By Steve Rhodes
“The Illinois Department of Public Health owes the federal government an estimated $24 million for debt that piled up from a complicated state program to vaccinate low-income kids, WBEZ has learned.
“The revelation adds another layer to Illinois’ byzantine effort to get vaccines for roughly 130,000 low-income children. The state had been using free vaccines from the federal government for kids in the Children’s Health Insurance Program, known as CHIP.
“But then the feds called for states including Illinois to pay for those doses. So former Republican Gov. Bruce Rauner stopped the financial bleeding with a major policy shift that led some doctors to stop vaccinating low-income children.”
Wait, what?
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“Dozens of physicians have told Illinois public health officials [that Rauner’s policy shift] ‘could lead to a public health crisis with disastrous consequences’ in light of the nationwide measles outbreak.
“Now, the new administration under Democratic Gov. JB Pritzker is hustling to potentially unwind his predecessor’s efforts while negotiating with the feds on how to pay down the state’s big debt.”
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So what was the Rauner policy shift that mucked this up?
“Illinois doctors say they thought they were allowed to use the free vaccine for patients on CHIP. In fact, Illinois was supposed to reimburse the CDC for those shots.”
I wonder why Illinois doctors thought that.
“To complicate matters, the state didn’t have a good system to track when doctors used the free vaccine for kids on CHIP.”
Of course it didn’t.
“So the debt swelled, reaching an estimated $24 million. Concerned about this climbing IOU, Rauner’s administration hit the brakes in 2016. The state public health department stopped providing free vaccines to doctors for CHIP patients. The providers would have to pay out of their own pockets to buy vaccines instead from manufacturers, then wait for private insurers that contract with the Illinois Medicaid program to reimburse them.”
Oy.
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“Doctors say that [Medicaid reimbursements] take months, if they get paid back at all. So they started turning away kids on CHIP, even as the program’s enrollment climbed, state records show.”
They just started turning kids away. For want of $24 million, which frankly isn’t a lot in context of a state budget – or Rauner’s net worth, annual income or a campaign contribution. It seems like the problem was eminently solvable. But no.
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“Nirav Shah, who led the Illinois Department of Public Health in 2016, defended the state’s policy change because he said stopping the rising debt was critical.”
Wrong answer.
But then, Shah doesn’t have the greatest track record.
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“The Illinois public health department is in the final stages of negotiations with the CDC that started more than a year ago. A spokeswoman for the CDC declined to comment.”
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“Tom Hughes is executive director of the Illinois Public Health Association, which represents most of the state’s local health departments and many public health employees,” the Capitol News Illinois reported last month.
Hughes is in talks with health care providers, insurers and vaccine distributors to combat the outbreak by restarting a part of the state’s Vaccines for Children (VFC) program, which in 2016 was discontinued for children enrolled in the state-funded Children’s Health Insurance Plan.”
“At the time, health care providers should have been using VFC vaccines only for VFC children,” Hughes said. “If a child was covered by private insurance, you wouldn’t be using VFC.”
But, he added, there was “no good accounting of what vaccine was being used for what child,” so the state pulled the program and stopped providing the vaccines.
Read that again: Instead of fixing the problem, the state just ended the program.
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Meanwhile . . .
“A team of researchers who in 2015 correctly predicted where the Zika outbreak would strike in the U.S. say they think the country’s next big measles outbreak is most likely to happen in Cook County,” the Tribune reports.
The researchers aren’t blaming Rauner, though.
“That’s based largely on the number of airplane flights to Chicago from global destinations where parents increasingly don’t have their children vaccinated.”
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“Rachel Rubin, a senior medical officer with the Cook County Health Department, wasn’t surprised by the study’s findings. The seven measles cases reported in Illinois this year likely stemmed from one person who was infected overseas and traveled back to Illinois, she said.”
But Illinois’ low-income kids are more vulnerable now than they would have been if not for Rauner. Callback:
“Dozens of physicians have told Illinois public health officials [that Rauner’s policy shift] ‘could lead to a public health crisis with disastrous consequences’ in light of the nationwide measles outbreak.
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Closing Clinics
“The biggest controversy of Rahm Emanuel’s first year as mayor was caused by his decision to close six of the city’s twelve mental health clinics. For months, protestors from the Mental Health Movement disrupted Emanuel’s events. In another dramatic action, 23 were arrested when they barricaded themselves inside the Woodlawn clinic,” Curtis Black writes for the Chicago Reporter.
“In January, the City Council passed a resolution by a margin of 48 to 0, noting that the clinic closings resulted in ‘leaving large areas of the city without adequate access to affordable safety-net mental health service,’ and establishing a task force to conduct a ‘comprehensive study to determine which community areas shall be prioritized for re-opening mental health clinics.'”
Let’s just take that in: The council passed a unanimous resolution essentially codifying that Rahm’s clinic closures were bad policy. Add it to the list, media-friendly legacy tour notwithstanding.
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“[Re-opening clinics is] getting some pushback from leaders representing private, nonprofit behavioral health providers, who have argued that ‘reopening the six public mental health clinics would be a step backward.’
Longtime MHM organizer Matt Ginsberg-Jaeckle recalls that leaders of nonprofit providers also backed the clinic closings seven years ago, promising that they stood ready to serve displaced clients.
It didn’t exactly work out that way. Hundreds of city patients fell through the cracks. City clients who were transferred to private providers often faced long wait times for appointments and long travel times and unaffordable co-pays when they got in. Psychiatric hospitalizations spiked after the clinic closings. Then, within a few months, two of the private agencies handling former city clients went out of business.
Since then, the subsidized private insurance provided to thousands of moderate-income Chicagoans by the Affordable Care Act – one of the rationales behind the clinic closings – has offered only spotty mental health coverage, often with deductibles that are cost-prohibitive.
Last year, the Collaborative for Community Wellness reported on what it called a “mental health crisis” on the Southwest Side.
There’s a lot more; go read the rest.
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— Beachwood Reporter (@BeachwoodReport) May 9, 2019
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The Beachwood McRibTipLine: Black coat, white shoes, black hat.
Posted on May 10, 2019