As Illinois political leaders maneuvered for advantage with a government shutdown looming today, the Southland social service agencies were trying to figure out if they were going to be able to pay their employees and how long they would be able to keep their doors open and telephone hotlines operating.
Edward Vega Sr., executive director for the Crisis Center for South Suburbia in Tinley Park, had a one-word answer when I asked him if his organization is having any difficulties as a result of the state’s budget crisis — “Confusion.”
“There’s basically a lot of confusion as to how the state departments, state legislators and the governor are going to deal with the budget crisis,” Vega said. “The Illinois Department of Human Services, the primary agency we deal with, has basically been scrambling to get as much information as they can from elected officials and pass the word on to us.
“But here’s an example of the confusion I am talking about. Last week, we were told by Human Services that after July 1 we shouldn’t expect to get reimbursed for any expenditures we have until a budget is passed. We were told, ‘you will not be paid for any services provided after July 1.’
“On Friday, we got a message from DHS that there was good news. We had been given a waiver from the services directive we previously received, and they would pay us provided I, as head of the agency, signed a document and returned it to them attesting to the need for the waiver and the services provided. I was told we would receive the document in the mail (Tuesday).
“The waiver notification did not arrive in the mail, and I have now been told that we may get it (Wednesday) or next week some time. And that’s just the way it has been going for some time now. It’s total confusion. It’s good news one day and bad news the next. Uncertainty is what we are all dealing with, and right now I don’t know if I will be paid for services we provide tomorrow or not.”
The Crisis Center provides housing and counseling to abused spouses and their children. And like most social service agencies in Illinois, its problems with the state started long before the most recent budget crisis. For years, the state’s payments for services rendered have been delayed, funding to many social services programs has been cut and there has been no increase in reimbursement rates.
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Vega acknowledged that his organization is in better shape than many others throughout Illinois. The South Suburban Council on Alcoholism and Substance Abuse in Hazel Crest, for example, has been operating in the red for two years now.
“We’ve cut our staff from 155 to 105 in recent years because the state has cut our funding by $1 million over the last five years,” said Allen Sandusky, president and chief executive of the South Suburban Council. “But our patient count has not decreased. In fact, we have a 60 residential-bed facility, and the people we’re seeing now are suffering from much more severe problems than those we dealt with 25 years ago. Yet the state has not only cut our funding but also cut our Medicaid reimbursement rate.”
Sandusky said his organization, which treated a predominantly south suburban client base, now receives referrals from “about 27 jails and county courts” in the Chicago metropolitan area, as well as hospitals and medical clinics.
“As you are well aware, when the Tinley Park Mental Hospital (a state center) was shut down a few years ago, the state provided some money for community programs, but the lack of facilities to treat the mentally ill who needed inpatient care created a problem,” Sandusky said. “So the state expanded our ability to treat patients who were abusing alcohol and drugs but were also suffering from some type of mental illness.
“We’ve been getting referrals from as far away as Rush (Medical Center) in Chicago and the state’s Madden Mental Health Center (near Maywood). When a police officer takes someone to an emergency room because of a mental health problem and they are also abusing drugs or alcohol, the hospital calls us for placement.
“What people don’t understand is that a medical placement for a person like that in a hospital bed can cost $2,000 a day,” Sandusky said. “Our cost is $140 a day. That’s because in a hospital you’re getting a lot more than a room and a bed, you’re getting lab tests, CT scans and other diagnostic work and the costs increase. The state ends up paying for those costs. So we are actually saving the state money, but people never seem to understand that.”
Since Illinois expanded its Medicaid program under the Affordable Care Act, he said, there are even more people seeking treatment.
“But the thing is that the Medicaid providers in Illinois are basing their reimbursement rates on the state’s rates, which have not been increased in years. Of course, our costs for electricity, water and health insurance have all gone up. But our people haven’t had a pay raise in three years. So our old employees are leaving, and we have to train new people and they leave in a year or so because they want more money and a better job.”
Sandusky said he has explored the idea of selling the South Suburban Council to another organization, “but I worry that they would not provide the same level of treatment, have the same commitment to the community that we do.
“I believe many of the organizations interested in buying us just want to take the programs where they think they can make a profit and eliminate those areas that are losing money,” he explained. “Where would people go for help? There are already too few facilities in the Chicago area. We’re now the largest substance-abuse treatment facility in the South Cook County region.”
Sandusky emphasized that the state government shutdown might cause his program more problems, but that the state’s cuts and refusal to address increases in costs have created more woes than any short-term shutdown likely would.
I understand that the Republican governor, Bruce Rauner, and the Democrats in the legislature, led by House Speaker Michael Madigan, D-Chicago, have fundamental differences over government spending and taxation. And the problems mentioned by Sandusky occurred under the unified watch of a Democratic governor and legislature.
But I would like to emphasize that the outsourcing of government programs to social service agencies was originally a Republican concept to reduce government spending and increase efficiencies. What has happened is that the government has cut spending and created a system that’s less efficient at providing services than it used to be.
These are programs that the vast majority of taxpayers support and understand. I am talking not only about treating the mentally ill and substance abusers (who would cost a lot more to warehouse in jails or treat in hospitals), but programs that provide home care services to the developmentally disabled and elderly. And day care services for single parents willing to work for a living, provided they have some help taking care of their children. I’m talking about paying the caregivers who wash and dress people who need such help more than $11 or $12 an hour.
It’s easy to blame the corrupt, incompetent political leadership in this state for all of its problems, but we are the stewards of the government. We all are responsible for making sure the programs that we pay for work as intended, in a way that actually help the people in need.
There is almost no discussion about any of that. Those who are willfully ignorant or choose tactical stupidity to deal with the consequences of such social injustice are as guilty as the political leaders who have created this financial mess by mismanaging state pension funds while filling the pockets of the well-connected.
I don’t believe the people running this state really care about these problems. But the rest of us should.