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April 2015

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Been there DONe that: trying to change HCBS eligibility
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Gov. Bruce Raune would like to reduce Illinois spending by limiting the number of people receiving state services. His budget proposal ups the qualifying score for the assessment, called the Determination of Need, or DON for short, that decides eligibility for seniors and people with disabilitiesfor home and community-based services. The cut-off score would increase from 29 to 37.

Elevating the eligibility threshold for the DON would help the Governor enact a $110 million cutto the Home Services Program and a $126 million cut for the Community Care Program. 10,000 people with disabilitiesand 36,000 seniors would be dropped.

Because so many people would be cut off from services, advocates for the disability community believe the cuts are misguided. At a Senate Appropriations Committee hearing, the President and CEO of Access Living, a disability advocacy group based in Chicago said "these people are the least likely to ask for help and the most likely to die should their services end; not to mention being forced into nursing home or going to jail or becoming homeless."

While advocacy groups are comforted by the fact thatpast attempts to raise the DON score in Illinois and Kentucky were rejected by the Centers for Medicare & Medicaid Services, they are not leaving anything to chance. They are organizing advocacy with lawmakersand conducting outreach with the disability and aging community. Illinois Health Matters is following the fight against raising the DON score and other cuts to health services. Stayed tuned for updates.

Navigators: meet brokers

The Small Business Healthcare Collaborative is bridging the gap between navigators and brokers. Navigators: learn about becoming a broker or how to work collaboratively with brokers. Contact Bryce Marable at if you would like to receive e-mail updates about upcoming networking and professional development opportunities. Read more...

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Rauner's Budget is Bad Medicine for State's Health Services

The much-anticipated “turnaround budget” from Illinois Gov. Bruce Rauner feels more like a “look back." Rauner says this budget "preserves services to the state's most vulnerable residents”óbut a quick review suggests this is far from true. Instead, we see a budget that, among other cuts, further decimates a fragile community mental health system; reduces access to lifesaving drugs for people living with HIV and prevention services for those at risk of HIV; and makes it harder, and in some cases impossible, for people with disabilities and seniors to get support to live at home. Read more...

In case you missed it

Gov. Rauner makes moves to close the budget deficit by negotiating a short-term deal with state lawmakers that enacted a 2.25% spending cutto most state programs for the next three months. The governor also halted funding for public health and social service grants for savings of $26 million.

Doc-Fix passes US House with bi-partisan support and will be voted on by Senate after lawmakers return from spring recess. The bill also would extend the Children's Health Insurance Program, or CHIP, for 2 years.

Half of adults with incomes below $23,540 will move between marketplace plans and Medicaid each year. Health insurance plans and policy analysts are crafting solutions, like offering complementary Medicaid and marketplace plans that minimize the impact of churn.

Recent resources

A guide from the National Health Law Program identifyinghow advocates and policymakers can locate data to promote accountability and quality care with managed care organizations.
Advocacy with Medicaid Managed Care

This issue brief from Kaiser Family Foundation outlinesthe consumer, regulatory and systems issues that could be addressed in new CMS rules for managed care organizations.
Predicting MCO Regs has been making incorrect eligibility determinations for Medicaid and CHIP bycounting Social Security income received by children and other tax dependents when calculating household income.
Eligibility Mistakes for Tax Dependents

This issue brief from the Department of Health & Human Services details the 16.4 million people who gained health insurance coverage by race and ethnicity, household income and age.
The Face of the Newly Insured


Find enrollment events in your area at the Get Covered Illinois Events page.

Find volunteer and community engagement opportunities at Get Covered America Events page.

Download a presentation and/or watch a recording from the EverThrive Illinois Webinar series.

Learn what the ACA means for a small business owner from the Small Business Majority's Thursday talks.

From our social media

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@ILHealthMatters: 50% of Medicaid recipients required by law to enter into coordinated care by 2015. Providers play key role

On Facebook
CDPH, together with the Partnership for Healthy Chicago, is hosting a series of community conversations to inform the development of our community health improvement plan, Healthy Chicago 2.0

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