy - Wednesday, May 17, 17 @ 4:05 pm:

    Please don’t feed the Troll. He knows not what he speaks…


  49. - RNUG - Wednesday, May 17, 17 @ 4:21 pm:

    == Please don’t feed the Troll. He knows not what he speaks… ==

    I know that. But his inaccurate statements need to be corrected with actual facts.


  50. - Oswego Willy - Wednesday, May 17, 17 @ 4:24 pm:

    - RNUG -

    With great respect, it wasn’t, at all, towards you.

    I know exactly what you are doing, my friend.

    My apologies. That’s on me.


  51. - don the legend - Wednesday, May 17, 17 @ 4:29 pm:

    Perhaps Ron needs to ‘get and stay focused’ and help the governor in his efforts to balance our budget with reforms and tax increases.


  52. - Ron - Wednesday, May 17, 17 @ 4:33 pm:

    Yes, reform the state workforce. It’s simply too expensive to maintain.


  53. - Anonymous - Wednesday, May 17, 17 @ 5:08 pm:

    Ron needs to drink some KoolAid, without the stuff in it.


  54. - RNUG - Wednesday, May 17, 17 @ 5:47 pm:

    == Yes, reform the state workforce. It’s simply too expensive to maintain. ==

    The only easy way to legally get rid of Tier 1 employees is to offer an ERI. Depending on the terms, it could cost more than keeping them.

    How bad do you want to get rid of them? Bad enough to offer another ERI with the same terms as 2002?


  55. - VanillaMan - Wednesday, May 17, 17 @ 7:28 pm:

    It seems some Rauner supporters want to believe in magical places where they live on everyone else’s labor without having to pay for it.

    They’re like those Good Book people who judge everyone around them, and never drop a dime into the collection plates. Always ready to justify doing the cheapest thing because someone, somewhere unworthy might benefit.

    Rauner thrives in these groups, promising his miser supporters that if they let the unworthy go without, they can keep more for themselves.

    It’s always raining when you ask Rauner supporters for enough money to keep their neighbors off the street.


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