An Indiana House committee is taking up a bill that would require nurses, doctors, dentists and other medical workers to pay for a national criminal background check when applying for a state license.
Bill sponsor Republican Sen. Patricia Miller of Indianapolis says current policy relies on the honesty of health workers to accurately report convictions when applying for licenses. About 198,000 people are currently licensed or certified in one of the 20 professions specified in the bill.
An Indianapolis Star investigation last year found several instances in which nurses failed to report arrests or convictions on their license renewal applications without the nursing board knowing about the incidents. The bill allows boards to require people seeking license renewals to submit to a national background check.
The bench trial of two Champaign County landlords continued Monday morning.
Bernard and Eduardo Ramos run the Cherry Orchard Village apartments, located outside of Rantoul in an unincorporated part of Champaign County. Cherry Orchard has been under scrutiny for the last three and a half years ever since state health inspectors discovered raw sewage seeping into nearby farmland. Champaign County officials say six out of eight apartment buildings on the property are in violation of the local health ordinance.
Acting as his own attorney and speaking through a translator, Eduardo Ramos called one witness during Monday's hearing - his son, Bernard.
Eduardo asked Bernard if it is possible to re-open the affected apartment buildings without clearance from a government agency.
"We have to fix them first before we open them," Bernard replied.
Bernard said he will take responsibility for the property, promising to have the six apartment buildings that are in violation of the county's health ordinance re-opened by this summer. There is typically an uptick in occupancy at the apartment complex during the warmer months due to an influx of migrant workers to the area. A 2007 migrant camp license application for the property reports there are at least 48 family rental units at Cherry Orchard.
Bernard said he and his father shouldn't get blamed for the sewage and septic issue since the Bank of Rantoul owned the property when health inspectors first noticed a problem in 2007.
"We got blamed for things other people did," Ramos said. "If anything was done to the property, we have nothing to do with it."
The property is currently owned by Bernard's sister, Evelyn.
Assistant State's Attorney Christina Papavasiliou says under the law, the Ramoses have a duty to maintain the property, which she says they have neglected to do.
"If you exercise possession or control," Papavasiliou explained. "Even as a landlord or in any capacity, you can be accountable under the ordinance."
Papavasiliou is pushing for an injunction that would prevent people from living in the apartment complex until the sewage problems are fixed. She is asking presiding Judge John Kennedy to fine the Ramoses $500 a day until the sewage and septic systems are fixed, and another $500 for everyday it takes them to vacate remaining tenants.
She says tenants are still living in buildings that are not up to code. Though occupancy at the property is unknown, public health officials estimate at least eight single men continue to live there and have noted several cars parked outside apartment buildings.
During Monday's trial, the Ramoses requested a motion of continuance, saying they needed 14 days to subpoena an official with the Illinois Department of Public Health who works on issuing licenses to house migrant workers. Judge Kennedy rejected the motion, calling the testimony of the official "marginal at best."
Once the request was denied, Eduardo Ramos filed a motion of prejudice against Kennedy.
"I have been a lawyer for many, many years and have not seen this type of verbal violence before," Eduardo said.
Eduardo explained he had studied law in his native Bolivia, but not in the United States.
Another judge, Jeff Ford, was brought in to take up the prejudice claim, and that motion was also denied.
The Ramoses have owned more than 30 properties in Champaign County, and have faced hundreds of code violations. Several of these properties, including Cherry Orchard, have been under foreclosure, according to the Champaign County Recorder's Office.
The Ramoses ignored a request for comment after the trial. In a 2009 interview with CU-CitizenAccess.org, Bernard Ramos said city housing inspectors have targeted him because he is Hispanic and rents to illegal immigrants. He said his financial problems were due to the decline in the economy and unemployment, which affected his tenants' ability to pay rent.
The prosecution rested its case last Wednesday. The trial will resume Friday, April 15 at 2:30 PM.
(Photo courtesy of the Champaign-Urbana Public Health District)
Last week's news that the state was going to stop offering a popular health insurance plan to government employees is being met with a backlash. On Monday, a bipartisan legislative panel heard testimony surrounding the decision, but details remain sparse.
Severing Illinois' 30-year relationship with Urbana-based insurer Health Alliance would save the state money. So says the Department of Health Care and Family Services, which last week announced state workers can instead sign up with Blue Cross Blue Shield's managed care. Savings is pegged at about $100 million per year.
But Health Alliance C-E-O Jeff Ingrum says the decision will "disrupt doctor patient relationships for ten thousands of state employees and their families."
Ingrum disputes the projected savings. Health Alliance has filed a formal protest. That puts the bid process under review, which means little information is being released.
Thousands of downstate state employees are caught in the middle. They could be forced to pay more for coverage or change doctors. The review could also push back the annual open enrollment period.
Once the review is complete, a legislative commission will have the final say over the health insurance contracts.
The state's rejection of Health Alliance from its new menu of health plans for state employees has prompted the Urbana-based medical plan provider to mount a campaign in its own defense --- including the filing of a formal protest with the state.
Health Alliance officials note that they provide exclusive HMO coverage for several providers including Carle (Health Alliance and Carle Physicians Group are both owned by the Carle Foundation). Without a Health Alliance plan, state employees and retirees will have no access to those doctors under an HMO plan.
But the new health plans for state employees offer other plans that include Carle. They are open access plans --- three-tier plans that work like HMO's at their lowest tier, but offer more expensive access to more doctors at their 2nd and third tiers. Two open access plans from PersonalCare and HealthLink would offer access to Carle doctors at their 2nd tier.
Without giving specific numbers, PersonalCare CEO Todd Petersen says the price difference between Tier One and Tier Two is not a big one.
"There is a difference in deductible and co-payment," Petersen said. "They (the 2nd tier prices) would be a little bit higher. But it's still --- compared to the general market --- it would still be one of the richest benefits on the market today."
Petersen predicts that Carle and and other providers with exclusive contracts with Health Alliance will make arrangements with other health plans --- but not until after Health Alliance's formal protest is heard.
"But then, I do expect that the market will adjust to the new realities and you're likely to see providers participating in products that they have historically not participated in," Petersen said.
In the meantime, Petersen notes the bottom tier of PersonalCare's open access plan includes several central Illinois medical groups and hospitals, including Christie Clinic, Provena, Sara Bush Lincoln and hospitals in Gibson City and Decatur.
Illinois' Junior Senator remains optimistic that a deal will be struck just short of midnight and that Congress will avoid a government shutdown.
Republican Mark Kirk says in general, Democrats should give on spending proposals, and the GOP should give on 'extraneous' policy measures to avoid the shutdown.
"I think congressional negotiators typically work up to the last minute," said Kirk. "But my guess is because President Obama doesn't want a shutdown, Speaker (John) Boehner doesn't want a shutdown, and Senate Majority Leader (Harry) Reid doesn't want a shutdown, you have a succesful end to the negoations today."
Kirk says there was also discussion in the Senate late Friday about a short-term continuing resolution that could last as long as 4 days, that fully funds military troops.
During a separate conference call earlier, Democratic Senator Dick Durbin said a budget deal hinged on funding for Planned Parenthood. Kirk says the program shouldn't be singled out for a 100-percent cut, but rather a broad-based, shared sacrifice.
Senator Kirk also says he won't keep his congressional pay if the government, instead giving it to charity.
The HMO plans that the Quinn administration wants to offer to state employees starting in July only covers 27 Illinois counties.
Blue Cross/Blue Shield of Illinois' two HMO plans would serve the state's most populous counties, covering Chicago, Rockford, Springfield, Peoria and the Metro East. But the health plans have no health care providers signed up in most of east-central, southeast, southern and western Illinois would not be included.
Blue Cross spokesperson Mary Ann Schultz says in a press release that they're working to sign up more providers in other counties. In the meantime, she says state employees could use the other available plans. Those are the Quality Care preferred provider plan, which offers access, but a lower level of coverage; and two open access plans from HealthLink and PersonalCare. They offer HMO-level prices for physicians in their lowest tier, and higher prices if you want access to other doctors.
The state Department of Healthcare and Family Services says the new plans will save the state over $100 million a year. But State Representative Chapin Rose says the state's research erroneously projects Blue Cross' lower operating costs in urban areas onto the state of Illinois as a whole.
Rose's Illinois House district stretches from Charleston to Champaign, one of the areas not covered by the Blue Cross HMO plans. The Mahomet Republican says the alternatives have their flaws, too. He predicts how those in his region would use the new health plans.
"You have a bunch of people that either migrate on to (the) QualityCare plan, which will be incredibly expensive to the state taxpayers," Rose said. "Or they will dump into PersonalCare, and go to Christie Clinic. The problem is, Christie Clinic does not have the capacity to suddenly have 55-thousand people at its doors. Just can't do it."
Rose says many of those seeking care from Champaign-based Christie Clinic will be former patients of Urbana-based Carle. Health Alliance, which has an exclusive HMO arrangement with Carle, was turned down in the bidding for the new health plans. The open access plans would offer Carle at its more expensive tiers, and Christie Clinic at the lower-priced tier.
Health Alliance is filing a formal protest against the new health plans, and Rep. Rose says that should make documentation available that he believes will show the flaws in the health plan selection process. In the meantime, a legislative commission will review the plans on Monday, April 11th. The meeting of the Illinois Commission on Government Forecasting and Accountability is set for 10 AM at the Illinois State Capitol Building in Springfield. Rose says he's worried that the commission will vote to approve the plans before those documents are available.
The lawmaker says the best course of action would be for the commission to take its time on the matter. But he argues that an even better course would be for the Quinn administration to withdraw the health plans, and start over.
Criticism and confusion continues with the Quinn administration's proposed health plans for state employees and retirees in the next fiscal year.
The proposal would remove Urbana-based Health Alliance from the mix, raising difficulties for patients who use doctors at Carle, Springfield Clinic and McDonough District Hospital in Macomb. Those hospitals and clinics have exclusive HMO contracts with Health Alliance (a Carle subsidiary).
Instead, HMO coverage for state employees would only be offered by Blue Cross/Blue Shield of Illinois which has no primary care physicians under HMO contracts in the Champaign County area. A spokesman for BCBS says they do not have HMO providers in every county.
But a spokesman for the Illinois Department of Healthcare and Family Services says there are other options in their proposals --- namely the open access plans offered by HealthLink and PersonalCare. Mike Claffey says those plans offer medical coverage at different levels. He says Tier 1, the least expensive, works like an HMO. Claffey says it's his understanding that Champaign-based Christie Clinic is part of the provider network at Tier 1 levels in the open access plans, while Urbana-based Carle is available at the more expensive Tier 2 and Tier 3.
State Representative Chapin Rose says the proposed health plan lineup goes before a legislative advisory panel in Springfield on Monday. And Rose says he thinks the Commission on Government Forecasting and Accountability is predisposed to approve the proposal. The east central Illinois Republican says the commission needs more accurate numbers on the new health plans --- numbers he says won't be available until after Health Alliance files its formal protest.
"Filing their protest is what gives them the cost document they need to officially disprove these cost issues," Rose said. "If the (commission) votes on Monday, they will be voting without the actual real numbers to prove or disprove what's going on."
Meanwhile, an organizer with Champaign County Health Care Consumers is urging state employees not to panic. Anne Gargano Ahmed says if the state's decision is approved, it should give Carle the incentive to negotiate with Blue Cross Blue Shield for HMO coverage.
Urbana-based Health Alliance says it will file a protest with the state over its decision not to continue their HMO contract for state employees and retirees.
The state Department of Healthcare and Family Services announced Wednesday it was awarding HMO contracts for the next fiscal year to Blue Cross Blue Shield, with Open Access Plan contracts to PersonalCare and HealthLink. The state said the new contracts would save taxpayers over $100 million a year, and over one billion dollars over the next ten years.
Health Alliance CEO Jeff Ingrum argues the savings aren't really there --- in part because people who had been under Health Alliance will be required to either change doctors, or go to the more expensive Open Access Plans selected by the state, or to the Quality Care Preferred Provider plan, which offers less coverage.
"One, it will increase the costs to state workers," Ingram said. "But it will also increase the costs to the state of Illinois, because those programs are anywhere from 10 to 20 percent higher than the Health Alliance HMO program."
Ingrum says Carle, Springfield Clinic and McDonough District Hospital in Macomb had signed exclusive agreements with Health Alliance that barred them from working with other state HMO plans.
In a statement, Carle says it's studying the implications of the DHFS decision. The company calls on their patients who are Health Alliance members to "share their concerns with the state and with elected officials."
The company says it will be reviewing options "for state employees to continue accessing Carle physicians and hospital services", but that the plans and costs for such access will change if the state's decision stands.
And the state Department of Healthcare and Family Services says --- in a fact sheet on its managed care announcement --- that while Carle and other hospitals and clinics may not be available through their new HMO plans immediately, it expects them to "adjust to market needs" over time.
Carle says that Carle Foundation Hospital has a long-standing contract with Blue Cross/Blue Shield, for hospital services. But Health Alliance's Ingram says the contract is for a Preferred Provider plan, not the HMO plans which the state approved its employees and retirees in FY 2012.
State Representative Naomi Jakobsson (D-Urbana) has complained about the state's decision not to use Health Alliance next year. She says the company was not given sufficient advance notice of the decision. Jakobsson is inviting people concerned about the change to sign a petition on her legislative website.
NOTE: This story was updated to show additional comments from the Illinois Department of Healthcare and Family Services.
The Cherry Orchard Village apartments lie just south of the abandoned Chanute Air Force Base near Rantoul - and like the base itself, Cherry Orchard has seen better days. Now the two landlords who manage the eight-building complex are charged with failing to maintain it - to the detriment of its tenants, mainly migrant worker families. Illinois Public Media's Sean Powers has been collaborating with the investigative journalism group CU-Citizen Access. He reports on the legal battle to bring Cherry Orchard up to code.
(English language voice over by Jenn Kloc)
(With additional reporting from Pam Dempsey and A. H. Gorton of CU-CitizenAccess)
A dismal ranking of overall health in Vermilion County for the second straight year has prompted a call to action from the county's health department.
Department administrator Shirley Hicks says about 130 people in affected areas have been invited to a meeting Thursday morning at her offices. She notes a lot of the findings in the county's ranking of 98th place out of the state's 102 counties have nothing to do with her department, like unemployment and education levels.
But Hicks says Illinois' fiscal woes will just force her department to work that much harder with social service agencies, primary care providers and others to seek solutions.
"The state of the Illinois economic crisis is a player as part of all of this," said Hicks. "So I think it's going to take all disciplines to look at what part can we do, and how can we best utilize resources that we do have."
Hicks commends the work of the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute for putting the findings together. She says the ranking for the county isn't nearly as important as the process researchers used to arrive at that figure.
"Any time you're looking at those reports, you're looking at where did the data come from, how did they ask the questions, so you can better understand the root cause of the problem," said Hicks. "I don't have any dispute with the actual data, it's really trying to dissect it down the the most common denominator and say 'how can we target our initiatives and our resources and pull those together to make an impact."
Hicks commends the work of the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute for putting the findings together. Thursday's meeting at the Vermilion County Health Department is expected to include primary care providers, social service agencies, law enforcement, hospitals, and members of the Vermilion County Board.