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1
HOUSE RESOLUTION

 
2    WHEREAS, Due to federal health care reform, an integrated
3care pilot program in Northern Illinois, and statewide Medicaid
4reform, a managed care approach to providing Medicaid coverage
5is no longer up for debate making Medicaid managed care a
6reality in Illinois; and
 
7    WHEREAS, Managed care has proven a sometimes inefficient
8provider of health care coverage especially for long-term care
9and those individuals - typically the elderly or people with
10disabilities - receiving it; and
 
11    WHEREAS, Illinois' pilot program and the recent Medicaid
12reform law make it mandatory for managed care to provide the
13services expected in a long-term care setting, which is a
14potentially risky scenario for those receiving these kinds of
15services; and
 
16    WHEREAS, A number of other states have discontinued managed
17care for people with disabilities and the elderly, including
18California which found it more cost-effective not to utilize
19managed care after an extensive overhaul of the state's health
20care program; and
 
21    WHEREAS, Illinois is setting forth on this venture with two

 

 

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1for-profit managed care organizations under contract, while
2not exploring other entities to provide quality care, such as
3not-for-profit organizations; and
 
4    WHEREAS, The Institute on Disability and Human Development
5at the University of Illinois at Chicago (UIC) is overseeing
6the consumer satisfaction levels and the managed care
7organizations' competency for the test population in the pilot
8program; nonetheless, only an estimated 40,000 individuals
9with disabilities are in the pilot program area and targeted to
10receive services; as Illinois Medicaid reform and federal
11health care reform become the norm for Medicaid recipients in
12this State, a conservative estimate is that 2.4 million people
13currently receive Medicaid, and approximately 1.2 million
14people - or 50% of the Medicaid population - under that program
15will move into a managed care system, as mandated by the
16Illinois Medicaid reform law; this increased number will not
17receive monitoring from UIC and, possibly, will not receive the
18adequate follow-up, thereby, leaving them more susceptible to
19fraudulent practices, abuse, neglect, and insufficient care
20through providers and the managed care organizations; as
21Illinois moves toward transitioning 50% of the Medicaid
22population to a managed care system, as with the pilot program,
23no other plans except those involving for-profit managed care
24organizations are presently receiving serious discussion;
25therefore, be it
 

 

 

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1    RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE
2NINETY-SEVENTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that
3there is created in the Department of Healthcare and Family
4Services the Medicaid Managed Care Oversight Task Force to
5monitor how Illinois approaches and manages a new form of
6health care delivery system based on a managed care model,
7particularly for people with disabilities and the elderly; and
8be it further
 
9    RESOLVED, That all members of the Task Force shall be
10appointed by the Governor and shall serve without compensation;
11the Department of Healthcare and Family Services shall
12facilitate the Task Force and provide the Task Force with
13administrative support, but shall have no hand in guiding its
14direction or ascertaining its results; the Task Force shall
15meet quarterly and report on its findings to the General
16Assembly and its appropriate committees; reports from the Task
17Force shall indicate (i) whether individuals within the pilot
18program and the intended 50% of Medicaid recipients
19transitioned into managed care are satisfied with their health
20outcomes, can access all necessary forms of medical care, and
21received all necessary information from the State and the
22Department regarding the changes to their health care delivery
23system; and (ii) any other satisfaction indicators deemed
24applicable by the Task Force, especially with the knowledge of

 

 

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1how UIC conducted satisfaction surveys; the Task Force's life
2span shall continue until January 1, 2017, unless the General
3Assembly deems a longer tenure necessary, as that date would
4mark the two-year anniversary of the transition of Medicaid
5enrollees into managed care programs, as mandated by the newly
6enacted Medicaid reform law in Illinois; and be it further
 
7    RESOLVED, That upon receiving reports from the Task Force,
8the General Assembly and all appropriate committees therein
9must take the necessary steps to ensure all individuals
10receiving health care through a managed care delivery system
11are satisfied with that care and are not receiving worse care
12as a result; if the General Assembly finds negative outcomes
13per reports from the Task Force, it should amend the process by
14which managed care is put to use for Medicaid recipients,
15especially for people with disabilities and the elderly, and
16further, if the reports are positive or neutral, the General
17Assembly should decide whether to continue monitoring the
18program for a set period to ensure that all recipients receive
19the best quality health care available to them under a managed
20care process; and be it further
 
21    RESOLVED, That as changes to health care delivery improve
22or changes come to pass based on new laws passed by the State
23or federal government, the General Assembly must decide if
24continuing the use of the managed care approach is the most

 

 

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1appropriate, cost-effective, and beneficial means in providing
2health care to Medicaid recipients in Illinois; and be it
3further
 
4    RESOLVED, That suitable copies of this resolution be
5delivered to the Governor and to the Director of the Department
6of Healthcare and Family Services.