Capitol - Your Illinois News Radar » If the governor had fixed this problem, then the GA wouldn’t have stepped in
SUBSCRIBE to Capitol Fax      Advertise Here      About     Exclusive Subscriber Content     Updated Posts    Contact Rich Miller
To subscribe to Capitol Fax, click here.
If the governor had fixed this problem, then the GA wouldn’t have stepped in

Friday, Nov 30, 2018 - Posted by Rich Miller

* Finke

Rauner also complained about a bill that says people entering medical facilities like nursing homes are presumed to be eligible for Medicaid benefits until the state determines otherwise.

“That has the likelihood of costing tens of millions and potentially hundreds of millions of dollars that cannot be recouped,” Rauner said. “It is a huge mistake on the part of the General Assembly.”

Rauner had proposed changes to the bill that he said would help control costs. However, the House and Senate voted to reject those changes without any dissenting votes.

Lawmakers passed the bill in the first place because the state is far behind in determining if someone is eligible for Medicaid assistance. They were concerned that nursing homes were assuming costs for patients who should have been covered by Medicaid but weren’t because the state was behind in its work.

* From a June 28th press release from Comptroller Susana Mendoza

Since taking office, Comptroller Mendoza, as the state’s chief fiscal officer, has prioritized payments to programs serving the state’s most vulnerable populations, including the roughly 55,000 Medicaid long-term care (LTC) program participants, many of whom reside in nursing homes and supportive living and hospice care facilities.

But now the failure to process millions of dollars in bills for critical services and a spike in enrollment delays is threatening care providers’ ability to cover basic costs like medicine, food, and payroll, Comptroller Mendoza said. […]

The Comptroller’s report, which uses Department of Healthcare and Family Services (HFS) data, found that the number of pending Medicaid eligibility determinations for LTC over 90-days-old rose 143 percent between December 2017 and May 2018. HFS has reported it can only process 60 percent of new, incoming applications in a timely manner and, as of the end of last month, there were 16,378 pending admissions. According to the Associated Press, the estimated cost of these pending admissions is up to $300 million.

These problems are occurring at the same time the Rauner Administration continues to dump tax dollars into a failed technology solution meant to streamline Medicaid eligibility processes. The state has committed $288 million to Deloitte, the global consulting firm, for an Integrated Eligibility System (IES) to modernize enrollment in benefit programs like LTC or the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps.

* Also from the comptroller’s office

HB 4771 enshrines into law the decision made in Koss v. Norwood, which requires the State to grant “provisional eligibility status to any applicant whose application is more than 46 days old.” Additionally, the bill requires the Department of Healthcare and Family Services to submit a voucher to the Office of the Comptroller within 10 business days of being granted provisional eligibility.

As noted above, the bill unanimously passed both chambers and then the governor’s veto was overridden without dissent. It had bipartisan sponsors, including Republicans with experience dealing with Medicaid issues.

The GA stepped in to fix something because Rauner couldn’t or wouldn’t. Legislative fixes opposed by the executive are never optimal. But they become necessary in these sorts of situations. And the time to influence legislation is during the spring session, not with a long amendatory veto in August.


  1. - Not a Superstar - Friday, Nov 30, 18 @ 11:58 am:

    This could be the title of nearly every post.

  2. - don the legend - Friday, Nov 30, 18 @ 12:07 pm:

    Blagojevich left office on January 29, 2009. On that day was there anybody that would have said that in just six years we would elect someone exponentially worse as a governor.

    Blago should have been a once in a hundred year catastrophe. Rauner took just six years to push that pile of corruption and incompetence out of the record book.

    Congratulations Bruce.

  3. - Honeybear - Friday, Nov 30, 18 @ 12:09 pm:

    God’s honest truth
    I struggle with IES
    every single day
    every single hour.
    The cost of the system is well over 350 million now.
    It’s an unmitigated, over technical, over engineered nightmare.
    In our 30yo legacy system
    I could approve Medicaid in 5 minutes
    10 minutes if something was screwed up or we had to fix something.

    Now, with one app, I can struggle with it for an hour trying to get it to certify and issue a benefit. One moment an app can take 5-10 minutes to do (too many pages to go through, too many drop downs, it’s designed for management to glean data, NOT for the frontline to process quickly.)
    The next app that might seem just like the last will eat your lunch, cause an hour call with tech support and result in sending it off to Springfield, or worse yet, left to rot in the queue as a “known error”, meaning we don’t know what the hell we have to do to solve it.
    The LTC apps are sent off to an overworked small unit.
    Why small? Ask Dimas
    Maybe they didn’t want it to work.
    Maybe they have a contractor lined up to do it.
    Another Maximus waiting in the wings.
    Instead of training up or retasking a platoon of especially trained HSC they continue to perpetuate the problem

    In order to offer their preferred solution
    privatize it
    Like Quinn tried to do incidentally

    Take note Pritzker crew
    You absolutely must cultivate and maintain
    quality workers
    Training for IES is minimal.
    Veteran caseworkers have to figure stuff out for themselves, if they don’t have an SDS in office.
    Even then I can’t tell you the number of times my amazing SDS has said “I have no idea how to fix it”, “Call it in”
    Learn the lesson
    Technology doesn’t fix it
    Outsourcing doesn’t fix it

    Only good/highly trained/competent crew
    with a decent ship
    can fight the ship

  4. - wordslinger - Friday, Nov 30, 18 @ 12:13 pm:

    Rauner wasn’t in it for “fixing problems.”

    It was just one long, navel-gazin’ ego trip. Even by politician standards, his self-reverence was extreme.

  5. - Fixer - Friday, Nov 30, 18 @ 12:14 pm:

    Honeybear, one HSC to another, preach.

  6. - Anon221 - Friday, Nov 30, 18 @ 12:20 pm:

    Care facilities that have to wait months and maybe over a year to be paid for patients and residents whose insurance has run out cannot always provide the care needed. They have to cut corners, reduce staff, pay less. Mom was in one nursing home that, at the end of the month, might only be able to serve something like beans and hot dogs… and I am not exaggerating. Before she died, her Medicaid case had already been pending for over 6 months. It’s hard on the family, the facility, the staff- all are stressed out not knowing what will be paid and when, and what the ultimate financial burden will be for the family.

  7. - RNUG - Friday, Nov 30, 18 @ 12:29 pm:

    Until they get the bugs out of the new system, maybe somebody should get Deloitte to pay for contractors to catch up the workload.

  8. - Honeybear - Friday, Nov 30, 18 @ 12:58 pm:

    RNUG- good luck with that. The Rauner gravy train stopped and so Deloitte no longer supports us. We’re on our own. They gave us a boxed, over engineered system and we’re stuck with it.

    The horror is that each one of these apps, changes, cases, is a person, or a family
    That’s getting screwed or neglected.

    It’s hard on the soul when you get a “known error” or someone needs care yesterday.
    And I have to tell them
    I’m sorry, we’re still trying to fix our problem
    Folks don’t know how emotionally strong you have to be.
    To look someone in the face, at least several times a week
    and say that.

  9. - NeverPoliticallyCorrect - Friday, Nov 30, 18 @ 1:28 pm:

    We work with these systems and I will say again, as I have on other issues, this problem goes beyond any single governor. The state of Illinois has somehow managed to institutionalize incompetence in it’s employees and systems. The employee issue is related to existing employees having the right to bid on job openings they are not qualified to hold. The systems issue is one of maintaining systems even when they don’t serve the people they exist to serve. SO now we have a new governor but his committees are made up of many of the same players. let’s hope he has the wisdom and courage to demand more than the same things in new wrapping.

  10. - Langhorne - Friday, Nov 30, 18 @ 1:35 pm:

    I had an experienced law firm do my wife’s Medicaid app. Prepped like an appeal, to avoid do overs. Zipped through in 10 months….9 months after she died. Her nursing home accepted her “Medicaid pending”. Not all do.

  11. - kitty - Friday, Nov 30, 18 @ 1:37 pm:

    Hopefully Gov Elect Pritzker’s new leadership will cut losses with IES ASAP. The former systems PACIS and IPACS weren’t perfect but they worked better than IES. The task based casework model is terrible for approving / maintaining LTC & SLF cases, individual HSCs need to be given facility -based case management again.

  12. - PublicServant - Friday, Nov 30, 18 @ 1:46 pm:

    My brother, Mike, got a degree in nuclear engineering from The University of Illinois - CU. He was snapped up by the Navy and given intensive training in submarine power plant and sonar. He was then deployed out of Groton, MA on a fast attack submarine. Smart guy, my younger brother. The best this country had. He just turned 58 and is now in a Skilled Nursing home. I’ve sold his house, and he’s got a decent pension. That and the SSD that he gets, would allow him to live on his own, but these skilled nursing facilities are double that. Around 8k per month. I’m now trying to protect his little bit of savings, and qualify him for Medicaid. He knows who I am, and that I’m trying to help him. He doesn’t know much more than that, but he’s my little brother, and I love him.

    It is what it is, but this bill looks like it might be able to help him. The paperwork burden for Medicaid is enormous. 5 years of taxes with supporting documents. 5 years of bank statements from all accounts. I’ve got an Elder Law attorney who’s helping me, and I’ve got a firm helping me get everything together for Medicaid. It’s a slow process. If I can’t get him on Medicaid soon, he’ll be bankrupt in about 18 months. I’m trying to protect his savings in a trust that the state can’t touch, so I can use it for a few extra medical things like an RN who specializes in caring for seniors in a nursing home. She makes sure staff doesn’t slip up, catching things I would never have thought of. She’s not cheap, but is indispensable.

    I hope this bill helps. He needs all the help he can get.

  13. - Honeybear - Friday, Nov 30, 18 @ 2:00 pm:

    Neverpoliticallycorrect- holy moose crap buddy-I’m bout to go Kifowit on you.
    There is no way you work with these systems.
    You obviously have no idea what you’re talking about.
    Bite me a billion times.
    This has absolutely nothing to do with bidding on positions.
    And IES phase II is a new system as of 10/24/17
    They pulled all the old systems offline.
    But you are right that they don’t serve the people they were designed for.
    They serve managements’ need for data.

    Pritzker folks- This is the type of putz you don’t want being anywhere in state government.
    Not that I think you have the courage, maturity, or intellgence to do what stateworkers do every day, you arrogant Raunerite.

    Go back to pleasuring yourself at IPI with your policy fantasies.

  14. - Fixer - Friday, Nov 30, 18 @ 2:44 pm:

    NPC, I’m guessing your employee issue is a thinly veiled reference to Upward Mobility. Also, if you’ve never worked side by side with front line staff, some of whom came up through that program and work to make the best of this system…

  15. - Anon221 - Friday, Nov 30, 18 @ 3:02 pm:

    PublicServant- My heart goes out to you, and I hope his application gets the efficient approval it deserves.
    Your statement, “If I can’t get him on Medicaid soon, he’ll be bankrupt in about 18 months,” hits home. All Mom and Dad had were small pensions and SS, plus their home. Her application was “lost” three times the last time Dad worked with the nursing home to get it submitted. Mom was there due to dementia that had intensified following a bad reaction to anesthesia (Post-operative cognitive disorder). She was in and out of homes for over 2 years before finally being able to stay in one that would work with her and the funding issues.
    There was a tweet in the Scribby the other day about a son who posted who his father (who had dementia) was- who he had been, what he had done in life, and who he was today. He posted this on his dad’s door, so the caregivers would know and could use those remembrances to try and relate to him, and even encourage him to talk about his past- something usually easier for people to remember than that present. Others who responded to the tweet added things like placing pictures with stories about the photos in his room to, again, given caregivers clues on how they might reach him. I wish you both peace. It’s a hard road to travel.

  16. - LTSW - Friday, Nov 30, 18 @ 3:12 pm:

    While the new system is a POS. The real problem is not enough caseworkers to do the work. Haven’t been since Blago. And the feds actually match these workers at 75% now so the real cost isn’t insurmountable.

  17. - Honeybear - Friday, Nov 30, 18 @ 3:14 pm:

    Anon221 and Publicservant, I was a hospice chaplain for 5 years. The best thing I found for quality of life for memory loss patients was, I kid you not, Hawaiian music. Seriously, it’s amazing how well that will improve mood, stabilize and stimulate any patient. Get you some Don Ho and you’re good to go. There was a paper that I posted on facebook just the other day about how the musical part of the brain is not affected by dementia or Alzheimer’s. You put on Hawaiian music and you’ll see. Takes them straight to the beaches of Waikiki.
    Hope this helps

Sorry, comments for this post are now closed.

* Reader comments closed for the weekend
* Isabel’s afternoon roundup
* Feds to provide more migrant funding... Just $19.3 million for Illinois
* Question of the day
* It’s just a bill
* Bill to expand IVF/infertility insurance coverage overwhelmingly passes Senate
* Open thread
* Isabel’s morning briefing
* SUBSCRIBERS ONLY - Today's edition of Capitol Fax (use all CAPS in password)
* Yesterday's stories

Visit our advertisers...







Main Menu
Pundit rankings
Subscriber Content
Blagojevich Trial
Updated Posts

April 2024
March 2024
February 2024
January 2024
December 2023
November 2023
October 2023
September 2023
August 2023
July 2023
June 2023
May 2023
April 2023
March 2023
February 2023
January 2023
December 2022
November 2022
October 2022
September 2022
August 2022
July 2022
June 2022
May 2022
April 2022
March 2022
February 2022
January 2022
December 2021
November 2021
October 2021
September 2021
August 2021
July 2021
June 2021
May 2021
April 2021
March 2021
February 2021
January 2021
December 2020
November 2020
October 2020
September 2020
August 2020
July 2020
June 2020
May 2020
April 2020
March 2020
February 2020
January 2020
December 2019
November 2019
October 2019
September 2019
August 2019
July 2019
June 2019
May 2019
April 2019
March 2019
February 2019
January 2019
December 2018
November 2018
October 2018
September 2018
August 2018
July 2018
June 2018
May 2018
April 2018
March 2018
February 2018
January 2018
December 2017
November 2017
October 2017
September 2017
August 2017
July 2017
June 2017
May 2017
April 2017
March 2017
February 2017
January 2017
December 2016
November 2016
October 2016
September 2016
August 2016
July 2016
June 2016
May 2016
April 2016
March 2016
February 2016
January 2016
December 2015
November 2015
October 2015
September 2015
August 2015
July 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004

Blog*Spot Archives
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005


RSS Feed 2.0
Comments RSS 2.0

Hosted by MCS SUBSCRIBE to Capitol Fax Advertise Here Mobile Version Contact Rich Miller