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February 22, 2001
Senator Syverson’s Senate Bill 608 Corrects Inequities
in Medicaid System for Seniors
CHICAGO -- Yesterday, Senator Dave Syverson (R-Rockford)
introduced Senate Bill 608 which corrects inequities
in the state's Medicaid system for persons residing
in long term care facilities. A coalition of long term
care providers and union employees strongly supports
this legislation as a means of ensuring quality nursing
home care for our state's 52,000 senior residents who
rely on Medicaid funding.
Currently, Medicaid rates paid to nursing homes have
been "frozen," based on wages and costs from
1992 and resident medical conditions assessed in 1993.
SB 608 goes beyond recent years' stopgap funding of
averaged inflationary increases and rectifies the state's
Medicaid imbalance for seniors through two solutions:
· Bringing Medicaid rates
in line with real costs and real wages by using the
most current cost reports on file with the state,
not costs from 1992.
· Basing the services
section of the nursing home rate on a real assessment
of current nursing home patients by using the most
current clinical assessments on file (these assessments
are called the "Minimum Data Set"), rather
than the last assessment from 1993.
"Since 1993, Medicaid rates have not been appropriately
raised to reflect current operating costs, staff wages,
and resident medical conditions, creating a widening
imbalance between Medicaid reimbursement and the daily
care needs of our state's nursing home residents,"
said Bill Kempiners, executive director of the Illinois
Health Care Association. "This crisis will only
get worse unless we have an increase in reimbursement
that reflects real costs, real wages and today’s patient
conditions,"
The state's leadership has been successful in deflecting
low-acuity residents from nursing homes to alternative
settings. One consequence of this shift has been spiking
the acuity levels of those who must use nursing home
services, and hence rising costs. Average census in
Illinois nursing homes has declined to 84 percent, causing
fixed costs to be spread over fewer residents. Although
Illinois nursing homes are ranked first in the nation
in promoting residents' functional independence, these
government-induced factors have made it increasingly
difficult for nursing home providers to meet the needs
of their residents.
"Many people don’t realize that nursing homes
provide an essential safety net for a healthy, caring
society, with services that aren’t offered in acute
care hospitals and can’t be provided at home,"
said Dennis Bozzi, Executive Director of the Life Service
Network of Illinois. "Basing current Medicaid rates
on today’s more sophisticated treatments and the needs
of today’s more complex patients is absolutely essential.
Senate Bill 608 does that."
Since the 1993 Medicaid freeze, long term care had
changed dramatically: technology has improved; geriatric
care practices are more sophisticated; the care needs
of today's elderly have increased; stays are shorter;
and more than a third of the people coming to nursing
homes for recuperation and rehabilitation go home. The
rehabilitation and restorative treatment that people
received in hospitals ten years ago, including therapy,
dialysis, ventilator care, and sophisticated intravenous
treatment, are now available procedures in nursing homes.
If the proposed measures are implemented, it is estimated
that basing Medicaid rates on 1999 cost reports will
cost a total of $80 million, with the State of Illinois
providing $40 million and the other $40 million being
supplied by the federal government through a matching
program for Medicaid. Utilizing clinical assessments
of current nursing home patients to recalculate the
Medicaid rate is estimated to cost a total of $18 million
in fiscal year 2002, with the state of Illinois providing
$9 million and the federal government a matching $9
million.
With more than two-thirds of the state's nursing home
residents dependent of Medicaid, the coalition strongly
supports Senator Syverson’s SB 608 as a means of ensuring
that the state of Illinois lives up to its commitment
to provide quality care for the elderly and disabled
through the Medicaid program.
"This senate bill better enables nursing home
providers to hire the nurses and therapists that residents
need, offer residents modern geriatric treatments, and
provide them restorative services that promote their
independence and overall quality of life," said
Terrence Sullivan, executive director of the Illinois
Council on Long Term Care. "Senator Syverson’s
bill provides the foundation for assuring that nursing
home care in Illinois continues to keep pace with the
needs of today's elderly."
The coalition that supports this legislation is made
up of the state’s four largest professional nursing
home associations – the Illinois Council on Long Term
Care, the Illinois Healthcare Association, the Life
Services Network of Illinois, and the County Nursing
Home Association – as well as the state’s largest nursing
home employee union – the Service Employees International
Union. Together they represent more than 54,000 professionals
and caregivers serving 73,000 nursing home residents.
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