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June 2015


Rauner's Eyes are on Slashing Senior Services
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Gov.Rauner has proposeda new round of cuts after he andstate lawmakers failed to pass a budget by the May 31st deadline. Of particular importance to health advocates: seniors in the Community Care Program (CCP)could now face income limits and a higher qualifying score for the Determination of Need (DON) screen. The DON screen determines eligibility for CCP based on factors that look at a person’s ability to live independently. The program isaimed at keeping seniors out of nursing homes byprovidingservices likelaundryor cooking help for those who are unable to do some activities of daily living independently.

To continue to qualify for CCP underGov. Rauner's proposed changes, seniors must have even greater needs and belowincome.The restricted eligibility requirementscould bumpabout onethird of seniors.

Health advocates warn thatseniors droppedwouldbe forced into nursing homes, ultimately at a greater cost to the state. Most impacted would beseniors with slightly fewer needs who would no longer qualifybecause of their DON score. TakeRay Miller, interviewed in a Chicago Tribune article, who would be cut becausehe has aDON scorelower than the potential newlimit. Heworries that he would likely go to a nursing home, a living arrangement that would cause him to "give up."

Are you working with clients similar to Ray? Illinois Health Matters wants to hear your stories of people who may fall through the cracks because of Gov. Rauner's budget actions. E-mail us.



alt tag From our blog

Redoing Redes: Strengthening Communication Procedures in the Illinois Medicaid RedeterminationProject
The stateis erroneously suspending vital medical care for people who remain eligible. Since the rollout of the IMRP in early 2013, the program has been plagued by inadequate communication from the state that leaves consumers confused and ultimately without healthcare. Consumers report that they are not receiving the required notices by mail and when they call with questions, frontline state staff cannot provide answers. Because of the state’s ineffective communication protocols and inadequate employee training, rightful Medicaid beneficiaries are in the precarious situation of being unable to fill their prescriptions, go to the doctor or receive treatment. The purpose of the IMRP is to save state dollars by trimming the Medicaid program of those who are no longer eligible, not cut people who still deserve services. Read more...

In case you missed it

Insurance plans requesting premium increases of 10% or more are now posted on HealthCare.gov. Consumers could face steep increases as insurance companies claim the proposed rates reflecttrue costs providing coverage. Some market analysts expected the increases, sayinghealth plans could now draw data from two enrollment cycles.

Illinois suffers from a"bare-bones" mental health system, according to a new white paper released by the National Alliance on Mental Illness- Chicago. The white paper warns Gov. Rauner's proposed mental health care cuts would further stress an over-burdened system.

Medicare released data for the 3rd year in a row oninpatient and outpatient spending. The data sharing is part of an effort to promote more educated healthcare consumers and further health systems transformation.


Recent resources

This timeline from the Make Medicare Work (MMW) Coalition lays out what services new enrollees can expect from Illinois managed care plans.
Managed CareTimeline


Events

Find enrollment events in your area at the Get Covered Illinois Events page.

Find volunteer and community engagement opportunities at Get Covered America Events page.

Download a presentation and/or watch a recording from the EverThrive Illinois Webinar series.

Learn what the ACA means for a small business owner from the Small Business Majority's Thursday talks.



From our social media

On Twitter
@ILHealthMatters: How to check the status of your #Medicaid application http://bit.ly/15lEBYp

On Twitter
@ILHealthMatters: C4 serves about 10,000 people through 5clinics, will now provide mental health services through CountyCare http://bit.ly/1F8zXIb #twill

On Facebook
Report Shows Massive Lack of Medical Treatment for Illinois Prisonershttp://bit.ly/1JUH39C



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