Additionally, reforms that have been passed into law by the General Assembly in relation to Medicaid, for example, sit unimplemented due to a lack of will, ability, or in some cases because the good people working in these departments are fighting an uphill struggle with antiquated information systems and protocols.

One of the many lingering repercussions of the ineptness of the Blagojevich Administration was a massive expansion of Medicaid eligibility thresholds without any semblance of a plan to pay for the services.  The Director of the Illinois Department of Healthcare and Family Services describes Illinois eligibility standards as among the most generous in the United States.

The reason this subject matter is important is that Medicaid is the most rapidly growing portion of Illinois budget.  The liability for Illinois is $700 to $800 million monthly and going north.  This, coupled with the fact that the state is only paying about $300 million a month to providers of care will leave us with $2.4 billion in payment delays at the end of FY2012, and the backlog will expand to a staggering $5.4 billion by the end of FY2013.

Prioritizing services based upon need is imperative if we are to make a good faith effort in directing limited resources to those in the margins of society.  Political types are excellent at expanding programs, and significantly less adept at facing the reality that the math doesn’t come close to working and serious decisions and reforms are imminent.

Where are we on the reform front?  A law commonly referred to at the Medicaid Reform Act passed into law and took effect on 1/25/11.  The Act contains comprehensive reforms, including enhanced eligibility verification across all lines of Medicaid.  Measures as non-controversial as one must be an Illinois resident to access Illinois Medicaid, and at least one month’s income verification for current and continued eligibility, and the elimination of presumptive eligibility.  Other measures called for utilization review of narcotic medication abuse, and providing by rule for dispensing of a 90 day supply of generic, non-narcotic maintenance medications.

To date, none of the above requirements enacted into law over eleven months ago have been implemented.  Instead of filing a State Plan Amendment consistent with past protocol, the Department of Healthcare and Family Services filed what amounts to a “mother may I” letter to the federal government, a tactic that almost asks for the reforms to be denied by the feds.  One could reasonably argue that this laissez faire tactic is a defacto way of undermining legislative intent by providing bureaucratic cover for measures that some in the current Administration simply do not want to implement.

An analysis by the Senate Republican staff suggests that the State can save in excess of $1 billion annually if the expansion in eligibility of the past few years is reversed.  Requiring enhanced verification and eliminating presumptive eligibility represents a major portion of these projected savings.

I personally pressed the Director of HFS in terms of why this measure, in addition to seven other reform laws that have been passed since 2009 that have not been implemented.  In totality, over $1.5 billion in savings annually could be realized.  The rationale for failure to implement ANY of the reforms is illustrative of how dysfunctional and unaccountable the government is in comparison to my experience in the private sector.

Where else would there be no apparent ramifications for admitting that not only are the reforms not implemented, but that the team of managers on the field in the department “lack the skill set” to facilitate the changes.  That is a direct quote.  Twenty-one positions are currently open due to cumbersome hiring rules and collective bargaining agreement barriers.  In short, the same people who agreed to, lobbied for, and enacted ridiculous hiring protocols, are now using them as an excuse to circumvent legislative intent.

Another reason for the inability to move forward is that the information systems that many of our field offices are using are from a bygone era.  The staff at the local human services office in Danville is saddled with a COBAL based system.  COBAL was invented in 1959 and taught to programmers in the 1970’s.  The last major update of this language was in 1985, centuries ago by modern information technology standards.  This revelation is both shocking, and a testament to how perhaps the only thing that rivals the disaster of our finances is the laughable managerial stewardship promulgated by the Executive Branch over the past decade.  To saddle the employees of our state offices with technology akin to a bag phone in an era of 4G capabilities underscores the total lack of a comprehensive management and personnel strategy.

Ironically, what will happen in the spring of 2012 is that many who will not advocate for simple reforms being implemented (and by definition will not have the intestinal fortitude to discuss major reforms over the next 24 months), will attempt to shove a huge decrease in reimbursement down the throats of our hospitals, nursing homes and physicians, most of whom are already providing services at a loss and waiting 150 days or more for payment.  Why?  Because simply cutting the providers off at the knees is easier than changing the culture of how we do business in Springfield – unconscionable in my view.

When I, and over 50 members of the General Assembly wrote a letter dated 10/11/11 to the federal Super Committee, imploring our Washington brethren to allow our simple Medicaid reforms to move forward, even a vote on the non-binding resolution was blocked by House Democrats.

These are the easy decisions in the context of budgetary reform in Illinois.  Compared to the extraordinarily tough votes that will come with the 2012 and 2013 budgets, history will judge these changes as perfunctory.

The public is increasingly, and appropriately, frustrated by what they perceive as either the inability, or what I suggest is the unwillingness, of many involved with the process to act with the purpose and urgency that our enormous challenges demand.

It can be done.  I had the privilege of working in healthcare over an extended period of time in a faith based organization that faced many of the same challenges that our State currently confronts.  Moving large organizations towards efficiency and accountability while providing services at a high level is not easy.  Too many in government see this exercise as a destination of incremental decisions with short term durations.  Reality suggests a change of culture that demands creativity, efficiency, utilization of technology, and using attrition as an organizational friend.

The bottom line is this:  every citizen in our state understands that if their government were a private sector entity it would be bankrupt with many of its leaders either in jail for corruptness, or at minimum unemployed due to being convicted on the charge of being ill equipped to address age old problems with modern solutions.

Incremental decisions and foot dragging over the implementation of the baseline changes and low hanging fruit will not get us to the promised land.  Straight talk, common sense, and a willingness to tear down silos and barriers is required.

Illinois is in an economic emergency.  We need to start acting accordingly.

My first year office as a State Representative has reinforced my belief that the urgency with which significant issues are addressed is not commensurate with the magnitude of our State’s fiscal crisis.  This is due in part to the glacial pace that business moves in Springfield legislatively.  Inordinate amounts of time and effort are spent on matters that are peripheral at best in relation to the real issues facing our State.

Additionally, reforms that have been passed into law by the General Assembly in relation to Medicaid, for example, sit unimplemented due to a lack of will, ability, or in some cases because the good people working in these departments are fighting an uphill struggle with antiquated information systems and protocols.

One of the many lingering repercussions of the ineptness of the Blagojevich Administration was a massive expansion of Medicaid eligibility thresholds without any semblance of a plan to pay for the services.  The Director of the Illinois Department of Healthcare and Family Services describes Illinois eligibility standards as among the most generous in the United States.

The reason this subject matter is important is that Medicaid is the most rapidly growing portion of Illinois budget.  The liability for Illinois is $700 to $800 million monthly and going north.  This, coupled with the fact that the state is only paying about $300 million a month to providers of care will leave us with $2.4 billion in payment delays at the end of FY2012, and the backlog will expand to a staggering $5.4 billion by the end of FY2013.

Prioritizing services based upon need is imperative if we are to make a good faith effort in directing limited resources to those in the margins of society.  Political types are excellent at expanding programs, and significantly less adept at facing the reality that the math doesn’t come close to working and serious decisions and reforms are imminent.

Where are we on the reform front?  A law commonly referred to at the Medicaid Reform Act passed into law and took effect on 1/25/11.  The Act contains comprehensive reforms, including enhanced eligibility verification across all lines of Medicaid.  Measures as non-controversial as one must be an Illinois resident to access Illinois Medicaid, and at least one month’s income verification for current and continued eligibility, and the elimination of presumptive eligibility.  Other measures called for utilization review of narcotic medication abuse, and providing by rule for dispensing of a 90 day supply of generic, non-narcotic maintenance medications.

To date, none of the above requirements enacted into law over eleven months ago have been implemented.  Instead of filing a State Plan Amendment consistent with past protocol, the Department of Healthcare and Family Services filed what amounts to a “mother may I” letter to the federal government, a tactic that almost asks for the reforms to be denied by the feds.  One could reasonably argue that this laissez faire tactic is a defacto way of undermining legislative intent by providing bureaucratic cover for measures that some in the current Administration simply do not want to implement.

An analysis by the Senate Republican staff suggests that the State can save in excess of $1 billion annually if the expansion in eligibility of the past few years is reversed.  Requiring enhanced verification and eliminating presumptive eligibility represents a major portion of these projected savings.

I personally pressed the Director of HFS in terms of why this measure, in addition to seven other reform laws that have been passed since 2009 that have not been implemented.  In totality, over $1.5 billion in savings annually could be realized.  The rationale for failure to implement ANY of the reforms is illustrative of how dysfunctional and unaccountable the government is in comparison to my experience in the private sector.

Where else would there be no apparent ramifications for admitting that not only are the reforms not implemented, but that the team of managers on the field in the department “lack the skill set” to facilitate the changes.  That is a direct quote.  Twenty-one positions are currently open due to cumbersome hiring rules and collective bargaining agreement barriers.  In short, the same people who agreed to, lobbied for, and enacted ridiculous hiring protocols, are now using them as an excuse to circumvent legislative intent.

Another reason for the inability to move forward is that the information systems that many of our field offices are using are from a bygone era.  The staff at the local human services office in Danville is saddled with a COBAL based system.  COBAL was invented in 1959 and taught to programmers in the 1970’s.  The last major update of this language was in 1985, centuries ago by modern information technology standards.  This revelation is both shocking, and a testament to how perhaps the only thing that rivals the disaster of our finances is the laughable managerial stewardship promulgated by the Executive Branch over the past decade.  To saddle the employees of our state offices with technology akin to a bag phone in an era of 4G capabilities underscores the total lack of a comprehensive management and personnel strategy.

Ironically, what will happen in the spring of 2012 is that many who will not advocate for simple reforms being implemented (and by definition will not have the intestinal fortitude to discuss major reforms over the next 24 months), will attempt to shove a huge decrease in reimbursement down the throats of our hospitals, nursing homes and physicians, most of whom are already providing services at a loss and waiting 150 days or more for payment.  Why?  Because simply cutting the providers off at the knees is easier than changing the culture of how we do business in Springfield – unconscionable in my view.

When I, and over 50 members of the General Assembly wrote a letter dated 10/11/11 to the federal Super Committee, imploring our Washington brethren to allow our simple Medicaid reforms to move forward, even a vote on the non-binding resolution was blocked by House Democrats.

These are the easy decisions in the context of budgetary reform in Illinois.  Compared to the extraordinarily tough votes that will come with the 2012 and 2013 budgets, history will judge these changes as perfunctory.

The public is increasingly, and appropriately, frustrated by what they perceive as either the inability, or what I suggest is the unwillingness, of many involved with the process to act with the purpose and urgency that our enormous challenges demand.

It can be done.  I had the privilege of working in healthcare over an extended period of time in a faith based organization that faced many of the same challenges that our State currently confronts.  Moving large organizations towards efficiency and accountability while providing services at a high level is not easy.  Too many in government see this exercise as a destination of incremental decisions with short term durations.  Reality suggests a change of culture that demands creativity, efficiency, utilization of technology, and using attrition as an organizational friend.

The bottom line is this:  every citizen in our state understands that if their government were a private sector entity it would be bankrupt with many of its leaders either in jail for corruptness, or at minimum unemployed due to being convicted on the charge of being ill equipped to address age old problems with modern solutions.

Incremental decisions and foot dragging over the implementation of the baseline changes and low hanging fruit will not get us to the promised land.  Straight talk, common sense, and a willingness to tear down silos and barriers is required.

Illinois is in an economic emergency.  We need to start acting accordingly.

As we have discussed here before, About 55,000 families across the State have invested their children’s college money in College Illinois!, but  questionable investment practices and management decisions as well as sky rocketing tuition have created a shortfall. Our College Illinois! Restoration Task Force is charged with finding solutions to bring stability back to the program.

In addition to hearing families’ personal stories at the recent hearing we also again heard from Illinois Student Assistance Commission Chairwoman Kym Hubbard who assured us that the fund will be viable for at least five more years, and she promised us a full actuarial report within 30 days.  Once we receive the report, we can begin working on a plan to secure families’ investment far into the future.

Last week I signed-on as a co-sponsor of legislation initiated by Illinois Attorney General Lisa Madigan that will make the pilot program permanent and help ensure our continued success in the battle against meth.

In drafting the new legislation, Attorney General Madigan consulted with the Illinois State Police and also shared the draft with the Illinois Retail Merchants Association. The proposed legislation does not expand or change the requirements of the current pilot program and is designed to allow a seamless transition to permanency without costs to the state or to Illinois pharmacies.

I look forward to working with the Attorney General to pass this legislation through the House as soon as possible.

A new Special Enrollment Period (SEP) began on Monday for those who receive their health insurance coverage through the state. Special Enrollment offers an opportunity to review your insurance carrier options and make a change if you wish. This may be particularly helpful now to Personal Care enrollees with Christie Clinic physicians.  Below are Central Management Services answers to some of the questions you may have:

Q. What changes can I make during the SEP?

A. You can only change health carriers during this SEP. No other changes will be permitted.
Q. I want to change carriers. Is there a form that I need to fill out?

A. Forms for individuals enrolled in the State, College or Local

Government plans can be found on the Benefits website (www.benefitchoice.il.gov). Individuals enrolled in the Teachers’ plan should have received a form directly from TRS.

Q. How do I know if my doctor is enrolled in one of the plans?

A. Information regarding each of the plan administrators coverage area and networks are available on their websites. You can also contact the plan administrator with specific questions.

Q. I am enrolled in PersonalCare and my primary doctor is at Christie Clinic. If I don’t change health insurance and they end their contract, what options do I have to choose a new health insurance plan?

A. Outside of the SEP or the annual Benefit Choice period, members may only change health insurance plans if they experience a Qualifying Change in Status (QCIS). For a contract issue, such as the one currently occurring between PersonalCare and Christie Clinic, the only issue that will result in a QCIS is the loss of a primary care physician (PCP). Only individuals enrolled in Persona1Care HMO are assigned a PCP so, only these members would be eligible to make a change. If you are enrolled in PersonalCare HMO and your PCP leaves the network, you may:

• Choose another PCP within that plan;
• Change managed care plans; or
• Enroll in the Quality Care Health Plan.

The latest news is that the Senate President and the Governor are discussing possible ways to scale-back the proposal by removing some of the language allowing slot machines at horse racing events such as harness racing at the state fairgrounds in Springfield.

President Cullerton indicates though that the discussions are not serious yet, and that the Governor has yet to outline his specific problems with the bill or suggestions to improve it.

This too is a jobs issue for me, and I will continue to work to keep the Danville Casino in the final bill. I’m hoping for a veto session agreement, and will keep you updated.

Our neighboring states are beating us in the battle for jobs. Why? Because they have made job creation their number one priority and have instituted jobs-friendly policies to help attract and keep employers.

We need to fight fire with fire. So, this week House Republicans introduced a new jobs package for Illinois that we will work to pass in our upcoming fall veto session. Our package will:

Re-instate the Net Operating Loss deduction.

Many businesses are losing money in this tough economy, this proposal allows them to use their net operating loss as a tax deduction extending the corporate carry forwards from 12 years to 17 years, and allowing a two year carry back.

Re-enact the Illinois Research & Development tax credit.

This tax credit expired in December 2010. Reinstating it would allow businesses that are doing legitimate research and development projects to qualify for a tax credit each year.  Our proposal would also add ethanol and biodiesel research as qualified R & D activities.

Extend the life of existing Enterprise Zones by up to 20 years.

Most designated Enterprise Zones in Illinois are set to expire in the next ten years.  Our proposal would allow current municipalities around the state to extend the enterprise zones in their communities to ensure tax incentives to businesses that have located or choose to locate in these underdeveloped areas.

Reduce the administrative costs and burdens involved with setting up and incorporating a Limited Liability Corporation in Illinois. 

In Illinois even the cost to set up a business is much higher than in surrounding states.  We are proposing to reduce that fee from $750 to $100. The highest fee that any of our neighboring states currently charges is in Wisconsin at $130.

Increase the estate tax exemption to $5 million.

Under the current law, when family farms are passed from generation to generation the heirs are hit with a huge estate tax if their assets are worth more than $2 million. Our proposal would raise the estate tax exemption to $5 million—which mirrors the federal tax code.

The initial cost to institute these business friendly policies is estimated at about $492 million, but remember, for every point we reduce our unemployment rate the state generates around $600 million in new revenue to fund state programs and services.  This is a true investment in our future.

The bottom line is this: jobs are created in the private sector and we need to get busy ensuring we are competitive with Indiana and almost every other state in the country.

Its official…A nine month extension of emergency state health insurance contracts authorized several weeks ago was finalized this week. Now, the temporary, emergency contracts with Health Alliance, HealthLink and Personal Care initially set to expire in late September will remain in effect through the end of the fiscal year on June 30, 2012.

This is very good news for thousands of local families. Extending the emergency contracts will ensure families continue to have access to their trusted doctors and providers while the lawsuits challenging this year’s procurement process are resolved.

The emergency contract extension was finalized Wednesday with completion of a public hearing required by law and authorization by the Chief Procurement Officer.

When we return to Springfield in late October, I will immediately push to override the Governor’s veto of Senate Bill 178. You will recall that this is the legislation that would effectively “throw out” this year’s bids and bid awards for state health care contracts and extend the previous contracts for an additional two years.

Senate Bill 178 would also empower legislators on the state’s Commission on Government Forecasting and Accountability (COGFA) to oversee healthcare contracting decisions, including the authority to approve or deny proposed contracts.

Open Enrollment Dates Set

Dates have now been set for a new open enrollment period from October 10 through October 28 during which those who participate in the State of Illinois Group Insurance Plan can change health insurance carriers if they choose. All members will be sent a postcard notifying them of the time frames for this special enrollment period.

Remember, for those who want to keep their current insurance carrier, no action is required. The open enrollment is for those who want to change their carrier.

The program has been in place for decades. It allows each member of the General Assembly to award the equivalent of eight one-year tuition waivers each year for students to attend a state university in Illinois.

First of all, these waivers are not funded– our universities are expected to just “eat” the costs. When we’re already not paying our universities what we owe them this is just adding insult to injury.

What’s even more troubling is that the program has been plagued by scandal. A recent investigation found that in six years, 122 waivers were given to students who do not live within the awarding legislator’s district. Some were given to political contributors, family members or friends.

I believe public trust will be rebuilt one act of integrity at a time…that’s why I’m sponsoring House Bill 201 which would abolish the program. I will be working to move this legislation forward in our upcoming Veto Session as well.

I hope you have a wonderful Labor Day weekend planned.

As our summer winds to a close, I’m getting ready to begin my fall traveling office hours in local communities throughout the district. Please check the schedule below to see when I’ll be in your community and stop by to share your concerns, or just to say “hi”.

In addition to activities here in the district, I’m preparing to return to Springfield for our Fall Veto Session next month. I’ll be doing a full Veto Session Preview for you in a week or two, but this week I wanted to highlight a couple of issues we’ll be dealing with: health insurance and General Assembly Scholarships.

In our last newsletter I wrote about working with the local and state Farm Bureaus in efforts to roll back recent changes in interpretation of federal rules regarding farm vehicles that would hurt Illinois farmers.  I’m very pleased to report that our efforts were successful…there will be no changes after all!

Here’s the background:

Earlier this year, the Federal Motor Carrier Safety Administration (FMCSA) began to define crop-share tenant farmers as “for-hire” carriers and implements of husbandry as “commercial motor vehicles.” The “for-hire” designation for crop-share tenant farmers would have a dramatic effect on farmers because it would void exemptions from the Commercial Driver’s License (CDL) program and would require a minimum of $750,000 in insurance coverage for the farmer.

This new interpretation of farm vehicle rules would have hurt Illinois farmers and our agricultural economy. They would have increased costs and interfered with existing crop-share arrangements.

I’m very pleased that working with the Farm Bureaus and our Illinois Congressional delegation we were able to convince The FMCSA to reverse their decision.