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1 | | HOUSE RESOLUTION
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2 | | WHEREAS, Due to federal health care reform, an
integrated |
3 | | care pilot program in Northern Illinois, and statewide Medicaid |
4 | | reform,
a managed care approach to providing Medicaid coverage |
5 | | is no longer up for debate making Medicaid managed care a |
6 | | reality in Illinois; and |
7 | | WHEREAS, Managed care has proven a sometimes inefficient |
8 | | provider of
health care coverage especially for long-term care |
9 | | and those
individuals - typically the elderly or people with |
10 | | disabilities - receiving it; and |
11 | | WHEREAS, Illinois'
pilot program and the recent Medicaid |
12 | | reform law make it mandatory for
managed care to provide the |
13 | | services expected in a long-term care setting, which
is a |
14 | | potentially risky scenario for those receiving these kinds of |
15 | | services; and |
16 | | WHEREAS, A number of other states have discontinued managed |
17 | | care for people with
disabilities and the elderly, including |
18 | | California which found it more cost-effective
not to utilize |
19 | | managed care after an extensive overhaul of the state's health |
20 | | care
program; and |
21 | | WHEREAS, Illinois is setting forth on this venture with two |
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1 | | for-profit managed care
organizations under contract, while |
2 | | not exploring other entities to provide quality
care, such as |
3 | | not-for-profit organizations; and
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4 | | WHEREAS, The Institute on Disability and Human
Development |
5 | | at the University of Illinois at Chicago (UIC) is overseeing |
6 | | the consumer satisfaction levels and the managed
care |
7 | | organizations' competency for the test population in the pilot |
8 | | program; nonetheless, only an estimated 40,000 individuals |
9 | | with disabilities are in the pilot
program area and targeted to |
10 | | receive services; as Illinois Medicaid reform and
federal |
11 | | health care reform become the norm for Medicaid recipients in |
12 | | this State,
a conservative estimate is that 2.4 million people |
13 | | currently receive Medicaid, and
approximately 1.2 million |
14 | | people - or 50% of the Medicaid population - under
that program |
15 | | will move into a managed care system, as mandated by the |
16 | | Illinois
Medicaid reform law; this increased number will not |
17 | | receive monitoring from
UIC and, possibly, will not receive the |
18 | | adequate follow-up, thereby, leaving them
more susceptible to |
19 | | fraudulent practices, abuse, neglect, and insufficient care
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20 | | through providers and the managed care organizations; as |
21 | | Illinois
moves toward transitioning 50% of the Medicaid |
22 | | population to a managed care
system, as with the pilot program, |
23 | | no other plans except those involving for-profit
managed care |
24 | | organizations are presently receiving serious discussion; |
25 | | therefore, be it
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1 | | RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE |
2 | | NINETY-NINTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that |
3 | | there is created in the Department of Healthcare and Family |
4 | | Services the Medicaid Managed Care Oversight Task Force to |
5 | | monitor how Illinois approaches and manages a new form of |
6 | | health care delivery system based on a managed care model, |
7 | | particularly for people with disabilities and the elderly; and |
8 | | be it further |
9 | | RESOLVED, That all members of the Task Force shall be |
10 | | appointed by the Governor and shall serve without compensation; |
11 | | the Department of Healthcare and Family
Services shall |
12 | | facilitate the Task Force and provide the Task Force with |
13 | | administrative support, but shall have no hand in guiding its
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14 | | direction or ascertaining its results; the Task Force shall |
15 | | meet quarterly and
report on its findings to the General |
16 | | Assembly and its appropriate
committees; reports from the Task |
17 | | Force shall indicate (i) whether individuals
within the pilot |
18 | | program and the intended 50% of Medicaid recipients |
19 | | transitioned into
managed care are satisfied with their health |
20 | | outcomes, can access all necessary forms of medical care, and |
21 | | received all necessary information from the State and the |
22 | | Department regarding the changes to their health care delivery |
23 | | system; and (ii) any other
satisfaction indicators deemed |
24 | | applicable by the Task Force, especially with the
knowledge of |
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1 | | how UIC conducted satisfaction surveys; the Task Force's life |
2 | | span
shall continue until January 1, 2017, unless the General |
3 | | Assembly deems a
longer tenure necessary, as that date would |
4 | | mark the two-year anniversary of the
transition of Medicaid |
5 | | enrollees into managed care programs, as mandated by
the newly |
6 | | enacted Medicaid reform law in Illinois; and be it further |
7 | | RESOLVED, That upon receiving reports from the Task Force, |
8 | | the General Assembly and all
appropriate committees therein |
9 | | must take the necessary steps to ensure all
individuals |
10 | | receiving health care through a managed care delivery system |
11 | | are
satisfied with that care and are not receiving worse care |
12 | | as a result; if the
General Assembly finds negative outcomes |
13 | | per reports from the Task Force, it
should amend the process by |
14 | | which managed care is put to use for Medicaid
recipients, |
15 | | especially for people with disabilities and the elderly, and |
16 | | further, if the
reports are positive or neutral, the General |
17 | | Assembly should decide whether to
continue monitoring the |
18 | | program for a set period to ensure that all recipients
receive |
19 | | the best quality health care available to them under a managed |
20 | | care
process; and be it further |
21 | | RESOLVED, That as changes to health care delivery improve |
22 | | or changes
come to pass based on new laws passed by the State |
23 | | or federal government, the
General Assembly must decide if |
24 | | continuing the use of the managed care
approach is the most |