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Earth to lawmakers: Wake up

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Illinois

* This is one reason why cutting the budget is so difficult…

A proposed pilot program that would affect about 40,000 elderly and disabled Illinoisans could save the state $200 million over five years, but that’s not reason enough to rush into things, legislators said today.

The program in question is Gov. Pat Quinn’s Integrated Care Pilot Program, which outlines changes to some Medicaid fee-for-service plans for residents in DuPage, Kane, Kankakee, Lake and Will counties and suburban Cook County starting as early as October 2010. The program – focused on wellness and prevention – would offer incentives to medical providers based on patient health outcomes.

HB 5086, sponsored by Aurora Democrat Rep. Linda Chapa LaVia, would halt the program before it begins and create a task force to analyze its merits.

Here’s another…

Heroin dealers would face tougher penalties under legislation the Illinois House approved today.

The minimum sentence for possessing five grams of heroin with the intent to sell would jump from four years to six years under the measure. Right now, heroin dealers face the longer sentence if they’re convicted of having 15 grams or more.

And another…

Criminals would no longer qualify for good time credit before setting foot in state prison under legislation a House committee approved today.

And another…

Elgin Area School District U-46 officials Thursday formally asked the state board of education to be reclassified as a Cook County district.

The move, which would help the district seize millions in lost general state aid payments each year, came just days after State Sen. Michael Noland detailed new legislation that would provide a funding fix.

However, since this bill was tied directly to tax revenues, it was more easily killed…

A proposed law to help the Illinois wine industry stalled Thursday because of concerns the cash-strapped state could lose money if it was approved.

State Rep. Mike Bost, R-Murphysboro, is sponsoring legislation that would divert a portion of the sales tax tacked onto purchases of wine to the Illinois wine industry. For every gallon of wine sold, or roughly five bottles, 2 cents would be put into a fund that would help promote wine industry tourism and research grapes that are more disease and weather resistant, among other things.

Without question, there are valid reasons behind all of these ideas. But it just goes to show how removed from reality so many legislators are that they’re still eagerly attempting to spend more money and reduce more state revenues.

We’re in a fiscal crisis, people. Wake the heck up.

* Related…

* Universities push for action on state budget

* Poshard: Borrowing ‘a last resort’

* RTA: Unless state pays up, more transit cuts likely

* RTA: Transit agencies running out of cash

* RTA chief Steve Schlickman resigns

* RTA chief quitting in fall to return to consulting gig

* Schlickman to bow out at RTA

* Task force targets nursing home violence in report

posted by Rich Miller
Friday, Feb 19, 10 @ 9:27 am

Comments

Fiscal Note:

Fiscal impact - requires more magic beans

Comment by Scooby Friday, Feb 19, 10 @ 9:40 am
Can you please tell us Rich, using your own educated and experienced background, why the GA still thinks it can avoid the repercussions of the fiscal disasters they are ignoring?

Are they not moving because it is an election year?

Are they out of ideas?

Is there a leadership problem?

One party controls this all. If the Democrats want to do something - they can.

What is the matter with these people?

Comment by VanillaMan Friday, Feb 19, 10 @ 9:42 am
In 2002 I remember Steve Schnorf spoke to an event I attended. He said he thought Blago could use smoke and mirrors to balance the budget maybe 2-3 times, maybe even through his whole first term but beyond that - no way it could be done without changing the whole revenue / expenditure system. (forgive me if I misquoted you SS)

While I personally still lay a lot of the blame for our budget crisis on Blago, he has been gone for 12 months now. Its time to fix this system.

Paying bills 6 months late with borrowed money and just shuffling unpaid bills around hoping that nobody dies is not a plan of action.

Revenues must be enhanced. Spending must be cut.

House Democrats have only themselves to blame. If they need Quinn to make some cuts before they agree to raise taxes - then tell him so. Give him a list of cuts you want made. Make some demands. DO…. SOMETHING!! DO . . . ANYTHING!

Comment by siriusly Friday, Feb 19, 10 @ 9:43 am
Linda Chapa LaVia’s bill to allow those affected by the managed care pilot to be involved in its development is not simply obstructionism in a fiscal crisis, but recognition that managed care has not lived up to cost savings expectations in states that have adopted it and have led to serious problems in delivering care to people with disabilities. Consumer directed plans and non-profit cooperatives to manage care for people with chronic conditions like diabetes and asthma have been much more successful in terms of both cost and care and should be on the table. Medicaid is a huge part of the state’s budget and one way to reduce costs to the State is to provide community based options for people with mental illnesses as the Tribune sets forth today and as Governor Quinn’s Taxpayer Action Board recommended. We need to make cuts but we also need to make smart cuts that don’t cost us more in the long run.

Comment by lakeviewlawyer Friday, Feb 19, 10 @ 9:48 am
What in the world is the GA going to do all summer if it doesn’t address the deficit? It will be stupefyingly useless and boring.

Comment by wordslinger Friday, Feb 19, 10 @ 9:51 am
Wouldn’t cutting the Integrated Care Pilot Program cost us more money in the long run?

Comment by Leroy Friday, Feb 19, 10 @ 9:54 am
When does the metaphorical bomb go off?

I remember when East St Louis had to turn over the deed to city hall to a private citizen when it lost a lawsuit it couldn’t pay off. Do I remember that right? Could it happen to the state? Could you imagine the state capitol building on ebay? Could we see Big Jim Thompson hawking his Helmut Jahn designed monstrosity on late nite TV? “Call before midnite tonite….”

Comment by dupage dan Friday, Feb 19, 10 @ 9:59 am
Quinn needs to face the reality that the votes are not there for a permanent income tax increase. He should propose an 18 month increase beginning July 1st and see if the votes are there to do that. If not, he should set out the alternative and call a special session to pass the doomsday budget.
The Senate Revenue Committe is not a revenue raiser. It exists to give tax breaks to various businesses, shift taxes from one group to a favored group and kill off any real attempts to raise revenue.
With the conservative tilt to the upcomiong campaigns, managing the budget is something that legislators could tout as showing they are standing up to government. Even the tax eaters recognize there is no money in the til.

Comment by Tom Joad Friday, Feb 19, 10 @ 10:01 am
The managed care program has been politicaly driven since day one. HFS has provided no data on how they expect to save $200 million over 5 years, they’ve released no rates per individual, and they don’t plan on releasing that data for serving individuals with disabilities - because they have no idea what they are doing when it comes to managing care for persons with disabilities - because it isn’t being done anywhere else in the country.

There is a reason federal CMS has not approved a single waiver for managing care for persons with disabilities….

Comment by Leroy Brown Friday, Feb 19, 10 @ 10:02 am
===Even the tax eaters recognize there is no money in the til.===

At least the ones who haven’t lost their jobs and started working at Borders by now.

Comment by Obamarama Friday, Feb 19, 10 @ 10:03 am
==
At least the ones who haven’t lost their jobs and started working at Borders by now.
==

Heh. Except for the Borders that are soon closing.

Comment by Macbeth Friday, Feb 19, 10 @ 10:11 am
We’ll know when they get serious when we see a bill that puts a moritorium on new spending, cuts in current spending and a bill outlining new revenues. Until that happens, these guys in Springfield are just playing with themselves. There can be no other way of looking at it.

Yep, the Dems won’t do anything because they’re worried the GOP will make political hay come election time. So their majority is useless. All the GOP seems to want is to “take-over” state government, but they don’t seem to have a clue on what to do if that should happen.

Yet, we keep sending these same gutless wonders back to Springfield time and time again.

Comment by Deep South Friday, Feb 19, 10 @ 10:12 am
“Consumer directed plans and non-profit cooperatives to manage care for people with chronic conditions like diabetes and asthma have been much more successful in terms of both cost and care and should be on the table.”

Should be but aren’t. The statutes that lord over professional regulation in Illinois are decades out of date. Stubborn refusal to adopt current standards despite clear, reliable data that show there are indeed better, less expensive ways of delivering need services and improving outcomes.

Comment by Indeedy Friday, Feb 19, 10 @ 10:31 am
The Bost plan (as I will call it) could actually help Illinois…

How you may ask. Simple, by promoting Illinois Wine and increasing it’s alcohol content and consumption those of us who are aware of the states financial problems may end up too plowed to care….

Comment by OneMan Friday, Feb 19, 10 @ 10:35 am
I think there is confusion about addressing medical services in a managed care program vs managing long-term services and supports.

I believe managed care on medical services could be a cost saver, no doubt. But there is zero data that managing long-term services and supports is a saver nor that it improves “health outcomes.”

I think the folks that developed this managed care plan think “developmental disability” is an old wooden ship.

Comment by Leroy Brown Friday, Feb 19, 10 @ 10:38 am
I support shifting IL Medicaid recipients into a Managed care plan.

However, the Integrated Care Plan, which moved to the RFP process with amazing speed, is limited to certain Chicago suburbs (those without a 606 area code) which smacks of political policy decision-making.

If this is a sincere attempt to create a system to better coordinate the medical care of these Medicaid patients and save state taxpayers $200 million in the first five years then not include the Medicaid patients who live in the city of Chicago?

The state continues to posit that too many hospital visits and duplicative medications and lack of preventive and coordinated follow-up care is draining the current system. People with disabilities have complex medical care needs not common chronic ailments (asthma, diabetes and congestive heart failure) that are indicated in data to burden the current system.

The Integrated Care Plan has some merit. It has the potential to move people who live in nursing homes, state-operated and privately run institutions into the community near or with family and friends.

These are not the deadbeats who abuse IL’s Medicaid system. These are adults with significant intellectual and developmental disabilities.

Please review SB3634 and it’s House companion HB5086. These bills ask the Governor to slow down the Integrated Care Plan pilot. I agree with shifting IL’s Medicaid recipients to managed care for the purposes of creating a more efficient and cost-saving system. However, the Integrated Care Plan pilot is moving ahead without a public participatory process. Successfully meeting the complex needs of IL’s adult citizen’s with intellectual/developmental disabilities cannot happen with the input from those who care for them. Let us help create a successful program.

Comment by Pam Harris (Josh's Mom) Friday, Feb 19, 10 @ 10:44 am
Hey dupage dan, if the State Capitol has to go on ebay, let’s hope the knuckleheads in springfield wait until ebay has one of its free listing promors for an under $1 starting price (although the state might only get a single 99-cent bid!).

Comment by fedup dem Friday, Feb 19, 10 @ 10:48 am
Who in the world is Rep. Linda Chapa LaVia, and who is she fronting for in opposing common sense, widely-accepted care coordination services that improve quality and lower costs? She should be the poster person for special interest pandering.

Comment by Dem observer Friday, Feb 19, 10 @ 10:48 am
Unpaid bills are stacked up for social service agencies and universities who are due money. Just a question: Are the members of the GA being paid on time? Are salary payments to them current?

Comment by Responsa Friday, Feb 19, 10 @ 10:50 am
Has anyone thought about the unnecessary drain state employees put on the managed care system by being forced to go to the doctor just to have a day off work? Employees who want the day off are forced to use sick time and “prove” they went to the doctor. At this point, many empoyees are willing to pay a $15 co-pay to have the day off. Are the taxpayers willing to pick up the other $75 for an unneeded office visit? They do, weather they know it or not. “Proof-status” is a useless policy that causes undue stress and financial burden on several state systems.

Comment by The Glove Friday, Feb 19, 10 @ 11:14 am
fedup dem,

I don’t know, I think the Capitol building could be subdivided into some nice condos-great view of the Prairie P&#!s!

Comment by dupage dan Friday, Feb 19, 10 @ 12:19 pm
The Glove,

I hope you are not a state employee. I am, and I do not know anyone going to the doctor just to get a day off work. State employees get plenty of benefit time including vacation and personal time.

Comment by So Blue Democrat Friday, Feb 19, 10 @ 12:22 pm
This is why you have to cut accross the board. Alot of programs are good in theory. The legislature has to make the cut accross the board and let the agency cheifs decide what stays and what goes.

Bost’s proposal goes to the income side of the budget equation. I see a lot of worthless farm land that is now profitable wine country. If we can use a few cents a bottle to encourage private invesstment that turns non viable land into a profitable, job creating industry, I say go for it. By taxing the wine, the people who will benefit are paying the tax, not the rest of us.

Comment by the Patriot Friday, Feb 19, 10 @ 2:40 pm
SBD,
I am a state employee, and it is almost impossible to get a vacation day at my 24/7 facility. Any second request for time off is a PD request, unless you bring in documentation that states you were unable to work due to illness. Hence, if I want the day off, and one other employee is already off - it’s personal time, or head to the doctor with “intestinal distress,” just to get the note. I’d estimate it happens multiple times daily at my large 24/7 facility.

Comment by The Glove Friday, Feb 19, 10 @ 4:38 pm
The big-spending Republicans (when it comes to IDOC) got the heroin bill through, with the majority of Dems opposed and almost every Repub in favor.

Comment by Reformer Friday, Feb 19, 10 @ 8:31 pm
The managed care plan will not save $200 million, or anything necessarily. Despite claims by the administration, this is a program for which there is no working model. Advocates and providers for the disabled are unanimous in their fear that it would be a disaster. If they messed up MGT Push, how is this crew going to implement a program like this, which is MUCH more complicated.

Comment by phoebe Sunday, Feb 21, 10 @ 6:47 pm
Generally I am not a great fan of Medicaid managed care because some of the HMO companies involved are Medicaid only and pretty low quality. However, if you were to try to save money in the Medicaid program, this is the only place to go. Of course the savings come out of the tail of the very politically powerful nursing home industry, and it looks like the Chicago nursing homes got a pass - amazingly. Integrated care can be a very good thing. Leroy is wrong. There are several states with managed care for persons with disabilities eg. Arizona.
While HMO care makes no sense in Medicaid for children and healthy adults as there is really no overutilization with the current rate structure, there are areas for seniors and the disabled that do have overutilization - eg. group pysch, nursing homes, some transportation and some hospital due to lack of care coordination. It will be interesting if the advocates and nursing home guys team up to kill this.

Comment by omg Sunday, Feb 21, 10 @ 8:23 pm