Residents of Illinois nursing homes would be protected under a nursing home residents managed care bill of rights if the Health Care Council of Illinois and its supporters are successful in Springfield.
The health care council – which represents more than 500 Illinois nursing homes – joined with residents Sunday at Jackson Square Nursing Center in Austin to call attention to the potential pitfalls for Medicaid managed care and to advocate for quality of care offered by managed care organizations.
“We have to protect the most vulnerable members of our society,” Health Care Council of Illinois Executive Director Pat Comstock said. “Someone needs to stand up for residents . . . to defend their rights.”
Comstock said without action by the Illinois General Assembly, the state is essentially essentially privatizing long term care through the Medicare-Medicaid Alignment Initiative (MMAI) and the Integrated Care Program (ICP).
The plans will auto-enroll seniors in a managed care plan if they don’t choose a plan on their own.
“We’re calling for a nursing home residents’ managed care bill of rights,” said Alan Gaffner, senior adviser for Health Care Council of Illinois.
“Just like the rights that our Founding Fathers wrote into the Constitution, we must guarantee that our seniors have rights, namely access to medically necessary care that’s in the best interest of the resident, not some state bureaucrat or managed care organization.”
The nursing home association supports Senate Bill 3450, which would provide a variety of protections and ensure basic rights for nursing home residents.
It would include the right to continuity of care and consistent delivery of services while also providing a clear and uncomplicated appeals process. The bill also provides consistent policies and procedures for all providers.
“Without these protections, the Illinois Department of Healthcare and Family Services will try to reduce costs by incentivizing the denial of nursing home care,” said Jackson Square Nursing Center Administrator Kenan Weekley.
“But many frail and elderly Illinois residents need to live in a nursing home like this because they require highly skilled round-the-clock care.”
Among other things, SB 3450 would give nursing home residents the right to receive health care services in a care setting of their choice. They would have the right to remain in their current nursing home and in their community. The bill would also extend to nursing home residents the consumer fraud protections included in the HMO Act and the HMO Reform-Patient Rights Act.
Sunday’s event in Austin was one of several stops on a statewide tour by the nursing home association, whose facilities care for more than 78,000 residents and employ about 100,000 people.
Attendees signed a banner that will be delivered to Gov. Pat Quinn. They also signed their own individual bill of rights that the nursing home association will give to legislators.