Arc and Gov Rewrites DON Score Bill

Once again people with disabilities are pawns in the budget tragedy here in Illinois. On
Friday, Governor Rauner used his amendatory veto powers to limit choices in the Home
Services Program. The House will return to the Capitol to consider an override of the veto
on Tuesday.

In my opinion, the Governor’s action is in conflict with the “choice” provision in Medicaid
law.

I did find the language in the Governor’s veto interesting about the choice between
institutional and community services.

As noted in the governor’s veto message House Bill 2482 “takes a step in the wrong
direction… For too long, Illinois has over-prescribed institutional care to lower-need
individuals when less expensive and more appropriate care options are available. In order
to provide the best particular care for each individual, to ensure that our support services
remain affordable, and to maximize the number of individuals served, we must rebalance
the services being provided with greater precision. Prescribing institutional care for
individuals who do not need it is wrong for the individual and wrong for taxpayers.
Moreover, over-prescribing institutional care is inconsistent with the direction being taken
across the country.”

Story from Chicago Tribune below.

Tony

By Monique Garcia Tribune reporter

SPRINGFIELD — Gov. Bruce Rauner used an amendatory veto Friday to rewrite
legislation aimed at blocking his cuts to home care for the elderly and disabled, saying
Illinois cannot afford to provide the services without more sweeping changes in the way
the it does business.

The move sends the bill back to lawmakers, who can vote to go along with his changes,
reject them or do nothing and let the measure die. The action comes as lawmakers
prepare to return to Springfield to vote on another Democratic proposal that would roll
back the Republican governor’s cuts to a child care assistance program that helps low-
income families.

“These bills may be well-intentioned, but they are ultimately harmful to the programs they
are trying to help,” Rauner spokesman Lance Trover said in a statement. “The governor
understands and shares the frustration of members who want to fund these programs,
but the appropriate way to do so is in the context of a truly balanced budget.”

The state has been operating without a complete budget since July 1, after Rauner
vetoed the majority of the unbalanced spending plan Democrats sent him. The sides
remain deadlocked as the governor seeks to tie the budget-making process to winning
his agenda that would limit union rights and benefitbusiness owners.

As the governor tries to trim state spending in the meantime, he proposed cutting the
number of people who qualify for services such as adult day care, personal assistants,
homemakers, meal delivery and in-home therapy. To determine whether someone is
eligible for services, and to what level, an assessment is used to arrive at what’s known
as the Determination of Need score.

That score is calculated using a variety of factors, including how much help is needed
with day-to-day tasks like eating, grooming, travel, housework and preparing meals. The
higher the score, the greater the need. The current minimal threshold is a score of 29,
which Rauner wants to raise to 37 — a prospect advocates say would leave 10,000
people with disabilities and 24,000 seniors without help.

The bill Rauner vetoed was aimed at blocking his administration from raising the score.
In rewriting the bill, the governor kept the score at 29. In effect, that means he won’t be
able to raise the score down the road without approval from lawmakers.

But in return, his rewrite contains what could be a poison pill among Democrats: a
provision that would force patients to choose between receiving care in a community
setting or an institution, instead of allowing them to take advantage of both.

The governor argues that the move would save money by limiting access to more
expensive institutional care. But advocates say the change could prove problematic for
some seniors, and lawmakers said they would have to consider changes before
deciding whether to attempt to override the governor.

“I think that we have to be very careful that seniors and very frail people are not put at
risk,” said Rep. Greg Harris, D-Chicago, who sponsored the bill. “It looks like they are
trying to set up different classifications for seniors and different classifications for
people with disabilities.”

Harris said it was too soon to say how he would proceed with the legislation, saying the
changes needed to be carefully reviewed to also determine how they would interact
with federal laws. Rauner’s administration argues the changes would give the state
more flexibility in drawing Medicaid dollars.

mcgarcia@tribpub.com
Twitter @moniquegarcia

Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)
Tony@thearcofil.org