Long-Term Care - Illinois General Assembly

• The most effective way of raising needed funds is through a provider tax, which brings in
increased federal matching funds without any cost to the state general revenue funds.
This would prevent a severe disruption to the continuum of the healthcare delivery
system, help address some of the geographic discrepancies in nursing home rates
around the state, and lay a foundation in long-term changes for the future.
• To stabilize payments for providers, at no cost to the state, a Medicaid receivable bond
program should be authorized through the Illinois Development Finance Authority. This
would give providers a regular payment cycle, and provide some up-front cash so
providers can pay the provider tax. The cost of the bond financing program is borne by
the providers, although at an interest rate below commercial markets.
• To improve nursing home care in the future, state government must be partners with the
nursing home profession to encourage more and better paid and better trained staff.
Specific recommendations include:
Career Ladder Programs — Implement the law passed 2 years ago that required the Illinois
Department of Public Health to develop a nurse assistant career ladder program. This program
would provide opportunities for nurse aides to receive advanced training, provide better resident
care, and enable them to reach higher levels in their professions with increased pay and status.
In addition, their training can be used as a bridge towards helping them become nurses.
Working with the universities, unions and providers, the state can establish the standards for
advanced training. Once standards are agreed upon, the schools, unions and providers can
work together to implement the career training that will open up doors of opportunity. Some of
the provider tax money can be used to establish the training programs in pilot sites around the
state.
Medication Technicians — Develop a state medication technician program. Through this
program, nurse aides receive up to 100 hours of both classroom and clinical training on
administering medications. Working under the direct supervision of a licensed nurse, the
medication aides would be able to pass out routine medications to residents. This program
would not reduce the number of nurses in nursing homes, but free up nurses for more direct
bedside treatment. Currently, at least 13 states successfully use medication technicians in
nursing homes, including Indiana, Iowa and Wisconsin.
Nursing Scholarships — The state should dedicate 20% of its existing nursing scholarship
programs for nurses who are willing to work in long-term care. The state pays for these
scholarships out of existing license fees and fines.
Single source case management referral system — There should be a consistent, impartial
area case management referral agency – without any ties to a particular provider agency – to
assess an individual’s needs and serve as a resource to clients and families to assemble the
best array of services in the community to meet a client’s needs.
A Moratorium on the Number of Nursing Home Beds — With the appropriate increase in home
and community alternatives to nursing homes, there are nearly 15,000 unused nursing home
beds in Illinois. Excess beds equal inefficiency; more beds than people drive up costs, and
creates insecurity in the healthcare delivery system. Too many nursing home beds in the
system cause unnecessary competition for clients with home and community-based services.
Those empty bedrooms are a waste of health care resources and could be converted to
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