Group of individuals with mild cognitive impairment and their loved ones.
The Illinois Coalition on Mental Health & Aging presents a condensed edition of a Legislative Report prepared by Terry Steczo for the Illinois Association of Area Agencies on Aging. We thank I4A for sharing this Report with the Coalition:
The Illinois General Assembly enters overtime session as the new state fiscal year begins without any sign of a new budget in place. Last week the Governor vetoed budget bills that were approved by the Democratic majority. However the Governor did sign two bills relating to education funding to make sure schools open on time.
On June 29 the Governor’s office released a statement informing state employees everything possible would be done to see that they would be paid even if there was no budget approved. That was followed by a memorandum from the Attorney General indicating that making any employee payments without a budget would violate the Illinois Constitution. What all this means is that the courts will be asked to referee as they have done in similar disputes in the past.
The Governor’s budget bill veto message cited the unconstitutionality of approving a budget that was almost $4 billion out of balance. The Governor has stated his willingness to discuss taxes. His own budget plan offered in February was $2.2 billion short and included deep cuts based on the loss of temporary income tax proceeds. But, he has also firmly indicated that he won’t go there until he gets his agenda approved and there has been absolutely no indication that the General Assembly is of the mind to make that happen.
Democrats in the General Assembly insist that creating a workable budget for FY 2016 be the major focus of overtime discussions in contrast to the Governor’s insistence that his “Turnaround Agenda” be approved before any budget and revenue discussions take place. Governor Rauner’s “Turnaround Agenda” is a fairly comprehensive list of statutory changes, many of which have been on certain wish lists for years and years. The following is a list of the major issues:
Worker’s Compensation Reform: This has been a legislative bargaining issue since the 1970s and reforms have been negotiated a few times since. In an effort to reduce worker’s compensation insurance costs for employers the Governor wants clarity on “causation” and some definitions including “traveling employees” and implementation of American Medical Association guidelines on impairment. Democrats argue that they made major concessions in 2011 that were supposed to have reduced worker’s compensation insurance rates but, as yet, they haven’t materialized and point to the insurance industry. They may be willing to deal here but probably not until they get some answers at to why the previous effort fell way short of expectations. Some changes in “causation” (linking benefits to the cause of an injury) could definitely be an outcome here.
Unemployment Compensation Reform: Another issue that has been at the center of employer/employee debates for years and also have been the subject of many negotiated statutory changes over the years. The Governor’s agenda specifies changes that would crack down on fraud and seek better definitions of workplace rules, such as for misconduct. Democrats have signaled that there could be meaningful changes here so if there is one area where compromise could come it would pertain to unemployment compensation.
Tort Reform: The Governor and business interests feel strongly that there must be a cap on awards and an end to what they consider frivolous lawsuits that hurt the Illinois business climate. Democrats are not inclined to limit the rights of those who file such suits and argue that the threat of suits leads to safer products, less medical malpractice and safer workplaces. The legislature did successfully negotiate tort reform changes in the mid-1980s. A tort reform modification also was approved in 2005 over the objections of the Illinois Trial Lawyers Association, a general ally of Democrats. Negotiations are the only way to find a middle ground here but the middle may be impossible to find.
Local Empowerment Zones: Represents the Governor’s suggestion for “local control” of union issues, namely Right-To-Work. Illinois is one of 26 states without a Right-To-Work statute. A Right-To-Work law generally prohibits agreements between labor unions and employers that govern the extent to which an established union can require employees’ membership, payment of union dues, etc. Democrats and some Republicans, argue that Right-To-Work laws diminish the rights in the workplace and tilt the playing field heavily toward management. They also argue that while such laws do not prohibit collective bargaining they do create a class of individuals known as “free riders” who benefit from collective bargaining without having to pay for it.
Freezing Property Taxes For Two Years: Governor Rauner originally proposed to a permanent freeze on property taxes, allowing for increases through local referenda. That plan has now been scaled back to a two-year freeze with the referendum option. His argument is that he considers Illinois to be a high property tax state and a freeze would allow both relief and a span of time to consider general tax reform. Opponents argue that Illinois is in the middle of the “tax pack” because other taxes are much lower than other states. They also argue that since many jurisdictions have already adopted tax caps a freeze on top of that diminishes their ability to provide services, and that even though there is the possibility of a referendum to allow increases the times when referenda are held are so limited and must be planned so far in advance that its usefulness in providing exceptions and budget flexibility is nil.
Term Limits: The Governor has put placement of a constitutional amendment on the 2016 ballot a negotiating point and would limit terms of legislators and state officials to eight years. Opponents argue that those legislators who feel strongly can volunteer to leave after eight years. They also feel knowledge is power and that removing too many legislators too quickly will diminish very important institutional knowledge and abdicate that to staff and lobbyists. Of the many issues in play there may actually be room for compromise here. Term limits that exempt current officeholders until they leave has been discussed and have an outside chance to win acceptance.
Moving all current state employees to 401(k) type of pension system: The recent pension decision of the Illinois Supreme Court will affect whatever pension reform plan emerges next if there can be a way to show that you can take the employee contributions that would have ordinarily gone to make the current system sound and shift it away without having an implosion. Since the ruling he has stipulated that retirees will be exempt from any pension reforms he proposes. The big question is whether or not anyone can agree on anything comprehensive enough that will save the system and that will be acceptable to the Supreme Court.
Budget and Revenue: The Governor insists that there will be no budget and revenue discussions until he gets an acceptable amount of the issues cited above but that “bottom line” has kept moving for the last few months. The budget presented by the Governor in February was $2.2 billion in the red while a budget crafted by the legislative Democrats was short by $3 billion meaning that there has to be some discussion of additional revenue in the mix. The lapsed temporary income tax proceeds amounted to $3.6 billion so that could have cured the revenue problem had it been left standing. The Governor has proposed expanding services taxes to the tune of $600 million but that won’t solve the problem. There has been some speculation about a reinstatement of the temporary income tax at a lesser rate for a shorter period but none of that will happen until there is some resolution of the above issues or unless a government shutdown causes one side or another to back down.
Bills Passed by the General Assembly and Sent to the Governor
HB 2462 – Rep. Harris, G./Sen. Link – Creates the Authorized Electronic Monitoring in Long-Term Care Facilities Act. Provides that, subject to certain conditions, a resident of a facility licensed under the ID/DD Community Care Act or the Nursing Home Care Act shall be permitted to use an audio or video surveillance system in his or her room at his or her expense. (Status – Sent To Governor)
HB 2731 – Rep. Hernandez/Sen. Steans – Provides that beginning July 1, 2015, the Department of Healthcare and Family Services shall publish monthly reports on its website on the enrollment of persons in the State’s medical assistance program, and the enrollment of recipients of medical assistance into a Medicaid Managed Care Entity contracted by the Department. Requires the Department to annually publish on its website every Medicaid Managed Care Entity’s quality metrics outcomes and to make public an independent annual quality review report on the State’s Medicaid managed care delivery system. (Sent To Governor)
HB 2915 – Rep. Costello/Sen. Rose – Creates the Caregiver Advise, Record, and Enable Act. Provides that after a patient is admitted as an inpatient into a hospital and before the patient is discharged or transferred, the hospital shall provide the patient or the patient’s legal representative with an opportunity to designate a caregiver. Provides that the hospital shall document the patient’s designation of a caregiver. Requires the hospital to notify the patient’s designated caregiver prior to the patient’s discharge or transfer, unless the patient indicates that he or she does not want the designated caregiver to be notified. Requires the hospital to consult with the designated caregiver and issue a discharge plan that contains certain information. (Status – Sent To Governor)
HB 3753 – Rep. Leitch/Sen. Morrison – Provides that subject to appropriations, the Department on Aging may provide grants to public and private nonprofit entities for projects that demonstrate ways to integrate mental health services for older adults into primary health care settings, such as federally qualified health centers as defined in the Social Security Act, primary care clinics, and private practice sites. (Status – Sent To Governor)
SB 1298 – Sen. Rose/Rep. Costello – Creates the Caregiver Advise, Record, and Enable Act. Provides that after a patient is admitted as an inpatient into a hospital and before the patient is discharged or transferred, the hospital shall provide the patient or the patient’s legal representative with an opportunity to designate a caregiver. Provides that the hospital shall document the patient’s designation of a caregiver. Requires the hospital to notify the patient’s designated caregiver prior to the patient’s discharge or transfer, unless the patient indicates that he or she does not want the designated caregiver to be notified. Requires the hospital to consult with the designated caregiver and issue a discharge plan that contains certain information. (Status – Sent To Governor)
SB 1846 – Sen. Biss – Provides that the Department of State Police shall develop a coordinated program for a statewide emergency alert system when a person 21 years old or older who is believed to have Alzheimer’s Disease or related dementias is reported missing. Provides that the system shall be referred to as the Silver Alert system and shall include, but is not limited to, an electronic message sent to all law enforcement agencies; use of the emergency alert system; the use of electronic billboards and message signs in coordination with the Illinois Department of Transportation if a vehicle is involved; posting of the Silver Alert message on Illinois Lottery terminals; the designation by the Department of a contact name and toll-free telephone number for tips and information; blast email and fax messages to media outlets; activation of a local reverse 911 systems to all businesses and residents if the person is on foot. (Status – Sent To Governor)
HR 561 – Rep. Gabel – Urges Congress to reauthorize the Older Americans Act. (Status – House Rules Committee)
SR 618 – Sen. Haine – Urges Congress to reauthorize the Older Americans Act. (Status – Adopted)
The 21st century is bringing about vast changes in the demographics of the United States. Notably, the population is aging at a rapid rate, and incidence of chronic illness and dementia is increasing, the disability population is aging, the nature of medical choices is changing due to evolving medical technology, and health care delivery systems are becoming increasingly complex. These trends bring health care clinicians up starkly against a growing challenge: The rising tide of patients with diminished decisional capacity.
Social group for people with early stage to moderate memory loss and their care partners.