The health and human services system in Illinois is in "crisis," according to Chicago-area residents who pressed state lawmakers at a public forum Friday night to address problems facing social safety net programs.
At the forum held at St. Ita's Church in Chicago's Edgewater neighborhood, residents provided personal testimony on a number of issues, including understaffed Illinois Department of Human Services (DHS) offices and inadequate wages paid to frontline service workers, to name a few.
A coalition of labor and community groups hosted the event, including Alliance for the Community Services, AFSCME Local 2858, IMPRUVE, Northside Action For Justice and SEIU* Local 73.
The coalition specifically wants a wage bump for direct service professionals, more assigned caseworkers in DHS offices and the restoration of Medicaid prescription drug and dental benefits.
State lawmakers in attendance, including Chicago Democrats State Sen. Heather Steans and State Reps. Kelly Cassidy and Greg Harris, all pledged to help bring change and increased funding to Illinois' health and human services system. But the first order of business, the elected officials said, is addressing the state's revenue dilemma.
"If we do not fix our revenue problem as a state, if we do not get a graduated income tax so that the wealthiest people in our state are paying their fair share, if we do not close corporate loopholes ... all we’re going to be doing amongst each other is scuffling for the crumbs," Harris said. "And that’s not where we ought to be.”
To help pull in state revenue for "chronically underfunded" public services, the coalition of organizations called for a progressive state income tax as well as a so-called Robin Hood tax, a sales tax on financial transactions made at the Chicago Mercantile Exchange and the Chicago Board Options Exchange.
While the elected officials said they support these revenue proposals, they pointed out that they are not quick fixes to the more pressing problem — the expiration of the state's temporary income tax increase.
The state is set to lose about $1.9 billion in revenue at the end of 2014 when the temporary tax hike begins to phase out, as it is scheduled to do beginning January 1.
"We need to be doing work on extending the current income tax now so that we don’t have another budget cut that we need to do right now," Steans said at the forum, attended by about 100 people. "So I think you need to be adding that to your revenue agenda, not just about a Robin Hood tax and the graduated income [tax], but doing something so that we’re not facing another cut right now, which is really upon us as we speak."
At the forum, a number of residents raised concerns about DHS offices that are becoming increasingly bureaucratic.
Specifically, Robert Kramer said the DHS office in Skokie where he works as a supervisor has about 15 staffers who serve more than 500 customers on a daily basis.
The Skokie office has been operating under a new service delivery model for the past two years to help drive efficiency. Under the model, Kramer said customers do not have assigned and individual caseworkers. Instead, different employees are in charge of reviewing cases and handling paperwork, a practice that has led to longer wait times, lost documents and other problems, he said.
"Our customers are feeling disconnected, because they don’t have a caseworker anymore," Kramer stressed. "If they have a problem, they don’t know who to call."
Medicaid recipient Anne Crowe frequents the Skokie DHS office. Not having an individual caseworker, she said, makes her feel as if nobody knows her there.
"You don’t know who you’re going to see," Crowe said. "You don’t know who has your paperwork, and you are feeling like nobody knows what you’re going through. And it’s true. There is no continuity to the services. Every time you go there, it seems like it’s a whole brand new thing."
The office also has just one switchboard operator and two call center workers. Kramer said that means a total of three employees answer phone calls for the office, which services about 100,000 total cases.
"This bad service delivery plan is their plan for the future unless somebody steps up and says no to it,” Kramer stressed.
In response, Cassidy said she will continue to talk with DHS officials about the caseworker problem, an issue she has already brought to their attention. The state rep added that she does not want to see the Skokie service model become the standard at other DHS offices.
"We're not treating folks like customers," Cassidy added. "We're not treating them like human beings, and this effort of efficiency is not only not efficient, it’s inhumane."
Additionally, those at the forum asked the elected officials to help restore dental benefits for adult Medicaid enrollees. As part of the state’s 2012 Medicaid reform legislation, called the SMART Act, non-emergency dental care was cut for adult Medicaid recipients. State legislation, HB 1516, which would reinstate the non-emergency dental benefits, passed through the Senate in November. Steans said the House does not yet have the votes needed to approve the measure.
Also under the SMART Act, the Department of Healthcare and Family Services is not allowed to provide Medicaid reimbursements for more than four adult prescription medications for an individual within a 30-day period, unless the agency has received prior approval from a doctor. Patients have experienced delays in getting their medicine, or have not been able to receive it at all, as a result of the pre-authorization requirement, those at the forum said. They want the General Assembly to pass HB 3671, a bill that would eliminate the pre-authorization requirement for prescription medications. Harris is a co-sponsor of the legislation, which was introduced by State Rep. Mary Flowers (D-Chicago) back in September.
Also, residents want Illinois lawmakers to approve SB 2604, a measure that would increase state reimbursement rates to community-based service providers that serve individuals with disabilities. As part of the proposal, the rate increase is designed to help facilities pay their direct service professionals a base wage of no less than $13 an hour by July 2016. Steans introduced the bill back in October. Cassidy and Harris both said they support the proposal.
Currently, the average wage paid to direct service professionals in Illinois is $9.35 an hour, which is 21 percent below the U.S. Department of Health and Human Services poverty threshold of $11.32 for a family of four, according to Steans' legislation.
Gail Jackson, a training counselor at Envision Unlimited, an organization that provides services to individuals in Chicago with intellectual and developmental disabilities, said she has worked at her job for 20 years, yet she earns less than $25,000 a year.
"I don’t get paid enough to provide and maintain a home nor help secure the future of my grandchildren," Jackson stressed.
Michael Watson, another Chicago caregiver for individuals with disabilities, has worked at Anixter Center since July of 2009. He currently earns just $21,000 a year, he said.
"This bill is important for our survival and sustainability," Watson added. "With the high costs of living that I have to endure and the college loans, which I can't even begin to pay back, I live from paycheck to paycheck. I have to decide whether I have to pay bills or eat on a day-to-day basis."
Facilities in Illinois that take care of people with developmental disabilities have not seen a rate increase in seven years, Steans said.
"It’s just plain wrong,” the state senator stressed.
Steans noted that she has talked directly with Gov. Pat Quinn and his budget director Jerry Stermer about the measure. It is her hope that the wage increase will be built into the governor's budget proposal, which will be unveiled in March.
But she quickly circled back to the temporary income tax issue.
"If we do not do something about the (income tax), we are going to be going in the wrong direction," Steans stressed. “Not only will we not be able to pay the increase in wages, not only will we not be able to restore dental benefits, we're going to be having to make more cuts."
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