Illinois falls short in providing the funding and worker compensation to keep the health care services industry stable, advocates representing various organizations from around the state said this week.
Of the state’s 102 counties, 85 are designated as “health professional shortage areas,” Sara Howe, CEO for the Illinois Association for Behavioral Health, said during a House Appropriations-Human Service Committee meeting Thursday at the Capitol.
Howe said Illinois is a “detox desert” with limited facilities, a national ranking of fifth for adult binge drinking, and hospitalization rates for adults with serious mental disorders that are 1.5 times higher than the national average.
While requests for substance abuse and mental health services have increased, organizations that provide them have been underfunded for at least a decade, she added.
“At the same time, the rates for mental health and substance use disorders have remained stagnant with only sporadic, inconsistent and negligible increases that have not kept pace with the cost of providing quality, evidenced-based services,” Howe said.
Rep. Robyn Gabel, a Democrat from Evanston, sponsored HB 2717 to increase by 10 percent the funding for community-based substance abuse center grants available through the Department of Human Services (to $9.2 million) and for certified community mental health centers (to $19.3 million).
Howe said those appropriations would be “a down payment to reverse the damage we’ve seen,” but the actual amount needed to bring funding back in pace with cost is most likely higher.
The budget impasse from 2015 to 2017 led to some closures of state facilities providing substance abuse care, she said. Additionally, funding for preventive services programs also was slashed from $7 million to $1 million.
“The agencies themselves that are gone are not coming back,” Howe said. “Most of them, their services have not been picked up in other communities.”
And the instability caused by underfunding has led to a reduced workforce, especially along the borders where workers travel to nearby states.
Supporting children and the elderly
Several organizations that provide services for the elderly and children hold a common position on funding: They need more money simply to maintain the services provided.
Sister Catherine Ryan, on behalf of Maryville Academy as well as Ann and Robert H. Lurie Children's Hospital, and Dr. Peter Smith, medical director of Almost Home Kids, gave testimony about services provided to children with complex needs and representing “stressed” populations. Most receive insurance through the state.
Ryan said without alternative programs, children would otherwise be hospitalized, incurring a cost to Illinois’ checkbook exceeding $3,000 per day for neonatal care or for a stay in a pediatric intensive care unit.
The reimbursement for service through insurance amounts to $683 a day, she added, when the actual cost of services is $950. House Bill 2714, also sponsored by Gabel, would allow alternative, transitional facilities like the ones Ryan and Smith represent to receive a reimbursement of $950.
No one anticipates a premature birth, or that their child will be the victim of gun violence or childhood cancer, but providing such services through alternative care is “cost-saving” and “the right thing to do,” Smith said.
“These families, as you’d imagine, are some of the families under the most stressed and difficult time of their lives in our communities,” Smith said. “Many of these families did not expect to be in these populations, to be parents of children with medical complexity.”
Organizations that provide in-home services for the elderly are also seeking an increase in funding.
House Bill 2776, sponsored by Rep. Jaime M. Andrade, a Democrat from Chicago, would increase in-home workers’ reimbursement rates from the state to $19.96 per hour for workers at a minimum hourly wage of $12, and to $21.64 per hour for those at a $13 minimum hourly wage.
Home care aide Cathy Everett said she left her $35-an-hour career four years ago after battling breast cancer and watching her father struggle to assist her mother after a dementia diagnosis.
She knew the career switch would result in a pay cut, which was $10 an hour, but she said she didn’t think it would amount to an unlivable wage.
“I knew I had to focus my time and energy on helping seniors live their remaining years where they want and desire to be, and that’s in their own homes,” Everett said. “... I didn’t enter this industry thinking I’d get rich, but I can’t believe that for all we do, home care aides don’t earn a liveable wage.
Dennis Mondero, executive director of the Chinese Mutual Aid Association, said it’s difficult hiring and keeping home care aides in the Chicago suburbs because they know they can earn more working in the city
“Potential employees could make more money working at Target,” he said.
Stephanie Johnson with Catholic Charities of the Archdiocese of Chicago, said without a funding increase, her organization’s community care program will need to lay off 700 people, which would end its program to care for the elderly on the south and southwest sides of Chicago.
Same for Mondero, who said his organization must consider laying off more than 200 if reimbursement rates don’t increase, leaving more than 500 seniors without services.
Johnson said the state would save money by paying more for human services instead of waiting for bills from nursing homes.
Marta Pereyra, executive director of Coalition of Limited English Speaking Elderly, said it’s five times more expensive for a senior to stay and be cared for in a facility than in their homes – in-home care costs average $1,200 monthly, compared to $5,000 to $6,000 at nursing homes.