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Brown: Disabled kids get funds, hospitals left waiting

Illinois Comptroller Leslie Munger’s office called Wednesday with a piece of good news: the state will resume payments to providers of Early Intervention services to developmentally disabled infants and toddlers.

That’s one of the programs I’ve been telling you fell through the cracks after the state started operating without a budget on July 1.

Gov. Bruce Rauner’s administration determined the program, which it was already targeting for major cuts, wasn’t covered by any of the existing court orders and consent decrees that are keeping most of the rest of state government functioning.

So they stopped paying the people who work with disabled kids, putting the whole program in danger of collapse. Parents were up in arms.

After further consideration, however, Munger said her office and Rauner’s Department of Human Services decided Early Intervention is covered by existing consent decrees after all.

Millions of dollars in payments owed to therapists and to agencies that coordinate the program will begin flowing again “ASAP,” a comptroller’s spokesman said, just as soon as DHS submits the proper paperwork.

So much for the good news.

OPINION


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The comptroller called with that piece of information just after I’d returned from the Dirksen Federal Building, where yet another federal judge had taken the comptroller to the woodshed, albeit gently.

Saying “the whole situation is outrageous,” U.S. District Judge Joan Lefkow instructed Munger and other state officials Wednesday to find a way to make Medicaid payments owed to hospitals serving the poor that have been put in financial crisis by the state’s budget woes.

Lawyers representing state Medicaid recipients had informed Lefkow the state isn’t paying designated “safety net” hospitals on an expedited basis as is its normal practice.

Instead of the long payment delays that have become the norm for state government, these hospitals, which receive the bulk of their income from the state Medicaid program, are usually paid relatively quickly.

But Charles Weis, chief financial officer of Sinai Health System, told the court in an affidavit that his hospital group has received only $16.5 million of the $34.5 million owed by the state for this fiscal year.

Most worrisome to Lefkow, Weis reported that “Sinai anticipates exhausting its lines of credit this week” and is facing “an increasingly urgent cash flow situation.”

Munger’s spokesman said the comptroller has paid all vouchers the Department of Human Services has submitted for the hospitals, suggesting any payment delay is not her fault.

Tom Yates, executive director of Legal Council for Health Justice, told Lefkow other hospitals serving the poor are in similar difficulty.

“They’re at great risk of going out of business,” Yates said.

Later Wednesday, Mount Sinai tried to downplay the idea it is in danger of closing.

Chief Deputy Attorney General Brent Stratton, representing the administration, argued the payment situation was caused by a cyclical cash flow crunch that hits state government every year at this time and is “not related to the budget impasse.”

Plaintiff’s lawyers scoffed at the explanation, and said that whatever the cause of the cash crunch, that Medicaid payments must be a priority when the state pays its bills.

Lefkow agreed.

“You’re under an order to pay,” she reminded the state’s lawyers.

She said she would “hate to get into the business of saying this is more important than that.”

But that’s where we will find ourselves next.

Faced with more court-ordered demands on state funds than there is money available to pay them, Munger and Rauner are already prioritizing who gets paid first and who waits. The next step will be for a court to start setting the priorities.

Lefkow made clear she doesn’t want to be the one to do that.

closing is a real possibility.

During the same hearing, Lefkow ordered the state to resume making payments to agencies providing services to the elderly in their homes under its Community Care program, another program the governor’s office had pretended it didn’t have to pay.

Follow Mark Brown on Twitter: @MarkBrownCST


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