Illinois Home Services Program Attempts to Cut Lifeline Services to Persons with Disabilities

Home-Care-WorkerAs an advocate concerned about the Home Services Program (HSP), I find capping IP services hours egregious! HSP, critically important to thousands of people with disabilities across the state of Illinois, ensures that everyday HSP customers receive care from their Individual Providers (IPs).
Capping the hours that IPs can work at 40 will mean that people with disabilities will not be able to access personal care assistance. In most places throughout Illinois, HSP consumers cannot find, hire and keep decent good IPs.
Parents, siblings and other relatives who act as IPs, with whom Illinois desires to cut work hours below 40 hours, jeopardizes financial and supportive IP, positive outcomes and quality of life. Until more effective policies emerge for persons with disabilities, this reduction of IP hours becomes cumbersome, undo-able and strict.
HSP customers and IPs deserve flexibility, not rigidity. Please eliminate the cap hours a week is too harsh and will put too many people’s lives at risk.
Photo from http://blog.abbeyspanier.com/wp-content/uploads/2012/08/Home-Care-Worker.jpg
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How to Address your State, Gov. Rauner Style

Serious

  1. First, try and smile when you have a hostile audience. Do not pause often for thunderclaps that will not happen.
  2. Secondly, keep an extremely serious tone throughout the address, even though you know that you will not factually mention change; just spin the important issues that you will not resolve.
  3. Talk in a homey type of speech by droppi’ the ‘g’s on all ‘ing’ words. This will ensure easy acceptance for uneasy information. The crowd will love this homegrown approach!
  4. Mention as many priority buzzwords like “good education,” “mental health,” “community health,” “criminal restoration,” and “good jobs.”
  5. NEVER, EVER even imply any state responsibility for any of the priority initiatives.
  6. Tell the legislators to pass your bills instead of askin’ them. This is very important to stay in total control of the law writin’ process.
  7. Slam the unions in any way possible, even namin’ names like AFSCME to blame the state’s fundin’ inadequacies on them. Name names of offensive unions. Be sure and use statistics to support the idea that mighty, greedy unions break the budget. Do not mention how you will not sit down with the “AFSCME” union to negotiate a fair contract. Take a snipe at teachers’ unions without mentionin’ their names because they are not in your jurisdiction!
  8. Do not address the closin’ of the state colleges and universities, closin’s of community health centers or any of the state’s accumulated faux pas presently in play. Do not address how the state will pay back the community for services already rendered.
  9. NEVER admit blame!
  10. Only propose revenue raisin’ in terms of income taxes. Show how you think that graduated income taxes are a good idea of yours.
  11. Ignore the underwhelmin’ response by your audience. They will learn, in time.
  12. Get off the stage as quickly as possible.

My testimony about the Department of Human Services (DHS) Proposed Changes on 08/26/15

082615 DHS Hearing

August 26, 2015

Ms. Tracie Drew, Bureau Chief
Bureau of Administrative Rules and Procedures
Department of Human Services
100 South Grand Avenue East
3rd Floor, Harris Building
Springfield IL 62762

Dear Ms. Drew:

Re:

Department of Human Services, Proposed Rules, 39 Illinois Register, pages 7301 est seq., May 29, 2015

As a Medicaid recipient of medical assistance and home services, I face a serious threat to my rights because the State of Illinois’ proposed hearing rules impose many overwhelming barriers for me to maintain my medical assistance benefits. I feel that the proposed rules would make it

difficult for me to appeal the Department of Human Services (DHS) decisions to terminate or deny my medical benefits, especially if I personally need to appeal a denial or termination of benefits.

Initially, I do not understand why

these proposed changes are necessary.

Secondly, because the hearing officer will impose the order of call of witnesses as she/he deems necessary, this two-hour hearing may be inadequate for me to fairly present my views in five minutes. I come here today to express my concerns.

Request for accommodation

To accommodate my disabilities, I request that DHS allow a 60-day appeal period, the historical time period, and that any delay caused by my medical condition may cause me medical and economic hardship. I suggest that a 30-days appeal period insufficient.

I request an accommodati

on for my disabilities that DHS offers me the option of an in-person hearing.

Benefits protection under federal law

The proposed rules are overwhelmingly complicated and confusing, and conflict with federal statutes and regulations that protect my eligibility rights for my Medicaid and Home Services benefits programs below noted.

Adequate notice

The proposed rules do not require adequate notices about termination or denial of my benefits. I suggest that DHS add language to the proposed rule to require a clear statement for the reason of its action. I suggest that the DHS does not delete the requirement that all written notices bear the same date as the date of their mailing and delivery.

DHS will not apprise me that I may request a hearing before a date of action (not the date of notice). I suggest that DHS gives me enough time to respond properly ‎to my notice. I suggest that it offers me a means to comment.

In the past, DHS sent me a notice of termination that did not allow me to respond to my resident agency service office in a timely manner, i.e., the respondent office was not

my assigned office. I did not have enough time to acquire the information requested. This made me spend 6½ hours travel and waiting time, and three office visits to submit my missing documentation. I needed to leave one office due to my long wait in an office with permeating fecal smell. After a two-hour wait, I had to leave to avoid vomiting. I returned to a fresher office the next morning. There were 250 people waiting before me, so I had to wait again. The condition of the two offices that I entered I found filthy, bug-infested, moldy and unhygienic. My visit to 5050 N. Broadway caused me to have an asthma attack.

With the proposed deletion of the word “adequate” in notices suggests that DHS thinks that notices can be something less than adequate, yet still be legally sufficient. If I receive a vague notice and think that it does not affect my benefits, I will lose my benefits. By the time I understand that DHS terminated my benefits, my appeal time and benefit payment pending appeal may have expired. I will again lose my needed medical benefits while I reapply and appeal.

Hearing judges

At a minimum, due process requires that hearing officers must be impartial. I suggest that the DHS include qualifications for hearing officers for all hearings, and specifically that hearing officers be licensed attorneys. An impartial hearing officer holds appeal hearings to determine fairly ‎the areas of agreement and disagreement. I strongly suggest that DHS replace the deletion of “unbiased” with “impartial” throughout the rules.

Free access to records

The proposed rules do not assure me free and timely access to my records for appeals. I suggest that DHS avail me of my full case record in the least burdensome manner.

I suggest that DHS not withhold my “confidential information” because that would restrict my review of my case record during an appeal process. DHS should not withhold anything in my case record for my review during the appeal process. Confidentiality is my choice, privilege, and not that of DHS.

Reasonable access to hearings

The proposed rules changed the hearing locations where I may not have reasonable access. I understand that long-term medical assistance, assigned to Chicago or Decatur, does not reimburse travel and associated costs. I could not afford to travel to Decatur.

The Bureau of Hearings (BOH) has the capability of taking appeals requests by telephone and has been doing so for many years. The proposed rules will not accept medical assistance appeals by telephone. This does not make any sense to me.

Due process

The proposed rules do not provide me with due process. I am entitled to administrative hearing procedures that have integrity and are fundamentally fair. The proposed rules require that only I may personally file a medical assistance appeal. I suggest that DHS permit my Power of Attorney agent, guardian or an authorized representative, and/or legal counsel to file appeals on my behalf. I suggest that the appeal form request attachment of my Power of Attorney document or other authorization form.

There is no rule requiring DHS to make the written appeal form readily accessible, although it requires acceptance of only written medical assistance appeals. There is no rule requiring the department to make the written appeal form readily accessible. Presently, I can only find the appeal form online and I do not always have Internet access. I suggest that DHS enclose a blank appeal form with any notice that initiates my appeal rights.

The proposed rules say that if I “improperly” request an appeal, then the BOH will advise me of the proper appeal process. I do not understand what this means. What is an “improper” appeal? Do I lose time to file my appeal? May I bring witnesses, pursue any argument without undue interference, submit evidence to establish all pertinent facts and circumstances, and question or refute any testimony or evidence, and include the opportunity to confront and cross-examine adverse witnesses?

I commend DHS for proposing to make an electronic recording of the hearing proceedings available to me at no cost and if such recording is not available, to make a transcript available to me at no cost.

Confusing deadlines

The proposed rules require that I provide evidence to DHS at least 3 days ( business?) days in advance of my medical assistance appeal or the hearing officer may not consider that information. This worries me because I have limited access to email, fax and/or scanned required documents. Will DHS provide me with free legal representation? What happens if my correspondence or records are lost?

The rules do not consistently specify identify deadlines; whether due dates are counted in calendar days, business or working days. I suggest that time be consistently stated throughout the rules.

Benefit payments pending appeal process

Presently, I understand that a provision exists that I am entitled to continued benefits pending appeal if I appeal in a timely manner. I cannot locate it in the proposed rules.

Burden of proof

The proposed rules require me to prove that DHS’s action is wrong, rather than requiring DHS to identify why the action is right. Because of the above-mentioned lack of reassurance for me to access to my records for the appeal, I could be unable to provide proof. This seems distinctly unfair to me. Since DHS has full access to my records located in various agency data stores, warehouses, databases, prisons, telephone records, emails and at different agency locations, I think that DHS is in a better position to provide the burden of proof.

If an attorney does not represent me, I do not have the wherewithal to defend my position within the network of governmental agency policies and procedures. Given my limitations and the inaccessibility of DHS staff, it is unfair to place the burden of proof on me.

Task-based services

Now that DHS moved to task-based staffing and special processing units, my accessibility problems have increased. With the task-based system, trying to talk to someone about my case in my DHS agency office requires me to recapitulate my entire DHS history at every encounter; affords me with little or no timely availability of my records; and, completely loses consistency of my issues with a different task worker every time. I need a caseworker to follow my case, not a task worker.

While task-based staffing and special processing units provide efficiencies for DHS, in the appeal context, it has the potential to overwhelm me and force me to abandon my meritorious appeal rather than try to navigate the system. I feel so discouraged.

In summary, these proposed rules will cause wrongful termination of my entitled benefits that will cause serious threats to my health and economic security. I implore you to review these proposed rules and their due-process violations, barriers, and uncertainties, through my eyes, as an at-risk citizen. Accordingly, I suggest that DHS withdraw the proposed amendments and refile them with adequate descriptions and reasons for every proposed change, addition and deletion in the rules.

Sincerely,

Kathleen A. Powers, A.A.S.
Northside Action for Justice, Member of the Board
The Alliance for Community Services, Steering Committee Member
Medicaid Recipient082615 DHS Proposed Changes Testimony

My Journey into Medicaid Cancellation

My Journey into Medicaid Cancellation

On Oct. 25, 2014, I received a DHS letter stating that “beginning 2014 your benefits will change as follows: YOUR MEDICAL BENEFITS WILL STOP.”

“Reason for this action: “YOU DID NOT RETURN YOUR REDETERMINATION FORM BY 10/14/14.”

On the back of the form, the letter said, “If you continue to need medical help, you may reapply.”

Day 1:

I hopped on the Red Line to 5050 N. Broadway to check with my DRS caseworker, who provided me with DRS paperwork.

While I sat waiting for the papers, I witnessed the “greeter” who yelled at an Asian woman, “What is your disability? DISABILITY?” The lady did not understand. “He said DISABILITY. What’s WRONG with you?” She said she is caring for her mother and wants reimbursement. The greeter asked what her mother’s name is. She gave a name and he looked her up in the computer and couldn’t find the mother. The lady said her mother wasn’t signed up for Medicaid. The man told her she had to sign her mother up. He walked away and another caseworker came over and discovered that the mother was 88 and not eligible for Medicaid. The daughter had to go to the Dept. of Aging. The lady was ready to cry so I told her where the Dept. of Aging was and that they would take good care of her. The greeter came back and said to the other caseworker, “I already talked to her.” I said, “She doesn’t understand.” He muttered under his breath, “She just doesn’t want to understand.”

After I received my paperwork, I went down to the “Family Community Resource Center Uptown” what was stated to be me DHS on a notice dated November 3, 2014. I entered a small waiting room with 45 filled chairs in it and about 30 more people standing and milling around. In the very back corner of the room was a security guard. I told her I wanted to apply for Medicaid so she gave me a number and a form to fill out. I  waited about an hour and was called to a window. I told the caseworker my problem, and he refused me serve me because he said I had to go to the Skokie office because that was where I was assigned. I asked him if I could change my office. He said it was possible, but it would take about 45 days. It was at this point that I began coughing, wheezing and sweating. The air seemed very stale and I became very anxious and had an asthma attack.

I left the office and as soon as I got outside, I felt better. Since it was late in the afternoon, I decided to go home and go to Skokie another day when I felt better. So I took the 36 bus back home.

Time elapsed, day 1: 2.5 hours

Day 2:

I hopped on the Red Line to Howard Street and caught the 97 bus to Oakton and St. Louis. I joined over 200 people waiting to see a caseworker. There are no caseworkers assigned to any one person so everybody had to wait. Again, like Uptown’s office, a desk with a security guard in the back of the room handed out number cards, depending on what you wanted to do. She gave me two cards: one to change my office (express line) and one to submit my application. I asked her if I should wait before changing my office so my file wouldn’t get lost. She said to go ahead and change the office first. Against my better judgment, I went to the express line and asked the man if I should wait before I change my DHS office. He said that yes, I should wait; in fact, my caseworker could do it all. I thanked him and sat down to wait for someone to call my caseworker number. After 45 minutes, they called my number, which I handed in. In the meantime, a half an hour later, I became very hot and sweaty, the room reeked of feces and when I entered the Ladies Room (inaccessible for handicapped), wet toilet paper line the based of the entire room and I had to flee from the building so that I wouldn’t vomit. Took the 97 bus to Howard Red Line and then home.

Time elapsed, day 2: 3 hours

Day 3:

In the morning the next day, I hopped on the Red Line to Howard Street and caught the 97 bus to Oakton and St. Louis. I joined over 250 people waiting to see a caseworker. I got a new number from the back desk, and the office smelled clean and the floors were clean. I thought I’d have to wait a longer time than the day before, and was pleasantly surprised to have my number called within 20 minutes. A caseworker called me within 10 more minutes. I had to sit in a temporary cubicle in the main waiting room to talk to my caseworker, with no privacy afforded me. I showed her my paper work and she made a copy of my bank statement that was the documentation missing from my predetermination report. This took about 15 minutes. When I left, there were almost 300 people waiting.

Time elapsed, day 3: .75 hours

Total time elapsed: 6.25 hours

Comment:

This is a mild case of how that State of Illinois, Department of Human Services treats its customers. It gives insufficient time to complete reports, gives conflicting and incomplete information, treats people disrespectfully, and keeps its facilities so dirty that customers may become ill. This is our fight, and removing these blights is our goal.

Please contact Kathy Powers to help the poor regain their dignity. If you have experienced problems in the DHS offices, join our team to solve these problems. You’ll be glad you did.

August 19, 2014 Time log Alderman Cardenas Hearing on Chicago Mental Health Clinic Closures

 

1:00 Doors to Chambers open. Witness slips filled in and collected.
1:15 Bechara Choucair starts CPHD powerpoint presentation.
2:43 Alderman Fioretti cuts off Choucair.
2:56 N’Dana stated that most of Choucair’s statements are false.
3:13 Alderman Cappleman gave jail discharge services a black eye.
3:35 Heather O’Donnell says mental illness safety net is broken due to systemic stigma.
3:42 Client interrupted hearing before her turn
3:50 Mark Heyrman says city, county & state need to transition discharges from jail and police should not be mental health taxi services.
4:02 Chattel start testifying.
5:55 Kathy Powers just asked for an official apology from the city for the harm they inflict on persons living with mental illness.
7:37 Hearing adjourned.

 

My Testimony on 2/21/14 at Stean-Cassidy-Cassidy Town Hall

My name is Kathy Powers. I am on the Steering Committee of the Alliance for Community Services and on the Board of Northside Action for Justice. I live with bipolar illness since the age of 11. I thank goodness that I have Medicare and Medicaid.

I sincerely believe that the four-drug limit be abolished. I take 20 different medications a day. If I had to choose only four of drugs on my list, I would have to choose losing my kidneys, thyroid, gi tract, perennial rhinitis, chronic pain that goes along my five back fusions, liver, suffer parkinsonian symptoms, suffer movement disorder symptoms that involve me biting my mouth spasmodically, lose control of my diabetes and/or risk my psychiatric welfare. When the rules change for dual-eligibles (persons with Medicare and Medicaid benefits), the reality of a medication limitation looms closer every day.

When the well-intentioned prior authorization process was added, there was some hope to obtain sufficient medication. Unfortunately, the prior authorization process yielded unworkable results. Persons at my C4 drop-in center had their medications denied. The reasons for the denials included “denial because it is denied,” “denial because it was already approved.”The latter denial of medication caused my friend to cut herself from head to toe in total frustration and spend a lengthy hospital time to heal from her physical wounds while she received her needed medication. The authorization process is broken and dangerous.

When one takes medications as I do, this situation effects dental health. I have three teeth left on the bottom of my mouth and I’m missing four teeth on the top (show). This lack of teeth causes me to choke a great deal when I eat, makes it almost impossible to chew. I need dentures, at least on the bottom, so I will stop choking, but I can’t afford them and can’t find any assistance to get them. I’ve been known to choke on liquids and solids, and now I have an unnecessary risk for heart disease because of my poor dental health.

Since prescribed medications prevent medical emergencies, hospitalizations and lower doctor visits, I think Congress would be wise to consider the cost savings by removing the limit on medications allowed, just as an economic boost to the Medicaid economy. As far as dental health goes, I’m sure I’m not the only one who is at risk for cardiac disease or a choking emergency or death because of lack of dental care.

Thank you for your time.

Northside Action for Justice

Northside Action for Justice (NA4J)
1020 West Bryn Mawr #312
Chicago, IL 60660
Meeting March 10, 2012
10:00 a.m.

Fran Tobin opened the meeting discussing how important it is that HR services be delivered in the communities where they are needed. Closing any office adds to overcrowded, understaffed conditions and causes the disabled, seniors and the poor to travel farther using less accessible public transportation. Administrative errors will inevitably occur causing lost records and information. The Alliance for Community Services issued a petition to the governor to not close IL Department of Human Service centers (attached).

Regarding the closing of city mental health clinics, on Wednesday, March 14, 2012, protest groups plan to congregate at City Hall on the 2nd floor at 9:00 a.m.

A discussion ensued whereby money is easily available by taxing large corporations thereby paying for human services. It appears that the cuts are in reverse priority.

The next item concerned the disposition of the Maryville center in Uptown. Developers wish to build high-end residences while the community desires TIF funds to finance the Sedgewick block to return the property to a low-cost youth center.

Brief reference was made to an OCCUPY/NATO education gathering in May hosted by several advocacy groups.

Eighteen city schools have closed in “special areas” of the city, especially on the west side.

A Tax Wall Street protest is planned on March 18 at 11:00 a.m. from the Sheraton to Daley Plaza (at 12:15).

Reported by Kathy Powers

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