COMPTROLLER ISSUES SPECIAL REPORT ON MEDICAID LONG-TERM CARE DETERMINATIONS

Thousands of Illinois seniors face growing housing, healthcare crisis

CHICAGO — Chronic mismanagement by the Rauner Administration has put tens of thousands of Illinois seniors and persons with disabilities at risk, according to a report released today by the Office of Illinois Comptroller Susana A. Mendoza.   

Since taking office, Comptroller Mendoza, as the state's chief fiscal officer, has prioritized payments to programs serving the state’s most vulnerable populations, including the roughly 55,000 Medicaid long-term care (LTC) program participants, many of whom reside in nursing homes and supportive living and hospice care facilities. 

But now the failure to process millions of dollars in bills for critical services and a spike in enrollment delays is threatening care providers' ability to cover basic costs like medicine, food, and payroll, Comptroller Mendoza said. 

"The Rauner Administration's continued dysfunction is again threatening the people of the state who, perhaps, need our help the most. For Illinois' aging population, this is a massive healthcare and housing crisis and it again demonstrates an inability by Governor Rauner to manage basic state functions and critical programs. The stakes – the immediate well-being of thousands of seniors and persons with disabilities – could not be any higher," Comptroller Mendoza said.  

Earlier this month in a letter to Governor Rauner, Comptroller Mendoza shared some of the report findings, outlined her concerns and proposed solutions including providing both immediate and sustainable support for the timely processing of claims to provide uninterrupted services and signing HB 4771 and SB 2913, the bipartisan legislation approved by the General Assembly earlier this year to simplify these functions and prevent future backlogs. 

The Comptroller's report, which uses Department of Healthcare and Family Services (HFS) data, found that the number of pending Medicaid eligibility determinations for LTC over 90-days-old rose 143 percent between December 2017 and May 2018. HFS has reported it can only process 60 percent of new, incoming applications in a timely manner and, as of the end of last month, there were 16,378 pending admissions. According to the Associated Press, the estimated cost of these pending admissions is up to $300 million.  

These problems are occurring at the same time the Rauner Administration continues to dump tax dollars into a failed technology solution meant to streamline Medicaid eligibility processes. The state has committed $288 million to Deloitte, the global consulting firm, for an Integrated Eligibility System (IES) to modernize enrollment in benefit programs like LTC or the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps.  

In six years, the cost of the Deloitte IES has doubled from $144 million to nearly $300 million. The IES has been plagued by public failures that have stopped or delayed critical services for eligible, needy families. And the cost continues to rise: Earlier this month, HFS issued an emergency request to outsource its application processing duties. The cost will likely exceed $14 million over the next two years. 

The full Office of the Comptroller's staff report on Medicaid long-term care determinations and pending legislation can be found here.

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You can download the PDF version of this release here.