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Thursday, May 12, 2011 06:39 am

Medicaid cuts threaten nursing home staff, services

$70 million in cuts under debate in Illinois budget talks

John and Phyllis Riech of Athens need state Medicaid funds to pay for Phyllis' long-term nursing home care.
John Riech of Athens speaks softly as he puts his hand on the shoulder of his wife, Phyllis. She is sitting in a wheelchair, slowly petting her small white dog, Sassy.    

“We were doing pretty good until she got sick,” John Riech, 74, says with an audible sigh. Phyllis Riech, 70, has Alzheimer’s disease and has lived through heart attacks, breast cancer and several other medical problems over the past year. Even though she lives at Capitol Care Center, a nursing home located at 555 W Carpenter St. in Springfield, taking care of her is a full-time job for John Riech.

“We’ve been married 54 years, but this is the first thing I couldn’t handle,” he says. “I just can’t say enough good about these folks. They just bend over backwards to take care of you, and there’s just about nothing they won’t do for you.”

But as the Illinois General Assembly debates cuts to several state agencies and programs, the Medicaid support on which the Riechs rely could be slashed significantly. Gov. Pat Quinn’s 2012 budget, released in February, contains a six-percent cut to Medicaid reimbursements for nursing homes, which translates to about a $70 million cut statewide, according to the Health Care Council of Illinois (HCCI), which represents for-profit nursing homes in Illinois. Stacey Solano, a spokeswoman for the Illinois Department of Healthcare and Family Services, says the cuts would be closer to $118.5 million.

John and Phyllis Riech were among about 100 protestors at Capitol Care Center on May 3, taking part in a rally hosted by HCCI against Medicaid cuts for nursing homes. The rally was one of 17 stops on a statewide tour by HCCI that also included similar rallies in Champaign, Peoria and Normal.

Capitol Care Center stands to lose about $400,000 next fiscal year if the cuts are approved, says administrator Cindy Schaaf, adding that 145 of the nursing home’s roughly 200 residents are on Medicaid.

“It would be virtually impossible to maintain the state guidelines and provide the quality of care that the residents are accustomed to right now with an additional $400,000 missing from our budget,” Schaaf says, adding that the proposed cuts would likely force Capitol Care Center to reduce staff and service levels. “It’s frightening to think about.”    

Pat Comstock, executive director of HCCI, says the state risks losing federal matching funds if it cuts Medicaid, so the real impact of the proposed cuts would be about $140 million. That estimate is based off of HCCI’s predicted $70 million in Medicaid cuts, so the actual number may be higher.

On July 29, 2010, the state passed a nursing home reform law requiring higher staffing ratios and other expensive mandates after several cases of nursing home violence and substandard care were uncovered in a Chicago Tribune investigative series. Comstock says that law is meaningless if the state doesn’t provide the funding necessary to meet those new requirements.

“The cuts are for care provided to residents on Medicaid, so not only are they our sickest citizens; they’re our poorest citizens,” she says. “The state plans to reduce what they pay for that care without changing their care expectations. They just expect a facility like this to do more with less, but we’ve been doing more with less for years. We can’t just absorb this cut.”

The budget process this year is different than in recent years, which could affect whether the proposed cuts are actually implemented. The Illinois Constitution requires the governor to create a budget and submit it to the General Assembly, which then “shall make appropriations for all expenditures of public funds by the State.”

In the past two fiscal years, the legislature has simply approved “lump sum” appropriations, which give the governor broad discretion to allocate that money as he sees fit. This year, however, the House and Senate are attempting to negotiate a specific line-by-line budget. That requires groups like HCCI to lobby several individual legislators instead of going straight to the governor, but that in turn increases the influence such groups can have on the budget process.

“If they closed this place down or made it so I couldn’t take care of my wife, I don’t know what we would do,” says John Riech. “I don’t have an answer. I just hope there’s some other answer than cutting this.”

Contact Patrick Yeagle at pyeagle@gmail.com.


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