* Expect numerous updates to this press release…
Governor Bruce Rauner issued an amendatory veto today of House Bill 2482.
Similar to Senate Bill 570, the proposed legislation concerning the Child Care Assistance Program, HB 2482 would have unintended consequences that would negatively impact the state’s long-term ability to serve individuals in need.
“These bills may be well-intentioned, but they are ultimately harmful to the programs they are trying to help,” Rauner spokesman Lance Trover said. “The governor understands and shares the frustration of members who want to fund these programs, but the appropriate way to do so is in the context of a truly balanced budget. As drafted, both pieces of legislation would create serious problems that jeopardize the future of the Child Care Assistance Program as well as services for the elderly.”
House Bill 2482 would lock into statute that an individual who qualifies for assistance is entitled to institutional care. Additionally, the approach contemplated by this legislation puts the state’s compliance with Medicaid waiver regulations and ability to maximize federal match funds at serious risk.
As noted in the governor’s veto message House Bill 2482 “takes a step in the wrong direction… For too long, Illinois has over-prescribed institutional care to lower-need individuals when less expensive and more appropriate care options are available. In order to provide the best particular care for each individual, to ensure that our support services remain affordable, and to maximize the number of individuals served, we must rebalance the services being provided with greater precision. Prescribing institutional care for individuals who do not need it is wrong for the individual and wrong for taxpayers. Moreover, over-prescribing institutional care is inconsistent with the direction being taken across the country.”
Bill No.: HB 2482
An Act Concerning Public Aid
Action: Amendatory Veto
Note: Veto Message Below
Veto Message
To the Honorable Members of
The Illinois Senate,
99th General Assembly:
Today I return House Bill 2482 with specific recommendations for change.
The State of Illinois provides important support services to elderly and disabled individuals through the Community Care Program, the Home Services Program, and State-funded nursing care. At a time when the State is struggling to afford its past promises, we have an obligation to make the economic and government reforms needed to continue providing these services to the neediest among us.
Unfortunately, while well-intentioned, House Bill 2482 takes a step in the wrong direction. The bill would lock into statute that an individual with a particular threshold score on the Determination of Need (DON) assessment tool would be eligible for both institutional and home and community-based long term care services. Instead, an individual with the threshold score should be entitled to institutional or home and community-based care. Retaining flexibility to determine whether an individual is eligible for institutional or home and community-based care – as opposed to both – will ensure that the State is compliant with Medicaid waiver regulations and protocols and maximize federal matching funds.
For too long, Illinois has over-prescribed institutional care to lower-need individuals when less expensive and more appropriate care options are available. In order to provide the best particular care for each individual, to ensure that our support services remain affordable, and to maximize the number of individuals served, we must rebalance the services being provided with greater precision. Prescribing institutional care for individuals who do not need it is wrong for the individual and wrong for taxpayers. Moreover, over-prescribing institutional care is inconsistent with the direction being taken across the country.
Therefore, pursuant to Article IV, Section 9(e) of the Illinois Constitution of 1970, I hereby return House Bill 2482, entitled “AN ACT concerning public aid”, with the following specific recommendations for change:
On page 10, line 17, by replacing “institutional and” with “institutional or”; and
On page 21, line 5, by replacing “institutional and” with “institutional or”; and
On page 50, line 21, by replacing “institutional and” with “institutional or”; and
On page 55, line 17, by replacing “institutional and” with “institutional or”.
With these changes, House Bill 2482 will have my approval. I respectfully request your concurrence.
Sincerely,
Bruce Rauner
GOVERNOR
…Adding… The bill received 74 votes in the House, including Republicans Batinick, Bryant, Hammond, Jesiel, McAuliffe and Unes.
*** UPDATE 1 *** Rep. Batinick just said that in his opinion, an amendatory veto is better than a total veto, but he won’t make a decision until he talks with supporters about how far-reaching Rauner’s change of “and” to “or” will be.
*** UPDATE 2 *** Chief House sponsor Rep. Greg Harris via text…
The Rules Committee will first have to determine if the Amendatory Veto is compliant with constitutional requirements. I will carefully review the language to see if the changes protect the needs of all of our seniors and persons with disabilities in community based, supportive living, nursing homes and other care settings. It is critically important that fragile and vulnerable people are not put at risk.
*** UPDATE 3 *** From Denise Gaines, legislative director, SEIU Healthcare Illinois…
“Bruce Rauner’s own history of abuse and neglect when it comes to nursing homes under his control should strike fear in the hearts of anyone affected by these changes, which ultimately limit choice for Illinois seniors and preserve Rauner’s own power to arbitrarily kick people off the program.
“Once again, Rauner is taking vulnerable Illinoisans hostage in pursuit of his extreme, non-budgetary political agenda. Today, it’s nursing home residents. This amendatory veto is unacceptable and we call on legislators to override it when they convene on Nov. 10th.”
*** UPDATE 4 *** Sen. Daniel Biss via text…
HB2482, which passed with strong support in both chambers, is provided needed protections to seniors and people with disabilities. While we are still reviewing Governor Rauner’s language, I will be watching closely to ensure that we protect the ability of those who most need long term care to choose the most appropriate services.
…Adding More… So, here is what the original bill said…
Individuals with a score of 29 or higher based on the determination of need (DON) assessment tool shall be eligible to receive institutional and home and community-based long term care services until such time that the State receives federal approval and implements an updated assessment tool.
So, under this AV, people would be eligible to receive institutional or home and community-based long term care services.
The trouble is, lots of seniors bounce around between those services. They’re receiving home care, they fall and break their hip, they go to the hospital and are released to a nursing home, then they eventually head back home.
How can you make this a purely “or” situation? Do they have to reapply? Do they just get one and not the other?
I have a call into the governor’s office to explain this. I’ll let you know what they’re saying.
*** UPDATE 5 *** So, according to the governor’s office, the example I used above wouldn’t be covered by their AV. This is for permanent care, not temporary bouncing around, I’m told. They also claim to have the support of several advocates for home and community-based care, which might explain the muted response so far from Democrats.
*** UPDATE 6 *** From the Health Care Council of Illinois (nursing home lobby)…
Governor Rauner’s Amendatory Veto of House Bill 2482 eliminates medical care for Illinois’ most vulnerable citizens. Rauner’s view of the future of long term care for people who cannot dress themselves or manage their own medication is to keep them isolated in an apartment with assistance of a part-time housekeeper.
Rauner’s amendatory veto strips away 24-hour skilled medical care and replaces it with a few hours a week of housekeeping chores. This move is strictly about money and politics, and not about the care needs of elderly people. With one pen stroke, elderly people and their families lost the right to choose the best health care setting based on their individual health care needs and family circumstances.
The Health Care Council of Illinois calls on members of the General Assembly to override this Amendatory Veto and uphold dignified medical care for our most vulnerable citizens.
Pat Comstock
Executive Director
Health Care Council of Illinois
