Medicaid reform in Illinois should help more people with disabilities move from institutions to community

From The Telegraph in Ill.:

SPRINGFIELD, Ill. - Moving the developmentally disabled and the mentally ill from Illinois institutions to community-based settings could get a boost from the Legislature's push to reform the state's Medicaid system.

Illinois House and Senate committees on Medicaid reform on Dec. 14 heard consultant John Stephen recommend the state move those individuals into community-based settings. As of 2009, Illinois ranked first in the nation in institutionalization, outpacing other high-population states such as Texas, New Jersey and California, Stephen said.

"It's all about re-balancing long-term care," said Stephen, who served as New Hampshire's commissioner of health and human services before joining the Boston-based Lucas Group.

As co-chair of the House committee, state Rep. Patti Bellock, R-Westmont, told Stephen he was preaching to the choir.

"We know we're 51st in the nation on this issue," she said.

Stephen also cited statistics from the Kaiser Family Foundation showing that Illinois currently spends $18,387 annually on caring for disabled individuals, while the national average stands at $14,481.

The concept of community-based care - or "money following the person" - is popular among both federal and state lawmakers because it's usually less expensive than institutional care. Additionally, disabled individuals generally are offered more freedom in community-based settings, in accordance with the 1999 U.S. Supreme Court Olmstead decision calling for the disabled to live in the least-restrictive setting.

But the "re-balancing" is easier said than done. Families of disabled individuals often resist moving them, Stephens said, because of the influence of caretakers who don't want to lose their jobs.

"The families work closely with the people who take care of their loved ones," Stephens said.

A spokeswoman for the American Federation of State, County and Municipal Employees said the individual's care is the issue.

"The state centers provide intensive, around-the-clock care that the smaller homes can't," said Anne Irving, AFSCME Council 31 director of public policy.

Politics already has reared its head regarding the closure of any state institutions. Gov. Pat Quinn has agreed to no layoffs and no state facility closures through June 30, 2012, in return for $100 million in state budget savings offered by AFSCME.

However, committee co-chair state Rep. Barbara Flynn Currie, D-Chicago, said that any move toward de-institutionalization must have the community support and resources to back it up.

"I think the issue for us is making sure the infrastructure is there," Currie said.