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A slow-motion disaster

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Illinois

* Stefano Esposito in the Sun-Times…

A federal judge in Chicago says the state of Illinois’ plan to boost wages for caregivers who work with the developmentally disabled falls “woefully short” of what’s required under a 7-year-old court decree.

U.S. District Judge Sharon Johnson Coleman ordered state lawyers this week to come up with a better “long-term” plan to comply with the 2011 consent decree.

Coleman called the state’s proposal “a reasonable start,” but she wrote she “doubts that the proposal is adequate to address the issue of wages, staffing and retention.”

The judge’s order was the latest ruling stemming from the consent decree requiring the state Department of Healthcare and Family Services and Department of Human Services to provide adequate funding for people with developmental disabilities who want to live in an independent community setting.

“We are very pleased with the court’s decision rejecting the state’s plan for coming into compliance with the consent decree,” said Barry C. Taylor, an attorney with Equip for Equality, an advocacy group for the disabled that is among those suing the state. “This decision puts plaintiffs a step closer to realizing the promise of the consent decree: to receive services that allow them to become active, engaged and included members of their communities,”

* From a reader via e-mail…

Rich I know everything is about Tim Mapes but this ongoing saga in federal court - with the state in non-compliance for the Ligas Court Decree - continues to show a lack of commitment to people with intellectual and developmental disabilities.

What this really means is a weakened community provider system and forced reliance on more expensive state operations.

With an estimated difference of residential care in the community being $80k to State operations at $250-$300k; AND the Medicaid system computer disaster losing matching funds after dropping an estimated 150,000 eligible recipients - we are choosing an expensive, inefficient and now not paid for by the feds option.

You have Dir. Norwood leaving while the HFS Medicaid computer system to be fixed; you have a federal court saying DHS/DD has an insufficient plan for supporting people with disabilities.

The court order is here.

* From an analysis by the Institute on Public Policy for People with Disabilities…

The Judge acknowledged the argument made by Plaintiffs and the Court Monitor, supported by data from the Institute, that the wage proposal was particularly inadequate in Chicago where minimum wage will rise to $12/hour on 7/1/18. Judge Coleman acknowledges that DSP wages were originally nearly twice as high as minimum wage and that gap has eroded since the inception of the CILA program. She acknowledges the State may not be able to raise current wages to that level, but “…this Court hesitates to affirm the devaluing of the role of caregivers for some of the more vulnerable members of society. At the same time, this Court is not in the position to act as super-legislator by dictating how the State should allocate funds and administer its budget.”

The Order further states that “it has been nearly seven years since the entry of the Consent Decree and this Court sees no end to the Court’s oversight.” The Order recommends convening a work group that includes the Monitor and other independent stakeholders to study DSP wages, the overall CILA and ICFSS rate methodologies and develop monitoring tools to assess the adequacy of services, funding and administration. The Order notes that ideally the monitoring tool would include an independent review component. The Court also agrees with the Court Monitor’s recommendation regarding expeditiously developing criteria for moving people off the PUNS list at a reasonable pace.

The final statement of the Order puts the onus for developing a solution to the problems it identified on the parties, acknowledging the Court’s lack of expertise and budgetary authority to impose measures to the resolve the issues outlined in the Order. Parties will return to Court on July 10, 2018 to discuss the Order.

posted by Rich Miller
Friday, Jun 8, 18 @ 9:42 am

Comments

–What this really means is a weakened community provider system and forced reliance on more expensive state operations.

With an estimated difference of residential care in the community being $80k to State operations at $250-$300k; AND the Medicaid system computer disaster losing matching funds after dropping an estimated 150,000 eligible recipients - we are choosing an expensive, inefficient and now not paid for by the feds option.–

That’s some brilliant management right there, fighting in court for an exponentially more expensive and outdated delivery system.

Comment by wordslinger Friday, Jun 8, 18 @ 9:46 am
As someone who works in this field, the truth is the state has avoided it’s basic responsibilities for decades and this has led to a waiting list of about 20,000 (yes 20,000) people waiting for any type of support service after they finish high school. This means thousands of families struggling to provide appropriate care after high school ends for their child, it means maybe losing a job for a caregiver, it means losing developmental progress gained in high school. This mess goes far beyond the waiting list. It means we continue to warehouse people in state centers that are more for union members than they are for the person with the disability. It means wasting dollars on outmoded management structure in the Department of Human Services, and it means not even filling needed positions at the state level. As the saying from the Bible goes: Without a vision the people perish. This is happening with our most vulnerable citizens.

Comment by NeverPoliticallyCorrect Friday, Jun 8, 18 @ 11:23 am
Wordslinger, I run a community disability organization and would be thrilled if residential rates were $80k on average.

However, while there is a significant difference between what the state pays itself in their operations vs community group homes, we should not give the impression to the legislature and others that the community is a less expensive alternative.

Illinois needs to rebalance the way it determines rates so that an individual receives sufficiently funded supports regardless of where they reside.

Comment by BobO Friday, Jun 8, 18 @ 11:51 am
“That’s some brilliant management right there, fighting in court for an exponentially more expensive and outdated delivery system.”

More like unintended consequences. If you can have robust community services at $10 instead of $13 you save money, obviously. Either is cheaper than residential. Question is how long can you keep that squeeze up before the system breaks and you start hurting patients AND costing the state more money. Think we’ve gone past that point by a long ways now.

Comment by Perrid Friday, Jun 8, 18 @ 3:42 pm