CHICAGO, Ill. - The Illinois Department of Healthcare and Family Services wants to work with state lawmakers to change the structure of nursing homes for patients and employees.
The Capitol Bureau sat down with HFS Medicaid Administrator Kelly Cunningham to talk about their plan Tuesday. State lawmakers and providers had the opportunity to share their thoughts about the report Wednesday morning.
Lawmakers agreed with the department and nursing home providers that they must move forward with action. However, they stressed that facilities must treat people with dignity and respect.
How can Illinois reform the nursing home industry? Most argue it's time to focus on patients rather than profit.
Andy Allison, HFS Deputy Director for Strategic Planning and Analytics, noted most of the nursing facilities across the state made money before and during the pandemic.
"Those who were making the most money, by far, were those that were both over 50% Medicaid and understaffed," Allison said.
Health Care Council of Illinois says plan has pitfalls
Still, the Health Care Council of Illinois, which represents over 300 of those facilities, says the state's new plan has pitfalls. They claim the HFS recommendations could threaten the equity provisions by moving funds away from facilities in minority communities with Medicaid patients.
Lawmakers are concerned the organization is only worried about money coming into the facilities they run and not improving care for residents.
"Why should we just continue to write a blank check and not expect some accountability? What is your plan for accountability," asked Rep. Anna Moeller (D-Elgin).
However, the Health Care Council argues it's not a blank check. Executive Director Matt Pickering also said IDPH staff are in nursing facilities to hold people accountable every day. He stressed that nursing homes continue to struggle with a staffing crisis. Pickering said most facilities have relied on temp agencies.
"We are struggling to find the staff and we're paying two, three, four times to get staff in. We are committed to appropriate staffing levels," Pickering said. "And again, we're open to this conversation with HFS."
Many nursing facilities could close without swift action
But the time for action is critical.
Leaders of St. Joseph's Home in Springfield just announced the facility will close next month due to financial loss and the operation of nursing homes during the pandemic. Many other facilities could close as well.
Lawmakers called the HFS recommendations a first step. However, they said there's much more work to do.
"We try to do our work in the agencies with recommendations," said Rep. Camille Lilly (D-Oak Park). "But we end up dealing with not addressing the issues."
Two of the major concerns are understaffed facilities and overcrowding in the majority of homes in low-income communities.
Create a culture where people want to work
Rep. Suzanne Ness (D-Crystal Lake) served on the McHenry County Board before becoming a lawmaker. She was part of the committee that oversaw the budget for a county-run nursing home.
Ness told lawmakers and advocates that she learned there simply aren't enough Medicaid beds in well-run facilities, similarly proving a disparity in care for Black and brown patients. She also said Illinois should improve the Medicaid rate to enhance the quality of care and staffing.
"Staffing is great. But unless you are committed to creating a culture where people want to work, pay will not keep people there. It doesn't matter what you increase that to," Ness said. "And even benefits won't."
Advocates urged lawmakers to create stricter laws for accountability and transparency within the industry. In fact, many believe change won't occur without addressing both of those concerns.
"Our members experience every day that the Medicaid money is not going to the right places," said Greg Will of SEIU Healthcare. "That's because the rate calculation isn't quite lining up with the care need. The current system lacks accountability for the care actually being provided with the money for it."
Cunningham told lawmakers the recent report shouldn't sit on a shelf and collect dust. She also stressed the need for action is now.
"The issues we're dealing with are urgent," Cunningham added. "Continuation of the status quo is not acceptable. And we must hold long-term care providers across Illinois to a higher standard."
The Health Care Council of Illinois plans to meet with HFS representatives Thursday.