STATE FUNDING
Ever been on a ride that zooms one way then
another? That is the current state budget process. The state wants to move
away from grant funding and move all programs to fee-for-service payments.
Under grants, Elm City receives a set amount of money per month in return
for a set amount of services. Governor Blagojevich feels that is not
accountable funding. He wants all programs to move to a fee-for-service
system where groups like Elm City get paid only for services provided. In
addition, the state can then bill many services to Federal Medicaid for a
50% match in reimbursement. Sounds reasonable.
From a cash flow point of view this is a
huge shift even with bridge loans from the state. Fee-for-service payments
come months later. Many community services have less that 1-2 months of
operating money saved. Several have multi million dollar credit lines. The
state wants make these changes in about 3-4 months. Is everything ready?
Depends who you talk to. In committee hearings in Springfield, DHS is set to
go. When very pointed questions are asked, many problems start popping up.
At a recent hearing a legislator told a DHS panel that his bank just turned
down a credit line to a community agency because under fee-for-service there
is no guarantee of repayment.
It is important to remember there are no
good guys, bad guys in this thing. The state is heading to a $3B debt and
revenue is falling farther behind. Some very tough, difficult decisions need
to be made between groups who do not always agree with each other on
anything. Community agencies need to look out for their interests just as
the schools, manufacturing, trucking, and other lobby groups are doing.
Trouble is there are so many interest groups
wanting something they cannot all win. Simply guessing, it would seem likely
the budget will stay the same as last year. No official word on that from
any state group. Unfortunately the costs any community agency faces continue
to climb regardless of how the state financial picture looks.
So, what does ECC do? There is no clear
picture on state funding from the DD or MI network offices. They simply do
not know. It changes week to week. The budget discussions have ranged from
8% cuts for all grant to fee-for-service conversions due to a 92% possible
consumer attendance rate (based on holidays and vacations), a 2% reserve
that is on or off depending on which meeting you go to, a requirement of 20%
Medicaid billing that popped up several weeks ago, targeted program cuts
(our 110 program outpatient funding was cut one month ago for $18,000. One
week later all cuts were back. MI network says it is still cut.), the new
threat by the governor to lay off mass numbers of state workers. The list
goes on. As usual there will be many last minute agreements.
IARF (our trade association) is at the table
for all the discussions. The education process for the legislators over the
last several years has been a huge help for our cause of serving people with
disabilities. I have been to meetings where the legislative reps have
clearly been briefed on specific issues as they question DHS. Locally,
Representative Jim Watson has been very supportive of services for people
with disabilities. Senator Vince Demuzio did many things behind the scenes.
Please write your local representative and ask for their support. |
Illinois
