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“You will own this and all of the deleterious consequences that are inevitable”

Friday, Jan 31, 2020 - Posted by Rich Miller

* From the Cook County Public Guardian…

January 31, 2020


Theresa Eagleson, Director
Illinois Department of Healthcare and Family Services

Marc Smith, Director
Illinois Department of Children and Family Services

Re: MCO Train Wreck

Dear Directors Smith and Eagleson:

Since I sent my letter this morning, we have continued to be inundated with inquiries from adoptive parents and subsidized guardians about the dump of their children, along with 19,000 other children, into the MCO scheme scheduled to take place tomorrow.

These parents are far more eloquent than I. I’ve reproduced one of the emails we received today to give a flavor of what these parents are going through. It is from a woman who adopted two medically complex children, yet has still not even received a medical card or insurance information for either of them with the transfer scheduled to happen tomorrow:

    “I am a DCFS licensed foster parent. I also have been a pediatric registered nurse for 28 yrs. I adopted a now 4yr.old boy from foster care in 2019. He is legally blind with multiple, complex medical and behavioral issues. I also currently have a 2.5yr.old foster daughter; who I will be adopting next week. She was severely abused and shaken multiple times in the first four months of life. She has severe cerebral palsy. She cannot walk or talk, has cortical blindness and cannot swallow so receives tube feedings.

    I still do not have medical cards or insurance information for either child. I spoke to IllinicareYouthcare multiple times; last on 1/28/20. They told me they “hoped” information and cards would “start” to be mailed this week. I asked what PCP [primary care physician] was assigned. They said “all children were assigned a random PCP based on zipcode” and that I would need to call and choose a different PCP if desired after 2/1/20. They said they were “offering” six months of continuity of care with out of network providers, but that the providers did not have to accept it.

    My children have 9 specialty physicians and 6 therapists providing 10 hrs. of therapy a week. We have 11 prescription medications that are given daily, including a $5,000 per month daily injection from a specialty pharmacy. The uncertainty of all parts of this transition makes me very nervous since my children’s lives depend on medications and that services go without interruption.”

It is alarming that DHFS and IlliniCare have not even started to distribute information and medical cards to many parents, or to assign primary care doctors, even for parents of such medically fragile children. This is unacceptable if the rollout is to happen tomorrow.

Another of the inquiries we received just today is from another adoptive mother who has still not received the medical card for her son. She asks, “Correct me if I’m wrong, but this is supposed to go live tomorrow. How can that be? How can something go live tomorrow and the [children and their parents] don’t even have a card to show at the doctor or hospital?”

This adoptive mother also reports that many people have received cards from a different network than the one they selected and a different primary care provider than they selected. She asks, “What was the point of going online or waiting hours to talk to a representative when you are just going to do what you want anyway? Things are not ready. This change needs to be put off.” She urges that “this drastic move in insurance [be delayed] until everything has been figured and all the foster parents who adopted do not have to scrounge for answers and worry whether our children’s medical needs will be covered as promised to us when we adopted them.”

People who adopt and care for these children are saints. They deserve a medal, not this disgraceful treatment. And their children deserve continuity of their medical care.

If you go forward with this tomorrow, knowing full well of all the problems, you will own this and all of the deleterious consequences that are inevitable.


Charles P. Golbert
Public Guardian

This morning’s letter is here.


  1. - NIU Grad - Friday, Jan 31, 20 @ 3:06 pm:

    Governors ignore DCFS at their own peril. It’s easy to talk about progressive social service’s another thing to implement them at the management level.

  2. - Captain Obvious - Friday, Jan 31, 20 @ 3:13 pm:

    Add this to the long list of Illinois state government incompetencies. JayBob would be well advised to focus less on the doom and gloomers owning the narrative and more on finding or two things the state isn’t screwing up. You want to shut up the naysayers, fix a problem. You know, like kids dying. I won’t hold my breath waiting.

  3. - Paula Hoolihan - Friday, Jan 31, 20 @ 3:27 pm:

    I am an adoptive/ family foster parent. I was notified a week ago from my 4yo therapist that as of Feb 1 he wouldn’t be receiving services because his insurance was changing. I had NO Idea. I started calling around, the Youth Care “ advocates” kept telling me that my child’s providers were wrong and didn’t know what they were talking about. Before, during and after I was reassured he’d always have All Kids, and I could take him anywhere and that he’s always get the services he needs. And now I’m struggling and at times felt like I was begging for him to keep these services. In my heart I can’t help but wonder how many more are out here not knowing what’s going on.

  4. - Juvenal - Friday, Jan 31, 20 @ 3:46 pm:

    Marc Smith is still Director?



  5. - JS Mill - Friday, Jan 31, 20 @ 4:04 pm:

    Pritzker had a very good first year. I think he is sharp and has a good team, but DCFS HAS to be a priority now. No more gradual anything. The sins of past governors, made dramatically worse by Rauner, demand a titanic effort to make this better. I don’t care what it costs and will laugh in the face of the anti tax people on this one.

  6. - Sweet Mama - Friday, Jan 31, 20 @ 4:15 pm:

    In the Aging network, when a significant portion of our seniors that we serve in home and community based services were rolled into MCOs, we were told that providers must serve our participants regardless of whether or not MCOs or the state would cover. We complied so while many providers have closed between the rollout of the MCOs and the budget impasse, we stood between harm and our seniors and few, if any seniors, were hurt. Unfortunately, it is on providers to make the state’s actions not cause harm to the people that we serve. We clearly cannot count on the state to make decisions that won’t cause harm.

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