Action Alert: Home Services and HB 4351

Here is an Action Alert from Access Living Director of Advocacy regarding veto of HB 4351 and other issues.

Dear Access Living friends and allies,

Last week, Governor Rauner vetoed House Bill 4351, the bill that many of you know as the “DON score bill.” This was the bill that aimed to preserve the Determination of Need (DON) Assessment minimum eligibility score at 29 rather than 37 (last November, the Governor committed in writing not raise the score). This bill also contains a significant amendment that would have protected non-Medicaid eligible seniors in the Community Care Program (CCP) from being moved to a new homemaker service program that would have provided fewer hours of service, plus a copay. This new program is called the Community Reinvestment Program (CRP) and more information from the State of Illinois can be located at this link .

The State claims this move will keep seniors in their own homes and delay nursing home admissions, but we at Access Living are not sure how a decrease in homemaker service hours will assist seniors who actually need help. Furthermore, there are thousands of seniors who may not be Medicaid eligible, but who don’t have very much income. While we do applaud the State’s intent to keep people living in the community who WANT to be there, we are very concerned that the development of the CRP has occurred in conjunction with other efforts that make access to home services increasingly difficult. That includes not only homemaker services for seniors, but personal care services for people with physical disabilities and mental health disabilities, as well as direct support for persons with developmental disabilities.

What do we mean? The failure to pay workers a living wage in all the state funded services for people with disabilities is but one aspect of the difficulties faced in the last couple of years. Both customers and workers in the Home Services Program (HSP) have often experienced barriers in complying with the Electronic Visit Verification (EVV) system, as well as the new overtime policy capping worker hours at 40 hours per week, allowing exceptions only in very limited circumstances. All workers in Medicaid-funded services have had to enroll in the new IMPACT system, and while updating tracking systems is not a bad thing, the IMPACT system carries a mandatory background check that could put certain people with disabilities at risk of loss of services if their worker has a felony on record that could result in termination. All of the above also put a significant stress on the State to carry out new requirements with limited staff and still comply with Olmstead, which delays accomplishing the everyday goals of ensuring that those who qualify for and need home services actually get them.

People with disabilities and seniors continue to remain at a significant disadvantage when advocating for themselves with these programs, in which changes are usually announced via snail mail sent to people’s home addresses. Difficulties arise given that some people’s living situations are unstable, and some people have difficulty reading and comprehending written English. We at Access Living hear from many in the Chicago community that they fear their counselor meetings and assessments, because the counselors can so easily destabilize their service needs with the stroke of a pen. Most people who have home services have little idea of how to pursue an appeal. The Home and Community Ombudsman Program, which serves seniors who have CCP and people with disabilities who have HSP, is an excellent resource to help people advocate, but it remains underpublicized by the State (Access Living’s Ombudsmen can be reached at (312) 640-2152 or ombudsman@accessliving.org ).

Can and should Illinois provide homemaker, personal care and direct support services without such a high level of bureaucracy, and with better wages? There does come a time when circumstances be the question of whether it’s better to not “fix” something that is not “broke.” Now that the Governor has vetoed HB 4351, the focus of effort swings back to our state legislators. Please use this easy link to remind your legislators that preserving and protecting home and community based services is of critical importance. We at Access Living would also like to hear about any issues you may have had getting and keeping state-funded home services or homemaker services by using the Ombudsman contact info above (the phone line is active Monday through Friday, 8:30 am to 5 pm). You can also write me by replying to this email.

Amber Smock