* Gov. Pritzker…
Governor Pritzker today signed historic and equity-focused nursing home rate form legislation (HB246) that will improve care for nursing home residents across Illinois. The legislation holds facility owners accountable by tying new funding to improving care for vulnerable Illinoisans.
The reform principles include increased funding that is tied to staffing levels, a proven predictor of improved health outcomes for residents; a new pay scale for certified nursing assistants that increases wages based on years of experience; and funding connected to improving key quality measures. The Illinois Department of Healthcare and Family Services first introduced these reforms in March 2021, and they were also included in the Governor’s budget for this fiscal year.
Illinois will become the first state to implement this reform model, as well as the first to incentivize better nursing home staffing at this magnitude. For the first time in Illinois, there will be a direct tie between funding for nursing home industry and quality measures, including the hiring of staff.
“Since day one of my administration, I’ve made it clear that everyone deserves quality, affordable healthcare,” said Governor JB Pritzker. “With today’s signing, Illinois will no longer tolerate an emphasis on profits over people, especially at the expense of our most vulnerable Illinoisans. When it comes to taking care of our seniors, Illinois is setting a new standard—the highest in the nation. This is what accountability looks like.”
“Under HB 246, we are carving the path for well-funded, well-staffed nursing homes with workers who have the training to provide quality care,” said Lt. Governor Juliana Stratton. “I have had the opportunity to hear from nursing home workers, who shared what it’s like to be stretched thin and how transformative this legislation can be. With this bill, we are building a better future for residents and workers alike with their voices at the forefront.”
Medicaid customers, and especially Black and Brown nursing home residents, are more likely to live in understaffed facilities, making equity a driving force behind the changes in the nursing home rate reform legislation. COVID-19 disproportionately affected nursing homes in vulnerable, often Black and Brown communities, further widening the inequities that exist within long-term care. But the need for change in the nursing home Medicaid payment system in Illinois began long before the pandemic.
The Illinois Department of Healthcare and Family Services (HFS) spends over $2.5 billion annually to care for the roughly 45,000 nursing home residents who are enrolled in the Medicaid program, which accounts for nearly 70% of nursing home residents in the state. The legislation ties new funding to accountability and transparency for nursing facilities by adopting the federal Patient Driven Payment Model (PDPM), which is designed to more accurately reflect the clinical care needs of residents and requires the disclosure of all individual nursing home ownership interests.
Accounting for federal matching funds, Illinois will invest more than $700 million in Medicaid funding in the nursing home industry through a combination of new revenues generated by simplifying and expanding the existing nursing home assessment tax, and by allocating additional general revenue funds.
Additional funding will be dedicated to addressing increased costs at nursing facilities due to labor shortages and wage increases, with an adjustment of $4 per resident day for facilities that serve an above average percentage of Medicaid customers. Medicaid funding to support the new wage scale for certified nursing assistants will increase funding for wages by as much as $8 per hour, depending on a worker’s role and length of service in nursing homes.
The Medicaid program will repay nursing homes that opt in for their share of the cost of the wage scale increase. For some facilities, Medicaid will fund virtually the entire cost of the scale. The scale is structured so that CNAs will receive an increase for each year of their experience in Illinois nursing homes.
For those with at least one year of experience, their wage will increase by at least $1.50 per hour, and Medicaid will pay its share of that $1.50 increase. The pay increase goes up by $1 for each year of experience, topping out at a $6.50 per hour increase for those with six or more years of experience in nursing homes. The legislation also allows for a $1.50 per hour wage increase to accompany qualifying promotions, which is in addition to the experience-based wage increases. Medicaid will fund its share of this increase too, up to 10-15% of nursing home CNAs.
* CMS…
Reforms sought to update business and labor practices of nurse staffing agencies have been signed by Governor JB Pritzker.
The pandemic increased demand for nurses and nurse aides, causing healthcare facilities in Illinois to increasingly rely on temporary contract nurses referred by nurse staffing agencies to fill staffing needs
HB 4666 amends and modernizes the Nurse Agency Licensing Act to bring transparency around fees charged, increase Nurse Agency reporting on their pay and labor practices, and expand protections for workers referred by nurse agencies. The Illinois Department of Labor (IDOL) is responsible for regulation and oversight of nurse staffing agencies pursuant to the Nurse Agency Licensing Act.
“This bill critically protects temporary nurses and nurse aides’ right to change jobs or get hired directly by a healthcare facility. It will also increase stability and transparency in the healthcare industry in the state. As the pandemic illustrated time and time again, healthcare workers and the healthcare industry are critical to the well-being of the people of Illinois,” said Illinois Department of Labor Acting Director Jane Flanagan.
The operational changes include the following provisions:
• Nurse staffing agencies are prohibited from entering into covenants not to compete with nurses and certified nurse aides.
• Nurse staffing agencies are prohibited from requiring the payment of liquidated damages, conversion fees, employment fees, buy-out fees, placement fees and or other compensation, if the employee is hired as a permanent employee of the health care facility.
• Nurse staffing agencies must disclose new contracts with facilities to IDOL within 5 business days of the effective date (protected from FOIA).
• Wage rates paid to nurses and certified nursing assistants (CNAs) must match wage rates identified on the contract. Failure to do so allows IDOL to recover underpaid wages for the worker.
The new reporting requirements include the following:
• Nurse staffing agencies must submit quarterly reports related to average charges to health care facilities to IDOL.
• IDOL must publish yearly a report by county of average amounts paid to employees and charged to health care facilities.
The changes take effect July 1, 2022.
* Sen. Hunter…
A lack of diversity amongst health care professionals can lead to disparities in treatment, which is why State Senator Mattie Hunter sponsored a new law to incentivize representation in health care.
More than half of practicing physicians are white, and only 17% are Asian, 6% are Hispanic, and 5% are Black.
“Diversity in the health care industry is so important, and it is proven to benefit patients’ quality of life,” said Hunter (D-Chicago). “When patients have professionals that look like them, there is increased trust, communication, and an enhanced understanding of values.”
The law creates an Equity and Representation in Health Care Workforce Repayment Program, which will provide loan repayments and scholarships for health care professionals who serve in Illinois medical facilities.
Increasing diversity in the health care sector is a priority of the program, especially in medically underserved areas.
“Unfortunately, medical professionals’ implicit bias can be a huge barrier for patients of color, LGBTQ patients, and those from lower socioeconomic backgrounds,” Hunter said. “This measure combats a lack of representation by providing scholarships for those who can help diversify the field.”
This measure builds upon measures in Hunter’s health and human services package, which was signed into law last year.
House Bill 4645 was signed into law Friday and goes into effect in January 2023.
* Sen. Stadelman…
State Senator Steve Stadelman joined domestic violence prevention advocates Tuesday to celebrate the recent signing of a law he championed to protect and empower survivors of domestic violence and abuse.
“The burden of trauma and abuse can weigh heavily on the lives of victims coping with their grief, and this law can help them take the first steps towards healing,” Stadelman (D-Rockford) said. “We are empowering survivors by giving them the choice to file for protective orders in the comfort and safety of their own home. By doing this, we are giving them the chance to move forward at their own pace.”
Stadelman’s measure, Public Act 102-0853, gives people the option to file a protective order either online or in-person. The law also requires any court in a county with a population above 250,000 to offer the option of a remote hearing to the petitioner for a protective order. It allows both the petitioner and the respondent to appear for related hearings remotely or in-person – and the courts would also have the discretion to grant or deny the request for a remote hearing.
Any and all types of protective orders would be covered under this law.
“We know from speaking with survivors that one of the most frightening and intimidating processes they engage in is seeking an order of protection,” said Manager of the Rockford Mayor’s Office of Domestic Violence and Human Trafficking Prevention Jennifer Cacciapaglia. “Providing options for survivors to engage in this process in a more survivor centered trauma responsive way is imperative to our overall efforts to improve our response to survivors across the state, and this legislation is a step in the right direction.”
The law allows both the petitioner and the respondent to appear for related hearings remotely or in-person – and the courts would also have the discretion to grant or deny the request for a remote hearing.
Senate Bill 3667 was signed into law earlier this month.
* Sen. Villanueva…
State Senator Celina Villanueva (D-Chicago) celebrates the signing of a measure she sponsored to expand women’s access to healthy pregnancies and fetal development.
“Modern lifestyles make nutrient-deficient diets extremely convenient, which presents great risk to soon-to-be mothers lacking access to steady sources of necessary vitamins and minerals,” Villanueva said. “Expanding insurance coverage to include prenatal vitamins will increase access to supplements that lead to safer pregnancy and healthy births.”
The new law requires insurance policies that already cover prescription drugs to also cover prenatal vitamins. Prenatal vitamins when prescribed by a licensed physician can have many health benefits to both mother and child that range from supplying more oxygen to the baby to preventing bone loss in the mother.
“These supplements can be vital to the safety and wellness of mothers and their children,” Villanueva said. “This is a commonsense piece of legislation protecting pregnant women and tearing down financial barriers to quality care strategies, and I am proud to have been the sponsor of this law.”
The new law was signed Friday and took effect immediately.
* Sen. Collins…
State Senator Jacqueline Collins successfully championed a new consumer protection measure, this time tackling predatory arrangements in litigation finance between legal funding companies and consumers.
“When a person has to seek legal remedy for an injury or wrongdoing, their ability to live comfortably hinges on financial stability,” said Collins (D-Chicago). “We have to make sure companies offering aid through legal funding transactions do not extort the people they serve under the guise of helping them stay afloat during difficult times.”
Litigation finance occurs when a legal funding company buys a portion of a plaintiff’s upcoming settlement to directly help the plaintiff make ends meet in exchange for repayment plus interest upon the claim’s success. The new law signed Friday creates the Legal Consumer Funding Act and places restrictions on these lawsuit funding agreements, which are meant to help a person get through their day-to-day life without missing vital expenses such as rent, utilities, medical expenditures and other necessities while they pursue legal remedy.
Though Illinois allows litigation financing, the Legal Consumer Funding Act requires legal funding companies to be licensed in the state and establishes punishment for violations of the law. Additionally, these types of agreements are subject to Senator Collins’ Predatory Loan Prevention Act placing a 36% annual interest rate cap on all consumer loans.
“These regulatory methods prevent legal funding companies from charging exorbitant amounts and preying on the vulnerability of consumers,” Collins said. “Promoting integrity among financial legal companies helps maintain the equitable practices I’ve been fighting for as a legislator.”
The new law took effect immediately.
* Sen. Sally Turner…
Legislation introduced by State Senator Sally Turner (R-Beason) that would provide victims of child sex crimes with additional privacy protections was signed into law on May 27.
Senate Bill 2942 clarifies that a judge can use his or her discretion to clear disinterested parties, excluding media, from the courtroom during the victim’s testimony even if the victim is over 18 years of age as long as the crimes were committed while the victim was still a minor.
“I was both shocked and appalled when my local State’s Attorney told me that a victim of a child sex crime was forced to share the intimate details of the worst day of their life in a room full of strangers and the accused’s former cellmate just because they had turned 18 by the time of the trial,” said Sen. Sally Turner. “This legislation will guarantee that a judge has the power to provide these victims with the privacy and discretion that they rightfully deserve. I’m thankful to be able to play a small role in ensuring that our legal system doesn’t unnecessarily add to the victims mental and emotional anguish.”
Under previous Illinois statute, a minor victim of a sex crime is afforded the right to testify without the presence of so-called disinterested parties. However, due to a lack of clarity within the statute, there was uncertainty on whether those privacy protections extended to victim’s who turned 18-years-old by the time of their trial.
“Having personally prosecuted cases involving victims of childhood sex assault, I’ve observed how the judicial process adds to their trauma and that of their families. To a person, they’ve relayed their dismay at the thought of sitting in front of a bunch of strangers to talk about the most horrific events in their life and asked why strangers would be allowed to view videos or pictures captured of them during those moments,” said McLean County State’s Attorney Don Knapp. “No legislation can magically wipe away that trauma. But I am confident that this legislation can lessen the additional trauma our most vulnerable victims suffer when having to come to court to testify. I am honored that Senator Turner asked me to write this bill and thank her and the entire General Assembly for acknowledging the need to search for methods to help victims of these horrific crimes.”
To safeguard the constitutional rights of defendants, the judge must find that particular parties do not have a direct interest in the case and must put their basis for that finding into the record. The new privacy protections and procedures are effective immediately.
Got a Republican in that one, but no House members.
