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* Interesting…
Federal Judge Joan Lefkow just ordered IL state govt to reimburse Cook County hospitals for Medicaid payments during budget impasse
— Tony Arnold (@tonyjarnold) July 23, 2015
Question still remains about whether hospitals outside Cook County will be reimbursed for Medicaid
— Tony Arnold (@tonyjarnold) July 23, 2015
As of yesterday, about 60 percent of the state budget was being spent without specific FY16 appropriations. This’ll add another big chunk.
…Adding… Background from WBEZ…
Some hospitals serving low-income communities are in imminent danger of closing, according to Shriver Center’s court filing. The filing further states that If those hospitals close because of the state’s failure to pay bills, it would violate a decade-old court order. The Shriver lawyers argued that order requires the state to complete Medicaid payments to hospitals in Cook County, even though Gov. Bruce Rauner and lawmakers have not approved a spending plan authorizing the state to reimburse those hospitals.
The court filing specifically named The New Roseland Community Hospital. It said delayed payments “will force Roseland Community Hospital, in less than a week, to begin the process of closing its hospital.” Roseland Community Hospital is dependent on the Medicaid program for 71 percent of its funding and it anticipates a $2 million shortfall in July and a $2.4 million shortfall in August, according to the Shriver Center’s filing.
Roseland Hospital said in a written statement that it has enough funding to make payroll on July 31st and it will be implementing a voluntary furlough, layoffs and service line suspensions before August 1.
“The families of those who are going to die because of this political budget impasse will not give a damn about party lines,” said Tim Egan, New Roseland President and CEO, in an emailed statement. “Just as bullets don’t recognize political boundaries, grieving families, critically injured patients and an abandoned community will not care about Republicans or Democrats. They will just know that the State of Illinois failed them. And the State of Illinois will have failed the New Roseland Hospital, its patients and its employees over a political stalemate.”
The Illinois Department of Healthcare and Family Services is a named defendant in the lawsuit. John Hoffman, a spokesperson for the department, said in response to the filing, “While we believe this motion incorrectly interprets the consent decree, this does highlight the importance of the General Assembly passing a balanced budget so our most vulnerable citizens will know they can continue receiving the care they need in the long run.”
…Adding More… Illinois Hospital Association…
“IHA and the hospital community appreciate the action taken by the Shriver Center seeking to assure access to health care services for Illinoisans who are insured by the Medicaid program – children, seniors, families and persons with disabilities. Access to health care should not be a bargaining chip in the budget debates in Springfield. Just like state employees, physicians, nurses, pharmacists, aides and other health care workers need to be paid during the budget impasse. IHA continues to urge legislators on both sides of the aisle and the Governor to find a reasonable and workable state budget solution so Illinoisans are able to receive the health care they need.”
posted by Rich Miller
Thursday, Jul 23, 15 @ 10:12 am
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I recall President Cullerton saying back in May that the Governor does not understand that a lot of spending would continue to happen in the absence of a budget. Seems to be more spending than even Cullerton anticipated. Before long, the state will be spending more money via continuing approp and court order than it is collecting.
Comment by SAP Thursday, Jul 23, 15 @ 10:16 am
@EditBoardChick - the “judicial budgeting” by Governor Rauner should be celebrated. Judges own the budget. Simple #ShillSpinOfTheDay #ObjectionOverruled
Comment by Oswego Willy Thursday, Jul 23, 15 @ 10:19 am
I’m curious. There doesn’t appear to be anything in the Illinois Constitution that says money cannot be spent in the absence of a budget. I’m no legal scholar, so I may be wrong or simply missing it, but I suspect that’s why the courts are loathe to take this on. In the absence of Constitutional language, a solution to this mess practically requires legislating from the bench.
Comment by 47th Ward Thursday, Jul 23, 15 @ 10:20 am
Yep.
It’s “Judicial Budgeting”
But Rauner called the courts and the Supreme Court here in Illinois… Well, we all know, don’t we?
Comment by Oswego Willy Thursday, Jul 23, 15 @ 10:22 am
Without a budget authorizing spending why is the state permitted to collect revenues. Just saying.
Also, before long, if this keeps up, we will have to ask the serious question of why do we need a legislative branch when their primary function has been usurped by the courts? How much could we save?
Comment by old-pol Thursday, Jul 23, 15 @ 10:24 am
This is getting bizarre. At what point do we just not have a budget for the year?
Comment by Ducky LaMoore Thursday, Jul 23, 15 @ 10:25 am
We may soon have a budget that matches revenue. It will be interesting to see what ends up on the cutting room floor and how well many things function over time, and what doesn’t.
Comment by Cassiopeia Thursday, Jul 23, 15 @ 10:26 am
Budgets are for losers. Rauner never loses so we’re trapped in a vicious circle.
Comment by How Ironic Thursday, Jul 23, 15 @ 10:29 am
Now it has become a matter of life and death.
End the games and pass a budget.
Comment by ananamous Thursday, Jul 23, 15 @ 10:32 am
== Also, before long, if this keeps up, we will have to ask the serious question of why do we need a legislative branch when their primary function has been usurped by the courts? ==
For that matter, why do we need an actual Governor since he doesn’t seem to be administering the State? Given our experiences with Blago, Quinn and now Rauner, maybe we should make the Gov office strictly a ceremonial job without the veto or administrative powers, eliminate the LT Gov position, and create a hired “State Manager” position to do the actual administrative work.
That’s a CA I could get behind. It may well get better results than the last 12 years ….
Comment by RNUG Thursday, Jul 23, 15 @ 10:34 am
old: Statutes imposing taxes, fees, penalties, etc allow the state to collect revenue. Budgets (and court orders) allow the state to spend money.
Comment by SAP Thursday, Jul 23, 15 @ 10:34 am
Who needs a budget when Judges keep allowing unauthorized budget expenditures. And just a note Judge Lefkow was a Clinton appointee.
Comment by CB Thursday, Jul 23, 15 @ 10:36 am
As Rich pointed out yesterday, if Medicaid is off the table, the $5 billion shortfall in anticipated FY16 spending has to come out of a $7 billion pot comprised mostly of social service grants, higher ed and group insurance.
You going to shut down social service providers in every legislative district? Decimate Catholic Charities? Start layoffs at every public university? Go without insurance?
Nobody can take that heat.
This scatter-brained “strategy” will end not with a bang, but a whimper.
Comment by Wordslinger Thursday, Jul 23, 15 @ 10:37 am
===…Judge Lefkow was a Clinton appointee.===
This matters… Why?
Comment by Oswego Willy Thursday, Jul 23, 15 @ 10:38 am
=pass the budget=
More like, Rauner sign the budget.
Comment by Hedley Lamarr Thursday, Jul 23, 15 @ 10:39 am
That’s why I think that Governor Rauner’s budgetary endgame is nothing more or nothing less than a change to “autopilot” programs.
That’s the fight at the federal level. It’s going to eventually become the fight at the state level.
I truly think that Governor Rauner would’ve had a much easier time with that fight than he is with his “turnaround agenda” scuffles.
Comment by Team Sleep Thursday, Jul 23, 15 @ 10:48 am
Rich? Let’s have some outrage about an *official* spokesperson (CEO & President), comparing the budget standoff with people’s literal deaths. Doesn’t that seem way, way over the top and unncecessarily cruel to family members of the hospitalized? And does anyone really believe people will be allowed to die? This speaker was not a worked-up, emotional, hyperbolic *retired* speaker at a rally. It was a considered, writen email by a professional businessperson. Come on…let’s show some proper outrage!
Comment by Contraire Thursday, Jul 23, 15 @ 10:49 am
Contraire, did we miss the statement about ISIS storming the hospital? Weak sauce.
Comparing the two situations is utterly goofy. Keep commenting on yesterday. It’s a better place for you.
Comment by A guy Thursday, Jul 23, 15 @ 10:55 am
==47th Ward - Thursday, Jul 23, 15 @ 10:20 am:
There doesn’t appear to be anything in the Illinois Constitution that says money cannot be spent in the absence of a budget. ===
See Sections 1(b) and 2(b) of Article VIII of the Illinois Constitution. Section 1(b) limits the ability of the state to make payments from public funds only as provided by law. Section 2(b) requires a law to make appropriations for all expenditures of state funds.
Comment by doh Thursday, Jul 23, 15 @ 10:57 am
Old Pol — medicaid is an agreement with the feds and their rules come first. The court is not usurping anything.
Comment by liberty Thursday, Jul 23, 15 @ 10:57 am
It is important to remember and remind all that it is the Governor’s job to propose a budget. I think we all can see how Rauner feels about governing.
Comment by Anon Thursday, Jul 23, 15 @ 10:57 am
Contrire - So exactly what are the consequences of a hospital losing 71% of its revenue? Hospitals are in the business of saving lives. A 71% reduction in revenue would clearly impact that business. If GM suddenly lost 71% of its revenue it would be logical to assume that they couldn’t produce cars. Why would this be an different? In short, I’m failing to see the outrage.
Comment by pundent Thursday, Jul 23, 15 @ 10:58 am
And others who are owed by the State? Will suits be filed on that issue? How will judges rule?
This judicial decision does open a whole new set of issues and questions
Comment by Federalist Thursday, Jul 23, 15 @ 11:03 am
Perhaps the better question is why Cook County is in the hospital business in the first place.
Comment by Team Sleep Thursday, Jul 23, 15 @ 11:04 am
CB - your comment about Clinton made me smile. I love to joke that Clinton was the third best Republican President this country ever elected. Right after Abe and TR… But that’s not fair to the more progressive Republican Presidents. Clinton is highly overrated. He gave us banking deregulation; which we all know how well that has turned out. He also gave us welfare reform… And that has contributed to the plight of working poor. The employer doesn’t have to pay a living wage, the minimum wage doesn’t need to be raised because the employer has a captive workforce. Work for what I tell you to work for or you and your family go hungrier. I would not call DINO Clinton a good President at all.
Comment by Triple fat Thursday, Jul 23, 15 @ 11:06 am
A bit off topic, but aren’t we also getting close to a, pardon the expression, fiscal cliff for the non-salary line items in the agencies? Unless I’m mistaken, most of the agencies under the Governor received funding on the pie-chart for payroll only. It’s hard to run DoC without food service, ISP without gas for the squad cars, the light bill everywhere, yada yada yada.
Comment by Arthur Andersen Thursday, Jul 23, 15 @ 11:08 am
Can we get a court to appoint a guardian for the state? Clearly, we need some supervision by an adult.
Comment by Norseman Thursday, Jul 23, 15 @ 11:12 am
== Can we get a court to appoint a guardian for the state? ==
Maybe a defacto “State Manager”?
Comment by RNUG Thursday, Jul 23, 15 @ 11:15 am
“why do we need a legislative branch?” The legislative branch represents the voters’ wishes. The guv does not seem to think he needs to represent the voters after he is elected.
Comment by Mama Thursday, Jul 23, 15 @ 11:16 am
Thanks Doh, I read those too, but they sure seem to be vague enough to invite a challenge. Looks like the courts are taking them one at a time. How long until ISU sues to get paid?
I’m also kind of surprised no one has filed a taxpayer suit against the state to stop collecting taxes in the absence of a budget for FY16.
Comment by 47th Ward Thursday, Jul 23, 15 @ 11:16 am
Team Sleep: It’s Cook County hospitals, not Cook County Hospital.
Comment by wendy Thursday, Jul 23, 15 @ 11:18 am
Au contraire Contraire.. (is that right? Lol!) It’s is you who needs to get up to speed on the very real consequences of decimating the safety net in very vulnerable communities. Unfortunately, this mess will cause very real consequences and yes some of them are life and death. That’s not hyperbole. It’s true.
Comment by sideline watcher Thursday, Jul 23, 15 @ 11:18 am
Wendy - duly noted, but Cook County does own and thusly operate John Stroger Jr. Hospital. I believe that is one of the largest hospitals in Illinois (if not the largest) and is one of the largest public hospitals in the country.
Comment by Team Sleep Thursday, Jul 23, 15 @ 11:21 am
“As Rich pointed out yesterday, if Medicaid is off the table, the $5 billion shortfall in anticipated FY16 spending has to come out of a $7 billion pot comprised mostly of social service grants, higher ed and group insurance.” Does the “group insurance” include the retiree’s group insurance or current employees only? Retirees 65 & older have different ins than the workers.
Comment by Mama Thursday, Jul 23, 15 @ 11:26 am
When is someone going to file a lawsuit to raise tax’s?
Comment by Anonymous Thursday, Jul 23, 15 @ 11:33 am
Norseman, it looks like the state will be purchasing on credit, and just shovel the debt on top of the rest.
Comment by PolPal56 Thursday, Jul 23, 15 @ 11:34 am
= Does the “group insurance” include the retiree’s group insurance or current employees only? Retirees 65 & older have different ins than the workers. =
It includes group insurance for both current employees and retirees, as well as their dependents.
Comment by cover Thursday, Jul 23, 15 @ 11:34 am
Still waitin’ Rich!
Comment by ~Contraire Thursday, Jul 23, 15 @ 11:38 am
Contraire;
Feel free to show your own outrage and/or start your own blog where others can tell you what to do.
Comment by Tommydanger Thursday, Jul 23, 15 @ 11:41 am
“This is getting bizarre. At what point do we just not have a budget for the year?” Ducky Lamoore @10:35 am
Respectful correction. Illinois has been bizarre for the 30 years I have been paying attention. It is getting more bizarre.
And this can keep going on until the kettles of money dry up and the lenders finally say “No.”
Perhaps, the federal and state judiciary is doing us a favor by slowing down the necrosis and making room for a yet unknown individual or group of individuals to find the words that a majority of Illinoisans will understand and finally comprehend that the State is in big trouble.
Comment by Anonymous Thursday, Jul 23, 15 @ 11:45 am
Team Sleep: Yes. Do you really think it should not exist? Do you think that other hospitals would just pick up all their inpatients, and do their outpatient care? The U of C Hospital won’t even do Level 1 trauma care.
I am admittedly affected by my personal experience: my daughter was fortunate enough to have been taken to Stroger and treated in their Head Trauma Unit when she fractured her skull. They saved her. She would not be the person she is today had she been in any other hospital in the area. Stroger has the volume of patients necessary to offer highly specialized care that is not available in most community hospitals, and has a patient population that is not welcomed — certainly not in that volume — elsewhere.
Comment by wendy Thursday, Jul 23, 15 @ 11:49 am
–I’m also kind of surprised no one has filed a taxpayer suit against the state to stop collecting taxes in the absence of a budget for FY16. –
Most taxes are imposed by already existing law, so I don’t think there’s a basis for such a lawsuit. Even without a budget, the law says you have to remit taxes.
Comment by the Other Anonymous Thursday, Jul 23, 15 @ 11:49 am
Trump is a walking lesson in hyperbole.
Comment by PolPal56 Thursday, Jul 23, 15 @ 11:49 am
Team Sleep, many Illinois counties have public hospitals. What’s your point?
Comment by PolPal56 Thursday, Jul 23, 15 @ 11:51 am
Since Rauner refuses to govern, it seems the courts have taken on the responsibility. The more often this happens, the more his own status is diminished in my opinion. We expect more from the top state official, not just trash talk.
Quinn would say the most ridiculous things, but at least he did his job.
Comment by Wensicia Thursday, Jul 23, 15 @ 11:57 am
Roseland hospital should have closed years ago. They currently owe the state $4 million. These are the same folks who claimed they were going to close last year because the state was late paying when the state had actually already advanced them money. They fired their CEO after that fiasco
Comment by LTSW Thursday, Jul 23, 15 @ 12:02 pm
Arthur Anderson @ 11:08, you are right. As a state employee, I am relieved that I’m still being paid (at least for now), but if a budget agreement is months away, that could severely hamper my ability to do my job. What happens when we run out of money for basic office supplies? When a fax machine or copier breaks down and we need to buy a new one or pay someone to fix the old one? A budget needs to be passed, and soon.
Comment by Curious Georgina Thursday, Jul 23, 15 @ 12:15 pm
=== Arthur Anderson @ 11:08, you are right. As a state employee, I am relieved that I’m still being paid (at least for now), but if a budget agreement is months away, that could severely hamper my ability to do my job. ===
Just wait until your medical providers start screaming about not being paid.
Comment by Norseman Thursday, Jul 23, 15 @ 12:17 pm
Then again, the genius Sandack said not to worry because “The sun will rise tomorrow.” Except for some of these patients, it won’t without the state living up to it’s responsibilities.
Comment by Michael Westen Thursday, Jul 23, 15 @ 12:22 pm
Norseman, that too.
Comment by Curious Georgina Thursday, Jul 23, 15 @ 12:23 pm
Part of the “very steep learning curve” for Rauner, which commenters here warned of early on, was the complexity of the legal and Federal constraints on managing state spending. Many things cannot simply be cut at will, which the courts will confirm when asked.
Executive management in state government is often more difficult than in big business.
Comment by walker Thursday, Jul 23, 15 @ 12:32 pm
Taking away the pressure points to have a budget, just makes it more likely there won’t be a budget. Pretty soon we’ll be just like the federal government, and we all know how bad they are with budgeting.
Comment by Just Me Thursday, Jul 23, 15 @ 12:46 pm
PolPal56 - maybe government bodies shouldn’t be involved in the hospital business.
Comment by Team Sleep Thursday, Jul 23, 15 @ 12:54 pm
Rauner “is governing”, by not capitulating to an unbalanced budget. Clever of Cullerton to suggest they start over with Rauner “introducing a balanced budget” - but the “duty to pass a balanced budget” is the legislatures. I think “duty to pass” is more important than “duty to introduce”.
Comment by old-pol Thursday, Jul 23, 15 @ 12:56 pm
Budgeting one court order at a time is a supremely poor plan. Each judge only reviews a small sliver of the budget and political pressure makes it near impossible to turn a thumb’s down. Needs to be done holistically, via GA and Guv.
Comment by SAP Thursday, Jul 23, 15 @ 1:13 pm
Medicaid providers must be paid but perhaps an emergency rule could be filed to reduce rates. This seems to be one move that could be used in the short term (how fast can provider organizations file lawsuits not just to give them a right to be paid but also to stipulate the amounts they will be paid for services provided).
Last week, there was testimony from state human service agencies about increasing the DON scores so that only lower functioning persons can be served by these agencies. As the move to increase DON scores is already law, how fast can these agencies move to implement these reassessments changes?
Comment by Illinois law Thursday, Jul 23, 15 @ 1:24 pm
=== Clever of Cullerton to suggest they start over with Rauner “introducing a balanced budget” ===
Ugh. Article VIII, Section 2(a).
Comment by Oswego Willy Thursday, Jul 23, 15 @ 2:10 pm
When a governor abdicates his budgetary responsibilities, then the government continues without a budget, just as it has been continuing over the past decade without a governor.
Comment by VanillaMan Thursday, Jul 23, 15 @ 2:11 pm
Team Sleep, what is your alternative for the absolutely essential services these public hospitals provide?
Comment by PolPal56 Thursday, Jul 23, 15 @ 2:18 pm
So who is not getting paid? If everyone is getting paid, then why don’t they just go home? Let the state run on autopilot. If the proverbial fan hits the proverbial fan, Rauner will get blamed.
Comment by Tina Bopper Thursday, Jul 23, 15 @ 2:38 pm
JM, if Medicaid is off the table, that means 81 percent of anticipated FY16 spending is in the clear, based on Cullerton’s chart from yesterday.
Again, that leaves about $2 billion in remaining revenue for an anticipated $7 billion on social services, higher ed and group health.
What brilliant, superstar, leveragin’ strategery for a reactionary agenda that the governor doesn’t want to talk about and that has no legislative or public support.
FUBAR.
Comment by Wordslinger Thursday, Jul 23, 15 @ 2:47 pm
Norseman - medical providers are already screaming about not being paid Employee group medical claims are paid at least 31 weeks after the claim is processed. States’ self-insured plan even longer. Governor wants to take that to 14 months.
Tina - state employees were ordered to keep reporting to work whether or not they got paid. If you don’t work, you lose your job.
Comment by thoughts matter Thursday, Jul 23, 15 @ 7:40 pm
== States’ self-insured plan even longer. ==
Last I knew based on the paperwork I’ve been handling for my mom’s estate, the State’s self-insured plan (aka Cigna administrated) was running between 56 and 68 weeks behind. And if Rauner’s proposed $700M cut goes through, it will probably reach between 90 and 100 weeks.
Comment by RNUG Thursday, Jul 23, 15 @ 7:57 pm