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Blog Posts from 2012

Welcome to the blog for Health & Medicine. We're a 33-year old 501c3 nonprofit that operates as an independent, freestanding center driven by a singular mission: formulating health policy, advocacy and health systems to enhance the health of the public.

2012

Nov 29, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG's Janna Simon (Stansell) Quoted in AP Article on Uninsured Patients Suing Swedish Covenant Hospital

Download article

 

CHICAGO(AP) — A lawsuit filed Thursday claims a nonprofit hospital in northwest Chicago failed to provide charity care to two low-income, uninsured patients, reopening a longstanding controversy in Illinois over whether hospitals aredoing enough charitable work to qualify for lucrative tax exemptions.

Swedish Covenant Hospital repeatedly lost one patient's financial assistance application and threatened to send her bill to acollection agency, according to the lawsuit. The hospital incorrectly told another patient she was ineligible for assistance and demanded cash from her, the complaint alleges.

Thepractices amount to "bureaucratic barriers" that prevent eligible patients from getting free care, according to the lawsuit, and the hospital has a policy of attempting to collect from "even the poorest of patients"through bill collectors and wage garnishment.

The hospital gets about $8 million in annual tax breaks and owes the community amore reliable charity care system, the plaintiffs' attorney Alan Alop of the legal services group LAF said ata press conference Thursday in Chicago. The lawsuit claims unfair practicesunder the Illinois consumer fraud law and seeks $50,000 in punitive damages anda change in hospital policy.

SwedishCovenant spokeswoman Leigh Ginther said Thursday she couldn't comment on the lawsuit, but she said every patient who is identified as uninsured isgiven an application for charity care and a personal explanation of the process.

"Itis the patient's responsibility to return the completed paperwork,"Ginther said. The hospital reported $6.2 million in charity care expenses last year, nearly 3 percent of its net revenue.

Nearly 2 million Illinois residents are uninsured, or about 15 percent. The state constitution, court decisions and state law require Illinois hospitals that receive tax exemptions to provide charity care, but until this year the definition of charity wasn't clear.

The lawsuit comes as Illinois Attorney General Lisa Madigan is writing new standards on hospitalcharity care as required by a law passed earlier this year.

A Chicago-based advocacy group, the Fair Care Coalition, wants Madigan to recommend that a standard, universal financial assistance application be used by all Illinois hospitals. The group also wants a thorough reporting mechanism so the public can check that hospitals are obeying the law, said Janna Simon of the coalition.

Read more


CHICAGO(AP) — A lawsuit filed Thursday claims a nonprofit hospital innorthwest Chicago failed to provide charity care to two low-income,uninsured patients, reopening a longstanding controversy in Illinoisover whether hospitals are doing enough charitable work to qualify forlucrative tax exemptions.

Swedish Covenant Hospitalrepeatedly lost one patient's financial assistance application andthreatened to send her bill to a collection agency, according to thelawsuit. The hospital incorrectly told another patient she wasineligible for assistance and demanded cash from her, the complaintalleges.

Thepractices amount to "bureaucratic barriers" that prevent eligiblepatients from getting free care, according to the lawsuit, and thehospital has a policy of attempting to collect from "even the poorest ofpatients" through bill collectors and wage garnishment.

Thehospital gets about $8 million in annual tax breaks and owes thecommunity a more reliable charity care system, the plaintiffs' attorney Alan Alopof the legal services group LAF said at a press conference Thursday inChicago. The lawsuit claims unfair practices under the Illinois consumerfraud law and seeks $50,000 in punitive damages and a change inhospital policy.

Swedish Covenant spokeswoman Leigh Ginthersaid Thursday she couldn't comment on the lawsuit, but she said everypatient who is identified as uninsured is given an application forcharity care and a personal explanation of the process.

"Itis the patient's responsibility to return the completed paperwork,"Ginther said. The hospital reported $6.2 million in charity careexpenses last year, nearly 3 percent of its net revenue.

Nearly2 million Illinois residents are uninsured, or about 15 percent. Thestate constitution, court decisions and state law require Illinois hospitals that receive tax exemptions to provide charity care, but until this year the definition of charity wasn't clear.

The lawsuit comes as Illinois Attorney General Lisa Madigan is writing new standards on hospital charity care as required by a law passed earlier this year.

A Chicago-based advocacy group, the Fair Care Coalition,wants Madigan to recommend that a standard, universal financialassistance application be used by all Illinois hospitals. The group alsowants a thorough reporting mechanism so the public can check thathospitals are obeying the law, said Janna Simon of the coalition.



Read more: http://www.newstimes.com/news/article/Uninsured-patients-sue-Chicago-nonprofit-hospital-4077774.php#ixzz2De8IseLh

HICAGO(AP) — A lawsuit filed Thursday claims a nonprofit hospital innorthwest Chicago failed to provide charity care to two low-income,uninsured patients, reopening a longstanding controversy in Illinoisover whether hospitals are doing enough charitable work to qualify forlucrative tax exemptions.

Swedish Covenant Hospitalrepeatedly lost one patient's financial assistance application andthreatened to send her bill to a collection agency, according to thelawsuit. The hospital incorrectly told another patient she wasineligible for assistance and demanded cash from her, the complaintalleges.

Thepractices amount to "bureaucratic barriers" that prevent eligiblepatients from getting free care, according to the lawsuit, and thehospital has a policy of attempting to collect from "even the poorest ofpatients" through bill collectors and wage garnishment.

Thehospital gets about $8 million in annual tax breaks and owes thecommunity a more reliable charity care system, the plaintiffs' attorney Alan Alopof the legal services group LAF said at a press conference Thursday inChicago. The lawsuit claims unfair practices under the Illinois consumerfraud law and seeks $50,000 in punitive damages and a change inhospital policy.

Swedish Covenant spokeswoman Leigh Ginthersaid Thursday she couldn't comment on the lawsuit, but she said everypatient who is identified as uninsured is given an application forcharity care and a personal explanation of the process.

"Itis the patient's responsibility to return the completed paperwork,"Ginther said. The hospital reported $6.2 million in charity careexpenses last year, nearly 3 percent of its net revenue.

Nearly2 million Illinois residents are uninsured, or about 15 percent. Thestate constitution, court decisions and state law require Illinois hospitals that receive tax exemptions to provide charity care, but until this year the definition of charity wasn't clear.

The lawsuit comes as Illinois Attorney General Lisa Madigan is writing new standards on hospital charity care as required by a law passed earlier this year.

A Chicago-based advocacy group, the Fair Care Coalition,wants Madigan to recommend that a standard, universal financialassistance application be used by all Illinois hospitals. The group alsowants a thorough reporting mechanism so the public can check thathospitals are obeying the law, said Janna Simon of the coalition.



Read more: http://www.newstimes.com/news/article/Uninsured-patients-sue-Chicago-nonprofit-hospital-4077774.php#ixzz2De7x00DV
Nov 16, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Update: Illinois’ Care Coordination and Managed Care System

The following is a blog originally posted on IllinoisHealthMatters.org by Kristen Pavle, Associate Director of the Center for Long-Term Care Reform at Health & Medicine Policy Research Group.

In January 2011, the Illinois legislature passed a bill that requires 50% of the State’s Medicaid population to be covered in a risk-based care coordination program by 2015. Subsequently, in May 2012, the State Legislature passed the SMART Act, cutting Medicaid services and projecting cost savings through various care coordination initiatives.

The care coordination, or managed care, initiatives referenced through this bill are: the Integrated Care Program, the Dual Eligibles Capitation Demonstration and the Innovations Program. All three of these initiatives have a goal to better coordinate primary, acute, behavioral health and long-term supports and services thereby improving the delivery of health services and lowering health costs.

The move to better coordinate care across primary, acute, behavioral health and long-term supports and services is in alignment with the federal Affordable Care Act (ACA), passed in March 2010. In fact, Illinois has made an effort to take advantage of several of the ACA provisions to move towards a better coordinated and integrated health system.

One of the ACA provisions Illinois is interested in is called Medicaid health homes for individuals with chronic conditions. To date, Illinois has filed a draft Medicaid state plan amendment to create health homes. The other federal ACA inititiave relating to care coordination that Illinois interested in is the Medicare-Medicaid Alignment Initiative, or the Dual Eligibles Demonstration Project. Illinois has submitted a proposal for this demonstration project.

For more details about the various care coordination, or managed care, initiatives in Illinois, please reference the document “Illinois Health Reform 2012: Care Coordination, Managed Care and Long-Term Services and Supports” developed by Health & Medicine Policy Research Group.

Kristen Pavle
Associate Director, Center for Long-Term Care Reform
Health & Medicine Policy Research Group

Nov 09, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois Health Matters Blog Post by Margie Schaps, Executive Director, Health & Medicine Policy Research Group

The Cook County Health & Hospitals System (CCHHS) 1115 Medicaid Waiver—what is CountyCare?

Last month the Cook County Health & Hospitals System received word from the Federal Centers for Medicaid and Medicare that their request for an 1115 Waiver to the Illinois Medicaid system had been conditionally approved, pending the State of Illinois officially accepting the “terms and conditions” of the Waiver.

So, as of right now, the expectation is that the State will make this official within the next couple of weeks.CountyCare, as the new Medicaid program will be known, has been provided for through the Affordable Care Act. CountyCare will allow the CCHHS to enroll tens of thousands of currently uninsured people into this Medicaid Program.

People can begin applying on November 5th by phone 312-8648200 or toll free at 855-6718883. Coverage will start January 1, 2013.This provides a great opportunity and enormous challenge for the health system to transform care by creating patient-centered medical homes rather than relying on expensive and inefficient use of emergency rooms.

The focus of the program will be primary care centric with all specialty care, diagnostic and inpatient services coordinated through the medical home.Eligible people include:

  • Live in Cook County
  • Be 19-64 years oldHave income at or below 133% FPL
  • Not be eligible for “state Plan” Medicaid
  • Not be eligible for Medicare
  • Be a legal immigrant for 5 years of more or a US citizen
  • Have a social security number of have applied for one

Not all doctors within the CCHHS system will be part of the network, and there will be many community health centers that will be part of the network (this list has not officially been released yet)

The CCHHS website has a list of answers to Frequently Asked Questions

Advocates, providers and patients still have unanswered questions, many of which have been submitted by us to the CCHHS leadership and consultants. We anticipate getting answers to these in the coming weeks and will provide updates to this blog post as we get the information.

Nov 07, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

CountyCare (State of IL 1115 Waiver)

“TheState of Illinois and Cook County Health & Hospitals System will beoperating a new Medicaid program for uninsured adults in Cook Countycalled CountyCare.   This is a Medicaid program throughthe Affordable Care Act (Healthcare Reform).  CountyCare will providecoverage for tens of thousands of currently uninsured patients, as CCHHStransforms into a patient-centered continuum of care. Thistransformation is changing the way that patients enter CCHHS, as theywill be assigned intelligently (based on risk, complexity and need) topatient-centered medical homes instead of relying on the emergencydepartment for basic services while waiting for new appointmentavailability. It is changing the way that care is delivered at theclinic site, as medical home teams built around primary care providerswill coordinate all services needed by their own panel of patients,supported by care management and information technology. It is changingthe way that services are delivered within the broader system, asemergency, specialty outpatient, diagnostic and inpatient services arereconfigured to assure that the care of patients is coordinated by theirmedical home and that they are returned there. It is changing the wayin which CCHHS works with other providers caring for similarpopulations, as new partnerships are being developed to assure adequateprimary care capacity, geographic accessibility to specialty andinpatient services and connections to services that CCHHS does notprovide itself.

The attached FAQswill be continually updated.  CCHHS is currently in the pre-enrollmentphase of 1115 waiver implementation.  There will be a controlled rollout of the application process.  As of today, the questions answered inthis document are based on the approved CMS Terms & Conditions,which HFS has 30 days to accept.   Therefore, please understand the FAQsare subject to change. Once the final Terms & Conditions arereceived, we look forward to working with the public on this waiver.”

 Download the FAQs

 

Nov 05, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

New Medicare Policy: Beneficiary No Longer Must "Improve", Now "Maintaining" Condition is Acceptable

For decades Medicare beneficiaries withlong-term needs due to chronic conditions and debilitating conditionswere denied care based on the "Improvement Standard." Care was onlyapproved to those whose conditions improved; care was not approved tomaintain current functioning levels.

As a result of the "Improvement Standard" case, Jimmo v. Sebelius, newpolicy provisions will state that skilled nursing and therapy servicesnecessary to maintain a person's condition can be covered by Medicare.

Thousands of Medicare beneficiaries stand to benefit from access toservices to help them maintain their current condition--many willreceive help in the community-based setting.

As baby boomers age, and the incidence of chronic conditions increases,this is welcome news. More care provided in a community-based settingthat allows individuals to remain functioning and healthy is better forindividuals' health, and the better for our health systems as a whole.

View more information on the Improvement Standard, and the related case. The Center for Medicare Advocacy has an easy to follow Question &Answer section to help you understand this Medicare change.

Nov 05, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Medicaid Primary Care to be Reimbursed at Medicare Rates


"Health care law delivers higher payments to primary care physicians"

Health and Human Services (HHS) Secretary Kathleen Sebelius todayannounced the final rule implementing the part of the health care lawthat delivers higher payments to primary care physicians servingMedicaid beneficiaries. The new rule raises rates to ensure doctors arepaid the same for treating Medicare and Medicaid patients and does notraise costs for states.

“The health care law will help physicians serve millions of Americansacross the country,” Secretary Sebelius said. “By improving paymentsfor primary care services, we are helping Medicaid patients get the carethey need to stay healthy and treat small health problems before theybecome big ones.”

The final rule implements the Affordable Care Act’s requirement thatMedicaid pay physicians practicing in family medicine, general internalmedicine, pediatric medicine, and related subspecialists at Medicarelevels in Calendar Years 2013 and 2014.

This payment increase goes into effect in January of 2013.

Get more information about today’s final rule

View a copy of today’s final rule

 

Oct 18, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Check Out Our Recent Presentation on Medicaid & Medicare "Dual Eligibles"

On Wednesday, October 17th, Kristen Pavle, Associate Director of the Center for Long-Term Care Reform at HMPRG, and Gayle Shier, Program Coordinator at Health & Aging at Rush University Medical Center gave a riveting presentation to The Chicago Bridge, an emerging aging professionals  group.  The presentation topic was on Medicare and Medicaid dually eligible beneficiaries and current policy changes in Illinois for this population.

Click Here to View the Presentation Matierials.

Oct 16, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Safe Moving and Lifting in Healthcare Conference - November 15th

Safe moving

Conference Overview
This conference will provide strategies and resources to design and sustain safe lifting programs in acute care, long term care, community and home care settings. Participants will:


• Discover why and how safe lifting and moving programs are cost-effective in reducing injuries
• Find successful, proven approaches for safe lifting and moving programs
• Share their profession’s role and expertise in safe lifting and moving
• Heighten their awareness of consumers’ perspectives, rights and strategies for safe moving
• Get hands-on experience evaluating equipment to resolve challenging situations
• Learn about the amended Illinois law on safe lifting and OSHA’s Special Emphasis Program for ergonomics in the nursing home industry

Location
Northern Illinois University
Conference Center
1120 East Diehl Road
Naperville, IL 60563

Who Should Attend
Administrators & Human Resource Managers in Health Care
Advocates for Independent Living
Healthcare Union Representatives
Nurses
Occupational Therapists
Physical Therapists
Social Workers
Ergonomists
Industrial Hygienists
Safety Professionals
Occupational Health Educators

Conference Co-Sponsors
Access Living
AFSCME Council 31
Health Care Council of Illinois
Health and Medicine Policy Research Group
Illinois Council on Long Term Care
Illinois Health Care Association
Illinois Occupational Therapy Association
Illinois Physical Therapy Association
Jesse Brown VA Medical Center
Joint Commission Center for Transforming
Healthcare
Metropolitan Chicago Healthcare Council
Northwestern Memorial Hospital
OSHA Region 5
SEIU Healthcare Illinois/Indiana
UIC School of Public Health
UIC University Health Service

Exhibitor Showcase
Vendors will demonstrate the latest equipment and assistive
devices for safe lifting and moving programs.

Continuing Education Credits
Continuing Education Units (.7) (7 contact hours) are provided by theUniversity of Illinois Department of Family Medicine in collaborationwith the Continuing Education Institute for nurses, nurse practitioners,nursing home administrators, occupational therapists and COTAs,physical therapists and PTAs, and social workers. The University ofIllinois will provide .7 CEs (7 contact hours) and pending approval, theAmerican Board of Industrial Hygiene will award 7.0 Industrial HygieneCM points for Industrial Hygienists. The University of Illinois willaward a certificate of attendance for 7 contact hours to SafetyProfessionals who attend the conference, which can be used to apply forBCSP recertification points. This program meets the guidelines for SHRM continuing education for SPHR/PHR recertification.

Conference Fee
$95.00 Fee includes continental breakfast,
lunch and a certificate of attendance.

Online Registration

Conference Questions:  Marsha Love. Conference Coordinator
(312) 996-9568

Download the Conference Agenda

Oct 16, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Medicare costs for beneficiaries lowered by Affordable Care Act

Medicarecosts for beneficiaries will be lower over the next 10 years as aresult of the Affordable Care Act (ACA).

According to a recentlyreleased Issue Brief from the U.S. Department of Health and HumanServices, the ACA will lower premiums, co-payments and co-insurance for Medicare beneficiaries.

The ACA lowers Medicare beneficiary costs by:
1. Reducing in extra subsidies paid to Medicare Advantage plans.

2. Reducing the rate of growth in provider payments.

3. Designing new financing options that support efficiency, coordination and quality; not quantity.

4. Reducing waste, fraud and abuse.

Check out the issue brief here for more information.

 
Oct 04, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Women and Retirement Security

Chicago Bridge blog writer, Alexi Vahlkamp, covers the issue of retirement for women in a recent blog post.

4 main issues for lack of a secure retirement for women were covered:
1. Lifespan
2. Caregiving responsibilities
3. Employment patterns
4. financial illiteracy

The post is based largely on findings from the Government Accountability Office's report released in July of 2012.

Read more about Women and Retirement Security here.

Visit Health & Medicine's Economic Security webpage for more information on Health & Medicine's work on economic security across the lifespan.

Oct 04, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Home Alone: Family Caregivers Providing Complex Chronic Care

A new study released by AARP and the United Hospital Fund  reveals thatfamily caregivers are doing much, much more than providing personal care(for example bathing or dressing).

The role of the family caregiver has dramatically expanded and includesmedical and nursing tasks. These tasks are quite complex, once reservedfor hospitals only. For example, family caregivers provide medicationmanagement, including administering intravenous fluids and injections.

The report includes 10 recommendations to better support familycaregivers, including providing family caregivers with thetraining/oversight they need to continue providing quality care.

Read the report here: "Home Alone: Family Caregivers Providing Complex Chronic Care."
Sep 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Please Join Us in Congratulating This Year's HMPRG Award Winners!

 2012 awards masthead

  • Emerging Health Leader – Tiffany Pryor, YouthDevelopment and Advocacy Coordinator,IllinoisCaucus for Adolescent Health (Bestowed in honorof founding HMPRG Board member, Jenny Knauss)

Join us for drinks and eats
followed by an awards video
and a brief moderated discussion
with our winners.

 
Date: Thursday, October 11, 2012

Location: Prairie Production
1314 W. Randolph, Chicago
(Street Parking; ADA Accessible)

Time:  5:30-8:30pm
(Program begins promptly at 6:30pm)

General Tickets: $75
Student /Schweitzer Tickets: $25
Friends’ Tickets: $135*
*Includes program listing, artists’ poster of Quentin Young,
1 Raffle Ticket and entry in our Special Drawing

PTO

Pay by check: mail check to HMPRG, 29 E. Madison,
Suite 602, Chicago, IL 60602. Please put “Awards” on
the subject line and include number and kind of tickets
and/or raffle tickets you are purchasing.

(All tickets will be held at the door)

Unable to attend? We welcome your donations.

DTHMPRG

Sep 13, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Health & Medicine Co-sponsoring a Train the Trainer Session with Cook County Commissioner Jesús G. García’s 7th District Health Task Force.

Health & Medicine Policy Research Group is co-sponsoring a Train the Trainer Session with Cook County Commissioner Jesús G. García’s 7th District Health Task Force, focused on the health and social issues facing the District.

The goal of the training is to provide background information on the Cook County Health and Hospital System budget and resource allocation. Participants will learn the budget process and how to prepare oral and written testimony to elected officials and letters to newspaper editors. This event is free and a public service from Commissioner García's office.

The first in a series, this Train the Trainer session will take place on Saturday, September 29, 2012 from 9:00 AM – 1:00 PM at Instituto Health Sciences Career Academy, 2520 S Western Ave, Chicago. (Street parking is readily available and a parking lot is located behind the school).

To register, please email Alvaro.Obregon@cookcountyil.gov or call the district office at (773) 376-2700 and provide the name of the participant; if there is a sponsoring agency; and the participant’s phone number.

We ask that you register for this event by Friday, September 21, 2012.

Aug 30, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago Area Health Education Center (AHEC) Receives Second Year Funding!

Chicago’s Area Health Education Center (AHEC) has received animportant green light to continue its work challenging healthdisparities by promoting diversity in the healthcare workforce. AHEC is acollaborative program of Health & Medicine Policy Research Groupand the University of Illinois, and is part of a national initiativethat promotes health careers and enhances the training of healthprofessionals. Chicago AHEC’s purpose is to meet primary care &public health needs in the Chicago area through health career promotion,community-based student education, professional education and supportand policy development. The program is designed to lead to jobs in thehealth professions along a continuum from entry level to professional.Funding was renewed by the Health Resources & ServicesAdministration (HRSA), allowing the program to continue until March,2013.

More information on AHEC
Aug 23, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG's Martha Holstein has a Letter to the Editor in Today's NY Times

Download or view the letter online

The Republican Proposal for Medicare

To the Editor:

Is David Brooks (“Guide for the Perplexed,”column, Aug. 21) really asserting that the choice between PresidentObama and Mitt Romney comes down to who will do a better job reducingentitlement spending, especially Medicare? If so, I find it a deeplyimpoverished idea of what this country is about and what is at stake inthis election.

With regard to Medicare, without major structural reform and studies todetermine what works and what doesn’t work, its costs will keep growing.The only question will be who pays for those escalating costs.

Combine privatizing Medicare with the repeal of the Affordable Care Act,which the Romney-Ryan ticket also promises, and America will furtherplummet in health care outcomes compared with the rest of theindustrialized world while deepening the disparities between theaffluent and everyone else.

MARTHA HOLSTEIN
Chicago, Aug. 21, 2012
Aug 22, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Join Us October 11th for The 2012 HMPRG Awards

2011 Revised HMPRG Logo

 invites you to a celebration
of visionary thinking, leadership and practice
in public health:

2012 awards masthead

Join us for drinks and eats
followed by an awards video
and a brief moderated discussion
with our winners.


(Winners will be posted on our website, blog and Facebook in mid-September.)

This year's Emerging Health Leader Award will honor the legacy of founding  HMPRG Board member,  Jenny Knauss.

Jksolo

Date: Thursday, October 11, 2012

Location: Prairie Production
1314 W. Randolph, Chicago
(Street Parking; ADA Accessible)

Time:  5:30-8:30pm
(Program begins promptly at 6:30pm)

General Tickets: $75  
Student /Schweitzer Tickets: $25 
Friends’ Tickets: $135
(Includes program listing, poster of Quentin Young by artist Robert Shetterley,
1 raffle ticket and entry in our Special Drawing)

 

Purchase Event Tickets Online

 

Pay by check: mail check to HMPRG, 29 E. Madison
Suite 602, Chicago, IL 60602. Please put “Awards” on
the subject line and include number and kind of tickets
and/or raffle tickets you are purchasing.
                 
(All tickets will be held at the door)

Unable to attend? We welcome your donations.

 

Download Event Flyer

_______________________________________________________________________

 

Cloudtout

 Get Raffle Info and Purchase Raffle Tickets Online

Download Raffle Flyer

Aug 22, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Why Aren't the Presidential Candidates Talking About Long-Term Care?!

8 Reasons Why the Presidential Candidates Should be Talking About Long-Term Care (from the National Council On Aging).

1. The need is now.

About 12 million Americans with disabilities need long-term services and supports, nearly half of them under 65 years old.

2. The need is growing.

As the U.S. population ages, the number of individuals needing long-termcare is projected to double to 27 million by 2050. Over 70% ofAmericans who reach age 65 will need some form of long-term care intheir lives.

Read the rest...

Aug 22, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

"Just the Facts" About Social Security

In case you've heard that Social Security is going broke, checkout this video that shares 'just the facts' about Social Security.

http://www.youtube.com/watch?v=lHAcy4SNVbo&list=UUQlxOsA7o2uhcWYT2Po28FQ&index=1&feature=plcp
Aug 22, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois Transitional Care Consortium (ITCC) Hosts Civic Engagement Event.

In May, 2012, ITCC hosted a Civic Engagement Event with Dr. SusanAltfeld, UIC School of Public Health--also an ITCC member--taking thelead.HMPRG is also member of the ITCC.

See what took place at event.
Aug 09, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

No Increase for Medicare Prescription Drug Costs

For individuals with Medicare Part D insurance that covers prescription drugs, the U.S. Department of Health & Human Service projects a monthly $30 premium for 2013. This is roughly the same as the current monthly premium.

This good news for Medicare Part D beneficiaries is a result of increased use of generic drugs, greater pharmaceutical company competition, and the Affordable Care Act of 2010.

http://www.reuters.com/article/2012/08/06/us-medicare-brief-idUSBRE8751F420120806
Aug 08, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Celebrate Community Health Center Week!

National Community Health Center Week is this week, August 5-11th. Community Health Centers provide high-quality, affordable primary and preventive health care.

The Affordable Care Act of 2010 strengthened Community Health Centers across the country by supporting on-going operations and expansion efforts. Serving over 20 million individuals in every state across the country, Community Health Centers are a critical component of the health care safety net.

http://www.hhs.gov/news/press/2012pres/08/20120806a.html

http://www.hrsa.gov/ourstories/healthcenter/healthcenterweek.html

Aug 08, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois, 13 Other States, Cut Medicaid to Balance Their Budgets

Illinois cut $1.6 Billion from the State Medicaid program May 25, 2012, keeping pace with states around the country who looked to Medicaid cuts to balance their state budgets. Kaiser Health News reports that Illinois' and other states' cuts are more extensive than last years.

Health & Medicine questioned the cuts to Illinois' Medicaid programs that are provided in the home- and community-based setting in a report recently released, prior to the enacted Medicaid cuts. Our research shows that Medicaid cuts to home- and community-based services are short-sighted: saving money in the short-run and costing the state in the long-run. With less access home- and community-based services, Medicaid beneficiaries are expected to use more costly emergency room, hospital and nursing facility services.

Illinois' financial crisis resulted in decisions that result in quick Medicaid dollar savings, but probable further financial strain on the Medicaid system. Health & Medicine will continue to advocate for policies and programs that result in long-term cost-savings through quality health programs that improve population health. For more information on our work regarding home- and community-based service advocacy, email Kristen Pavle, Associate Director, Center for Long-Term Care Reform @ Health & Medicine.

Aug 08, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois, Federal, Dual Eligible Reform Too Fast?

As Illinois, and many states across the country, looks to reform its Dual Eligible (Medicare/Medicaid) health insurance programs, there is much concern that the reform process happening too quickly.

Health & Medicine voiced this concern in an official letter to the Illinois Department of Healthcare and Family Services (Illinois' Medicaid Agency) in March 2012 ( Download Hmprg_comments_hfs_dual_eligible_initiative_2012_final2 )

Illinois has been moving forward on an aggressive timeline to implement a Dual Alignment Initiative project. The Dual Alignment Initiative is currently in the processing of reviewing applications from managed care organizations and will be announcing contracts in August 2012. Successful contracts will be awarded and held between the managed care organization, HFS and the federal Centers for Medicare and Medicaid Services (CMS). The tentative start date for enrollment through the Dual Alignment Initiative in Illinois is April 2013.

Despite the Dual Eligible population tending to be more costly as a result of having more complex conditions, there is concern that the goal of achieving cost-savings is eclipsing the need for real health reform.

Senator Jay Rockefeller voiced his concern , as did the Medicare Payment Advisory Committee, and others across the country.

Stay tuned as Illinois moves forward with its Dual Alignment Initiative. For more information, email Kristen Pavle, Associate Director, Center for Long-Term Care Reform @ Health & Medicine.

Aug 07, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Hospital Readmission Rates Still Too High

Despite pending hospital penalties for readmission cases (section 3025 of the Affordable Care Act), officials say that readmission rates are still too high.

Health & Medicine is the proud partner of a Community-based Care Transitions Program award to address the high readmission rates in Suburban Cook County, Illinois.

For more information email Kristen Pavle, Associate Director, Center for Long-Term Care Reform

 
Aug 07, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Affordable Care Act Cheaper, Will Cover Less Lives Depending on States' Actions

The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) recently released its findings that the Affordable Care Act (ACT) will cost $84 Billion less as a result of not all states expanding their Medicaid programs . The Supreme Court ruling on the ACA upheld the law, but also specified that states have the choice to expand their Medicaid programs.

Several states are choosing not to expand their Medicaid programs, thereby choosing not to provide health insurance for many of their low-income citizens. Perhaps good for the federal and state budgets in the short-run.

Speaker of the House John Boehner received CBO and JCT estimates that if HB 6079 was enacted to repeal the ACA, the cost to the federal government would add $109 Billion to the federal budget deficit from 2013-2022.

Aug 07, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

We Need to Raise the Minimum Wage in Illinois

Illinois Senate Bill 1565 would gradually restore the state's minimum wage to an inflation adjusted value (over $10/hour) and then adjust the wage each year to keep pace with the cost of living. SB 1565 awaits a vote in the Senate now, and may be up for debate in the fall of 2012.

Livable wages are an important part to economic security for working individuals and families. According to research done by Health & Medicine Center for Long-Term Care Reform Co-Director Martha Holstein, economic security across a life time is important, too. [Link to attached document].

The theory of cumulative advantage/disadvantage tells us that an individuals socioeconomic status in the middle-working years is reflective of socioeconomic status in one's later years. So providing livable wages during middle-working years is key to helping individuals age in economic security.


Read & Download Economic_security_across_generations

For more information on Economic Security visit Health & Medicine's Elder Economic Security Initiative website or email Kristen Pavle, Associate Director, Center for Long-Term Care Reform.

 
Aug 07, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago Tribune Article Focuses on Illinois' Supportive Living Facilities, an Affordable Housing Option for Low-income Seniors.

Download full article from the Chicago Tribune

Bridging a gap

Supportive living facilities offer an affordable housing option for low-income seniors

August 03, 2012|By Jane Adler, Special to the Tribune 
Glenna and Ralph LaCroix relax in a gazebo at Heritage Woods in South Elgin. (Stacey Wescott, Chicago Tribune)

At some point in life, everyone needs a little extra support.

Glenna and Ralph LaCroix lived for years in Byron, where they raised five children amid the easy rhythms of the small river town in northwest Illinois. But, as they aged and needed more help with daily activities, their children, some of whom had moved to the Chicago area, wanted their parents nearby.

"Our kids were concerned about us," said Glenna.

The couple sold their house and moved about six months ago to a one-bedroom apartment at Heritage Woods of South Elgin, a supportive living building in the northwest suburb. As a result, her adult children have peace of mind knowing their parents are safe and secure.

"There's nothing not to like about this place," said Glenna, happy to be living near her children and extended family.

Supportive living and assisted living facilities share similarities by combining apartment-style housing with personal care and services.

The LaCroixes receive three meals a day. Staff members provide personal assistance — a plus since Ralph suffers from memory loss. The staff also cleans the apartment and changes the linens. The development fosters an engaging, independent environment with activities and a wellness program.

Low-cost alternative

Private funds, long-term care insurance or veterans benefits are typically used for paying for assisted living. But while supportive housing accepts people who pay their own way, it also opens its doors to low-income residents who qualify for Medicaid.

About 10,000 Illinois residents live in the state's 136 supportive living buildings. The Chicago area has 45 buildings with a few aimed at young people with disabilities. Most, however, are for elderly residents.  Read full article

Aug 07, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

New SCAN Foundation Resources Provide Wealth of Facts on Long-Term Care.

"Do you have questions about the “who, what, where, when, why, and how” of long-term care?

Check out this series of fact sheets produced by The SCAN Foundation. The national fact sheets provide basic information on long-term care from a national perspective. The Foundation website is updated periodically with new fact-sheets.

For more information on HMPRG's work on long-term care, email  Kristen Pavle, Associate Director Center for Long-Term Care Reform  or phone Kristen at 312.372.4292 x 27.

Aug 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG's Margie Schaps Speaks at Citizen Action Press Conference on Women's Issues and the ACA

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From our friend Alyssa Rathan at Citizen Action Illinois

Thank you for taking the time to celebrate women and the Affordable Care Act with us on August 1, 2012. The press conference that we had yesterday was a major success.  Below are some of the press stories on the event. For the record, CBS, ABC, WGN, Univision, and FOX had cameras in the room. Attached are a couple of pictures from the event as well. 

Over the next few months, it is important that we keep the benefits of the health care law in front of the media. We look forward to working with you in the future on this and other important issues facing women.

Click here to see ABC coverage of the event.

Click here to see CBS coverage of the event

Click here to see Univision coverage of the event

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Jul 30, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Tennessee's experiment with Medicaid home and community-based services (HCBS)

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Tennessee is looking to Medicaid home- and community-based services (HCBS) to save the state money by making it easier for individuals to become eligible for HCBS than to be admitted into a nursing home. During an ongoing economically difficult time, the state will essentially be taking money from nursing homes and using it to provide home- and community-based care.

Tennessee is the first state to change long-term services and supports (LTSS) eligibility between nursing home and HCBS. Now, individuals who are not nursing home eligible will be eligible to receive HCBS. Previously, all LTSS eligibility was based on a nursing home level-of-need.

What does this mean? More individuals with a need for LTSS will be eligible to receive care in the community. As Tennessee implements this new policy, the country will watch to see if money is saved and individual LTSS needs are met. The article below was published in the Kaiser Health news in collaboration with The Washington Post.

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Tennessee Cuts Medicaid Benefit Funding For Some Long-Term Care Patients

By Guy Gugliotta

Jul 29, 2012

This story was produced in collaboration with wapo

In a unique experiment being watched nationally, Tennessee is revising its Medicaid long-term care options to make it harder for certain low-income elderly people to qualify for state-paid nursing home care.

The state is focusing on seniors who officials say need assistance but not in a nursing home and not with an equivalent level of treatment in home or community-based services. The state TennCare Medicaid program will pay up to $15,000 a year to help these participants stay in their homes or receive meals and other services in adult day care facilities or other less restrictive community settings. Under its old program, all participants qualifying for long-term care under TennCare—whether they were in a nursing home or other care—were entitled to benefits equal to the cost of a nursing home.

The program, which has received federal approval and began this month, is the first of its kind in the nation because it creates this new category of patients who don’t qualify for nursing home care. Up to now, under federal law, everyone who receives long-term care under Medicaid first had to qualify to be admitted to a nursing home.

"Federal law requires that program eligibility be tied to eligibility for nursing homes," said Matt Salo, executive director of the National Association of Medicaid Directors. "Tennessee is stepping ahead to create this new category of at-risk individuals whose benefits are not linked to nursing homes."

But consumer advocates worry that the $15,000 annual limit will fall short of meeting the needs of some seniors, who could end up going without services or relying on funds from family or friends. Gordon Bonnyman, executive director of the Tennessee Justice Center, said he feared that "a lot of frail people are not going to make it on the reduced package."

State officials say the money should be sufficient and that seniors whose need for care increases may qualify for more extensive TennCare benefits: nursing home or community-based care up to $55,000 a year.

TennCare hopes to save $47 million from the new program this year. In the longer run, the state expects by retooling the system it will be better prepared to accommodate an expected spike in enrollees as baby boomers grow older.

TennCare's long-term care system serves 23,705 elderly. TennCare, like Medicaid in other states, is financed with federal and state funds. In addition to low-income seniors, it covers children, pregnant women and the disabled. Tennessee’s financial share for long-term elderly care is $1.1 billion per year.

Nationally, Medicaid plays a key role in long-term care, covering more than two-thirds of all nursing home residents and footing more than 40 percent of the industry's costs. The average cost per year for nursing home care nationally is about $80,000.

The new program is the second time in three years TennCare has moved to reduce use of nursing homes. In 2009, the state obtained permission from the federal government to offer nursing home patients—and new long-term care enrollees—the option of receiving care in a family- or community-based setting. Under that program, nursing home care would only be required if the alternative setting could not meet the patient’s needs or if the cost of those needs exceeded the $55,000 per year.

That change has been successful. In 2010, around 83 percent of Tennessee’s long-term Medicaid patients were in nursing homes, with 17 percent in home and community settings under a prior waiver. Today, 66 percent of patients are in nursing homes and 34 percent are receiving home- and community-based services.

Dr. Melinda Henderson, executive director at the UnitedHealthcare Community Plan, one of three managed care organizations that administer Tennessee’s Medicaid system, said patients overwhelmingly choose not to be in nursing homes.

"You kind of lose your independence at a nursing home," said Sarah Stewart, who lives in Bolivar in rural southwest Tennessee. "I just prefer to be at home and be independent."

Read the full article

Jul 19, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Greetings from the "Intern Desk" at Health & Medicine!

Between dwindling budgets, poor health indicators that vary widely by social status, and politicians who care more about attacking the other side than formulating their own stance, it’s easy to get discouraged in our current political, economic, and social landscape.

Sometimes it feels like we are the Greek King Sisyphus, constantly pushing a heavy boulder uphill, only to watch it plummet again and again. But Health & Medicine is making progress, even if that boulder sometimes gets in the way.

Through initiatives such as Regional Safety Net, Long Term Care Reform, the Bridge Model, AHEC, and the Schweitzer Fellows Program, Health & Medicine has an impact on individuals, communities, and regions.

Before my internship at Health &Medicine, I had only dedicated my energy to investigating programs that reduced health disparities, such as helping build a community garden in a food desert in south-central Wisconsin. But this summer Health & Medicine has helped teach me the importance of policy.

For instance, what policies are in place that make certain communities not have the ability to afford healthy food? A staff member here recently recounted how she used to be involved in on-the-ground health programs but joined HMPRG because she wanted to make a difference at a more systemic level.

Similarly, Health & Medicine interviewed a health care provider to be featured in our recent publication about Medicaid Cuts. The woman we spoke with cited a parable in which a small community keeps finding bodies floating down their river. Each day a body floats by, and each day the community removes it. This happens day after day until finally someone thinks to check what is happening upstream. This parable parallels my realization about policy: you can have excellent programs dedicated to promoting health and reducing health disparities, but policy serves as that “upstream check”. For me, this is really what public health is about---emphasizing prevention over treatment.

This summer has been filled with many realizations, informative meetings, and sources of inspiration. For instance, at Health and Medicine’s strategic planning event last month, a board member offered this quote: “If you’re not enraged, you’re not engaged.” Quentin Young, founder of Health & Medicine, is almost 90 years old and still shows up to work enraged and engaged. And let me tell you, he’s helping us push that boulder up the hill.

-Megan Slavish will be a junior at Beloit College in Wisconsin in fall 2012

Jul 19, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Prevention Meta Analysis

Jul 18, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Primary Prevention Mental Health Programs for Children and Adolescents: A Meta-Analytic Review

Jul 18, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG Co-Sponsors August 1st Town Hall Meeting on the Impact of Medicaid Cuts in Communities of Color

Download the flyer

click the images below to have them open in a seperate window

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Jul 13, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

CAN-TV to Broadcast Leadership by Example Lecture by HMPRG Board Member, Gayle Riedmann, CNM

On June 13, 2012, Certified Nurse Midwife, Gayle Riedmann. owner of West Suburban Midwife Associates in Oak Park ( one of the few CNM-owned midwifery practices in the state)  delivered a Schweitzer Fellows "Leadership by Example lecture.

The lecture - a must view for anyone interested in the history of birth centers and an assessment of where we're presently at - will be broadcast by CAN=TV  the following dates and times:

Sunday, July 15th, 11:30 AM, Channel 21
Wednesday, July 18th, 8:00 AM, Channel 19
Thursday, July 19th, 12:00 PM, Channel 21

Jul 12, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

From The Shriver Brief: Expanding Medicaid: The Choice is Clear (for Illinois)

Andrea Kovach at the Shriver Center has put together a very good blog, filled with facts and links, on why it is important that Illinois expand the Medicaid program.  Please find it on either Illinois Health Matters or at the Shriver Brief. Dowbload the post from The Shriver Brief  or from Illinois Health Matters

 

The Shriver Brief

Posted at 7:58 AM on July 10, 2012 by Andrea Kovach

Expanding Medicaid: The Choice is Clear

The Supreme Court on June 28th ruled that while the federal Affordable Care Act’s (ACA) Medicaid expansion is constitutional, in the event that a state does not implement the expansion, it would be unconstitutional to withdraw all Medicaid funding from that state. The ruling appears to leave intact both the mandatory nature of the expansion and the other remedies that the federal Medicaid authorities might use to enforce it. The states, however, might view the removal of the most aggressive remedy (full Medicaid defunding) as opening up some additional degree of choice about whether to forego the expansion and risk whatever lesser penalties federal authorities may impose (such as a partial withholding of funds). In Illinois, as in any other state, it is clear that expanding the Medicaid program on schedule in 2014 is by far the smart and right thing to do, regardless of the potential federal penalties for not expanding.

1.  The ACA’s expansion is aimed at covering some of the most vulnerable low-income adults who are otherwise unable to afford private insurance. Not all low-income Illinoisans are currently eligible for Medicaid. Instead, right now, to qualify for Medicaid, a low-income person must fit into a “category,” such as being 65 or over, or totally and permanently disabled, or pregnant, or a child under age 19, or a parent or caretaker relative of a child under age 19. But if you are a single, childless, non-disabled adult without a penny to your name, you do not qualify for Medicaid. This expansion adds another category—having household income less than 138% of the Federal Poverty Level (FPL), which would apply to an estimated 500,000 individuals in Illinois. People in a wide range of circumstances will belong to the “newly eligible” group. Many will be low-wage, part-time workers. Some will be unemployed, either recent or long term. Some will have health conditions that, if addressed by consistent medical care, could and would allow them to get jobs. Some are really destitute, even homeless. Some are young adults, perhaps having aged off Medicaid, which they received as children, but are not fortunate enough to have parents with insurance that would cover them until they turn 26. Others are middle-aged or close to 65. Some are people who had insurance coverage, but lost it through changes in circumstances such as job loss or divorce. 

Of the newly eligible population in Illinois, an estimated 431,000 Illinoisans with household incomes less than 100% FPL will be left in the cold without the Medicaid expansion. The ACA envisioned that these folks would qualify for Medicaid. That’s why the federal subsidy to help pay for private insurance premiums starts at 100% FPL and goes to 400% FPL. So, without the Medicaid expansion, these folks will likely be priced out of affordable health insurance through the Exchange because they won’t qualify for the federal financial help (unless they are lawfully residing residents ineligible for Medicaid). They will have to continue to access safety-net providers and emergency rooms for care, driving up costs for these providers and showing up sicker. And, these folks are still held responsible under the individual mandate to prove insurance coverage or why they are exempt.

2.  Minimal state investment will reap overwhelming benefit. The ACA increased the Federal Medical Assistance Percentage (FMAP) rates for the newly eligible individuals under the expansion to 100 percent for calendar years 2014 through 2016, and then gradually declining to 90 percent in 2020 where it remains indefinitely. By 2020, when Illinois will pay just 10 percent of the cost of care for this new population, the annual state cost is estimated at $157 million. (This is 10% of the current cost per adult beneficiary in Illinois, $3,157, times 500,000 new beneficiaries). But even as this cost will rise due to inflation, it will also be offset by benefits such as larger state tax revenues from increased employment and provider income and an increased insured population. It will also be offset by increased efficiencies due to the new system to simplify and coordinate eligibility and enrollment for Medicaid and the Exchange, which is nearly entirely paid for by the federal government. It may also be offset by the stabilization of the health of almost half of the newly eligible population in the event that the federal government gives permission for Cook County to expand Medicaid early, this year or next. If Cook County is allowed to expand Medicaid early, an estimated 250,000 folks will have medical homes and coordinated care, which would likely stabilize chronic conditions, prevent disabilities, and therefore reduce future Medicaid costs. Finally, state costs can be further minimized by increasing efficiency through care coordination initiatives, especially for persons with chronic conditions and for dual eligibles (persons eligible for both Medicaid and Medicare). The Lewin Group estimates that the ACA will increase Illinois’s Medicaid spending by just 2.8% between 2014 and 2019. The Congressional Budget Office has estimated that the ACA would impose less than a 1% increase in state Medicaid costs.  Moreover, these high federal matching rates are highly likely to stay. In Medicaid’s close to 50-year history, Congress has never decreased FMAP levels in Medicaid other than to allow the expiration of temporary FMAP increases enacted as parts of stimulus packages in recessions. The more states that adopt the “newly eligibles” expansion, the more members of Congress who will resist any reduction below 90% down the line. In fact, with sufficient support, Congress could amend the matching rate, keeping it at 100% indefinitely.

3. Expanding Medicaid creates jobs. We know from our recent past that an increased federal matching rate in the Medicaid program has an enormously significant economic impact—called a multiplier effect—throughout the economy and positively impacts jobs. When Congress included an increase in the federal Medicaid matching rate in the American Recovery and Reinvestment Act from 50% to 61.88% from October 2008 through December 2010, $1.2 billion per year for that period flowed into Illinois. For FY 2009, one estimate places the value of the wages generated from the Medicaid program that included the enhanced match as high as $15.8 billion, supporting as many as 385,742 jobs. The job growth and wages generated are likely to be much more substantial under the ACA’s Medicaid expansion, since the federal matching rate under the ACA is 100% from 2014 through 2016 and an additional roughly 500,000 newly eligible Medicaid patients are expected to enroll. State and local revenue increases when Illinois residents pay income, sales, and other taxes generated by the federal funding for the Medicaid expansion; this revenue would offset much, perhaps all, of the additional costs.

4. Participating in the Medicaid expansion will help stabilize the state budget. The budget is critically dependent on federal Medicaid funding. The Illinois Medicaid program is by far the largest source of federal revenues to the state. Federal funds also support the Department of Human Services, Department on Aging, Department of Children and Family Services, local public health departments, Cook County Health and Hospitals Systems, Illinois’s state universities, and local school districts’ special education programs, among others. The Medicaid expansion will provide crucial federal funds across the state and local governments to support programs now being delivered to the expansion population with no federal funds, or being withheld from that population due to lack of funds.

5. We pay for the health care for the uninsured in any event, so let’s use federal dollars to pay for their current uncompensated care. A Kaiser and Urban Institute report on state spending under the expansion found that under the expansion, by 2019, Illinois would have reduced its number of uninsured adults in this newly eligible population by over 42% with the federal government paying for over 94% of the cost. This could translate into a decrease in Illinois’s uncompensated care spending of as much as $1.5 billion. And any cost to the state will be there, whether or not Illinois takes the money provided for the expansion. Working Illinoisans in low-wage jobs without insurance still get sick, still get injured. But without the federal dollars from the Medicaid expansion, other Illinoisans with insurance will still have to pick up the cost of their care, to the tune of $1,000 per year in increased annual premiums. And local property taxes are strained to support the township medical assistance programs and safety net health systems that provide care for low-income uninsured people now. In fact, currently over $400 million in services for uncompensated care is being provided annually by just one hospital: Cook County’s Stroger Hospital. 

6. Illinois hospitals need the Medicaid payments to offset reductions in federal funds in other areas. Targeted hospital subsidies, known as disproportionate share hospital (DSH) payments, will decline under the Affordable Care Act. The reduction was justified on the theory that the Medicaid expansion will eliminate the need for DSH subsidies by greatly reducing the burden of uncompensated care. If hospitals lose those payments, and the loss is not made up by the expansion of Medicaid, it will devastate not only hospitals, but entire communities. Many Illinois hospitals, especially in rural areas, simply are not viable if their DSH subsidies decline without being replaced by expanded Medicaid. Hospitals are among the largest employers in their communities. When a hospital closes, the community not only loses a major employer, but providers leave too, and then the community has great difficulty recruiting new industry. Additionally, expanding Medicaid will ensure that Illinois’s medical providers will have the financial support coming from the Medicaid expansion to offset the ACA’s Medicare payment reductions. Doctors and hospitals are counting on the Medicaid expansion (which will bring in revenue for services to the newly eligible and reduce the need for uncompensated care) to be in place as the Medicare payment changes are phased in.

7. Expanded coverage is the linchpin for the big picture reforms that will deliver both better health outcomes and lower costs. Coverage requires an investment (which the federal government virtually entirely funds under the ACA). But the investment will yield returns. Coverage makes possible a relationship with a regular medical provider. That, in turn, facilitates prevention, wellness advice, early detection of conditions, maintenance care (avoiding acute care), a platform for the full use of health information technology that avoids duplication and mistakes and spreads best practices, and care coordination. Coverage thus addresses the cost of health care by improving health outcomes across the system. This overall downward bending of the cost curve helps all of us, not just the newly insured. 

8. Federal Medicaid dollars will finally be paying for behavioral and mental health services for Medicaid enrollees. Under the ACA, the newly eligible population will have a benefit package that includes mental health and behavioral health services. These are costs now being borne by state and local funds, or else the services are simply not being provided—with impact on emergency rooms, state institutions and the criminal justice system. These state and local costs will be replaced with federally funded Medicaid.

9. Illinois’s veterans deserve health insurance. Not all veterans are able to get care at a Veterans Affairs hospital. And, in fact, roughly 43,000 Illinois veterans are uninsured (along with 25,000 of their family members). Illinois needs to take care of veterans, and the ACA’s Medicaid expansion will do just that. At implementation in 2014, nearly half of uninsured veterans will likely qualify for expanded Medicaid coverage. Illinois should serve these veterans, just like they served its citizens.

10. Does Illinois really want to subsidize health care in other states? As Justice Scalia stated in his dissent, “Those States that decline the Medicaid Expansion must subsidize, by the federal tax dollars taken from their citizens, vast grants to the States that accept the Medicaid Expansion.” So if Illinois does not take advantage of the federal 100%/90% funding for the Medicaid expansion, other states that chose to expand will get the benefit of Illinoisans’ federal tax dollars.

11. Expanding Medicaid coverage helps the financial viability of community clinics. Clinics are our best—really only—strategy for providing health care to the uninsured outside of emergency rooms. There will still be plenty of uninsured after the ACA is implemented, plus many of the newly insured Medicaid beneficiaries will get their care from clinics. The only way that clinics can serve the uninsured is by serving a critical percentage of patients who have coverage. The Medicaid reimbursement for covered patients allows the clinic to also serve the uninsured. With a high percentage of patients covered, the clinics will be able to expand capacity to serve the uninsured as well as those newly coverage by Medicaid.   

12. The Medicaid expansion is simply the right thing to do. We have a chance, through the incredible leveraging of federal funds, to provide health coverage—and the chance for better health and upward mobility—to hundreds of thousands of our state’s most vulnerable, needy residents. We can create a system that expands its circle of moral concern to include the uninsured, recognizing as Justice Ruth Bader Ginsburg wrote in N.F.I.B. v. Sebelius, that “[v]irtually everyone … consumes health care at some point in his or her life.”

Jul 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois Medicaid Cuts: What to do about changes to your Medicaid benefits

Illinois legislators passed a law cutting some Medicaid benefits starting July 1, 2012. Even if you have lost coverage, you may still be eligible for other programs and benefits. The Illinois Maternal & Child Health Coalition released a helpful fact sheet to help you find other ways to get care.

Click here to download

Jul 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

"Make Medicare Work" Webinar Materials on Illinois Cares Rx Elimination

Click on the links below for materials from the AgeOptions June 15th Make Medicare Work Coalition Webinar on the Illinois Cares Rx elimination and options for people who have lost their Illinois Cares Rx coverage.  

Webinar Recording (Windows Media File):

http://ageoptions.org/whatwedo/2012-06-1511.04MMWWebinar-IllinoisCaresRx_000.wmv

Webinar Slides:

http://ageoptions.org/whatwedo/documents/UPDATEDMMWICRxwebinarPPT.6.15.12_000.pdf

Chart of Charities and Co-Pay Assistance Organizations
(which may offer assistance on specific drugs):

http://ageoptions.org/whatwedo/documents/CharitiesPAPsDiscountCards6-6-12.pdf

AgeOptions will be releasing a Topical Brief on Medicaid Spenddown (which is one option to assist people on Medicare in acquiring federal Extra Help/Low Income Subsidy assistance in paying for drugs), as well as an FAQ document addressing some of the major questions they have been receiving from counselors helping clients with the loss of Illinois Cares Rx. 




Jun 29, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Quentin Young quoted in Sun-Times explaining problems of health care law

Read Dr. Young's remarks in the Backtalk section of the Chicago Sun-Times, linked here:

"Health Care Law: It may be legal, but it's not reform"

Jun 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

From the Supreme Court (SCOTUS) Blog) Court holds that states have choice whether to join medicaid expansion

Read the post

This post by Kevin Russell, (Jun. 28, 2012, 11:16 AM), claerifies this part of the ruling rather well. 

The Court’s decision on the constitutionality of the Medicaid expansion is divided and complicated.  The bottom line is that: (1) Congress acted constitutionally in offering states funds to expand coverage to millions of new individuals; (2) So states can agree to expand coverage in exchange for those new funds; (3) If the state accepts the expansion funds, it must obey by the new rules and expand coverage; (4) but a state can refuse to participate in the expansion without losing all of its Medicaid funds; instead the state will have the option of continue the its current, unexpanded plan as is.

 The votes for this outcome are divided among several opinions.  Three Justices – the Chief, Justice Kagan, and Justice Breyer – took the position that depriving a state of all of its Medicaid funding for refusing to agree to the new expansion would exceed Congress’s power under the Spending Clause.  Although Congress may attach conditions to federal funds, they concluded, it may not coerce states into accepting those conditions.  And in this case, taking away all the states’ funds for the entirety of its Medicaid program just because it disagreed with a piece of the program would be coercive.  But the remedy for that constitutional violation is not to declare the expansion unconstitutional – such that even states that want to participate would not have the option.  Instead, the plurality held that the provision of the statute that authorized the Government to cut off all funds for non-compliance with the expansion was unconstitutional.  The result is that states can choose to participate in the expansion, must comply with the conditions attached to the new expansion funds if they take that new money, but states can also choose to continue to participate only in the unexpanded version of the program if they want.

 

Justices Ginsburg and Sotomayor would have held the entire expansion program constitutional, even the provision threatening to cut off all funding unless states agreed to the expansion.  Their votes created a majority for the proposition that the overall expansion was constitutional, and that states could choose to participate in the expansion and would have to comply with the expansion conditions if they did.

 

But there was still no majority about what to do about the states that do not want to participate in the expansion – the Chief Justice’s 3-Justice plurality voted to strike down the provision allowing the Government to withhold all funds from states that reject the expansion; Justices Ginsburg and Sotomayor voted to uphold it.

 

The deadlock was broken by the dissenters.  Justice Scalia – writing on behalf of himself, and Justices Kennedy, Thomas, and Alito – agreed with the Chief’s plurality that the threat to withhold all funds was unconstitutionally coercive.  But they would have held that the consequence is that the entire expansion program should be stricken.  The result would have been that even states that wanted to participate in the program could not.  The plurality’s approach of simply striking down the provision that allowed withholding all funds if the state refused the expansion was, in the dissenters’ view, tantamount to rewriting the statute.

 

At this point, that meant that there were 2 votes to uphold the expansion in its entirety, 4 votes to strike the entire expansion down, and 3 votes to strike down only the provision withholding all funds for non-compliance with the expansion mandate.  So where does that leave things?

 

Fortunately (for the sake of clarity at least), Justices Ginsburg and Sotomayor resolved the ambiguity by voting with the plurality on the remedy question.  That is, these Justices voted that if the statute was unconstitutionally coercive, then the remedy would be only to strike down the all-or-nothing sanction.

 

The consequence was a bottom line of 7 Justices – the Chief, Breyer, Kagan and the four dissenters – finding the expansion unconstitutional.  But a different majority – the Chief, Ginsburg, Breyer, Sotomayor and Kagan – held that the remedy for the violation was to strike down only the provision allowing the federal government to withhold all Medicaid funds unless a state agrees to the expansion.

 

Jun 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Supreme Court Maintains the ACA 5-4 and RetainsThe Individual Mandate

Download What the ruling means to people in Illinois

What the ruling means to people in Illinois:

How the Health Care Law is Making a Difference for the People of Illinois

The new health care law improves access to health care for over one million Illinoisans and Illinois small businesses.  Health reform is already making a difference for the people of Illinois by:

Providing new coverage options for young adults
Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family coverage, and, thanks to this provision, 3.1 million young people have gained coverage nationwide. As of December 2011, 125,000 young adults in Illinois gained insurance coverage as a result of the health care law. For more details on these numbers, visit here.

Making prescription drugs affordable for seniors
Thanks to the new health care law, 152,170 people with Medicare in Illinois received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. Since the law was enacted, Illinois residents with Medicare have saved a total of $155,851,726 on their prescription drugs. In the first five months of 2012, 26,332 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they hit the donut hole. This discount has resulted in an average savings of $636 per person, and a total savings of $16,756,840 in Illinois. By 2020, the law will close the donut hole.

Covering preventive services with no deductible or co-pay
In 2011, 1,353,031 people with Medicare in Illinois received free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor. And in the first five months of 2012, 665,852 people with Medicare received free preventive services. Because of the law, 54 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 2,390,000 in Illinois.

Providing better value for your premium dollar through the 80/20 Rule
Under the new health care law, insurance companies must provide consumers greater value by spending generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 299,544 Illinois residents with private insurance coverage will benefit from $61,802,411 in rebates from insurance companies this summer. These rebates will average $380 for the 163,000 families in Illinois covered by a policy.

Scrutinizing unreasonable premium increases
In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Illinois has received $4.5 million under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits
The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 4,670,000 residents, including 1,743,000 women and 1,192,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.

Creating new coverage options for individuals with pre-existing conditions
As of April 2012, 2,384 previously uninsured residents of Illinois who were locked out of the coverage system because of a pre-existing condition are now insured through a new Pre-Existing Condition Insurance Plan that was created under the new health reform law. To learn more about the plan available in Illinois, check here.

Supporting Illinois’s work on Affordable Insurance Exchanges
Illinois has received $6.2 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges.

  • $1 million in Planning Grants:  This grant provides Illinois the resources needed to conduct the research and planning necessary to build a better health insurance marketplace and determine how its exchange will be operated and governed. Learn how the funds are being used in Illinois here
  • $5.2 million in Exchange Establishment Grants:  These grants are helping States continue their work to implement key provisions of the Affordable Care Act. Learn how the funds are being used in Illinois here.

Preventing illness and promoting health
Since 2010, Illinois has received $31 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to support effective policies in Illinois, its communities, and nationwide so that all Americans can lead longer, more productive lives.

Increasing support for community health center
The Affordable Care Act increases the funding available to community health centers in all 50 states, including the 537 existing community health centers in Illinois. Health centers in Illinois have received $118.3 million to create new health center sites in medically underserved areas, enable health centers to increase the number of patients served, expand preventive and primary health care services, and/or support major construction and renovation projects

Strengthening partnerships with Illinois
The law gives states support for their work to build the health care workforce, crack down on fraud, and support public health.  Examples of Affordable Care Act grants to Illinois not outlined above include:

$10.3 million for Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn - such as health care, early education, parenting skills, child abuse prevention.

By Citizen Action Illinois

 

Jun 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Landmark health reform law ruling a major public health victory, provisions still require support

Statement from Georges C. Benjamin, MD, FACP, FACEP (E), executive director of APHA

Washington, D.C., June 28, 2012 — “The American Public Health Association heralds the U.S. Supreme Court ruling announced today upholding the Affordable Care Act, a landmark law enacted in 2010 to dramatically improve the health of all Americans and control health care costs.

“Today’s historic ruling by the nation’s highest court marks a significant milestone in our national efforts to improve the delivery and financing of health services in the U.S. and to promote health and wellness rather than disease treatment. The Supreme Court’s decision allows for long-overdue changes made possible by the law to move forward without question or further delay. The law will bring relief to millions of Americans in addition to those who are already receiving life-saving benefits, including:

  • 31 million Americans are projected to gain health coverage by 2019 due to critical upcoming reforms, including the exchanges, exchange subsidies, minimum coverage provision and Medicaid expansion;
  • 54 million U.S. families have additional benefits, including greater access to preventive health care services recommended by the U.S. Preventive Services Task Force, such as vaccines and preventive care and screenings for women;
  •  2.5 million young adults up to age 26 are able to stay on their parents’ health insurance plans;
  •  nearly 18 million children with pre-existing conditions are protected from insurance coverage denials;
  •  3.6 million seniors received 50 percent discounts on their drugs in 2011 as an initial step in closing the “donut hole”; and
  •  nearly 33 million seniors accessed preventive services now available without cost-sharing through Medicare.

“In upholding these essential reforms, today’s decision marks tremendous progress towards reshaping our health system into one that saves the lives of at least 44,000 people who die annually simply because they do not have health insurance that could keep them healthy.

“While we celebrate this major public health victory, we must work to ensure the law reaches its full potential. Specifically, we must continue to protect the Prevention and Public Health Fund, a sound, long-term investment in the future of our nation’s health. Through Community Transformation Grants, as part of the fund, $145 million was invested in fiscal year 2011 to help communities reduce chronic disease rates, address health disparities and strengthen prevention efforts. Another $226 million is allocated for fiscal year 2012. The public health community must work to ensure these critical investments are maintained and increased to the full amount no later than 2022.

“Since the law’s passage, APHA has been working to engage public health advocates from communities across the country to support and protect the law.

As part of its advocacy efforts, APHA was a signatory on two friend-of-the-court briefs with other health groups in support of the law. “The Supreme Court did the right thing by upholding the Affordable Care Act. APHA is overjoyed by today’s ruling."

# # #

Founded in 1872, the APHA is the oldest, largest and most diverse organization of public health professionals in the world. The association aims to protect all Americans and their communities from preventable, serious health threats and strives to assure community-based health promotion and disease prevention activities and preventive health services are universally accessible in theUnited States. APHA represents a broad array of health providers, educators, environmentalists, policy-makers and health officials at all levels working both within and outside governmental organizations and educational institutions. More information is available at www.apha.org.

Jun 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

According to Huffington Post, Single-Payer Health Care Favored By House Progressives If Court Strikes Down Obamacare

Download the post from today's Huffington Post

This article appeared in today's Huffington Post in antipation of Thursday's Supreme Court ruling.

WASHINGTON -- The last thing House progressives want is for the Supreme Court to strike down President Barack Obama's health care law. But if the high court rules Thursday that some or all of the law is unconstitutional, progressives are ready to renew their push for the model of health care they wanted all along: the single-payer option.

"It's easy to see it's a good idea," Rep. Keith Ellison (D-Minn.), co-chairman of the Congressional Progressive Caucus, told The Huffington Post. "It's the cheapest way to cover everybody."

Ellison said all 75 members of the caucus have already signed onto a bill by Rep. John Conyers (D-Mich.) to create a single-payer, publicly financed, privately delivered universal health care program. The proposal would essentially build on and expand Medicare, under which all Americans would be guaranteed access to health care regardless of an ability to pay or pre-existing health conditions.

House progressives pushed hard for a single-payer option, such as the "Medicare for all" approach, during the health care reform debate in 2009. But House Democratic leaders couldn't come up with the votes to pass the proposal, and progressives ultimately caved on the idea in order to pass the president's plan, on the reasoning that some reform was better than none at all.

Asked why progressives think a single-payer option could advance this time around, Ellison said if the Supreme Court strikes down some or all of the existing health care law, it shows that the individual mandate at the heart of the law -- a concept originally backed by conservatives -- was a failed approach.

"We've tried it the right-wing way. Let's try it the right way," he said. Read the full article...

 

 

Jun 19, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

From Crain's Chicago HealthCare Daily: County hospital board member abruptly resigns

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County hospital board member abruptly resigns

By Kristen Schorsch June 18, 2012

(Crain's) — Cook County hospital board member Benn Greenspan has abruptly resigned after County Board President Toni Preckwinkle picked replacements for a third of its members, including its chairman.

Mr. Greenspan, a public health professor at the University of Illinois at Chicago, is stepping down after Ms. Preckwinkle decided not to reappoint chairman Warren Batts and Dr. David Ansell, chief medical officer at Rush University Medical Center. Both have expressed interest in another term on the 11-member board that oversees the Cook County Health and Hospitals System.

Last week, Crain's reported that Ms. Preckwinkle was preparing to nominate Abbott Laboratories executive Edward Michael, community activist Rev. Calvin Morris, Carmen Velasquez, executive director of a network of Southwest Side clinics, and Dorene Wiese, president of American Indian Association of Illinois to fill four upcoming vacancies.

In a June 15 letter addressed to Mr. Batts, Mr. Greenspan said, “Some months ago, you and I had a discussion about board reappointments and our mutual concern about keeping politics out of the process.”

“I cannot adequately express my dismay,” he said.

The hospital system provided a copy of the letter.

A spokesman for Ms. Preckwinkle said she too was dismayed at reports that implied she was penalizing Mr. Batts because last year he did not support Dr. Terry Mason, who was her candidate to become county health system CEO.

The independent board named Dr. Ramanathan Raju to the post over Dr. Mason, who is now chief medical officer of the system.

“This has been a collaborative process,” the spokesman said.

Ms. Preckwinkle called Mr. Greenspan today and thanked him for his service, the spokesman said. Read the full post.

Jun 12, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Health & Medicine (HMPRG) Board Member, Carmen Velasquez, Picked for the County Hospital Board.

Carmen Velasquez, Executive Director of Alivio Medical Center, and a Health & Medicine Board Member, has been nominated by Cook County Board President Toni Preckwinkle to the
Cook County Health and Hospital Systems board, along with Dorene Wiese, President of American Indian Association of Illinois,  retiring Abbott Laboratories executive Edward Michael, and retiring Executive Director of the Community Renewal Society and community activist Rev. Calvin Morris.

While we will miss the insight, expertise and unique perspective of Dr. David Ansell, we applaud President Preckwinkle's choices and believe  that all four candidates will bring thoughtful and diligent oversight to the  Cook County Health and Hospitals System.

Jun 05, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG's Janna Stansell quoted in Bloomberg News Article on Charity Care

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Illinois Hospitals Escape Taxes With Big Dose of Lobbying

By Bob Kazel - Jun 1, 2012

The Illinois Hospital Association took no chances as state lawmakers debated in recent weeks whether nonprofit hospitals should pay property taxes. It unleashed a self-described media blitz.

“My baby is sick -- anyone help, please!” screamed an actress portraying a mother in radio ads aired in Chicago and 41 other markets starting in early May. A baby wailed, an ambulance siren blared and a voiceover asked what the terrified parent would do if no hospital were around.

The blitz worked. The Illinois General Assembly this week handed hospitals a long-sought victory: a sweeping legislative antidote to a recent state Supreme Court decision that threatened to slap many hospitals with potentially millions of dollars in tax liabilities just as they say they’re struggling to survive.

The victory in Illinois is significant because the state had become the most dramatic example of courts and regulators challenging the tax-exempt status of nonprofit hospitals. They’re doing so as local governments hunt for revenue to help plug budget gaps in a sputtering economy.

The Legislature preserved nonprofit hospitals’ tax-exempt status while expanding the official definition of the charity care they must provide to qualify for that exemption. Instead of just counting what they spend covering the bills of patients who can’t pay, hospitals could include such things as preventive- care community outreach and a portion of the costs of medical research, professional training and psychiatric care.

Quinn Signature

The office of Governor Pat Quinn has said he will sign the bill. Quinn, a Democrat, had earlier ordered his revenue department to reconsider the tax-exempt status of several hospitals. Under the legislation, hospitals must annually show that they would pay the same or less in property taxes than they donate to the community as charity.

Community and consumer advocacy groups are reeling from the Illinois vote, which they said will remove hospitals’ motivation to increase free care for the poor.

“They kowtowed to the IHA,” said Diane Limas, a spokeswoman for the Albany Park Neighborhood Council, a citizens organization on Chicago’s north side. “I don’t understand the horse trading that goes on in Springfield. But it’s clear that the legislators don’t know what happens when a patient is smacked with a $100,000 hospital bill and is already struggling to make ends meet.”

Online Petition

The association, representing about 200 hospitals and health systems, urged Illinoisans to write to state officials. By this week, the IHA reported, more than 12,000 people had signed an online petition. The group created templates for member hospitals to customize anti-tax e-mails to legislators and letters to local newspaper editors. And it suggested members provide kiosks or special computers for workers to send notes condemning property taxes for hospitals and Quinn’s proposed $2.7 billion in reductions to projected Medicaid payments.

The governor had previously ordered his revenue department to review hospitals’ tax-exempt status. He is expected to sign the legislation, though, because it includes a $1-a-pack boost in the cigarette tax that will help rescue the state’s Medicaid program by raising about $350 million a year.

Some consumer groups said the outcome -- approved on a largely party-line vote by the Democratic-controlled Legislature -- reflected the money spent by the hospital association on advertising and campaign contributions.

Political Contributions

For 2011 and the first quarter of 2012, the association contributed about $397,000 to state office holders, candidates and the state Democratic Party, according to the Illinois Campaign for Political Reform, a watchdog group. That included $143,000 to legislative leaders of both parties and $198,000 to other lawmakers in the General Assembly.

“They completely out-resourced us as patient advocates,” said Janna Stansell, senior policy analyst at the Health & Medicine Policy Research Group, an Illinois nonprofit agency that pushes for health-care equality.  Read the full article.

Jun 04, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HHS Announces Availability of Funding to Help Older Adults, People with Disabilities Access Long-Term Services and Supports and Thrive in Their Communities

VHA to partner in this effort and offer $27 million in additional funding for similar services to Veterans Health and Human Services (HHS).

Secretary Kathleen Sebelius announced on May 31st, a new $25 million funding opportunity made possible by the Affordable Care Act to help states strengthen and expand their ability to help seniors and people with disabilities access home and community-based long-term services and supports.

Over the next one to three years, funding will support Aging and Disability Resource Centers (ADRCs) in nearly every state. Each year, more seniors, people with disabilities and their families are confronted with often challenging decisions about how to obtain the long-term services and supports they need. Choices range from care in their home to care in a nursing home; social supports for daily living to home health care; transportation to physical therapy to name a few. ADRCs will make it easier for people to learn about and access the services that are available in their communities and best meet their needs.

The initiative, known as the Aging and Disability Resource Center Program, is established through a partnership between the Administration for Community Living (ACL), the Centers for Medicare & Medicaid Services (CMS), and the Department of Veterans Affairs’ Veterans Health Administration (VHA). VHA will make an additional $27 million available over 3 years in ADRC-funded states through VA Medical Centers. This funding will increase access to home and community-based services for veterans through ADRC programs. The ADRC Program will help state agencies administer and better coordinate state and federal long-term service and support programs for older adults, people with disabilities, and veterans with disabilities.

Approximately eight states will be competitively selected to accelerate the development over a three-year period of the creation of single entry point models, which provides one-on-one options counseling to streamline the intake and eligibility determination processes for consumers accessing long-term service and support programs. This new funding opportunity is part of the Obama administration’s long-standing commitment to ensure that seniors, people with disabilities and those living with chronic illness have the necessary services and supports to stay in their own homes when they wish to do so. Get more information about Funding Opportunity Numbers HHS-2012-ACL-RO-1210 and HHS-2012-ACL-DR-1213. 

More information on CMS

May 30, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

BIPARTISAN GROUP OF SENATORS ANNOUNCE SUPPORT FOR DISABILITY TREATY

This was posted on Senator John McCain's website on May 25, 2012

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Washington, D.C. – U.S. Senators John McCain (R-AZ), Dick Durbin (D-IL), Jerry Moran (R-KS), Tom Harkin (D-IA), John Barrasso (R-WY), Chris Coons (D-DE) and Tom Udall (D-NM) today announced their support for U.S. ratification of the Convention on the Rights of Persons with Disabilities (CRPD). Senate consent to U.S. ratification of CRPD will recognize the fundamental values of non-discrimination and equal access for persons with disabilities in all areas of life and help protect Americans with disabilities who work and travel abroad from discrimination, including disabled veterans.

“As a cosponsor of the Americans with Disabilities Act and the ADA Amendments Act, I have long advocated on behalf of equal access and non-discrimination for all Americans, including our veterans and today’s disabled soldiers returning home from serving their nation in war,” said Senator John McCain. “I support U.S. ratification of the disability treaty, as it seeks to advance these same fundamental values of equality and human dignity around the world.”

“The Convention on the Rights of Persons with Disabilities promotes independence, dignity and inclusion while protecting the rights of Americans with disabilities when they travel abroad,” Senator Dick Durbin said. “These basic rights should be promoted and emphasized across the world and that’s why I support ratification of this important treaty.”

“Each person has the inherent right to life and should have the opportunity to pursue happiness, participate in society, and be treated equally before the law,” Senator Jerry Moran said. “The CRPD advances these fundamental values by standing up for the rights of those with disabilities, including our nation’s veterans and servicemembers, and respecting the dignity of all.”

“The UN Convention on the Rights of Persons with Disabilities builds on the U.S. experience implementing the Americans with Disabilities Act and promoting equal opportunity and full participation for all people with disabilities in the lives of their communities,” said Senator Tom Harkin. “As a lead Senate sponsor of the ADA, I look forward to working on a bipartisan basis to ratify the Convention and reaffirm our country’s commitment to improving access and opportunities for people with disabilities around the world.”

“The United States must remain the leader when it comes to providing opportunities and protections for individuals with disabilities,” said Senator John Barrasso. “This agreement will work hard to ensure all Americans with disabilities are guaranteed these same protections while traveling abroad.”

“America has long been a global leader in recognizing and protecting the rights of persons with disabilities, and ratification of this convention is an essential step to ensuring disabled persons are protected globally,” Senator Chris Coons said. “All people deserve to be granted full and equal basic human rights, regardless of their physical or mental capabilities. I strongly support ratification of this critical treaty, and urge my colleagues to do the same.”

“The United States is a leader in advocating for the empowerment of disabled Americans, including our veterans who have returned home with life-changing injuries," said Senator Tom Udall. “This treaty is an important tool to improve conditions for citizens living and working abroad and ensures that we remain a beacon for fairness and opportunity around the world.”

An American delegation under President George W. Bush negotiated and approved the Convention in 2006. The United States signed the treaty in 2009 and submitted it to the U.S. Senate this May for its advice and consent for ratification. The treaty requires no changes to U.S. laws or new appropriations.

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May 30, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Two Charity Care Bills Pass the Illinois House and Senate

Two bills passed the Illinois House and Senate related to the provision of charity care at Illinois non-profit hospitals.  While one bill shows promise for helping patients (SB 3261, House Amendment 2), the other provides little incentive for hospitals to provide charity care to those who qualify.

After months of negotiations which led to little compromise, the Illinois Hospital Association’s proposal for how hospitals can earn and maintain their tax exempt status prevailed in Springfield through the passing of SB 2194, House Amendment 3.  The bill allows hospitals that provide a set of benefits to low-income communities equivalent in value to their estimated property tax liability to receive state tax exempt status.  The benefits include free and discounted care to uninsured and low-income patients, a “subsidy” to the Medicaid program, medical education initiatives, and many other “community benefits.”  The Fair Care Coalition believes this is not the solution intended by the 2010 IL Supreme Court Provena decision.

Separately, SB 3261, House Amendment 2, also passed both houses and sets standard eligibility criteria across all IL hospitals for the provision of free care: 100% discount for patients under 200% of the Federal Poverty Level (FPL) in urban areas and under 125% of the FPL in rural and critical access hospital areas.  It also sets in motion rule-making by the Attorney General for developing standard language for charity care applications and processes for determining “presumptive eligibility.”  The Fair Care Coalition believes this is a step in the right direction for helping patients access the care they need.

For more information, please contact Janna at 312-372-4292 ext. 25.

 

May 23, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Report Highlights Severe Cuts to Medicaid and Medicare that Romney's Proposed Budget Cuts Would Require

A report from the Center on Budget and Policy Priorities explains that if policymakers exempt Social Security from the cuts (as Romney has suggested) and cut Medicare, Medicaid, and all other entitlement and discretionary programs by the same percentage, then non-defense programs
other than Social Security would have to be cut 29 percent in 2016
and 59 percent
in 2022.
The report is available at http://www.cbpp.org/cms/index.cfm?fa=view&id=3658.

May 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois receives funding to establish Insurance Exchange

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From the HHS.gov website

News Release

FOR IMMEDIATE RELEASE
May 16, 2012

Contact: HHs Press Office
(202) 690-6343

More states work to implement health care law

Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington receive grants to establish Affordable Insurance Exchanges

Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington will receive more than $181 million in grants to help implement the new health care law. The grants will help states establish Affordable Insurance Exchanges.  Starting in 2014, Affordable Insurance Exchanges will help consumers and small businesses in every state to choose a private health insurance plan. These comprehensive health plans will ensure consumers have the same kinds of insurance choices as members of Congress. Including today’s awards, 34 states and the District of Columbia have received Establishment grants to fund their progress toward building Exchanges.

HHS also issued two guidance documents today to help states build Affordable Insurance Exchanges.

“States across the country are implementing the new health care law,” said Secretary Sebelius. “In 2014, consumers in every state will have access to a new marketplace where they will be able to easily purchase affordable insurance.”

Today, the Department released:

  • New resources for states: The six new Exchange Establishment grant awards to Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington total more than $181 million. This round of awards brings the total of Exchange-related grants provided to states over the last two years to more than $1 billion.  Illinois, Nevada, Oregon, South Dakota and Tennessee today have been awarded Level One Exchange Establishment grants, which provide one year of funding to states that have begun the process of building their Exchange. Washington is the second state to be awarded a Level Two Establishment grant, which is provided to states that are further along in building their Exchange and offers funding over multiple years.

    In 2010, 49 states and the District of Columbia received Exchange Planning grants totaling more than $54 million; in 2011, seven states received more than $249 million in Early Innovator grants; and to date, 34 states and the District of Columbia have received more than $856 million in Establishment grants.

    States can apply for Exchange grants through the end of 2014, and these funds are available for states to use beyond 2014 as they continue to establish Exchange functionality. This ensures that states have the support and time necessary to build the best Exchange for their residents.

    To see a detailed state-by-state breakdown of grant awards and what each state plans to do with its Exchange funding, visit our new map tool on HealthCare.gov - http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html

  • New guidance for states: Today’s guidance includes an Exchange Blueprint states may use to demonstrate how their Affordable Insurance Exchange will work to offer a wide range of competitively priced private health insurance options. The Blueprint also sets forth the application process for states seeking to enter into a Partnership Exchange. If a state chooses to operate its own Exchange or a Partnership Exchange, HHS will review and potentially approve or conditionally approve the Exchange no later than Jan. 1, 2013, so it can begin offering coverage on Jan. 1, 2014.  To see the state Exchange Blueprint, visit http://cciio.cms.gov/resources/other/index.html#hie
  • Exchanges in every state: Consumers in every state will have access to coverage through an Affordable Insurance Exchange on Jan. 1, 2014. If a state decides not to operate an Exchange for its residents, HHS will operate a Federally-facilitated Exchange (FFE). This guidance describes how HHS will consult with a variety of stakeholders to implement an FFE, where necessary, how states can partner with HHS to implement selected functions in an FFE, and key policies organized by Exchange function. To see the guidance on the FFEs, visit http://cciio.cms.gov/resources/regulations/index.html#hie

The Department will conduct implementation forums in the coming months to work with states and stakeholders on their questions and the work to be done in building Exchanges. The Department will also engage in consultation with Tribes, Tribal Governments, and Tribal Organizations on how Exchanges can serve their populations.

For more information on these implementation forums, visit http://cciio.cms.gov/resources/factsheets/index.html#hie

For more information on Exchanges, including fact sheets, visit http://www.healthcare.gov/exchanges.


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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last revised: May 16, 2012

 

May 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Article in the Illinois Statehouse News on HMPRG Study Showing Negative Impact of Home Health Care Cuts

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Study says cuts to home care lead to rising costs elsewhere

By Anthony Brino | Illinois Statehouse News

SPRINGFIELD — Illinois Gov. Pat Quinn wants to cut $11 million in Medicaid spending on home health care and, according to a new study, the move could lead to higher costs in nursing homes and hospitals.

The Chicago-based Health and Medicine Policy Research Group [1], a health-care policy nonprofit, found that other states that cut funding for home-based services, such as Hospice, saw costs rise for hospitalization and nursing homes.
 
The group scoured national studies and data on spending for Medicaid home services and spending on nursing homes and hospitalization for elderly patients. In Michigan, the group found, after home-care waivers were cut, spending on nursing homes and emergency hospitalization increased.

“Home care stretches dollars,” said Lisa Hardcastle, president of the Illinois HomeCare and Hospice Council [2], an association of home-care providers, which commissioned the study. “It is a service that can help more people for less money.”

The study comes amid the governor’s efforts to find $2.7 billion to plug shortfalls for Medicaid, a federal-state health care program for low-income residents, and a larger battle among lawmakers and interest groups over next year’s budget.

It also highlights a looming challenge for the state health-care system — health care for the elderly. Within a decade the number of retired Illinoisans, now about 2.3 million, is expected to grow to 3 million, according to the study.

May 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG Study Shows Negative Fiscal Impact of Home Care Cuts

The following was sent to members of the Illinois HomeCare & Hospice Council (IHHC), re: the study we were commissioned to do by the IHHC which showed the deleterious effects of cutting home care.

The Illinois Legislature will soon be deciding on how to slash the Medicaid program to satisfy the Governor's request of a $2.7 billion cut. The initial proposal from Governor Quinn was a 10% reduction in home care and hospice services through utilization controls. The Illinois HomeCare & Hospice Council has responded by commissioning a study by the Center for Long-Term Care Reform at Health & Medicine Policy Research Group (HMPRG) on the negative fiscal impact of home care cuts. We invite you to read the study.

As leaders in the home care industry, we have always claimed that the more money government leaders invest in home care, the less they will need to spend on health care.

The HMPRG report found several pieces of research to back our claims:

*       One national study found that home health services for patients with chronic illnesses who had been hospitalized lowered the costs and readmissions significantly.
*       Another national study showed that investments in hospice decreased Medicaid costs by lowering use of acute hospital care and medications.
*       An Oregon study found a ripple effect of state Medicaid cuts which triggered an equal loss of federal funds and resulted in a decline of jobs and economic activity.

In an effort to reach members of the Illinois General Assembly with this new study, we are taking a multi-pronged approach.

First, we have sent out a press release to the major news outlets in Illinois. The study is garnering attention as evidenced by this article in the State Journal Register  published at the end of last week (May 16, 2012) which is also being picked up to others in the chain. 

The IHHC asked members to help push the news to their communities. We at HMPRG urge you to do the same.

*       We are asking you to submit a "Letter to the Editor" to your local newspaper that details the main points of the study.
*       We are also asking you to send a message to your legislator with many of the ideas from the press release as well as a link to the study.  Feel free to edit this message with your own personal stories.
*       Finally, please help distribute this study by using your own social media (Facebook, Twitter, etc.) and other relevant organizations you may be involved with.

This is an important time for home care providers to make their case as the cost effective alternative in Illinois. Legislators are being forced to understand the different services under the Medicaid program like no other time. With their eyes temporarily wide open, we have the voices, and now the tool, to educate them on how we are the solution the Medicaid cost problem in Illinois.

May 03, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In Chicago, Over 60 and Transitioned from Home to an In-patient Hospital Stay (Or Provided Care for Someone in This Situation?) Join the From Hospital to Home: Consumer Voices Forum on May 10.

Health & Medicine's Center for Long-Term Care Reform has been helping our colleagues at UIC’s School of Public Health to recruit for an upcoming civic engagement event: From Hospital to Home: Consumer Voices Forum.

This is part of the Bridge Program/Illinois Transitional Care Consortium project of the Center.

The forum targets individuals 60 years or older (or individuals who have provided care for someone 60 years and older) who have transitioned home from an in-patient hospital stay in the last 3 year

Date: Thursday May 10th 2012

Time: 9AM-2PM

Location: Plymouth Place
315 N La Grange Road, La Grange Park, IL 60526

For more information or to RSVP:
call (312) 355-1134 or email: Civic.RSVP@gmail.com

Continental Breakfast and Lunch will be served
Transportation assistance can be provided
Free parking 

There is no charge for this event

Download the flyer. Please spread the word toyour colleagues/friends/family that may be available to participate.  The event is next Thursday, so get the word out! If you have any questions, please let us  know by email  or call Kristen at 312.372.4292, x 27.

  Forum

May 01, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Quentin Young Speaks at Chicago Press Conference Re: the Closing of City Mental Health Clinics

Quentin Young, MD, Chairman and Founder of HMPRG spoke yesterday at a Chicago press conference calling attention to the City’s plan to close six mental health clinics.  Dr. Young pointed out the need for increased public investment in behavioral health as part of a comprehensive approach to coordinating and reforming our health system.  Dr. Young also talked about the use of our prison system as the defacto mental health system in our country as continue to cut budgets at City, County, State and Federal levels.  Reliance on the criminal justice system will neither improve people’s mental health nor reduce health care spending.

 Below are some links leading to coverage of the "Occupy City Hall-Chicago" Protests. 

http://progressillinois.com/quick-hits/content/2012/04/30/mental-health-advocates-decry-clinic-closings

http://www.huffingtonpost.com/2012/04/30/chicago-mental-health-pro_n_1465673.html

http://capriciousyetconstant.tumblr.com/post/22131986891/live-from-occupied-chicago-city-hall

http://chicago.cbslocal.com/2012/04/30/fight-for-mental-health-clinic-comes-to-obama-campaign-headquarters/

NBC photos: http://www.nbcchicago.com/blogs/ward-room/Occupy-City-Hall-132648913.html

Apr 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago-based Firm Doing Aggressive Debt Collection INSIDE Hospitals!

The NY Times story on aggressive debt collection and the "bottom-feeding ‘revenue cycle’ firm Accretive Healt" which positions people inside hospitals demanding upfront payments and debt repayment from patients seeking care, sparked interest by the Illinois Attorney General's Office which is  now investigating their practices.

 

Accretive is based in Chicago, right on Michigan Avenue. Their largest customer is Ascension Health, the largest Catholic hospital system in the U.S. Ascension is in the process of acquiring the suburban Alexian Bros. system.

Read the New York Times Story

Read the Crain's Story

Read the Crain's Healthcare blog post on how Minnesota's investigation of the company will impact the nonprofit (?) clients that use them

 

 

Read the New York Times Story

 

 

http://www.nytimes.com/2012/04/25/business/debt-collector-is-faulted-for-tough-tactics-in-hospitals.html?pagewanted=1&_r=1&hp

 

They don’t disclose all their customers, but they are based in Chicago, on Michigan Avenue. Their largest customer is Ascension Health, the largest Catholic hospital system in the U.S. Ascension is in the process of acquiring the suburban Alexian Bros. system.

Apr 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

From the Center on Budget and Policy Priorities: Medicare is NOT Bankrupt!

View the full Report

CBP

Medicare Is Not "Bankrupt"
Health Reform Has Improved Program’s Financing

"Claims by some policymakers that the Medicare program is nearing 'bankruptcy' are misleading. Although Medicare faces major financing challenges, the program is not on the verge of bankruptcy or ceasing to operate. Such charges represent misunderstanding (or misrepresentation) of Medicare’s finances.

"Medicare’s financing challenges would be significantly greater without the health reform law (the Affordable Care Act, or ACA), which substantially improved the program’s financial outlook. Repealing the Affordable Care Act, a course of action promoted by some who simultaneously claim that the program is approaching 'bankruptcy,' would make Medicare’s financial situation much worse."


Apr 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG Participates in Panel on "Rethinking Charity Care" At Chicago's Union League Club

Dowbload article and view related slideshow at Crain's  Chicago Business Thursday, April 26, 2012 (April 17 Crain's Chicago Healthcare Daily)

Panel examines hospital charity care

Crain's) — What non-profit hospitals should do to receive tax-exempt status was the topic at “Rethinking 'Charity Care,' " a breakfast panel discussion at the Union League Club of Chicago.

The event comes as efforts to reach a state legislative compromise on the question are at an apparent impasse. The spirited debate, which drew 110 attendees on April 12, was sponsored by Leadership Greater Chicago and the University of Illinois.

(Click here to view photos from the event.)

Kenneth Munson, Region V director of the U.S. Department of Health and Human Services, moderated the discussion by Mark Deaton, general counsel of the Naperville-based Illinois Hospital Association; Paul Gaynor, chief of the public interest division for the Illinois attorney general's office; Michael Gelder, senior health care policy adviser to Gov. Pat Quinn, and Janna Stansell, senior policy analyst at Chicago-based Health & Medicine Policy Research Group.

 

Apr 26, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago Tribune Prints HMPRG's Kristen Pavle's Letter to The Editor Re: Proposed Cuts to Illinois' Medicaid Community-Living Waiver program

Download the letter from the April 26 Chicago tribune site

3:01 p.m. CDT, April 25, 2012

Medicaid cuts

Many of the impending Illinois Medicaid cuts are short-sighted and will result in an increase in expenditures. This is particularly true for Medicaid community-living waiver programs that offer services for older adults and younger persons with disabilities.

A 2009 article in The Gerontologist showed that 2006 budget cuts to Michigan's state Medicaid community-living waiver program "were associated with increases in adverse outcomes: ER visits, hospitalizations, and permanent [nursing facility] placement." The study suggests that when we cut Medicaid waiver programs for persons with disabilities, these individuals cannot continue to live at home and require greater use of health services.

The Illinois legislature proposes changing the eligibility criteria for Medicaid community-living waiver programs, much like in Michigan. Let's be clear: this cut will backfire. It will ultimately cost the state more money through increased rates of hospitalization, ER visits and permanent nursing facility placement.

And I haven't even mentioned that there's more than balancing the state's budget at stake: in Olmstead v. L.C., the U.S. Supreme Court mandated a community-living option for all persons with disabilities. With three landmark lawsuits in Illinois recently settled under Olmstead (for mental health, developmental disabilities and physical disabilities), is the state of Illinois seeking to add a fourth lawsuit to the docket?

— Kristen Pavle, Associate Director, Center for Long-Term Care Reform, Chicago

Apr 23, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Press Release from The Chicago Department of Public health (CDPH) Re: Psychiatry Services to Be Expanded For Over 1,000 People Across Chicago

Chicago Department of Public Health Mental Health Reforms Continue to Expand  

Access to Care

Funding Awarded To Increase Psychiatry Services For Over 1,000 People Across Chicago

CHICAGO, ILLINOIS 

Today, the City of Chicago's Department of Public Health (CDPH) announced community mental health providers who will be the recipients of $500,000 to expand mental health psychiatry services across Chicago.

 

"These funds will provide access to psychiatric services to over 1000 more persons with serious mental illness in Chicago that visit community mental health centers," said CDPH Commissioner Dr. Bechara Choucair.

This award is just one part of a larger effort established by CDPH to improve the quality of the mental health system in Chicago in order to expand access to mental health services and increase support for the uninsured. CDPH is  increasing its focus on serving the uninsured and expanding partnerships with community mental health providers with over 60 locations across the city, so that individuals can receive quality service in their communities.

"These changes are long overdue. We will finally begin to see the types of reforms that will allow community mental health providers to better partner with the City to serve more residents and improve the delivery of services in every neighborhood," said Dr. Carl Bell, President/CEO of the Community Mental Health Council.  

In addition to this $500,000 investment, $3 million has been made available to community providers to expand and integrate HIV testing and substance abuse treatment into mental health services.

"A strong collaboration between the City, federally qualified health centers and community mental health providers is critical to strengthening the mental health infrastructure in Chicago," said Eric Whitaker, MD, Executive Vice President for Strategic Affiliations and Associate Dean for Community-Based Research at the University of Chicago Medical Center.

CDPH's reform plan also improves the quality of services provided in its own mental health system. The plan calls for the consolidation of the City's twelve mental health clinics into six and not only maintains its capacity to serve its current 4,000 clients a year but expands its network by working with community mental health providers at over 60 community-based locations across the city. These community-based mental health providers will provide comprehensive services to approximately 600 of CDPH's existing insured clients once the reform plan is fully implemented. CDPH has released a detailed update on the progress being made during the transition. The update can be found here.

Community leaders and experienced mental health service providers also expressed their support for CDPH's reforms:

"As the newest member of Chicago's Board of Health, I applaud CDPH's focus on the uninsured and look forward to working closely with the Department to monitor the progress of these changes," added Apostolic Faith Church Bishop Horace E. Smith, M.D.

"I applaud the City for looking at additional funding sources to support mental health and for focusing on one of the city's most vulnerable populations, the uninsured," said Dr. Terry Mason, Chief Medical Officer at Cook County Health & Hospital System.

"I commend the City for recognizing the need to expand psychiatric services in Chicago and for supporting the growth of community based mental health services in Chicago," said Joel Jonson, CEO of Human Resources Development Institute (HRDI)

"I am very grateful for the City's support and its focus on working with community partner's like LSSI to expand psychiatry services in the City's most underserved communities. It is a necessary step in improving the mental health system in Chicago," said Rev. Denver Bitner, D.Min., President/CEO of Lutheran Social Services of Illinois.

"Supporting community mental health centers that meet the diverse cultural and linguistic needs of our communities is a crucial step towards improving the mental health system. I applaud CDPH's new approach to mental health," said Francisco Cisneros, Ph.D. President & CEO of the Pilsen Wellness Center.  

"I commend the Department's focus on improving mental health infrastructure city-wide. It is critical that we improve the overall system to better meet the needs of our communities," said Ricardo Estrada, President/CEO of Metropolitan Family Services.

In November 2011, CDPH began implementing reforms to improve access to mental health services across the city. CDPH plans to continue serving over 80% of its currently active clients in existing mental health centers, and 20%, or only 602, clients with insurance will be served by community mental health providers throughout the city - including the more than 60 CDPH locations of partner mental health providers. Every CDPH client transferring to a new facility, service provider, or therapist, has a personal transition plan developed in consultation with their therapist to ensure every client continues to have access to care. A detailed report on the progress being made during the transition can be found here.

Improving access to care is a CDPH public health priority outlined in Healthy Chicago, the City's plan with a vision of making Chicago the healthiest city in the nation. Through collaborative efforts and with a focus on policy, systems, and environmental factors, CDPH will continue to lead the improvement of the city's mental health system. For more information about Healthy Chicago or the CDPH mental health reforms visit www.cityochicago.org/health.   

The community mental health providers that have been awarded funding to increase psychiatry services across the city are Community Counseling Centers of Chicago (C4); Human Resources Development Institute (HRDI); Lutheran Social Services of Illinois (LSSI); Mercy Hospital; Metropolitan Family Services; Mt. Sinai Hospital; Pilsen Wellness Center; and Thresholds.

 

 

 

 

 
Apr 17, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In Chicago? Call for Nominations for The 2012 HMPRG Awards

 

Call for nom

NOMINATIONS ACCEPTED

APRIL 15-JULY 30

As many of you know, every fall in a non-gala year, Health & Medicine hosts a special HMPRG Awards event to honor members of the public health and policy communities – from veteran practitioners to young justice-driven activists – for their vision, leadership and work that serves as a living embodiment of, or testament to,  public health and social justice.
General Eligibility Criteria:
- Current members of HMPRG Board, Committees, or staff ineligible
- Posthumous awards not considered
- Must live or work in Illinois or Northeast Indiana (Metro Chicago area)
- Self nominations are accepted
  • AWARDS CATEGORIES

  • HEALTH (Individual Award) Individuals who work within the health arena, using the broadest definition of health, with an emphasis on public health and improvements in the health of populations.
  • MEDICINE (Individual Award) Individuals whose work in any aspect of health care delivery (e.g. medicine, dentistry, mental health, nutrition, home care, pharmacy, insurance, medical groups) fosters system or institutional improvements.
  • POLICY (Individual Award) Individuals working in advocacy, government, media, or philanthropy, whose work encompasses the many facets of policy analysis, development, planning, and implementation.
  • RESEARCH (Individual Award) Applies to individuals involved in any aspect of quantitative or qualitative research, community-based research, or evaluative research that serves to promote improvements in the quality of life (recognizing the multiple determinants of health).
  • GROUP (“The Quentin Award”) (Organization Award) Recognizes that the sum of the whole is often greater than the individual parts, and honors a group, organization, or coalition that supports or enhances community self-determination and independence, focuses its work on any of the determinants of health, and has had an impact beyond the scope of its programs. In the spirit of Quentin Young’s support of creating long-lasting improvements through coalition-building and collective action, this award will be affectionately referred to as “the Quentin” award.
  • EMERGING HEALTH LEADER (Individual Award) Inaugurated in 2007, this award honors a leader under 30 currently involved in community-based work with broadly defined public health implications.

Nominate your candidate online

Download the nomination form

Download the HMPRG  Awards Call for Nominations flyer

Scan the qr code to get the HMPRG Awards form on your mobile phone

 Get information on the 2012 HMPRG Young Health Activist Challenge and Call for Nominations

The 2012 HMPRG Awards are Thursday, October 11, 2012
5:30-8:30

Save the Date!

The 2012 winners will be invited to participate in a brief moderated round table at the October 11th Awards Celebration, where they will be invited to respond to a question pertinent to all who work in public health. (Think “Ted Talks.”) It promises to be an exciting evening. We look forward to your nominations and to celebrating the winners with you in October.

Stay Tuned for HMPRG Raffle Information!

Apr 10, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

"No Safety Net," Quentin Young's Letter to the Editor April 9, 2012 Crain's

Download the letter from Crain's

No safety net

The proposal put forth by the safety-net hospitals in Illinois will cut as many as 300,000 people from Medicaid coverage ("Hospitals failing checkups," Crain's, Feb. 27). This reality places in stark relief the perpetuation of a broken health financing system. The toll will be exacted in preventable suffering, preventable death, in a word, the inhumanity of a health system that is the costliest in the world and yet leaves millions without financial protection.

This is true, of course, because the private insurance lobby insists on a high-profit denial-of-service model. Single payer financing would cover everyone with no increase in present expenditures. The continuing reliance on the existing model supplemented by public programs not only punishes the poor but increasingly makes our national economy unable to compete with countries worldwide that have adopted a rational health financing system.

Safety-net hospitals are indeed in jeopardy and rightly searching for solutions that will protect them and solve the state's financial challenges. Sadly, while cutting the Medicaid budget, the safety-net hospitals' proposal guarantees the swelling of the uninsured population in Illinois. In so doing, we will see more people using costly emergency room services paid for through the already strained county and city budgets.

QUENTIN YOUNG

Chairman,  Health &  Medicine Policy Research Group Chicago

Apr 09, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In the Chicago Area? Know a Health Hero???? Nominations Now Open for the 2012 HMPRG Young Health Activist Challenge

 

Invite part 1 blog

Click image above to open full size and scan qr code

Nominators must fill out the application form (downloadablebelow or available online) and write a brief 250-600 word essay describing why their candidate deserves the award. The essay may be attached to the online application, or you may email your essay along with the downloadable  form to hmprghealthchallenge@gmail.com, mail it to HMPRG, 29 E. Madison Suite 602, Chicago, IL 60602 or fax to  (312) 372.2753. Make sure your name and email are included.  

Nominees who are notified about their nominations (and  Self Nominators) must  fill out the application form and write brief 250-600 word essay describing your work as a health activist.  You may use the above methods to get your forms and essays to us. OR if you prefer to shoot a (3 minute max.) Flip Camera or smart phone video about yourself send an email to the above address and we will send you instructions for uploading.

The winner will be notified by September 15, receive a CASH AWARD, be invited to deliver personal remarks at the HMPRG Awards  Ceremony in October and appear in a videotape shown on HMPRG’s website and YouTube.

Nominees under 18 must submit the signature of a parent or  guardian on a release form.

All nominees will receive certificates  of  appreciation and invites to future events.

SUBMISSIONS ACCEPTED APRIL 15-JULY 30

NOMINATE YOUR CANDIDATE ONLINE (or scan the qr code above to fill out the application on your phone

DOWNLOAD THE APPLICATION

HAVE A FORM MAILED OR FAXED:  Call 312.372.4292, extension 30

DOWNLOAD A FLYER TO SHARE WITH COLLEAGUES, FRIENDS, SCHOOLS, CHURCHES, AND OTHER YOUTH-FOCUSED ORGANIZATIONS YOU KNOW

DOWNLOAD AN 11? X 17? POSTER TO SHARE

Questions? Send an email

 

 

Apr 04, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Something to think about in the wake of the Commonwealth Fund Report...

Link to the story

In a region where there are more hospitals and more medical schools than almost anywhere in the country, we have to wonder why Chicago ranks 215 of 306 in health care quality, cost, rates of uninsured, preventive care and preventive hospitalizations in the report released by the Commonwealth Fund this week

Our national leadership in lack of investment in public health coupled with the very limited amount of coordinated care across silos of institutions (hospitals and community based) are surely largely to blame.  Health and Medicine is convening groups to develop meaningful partnerships and commitment to public health that will address many of these indicators.

Apr 04, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Fair Care Coalition Letter to the Editor on Charity Care and Fare Share from April 3, 2012 Chicago Tribune

View the letter at Chicago Tribune online

This is in response to "Many hospitals facing stress test; Specter of losing property tax exemptions, massive state cut in Medicaid funding has some talking cutbacks, others of closing" (Page 1, March 27). The hospital officials quoted in your story on Medicaid cuts and hospital tax exemptions neglected to point out an important distinction between the two.

Medicaid cuts are part of a crisis that hospitals did not create. Tax-exemption revocations are a self-inflicted wound from years of behavior by some hospitals that have strayed from their mission.

While those hospitals have triggered the current debate, many safety-net hospitals do more than their fair share to provide charity care to patients in need and should be supported with a fair legislative solution.

At the same time that hospitals like Northwestern pay their CEOs huge salaries and claim they cannot help more poor people, hospitals like Norwegian American and Children's Memorial already see the most vulnerable populations and any reduction in revenue could reduce services or close the hospitals.

The Fair Care Coalition is concerned about adequate Medicaid rates, but the state is not "doubling down" on hospitals by seeking a real standard for property-tax exemption.

Rather, the governor, the Fair Care Coalition and others are looking for a solution that increases access to care for patients in need and fairly distributes the burden of free and discounted care.

Legislation should be passed this session that ensures no less.

Diane Limas, board president, Albany Park Neighborhood Council, and Curtis Smith, board member, Lakeview Action Coalition, the Fair Care Coalition, Chicago

Mar 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Quentin Young's Letter to the Editor in March 26, 2012 NY Times Science Section

Download the letter from the NY Times

To the Editor:

Your article ( A Drumbeat on Profit-Takers, March 19, 2012) captures Dr. Relman’s and Dr. Angell’s decades of responsible criticism of the major corporate entities that have disfigured American health care: the private insurances companies and Big Pharma. As we once again approach national elections, the pertinence of the views of these two medical giants should ring out loud and clear: The initiation of a single-payer national health program, an improved Medicare for all, is not only desirable but urgent.

Quentin D. Young, M.D.

Chicago

The writer is national coordinator, Physicians for a National Health Program.

Mar 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG Stands with Advocates Across the State inSupport of Solutions to the Medicaid Financing Challenge (Revised list of supporters)

 Download Keep Illinois Medicaid Strong principles 3-28

Keep Illinois Medicaid Strong: Principles for Financial Stability

The Illinois Medicaid program provides life-saving health coverage to nearly 2.7 million low-income children, parents, seniors, and people with disabilities and behavioral health needs, including addiction and mental illness. However, the program faces a $2.7 billion deficit this year, and legislators are exploring a range of solutions. We all need to ask: How much does each of these “solutions” actually cost us in health and long-term care outcomes and state funds? Our organizations endorse the following principles for stabilizing the Illinois Medicaid program.

Solutions such as cutting prescription drug coverage, eligibility, or optional services are unacceptable and will drive up long-term state costs. The services people on Medicaid receive now reduce future state health spending by providing prevention services and early intervention.

Transformative Medicaid reforms are being implemented but need time to work. To improve the health and lives of Medicaid recipients while reducing costs, Illinois is contracting with commercial managed care companies and networks of providers to implement robust care coordination models. However, these programs cannot be in place overnight.

The General Assembly and Governor have underfunded Medicaid for 20 years; a multi-year solution is needed to balance the program budget. Medicaid reforms enacted in 2011 already establish a decade-long glide path to pay old bills, and this plan should be followed.

The Medicaid budget cannot be balanced with Medicaid cuts alone. New revenue and savings from legislative changes in other budget areas must be applied to Medicaid. Medicaid cannot be firewalled from the rest of the state budget; it is an economic engine that supports families, creates jobs, and helps children learn.?

Supporters (3/28/12)

AARP Illinois

Access Living

AgeOptions

AIDS Foundation of Chicago

American Cancer Society, Illinois Division

Campaign for Better Health Care

Citizen Action Illinois

Chicago ADAPT

CJE SeniorLife

Health and Disability Advocates

Health and Medicine Policy Research Group

IL Alcoholism and Drug Dependence Association

IL Alliance for Retired Americans

IL Association of Public Health Administrators

IL Association of Rehabilitation Facilities

IL Chiropractic Society

IL Coalition for Immigrant and Refugee Rights

IL Maternal and Child Health Coalition

IL Society for Advanced Practice Nursing

IL Partners for Human Service

IL Public Health Association

IL Primary Health Care Association

Heartland Alliance for Human Needs & Human Rights

New Age Services

Ounce of Prevention Fund

Planned Parenthood of Illinois

Sargent Shriver National Center on Poverty Law

SEIU Healthcare Illinois Indiana

SEIU Illinois Council

 

 

Mar 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Health & Medicine's Comments Delivered to HFS Director Hamos on the Dual Eligible Initiative Proposal from HFS

Download the full comments and recommendations

Dear Director Hamos,

Thank you for the opportunity to submit comments on the Illinois Medicare-Medicaid Alignment Initiative Proposal (Initiative, or Proposal).  Health & Medicine Policy Research Group (HMPRG) is pleased to see Illinois, and in particular the Department of Healthcare and Family Services (Department), developing specific and strategic programs to serve the vulnerable and complex individuals who are dual Medicare and Medicaid eligible (dual eligibles). 

HMPRG has for over 30 years supported a public health system that is centered on a care coordination model that is person-centered, that integrates funding streams, that helps individuals remain healthy and out of institutional care settings, that improves the quality of care provided, and that lowers the cost of care. HMPRG agrees with the Department’s statement of the problem as presented in the Executive Summary of the Proposal: our current system of care (including acute, primary, long-term, emergency) is fragmented for Medicaid beneficiaries, and even more so for dual eligibles.  Indeed, for the reasons the Department outlines in the Executive Summary, it is precisely this fragmentation and lack of care coordination that leads individuals in poor health to have frequent visits to myriad healthcare settings, and ultimately results in high care costs with less than optimal health outcomes.

In this testimony, HMRPG will comment on the following issues as referenced in the Department’s Proposal:

  1. The timeline proposed for implementation of the Initiative
  2. The necessity to coordinate Medicare/Medicaid covered services and non-covered medical and social services
  3. Coordinating with HCBS case managers
  4. Care management risk stratification
  5. Care coordinators
  6. Multi-disciplinary team responsibilities
  7. Care plan development
  8. Care transitions

Download the full comments and recommendations

Mar 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

From Our Friends at Ounce of Prevention Fund-Early Childhood Advocacy Day is April 17

From Our Friends at Ounce of Prevention Fund:

Please join us April 17 in Springfield for Early Childhood Advocacy Day. With budget cuts threatening early childhood programs throughout Illinois, your legislators need to hear from you now! This is your chance to speak up about the importance of early childhood investments. 

At this free event, you'll learn about current legislative and budget issues affecting early childhood programs, including Preschool for All, home visiting and child care. The Ounce will provide you with everything you need to speak to your legislators, including training, talking points and lunch.

Early Childhood Advocacy Day
April 17

10:30 am – 3 pm:  Activities in Springfield
New Location: The State House Inn
101 East Adams Street, Springfield
Register Today

Vote for Your Favorite T-shirt
If you have been to Advocacy Day before, you know we make a statement at the Capitol in our yellow t-shirts! This year, you can help pick the t-shirt design. Visit our Facebook page to vote on your favorite design.

Early Childhood Rockets
You and your children can send a message to legislators by decorating early childhood rockets, which illustrate that early learning is the launching pad that children need to succeed in life.

Transportation
Transportation from Chicago is available to the first 60 registrants. Contact us if you have a large group that needs transportation from outside of Chicago. We may be able to provide assistance with transportation.

Contact us at advocacy@ounceofprevention.org if you have any questions. Registration closes April 12, so RSVP today. We hope to see you on April 17

Mar 13, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Interesting Post on Charity Care from The Washington Monthly

Download the post from the March 11, Washington Monthly

March 11, 2012 12:36 PM                     “Nonprofit” Hospitals and the Push for Fair Care

By Kathleen Geier

I’m loath to write about local issues on what is, after all, a blog with a national focus. But I do want to mention an initiative here in my home state of Illinois that I believe is important, and may have national implications. Progressive organizations and the Quinn administration are pushing for a bill that will ensure free and discounted health care, known as “charity care,” at hospitals that enjoy nonprofit status.

Currently, nonprofit hospitals are exempt from paying property and other taxes, so long as they provide a substantial amount of charity care; many such hospitals, however, have long ceased providing such care. Groups like The Fair Care Coalition are calling for legislation that “ensures access to healthcare, equity for all hospitals, and accountability to taxpayers.” They are seeking a standard that would require nonprofit hospitals to “pay 5% of their revenue in charity care and 1% of their revenue in the provision of health care services not located directly on the hospital’s site,” or otherwise risk losing their nonprofit status. Governor Quinn supports these efforts and has directed the state’s Department of Revenue’s to review of hospitals seeking charity-care exemptions.

As you may guess, there are all too many horror stories here in Illinois involving sick patients being denied care, or socked with astronomical bills, at taxpayer-subsidized hospitals. Here is just one of countless examples:

In 2010, Gudeliva Medina fell at work hit her head and lost consciousness. When she awoke she was at her local community hospital where she stayed for seven days. She told the hospital staff that she was uninsured but no one talked with her about charity care. She was told that she would receive her bill by mail. Soon she had received bills from the hospital for more than $70000.00.
Gudeliva, a mother of four, could not afford to pay her bill particularly since her husband had recently lost his job. Eventually her account went into collection. In 2012 0udeliva attended a meeting at her local church where she learned about charity care. She requested a copy of her bill from the hospital so she could apply for charity care. The hospital staff did not give her a charity care application. Instead the hospital staff told her that her husband could go to jail if she didn’t pay the bill. Her bill currently remains in collection.

I have my own personal tale of woe where this issue is concerned. I don’t have health insurance; I have not been able to find a full-time job and so right now I’m working part-time, without benefits. I applied for health insurance on the open market but was denied due to a pre-existing condition (though as it turned out I wouldn’t have been able to afford it, anyway). Last year, I needed to get a prescription refilled (not the meds itself, just a script), and not knowing where else to turn, I went to the nearest emergency room, which is at the University of Chicago hospital. Read the full post...

We've added The Washington Monthly's Political Animal Blog to our site. You can find it in the column to the right


Mar 12, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In Chicago? Come Join Us April 19th as former ABC News Medical Editor, Dr. Tim Johnson Discusses The Truth About Getting Sick in America: The Real Problems with Health Care and What We Can Do

Download the flyer

RSVP now to join us for a provocative dialog with Dr. Tim Johnson, former Medical Editor for ABC News; reporter for Nightline, 20/20 and World News Tonight; and founding editor of the Harvard Medical School Health Letter.

In the words of Dr. Johnson, “We seem to be a country that does not take decisive action on many social problems (civil rights, home mortgages, immigration, education reform) until our backs are against the proverbial wall.”

An expert surveyor of the health care landscape, he has many lessons (and strong opinions) to share about the problems that plague the American health care system and the urgent need for true reform.

When:   Thursday, April 19, 2012  
5:00-7:30pm

Where:  Loyola University Corboy Law Center
 (Kasbeer Hall)
25 E. Pearson St., Chicago

Program will begin at 5:30 and will be  followed by a Q & A Session.
Light Refreshments will be served.

RSVP:     The event is free to the public but   space is limited. Please reserve yours      
by April 16, 2012 at:    http://www.signmeup.com/82841
(Let us know if you are bringing a guest.)

 If you are unable to make it but would like to receive
invitations to other upcoming events, please update your information.

 This event is co-sponsored by health & medicine Policy Research Group, a nonprofit health policy center and the Loyola University Chicago Shareholders Advocacy Committee

Logo-johnson
Questions? Call 312-372-4292


 
 
 
 
Mar 12, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG's Margie Schaps' and Diane Limas' Letter to the Editor on Charity Care Published in March 12, 2012 Chicago Tribune

Download the ppost from the Chicago Tribune, March 12, 2012

From Voice of the People

Hospital taxes

Your March 2 editorial about hospital property-tax exemptions suggests that the best thing for hospitals, patients and communities would be to allow broad definition of charity that lets hospitals maintain their tax exemption based on the good work they already do. The Fair Care Coalition sees the unmet need in our communities, however, and we know that some needy patients ask for charity care at tax-exempt hospitals and are told it does not exist. A patient like this whose bill is classified as bad debt instead of as charity care may endure a stressful debt-collection process even if he or she should have qualified for financial assistance — and this while the patient is recovering from the illness or injury that put him or her in the hospital in the first place.

This cannot be considered charity, and it certainly doesn't distinguish tax-exempt, not-for-profit hospitals from tax-paying, for-profit hospitals, or indeed from any other business that has unpaid bills from customers.

No one in the hospital charity-care debate wants to hurt hospitals; what the Fair Care Coalition seeks is a system that works and encourages hospitals to live up to their own mission. If hospitals are serious about making a good-faith effort to relieve the burden of government, they could begin by providing diagnostic services to some of the thousands of patients on waiting lists in the county health system.

Margie Schaps, executive director, Health & Medicine Policy Research Group, Chicago
Diane Limas, community leader, Albany Park Neighborhood Council, Chicago

 

Mar 06, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Margie Schaps Crain's Letter: Think Through Medicaid Cuts

Posted march 6, 2012 Crain's

Think through Medicaid cuts

I am writing to clarify my position on the Medicaid cuts proposed by Illinois Gov. Pat Quinn, which I am afraid may be misunderstood ("Medicaid cuts would squeeze struggling hospitals even more," ChicagoBusiness.com, Feb. 23).

Health and Medicine Policy Research Group has been an unwavering supporter of the health care safety net in Illinois for 30 years. The proposed cuts may cut so close to the bone that some hospitals will be forced to close. It makes no sense for that to occur until we all look harder at system reforms, do better health system planning, identify new ways to generate tax dollars and find ways for the not-for-profit health care sector to collaborate with and support safety-net institutions (through charity care for example) so that they survive and thrive.

MARGIE SCHAPSExecutive director Health and Medicine Policy Research Group Chicago



Mar 01, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago Tribune Breaking News: Gov. Quinn Lifts Moratorium on State Review of Hospital Property Taxes

Download the full story

Gov. Quinn lifts moratorium on state review of hospital property taxes

By Peter FrostTribune reporter11:40 AM CST, March 1, 2012


Stakeholders, including the Illinois Hospital Association, representatives from the governor's office, the state Department of Revenue and the state Attorney General's office, among others, have negotiated for several months in an attempt to draft consensus legislation that would more clearly define how much free care nonprofit hospitals much provide in order to qualify for the tax breaks.

The governor in October called for the meetings and imposed a moratorium on further decisions about hospitals' exemptions from property taxes.

The issue stems from an August ruling by the state Department of Revenue that denied property tax exemptions for three hospitals, contending they did not provide enough charity care to qualify. Those hospitals — Northwestern Memorial Hospital's Prentice Women's Hospital, Edward Hospital in Naperville and Decatur Memorial Hospital; disputed the assessment.

The Illinois Department of Revenue decisions came in the wake of an Illinois Supreme Court ruling in 2010 that said the department was justified in withdrawing Provena Covenant Medical Center's property-tax exemption in 2004. The court found the Urbana hospital's charity care was insufficient to justify the exemption. Download the full story

 

Mar 01, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Crain's Chicago Business Article: Cook County Board President Preckwinkle Issues Letter to Gov. Quinn to Resume Consideration of Tax-Exemption Proposals

Read the full post

As talks stall, Preckwinkle prods Quinn over hospital tax exemptions

By Andrew L. Wang February 29, 2012

(Crain's) — Cook County Board President Toni Preckwinkle turned up the heat today on stalled negotiations over new rules exempting nonprofit hospitals from property taxes, asking Gov. Pat Quinn to resume evaluating applications for tax exemptions on March 1.

Mr. Quinn set that date last September as the deadline for a committee of hospital officials, government administrators and community groups to come up with a legislative solution for evaluating the hospitals' property tax liabilities. The governor imposed a moratorium on tax-exemption decisions while the committee met.

“As of today, no agreement exists,” Ms. Preckwinkle wrote to the governor. “Consequently, I am formally requesting that tomorrow you direct the Department of Revenue to resume consideration of all tax exemption applications from Illinois hospitals.”

In 2010, the state Supreme Court ruled that discounts given to the state's Medicaid program could not be considered charity care. The ruling upheld the denial of tax-exempt status for a hospital that is now part of Presence Health, the hospital network formed by the merger of Mokena-based Provena Health and Chicago-based Resurrection Health Care Corp.

The latest firestorm was ignited in August, when the Illinois Revenue Department stripped charitable status from Northwestern Memorial's Prentice Women's Hospital in downtown Chicago, Edward Hospital in Naperville and Decatur Memorial Hospital downstate, in part because they each spent less than 2 percent of net patient revenue on free care.

A spokeswoman for Mr. Quinn said the governor's office was aware of the letter and added only that the governor will announce next steps on Thursday. Read the full post...

Mar 01, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

USA Today Article: Cook County Board President Toni Preckwinkle Presses Gov. Quinn to Resume Thursday Considerations, Re: Charity Care and Hospital Tax-exemptions

Read the full article

Posted 8:26 PM Feb 29, 2012

By Carla K. Johnson, AP Medical Writer

CHICAGO (WTW) — With hospitals and consumer groups failing to find a compromise, Illinois Gov. Pat Quinn faced pressure to stick to his Thursday deadline and authorize rulings that could strip some nonprofit health care institutions of valuable tax exemptions.

Negotiations between hospital leaders and consumer advocates ended Wednesday afternoon in Springfield without a common framework or standard for hospital property tax exemptions, said Illinois Hospital Association spokesman Danny Chun. He described the two-hour meeting as "productive and cordial." The hospital group wants the talks to continue, Chun said.

But others say the discussions, which Quinn orchestrated, have failed and they prodded him to act. Cook County Board President Toni Preckwinkle pressed Quinn to direct the Department of Revenue to resume Thursday considering whether hospitals should be granted or denied tax-exempt status based on a 2010 Illinois Supreme Court ruling.

A consumer coalition also is calling on Quinn to authorize more rulings on the tax-exempt status of hospitals. The Fair Care Coalition accused the Illinois Hospital Association of "foot-dragging" during talks. The coalition plans to demonstrate outside a Chicago hotel Thursday where hospital trustees will be taking part in a breakfast meeting. Read the full post...

Feb 29, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago Tribune Article Quotes HMPRG Policy Analyst, Janna Stansell, on Charity Care Issue

Read the full article in the February 28, 2012 Chicago Tribune

Illinois Hospital Association readies draft legislation on tax exemptions as deadline nears

CARLA K. JOHNSON

AP Medical Writer

6:15 PM CST, February 28, 2012

CHICAGO (AP) — Finding a compromise on a legal standard that would allow Illinois' nonprofit hospitals to keep their valuable property tax exemptions is proving difficult as a Thursday deadline set by Gov. Pat Quinn approaches.

An eleventh-hour meeting is scheduled Wednesday with advisers from Quinn's office, representatives from hospitals and consumer advocates. If a compromise can't be reached, the Illinois Hospital Association is ready with its own draft legislation, while a consumer coalition is arguing in favor of a standard that most hospitals aren't meeting now.

Five months ago, Quinn set a March 1 deadline and halted the Illinois Department of Revenue from issuing rulings that would strip hospitals of the tax exemptions if they were deemed not to be providing sufficient charity care.

The governor's office will determine its next step on Thursday, said Quinn spokeswoman Brie Callahan. Quinn could extend the negotiations if a compromise can't be reached. It's also possible he could order the Department of Revenue to resume issuing rulings that could mean more hospitals would have to start paying local property taxes.

"We're prepared to follow the governor's instructions on March 1 regarding the moratorium on dealing with hospital applications for charity exemptions," said Department of Revenue spokeswoman Sue Hofer.

Illinois Hospital Association spokesman Danny Chun said the group wants the talks to continue, but that it has draft legislation ready and has lined up East St. Louis Democratic Sen. James Clayborne Jr. as the sponsor, Chun said.

"We're assuming (Wednesday) is not the last meeting. We're assuming these very important talks will continue," Chun said. "We do need a legislative solution passed this spring."

Chun said the hospital association supports a framework floated Monday by the Civic Federation. Under the proposal, a nonprofit hospital would be required to provide charitable care and other community benefits at least equal to the property taxes it would have paid.

On the other side, consumer group Fair Care Coalition wants each hospital to provide 6 percent of its revenue for charitable benefits to get a tax exemption. Eighty percent of that would have to be in the form of free or discounted care for the poor.

Few nonprofit hospitals meet that standard now, said Janna Stansell, who is a part of the coalition and a senior policy analyst for the Health and Medicine Policy Research Group in Chicago.

"We believe hospitals could do a better job of helping people access charity care," she said.

Only four of 25 nonprofit hospitals in Cook County are now meeting the standard proposed by the coalition, according to new data analysis that the coalition shared with The Associated Press.

Read the full article

Feb 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Crain's Article: IHA About to Take Charity Tax Exemptions Challenge to Illinois Legislature

Read the story in Crain's

By Kristen Schorsch February 28, 2012

(Crain's) — Barring a last-minute deal with the Quinn administration over the tax-exempt status of nonprofit hospitals, a powerful hospital lobbying group has lined up a prominent downstate Democrat to propose legislation to expand what counts as charity.

State Senate Majority Leader James Clayborne Jr., D- East St. Louis, has agreed to sponsor the Illinois Hospital Association's proposal, which would overrule a two-year-old Illinois Supreme Court decision that tightened the requirements for nonprofit institutions to be exempt from property taxes.

The proposal by the 200-member IHA would expand the definition of charity in the state's Property Tax Code to include not only free medical care to the indigent but also programs and losses that hospitals incur treating patients under Medicaid, whose reimbursement fees are well below market rates, according to a copy of the proposed legislation obtained by Crain's.

In 2010, the state Supreme Court ruled that discounts given to the state's Medicaid program could not be considered charity care. The ruling upheld the denial of tax-exempt status for a hospital that is part of what is now Presence Health, a hospital network formed by the merger of Mokena-based Provena Health and Chicago-based Resurrection Health Care Corp.

The latest firestorm was ignited in August, when the Illinois Revenue Department stripped charitable status from Northwestern Memorial Hospital's Prentice Women's Hospital in downtown Chicago, Edward Hospital in Naperville and Decatur Memorial downstate, in part because they each spent less than 2 percent of net patient revenue on free care.

A leader in the Chicago-based Fair Care Coalition, which calls for nonprofit hospitals to spend 6 percent of total revenue on charitable benefits, blasted the IHA's proposal.

“Not-for-profit hospitals are mandated by law to provide direct care to people who are underinsured and uninsured,” Curtis Smith said. “Providing a broader definition (of charity) clearly misses the mark.”

Read the full article

Feb 28, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Chicago Tribune Article - Hospitals & State Not Likely to Make Thursday Deadline on Charity Care Exemptions

Download the full article from the Chicago Tribune, February 28, 2012

Hospitals, state unlikely to make Thursday deadline on charity-care tax-exemption talks

Sources say parties divided on key issues, but progress being made; stakeholders from Illinois Hospital Association, Gov. Quinn's office, Department of Revenue, others plan last-ditch meeting Wednesday

By Peter Frost, Chicago Tribune reporter

February 28, 2012

Just days before a March 1 deadline to devise a formula for measuring how much free health care hospitals must provide in order to qualify for tax breaks, hospital and state officials remain divided on several key issues.

While the talks have been productive and are progressing, sources close to the negotiations say it is increasingly unlikely the parties will come to terms on the new rules before the Thursday deadline set by Gov. Pat Quinn.

Stakeholders, including the Illinois Hospital Association, representatives from the governor's office, the state Department of Revenue and other groups, have been meeting for months to draft new rules. They are scheduled to meet Wednesday in a last-ditch effort to resolve the issues prior to the deadline, said one source familiar with the talks.

But in a conference call with hospital leaders Friday, the hospital association told participants that it was "99 percent sure" a deal wouldn't be struck by Thursday, said two other sources.

Quinn called for the meetings in October at the same time he announced the state would temporarily hold off on further decisions about hospitals' exemptions from property taxes.

He set a March 1 deadline for recommendations with the goal of crafting legislation that would more clearly define what constitutes charity care, a measure by which the state determines whether nonprofit hospitals should qualify for property tax exemptions.

Illinois sent a chill through the nonprofit hospital world in August when it denied exemptions for three hospitals, contending they did not provide enough charity care to qualify. Those hospitals — Northwestern Memorial Hospital's Prentice Women's Hospital, Edward Hospital in Naperville and Decatur Memorial Hospital — disputed the assessment.

Hospital executives have since complained that the government's definition of charity care is too narrow and does not give hospitals enough credit for providing other community benefits, including donations to charitable health care organizations, education and outreach programs.

When Quinn announced the moratorium in October, at least 15 other evaluations were in the pipeline. If the state moved to revoke the tax-exempt statuses of those hospitals, they could be forced to pay millions in property taxes.

Read the full article

Feb 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Coalition to Quinn: Illinois nonprofit hospitals could keep tax exemptions by meeting standard

(Associated Press) First Posted: February 27, 2012 - 6:00 pm

CARLA K. JOHNSON  AP Medical Writer

CHICAGO — A coalition of health care advocates has a proposal for how nonprofit hospitals in Illinois can keep their tax exemptions.

The Fair Care Coalition has proposed to Gov. Pat Quinn's office that each hospital provide 6 percent of its total revenue for charitable benefits. Eighty percent of that amount would have to be in the form of free or discounted care for the poor.

The Illinois Hospital Association has been opposed to similar proposals in the past.

Last year, the Illinois Department of Revenue denied tax exemptions to three hospitals, citing an Illinois Supreme Court ruling.

Quinn later ordered state officials not to issue any new rulings, saying he hoped to work with the hospital industry to find a legislative compromise. Quinn set March 1 as a deadline for recommendations.

Download this post which now contains updatesd information

Feb 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In Crain's Article, DHFS Director Hamos says "...saving Medicare is the major social justice issue of our time."

Download the Greg Hinz post from February 27, 2012

From this week's Crain's Chicago Business

Ask Julie Hamos about Medicaid and, within about 10 seconds, she starts sounding like a GOP presidential candidate.

“The system is going bankrupt. It's going to collapse. I really believe that,” she says. The traditional fee-for-service medical delivery system “is killing us,” and key stake-holders are gaming a program filled with “abuse.” She concludes, “It's soooo screwed up.”

Good right-wing red meat, no? The only thing is Ms. Hamos is a liberal Democrat from the North Side. And in one of those odd twists that life sometimes throws, the former union lobbyist and state legislator is the lady in the bucket on the crucial task of somehow saving a Medicaid system that is nearly drowning Illinois in red ink.

As director of the Department of Healthcare and Family Services, Ms. Hamos, 63, has been tasked by Gov. Pat Quinn to hammer out a deal to slash spending by $2.7 billion this year, the minimum she says is needed to pay overdue bills and get spending back to a sustainable level. Though Ms. Hamos got the job about two years ago and pushed through some changes last year, it's only now that Mr. Quinn has decided that reining in Medicaid outlays is a priority.

Mr. Quinn's shift may have something to do with a recent report by the Civic Committee of the Commercial Club of Chicago that says Illinois is on track to tote up a staggering $21 billion in Medicaid IOUs by fiscal 2017. Whatever. Ms. Hamos' job is to avoid that fate, against long to extremely long odds.? Read the full post...

Feb 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

An Analysis, Re: the Impact of the President's FY 2013 Budget on Medicare

Center for Medicare Advocacy, Inc. released an analysis of the Presidents FY 2013 Budget, and its impact on Medicare.  Overall the Budget shows a commitment to strengthening and supporting Medicare, but there are some concerns about cost-shifting to Medicare beneficiaries.

 

Feb 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

SCAN Foundation Releases Comprehensive Report on the Diverse Characteristics and Needs of the Aging Population

SCAN Foundation releases an updated report on theDemographic & Economic Characteristics of Aging Americans”.  With the aging population growing as the baby boomers age, it is important to understand the diversity of the aging population as new policies and programs are designed to best fit the older American population’s needs.

For more detail at the state level, download the profile on older Americans developed by the Administration on Aging.  

 

Feb 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

AARP Policy Institute Publishes Report on Health Insurance for 50-64 year olds

Report notes that, though access drops as costs rise and employer-sponsored plans are declining, the new health care law promises help

AARP's Public Policy Institute examines sources of coverage for the 50 to 64 age group, issues confronting those not covered through an employer, characteristics of the uninsured, shifts in coverage with retirement, market trends, health care spending, and the impact of the Affordable Care Act.

Download the fact sheet

Download the full report

NOTE that you can now access AARP's blog on the Health & Medicine blog in the column  to the right.

Feb 27, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

AARP Unveils a Health Law Guide (In English and Spanish) to Help Clarify New Health Care Laws

 The Health Law Guide developed by AARP , an online tool to help individuals and families make sense of the health care law, launched publicly on Febrary 23, 2012. Access the Spanish version

 AARP's goal in developing this tool is to give people an easy way to learn about the provisions that fit their personal circumstances, so that they can make informed decisions about their health care choices. Visitors to the tool answer six simple questions and receive a personalized report that:

  • provides information about what is available now and over the next few years when the health care law goes fully into effect;
  • explains benefits and protections such as expanded coverage for preventive care and screenings and protections against insurance cancellations and lifetime limits on health insurance coverage; and
  • describes state specific programs and resources for people who are uninsured or who are having difficulty finding coverage.

AARP's Health Law Guide is designed specifically with the 50-plus audience in mind, and it is the only online tool on the Affordable Care Act that is also available in Spanish. AARP hopes our constituents will benefit from this resource, and invites us all to spread the word about this helpful tool.

Also, join AARP on March 1 at 7:00 p.m. eastern time for a free webinar that provides an overview of the Affordable Care Act and an introduction to the Health Law Guide.

 

Feb 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Companies and nonprofits unveiling new low-cost support resources for caregivers of the elderly

Read the February 12, 2012 Wall Street Journal article on some of the new low cost online, telephonic and other professional  resources for caregivers of the elderly. 

The article focuses on the companies and NPOs that are beginning to innovate new ways of supporting both professional and unpaid family caregivers in areas like care-coordination and quality assessment.

Read the full post

Feb 21, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Uprising Radio Features Quentin Young Talking About Single-Payer Health Care

Venerated Physician & Activist Dr. Quentin Young Urges ‘Single-Payer Healthcare’

Single payer healthcare has been a hot topic since the great healthcare debates of 2009 and 2010, but the organization, Physicians for a National Health Program, has advocated for a single payer system since 1987. The National Coordinator for the program, Dr. Quentin Young, spoke with Uprising host Sonali Kolhatkar on February 13, 2012.

Quentin_young_video

Being one of the founding members of the group is only one of many distinctions in Dr. Young’s storied career. Dr. Quentin Young was a founding member of the Medical Committee for Human Rights in 1964 and volunteered to provide medical care to civil rights protesters in Mississippi during Freedom Summer. He was a personal physician to Martin Luther King Jr and helped the Black Panthers and the Young Lords set up medical clinics in their communities. Dr. Young also provided medical care to protesters injured by police at the 1968 Democratic Convention in Chicago where 23,000 police officers were dispatched to quell protests. He is a personal friend of President Barack Obama with whom he disagrees on the need for single payer healthcare. Visit www.pnhp.org for more information.

Listen to or watch  a YouTube of the interview

Feb 16, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In 2011, the Affordable Care Act (ACA) extended free preventive services to 54 million privately-insured and 32.5 million on Medicare

Read the post on the USDHHS website

Health and Human Services Secretary Kathleen Sebelius announced today that the Affordable Care Act provided approximately 54 million Americans with at least one new free preventive service in 2011 through their private health insurance plans. Secretary Sebelius also announced that an estimated 32.5 million people with Medicare received at least one free preventive benefit in 2011, including the new Annual Wellness Visit, since the health reform law was enacted.

Together, this means an estimated 86 million Americans were helped by health reform’s prevention coverage improvements. The new data were released in two new reports from HHS.

“Americans of all ages can now get the preventive services they need, like mammograms and the new Annual Wellness Visit, free of charge, as a result of the new health care law,” Secretary Sebelius said. “With more people taking advantage of these benefits, more lives can be saved, and costly, and often burdensome, diseases can be prevented or caught earlier.”

Read the post on the USDHHS website

Feb 15, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Hospital Charity Care Becoming a Hot Issue Across the Country

Yesterday's Wall Street Journal Market Watch featured an article on the success California healthcare workers are having  in their efforts to build broad consumer support for two ballot measures to liminate price gouging at hospitals and increase charity care for the needy.

1.7  million signatures are required  to have The Fair Healthcare Pricing Act of 2012  and The Charity Care Act of 2012 included on California's November 2012 ballot. In the first three weeks since the signature initiative  was launched, 200,000 names have been collected.  Read the full post

 

 

http://www.marketwatch.com/story/healthcare-workers-crisscross-the-state-gaining-support-for-initiatives-to-end-hospital-price-gouging-increase-charity-care-2012-02-14

Feb 14, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Nurse-Midwives in Massachusetts No Longer Required to Have Physician Approval to Practice

...across the country, states are increasingly moving away from requiring a supervising physician  for nurse-midwives; a move that will broaden health access for women...

Download the February 9, 2012 post from Kaiser Health Capsules on the Kaiser Health Network Blog

Certified nurse-midwives in Massachusetts no longer need to have a physician sign on the dotted line in order to work in the state.

Under a new state law, nurse-midwives do not have to practice under a physician’s supervision.  Instead, they will be required to practice within a health care system and have a clinical relationship with an obstetrician-gynecologist.

At a practical level, the law means that nurse-midwives, who long have been able to write prescriptions and order tests, won’t need a doctor to oversee their decisions.  Massachusetts only licenses certified nurse-midwives, so the law does not apply to any other midwives.

Kathryn Kravetz Carr, president of the Massachusetts Affiliate of the American College of Nurse-Midwives, said the changes will make it easier for women to access health care.

Read the full post

Feb 13, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

NY Times Article Cites Research Showing NY Hospitals Persist in Agressive Collections Despite Charity Care Laws

This past Sunday, the NY Times featured an article on research showing that the state's hospitals are getting around charity care laws and engaging in aggressive collections policies.

Read the NY Times article from 2/12/2012: Hospitals Flout Charity Aid Law

In another development,  this past weekend, blogger Francine  from US Health  Crisis-Survival Strategies commented on a recent, disturbing USA Today article  about ways that hospitals are using purchased patient data to do targeted marketing designed to stream more private pay patients in for lucrative screenings, testing and more...

Read the original USA Today article

 

Feb 09, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Center for Long-Term Care Reform Co-Director Martha Holstein Writes about Lack of Economic Security Among Older Women.

Download a pdf of the article

HMPRG's Center for Long-Term Care Reform Co-Director Martha Holstein has written an op-ed, "A Troubled Old Age: Women and Retirement Insecurity,” for the Center’s January, 2012,  Elder Economic Security Newsletter.
 
“Many years ago, Tish Sommers, the savvy co-founder of the Older Women’s League (now OWL), and one of my heroines, observed that “women are one man away from poverty.” For many women, especially women lower on the economic ladder, that observation remains painfully true. Across the income spectrum however, older women tend to be poorer than older men. 70% of the elderly poor are women. Blame that on women’s longer life expectancy though not necessarily better health, their shortened work histories and lower earnings when working, the kinds of jobs they have had (less likely to offer pension benefits or salaries that were adequate to permit savings), and the financial penalties of drop-out years to have and raise children or to care for older family members. As a result, “women’s median retirement income is 58% of men’s median retirement income” (Rappaport, 2008, p. 1). The now familiar phrase “the feminization of poverty,” introduced in the late 1970s, continues unabated not only in this country but around the world.” (Download and read entire op-ed article here.)
 
The Center for Long-Term Care Reform is the official state-partner of the Elder Economic Security Initiative™ (EESI) a program of Wider Opportunities for Women.  For more information about EESI, visit our website  or email Kristen Pavle, Associate Director, Center for Long-Term Care Reform. Use the link below to subscribe to HMPRG's monthly EESI Newsletter.

Sign Up To Receive the Elder Economic Security Initiative (EESI) Newsletter!



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Feb 06, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

A Chance to Hear the Cook County Health and Hospitals Systems' New CEO, Dr. Ramanathan Raju

Listen to the presentation made on January 30, 2012 at the City Club of Chicago by Dr. Ramanathan Raju, the new CEO of the  Cook County Health and Hospitals Systems

Raju
In this 45 minute presentation, Dr. Raju addresses the challenges faced by the CCHHS and his vision for guiding the system and improving health access for the people of Chicago.

Feb 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Potential Resistance to Request for Cook County Medicaid Waiver

Earlier today we posted that the Illinois Department of Healthcare and Family Services submitted to CMS a request for a Medicaid waiver to expand coverage this year to people who would otherwise become eligible in 2014.  Before this waiver application is granted, the Illinois legislature must pass an exception to the Medicaid expansion moratorium passed last year. The notice below was just received and illustrates the opposition in the General Assembly to overriding last year’s moratorium.  We will keep you posted on the status of the application and the progress in the General Assembly as we hear.

Righter, Bellock: Administration Needs to Implement Medicaid Reforms, Drop Plans for Cook County Expansion

 Springfield, IL…..State Representative Patti Bellock (R-Hinsdale) and State Senator Dale Righter (R-Mattoon) today called on the Quinn administration to implement cost-saving Medicaid reforms already passed into law and to drop plans to seek a Medicaid expansion for Cook County.

“Governor Pat Quinn yesterday barely touched on the subject of Medicaid reform in his State of the State speech. Meanwhile, we have hundreds of millions of dollars in cost saving reforms we worked hard to pass into law that his administration has failed to implement, including the Medicaid Payment Recapture Audit that estimates say could recapture up to 10% of our total Medicaid costs through identifying fraud and other errors,” Bellock said. 

Other Medicaid reforms passed into law but not implemented include P.A 96-1501 requiring income and residency verification for Medicaid applicants; and P.A. 96-941 authorizing the Department of Health Care and Family Services to develop and implement an Internet-based transparency program that would be helpful in tracking provider fraud and improve service.

“Last year lawmakers passed bipartisan Medicaid reform that placed a moratorium on the creation or expansion of Medicaid programs, and established what I’m sure most people in this state would consider common sense income verification measures,” said Righter. “So I was dumbfounded to learn that even as the Administration drags its feet on filing the paperwork necessary to actually implement these reforms, they are expediting efforts in pursuit of an expansion of the Medicaid program in Cook County.”

The Illinois General Assembly passed and the Governor signed P.A. 96-1501 prohibiting any expansion of Medicaid programs for two years.  The moratorium took effect January 25, 2011.  This week it was learned that Quinn’s Director of Healthcare and Family Services is seeking a waiver to expedite by two years the influx of new Medicaid enrollees in Cook County expected under the new federal Affordable Care Act.  This expansion would unquestionably violate the moratorium and state law.

 “You don’t have to be a budget expert to understand that Illinois’ Medicaid program is growing at a rate that is unsustainable,” Righter added. “The Governor’s budget projections show that by Fiscal Year 2017 the Medicaid backlog will have reached $21 billion. These expansions are jeopardizing the entire program. Reforms are needed to pull this program back from the brink of insolvency, to ensure we still have a safety net for the people who truly need it.” 

Proponents argue this will not cost the state any money.  This is, at the least, a highly debatable point.  If we allow Cook County to add 100,000 people to its Medicaid rolls and the federal ACA is repealed or struck down in the courts, Cook County will turn to the State to make up the lost federal dollars it expected to receive. This could be as much as $125 million annually.

 “The moratorium was the top priority of our major reform bill of 2011, and it would set a bad precedent to ask for a waiver to expand the Medicaid population in this time of fiscal crisis,” said Bellock.  “We will be introducing legislation encouraging prompt enactment of our bi-partisan reforms already passed into law.”

####

Feb 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Center for Long-Term Care Reform Co-Director Martha Holstein Writes about Lack of Economic Security Among Older Women

In the Center for Long-Term Care Reform Co-Director Martha Holstein writes about the lack of economic security among older women.

 

Center for Long-Term Care Reform Co-Director Martha Holstein wrote an op-ed for the Center’s January Elder Economic Security Newsletter: “A Troubled Old Age: Women and Retirement Insecurity”

 

“Many years ago, Tish Sommers, the savvy co-founder of the Older Women’s League (now OWL), and one of my heroines, observed that “women are one man away from poverty.” For many women, especially women lower on the economic ladder, that observation remains painfully true. Across the income spectrum however, older women tend to be poorer than older men. 70% of the elderly poor are women. Blame that on women’s longer life expectancy though not necessarily better health, their shortened work histories and lower earnings when working, the kinds of jobs they have had (less likely to offer pension benefits or salaries that were adequate to permit savings), and the financial penalties of drop-out years to have and raise children or to care for older family members. As a result, “women’s median retirement income is 58% of men’s median retirement income” (Rappaport, 2008, p. 1). The now familiar phrase “the feminization of poverty,” introduced in the late 1970s, continues unabated not only in this country but around the world.” (Download and read entire op-ed article here.)

 

The Center for Long-Term Care Reform is the official state-partner of the Elder Economic Security Initiative™ (EESI) a program of Wider Opportunities for Women.  To learn more about EESI, visit our website  or contact Kristen Pavle, Associate Director, Center for Long-Term Care Reform.

Feb 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Hospital Penalties for Readmissions Make New Transitional Care Models Imperative

The Chicago Tribune's January 30th article  on the possibility of hospitals facing substantial financial penalties for high patient readmission rates - and the impact on low income patients - reaffirms the need for new transitional care models.

The Bridge Program - developed by The Illinois Transitional Care Consortium (in which Health & Medicine Policy Research Group plays a lead role) is an innovative model designed to assist older adults in the transition from the hospital back to the community, and reduce readmission rates.

Read the Tribune article

Learn more about the Bridge Program and the work of the Illinois Transitional Care Consortium

 

Feb 02, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Illinois Pursuing Early Medicaid Expansion

 Download the Associated Press article that ran in the  State Journal Register on Jan 31, 2012

The State Journal Register

State pushes Cook County Medicaid plan

By CARLA K. JOHNSON

The Associated Press

Posted Jan 31, 2012 @ 10:20 PM

CHICAGO — Illinois is asking the federal government to allow an early expansion of Medicaid coverage to low-income childless adults in order to bring millions of federal dollars into the struggling Cook County health system. 

Illinois Department of Healthcare and Family Services Director Julie Hamos sent a letter Monday to the U.S. Department of Health and Human Services supporting the proposal and asking for an expedited review.  

Any change would require state lawmakers to lift a freeze they put on Medicaid eligibility expansion last year. 

The Cook County Health and Hospitals System collected only $190 million in patient fees last year when it was expecting nearly twice that amount. County health system officials estimate expanding Medicaid would cover 100,000 currently uninsured patients a year who already receive care, bringing in federal matching dollars now unavailable. Only legal residents would be eligible. 

Medicaid costs generally are shared by the federal and state governments. But the proposed expansion wouldn’t use state money because Cook County pays its share of Medicaid. 

“We are thankful and looking forward to approval” from the federal government, said Dr. Ramanathan Raju, the county’s new health system chief, who has been pushing for the expansion. 

It’s unclear what would happen if the expansion isn’t approved. Cook County health system spokeswoman Marisa Kollias said the system “would never turn a patient away.” The county already converted a suburban charity care hospital into an outpatient center last year because of financial difficulties. 

Hamos’ letter seeks a waiver under the Affordable Care Act to move up the date of expanded Medicaid coverage for Cook County. In 2014, under President Barack Obama’s health-care overhaul, Americans who earn less than 133 percent of the poverty level will be eligible to enroll in Medicaid. States will receive 100 percent federal funding to cover the expansion for the first three years. 

Illinois lawmakers placed a moratorium on expanding Medicaid eligibility last year as part of a Medicaid reform package.  

“I do need to inform you that the Illinois law currently on the books will need to be altered before this waiver request can proceed under the contemplated timeline,” states Hamos’ letter to HHS. 

Hamos said it will be up to Cook County to convince state lawmakers. “They’re going to have to really reach out to the legislature,” Hamos told The Associated Press. “They’ll have to explain why this is important.”

Five other states and Washington, D.C., have expanded Medicaid early under the Affordable Care Act, according to the Kaiser Family Foundation. The states are Connecticut, Minnesota, California, New Jersey and Washington, said Samantha Artiga, a Kaiser Family Foundation analyst. 

 

Jan 30, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In Chicago? Participate in a DoughRaiser to Raise Funds for the Chicago Schweitzer Fellows Program!

DR4

Dine In or Take Out from any of Uno Pizzeria and Grill's 3 restaurants
on Wednesday, February 1 and/or Thursday, February 2 and up to 20% of your bill will be donated back to the Chicago Schweitzer Fellows Program!

? Uno Pizzeria and Grill, 29 E. Ohio
? Pizzeria Due, 619 N. Wabash
? Su Casa, 49 E. Ontario                                                                                                                                            

Visit any of the restaurants...
Order "take out" for your office...
Grab something delicious (pizza? salad? burger? taco? ) on your way home from work... (UNO was voted #1 healthiest chain restaurant in America by Health Magazine!)


Customers must present a DoughRaiser coupon for the donations to occur. The coupons will not be handed out at the restaurant so be sure to print them out before you go, or forward the pdf to friends.

Tix


Please encourage everyone you know to eat at Uno's on these days too – to help raise much needed funds for Schweitzer programs.

Jan 26, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Arthur Kohrman, MD, appointed as acting director of the Illinois Department of Public Health

Illinois Governor Pat Quinn has appointed Arthur Kohrman, MD (a long-time member of the Health & Medicine Board) to serve as acting director of the Illinois Department of Public Health (IDPH) effective January 29, 2012.

A physician-scholar whose works have appeared in journals and books and a recipient of several prestigious fellowships, Dr. Kohrman’s record of service accomplishments and honors is long:  since  completing pediatric and infectious disease residencies at Cleveland Metropolitan General Hospital and University Hospitals of Cleveland, Ohio, he has held several key hospital administrative appointments including Associate Chairman, Department of Pediatrics, Pritzker School of Medicine at University of Chicago; President and CEO of LaRabida Children’s Hospital and Research Center; and Associate Chair, Advocacy, Children’s Memorial Hospital and Department of Pediatrics at Northwestern University Medical School. In addition, Dr. Kohrman has held academic appointments at Stanford University, Michigan State University, University of Chicago and Northwestern University where  he is currently Professor Emeritus at Northwestern University’s Feinberg School of Medicine.

HMPRG board and staff congratulate Dr. Kohrman on this well-deserved honor to serve.

Jan 26, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

In Chicago? Participate in a DoughRaiser to Raise Funds for the Chicago Schweitzer Fellows Program

Jan 26, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Quentin Young and Lester Crown to direct new nonprofit foundation that aims to raise funds to support the Cook County Health and Hospitals System

The following appeared in Crain's Chicago Business,  Chicago Healthcare Daily, Jan. 24, 2012

Cook County health system wants to infuse new foundation with $250,000


Public health advocate Quentin Young and investor Lester Crown have been named directors of a new nonprofit foundation that aims to raise money for the cash-strapped Cook County Health and Hospitals System. The county health system's board is expected Friday to consider a proposal to give the foundation $250,000 in seed money to help launch fundraising efforts, a health system spokeswoman said. The money will go toward retaining professional fundraising services and, likely, toward insurance for board members, the spokeswoman said. Health system CEO Ramanathan Raju and interim Chief Financial Officer John Cookinham are nonvoting members of the foundation board, which will have nine members.

View the post

A bit of background as reported on the website of The Civic Federation on December 28, 2011:

Cook County Health System Names Crown and Young to Board of New Foundation

The Cook County Health and Hospitals System appointed Lester Crown and Dr. Quentin Young to be directors of its newly created not-for-profit corporation, the Cook County Health Foundation.

On May 26, 2011 the Health System’s Board of Directors approved the creation of the new foundation to seek charitable contributions for the public health system. The Cook County ordinance (Cook County Code of Ordinances, Chapter 38, Article V, Sec. 38-80(n)) that established the Health System in 2008 specifically authorized the Health System Board to encourage the formation of a philanthropic arm.

The Foundation is designed to operate independently from the Health System. The Foundation’s board will have nine members, including seven voting members. The Health System’s Chief Executive Officer and Chief Financial Officer will serve as non-voting, ex-officio members. 

The Health System’s Board on November 18, 2011 named Mr. Crown and Dr. Young as the first voting directors of the Foundation’s board. A business and civic leader in Chicago, Mr. Crown has been a long-time supporter of the Cook County public health system. Mr. Crown spearheaded the Chicago business community’s initiative to replace the old Cook County Hospital with the John H. Stroger Jr. Hospital, which opened in 2002. Dr. Young, a former Chairman of the Department of Medicine at Cook County Hospital, is the founder and Chairman of the Health and Medicine Policy Research Group, which advocates for improved health care for the poor in Illinois.

View the post

Jan 11, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Phyllis Mitzen from HMPRG's Center for Long-Term Care Reform Quoted in Tribune Series on Aging

In the December 1, 2011 Chicago Tribube article by Deborah Shelton on the high cost of long-term care, Phyllis Mitzen, Co-Director of HMPRG's Center on Long-Term Care Reform offered this explanation for the difficulty many people have planning early for their long-term care needs:

"People buy insurance for their life because they know they are going to die, for their car because they know that can get in an accident and for their health because they know they can get sick, but people don't tend to buy insurance because they think they are going to need someone to help them take a bath.."

Read the full article which offers several insightful comments by members of the aging community on this issue.

 

Jan 04, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

Covering Health

 

 

Also of interest, check out  Covering Health : Keepng  Keeping journalists informed – and connected, the website of the American Association of Healthcare Journalists.

the    http://www.healthjournalism.org/blog/category/health-care-reform/

Jan 03, 2012 Written By: Health & Medicine Policy Research Group (HMPRG)

HMPRG's Margie Schaps quoted in Crain's article on The Cook County Health and Hospitals System's desire for early Medicaid expansion

Download the full article here

Kristen Schorsch's article in  today's Crain's (January 3) frames how the county health system wants the new Medicaid eligibility rules to be applied to its patients later this year instead of waiting until 2014, when federal health care reform begins--to  give the public hospital system a competitive head start on serving the new Medicaid patients.

Margie Schaps, Executive Director of the Health &  Medicine Policy Research Group is quoted as saying:

"Cook County’s application likely will prompt badly needed changes. I think this will force (the county) to put better systems in place, to organize health care in a way that best serves the patients, and it will help ensure that the county system has a base of revenue so that it can operate and continue to serve the people in need who don’t have insurance”

Read the full article

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