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Consumers, workers, and other stakeholders in the Illinois nursing home industry are voicing their opposition to a proposed 18 percent cut to the state Medicaid program.

Details of the potentially devastating round of cuts began to emerge on April 19. According to published reports, Governor Pat Quinn (D) wants to slash Medicaid rolls by 215,000 while lowering Medicaid reimbursement rates for doctors, hospitals, and nursing homes.

Quinn’s plan would save the state $2.7 billion.

A Quick Response

Nursing home stakeholders responded immediately to the threat. The Health Care Council of Illinois (HCCI), an organization representing nursing homes, scheduled a 17-stop protest tour to speak out against the cuts. HCCI held rallies in Rockford and Chicago during the weekend of April 21-22.

If enacted, the drastic Medicaid cuts would cause thousands of elders to be kicked out of their nursing homes, according to HCCI Executive Director Pat Comstock.

“What will happen to some of these residents is that they may not be able to stay here. They may lose their home,” Comstock told WBBM, a Chicago-area television network.

Report Shows Folly of Cuts

On April 25, the Campaign for Better Care and Families USA released a joint report (pdf) documenting the economic toll Quinn’s cuts would take on Illinois.

The report finds that the proposed $2.7 billion worth of cuts to Medicaid would put more than 25,000 jobs at risk and cost the state $3.3 billion in economic activity.

Many of those imperiled jobs would be in the nursing home industry, the report says.

“Cuts could mean jobs lost for [nursing] facilities’ employees, such as aides, nurses, pharmacists, and facility maintenance and management staff,” the report states. “Inadequate staffing lessens the quality of care that facilities are able to provide.”

– by Matthew Ozga

Illinois State Capitol in Springfield

Registered nurses will be required to provide at least 46 minutes of direct care each day to residents in Illinois nursing homes, pending a decision from a panel of state lawmakers.

The requirement stems from the state’s wide-ranging 2010 nursing home reform law, which mandated that skilled-nursing facility residents receive 3.8 hours of “nursing and personal care” each day by 2014, up from the current level of 2.5 hours a day.

As originally passed, however, the 2010 law did not specify how much of that care must be provided by a registered nurse.

The panel of lawmakers is considering a proposal that would fix that. The proposed rule would require a minimum of 46 minutes of care from a registered nurse each day. The figure represents 20 percent of the total 3.8 hours required.

Effect on CNAs

David Vinkler, associate state director of advocacy and outreach for AARP‘s Illinois legislative office, which supports the proposed rule, told the Chicago Tribune, “I wouldn’t be surprised if some homes might be staffing more heavily with [certified nursing assistants] in the absence of definition.

“That’s why it makes sense to do all of this,” Vinkler added. “You have to be comprehensive about how you address staffing in nursing homes.”

The legislative panel was originally scheduled to vote on the ruling March 6. However, it opted to delay the vote until at least April 17.

– by Matthew Ozga

(L-R) Personal assistant Katrina Nathans, client Mildred Davis, Illinois State Senate candidate Steve Stadelman

Four candidates for the Illinois legislature spent time alongside home care workers in February to learn more about the issues faced by both workers and consumers.

The candidates included three contenders to become the Democratic State Senate nominee representing Illinois’s 34th district: Dan Lewandowski, Steve Stadelman, and Marla Wilson.

“It was a great opportunity to see the importance of home health care to those who need the services, and the skills and caring attitude of workers who provide them,” Stadelman told PHI.

“The services are also cost-effective for the state,” he added.

Sue Scherer, a Democrat running for the Illinois House of Representatives from the 96th district, also shadowed a home care worker last month.

The Illinois primary will be held on March 20.

Walk a Day

The four events were arranged by SEIU as part of its “Walk a Day in My Shoes” series.

In 2007, then-Senator Barack Obama participated in a “Walk a Day” event, following home care worker Pauline Beck as she conducted her daily work routine.

Beck was invited to the White House in December 2011, when Obama announced a proposal to extend minimum-wage and overtime protections to home care workers.

PHI also encourages legislators and candidates to shadow home care workers as part of its “Come Care with Me” series.

– by Matthew Ozga

Senator Herbert Kohl

The Retooling the Health Care Workforce for an Aging America Act, originally introduced by Senator Herb Kohl (D-WI), chairman of the Special Committee on Aging, has picked up two new sponsors in the Senate — Blanche Lincoln (D-AR) and Bob Casey (D-PA), and a lead sponsor in the House of Representatives — Jan Schakowsky (D-IL).

The bill aims to address the impending shortage of health care workers who are adequately trained and prepared to care for older Americans and incorporates major recommendations put forth in an Institute of Medicine report released in April 2008. Read the full story

Wall Street Journal's Rundown of LTC Cuts

Health care stakeholders hoped this week the lame-duck session of Congress would examine a stimulus package that includes an increase to the federal medical assistance percentage (FMAP), the federal matching funds that states receive to fund their Medicaid programs.

Many states, such as New York, are threatening to cut Medicaid to make up for budget shortfalls.

According to a recent Wall Street Journal story, at least 15 states, including Alabama, Virginia and Massachusetts, are targeting funding for programs that allow low-income direct-care consumers to receive personal care in their own homes.

The story says the cutbacks are exacerbating the already long waiting lists for home-care support services in many states. With forced reductions due to state budget shortfalls, the low-income elderly and disabled may be forced into nursing homes.

Read the full story

“Every day, my family and countless others trust direct care staff to care for our loved ones. Yet we pay them less than we pay many of the college students brewing skinny lattes at Starbucks. Meager staff pay and benefits are the shameful back story of the generally positive effort to move intellectually-disabled people out of state institutions into the community. Starting hourly wages for direct care workers are typically a dollar or two above minimum wage,” says a piece in the widely read Huffington Post. The posting calls for paying direct-care workers “a living wage.”

In Think You Need a Raise? Caregivers for the Disabled Need One More Than You Do, Harold Pollack talks about Rayshawn, a direct-care worker at his brother’s group home in Chicago who, he says, his brother is “crazy about.”

Rayshawn and most of his colleagues, Pollack points out, are paid through Medicaid, “a program that bleeds red ink in just about every state. Our Governor’s proposed FY2009 budget again includes no cost of living adjustment for these workers. Nothing new or surprising there. Politicians are rewarded by powerful constituencies for good provided…. Direct care workers are not a powerful constituency, and they are pretty invisible to most voters.”

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org