Health care, human services providers cope as state’s unpaid bills pile up

By Dean Olson, The State-Journal Register

Local providers of human services and health care were hit by a wave of disappointment and anxiety last week when the governor and General Assembly failed to reach a compromise on a state budget for the current or coming fiscal year.

Providers and advocates for their clients now have both short-term and long-term worries.

“We’re taking it month by month,” said Amy Voils, executive director of Helping Hands of Springfield, a homeless shelter for adults that has been operating at capacity and gone almost a full year without the $126,000 state grant that is key to its survival.

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And the state’s debts to Springfield hospitals and medical clinics top a record $144 million for the care of state workers, retirees and their dependents — an increase of almost one-third since Jan. 1 — one hospital executive said the state budget situation is “casting a shadow over the economy of the region.”

When there’s so much instability in the public sector, and even continued state funding for public schools is in doubt, it’s more difficult to recruit new doctors and other highly skilled professionals with families to Springfield, said Dr. Charles Lucore, chief executive officer of HSHS St. John’s Hospital.

“This needs to be settled sooner rather than later,” he said.

St. John’s is owed $36 million for the care of state workers, retirees and dependents, compared with about $30 million as of early February and $24 million as of June 30, 2015.

The amount owed has increased by one-half from a year ago, and the average bill is more than a year old, Lucore said.

St. John’s has financial reserves that protect the 439-bed hospital from making severe cuts or having to lay off workers when the lack of a state budget prevents the state’s self-funded insurance plans from paying health-care providers.

But Lucore said his concerns deal more with the future.

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“You need the government to do its part to have a healthy community,” he said.

Memorial Medical Center, as of April 30, was owed $57.8 million by the State Employees’ Group Health Insurance Program, compared with $46.3 million owed to the 500-bed hospital as of Dec. 31, according to Edgar Curtis, chief executive officer of Memorial Health System.

The not-for-profit system as a whole, which includes a physician group and hospitals in Springfield, Jacksonville, Lincoln and Taylorville, was owed $73.8 million for the care of state workers as April 30, compared with $58.3 million as of Dec. 31, Curtis said.

Springfield Clinic is owed $50 million for state workers’ medical bills, according to Mark Kuhn, the clinic’s chief administrative officer. That amount has increased by more than 50 percent since February, when the clinic was owed $33 million.

State workers, retirees and dependents, when combined with Medicaid patients, represent about one-third of the clinic’s business.

“We continue to use internal reserves for payroll and to pay our vendors on a timely basis,” Kuhn said.

SIU HealthCare, the physician group at Springfield’s Southern Illinois University School of Medicine, didn’t disclose how much it is owed in total for patients in the state employee plan. But SIU spokeswoman Karen Carlson said state employees account for 7 percent of SIU HealthCare’s business and 33 percent of all money owed to the group practice.

“Twelve months ago, receipt of payments on state employees took about six months; that average is now 10 months,” she said.

The payment delay, she said, is equivalent to a $4 million drop in payments for the fiscal 2016 period ending in May, she said.

Voils’ not-for-profit agency at 1023 E. Washington St. can serve as many as 46 people, mostly men, each day and night. Helping Hands shut down weekend daytime services for homeless clients April 1 as a cost-cutting move amid the budget impasse.

She didn’t have high hopes that Republican Gov. Bruce Rauner and the Democratic-controlled House and Senate would resolve the impasse by the end of May for the current fiscal year or fiscal 2017, which begins July 1.

But the passing of that Tuesday deadline, after which supermajority votes will be required in each chamber to pass legislation, did bring more disappointment, Voils said.

“I’m angry, I’m frustrated, I’m scared,” she said Friday from her office about one mile northeast of the Capitol building. “It really has been a week full of emotion for me.

“Where do we go from here? If the Legislature and governor can’t come together to solve this crisis, they’re literally going to see people on the street.”

With the budget crisis in its 12th month, Voils said the shelter has been able to remain open and continue serving up to 46 people each night mainly because of increased donations from the public.

There was a surge in donations and unexpected funding from Capital Township and city government in late January and early February after a story was published in The State Journal-Register describing a partial shutdown being considered by Helping Hands, one of Springfield’s largest homeless shelters.

That partial shutdown was averted, though the extra money didn’t stop the April 1 reduction in hours.

A fundraising dinner and auction benefiting Helping Hands in late April raised $40,000 — twice the amount the annual event normally generates, Voils said. She believes the agency’s donors are responding to the urgency of the situation.

She doesn’t know how long the generosity can continue, however. She said additional fundraisers are being planned, and people can donate anytime through the agency’s website, helpinghandsofspringfield.org.

Helping Hands has put off replacing a full-time caseworker who resigned two weeks ago, instead using another employee and a volunteer to shoulder the former worker’s tasks.

But if the agency continues to reduce services, or if it has to close completely, Voils said more of Helping Hands’ clients will end up in local hospital emergency rooms as the additional stress exacerbates clients’ chronic health conditions and mental illnesses.

Voils and many other human-service providers are calling on Rauner to sign into law Senate Bill 2038, a stopgap funding bill for human services that was passed unanimously by the House and Senate and would provide about 46 percent of annual funding.

Also sitting on Rauner’s desk is Senate Bill 2046, which would provide full-year funding for human services.

Rauner spokeswoman Catherine Kelly didn’t respond to questions about the stopgap human services funding bill. The governor appears to be focused on the stopgap funding proposal for all of state government that has been proposed by Republican legislative leaders.

Providers of substance abuse treatment throughout the state, including Gateway Foundation’s Springfield treatment center, have cut back on services during the impasse. The lack of a short-term or long-term budget solution last week “perpetuates the uncertainty,” said Eric Foster, chief operating officer of the Springfield-based Illinois Alcoholism and Drug Dependence Association.

After last week’s failure to reach a compromise, Foster said it’s upsetting that the governor and lawmakers now seem to be focused solely on coming up with money to help Illinois public schools open on time this fall.

A fully funded network of human services is just as important in promoting healthy children and families, he said.

Many human-service providers in the Springfield area have “very little optimism” that the budget crisis will be resolved anytime during the next fiscal year, said John Kelker, president of the Springfield-based United Way of Central Illinois.

“There’s a lot of frustration,” he said.

©2016 The State Journal-Register, Springfield, Ill.

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