This weekend the State-Journal Register published an interesting story on the latest developments in legislation that originally sought to target Illinois nursing home neglect. The main issue involves “compromises” allegedly made behind closed doors between the Governor’s office and long-term care industry insiders. The agreement essentially eased up on proposed changes in nursing home staff requirements in exchange for lower reimbursement rates from state Medicaid officials.
The Main Issue
In 2010 the state passed a nursing home reform law—the most-far reaching piece of legislation on the issue ever. However, part of the law may be chipped away at, say advocates, because of a compromise made this year by Governor Pat Quinn.
The 2010 law includes a gradual increase in the nursing staff ratio requirements in the state. Our Illinois nursing home lawyers frequently share information on the way that quality staffing levels correlate with lower incidence of preventable harm to residents. The 2010 law listed specific “nursing and personal care” hourly requirements—to increase yearly until 2014. However, the specific definition of the care was left open in the bill to be worked out by various parties later.
Different interest groups soon began negotiations to determine what type of care constituted the applicable care per the 2010 law’s requirements. The Joint Committee on Administrative Rules (JCAR) is the body that issues final decisions on these sorts of issues. Earlier this year it seemed that all sides agreed that 20% of the total required care would be provided by “registered nurses” instead of the less-trained “licensed practical nurse.” This was deemed a fair balance to ensure that residents actually received close observation from well-qualified professionals sufficient levels.
However, before the 20% rate was finalized by JACAR, the Governor’s office engaged in some behind-the-scenes maneuvering with nursing home industry insiders. A compromise bill (Senate Bill 2840) seemingly discussed Medicaid cuts that the state was proposing—a separate issue. The cuts ended up being 2.7%–far less than then 15% cut that nursing home industry insiders feared. At the same time, the agreement also set the RN staffing level at 10%–only half of what was previously agreed by the group negotiating the issue.
State Senator Anazette Collins was working closely on the original negotiations. She was understandably furious that the previous negotiations were scraped following a secret meeting at which no Illinois elder abuse advocates were present. Senator Collins said: “To me, that was betrayal. There will be very little change in staffing. Seniors are going to be extremely disadvantaged. T he weak are victimized. They don’t have lobbyists down here.”
The article noted how the Illinois nursing home lobby is one of the largest contributors to state campaigns. It is hard not to grow disillusioned by the possible connection between collecting campaign contributions and enacting policy that favors one group over another—particularly when the disadvantaged group is one that does not have much political clout. It is partly for that reason that each Chicago nursing home neglect attorney at our firm is proud to stand up for the rights of local seniors.
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