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The Associated Press has learned that private Illinois nursing homes are fronting $300 million for residential care because the state is so far behind on determining whether they’re eligible for Medicaid.

Numbers compiled by state Comptroller Susana Mendoza and obtained by the AP show the state has a backlog of 15,000 people who are awaiting Medicaid eligibility determinations. The backlog has nearly tripled since August 2014.

A judge in a federal lawsuit ordered the state to clear up the backlog by Thursday or presume everyone is eligible and put up the state’s Medicaid share of $300 million.

Unbelievable.

*** UPDATE *** Excerpt from the comptroller’s press release…

The Comptroller’s report, which uses Department of Healthcare and Family Services (HFS) data, found that the number of pending Medicaid eligibility determinations for LTC over 90-days-old rose 143 percent between December 2017 and May 2018. HFS has reported it can only process 60 percent of new, incoming applications in a timely manner and, as of the end of last month, there were 16,378 pending admissions. According to the Associated Press, the estimated cost of these pending admissions is up to $300 million.

These problems are occurring at the same time the Rauner Administration continues to dump tax dollars into a failed technology solution meant to streamline Medicaid eligibility processes. The state has committed $288 million to Deloitte, the global consulting firm, for an Integrated Eligibility System (IES) to modernize enrollment in benefit programs like LTC or the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps.

In six years, the cost of the Deloitte IES has doubled from $144 million to nearly $300 million. The IES has been plagued by public failures that have stopped or delayed critical services for eligible, needy families. And the cost continues to rise: Earlier this month, HFS issued an emergency request to outsource its application processing duties. The cost will likely exceed $14 million over the next two years.

The full report is here.

posted by Rich Miller
Thursday, Jun 28, 18 @ 2:04 pm

Comments

Phase II IES not being ready and faulty
Loss of Caseworkers b/c of Rauner
Only so many overtime hours
Equals
Our current backlog
Oh and the failure of management
To manage any of it

Comment by Honeybear Thursday, Jun 28, 18 @ 2:15 pm
This what you get when you force the workforce to collapse.
We’re down 35% at our DHS office

Comment by Honeybear Thursday, Jun 28, 18 @ 2:16 pm
Yep. When I signed the kids up for Allkids, took over 4 months to get it. But before that, they had to be on medicaid even though we weren’t eligible. I told them we weren’t eligible. They said we were, so the kids were on medicaid for a few months, then they kicked us off because we weren’t eligible (like I told them). But the worst part was, the letter that said we are going to be losing benefits on such and such date arrived 3 weeks after that date. Then had to reapply to get Allkids. Oy. Dealing with DHS in Illinois is generally awful.

Comment by Ducky LaMoore Thursday, Jun 28, 18 @ 2:23 pm
Imagine how bad it would be if Rauner hadn’t hired all of those “superstars”.

Comment by Anonymous Thursday, Jun 28, 18 @ 2:27 pm
If Rauner can figure out how to get any or all that $300 million that backlog will shrink overnight. /s

Comment by don the legend Thursday, Jun 28, 18 @ 2:28 pm
At the risk of doing some math…roughly 600,000 folks on Medicaid in IL…15,000 backlog is 2.5% of the population. Considering the change in policy of automated Medicaid rede’s…this number seems pretty reasonable at any given point in time. I realize that it is easier to quip, but the numbers listed don’t support the comments themselves.

Comment by Mod Dem Thursday, Jun 28, 18 @ 2:54 pm
One person’s “sorry state” is another’s “something to brag about.” https://capitolfax.com/2018/06/22/rauner-brags-hes-dramatically-reduced-medicaid-enrollment-but-hit-on-failing-computer-system/

Comment by Anonymous Thursday, Jun 28, 18 @ 2:55 pm
Sorry - 2:55 was me.

Comment by Earnest Thursday, Jun 28, 18 @ 2:55 pm
===15,000 backlog is 2.5% of the population===

Um, no. A much more accurate gauge would be of the Medicaid-covered nursing home population.

Comment by Rich Miller Thursday, Jun 28, 18 @ 3:06 pm
Good for the judge. Make them all eligible till the state can figure out who really is. Why punish innocent because of state incompetence

Comment by DuPage Saint Thursday, Jun 28, 18 @ 3:13 pm
===Earlier this month, HFS issued an emergency request to outsource its application processing duties.===

Is there no end to the good news for the Rauner camp?

Comment by Cubs in '16 Thursday, Jun 28, 18 @ 3:27 pm
…”beacause of state incompetence” is such a lazy phrase.

As Honeybear points out it may be a large case of doing the best you can with what you have.

Elected officials and candidates that blindly say government is the problem and not the solution rarely take the time (and usually don’t want to)to find out why such backlogs exist.

We, the electorate, also let them get away with this easy out and we inevitably get the services we deserve.

Comment by don the legend Thursday, Jun 28, 18 @ 3:32 pm
Honey Bear- actually this is what you get when nearly 35 percent of all state revenue needs to go to pensions

Comment by Sue Thursday, Jun 28, 18 @ 3:34 pm
“- Rich Miller - Thursday, Jun 28, 18 @ 3:06 pm:

===15,000 backlog is 2.5% of the population===

Um, no. A much more accurate gauge would be of the Medicaid-covered nursing home population.”

Rich is spot on here. Yet another way to put into perspective what this means for providers and residents… the full pool of funding for Medicaid long term care residents is approximately $1.4 billion. The backlog of delayed determinations represents about $300 million. That is a cost of care entirely covered by providers with no guarantee they’ll ever be paid for the care they provided. If a resident dies or moves to another state and doesn’t follow through with the Medicaid application, the provider will never see payment.

Comment by NoUseForAName Thursday, Jun 28, 18 @ 3:34 pm
Oh Sue there you are! Back to the actual subject, pray tell how this is not another example of fundamental mismanagement? Not enough seniors at risk or are the wasted dollar totals not meeting your threshold?

Comment by Sonny Thursday, Jun 28, 18 @ 3:40 pm
ModDem - In IL there are just over 80,000 people in nursing homes and on average over half are Medicaid covered. It fluctuates month to month so 15,000 represents 25-30%.

Comment by Hoping for Rational Thought Thursday, Jun 28, 18 @ 3:41 pm
Rauner’s IT upgrade was pinstripe patronage at its finest. I wonder if and when JB hammers them on it.

Comment by The Dude Abides Thursday, Jun 28, 18 @ 3:54 pm
IES has added to the problem however this was an issue in 2013 and has continued to grow. Legislation in 2014 required the state to report the number of backlogged cases monthly. Until that time the state didn’t know how bad the problem was!

Comment by Hoping for Rational Thought Thursday, Jun 28, 18 @ 4:05 pm
==actually this is what you get when nearly 35 percent of all state revenue needs to go to pensions=

Ahh, the same old song and dance. We’re back to the “it’s all those evil public employee’s” fault nonsense.

Comment by Demoralized Thursday, Jun 28, 18 @ 4:06 pm
==actually this is what you get when nearly 35 percent of all state revenue needs to go to pensions==

Do you write for the Tribune. That sounds a lot like their silliness in blaming all of the state’s woes on unions.

Comment by Demoralized Thursday, Jun 28, 18 @ 4:07 pm
Sue are you paid to be like this
or do you do this cause you like it?
You are quite simply caustic.

Comment by Honeybear Thursday, Jun 28, 18 @ 4:12 pm
Honrybear,

Remember before IES Phase 2 implementation, how worried you were that the new system would automate caseworkers out of existence?

We State programmers knew that the new system (if it worked correctly) would actually increase workload for caseworkers. We told Deloitte that this would happen and the response was that they expected about 50% of the caseworkers would retire or quit out of frustration and caseworker jobs could then be outsourced.

The additional bugs you have discovered in IES have only made the frustration greater, maybe driving 75% out of their jobs.

See the current $14 contract that is out there to outsource your work.

It’s not a bug, it’s a feature.

Comment by Me Again Thursday, Jun 28, 18 @ 4:13 pm
$14 million

Comment by Me Again Thursday, Jun 28, 18 @ 4:15 pm
And there are real consequences to all this. Nursing homes are caring for these people with zero payment but they can’t cover the care needed outside the home. From the Koss v> Norwood order:

“Koss’ declaration shows that the risk became a reality for her. She avers that while her
application for long-term care Medicaid benefits was pending, she lost her eyesight because her ophthalmologist hadn’t been paid and wouldn’t give her needed eye injections (she was unable to find any medical provider who would help her).”

The state’s negligence and failure to comply with federal Medicaid deadlines is not just about late payments…

Comment by Hoping for Rational Thought Thursday, Jun 28, 18 @ 4:19 pm
The Rauner administration has known about this problem since 2015 and has done nothing to fix it. Countless meetings were conducted with his staff (Felicia Norwood, James Dimas, Jennifer Hammer, Fred Flather just to name a few). They all denied the problem and didn’t lift a finger to help citizens of the State. His administration has a distain for elderly Medicaid recipients, and providers of their health care.

Comment by Advocate Thursday, Jun 28, 18 @ 4:28 pm
Sue, nowhere near 35 percent of the State’s budget goes to pensions. The most commonly used figure is 25 percent for pensions AND debt service.

Comment by Arthur Andersen Thursday, Jun 28, 18 @ 5:25 pm
AA- last FY it was just above 30. Google it

Comment by Sue Thursday, Jun 28, 18 @ 5:48 pm
IES big mistake and I deal with problems all day due to poor judgment and poor insight. To Rauner it is an excuse to show that state employees are worthless, lets replace them.

Cannot wait till the election I just hope folks see what is really going on.

Comment by cler dcn Thursday, Jun 28, 18 @ 6:34 pm
Are there no prisons?

Are there no workhouses?

So, who’s cool that your taxes are automatically deducted from your paycheck, but BTIA(TM) is either so profoundly incompetent or so morally bankrupt that your money actually doesn’t go where you know it needs to?

To take care of the folks?

* Great governing…

Great reporting. Way to hit, O’Connor.

Comment by wordslinger Thursday, Jun 28, 18 @ 7:45 pm
@Sue-The debt exists because politicians from both parties failed to pay the bills in the name of low taxes and you bought that nonsense and now you are going to pay the piper just like everyone else.

You are welcome.

Comment by JS Mill Thursday, Jun 28, 18 @ 8:39 pm
Wide awake at three a.m. Sue seems to be a lost bitter bitter human being. I’ll pray for her to somehow, somewhere to find peace within herself.

Comment by cc Friday, Jun 29, 18 @ 3:06 am
Stuff happens

Comment by Rabid Friday, Jun 29, 18 @ 6:37 am