Thursday, Aug. 27, 2015 12:05 am
Rauner wants to cut home services for 34,000
Proposal raises bar for receiving help
A proposal to save the state money on independent living services could mean dire consequences for as many as 34,000 people.
Gov. Bruce Rauner wants to decrease the number of people in Illinois who receive in-home care, a move disability advocates say could put people on the street. The proposal appears unlikely to clear two major hurdles for approval, and its acceptance could even cause the state to run afoul of a longstanding court order.
Among Rauner’s many other proposed cuts to social services is a plan to raise the threshold for elderly people and people with disabilities to receive home services, a pair of state-funded programs which offer qualified people help with basic tasks like laundry and paying bills. Home services allow recipients to live independently, instead of living in nursing homes or other institutions. In order to qualify, an individual must undergo a “determination of need” assessment, which scores each person’s needs on a scale of 0 to 100. Currently, anyone who scores 29 or above qualifies for home services, and a higher score means more hours of service. Rauner, who campaigned for governor as a compassionate conservative, wants to increase the threshold from 29 to 37.
Amber Smock, director of advocacy for the Chicago-based disability group Access Living, estimates that the change would knock 10,000 people with disabilities out of the program, along with 24,000 senior citizens. Smock says some of those people would have to go to nursing homes or become homeless.
Mike Herzovi of Chicago has a “DON score” of 33, meaning he would lose home services if Rauner’s proposal is approved. Herzovi, who spoke in Springfield on Aug. 12 against the proposal, works part time and has a worker come to his apartment once a week to help him with laundry and housecleaning. He says that if he loses that help, he would be at risk of being evicted from his apartment because he couldn’t take care of it.
Springfield disability advocate Tyler McHaley says that those people who would be affected face a major loss of independence. Although McHaley’s own home services aren’t at risk because his score is higher than 37, he says losing services would strip him of the ability to simply get out of bed and shower.
“It would basically be a very bad situation,” he said. “It would be a drastic, drastic problem for me if I had to lose any hours at all.”
McHaley says most people who receive home services are low-income, meaning they won’t be able to hire outside help if they lose their state assistance. That could result in more people being sent to nursing homes or other institutions, he said. McHaley says the tightened eligibility would have a ripple effect even outside of those directly affected. As clients lose services, the people who provide those services would be put out of work.
In order to raise the determination of need threshold, Rauner must first get approval from the Illinois General Assembly and from the federal government. It’s unlikely that the Democrat-controlled state legislature will approve the change, and there’s even a bill to block the proposal.
The federal Centers for Medicare and Medicaid Services (CMS) operates a website showing each state’s approved and pending Medicaid waiver requests. The website does not appear to list a request from Illinois to raise its determination of need threshold.
CMS spokeswoman Marilyn Jackson says that in order for the federal government to approve a change in a state’s waiver, the state must show that the change would increase or strengthen coverage of low-income individuals, increase access to or strengthen service providers, improve health outcomes, or increase the efficiency or quality of care.
If Rauner’s proposal is approved, it may cause Illinois to conflict with a consent decree which ordered the state to reduce the number of people living in nursing homes and institutions unnecessarily. If fewer people are eligible for in-home help, McHaley says, more people will have to go into assisted-living facilities, which costs taxpayers even more than home services.
Even if Rauner doesn’t succeed in getting the threshold raised, however, McHaley believes the governor can still reduce the number of people receiving home services by directing state agencies to be “stingy” with benefits.
“He could tell them to look very critically at any applicants and not give out as many hours,” McHaley said.
Contact Patrick Yeagle at firstname.lastname@example.org.