Opponents stand firm against Rauner’s ‘flexible’ options for elderly

Despite objections from senior advocates, Gov. Bruce Rauner’s administration is forging ahead with a cost-cutting plan to dramatically alter how older adults receive services intended to keep them from needing to go into nursing homes.

Rauner’s team is projecting it can save $120 million a year by reducing the number of hours state-paid home care workers are needed in the homes of elderly individuals by substituting “flexible” alternatives.

Opponents, including AARP, say the plan in reality is a reckless reduction of services that will result in higher costs to the state by forcing more Illinois residents into expensive nursing home care.

Some of those opponents testified at a public hearing in Chicago this past week where they urged Rauner’s Department on Aging to reconsider.

One “flexible” alternative suggested by state officials that came in for particular criticism is for Illinois to pay ridesharing services such as Uber to transport seniors to medical appointments instead of relying on their home care workers.

“That sounds great, but how many older people with multiple health problems are going to be dealing with Uber,” said Charles Johnson, who spent nine years as the director of the Department on Aging under two Democratic governors.

“So much of this is not based in reality,” said Johnson, who appeared in his new capacity as an AARP Illinois board member.

Defending the plan, Department on Aging Deputy Director Jennifer Reif told me the ridesharing alternative would only be used with individuals for whom it makes sense.

Driving the debate is that enrollment of seniors in the state’s Community Care Program jumped from 40,965 enrollees in 2005 to 83,787 in 2015.

When coupled with projections the population of Illinois residents age 60 or older will more than double by 2030, there’s even some agreement the cost of the current program is unsustainable.

All parties also agree that it costs the state vastly more to pay for seniors’ care in nursing homes than it does to help them stay in their own homes by assisting with meal preparation, housecleaning and personal hygiene.

The question is how to accomplish that.

If Rauner had a better track record on social service issues, instead of using the poor and sick as pawns in his political battles, it might be easier to give him some leeway to try it his way.

As it is, there’s not much reason to trust him.

Organizations that provide homemaker services are some of the same groups struggling to stay in business during the budget impasse because the state owes them millions of dollars.

And not coincidentally, most of the home care workers who would be directly affected by the cutbacks are members of SEIU Healthcare, one of the unions Rauner especially despises for its Democratic political activism.

About half the individuals in the Community Care Program are covered by Medicaid. The federal government pays 50 percent of the cost of their care, with the state paying the rest. The state pays the entire cost of those who do not qualify for Medicaid.

It’s this latter group of about 36,000 non-Medicaid enrollees who Rauner proposes to move into his new Community Reinvestment Program, a rather Orwellian name choice considering the reality.

The proposal has opened another battlefront between Rauner and the city of Chicago, which is backing state legislation to block it from taking effect.

City Aging Commissioner Joyce Gallagher questions whether the state is trying to “off load the responsibility” for caring for the elderly to the city.

Reif argues the state must make immediate changes.

“If the department does not provide a proactive solution, what is going to happen is the state is going to have to move to Medicaid only. And then those 30,000 people we’re talking about will receive no service,” she said.

If senior citizens were polled on who is more likely to have their best interest at heart, AARP or Bruce Rauner, pretty sure I could guess the result.