UPDATE ON LONG-TERM CARE REFORM
August 12, 2004
LEGISLATION:
After the Speaker's Summit on Senior Services held more than 30 hearings in the summer of 2003, Illinois seemed ready for long-term care reform. The Conference of Women Legislators adopted this issue as one of particular concern to women – as widows, adult family caregivers and professional caregivers.
With the participation of a large coalition of advocates, providers and nursing home industry representatives, the General Assembly passed two bills to advance this agenda:
- SB 2880 – Older Adult Services Act – SIGNED INTO LAW (Public Act 93-1031)
This comprehensive legislation is intended to transform the long-term care system, by first offering home and community-based services that will enable seniors to live independently and remain out of nursing homes as long as possible. The state will create a comprehensive statewide network of services for seniors and their families with a uniform name, logo, and toll-free number; will target funding to priority service areas where programs need to be expanded or developed; and will offer incentives to convert empty nursing home beds for community uses.
- HB 5057 – Community Reintegration Program or “Transition Services” – SIGNED INTO LAW (Public Act 93-902)
This legislation will create a program of “transition services” to help seniors move from nursing homes back into the community. The Department of Aging will develop rules for the program regarding resident eligibility; assessment of the resident's health, cognitive, social, and financial needs; development of comprehensive service transition plans; and the level of services that must be available prior to transition of a resident into the community.
BUDGET:
The priorities of the State are often reflected more in the budget than in substantive legislation. We believe that the final FY05 budget adopted on July 24 falls short in demonstrating the same spirit of long-term care reform for which we advocated all year. In summary, nursing homes will receive an additional $68 million this year, while Community Care Program line items were cut.
Nursing Homes
Despite a tough budget year, nursing homes are due to receive rate increases in 3 different ways: (1) an additional $27 million toward a 3% rate restoration, beginning in January for 6 months this fiscal year – costing $54 million next year; (2) an additional $5 million to restore a “bed-hold” policy that allows nursing homes to charge 75% of the daily rate for 10 days when the bed is empty due to temporary hospitalization of residents; and (3) an additional $36 million under HB 2220 that will allow insurance increases to be passed through on cost reports. NOTE: the total $68 million is 50% state dollars and 50% federal Medicaid reimbursement. Nursing homes were the only provider group that saw these kinds of rate increases in a very tough budget year that held up the budget process by a historic 54 days.
In addition, we voted on a “budget implementation bill” to make sure that nursing homes will automatically receive an additional 3% rate increase as a condition of the hospital assessment law under review by the federal government – in other words, there is a possibility that nursing homes will receive over $120 million this year.
Community Care and Reintegration
The Community Care Program, including homemaker services, adult day services and case management, was cut by 2.25% or $5.3 million from the Governor's introduced levels. The homemaker services line will actually see a decrease from FY2004 levels, in the amount of $3.5 million – although the Department of Aging is working to prevent service cuts.
On the last day of the budget cycle, we were able to add money for home delivered meals, putting that program $351,000 over the Governor's budget in order to eliminate waiting lists.
The Elder Abuse Program received an additional $1.5 million over the Governor's budget level to give local programs their first rate increase since the program began in 1989.
Despite an effort to create a line item of $2 million for a community reintegration program for seniors, we were able to secure a handshake agreement with the Governor's Office that an Intergovernmental Agreement will transfer the dollars from the Department of Public Aid to the Department of Aging.
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You will draw your own conclusions as to whether this is the hoped-for end to the major work that was accomplished during the year to redesign the long-term care system.
If you disagree with the result: (1) contact your own local Representative and Senator to discuss with them what a “balanced” system means for seniors, in both substantive legislation and appropriations; and (2) contact us if you would like to be part of a process to plan for a more balanced budget for next year. Thank you.
Rep. Julie Hamos
Rep. Sara Feigenholtz
