Presentation toThe Medicaid Leadership Group

David CarvalhoDeputy Director

Office of Policy, Planning & Statistics,Illinois Department of Public Health

November 3, 2005

• Outline The Problem The Health Care Justice Act (HCJA) The Task Force and the Health Care Access Plan The Final Report Task Force Highlights and Timeline Next Steps How to Get Involved Questions

• The Problem A person’s ability to access the health care

system influences his or her treatment, outcomes, and health status.

Access to health care is most affected by the ability of those seeking care to afford the services that they need.

• The uninsured, working poor, racial and ethnic minorities, and undocumented immigrants in the Illinois are least likely to be able to afford to pay out-of-pocket for many health care services.

• The Problem (cont.) Many Illinoisans lack access to the health care system

because they lack health insurance. • Approximately 1.8 million Illinoisans are uninsured.• A growing number are under-insured.• The consumer's share of the cost of health insurance is

growing. While Illinois has many “safety net” providers, many

uninsured Illinoisans lack access to a usual source of preventative and comprehensive care.

• Public and private clinics, public hospitals, and charity care administered by private hospitals

• The Health Care Justice Act Sponsored by Illinois Senator Barack Obama Signed into law by Governor Blagojevich in August

2004 Goal is to Ensure Access to Quality and Affordable

Health Care for All Illinoisans Created the Adequate Health Care Task Force Not funded in FY05, but $1M was appropriated in the

FY06 Budget Task Force appointed in Summer 2005

• 29-Member Task Force Governor appointed 5 President of the Senate appointed 6 Minority Leader of the Senate appointed 6 Speaker of the House appointed 6 Minority Leader of the House appointed 6

• Illinois Department of Public Health is the lead state agency, working cooperatively with representatives from: Department on Aging Department of Healthcare and Family

Services (formerly Public Aid) Department of Human Services Division of Insurance

• Charge of the Task Force – To develop a comprehensive health care access plan for Illinois Must provide for access to a full-range of

preventive, acute, and long-term health care services to all Illinois residents

• Recommendations are to be submitted to the General Assembly General Assembly is strongly encouraged to

enact the plan by December 31, 2006 The Plan is to be implemented by July 1, 2007

Criteria for Health Care Access Plan:1) provides access to a full range of preventive,

acute, and long-term health care services; 2) maintains and improves the quality of health

care services offered to Illinois residents; 3) provides portability of coverage, regardless of

employment status; 4) provides core benefits for all Illinois residents;

Criteria for Health Care Access Plan (cont.):5) encourages regional and local consumer

participation; 6) contains cost-containment measures;7) provides a mechanism for reviewing and

implementing multiple approaches to preventive medicine based on new technologies; and

8) promotes affordable coverage options for the small business market.

Other Items to Note – 19 or More Public Hearings (at least one in

each Congressional district) to Collect Public Input

Health Care Justice Act and Adequate Health Care Task Force Website –

www.idph.state.il.us/hcja/index.htm

Other Items to Note – Research Entity

• To be contracted by IDPH• At the Task Force’s disposal (given available

funds) to assess health care reforms, health care financing, and health care delivery models

• Can be called by consensus of 8 members of the Task Force

Final Report must make recommendations for a health care access plan or plans that would provide access to a full range of preventive, acute, and long-term health care services to residents of the State of Illinois by July 1, 2007

Recommended Plan(s) Must Include:1) an integrated system or systems of health care

delivery;

2) incentives to be used to contain costs;

3) core benefits that would be provided under each type of plan;

4) reimbursement mechanisms for health care providers;

Recommended Plan(s) Must Include (cont.):5) administrative efficiencies;

6) mechanisms for generating spending priorities based on multidisciplinary standards of care established by verifiable replicated research studies demonstrating quality and cost effectiveness of interventions, providers, and facilities;

7) methods for reducing the cost of prescription drugs both as part of, and as separate from, the health care access plan;

Recommended Plan(s) Must Include (cont.):8) appropriate reallocation of existing health care

resources;

9) equitable financing of each proposal; and

10) recommendations concerning the delivery of long-term care services.

Adequate Health Care Task Force Highlights Elected Chair, Vice-Chair, and Steering Committee (each from

different appointing authorities per the Task Force Bylaws)• Wayne Lerner, Chair

– Appointed by Minority Leader of the Senate

• David Koehler, Vice-Chair– Appointed by Speaker of the House

• Joe Roberts, Steering Committee Member– Appointed by Minority Leader of the House

• Ruth Rothstein, Steering Committee Member– Appointed by the Governor

• Quentin Young, Steering Committee Member– Appointed by the President of the Senate

Adequate Health Care Task Force Highlights Adopted Bylaws

• Absent Task Force members may be represented by surrogates, but these surrogates cannot vote;

• Task Force decisions will be made by majority vote; and

• Amending bylaws requires a 2/3 vote of present Task Force members.

Task Force Timeline Engage in Deliberative Process from August

2005 through September 2006 Complete 21 Public Hearings by April 2006

One in each Congressional District (19) One in Collinsville One in Springfield

Complete Final Report between July 1, 2006 and October 1, 2006

What’s Next? Substantive Presentations before Task Force

Leading Health Policy Experts from Illinois and across the United States

State Coverage Initiatives Illinois Health Forum – Wednesday, December 7th

Future Public Hearings (4 pm – 7 pm): Wednesday, November 9th in Homewood (2d District) Wednesday, November 16th in Bourbonnais (11th District) Tuesday, December 13th in Naperville (13th District) Wednesday, December 14th in Aurora (14th District)

Contracting with a Research Entity

How to Inform and Influence the Process Attend Task Force and Steering Committee

Meetings to observe Task Force Proceedings Participate in Task Force Public Hearings Contact Members of the Task Force to

express your views Watch the Website:

www.idph.state.il.us/hcja/index.htm

If you have more questions about the HCJA or the Task Force, please contact –

Ashley Walter, MBA, MPH

Policy Analyst, Division of Health Policy

Illinois Department of Public Health

100 West Randolph Street, Suite 6-600

Chicago, IL 60601

Phone: (312)814-4730

Fax: (312)814-1503

Email: awalter@idph.state.il.us

Questions?