I4A Network Alert

I4A Alert

Illinois Aging Network Alert

A periodic report of the impact of the state budget crisis on Illinois Seniors and Community Programs on Aging, from

I4A - Illinois Association of Area Agencies on Aging

Contact:  Joy Paeth 618-222-2561 or Jon Lavin 708-383-0258

Aging Network Continues to Lose Ground

Number of the Day – 12

According the Department on Aging, twelve different organizations have dropped Community Care Program Contracts since July 1, 2016.  Not all have completely left the program - some sold components of their business with the purchaser becoming the new contractor, some closed sections of their programs while keeping others, but most have laid off staff and stopped serving Illinois seniors because payment for half their clientele was not and is not forthcoming.  The costs of staff and the costs of doing business in Illinois must still be paid even though there is no State Budget resulting in payments are almost twelve months in arrear. 

Right now there are nineteen current Community Care Program Providers that are reporting severe financial distress, some delaying their payrolls.   This affects home care and adult day services staff who are already paid minimally. They are waiting for a paycheck, hoping their landlords will understand the delay in their rent, and dealing with reduced food and transportation budgets.

Here, in the last days of the 2017 General Assembly scheduled session, there seems to be some profiles in courage as bills have passed one or the other chamber to realistically and fairly deal with the Budget, but there also seems to be a willingness to permit the impasse to continue and to convince voters that someone else is to blame for the state situation, or even worse to say that Illinois can get out of this mess with smoke and mirrors. 

I4A asks that the General Assembly and Governor care enough about older persons to put aside the posturing and solve the budget mess.  We will have your backs if you step up and do what is right for Illinois – pass a budget, identify revenues to solve the current and long term challenges, and stop the politicking that tells the public “integrity and action” are mistakes.  Doing what is right is right – the current situation is wrong!

Distributed for I4A by:

Jonathan Lavin

Chief Executive Officer

AgeOptions

1048 Lake Street

Oak Park, Illinois 60301

708-383-0258

708-524-0870 fax

708-309-1361 cell

Medicaid Managed Care Transformation

Date:  Ap

Date: April 7, 2017

To: All Medical Assistance Providers

Re: Medicaid Managed Care Transformation

Date:  Dat
The Illinois Department of Healthcare and Family Services (HFS) is transforming its current managed care program. HFS intends to extend its Medicaid managed care program into every county in Illinois beginning on January 1, 2018.
HFS has recently issued a Request for Proposal (RFP) with the intent to award contracts to no fewer than four (4) and no more than (7) qualified, experienced, and financially sound Managed Care Organizations (MCOs) to enter into risk-based contracts for the Medicaid managed care program.  
The program will expand managed care coverage to additional populations including special needs children and children under the care of the Department of Children and Family Services (DCFS). Through this transformation, more than 80 percent of Medicaid beneficiaries will transition into a managed care health plan, an increase from the 65 percent who are currently enrolled in a managed care health plan.
HFS recognizes that providers are an important part of the overall transformation process. HFS encourages providers to begin contract discussions when MCOs are reaching out to establish networks. Providers who have contracted with MCOs that are awarded a contract will be able to seamlessly serve Medicaid participants during this period of transformation. In addition, the only way for providers to ensure payment for services rendered to clients enrolled with MCOs under the transformed Medicaid Managed Care Program is to contract with the MCOs.
The RFP webpage can be accessed for additional information including the draft model contract and also includes Frequently Asked Questions. Continue to visit the Medicaid Managed Care Program RFP webpage for updates, including contract award notices and transformation timelines.
 
Thank you for your continued support of the Illinois Medicaid Managed Care Program.  
Felicia F. Norwood
Director

IMPORTANT: Molina HealthCare of Illinois MMAI coverage will end on 05/01/2017

This Molina Action affects Macon and Piatt Counties beginning May 1, 2017

 
Molina HealthCare of Illinois MMAI will no longer provide coverage through the Medicare-Medicaid Alignment Initiative (MMAI) program after April 30, 2017. However, you will still have Medicare and Medicaid benefits, including prescription drugs. You will be automatically enrolled in the regular Medicaid fee-for-service program. Unless you make another choice, you will be automatically enrolled in the Original Medicare fee-forservice program and a SilverScript Insurance Company Medicare Part D prescription drug plan effective May 1, 2017. If you do not want to be automatically enrolled in Medicare coverage, you have options, which are listed below.
What are my options?
1. Original Medicare and a Medicare Prescription Drug Plan
You can get your Medicare services, such as doctor visits, through Original Medicare. If you choose Original Medicare, you need to join a separate Medicare prescription drug plan, also known as a “Part D plan” to get prescription drug coverage. If you don’t choose a drug plan on your own, Medicare will enroll you in a SilverScript Insurance
Company Medicare Part D prescription drug plan.
 
2. Medicare Advantage
You can enroll in a Medicare Advantage health plan to get your Medicare services. A Medicare Advantage plan is offered by a private company that works with Medicare to provide benefits. Medicare Advantage plans cover all services that Original Medicare covers and may offer extra coverage such as vision, hearing, or dental. Most include prescription drug coverage as well. If you choose a Medicare Advantage plan, check with your current providers to see if they are part of the new plan. You should also ask the new plan to see if your current medications will be covered. You can call the new plan or look at the plan’s provider directory and prescription drug list online.
 
If you want help, you can get free, confidential assistance by calling the Senior Health
Insurance Program at 1-800-252-8966, or 1-888-206-1327 (TTY) Monday through Friday between 8:30 a.m. and 5:00 p.m.
No matter what choice you make, you will still have Medicare and Medicaid benefits, including prescription drugs.
 

Illinois Association of Area Agencies on Aging Alert for March 15, 2017

I4A Alert

Illinois Aging Network Alert

A periodic report on the impact of the state budget crisis on Illinois seniors and community programs on aging from 

I4A- Illinois Association of Area Agencies on Aging

Prepared by: Southeastern Illinois Area Agency on Aging

Week of March 13, 2017

Nuke Nightmare Continues!

 Nuke Nightmare

The devastation of budget warfare endures – “Without an appropriation or a court order, we will be unable to continue payments to nonprofits, social services and small businesses that are not covered,” then-Illinois Comptroller Leslie Munger stated when the Legislature and Governor Rauner failed to agree on a budget in May 2015.

After waiting20 months and 2 weeks for a full budget to be enacted and implemented, disaster continues. Agencies continue to close their doors, and services are being sparsely funded. Older adults and persons with disabilities are still feeling the splinters of this explosion.

Southeastern Illinois is a very impoverished region. Many constituents have to decide between basic necessities such as food and medications in their cupboards, or electricity in their homes. They need and rely on nonprofit/social service agencies to assist them with any state-funded programs that meet their basic needs so they can live with dignity in their homes.

Impacts still looming without a budget!

  •  Reduced hours for remaining SWAN (Domestic Violence) staff

  •  Reduced hours for remaining Ombudsman agency staff

  •  NO (Domestic Violence/OMB) prospective planning due to insufficient funds

  •  Reduced or unavailable funding for services by community agencies

  •  Inability to donate for services by most of the older persons who are served

Illinois Needs a Rocket Reboot!

The time is now before any further destructive decreases in services or closures occur. Please act to thrust Illinois into prosperity. We owe those who have devoted themselves to Illinois all of their lives a state made great again!

Please contact Joy Paeth, President (618-222-2561) or Jonathan Lavin, Legislative Chair (708-383-0258) with questions.

Legislative Update: n4a Releases Analysis of ACA Repeal’s Effects on Older Adults and the Aging Network

Legistlative Update

n4a Releases Analysis of ACA Repeal’s Effects on Older Adults and the Aging Network

 

Policy Brief Outlines Key Considerations and Questions for Lawmakers

January 19, 2017

 

Last week, lawmakers in Congress took the first steps toward repealing the Patient Protection and Affordable Care Act (ACA) when, four months into the current fiscal year, the House and Senate passed an FY 2017 budget resolution that included instructions to legislative committees to develop proposals to rescind key parts of the law. The resolution, which passed both chambers largely along partisan lines, makes no immediate changes to the law, but rather sets in motion the legislative process to repeal the ACA. Lawmakers have not announced details on the policies they intend to replace the ACA, but four key committees in Capitol Hill now have until January 27 to develop the legislative proposals to repeal and ultimately replace the law.

n4a has developed an issue brief that evaluates the implications that ACA repeal could have for older adults, caregivers and Aging Network entities—especially  AAAs and Title VI Native American aging programs—that serve these populations. We have also identified key issues and questions that Aging Network stakeholders and aging advocates should be asking their elected officials as ACA replacement proposals are discussed and introduced. Additionally, the issue brief highlights several comprehensive resources with more detailed information about the impacts that repealing the ACA could have on health care consumers and taxpayers.  

What Would ACA Repeal Mean for the Aging Network and Older Adults?  

Previous proposals to repeal the ACA have focused on both dismantling the federal insurance exchange Marketplace and rolling back state Medicaid expansion—particularly for low-income adults. However, ACA repeal proposals have also targeted both curbing efforts for delivery system reform promulgated through the Center for Medicare & Medicaid Innovation (CMMI) within CMS and also eliminating funding for disease prevention and health promotion activities through the Prevention and Public Health Fund (PPHF). Republicans crafting repeal proposals have also taken aim at efforts to rebalance state LTSS systems toward providing home and community-based options (HCBS). n4a details in our policy brief how each of these initiatives may affect both Aging Network agencies involved in ACA-driven driven programs and reforms and older adults.  

Additionally, while many older adults age 65 and over would not be directly affected by Marketplace or Medicaid changes in an ACA repeal and/or replacement effort, there are key coverage and financial protections that could be at risk in an ACA repeal. Specifically, n4a evaluates both what changes to Medicaid might mean for the pre-Medicare population ages 54 to 65 and how Medicare benefits and solvency might be affected by ACA repeal.  

Considerations for Policymakers in Developing ACA Replacement Proposals  

Details about both a timeline for ACA repeal/replacement, as well as specific policy proposals, are vague at this point. However, there are key considerations that stakeholders and advocates should be raising with lawmakers as they discuss both the implications for ACA repeal and the forthcoming replacement packages. n4a outlines a few key concerns and questions that we are asking lawmakers, and we encourage advocates to raise these questions as well.  

Primarily, Aging Network advocates should be asking both how ACA repeal efforts will preserve and continue to promote integration between health care and social services systems, as well as what lawmakers will do to continue to advance rebalancing efforts promoted through ACA.  

Next Steps in Health Care Reform and ACA Advocacy  

At this point there are many details still up in the air about exactly how Congress will move forward in reconsidering the ACA and any replacement provisions. National advocates, including n4a, remain focused on ensuring that Members of Congress understand the risks of repealing entrenched health care policy without sufficiently detailed replacement proposals. We encourage local agencies and advocates to echo these concerns to your Senators and Representatives, as well.  

It remains to be seen whether Congress—specifically the Senate—will have the votes necessary to pass a repeal package in the coming weeks. A legislative package to eliminate the ACA would not be subject to filibuster and would require only a simple majority vote in the Senate to move to then-President Trump’s desk for signature, although the anticipated timeline for ACA repeal and replacement remains notably ambitious. However, there are currently 10 Republican Senators who have expressed significant concerns with voting to repeal without a clear vision for replacement. More details on the Congressional budget and reconciliation processes that we expect to shepherd ACA repeal proposals are available in our recent n4a Legislative Update.  

We do know it is more critical than ever that local aging advocates weigh in with lawmakers and stress the need to protect key ACA provisions affecting older adults, caregivers and the Aging Network. We also encourage aging advocates to attend the 2017 n4a Aging Policy Briefing and Capitol Hill Day, April 3-4, to learn the latest in a rapidly changing landscape for aging and health care policy and to meet directly with your Members of Congress!  

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This Legislative Update is an n4a membership benefit. For more information about these and other federal aging policy issues, please contact n4a’s policy team: Amy Gotwals (This email address is being protected from spambots. You need JavaScript enabled to view it.) and Autumn Campbell (This email address is being protected from spambots. You need JavaScript enabled to view it.), 202.872.0888.

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