Thursday, March 22, 2012

Medicaid expert sees few options for cuts

By Jamey Dunn

As lawmakers look to cut billions from the state’s Medicaid budget, one expert told them today that the task will be difficult and their options are limited.

Joy Johnson Wilson, health policy director for the National Conference of State Legislatures, addressed the Illinois Senate today about Medicaid trends across the country. She indicated that Gov. Pat Quinn’s demand that lawmakers find a way to curb Medicaid growth by $2.7 billion next fiscal year is an ambitious goal. She said she was not aware of another state that was trying to cut costs as much as Illinois, and that states that had successfully trimmed Medicaid expenses had done it through multi-year plans. “It is very hard to get savings in the Medicaid program in real time. It just is.”

Wilson emphasized that under the Affordable Care Act, states cannot make changes to who is eligible for Medicaid until 2014. At that time, residents above a certain earning level may be deferred to an online insurance exchange, where they could buy low cost insurance with the help of government subsidies. States can seek permission from the federal government to more rigorously check residents' eligibility status. After some delay, Illinois was granted permission to verify through state records whether applicants are residents. However, federal officials have not signed off on another piece of Medicaid reform passed in the state that would require applicants to provide multiple paychecks to prove their income level under eligibility requirements.

Wilson pointed out that the federal law leaves only a few areas to look for substantial savings. Lawmakers can reduce the rates paid to health care providers, limit how often patients can access some services, go after fraud and reduce services offered that are not required by the federal government.

“Optional programs in Medicaid are not like options on a car.” She said that options on a car are often considered luxury items, such as seat warmers or nice stereos, but they are not essential to making the car run. Wilson said many so-called optional Medicaid offerings, such as prescription drug coverage, are essential to the success of the program. She cautioned lawmakers to look at the “downstream financial, legal and political impacts” of cuts and reductions to services. “It’s very important that you make sure that you don’t make cuts that actually cost money,’ she said. Wilson said many states that eliminated adult dental services, something that is under consideration in Illinois, put the services back in place after they found that hospitalizations were going up. “So it actually cost them more when they eliminated them than what they were actually paying for them.”

She said some cuts can go too far and be met by public backlash. Arizona eliminated transplantation services but then put some back in place after a public outcry. “They have since restored some but not all of the transplantation services. She noted that Illinois is considering cuts to in-home services and said such reductions could run counter to Quinn’s stated desire to move people out of  institutional settings whenever possible. She said such cuts might also put the state in violation of court agreements, known as consent decrees. “If you are going to do something on the institutional side, then you’ve got to make sure that there’s some support for home and community based services.”

Wilson indicated that Quinn’s plans to transition people with developmental disabilities and mental health issues from institutional care to community care could be a crucial factor in the state’s efforts to find savings. “The critical piece is the assessment piece. Who belongs in an institution and who doesn’t? If you get that wrong, you will lose money. So that’s critical,” she said. “Who can actually be taken care of and function in a community, and who needs institutional care?”

According to Wilson, states that were early adopters of HMO-style managed care systems saw savings of up to 20 percent, but she said Illinois would likely not see such savings from a managed care program now. Instead, the state might see upfront costs. “We’re not seeing that now. … I think that you’re not going to get those big savings up front. In fact, it may actually cost something to expand Medicaid [managed care] to get savings later on because you have to make sure that your [health care provider] networks are adequate and that you do all the education outreach activities that are necessary to get people in the system and teach them how to utilize managed care.” She also said that managed care programs in the state’s rural areas would likely face challenges, but as the trend grows, more providers have become familiar with managed care.

Wilson also warned that ferreting out fraud involves upfront costs, such as hiring investigators. She said that eliminating fraud would not produce the desired savings on its own.

Sen. Heather Steans, who is a member of the working group looking to find the cuts Quinn has called for, said she found Wilson's presentation ‘a little disheartening.” “There’s a lot of restriction being put on by the feds in terms of the flexibility the states have, so there’s only certain things we can really look at, and that makes it, I think, more challenging to achieve the kind of reductions in the short period of time in which we’re talking about.”

But she said the presentation reassured her that her group is looking at all possible options. “Everything she talked about we’re actually already looking at and considering here. So I do think we’re on the right track in terms of making sure we are looking across the breadth of things that are possible,” said Steans, a Chicago Democrat. She said the Medicaid working group is meeting weekly to work on a plan to reduce the state’s Medicaid liability.

For more on the legislature’s efforts to cut billions from Medicaid, see the upcoming April edition of Illinois Issues.

University of Illinois president to step down

By Jamey Dunn

Almost a month after several high-profile faculty members called for his resignation, University of Illinois President Michael Hogan has decided to step aside.

The university announced today that Hogan will step down July 1, when Robert Easter, a long time University of Illinois employee and current interim vice chancellor for research on the Urbana-Champaign campus, is slated to take his place. A news release from the U of I said that after he resigns from the presidency, Hogan plans to continue working for the university as a tenured professor.

“It has been a distinct honor and privilege to serve as president of the University of Illinois,” Hogan said in a prepared statement. “While the university has faced some significant organizational and budgetary challenges over the past several years, we have initiated the reforms necessary to modernize and streamline our business functions and redirect the savings to academic purposes. The underpinnings of this great institution are sound." Hogan took the job at U of I in 2010 after then-President B. Joseph White resigned as part of the fallout from an admissions scandal. Before coming to Illinois, Hogan was president of the University of Connecticut.

The news of Hogan’s resignation comes after the U of I Board of Trustees received a letter in February signed by more than 125 of the university’s faculty members calling for Hogan to resign. Several endowed professors, a Nobel Prize winner and a Pulitzer Prize winner were among those who signed the letter. “We wish to state for the record that we have no confidence in Michael J. Hogan as president of this university. In our view he lacks the values, commitments, management style, ethics, and even manners, needed to lead this university, and his presidency should be ended at the earliest opportunity,” the letter said.

The faculty members said Hogan should step down because, among other issues, he used bullying tactics when dealing with university administrators and “exempted himself and those who immediately serve him from the financial discipline to which the rest of this University has been subject in times of frozen salaries and tight budgets.” Hogan was criticized by legislators and others for his more-than-$600,000 salary and additional perks that came with his job.

Hogan came under fire last January when his chief of staff, Lisa Troyer, resigned amid allegations that she posed as a member of the faculty Senate in emails that seemed intended to influence the group’s debate. She denied those allegations. The university later announced that Troyer would work as a faculty member in the Department of Psychology. Hogan has denied any involvement with the fraudulent emails, but the faculty letter chastised him for a “failure of ethical leadership” in the incident.

Christopher Kennedy, president of the University of Illinois Board of Trustees, said in a letter to U of I faculty and staff announcing Hogan’s resignation: “President Hogan joined the university at a very challenging time, when it had just weathered a long and very public controversy around admissions and enrollment practices, had major gaps in the administrative team, and was under such significant financial constraint that furloughs and salary freezes were required. Th board sought out a reform-minded leader and was glad to find Mike Hogan, a veteran and accomplished educational leader with a distinguished record, who was committed to carrying out an exhaustive mandate of change with a sense of necessary urgency." Kennedy touted some of Hogan’s accomplishments during his short time in the office, including budget cuts and efficiencies that Kennedy said resulted in $30 million in annually recurring savings. “It has not been easy. Some of what Mike Hogan was compelled to do was not popular, but he did what this University needed over the past 20 months, and we thank him for his hard work, perseverance and achievement.”

The Executive Committee of the Board of Trustees is scheduled to meet tomorrow to vote on the terms of Hogan’s resignation and to appoint Easter as president-designate. The full board is expected to vote on both actions during its May 31 meeting.

Easter has worked on the Urbana-Champaign campus for 36 years. He started there as a doctoral student.  He was dean of the College of Agricultural, Consumer and Environmental Science for seven years and later served as interim provost for the campus and also served as interim chancellor. He was appointed to his current post as interim vice chancellor of research last October.

Kennedy said the board thought the next president should be “a proven administrator with a track record of collaboration and success within our university.” Easter said in a written statement that he plans to “move forward energetically and collaboratively with an agenda that reaffirms the University of Illinois’ special place among the very best of institutions of higher learning in the United States.

Wednesday, March 21, 2012

House takes up legislative scholarships and eavesdropping law

By Jamey Dunn

The Illinois House hit the ground running when it returned today after the state’s primary election. The chamber took votes on two controversial issues, with mixed results.

The House approved House Bill 3810, a measure banning scholarships handed out by legislators. The legislative scholarship program has been a target of ire for years after reports that some lawmakers gave the scholarships to the children of campaign contributors and political allies. Rep. Fred Crespo, a sponsor of the HB 3810, said before today’s vote was cast, “A no vote means that you’re enabling unethical behavior.”

Gov. Pat Quinn pushed for the elimination of the program with an amendatory veto last year. But the amended bill was not called for a vote. “I applaud the members of the House for voting to end the legislative scholarship program. As I have repeatedly advocated in the past, scholarships — paid for by Illinois taxpayers — should be awarded only to those with merit who are in true financial need,” Quinn said today in a written statement. “I urge the Senate to pass this legislation swiftly.” Quinn wants the money spent on legislative scholarships to go instead toward the need-based Monetary Assistance Program (MAP) grants. Administrators of the MAP grant program announced today that it has run out of money for the year, and any students who applied after March 14 will not receive assistance.

But many lawmakers argued that the legislative scholarships are a relatively low cost way to ensure that some form of financial aid goes to students in every legislative district in the state. The program costs universities about $13.5 million annually. “This is not a significant cost to the universities,” said Rep. Jim Sacia, who has local superintendents choose the students that receive waivers in his district. Some lawmakers use independent panels to award the scholarships to avoid the appearance of corruption. “What a shame that some of our colleagues have abused this system. This is one of the finest opportunities for young people out there. It gives kids the opportunity to go [to college] who don’t have the financial wherewithal,” said Sacia, a Pecatonica Republican.

Crespo, a Hoffman Estates Democrat, said that he thinks there is enough support for the bill to pass in the Senate.

The House voted down a measure that would allow citizens to make audio recordings of on-duty police officers. Rep. Elaine Nekritz, a sponsor of HB 3944, said that the measure was meant to “level the playing field” because police officers can record suspects — such as a recording made at a DUI stop — while taping a police officer is a felony that can carry a penalty of up to 15 years in prison. “It would allow a citizen to record a public officer performing public duties on public property,” the Northbrook Democrat said of her bill. Illinois' strict provision in its eavesdropping law applying to public officials has come under scrutiny lately as some high-profile cases have played out in the state’s courts. Several defendants arrested for recording police have said that they had no idea they were breaking the law until they found themselves facing felony charges.

Opponents to HB 3944 said that allowing citizens to record on-duty officers could interfere with police operations. Chicago Democratic Rep. Dena Carli, a sergeant in the Chicago Police Department, said:  “These officers go out there on a daily basis. It’s not a level playing field when we go out there. We don’t know what we’re going to encounter, what we’re going to see, what we’re going to do, if we’re even going to come home.” Nekrtiz has said laws are already in place that would allow police to keep citizens from getting in the way of their work.

Rep. Roger Eddy, a Hutsonville Republican, voted against the bill, but he said he thinks the issue does need to be addressed. “I think something needs to be done, and I think often times addressing this type of a complicated issue in this body takes some time. I think the effort is there. I think maybe it needs a little more work to be soup.”

Low voter turnout favored well-established candidates

By Jamey Dunn

Yesterday’s primary saw low voter turnout and resulted in few surprises.

The new legislative map drawn by Democrats pitted several Republicans who currently hold seats in the General Assembly against each other. “It was essentially that the map was working the way that the Democrats designed to map to work,” said Kent Redfield, an emeritus professor of political science at the University of Illinois Springfield. He said the tactic of pushing incumbents to run against each other — either by mapping them out of their current districts or into districts with other Republicans under the new map — will allow Democrats to avoid facing incumbent Republicans in the general election. And looking ahead to next year, when the new General Assembly begins its session, the practice eliminates some incumbents who may have wielded political power in the legislature.

Races featuring current office holders involved negative campaigning, as candidates with similar records and views tried to differentiate themselves to a small pool of voters. “If there’s not any kind of policy difference, then it comes down to character issues, and those can be expressed negative or positively,” Redfield said. The State Board of Elections does not compile numbers for statewide turnout until a few weeks after the election, but media organizations across the state reported low turnout rates. The Associated Press reported that turnout was near 20 percent for many districts throughout Illinois. In some areas, this could mean record low turnouts. John Jackson, a visiting professor with the Paul Simon Public Policy Institute at Southern Illinois University, said the low voter turnout favored well-established candidates with money, name recognition and the campaign infrastructure to get out the vote. “It leads to organizations and people with money getting their personal robocalls made.”

This played out in several Republican primaries. Sen. Carole Pankau from Itasca beat Rep. Randy Ramey from Carol Stream 58 percent to 42 percent in the primary race for the 23rd Senate district. Pankau has served in the General Assembly since 1993. She hit Ramey hard with negative ads about his recent DUI arrest.

Sen. Kirk Dillard defeated Rep. Chris Nybo 62 percent to 38 percent in the GOP primary race for the 24th Senate District. Nybo, who took his current seat in 2011, criticized Dillard for his long political career. But in the end, the senator — who worked for Gov. Jim Edgar, served in the Senate since 1993 and made a failed run for governor in 2010 — prevailed.

Redfield said the race for the 53rd Senate District was in some ways the exception to the trend. Rep. Jason Barickman from Champiagn beat Sen. Shane Cultra, who is from Onarga and has served in the General Assembly since 2003. Barickman was appointed to fill Cultra’s House seat when Cultra moved to the Senate in 2010. While the less-experienced candidate won in this case, the two do have similar stances on many issues.

Redfield said such races that sometimes got personal and very negative can lead to some hurt feelings within the party and could cause tensions for the rest of this year as lame ducks and candidates must work side by side. “In some cases, people feel like their turf is being invaded or that good form in politics is to wait your turn, and people are not waiting their turn,” he said. “That good form kind of goes out the window when you get into these circumstances because people feel that it’s down to survival.” He said many of the winners of hard-fought Republican primary battles can now breathe easily because they are sitting comfortably in districts that were drawn to produce Republican winners. Many do not have challengers in the general election, and Redfield said the few who do will probably not face a difficult race.

During redistricting, the party in power often draws very solid districts for the minority party because then there are fewer voters from the minority to deal with in the majority party’s districts. (Regional demographics play into the map making, as well, and sometimes an area just leans heavily one way or the other.) So especially in the first few elections after the map is drawn, there are many districts that are dominated by either Republican or Democratic voters.

According to a column from Charles N. Wheeler III for the current edition of Illinois Issues, 35 out of 59 Senate candidates do not face a challenger in the general election, and 81 out 118 House races only have on party’s candidate in the general election. Jackson said that he thinks most voters did not realize that so many of the races for the General Assembly and some congressional races were effectively decided in the primary. “I think they just weren’t paying attention,” he said “I doubt that was widely understood in the mass consciousness.”

Party power did not go as far as expected in at least one race on the Democratic side. Sue Scherer, a Decatur teacher backed by House Speaker Michael Madigan, won the House 96th District, but only by 70 votes. Redfield said that while Scherer won, her association with Madigan could hurt her in the general election in a downstate district. The 96th was drawn to give a Democratic candidate a chance, but Redfield said that the race could go either way. “Madigan got the person that he wanted, but the way the campaign turned out really does put her in a hole going forward.” Update: While some media outlets have called the race in Scherer's favor, the results could change as absentee ballots come in over the next two weeks.

Jackson said that the low Democratic turnout can be attributed President Barack Obama not having a primary challenger, and the low Republican turnout may be indicative of many voters’ “lukewarm” feelings about Mitt Romney.

Perhaps the most controversial race in the state resulted in a win for a representative who was arrested on bribery charges last week. Rep. Derrick Smith, a Chicago Democrat, won the primary in the 10th House District. Democrats pushed for Smith’s election even after his arrest because they hope that he will step down, so they can replace him on the general election ballot. Smith’s opponent, Tom Swiss, is a former Republican who ran as a Democrat in the race. Smith won with 77 percent of the vote. “Obviously we lowered the bar a bit last night,” Redfield said. However, he said that most Democrats likely found Swiss “totally unacceptable” as a candidate and likely felt they were voting for Smith as a placeholder. “I think most people understand that Smith is not going to be around.”

The pressure for Smith to step down from his legislative position has already started. A group of House Republicans called for the creation of a House Special Investigative Committee to look into the charges against Smith. And his former employer and political supporter, Secretary of State Jesse White, has called for his resignation. Update: The investigation committee has been formed and is scheduled to meet on March 27.

Tuesday, March 20, 2012

Races to watch

With every seat in the General Assembly up for grabs under a new legislative map, this should prove to be an exciting and interesting election year, and the primary is no exception. Several Republican incumbents are running against each other after being drawn together into the same district or mapped out of their current districts, and the fight over a district that spans Springfield and Decatur has brought one candidate’s personal life under scrutiny and raised questions about the tactics House Speaker Michael Madigan is willing to use to see his chosen candidate prevail. Here are some races to watch:
  • The District 23 Republican Senate primary pits Rep. Randy Ramey from Carol Stream against Sen. Carole Pankau from Itasca She has gone after Ramey for his recent DUI, while Ramey has criticized her for being a largely self-funded candidate and saying she has done little during her time in the Senate. 
  • The District 50 Republican Senate primary race includes Sen. Sam McCann from Carlinville. McCann has Tea Party backing and the support of popular national politicians such as U.S. Rep Aaron Schock. Challenger Gray Noll is backed by the local party operatives and outgoing Springfield Republican Sen. Larry Bomke. 
  • The District 24 Republican Senate Primary will see Sen. Kirk Dillard from Hindsdale against relative newcomer Rep. Chris Nybo from Elmhurst. Dillard is a veteran of Illinois politics who worked for Gov. Jim Edgar before coming to the Senate in 1993. Dillard lost to a close primary to Sen. Bill Brady in the 2010 race for the governor’s office. Nybo is touting the fact that he is a fresh face and trying to play off backlash against so-called career politicians.
  • The District 96 Democratic House primary is a three-way race. Sue Scherer, a teacher from Decatur, is backed by Madigan. Sam Cahnman, a lawyer and Springfield alderman, is suing Madigan’s political action committees for fliers that highlight Cahnman’s alleged history of sexual misconduct, including charges of soliciting a prostitute. Cahnman was acquitted on the charges. The fliers paint him as threatening and potentially dangerous. Winston Taylor is also running for the Democratic slot on the ballot in the new district, which covers urban areas of Springfield and Decatur and was drawn as a potentially Democratic seat. 
  • The District 10 Democratic House race features a match up between a man many say is not a Democrat and a lawmaker who was arrested for bribery last week. Rep. Derrick Smith was arrested for allegedly taking a $7,000 bribe, but some Democrats are still urging those in their party to vote for him. That is because they say his opponent, Tom Swiss, is actually a Republican masquerading as a Democrat. Swiss denies this accusation, although the practice is not unheard of in the state. Democrats hope that if they can get Smith a primary win, they can push him to bow out and replace him with a candidate of the party’s choosing. 

There are several compelling congressional races across the state as well. They include:
  •  In the 16th U.S. Congressional District Republican primary, U.S. Rep Adam Kinzinger is running against U.S. Rep. Donald Manzullo. Each is trying to undermine the other's conservative bona fides, and the race has turned to personal attacks on both sides, as well. 
  • In the 8th U.S. Congressional District Democratic primary, Tammy Duckworth, who worked for President Barack Obama in the U.S. Department of Veterans Affairs and was director of the Illinois Department of Veterans Affairs, is running against Raja Krishnamoorthi, who lost a bid for the state comptroller's office in 2010. The polls close at 7 p.m. tonight. 
Here are some sources for breaking election coverage across the state:

Chicago Tribune / WGN

Lee Enterprises 

The Chicago Sun-Times

The State-Journal Register's The Dome

The Daily Herald

NBC Chicago

Check back tomorrow for analysis on tonight's results.


Corruption study on states yields surprising results

By Jamey Dunn

A watchdog project took a comprehensive look at the potential for corruption in state government, and the results were somewhat unexpected.

The State Integrity Project spent months looking into several areas of state government in all 50 states. The investigation — a joint project between the Center fro Public Integrity, Global Integrity and Public Radio International — issued a report card and ranked the states this week on their potential for government corruption. And for once, Illinois was not at the bottom of the class.

No states received an “A” from the group and eight states earned a failing grade. Illinois, along with 18 other states, received a C. A passing grade is little surprising for a state that has seen its two previous governors sent to federal prison for corruption convictions. And New Jersey, the state with the highest grade, has also been associated with corruption in recent years. New Jersey and five other states received a “B.” California, which ranked with Illinois in the top three states for corruption convictions in a recent report from the University of Illinois Chicago and the University of Illinois’ Institute of Government and Public Affairs, also received a “B.”

Illinois scored well in the areas of internal auditing, public access to information and its procurement process. The state's procurement procedures and its public information laws were revamped in the wake of former Gov. Rod Blagojevich’s impeachment and removal from office.

The state earned "Ds" for civil service management and legislative accountability and its only "F" for its redistricting process. A push grew before the 2010 census to revamp the way the state draws its legislative districts every 10 years. But reform efforts fizzled, and lawmakers redrew the maps last year in the same highly partisan and relatively secretive way that they have for decades.

The study warns that changes made in Illinois may do little to address the breadth of the state’s legacy of corruption. “But in some ways, they are like nips and tucks — cosmetic facelifts that conceal a host of ethical loopholes. Despite wide knowledge of its crooked history, Illinois remains a state where lobbyists do not have to disclose their fees, where legislators cannot be sanctioned for conflicts of interest, and where the judges who make it on the bench are those with the best political connections,” wrote Amanda Vinicky, Statehouse bureau chief for WUIS Public Radio and an Illinois researcher on the project.

David Morrison, deputy director of the Illinois Campaign for Political Reform, said Illinois and other states with reputations for corruption likely got passing grades in the study because their legislatures have approved anticorruption laws in reaction to scandal. "If nobody killed anybody, you wouldn’t need laws to outlaw murder. But that doesn’t mean you are protected from being murdered," he said. Morrison said that the State Integrity Project is an important measure but that it only looked at certain aspects of what plays into state level corruption. He said that the culture is also important, and in that area and others, Illinois still has work to do.

James Nowlan, a senior fellow at the Institute of Government and Public Affairs, said that culture extends beyond politicians to the state’s citizens. “Many in the public tell their children that politics is a dirty business,” he said. Nowlan said the idea that corruption is just a way of life in Illinois can be used to justify it when it occurs. “I think Illinois needs to work on the cultural underpinnings that seem to tolerate corruption.”

Nowlan said that not just Illinoisans but people across the country might be surprised that Illinois ranked in the top 10 states in an investigation that weighs protection against corruption. When Illinois usually gets a high ranking in such a study, it is similar to the one it got in a recent poll Nowlan conducted. He said that Illinois was perceived as the third most corrupt state in a recent nationwide poll he did to gauge public opinion of corruption across the country. “Illinois sticks out like a sore thumb in the Midwest as perceived to be a corrupt state.” However, most of Illinois’ neighboring states that were perceived to be far less corrupt in Nowlan’s survey ranked equal to or lower than Illinois on the State integrity Project’s scale.

The basics of the Affordable Care Act


Editor's note: This is the first in a periodic series of articles by Illinois Issues on health care. 

By Jamey Dunn
The fate of some of the the most integral components of federal heath care reform are in the hands of the United States Supreme Court, but many Americans are unaware of aspects of the law that are already in effect.

President Barack Obama signed the Affordable Care Act into law two years ago. Since 2010, provisions of the plan have rolled out across the country:

2010 
  • Tax credits became available for small business and nonprofit organizations that contribute to the cots of their employee’s health insurance. According to the Chicago-based Campaign for Better Health Care, 159,900 Illinois businesses are eligible for the credit. A Pre-existing Condition Insurance Plan (PCIP) was created. According to the Obama administration, the plan is meant to serve as a “bridge” to 2014, when in insurance companies will no longer be able to deny coverage to adults because of a pre-existing condition. In 2011, almost 2,000 Illinoisans had enrolled in PCIP. Individuals must be uninsured for at least six months before they can qualify for coverage under the plan. 

  •  Children can stay on their parents' insurance up to age 26 if they are unemployed or do not have access to insurance through their jobs. An Illinois law that went into effect in June 2009 allows unmarried dependents to remain on their parents plan until they turn 26. The federal law allows married residents under 26 to remain on their parents’ insurance as well. Under the state law, Illinois veterans qualify up to age 30. 

  • Children under 19 years old cannot be denied coverage due to a pre-existing condition. New insurance plans must cover some wellness and preventative procedures, such as cholesterol tests, without charging a copay or deductible. According to the campaign for Better Health Care, almost 2.4 million Illinoisans with private insurance received free preventative services as of 2011.

  • Insurance plans that offer obstetrical or gynecological coverage must allow women to see any OB-GYN within the plan’s network of doctors without requiring a referral. 

  • Insurance companies are no longer allowed to rescind coverage unless fraud is committed. In the past, insurance companies had taken away coverage for basic mistakes made on forms and other minor errors, sometimes leaving chronically ill patients without coverage. According to the Illinois Department of Insurance, Illinois had the most rescissions per capita in the country prior to the new rule. 

  • Lifetime caps on medical coverage costs where eliminated. Annual caps will be phased out in 2014. Caps can lead to patients with serious illnesses, such as multiple sclerosis or cancer, paying for costly treatments out of pocket or missing out on care. An appeals process must be in place for patients seeking to contest claims denied by insurance companies. 

 2011 
  • Medicare Part D patients who reach the so called doughnut hole, a point in coverage where they must purchase their prescription medicines out of pocket, get a 50 percent discount on Medicare Part D covered brand-name prescription drugs. Medicare is a federal program that provides health care services to people over 65. The affordable Care Act seeks to close the doughnut hole by 2020. In Illinois, more than 144,000 people received the discount last year. The average savings was $667 per person, and Illinois had a total savings of $96,216,548 according to the Campaign for Better Health Care. 

  • Medicare patients receive free preventative services, such as cancer screenings. More than 1.3 million Medicare patients in Illinois received such services in 2011. 

  • Large employers’ group plans must spend 85 percent of the premiums they collect on health care services or improving health care quality. Plans for individuals and smaller employers must spend 80 percent of premiums on care. Companies that fail to meet these thresholds because their overhead costs or profits are too large will be required to give a rebate to customers. 

  •  The Community Care Transitions Program was created to help high-risk Medicare patients access care after a recent hospitalization. The program is intended to keep such patients from needing to be readmitted because of a back slide in health due to a lack of care once they head home. 

2012 
  • The Department of Health and Human Services is required to collect, analyze and report on demographic data in an effort to address health care disparities across racial, ethnic and socio-economic divides. 
Some provisions of the Affordable Care Act only apply to individual plans purchased before March 23, 2010, or group plans created before that date. See the federal website created to explain health care reform, healthcare.gov, for more information.

Despite all these and other provisions, the bulk of the plan goes into effect in 2014. Health care advocates in Illinois estimate that 20 percent to 40 percent of Americans are unaware that any of the Affordable Care Act has been implemented so far.

Some of the most controversial pieces are facing a constitutional challenge. The mandate that after 2014, most Americans must purchase health insurance or face a financial penalty collected by the Internal Revenue Service is the focus of most of the legal challenges. Under the mandate, those who cannot afford insurance would receive subsidies to purchase it or be put on Medicaid, a joint state and federal program that provides health care to the poor.

The mandate is meant to keep people from gaming the other changes to the rules. If insurance companies cannot turn away people with pre-existing conditions, people could wait until they got sick to get insurance. If there were no healthy people in the pool of the insured to balance the costs of caring for the sick, premiums would skyrocket. The theory goes that if everyone buys insurance, the cost of insuring those with chronic illness would be paid for with the premiums of those who are relatively well and who are not seeking much health care. In turn, the healthy insured would have coverage when the time came that they might need it. The Obama administration argues that the requirement falls under the government’s power to regulate commerce and levy taxes.

But 26 states sued over the mandate, and new requirements that would be put on states. The U.S. Supreme Court will decide whether the mandate goes too far, punishing Americans for failing to purchase a product. The court will also decide if Congress overstepped its power by requiring states to accept new Medicaid provisions and a vast expansion to remain in the program. If the court strikes down any one part of the law, it must determine whether the other pieces would stand alone. The U.S. Supreme Court is scheduled to hear arguments on the case beginning on March 26. The court has planned for six hours of hearings over three days. A ruling is expected this summer.

As the court weighs the issue, many states are dragging their feet on implementing other pieces of the reform. States are reluctant to create health insurance exchanges, online marketplaces where customers can comparison shop for insurance, until the court has ruled.

Mayra Alvarez, director of Public Health Policy in the Office of Health Reform at the U.S. Department of Health and Human Services, said that states need to have exchanges in place by the fall of 2013 to meet requirement that they go online January 1, 2014. She said new rules the administration issued this month would allow states great flexibility in creating their exchanges and the option to partner with the federal government to run a hybrid exchange. States who are not ready by the deadline could use such a plan until they have their own exchanges up and running. Residents in states that do not create their own exchange would be able to access a federal exchange. “A federally facilitated exchange will be up and running in 2014,” she said. “The state may run a component, and the federal government may run a component.”

Illinois has received $6.2 million in federal grants for planning and implementation of its exchange. The state has begun the process, but advocates do not expect lawmakers to vote on the core aspects of the exchange until after the primary election at the earliest, or next fall, after the U.S. Supreme Court has ruled, at the latest.

Monday, March 19, 2012

Romney talks energy policy and reaches out to women in Illinois


Ann and Mitt Romney with Springfield Mayor Mike Houston (background) at a local diner.

By Jamey Dunn 

Republican presidential hopeful Mitt Romney stopped in the state capital this morning as part of his push to gain support in Illinois before tomorrow’s primary.

Romney, the former governor of Massachusetts, focused on the economy and energy policy as he addressed the crowd at Springfield's Charlie Parker’s Diner. “People across this country are wondering what they’re going to do with these gasoline prices,” Romney said. “ A lot of moms wonder: Can they take their kids from event to event and to school and to soccer practice? People are hurting in this country with gasoline prices the way they are.”

He said the increasing gas prices have been “caused to a degree” by President Barack Obama’s energy policy decisions. However, as Republicans have made gas prices a predominant issue in the primary, some have argued that the spiking price at the pump has less to do with energy policy and more to do with speculators gambling on the market or international crises.

Romney’s nod to mothers seems to be a part of his efforts to connect with female voters in the state. His wife has been regularly taking the podium at campaign events, voicing her concerns about the nation’s deficit and the legacy that will be left to her children and grandchildren. “I am hearing this from women everywhere. They are concerned about the economy. I love it that women are talking to me about the economy and about deficits,” Ann Romney said today.

The Romneys' message resonated with some of the women who came out to see him this morning. “I like his ideas. I want somebody that’s going to cut spending, but my main interest is energy independence. I send emails all the time to congressmen. I send them to Romney all the time,” said Diane Munkirs, a retiree from Rochester.

“I read his book  —  parts of it  —  and I really liked his emphasis on family,”said Munkirs, who described herself as a political news “junkie.” “People fuss about him not being as conservative, it seems, as other [candidates]. But yet, as a Mormon — that’s a conservative religion. As a businessman, you have to be conservative with money. He has five boys. I think they’re probably a pretty conservative family. I just think he’s a great candidate. I really do." She said she is urging Republicans and Tea Party members she knows to back Romney so the party can line up behind him and he can build a war chest that will rival Obama’s successful fundraising totals. “We should all get behind Romney, and let’s get going and have a candidate to support.”

Illinois politicians came out to support Romney, touting him as the candidate who can defeat Obama. U.S. Rep. Aaron Schock said, “As Illinoisans, we know better than anyone what Barack Obama and his team are all about.” At the mention of the president, who began his political career in Springfield, a few audience members responded with groans. “Of all the candidates in this race, in the Republican primary, there is only one candidate who has put together the organization in every state, who has raised the resources that can go to go toe to toe with Barack Obama and who has the track record of being able to withstand the inferno of attack ads and win on election day, and that is Gov. Mitt Romney.”


But at least one Obama supporter was in the crowd today. “I think that it’s important to see issues from both sides of the aisle,” said Kerry Hansen, a Springfield resident who said she turned 21 today. “He was a good speaker. He was very nice. I got a picture with him. It’s my birthday, so I pulled the birthday card.” Picture aside, Hansen said she does not plan to vote for Romney because she doesn’t support his views on social issues such as same-sex marriage. She also said she agrees with the national mandate that insurance provide birth control for women, something Romney has opposed on the grounds that it would force religious employers to go against their beliefs. “I do think gay marriage should be legalized. I think abortion should be made safe. I think birth control should be free under health care,” Hansen said.

Romney made no mention of his Republican opponents by name, but he did hint at them not having the experience he says is needed to pull the country out of its slump. “I’m someone experienced in the economy.  I’m not an economic lightweight. We’re not going to be successful in replacing an economic lightweight with another economic lightweight. We’re going to have to replace him with someone who knows how to run this economy.”

Former U.S. Sen. Rick Santorum, Romney’s closest opponent, is also travelling the state looking for support. He hit back at recent events, calling Romney a “Wall Street financier” who was unable to create jobs in his stint as governor. Former U.S. House Speaker Newt Gingrich and U.S. Rep. Ron Paul trail behind but have yet to exit the race. They latter two have made appearances in the state but are not putting on the kind of 11th-hour campaign blitz that Santorum and Romney are in Illinois.

Illinois has 54 delegates up for grabs in tomorrow’s election. Fifteen other Illinois delegates will head to the Republican convention in June not tied to any candidate. Santorum failed to meet the filing requirements in four of the state’s 18 congressional districts, so voters in those districts will not be able to choose delegates to back him for the nomination. This means Santorum cannot compete for 10 of the state’s delegates. A candidate must get 1,144 delegates nationwide to win the Republican nomination. Heading into tomorrow's primary, Romney has 521, Santorum has 253, Gingrich has 136 and Paul has 50. Recent data from Public Policy Polling gives Romney a comfortable 15-point lead in the Illinois primary tomorrow.

For an interesting look at what Illinois Republican officeholders past and present think of Romney and the race for the Republican nomination, see Politico.

Thursday, March 15, 2012

Unions call for repeal of business tax breaks to stave off closures

By Ashley Griffin 

“Show some guts, not cuts!” and “Quinn says cutback, we say fight back!” were some of the chants from hundreds of American Federation of State, County and Municipal Employees who protested in front of the Executive Mansion in Springfield Thursday afternoon.

The protest brought together hundreds of caregivers, child protection workers, correctional officers, state police personnel and other state employees who could possibly lose their jobs under Gov. Pat Quinn’s FY 2013 proposed budget. Quinn aims to cut most state agencies’ funding by 9 percent and close several state facilities, including mental health centers and residential centers for the developmentally disabled. But according to some workers, instead of cutting, Quinn should repeal the tax breaks for businesses that was passed last December. According to Jeff Bigelow, a regional director for AFCSME Council 31, repealing the tax cut package would be an “easy way to avoid these cuts.”

“They want to cut the Jacksonville Developmental Center [and] another developmental center,” Bigelow said. “They want to cut mental health centers. They want to cut adult transition centers. They want to cut prisons. They are closing 24 offices where people go apply for food stamps, and Medicaid, putting it further out of reach for people who can’t afford to get there anyway because they don’t have money to put gas in the car. Everything that they are doing is government for the rich and cutting back for the rest of us, and we’re saying they are wrong.”  But the tax breaks, geared at keeping the CME Group and Sears in Illinois, were the product of months of negotiations, and lawmakers are unlikely to repeal them.

Quinn argues that the cuts and closures are necessary and part of an overall plan to trim state costs. “The closures and consolidations proposed in the state budget are hard but necessary,” Kelly Kraft, Quinn’s budget spokeswoman, said in a prepared statement. “They impact every region in our state, but due to decades of fiscal mismanagement, tough decisions need to be made to address the state’s budget challenges, If action to change Medicaid and pensions this legislative session does not take place, more and more services will be reduced or eliminated just to pay these costs. We need to stop being in denial, need to stop delaying payments and need to stop the disinformation campaign in order to resolve our Medicaid and pension challenges and to make certain [that] education, public safety and our most vulnerable are always protected.”

While AFSCME members marched and chanted today, most lawmakers and Quinn were far from Springfield. The legislature is not in session this week, and many lawmakers are presumably doing last-minute campaigning for next week’s primary election. “We wanted to let [the General Assembly] know they are going to hear about it, whether they're here or not. We’ll let them know that people oppose Gov. Quinn’s proposed cuts because they definitely hurt public service,” said Kent Beauchamp, another regional director for AFSCME Council 31. “It's really outrageous that he is making these cuts as a way to pay for the huge tax break that he gave to large corporations in this state. What he’s saying is that ‘My priorities are giving tax breaks to the corporations and not providing services to the public.’ That’s exactly what he is saying.”

Today’s demonstration in the capital was one of 50 protests AFSCME plans to hold statewide.

Tuesday, March 13, 2012

Court tosses out campaign finance limits for independent PACs

By Jamey Dunn

A week before the Illinois primary election, a federal court tossed out a piece of the state law that limits campaign contributions.

The court granted pro-choice political action committee Personal PAC’s request for a permanent ban on the amount donors can give to such groups. Previously, individual donors were capped at $10,000 and corporations and unions could only give $20,000. But after the U.S. Supreme Court ruling in Citizens United vs. the Federal Election Commission, Personal PAC argued that such limits are unconstitutional, and U.S. District Judge Marvin Aspen agreed.

The Supreme Court found that limiting how much groups spent independently from candidates violated their free speech. Personal PAC argued that limiting how much they can raise on such efforts, known as independent expenditures, violated their First Amendment rights as well. “Personal PAC sought to bring Illinois campaign finance law into compliance with what the First Amendment supports. We are thrilled that the Court ruled quickly and in our favor,” Terry Gosgrove, president and chief operating officer of Personal PAC, said in a written statement. The group claims that it has already missed out on about $100,000 in contributions that it would have raised without the caps and was holding a check for more than $17,000 it could not deposit under the state’s campaign finance laws that went into effect last year.

The group also asked the court for permission to form more than one political action committee. The new campaign finance reform laws barred organizations from having more than one committee. The ruling allows such groups to create second committees that would be used solely for independent expenditures, and they would be allowed to raise unlimited funds. “Personal PAC asserts that it only seeks to vindicate its right to create a separate PAC that would solely engage in independent expenditures, and once doing so, to receive unlimited contributions. In other words, it is not proposing to make independent expenditures and direct contributions from the same PAC,” the opinion stated.

“It’s about the decision I expected,” said Kent Redfield, director of the Sunshine Project, a nonprofit campaign contribution database connected to the Illinois Campaign for Political Reform. “It seems like a reasonable extension of Citizens United, although it is an issue the court has not considered.”

But Redfield and others take issue with the logic of the U.S. Supreme Court’s ruling. “The fiction of Citizens United is that because it is an independent expenditure, the people making the independent expenditure are promoting a candidate and there’s no policy component, no quid pro quo, so there can’t be corruption or the appearance of corruption,” Redfield said. “It will be a way for people to funnel large contributions to support a candidate.”

However, he said that today’s decision is likely to have a larger effect on the 2014 governor’s race than it will on this year’s legislative elections because the legislative leaders are so well-funded and there are relatively few races that are actually up for grabs in November. “Elect someone independent from [House Speaker Michael Madigan]?” he asked. “It didn’t work out really well for [former governor] Rod Blagojevich and his Move Illinois Forward PAC.”

Redfield predicts super PACs will support single candidates in the 2014 races for governor and other statewide offices — much like the ones that have been making unlimited independent expenditures for Republican candidates during the presidential primaries and others that have been collecting money to help President Barack Obama's reelection bid. “The real muddling thing in all of this is, when you get to single-candidate independent-expenditure PACs,” he said, “is there a wink and a nod? … Is there leverage in terms of if certain things don’t happen you’re not going to get any support in the next election?”

Representative arrested for bribery eligible to run in next week's primary

By Jamey Dunn

State Rep. Derrick Smith was arrested today on bribery charges but could remain a candidate in next Tuesday’s primary election.

Prosecutors allege that Smith accepted a $7,000 bribe in the form of a campaign contribution to write a letter of support for a day-care center that he thought was vying for a $50,000 Early Childhood Construction Grant from the Illinois Capital Development Board.

But the day care owner was fictional, and the day care was not seeking the grant. Smith was the subject of a federal sting.

According to the criminal compliant, an employee who cooperated with prosecutors said that shortly after Smith was appointed to the General Assembly last March, he floated the idea of using a state grant to pay the employee for work on his failed campaign for Cook County commissioner. The employee is referred to as CS-1 (short for Cooperating Source) in the complaint. “Almost immediately following his appointment as state representative in March 2011, Smith agreed to present CS-1 as a contractor so that CS-1 could apply for and receive a state grant. Smith told CS-1 that the grant funds would be used to pay CS-1 for [his] campaign work. Smith told CS-1 that Smith, in turn, would take a ‘fee’ for approving the grant.” The employee said he turned down the proposal.

He went on to work with the feds to broker a phony deal between Smith and the day care. According to the complaint, the Federal Bureau of Investigation paid the employee $4,000 for his cooperation and also helped cover moving costs.

Between December of last year and March of this year, prosecutors say and Smith and the employee worked out a deal to sell a recommendation letter for campaign contributions as prosecutors recorded their phone calls and in-person conversations. The complaint said that Smith provided an official letter of support on March 2, 2012. The complaint said that Smith wanted the $7,000 in cash, quoting him as saying, “‘I don’t want no trace of it.’” Smith agreed to give the employee $2,000 for brokering the deal and to cancel the debt owed him for campaign work.

According to the complaint, the two met last Saturday afternoon, and the employee gave Smith $7,000 cash provided by prosecutors. Smith allegedly gave the employee $1,000 cash and promised another $1,000 in the form of a check.

 If convicted on bribery charges, Smith faces up to 10 years in prison and a $250,000 fine.

Smith is running in next Tuesday’s primary in the10th legislative district. He faces Tom Swiss, a former director of the Cook County Republican Party who is now running as a Democrat. Swiss has called for Smith to resign. Smith was not available for comment at his district office.

 However, there is nothing in the law to force a resignation or stop Smith from running on Tuesday. “[He’s] innocent until proven guilty,” said Ken Menzel, deputy general council for the State Board of Elections. Menzel said that Smith would only be ineligible from holding his position if he is convicted. “Unless he withdraws as a candidate, he’s still in the game.”

However, Menzel added, “This kind of news a week before the election is the kind of thing that generally loses you the election.”

There is no Republican opponent slated for the general election, but the party could change that. The Republican central committee could pick a candidate after the primary, and that person would then have until June 4 to gather the required 500 signatures.

U of I officials eye Medicaid and pension reform

By Jamey Dunn

University of Illinois officials say they are worried about more than just their line item in the state’s budget for next fiscal year.

U of I President Michael Hogan said that Gov. Pat Quinn’s recommendation for flat funding to the state’s universities is a positive development. “We are grateful for that recommendation.” But Hogan said flat funding levels do not ensure that the U of I is safe from cuts. He said university officials are closely watching the legislature’s actions, especially when it comes to Medicaid and pension reform.

He told a Senate budgeting committee Monday in Chicago that retirement benefits are “critical part of the overall compensation package” that must be competitive so the university can “recruit and retain” sought after faculty and staff. Hogan said that faculty members bring in millions of dollars of research funding. However, he said, “I understand there will be shared pain as we wrestle with this issue.” Legislative leaders and Quinn have tossed around the idea of asking universities to chip in on employee pensions. It is unclear how much cost would be shifted to universities under such a plan.

Walter Knorr, chief financial officer and vice president of U of I, said the possibility of Medicaid cuts “puts us at the edge of our seats.” He said that almost 40 percent of those seeking treatment at the university’s hospital in Chicago are Medicaid patients, and the hospital also administers about $42 million annually in charity not covered by Medicaid. Knorr said that Quinn’s call for legislators to cut more than $2 billion from Medicaid costs next fiscal year is “another uncertainty added to our list.” Hogan said the hospital serves many who otherwise would not have convenient access to health care. “There’s literally no other place for them to go that’s easily accessible to them.”

 Some lawmakers have targeted tuition waivers given to university employees as a potential area for savings. Knorr gave the breakdown for the cost of all the waivers the school gave out in Fiscal Year 2011. Mandatory waivers that the school must give included: $9 million for veterans, $4 million for faculty and staff who have been on the job for seven years and $9 million for General Assembly scholarships doled out by legislators. General Assembly scholarships have been the focus of controversy after some have been given to the children of big political donors and other politically connected individuals. Legislation to eliminate the program has failed to gain the needed support. However, many lawmakers now use independent panels to award the waivers, and some have stopped giving them out altogether.

The U of I also gave $20 million in discretionary waivers to undergraduate students and $175 million to graduate students, much of which is compensation for working as teaching and research assistants.

Sen. John Mulroe, a Chicago Democrat, said he is worried about the increasing costs for public education in the state. “[Tuition rates are] going up and up and up and up,” he said. “We have to find some ability to flatten them or to keep them flat so we don’t price out education for the average kid.”

In January, the U of I approved a 4.8 percent tuition increase for incoming freshman. Knorr said that under the increase, a semester at Urbana-Champaign campus would cost about $5,800, at the University of Illinois Chicago campus about $5,100 and at the University of Illinois Springfield about $4,500 for in-state students. Under state law, tuition rates for each year's class of incoming freshmen are guaranteed to remain the same for four years.

Thursday, March 08, 2012

Universities hope to keep guns off campuses

By Jamey Dunn

Proponents of concealed carry hope that it’s their year to end the state’s ban on carrying firearms in public, but a provision aimed at universities is causing some tension.

Illinois is the last state in the nation to bar any form of concealed carry for residents. A bill that would have allowed concealed carry came up for a House vote last year but failed to reach the three-fifths majority that it needs to pass. “I think we’re very close. I think it’s the closest we’ve every been, actually,” said Rep. Brandon Phelps, a Democrat from Harrisburg who sponsored that bill and a new incarnation being considered now. (For more on the push to pass concealed carry in Illinois, see the current Illinois Issues.)

University presidents and chancellors came out hard against concealed carry legislation last year, sending an opposition letter to legislators that asked for an exemption for university and college campuses. “We fully support the concept of individual rights, a core value at each of our universities, but we also must uphold the security of our campuses. We believe that, at the minimum, an exemption to any future law that permits the carrying of concealed weapons on all college and university campuses within the state is fundamental,” the letter said.

Under the new legislation, House Bill 5745, universities would have the option to ban concealed carry on campuses. However, if they did, they would be opening themselves up to potential lawsuits. The bill says: “If a community college, college or university elects to prohibit the carrying of firearms on its campus, it shall be civilly liable for any injury from a criminal act upon a person holding a permit for carrying a concealed firearm who was prohibited from carrying a concealed firearm on the premises.”

Supporters said they wanted to give colleges the option to prohibit guns on campus. However, Todd Vandermyde, a lobbyist for the Illinois Rifle Association, said, “You can’t have it both ways.” Vandermyde explained the liability provision to a House committee that approved the bill this week. “If I’m there and I have a carry permit and because of college campus policies, I can’t have my firearm on me and something like [the ]Northern Illinois [school shooting] happens and I’m injured, they bear all liability for my injuries because I was disarmed and unable to protect myself.” In February 2008, a former NIU student shot more than 20 people — killing five students and himself — on the school’s campus.

Not surprisingly, university officials are unhappy with the new bill. “Our view is that is has no basis or precedent at all. It turns the issue of civil and criminal liability on its head,” said Paul Palian, a spokesperson for Northern Illinois University. “That would be like Ford’s Theatre being held responsible for John Wilkes Booth shooting Abraham Lincoln.”

According to the National Conference of State Legislatures, last year, lawmakers in 18 states considered bills that would allow for some version of concealed carry on campuses. Conversely, recent school shootings also led to calls for greater restriction of guns on campuses. Last year, two states considered bills banning concealed carry on campuses, but neither bill passed. Twenty-five states allow universities to decide whether students can carry guns on campus, while 21 states ban guns on campus, and four require campuses to allow concealed carry.

A recent court ruling overturned university rules in Colorado that barred concealed carry on campus. The state’s law did not include an exemption for universities, but the University of Colorado Board of Regents argued that it had the right to ban guns on campus. “We are disappointed the Colorado Supreme Court determined that the Board of Regents does not, in this instance, have the constitutional and statutory authority to determine what policies will best promote the health and welfare of the university’s students, faculty, staff and visitors, whose safety is our top priority,” Bruce Benson, president of the University of Colorado at Boulder, told Inside Higher Ed. “The Board of Regents is in the best position to determine how we meet that imperative. We will abide by the ruling and determine how it affects our campuses.”

A study from Arizona's three public universities found that allowing concealed carry on campus would cost them $13.3 million in upfront spending for signs to inform students of areas that they cannot carry weapons and lockers to hold guns while students are in classrooms.  Lawmakers in the state are considering legislation that would allow guns on campus. The study also found that universities would have to spend about $3.1 million in annual costs such as additional security. But Arizona proponents of concealed carry on campus said that the study overestimated costs.

Southern Illinois University President Glenn Poshard said he is concerned that allowing guns on campus would mean big costs to universities during tough budget times. “The accommodations to this — I’m telling you we’ve had our budget cut $30 million per year since 2002. How are we going to afford additional millions of dollars in spending, when the state owes us $112 million right now as we speak?” Poshard asked.

University representatives say they have other logistical concerns, as well. “I’m sure that what is on university administrators’ minds is how do you implement this situation,” Palian said. He said that Northern would not support a provision in the bill that would allow for concealed carry on roads that pass through universities, even if the institution had opted to ban concealed carry on campus. “We have a thoroughfare right through central campus,” he said. “That would mean people could transport guns through there.”

David Steelman, director of government relations for Western Illinois University, said he is concerned that a provision that allows for concealed carry on public transit would allow students to carry guns on the university’s bus system that is set up through the local transit district. “Keeping in mind that that bus operates very late on a Friday night and picks up many students downtown … that makes some people very nervous.”

Steelman said that he does not understand why universities are the only entities in HB 5745 that would be subject to liability if they opted against concealed carry. “We’re all a little bit puzzled and uncertain as to why that language was included. It seems a little punitive to us.” Under the proposal, guns would be barred from other state-owned buildings, such as the Statehouse, courts and schools.

 During the hearing, some lawmakers in support of the bill warned that the liability clause might hurt the legislation’s chances of passing. “This just from the guy who’s been around the track quite a few times. The objective here is to move toward concealed carry, and I support that,” said Gilson Republican Rep. Donald Moffitt.  “I have voted for it every time. We look kind of silly here in Illinois now that we’re the only state not to have it. The added provision in here about the liability … that may not be building support.”

Vandermyde said that other entities do not fall under the liability provision because many of those groups have come forward to negotiate on the bill. “The position of the universities, community colleges and everybody has been just an absolute flat out no. And so they don’t want to have a dialogue, so maybe this will push the dialogue,” he said.

But Steelman said the universities have been at the table. “I think we did a considerable amount of negotiations last year when this came up. We spoke specifically about exemptions we had hoped might be contained.” He added, “Sometimes people’s interpretation of failure to negotiate is that it’s not what they want.”

 Poshard said that he thinks there is still plenty of time to work on finding compromises. “We would like the ability to continue to discuss this,” he said. “Because we do believe that universities represent an exempted area.”

 Phelps said during the House hearing on the bill this week, “This is deadline week [to get bills approved by committees], and we want to get this out … so it is a work in progress.” Phelps says he is open to negotiate. “Here’s the deal: We just found out really not too long ago where they stood,” Phelps said. “We’re willing to sit down with anybody.”

Representatives from the University of Illinois, Illinois State University and Northeastern Illinois University all said their institutions oppose concealed carry on campus. Calls to Eastern Illinois University and Governors State University were not returned.

Wednesday, March 07, 2012

State police consolidation would have upfront costs

By Ashley Griffin

The Illinois State Police are weighing a consolidation that could result in the layoffs of dozens of communications personnel.

Under Gov. Pat Quinn’s budget plan, the state police would consolidate its 20 communications centers down to four centers. In a committee hearing Wednesday afternoon, state police Director Hiram Grau testified that the agency now has the technology for such a reduction. “I should tell you that the Illinois state troopers have been considering [consolidation] since 1995. Back then, the technology wasn’t there, but today, the technology is,” Grau said. “Based on the technology that’s available, we need to make sound decisions and operate as fiscally responsibly as we can. So we looked at the technology, and we think we can consolidate from 20 communications centers down to four. We’re asking for the approval and the money to make that happen.”

But the move will not result in immediate savings. Grau said the consolidation of the centers could cost the state nearly $13 million in capital funding upfront but would save the state money in the long run. The plan would come with up to 40 layoffs among the current 150 communications personnel but would not leave any districts without communications services. Although some layoffs may occur in communications departments, Grau said that two new cadet classes to train state troopers would be added later this year and another one is anticipated for early 2013. They would be funded from general revenue funds.

However, some argued that it is essential to have communication staff who know the area they cover. “Some of the things our telecommunicators say why we should have 20 dispatch call centers are that they know their district, they know the terrain, they often take calls from people driving through the area on the interstate who don’t know where they are. Being familiar with the area, telecommunicators can help them identify their location, so the police can respond,” said John Coleman, who said he spoke on behalf of the American Federation of State County and Municipal Employees.

Coleman said communications workers sometimes assist callers who need help if a state trooper is not immediately available. “With the short staffing, there are not always officers available in the headquarters when people come to look for help, so its usually the telecommunicators when there is no officer there who can keep the headquarters open and get a quick response from someone who is in trouble.”

But lawmakers said the state’s current budget situation puts such consolidations on the table. “I don’t think individual troopers probably are wanting to see their local radio centers closed. However, in these economic times, I think everyone can understand the efficiencies of doing that,” said Rep. Jerry Mitchell, a Republican from Sterling.

Senate approves same revenue projection as House

The Illinois Senate today approved a revenue estimate that mirrors one the House approved last week.

Today’s action puts the General Assembly on course to cut from the governor’s proposed spending plan. Both chambers agreed to spend no more than $33.7 billion in Fiscal Year 2013, but Quinn’s budget is based on a $33.9 billion revenue projection.

Last year, the chambers did not agree on an estimate. Senate Democrats favored a revenue projection from the Commission on Government Forecasting and Accountability that was almost $1 billion more than the House’s number. But the House got a jump on the Senate and approved its budget first. In the end, it was the House’s budget that went to Quinn’s desk, although some new spending was tacked on in the legislature's fall veto session.

 “Starting with the same number this year should definitely make it easier to reconcile our budget proposals in the end,” said Park Ridge Democratic Sen. Dan Kotowski, a chairman of one of the chamber's two budgeting committees.

The estimate was approved with overwhelming support. However, Senate Minority Leader Christine Radogno emphasized that Republicans agree with the $33.7 million figure as an estimate for how much money there will be next fiscal year but do not necessarily agree that all of it should be spent. She said cuts would be needed to allow the income tax increase implemented last year to begin to phase out on schedule in Fiscal Year 2015. “It’s hurting Illinois families, and the jobs climate,” Radogno said.

Quinn takes issue with the lower revenue estimate. “The governor's FY 2013 revenue projections utilized economic forecasts from nationally recognized forecasting firms, with final revenue estimates developed by state agencies using detailed historical tax collection data and employment records,” Kelly Kraft, a spokeswoman for Quinn’s budget office, said in a written statement. “A difference of more than $200 million will lead to even further reductions during a time when many legislators call for cuts, but when cuts are proposed they say, ‘Don't cut here.’”

Under flat budget, SIU tuition would likely rise

By Jamey Dunn

Southern Illinois University President Glenn Poshard said today that the Southern Illinois University system could cope with flat funding next fiscal year. But under Gov. Pat Quinn’s budget plan, a tuition increase would likely be in the cards.

Poshard said that a decade ago, SIU got $247 million in state funds for operations, compared with $219 million for operations last year. “We are actually grateful this year for a flat-funded budget,” Poshard told a Senate budgeting committee this evening.

Quinn’s spending plan would hold SIU funding practically level and calls for the school to get about $218 million in general revenue funds for FY 2013. “That’s what the governor has said that we’re going to get, so we’re not fighting that,” Poshard said.

He said the university system is still coping with late payments from the state and maintenance projects that have been put off. “Our need for addressing deferred … maintenance is greater than ever.” He said that the state owes the university about $112 million for the current fiscal year, and more than $500 million in maintenance has been delayed across the SIU campuses in recent years. Poshard said he is concerned about SIU’s “inability” to replace faculty and staff after they retire. “SIU is the economic engine for southern Illinois, which has the highest unemployment rate in the state,” he said. “We have made the necessary cuts to keep our head above water by reducing our workforce by 206 full-time people and hundreds of part-time positions over the last two years. That hurts the university, and that hurts the region.”

With no new funding from the state, the university president said incoming freshman next summer at SIU would likely see a 4.8 percent tuition increase and a 1.8 percent increase in fees. The SIU Board of Trustees is scheduled to vote on the proposed increase in May. Poshard said he thinks it will be approved. Sen. Pam Althoff, a McHenry Republican, was critical of growing tuition rates at the state’s public universities. “I have grave concerns with regard to the continual increase of tuition costs.”

Althoff asked how universities justify giving tuition waivers to family members of faculty and staff, even as tuition rates increase for other students. Poshard responded, “If the state declines operationally, then we have no choice but to raise the tuition.” He said the waivers are necessary to make Illinois competitive when competing with other schools for employees. House Bill 5531, which was approved by a House committee last week, would eliminate discounted tuition for university employees. “If you’re going to go out on the market and you’re going to try to get the best faculty member that you can bring to your university, it’s going to cost you,” Poshard said. He added that new faculty members often bring millions of dollars in research grants with them when they come to a university.

Poshard said he is concerned that despite Quinn’s spending proposal, universities will see cuts in Fiscal Year 2013. He said that proposals to push pension costs onto school districts and universities would result in a reduction of resources for operating costs. Poshard said he supports a proposal from two University of Illinois professors that would require employees to pay more and call upon universities to cover some of their retirement costs. “They have come up with what I consider to be the very best effort that has been put on the table so far.” However, union officials and some legislators say that requiring employees to pay more for their pensions violates the state’s Constitution.

For information on the budgets of other Illinois  universities, see Illinois Issues' February 29 blog.

Tuesday, March 06, 2012

DNR supports admission fees at state parks

By Jamey Dunn

Hikers, hunters, vacationing families and outdoors enthusiasts may soon have to pay a fee for entrance to the state’s parks.

House Bill 5789 would allow the Department of Natural Resources to set fees for people driving and walking into Illinois state parks. A House committee approved the legislation this afternoon.

Jay Curtis, chief of staff for the Illinois Department of Natural Resources, said the need for new revenue has grown out of a decade of under funding the department. However, Curtis said he overstated the problem when he recently said that his agency is on the brink of closing its doors. “What I was really saying was that we need to find an alternative funding mechanism for the agency to make it sustainable. We all know the [general revenue funds are] being stretched thin and rightfully so. I mean, there’s a lot of needs all over the state,” he said. “What we’re trying to do this session is find a way to fund this agency outside of [the general revenue fund].”

Curtis said that in the past, DNR has tried to “slow down” bills that would allow entrance fees at state parks, but this year, the department supports the idea. “We’re one of only seven states right now in the United States that does not have an entrance fee [for parks] of some sort.”

The bill does not set specific fee levels, and Curtis said the department is still in the early stages of determining what the fees might be. However, he estimates they could bring in $8 million to $12 million for DNR. Curtis said the department is still working on other ideas to find funding outside of the General Revenue Fund. Gov. Pat Quinn’s budget proposal calls for $45.3 million for DNR, which would be a 13 percent cut from last year’s budget. Curtis says it is years of cuts and fund sweeps, not Quinn’s proposal, that created the need for the fees.

Rep. Mary Flowers, a Chicago Democrat, voiced concern for families who may not be able to afford entry into parks. “These are very difficult times for people across the nation and certainly across the state,” Flowers said at today’s committee hearing. “Sometimes you just need a place to go.”

Rep. JoAnn Osmond, the bill's sponsor, responded, “Unless we can get the money to get them safe, we’re not going to be in position where we can keep our parks open."

Osmond, an Antioch Republican, pointed to the Adeline Jay Geo-Karis Illinois Beach Park in her district. The park, located in Zion, suffered damage during storms last July that knocked over several trees and left many of them leaning. Parts of the park have since been closed because the trees present a safety hazard. Osmond said DNR hopes to reopen all of the park by April 1.

 “Our parks are a place where people can go — and especially at a time when there’s such budget problems for people in their homes — to find a place that’s cheap, inexpensive, but good for their family,” Curtis said. “A $5 to $10 fee for entrance, there would be people in the state that it could have an effect on, but by and large, just about everyone could afford that entrance [fee.] It’s still a cheaper option than going to Six Flags or taking the trip to Florida that people can’t afford right now.”

He added, “The alternative is struggling to have a sustainable park system in the future.”

Marc Miller, director of the Illinois Department of Natural Resources, has vowed not to close any state parks.

For more on the deterioration of Illinois' state parks, see Illinois Issues July/August 2011.

Committee fails to vote on nursing home staffing

By Ashley Griffin

The debate over expanding staffing at some Illinois nursing homes will continue after a legislative committee failed to make a decision today.

The Joint Committee on Administrative Rules was scheduled to take up a staffing rule this morning, but lawmakers say they did not receive the information they needed from the Illinois Department of Public Health in time to take a vote. The issue at hand is a requirement in a 2010 nursing home reform law that nurses supply 20 percent of direct care to patients by 2014. Some nursing homes say the care can be administered by nurses with less training than registered nurses, but the new rule would require that registered nurses provide direct care.

Lawmakers on the committee complained that the IDPH did not provide them with info about the proposed rule until 5 p.m. Monday night. “I was definitely disappointed in how the procedure occurred. I thought this was a very important issue, something that has to be resolved in the state, and because the department pretty much was not inclined to work with all the parties that were involved, the action that occurred today occurred,” said Sen. Andre Thapedi, a Democrat from Chicago. JCAR took a vote today that in effect puts the rule on hold until the committee can take it up again. Members said they would likely revisit the issue next month.

David Vinkler, associate state director of advocacy and outreach for AARP Illinois, believes that it is a good sign that JCAR and the department of public health are willing to work together. But he also believes that the ruling should not be put off. “Nursing homes really need changes. This should not be delayed until next month,” Vinkler said.

Protesters who held up signs in the hall outside of the committee hearing were disappointed that the rule was not approved today, and some blamed the IDPH. “I feel very disheartened about today’s vote. I think it was [the IDPH] that made the decision to advise everyone of the changes that they wanted so late that they couldn’t vote, so [IDPH Assistant Director Teresa] Garate’s department screwed us,” said Jim Rhodes, a member of the Illinois Jane Addams Senior Caucus. “She wanted to make the changes so late that they couldn’t vote in honesty, and so we shouldn’t blame JCAR or the JCAR committee. They could not vote in honesty on these rules because they didn’t get them until last night at 5:30. It’s just ridiculous.”

Garate said IDPH was trying to work with JCAR members up until today’s meeting. “We were trying to appease some of the concerns and feedback that we had received from JCAR on the version of the rules we submitted, and that is why we submitted even more revisions on Friday and yesterday. Because they felt the members of JCAR did not have sufficient time to review our revisions, they were not ready to take a vote,” Garate said. “We plan to submit revised language by the end of the week.”

Monday, March 05, 2012

Rule would make some nursing homes hire more RNs

By Ashley Griffin

Nursing home reform approved in 2010 sought to address problems in some of the state’s long term care facilities by increasing staffing levels. But sponsors of the legislation say that some for-profit nursing homes have found a loophole in the law.

In the wake of a series of Chicago Tribune investigations that exposed abuse and neglect that resulted in the deaths of some nursing home patients, the reforms pushed to increase staffing levels at nursing homes and tighten existing criminal background checks of incoming nurses and patients. The law requires that by 2014, patients receive a minimum of 3.8 hours of direct care a day. That number is up from the 2.5 hours required before the law. The reforms also require that .75 hours — 46 minutes a day — of that care be provided by a nurse.

But the 2010 legislation does not distinguish between registered nurses (RNs) and licensed practical nurses (LPNs), who do not have to undergo as much training as RNs. A  new rule expected to come up Tuesday before the bipartisan Joint Committee on Administrative Rules would require facilities to use RNs for 20 percent of direct care.

Lawmakers who worked on the reforms said that was their intent. “There can be no true nursing home reform without addressing the issue of RN staffing ratios,” says Sen. Jacqueline Collins, a Democrat from Chicago, in a prepared statement.

However, many for profit nursing homes argue that they cannot afford to hire enough RNs to fulfill such a demand. “We are not against improving staffing, but we are against putting in a requirement that sets nursing homes up to fail,” Pat Comstock, executive director of the Health Care Council of Illinois, told the State Journal-Register. Comstock did not return a call from Illinois Issues.

Sen. Heather Steans, who was a sponsor of the reforms, said that a revenue stream was built in to pay for higher staffing levels. “I very much urge the JCAR members to support and pass the rule. I think it will very much help improve the quality of care in our nursing homes. We also passed the bed tax, which was primarily to fund the increased staffing we are putting into place, so funding has been put in place for that,” Steans said.

According to David Vinkler, associate state director for AARP Illinois, which supports the proposal to increase the number of hours a register nurse should spend with a patient, Illinois is in the top five states for the number of bed sores cases for high risk patients and No. 24 for quality of life and quality care. He said registered nurses are vital to the nursing patients. “They [registered nurses] are the only ones who can assess the patient and adjust their care. They can make changes quickly,” said Vinkler. “We all have heard the stories about abuse and neglect in nursing homes. We need a change, I think at the end of the day, the fact that Illinois nursing homes don’t have enough RNs' staff is ridiculous.”

Some members of JCAR say they support the higher RN staffing levels. “I intend to vote in favor,” said Rep. Gregory Harris, a Democrat from Chicago who serves on the JCAR committee. “I believe this is the right thing to do in public policy. We as lawmakers have to advocate for those who are not able to advocate for themselves.”

Harris said the 20 percent requirement is what the bill sponsors wanted, but not all committee members are sure about tomorrow’s outcome. “I have some real concerns about the rule,” said Sen. Dale Righter, a Republican from Mattoon, who also serves on JCAR. Righter says he will weigh what both sides have to say Tuesday.

The JCAR hearing is scheduled for 9:30 a.m.

Thursday, March 01, 2012

House passes spending cap

By Jamey Dunn

The Illinois House is on track to cut from Gov. Pat Quinn’s proposed budget in the same way that it did last year.

The chamber today approved an estimate of what the state would have available to spend for the Fiscal Year 2013 budget, and the number was about $200 million less than Gov. Pat Quinn’s revenue estimate. The House estimate of general revenue funds that will be available for FY 2013 is $33.7 billion, and Quinn’s, $33.9 billion. “I thought we needed to take a conservative approach. I think we needed to give ourselves some breathing room,” said John Bradley, a Marion Democrat.

The resolution setting the estimate and committing the chamber not to approve a budget with more than $33.7 in spending passed with bipartisan support. The House approved an identical joint resolution, which will head over to the Senate for consideration. Last year the House only passed its own resolution and left the Senate behind in the budgeting process.

Opponents say setting a spending cap limits flexibility and could lend to unnecessary cuts. William McNary, co-director of Citizen Action Illinois, said the state should work off of projections but not set a cap. He said that lawmakers should instead base spending decisions on the need for and effectiveness of programs. “Upfront hard spending caps put the cart before the horse. It would arbitrarily set an appropriations number and try to get the need to fit to this number. ” He added: “One way to find over $200 million immediately is to use the [Commission on Government Forecasting and Accountability] revenue estimate. They’ve been historically reliable.” COGFA’s projection is $50 million more than Quinn’s.

This year’s House estimate is much more in line with the governor’s numbers than last year’s House projection, which was $750 million less than Quinn’s revenue estimate. “Last year we were below the numbers of [Commission on Government Forecasting and Accountability] and the Department of Revenue and [the Office of Management and Budget] and we were right. And so I would rather err on the side of safety and caution, then to be high and get into trouble at the end of the year--worse than what the state’s already in,” Bradley, who is the chair of the Houses’ revenue committee—which produce both the estimates from last year and this year.

Supporters of last year's admittedly conservative estimate said that any additional money would go toward paying off the backlog of overdue bills. The state has paid off about $1 billion of those bills with additional revenues. However, Illinois is projected to complete the current fiscal year with a deficit of about $500 million. One possible trigger for the deficit is the repayment of more than $600 million in interfund borrowing.

This year, some lawmakers support the idea of setting aside revenue before any operating expenses are paid and spending it on the backlog. The idea is similar to the way lawmakers paid the pension payment and debt service last year. “I would personally be in favor of taking money off the top to begin the process of paying off the backlog of bills,” Bradley said.

But such a move would add to the list of growing costs that are putting pressure on state spending. “We know the pension payment is up. We know we have Medicaid pressures, and we know we have general operating pressures. And we’ve only estimated about $500 million additional [revenue] from what was available last year, and you may have as much as $4 billion of additional pressure, not including the backlog of bills,” he said. Quinn proposed closing corporate tax loopholes to help pay off the bills. If lawmakers fail to close such loopholes, Quin also proposed spending about $160 million less than his projection and using the extra cash to pay down bills.

“The governor's FY 2013 revenue projections utilized economic forecasts from nationally recognized forecasting firms with final revenue estimates developed by state agencies using detailed historical tax collection data and employment records,” Kelly Kraft, a spokeswoman for Quinn’s budget office, said in a written statement. “A difference of more than $200 million will lead to even further reductions during a time when many legislators call for cuts, but when cuts are proposed they say, ‘Don't cut here.’”

Rep. Ed Sullivan, a Mundelein Republican, warned that the state must get a handle on spending before last year's income tax increase is set to begin phasing out in FY 2015. “We have to address the structural problems that we have because in FY 15, [FY] 16 we’re on a cliff if we don’t start building in numbers to get rid of the tax increase. Or is the governor just saying, ‘We’ll make that tax increase permanent?’” Sullivan said that despite some large growth in expenses, such as a pension payment that will be about $1 billion more, Republicans do not want spending for FY 2013 to total more than the FY 2012 spending.

 He said some Republicans are frustrated that additional spending for the current fiscal year was approved last fall. “Last year we made this leap of faith,” and then the legislature passed additional spending bills. “The next step [in the budgeting process for FY 2013] is the big step, and the next step is the trust that we’re going to build between the caucuses,” he said.

 Bradley said that the House plans to handle the budgeting process in a similar manner as last year, when the projected revenue was carved up and assigned to different areas of state spending, such as education or human services. The budgeting committees for those sectors were then asked to craft a spending plan based on the amount they were assigned.