health – Chicago Newstips by Community Media Workshop http://www.newstips.org Chicago Community Stories Mon, 14 Jul 2014 17:31:05 +0000 en-US hourly 1 https://wordpress.org/?v=4.4.12 Human services in the Age of Austerity http://www.newstips.org/2013/07/human-services-in-the-age-of-austerity/ Sun, 07 Jul 2013 20:05:10 +0000 http://www.newstips.org/?p=7557 Clients and welfare workers from the state’s human services system will discuss attacks on public services coming under the guise of austerity — including a privatization contract that an artbitrator recently ordered shut down — at a public meeting Monday.

The Alliance for Community Services is sponsoring the meeting on health care and human services at 6:30 p.m, Monday, July 8, at Teamster City, 300 S. Ashland.

Ralph Martire of the Center for Tax and Budget Accountability will discuss the state’s fiscal crisis.

“The reality is, we’re not broke,” said Fran Tobin of Northside Action For Justice, one of the initiators of the alliance.  “There’s lots of wealth in the state, but our regressive revenue system is failing to tap into it.”

Human service clients and welfare workers will tell stories of difficulties caused by a chronically understaffed system, said Steve Edwards, a retired union activist.

One source of problems is a new DHS pilot program — poised for expansion — that shifts from case-based to task-based organization of office work.  Under the program, caseworkers have been shifted to “teams” devoted to specific tasks.

“You have former caseworkers — who have college degrees in specific fields and a year of additional training — spending all day opening mail,” he said.  Everyone’s work goes into a single pile, with no one responsible for the ultimate disposition of particular cases.  It means clients no longer have a caseworker who they can call to address problems.

“They’ve blown up accountability,” Edwards said.  “It looks to me like sabotage.”

“Under the rhetoric of increasing efficiency, they’re clearly making things worse,” Tobin said.  “It’s insane.”

AFSCME Council 31, which represents state human service workers, has filed a grievance charging DHS with eroding job titles, said Edwards, a former AFSCME local president.

AFCME recently won an arbitration charging that a contract with a private firm to review Medicaid recipients’ eligibility violated contract language on contracting out.  An arbitrator ordered the state to cancel its contract with the consulting firm Maximus at the end of the year, according to the union.

Edwards estimated that for the cost of the $75 million contract, the state could have hired 1,500 additional caseworkers, increasing the workforce by something like 50 percent.

He said some caseworkers currently have caseloads of more than 2,000 individuals or families — far above the recommended caseload of 400 to 500.

]]>
Barriers to health care for people with disabilities http://www.newstips.org/2013/06/barriers-to-health-care-for-people-with-disabilities/ Wed, 26 Jun 2013 20:30:46 +0000 http://www.newstips.org/?p=7551 People with disabilities face an array of obstacles to getting health care, and budget cuts and market-oriented “reform” of Medicaid could be making things worse.

Results from a participatory research study of the health care experiences of Medicaid beneficiaries with disabilities will be presented at a town hall meeting Thursday afternoon, with health care consumers and providers commenting on their experiences and possible solutions.

The town hall takes place Thursday, June 27, at 1:30 p.m., at Access Living, 115 West Chicago Avenue.  The study was conducted by Access Living’s health policy team and UIC’s Department of Occupational Therapy.

Relatively simple problems, like access to clinics and exam tables for people who use wheelchairs, can lead to significant gaps in care, said Marilyn Martin, policy analyst at Access Living.

Many are examined in their wheelchairs instead of on exam tables, though that’s not considered an acceptable practice, she said.  As a result, pap smears and prostate exams are often not given to people in wheelchairs.

With mammogram units that aren’t accessible for mobility-impaired patients, many people go years without cancer-detection exams — and mortality rates for breast and cervical cancer are significantly higher for people with physical disabilities, Martin said.

People in wheelchairs are almost never weighed during exams, she said, so potentially significant information on weight gain and loss is unavailable, and prescriptions for medications are written based on guesses about weight.

State laws that mandate “safe lifting” standards for treating wheelchair users in hospitals and nursing homes don’t extend to clinics and doctors’ offices, she said.

People with mental illness report being treated disrespectfully by doctors, and “providers often don’t believe what consumers are telling them or discount it” with the attitude that “it’s all in your head,” said Martin.  “Sometimes this leads to illnesses not being treated.”

Sign language interpreters are often unavailable at hospitals and clinics, Martin said.  One survey participant told of spending a week in a hospital for emergency open-heart surgery with no interpreter until he was being released.

One problem is that the federal government has yet to issue regulations for health care providers under the Americans with Disabilities Act, though it was passed 23 years ago, Martin said.

Now Medicaid is being expanded under the Affordable Care Act, one year after the state cut its budget by over $1 billion.  But the expanded Medicaid will more closely resemble cut-rate private insurance, with increased out-of-pocket charges for consumers.

For people with extensive health issues requiring regular doctors’ appointments and multiple medications — especially those living on the limited income of SSI disability benefits — higher co-pays mean “people are being increasingly forced to choose which of their conditions they can afford to have treated,” Martin said.

]]>
Stroger staff oppose pediatric cuts http://www.newstips.org/2013/04/stroger-staff-oppose-pediatric-cuts/ http://www.newstips.org/2013/04/stroger-staff-oppose-pediatric-cuts/#comments Thu, 25 Apr 2013 23:06:06 +0000 http://www.newstips.org/?p=7157 County Hospital staff say administration proposals to limit pediatric admissions are “unnecessary and shortsighted” — and come at a cost of millions of dollars in revenues, potentially threatening the long-term viability of of the county’s entire health system.

Staff from Stroger Hospitals Neonatal Intensive Care Unit will speak at the Cook County Health and Hospital System board meeting Friday morning (April 26, 8 a.m., 1900 W. Polk) and will be available for the media shortly after the public comment portion of the meeting ends at 8:15.

They say that earlier this month, administrators told senior staff that patients should be turned away after 17 beds are full — the number was raised to 24 after an impromptu meeting with county health system chief Ram Raju last week, I’m told — due to “patient safety” concerns.

The unit has 54 beds and an average daily census of 29, and the safety issue is unfounded, staff say. Patient outcomes meet all standards, and the unit’s 1-to-3 or less nurse-to-patient ratio is in line with other hospitals — and much better than staffing levels in Stroger’s adult medicine and surgery wards, which far exceed staffing norms, according to a release from NICU advocates.

And in a health system desperate for revenue to fund care for the uninsured, the unit — all of whose patients are covered by Medicaid — generates betweeen $10 million and $14 million a year.

Advocates say they worry that the administration is “manufacturing a financial crisis” that could threaten the entire system county health system, which could provide a pretext for selling off the system.

]]>
http://www.newstips.org/2013/04/stroger-staff-oppose-pediatric-cuts/feed/ 2
Patients ‘disappeared’ in mental health closings http://www.newstips.org/2012/10/patients-disappeared-in-mental-health-clinic-closings/ http://www.newstips.org/2012/10/patients-disappeared-in-mental-health-clinic-closings/#comments Wed, 31 Oct 2012 23:17:59 +0000 http://www.newstips.org/?p=6735 Last year’s closing of six of the city’s twelve mental health clinics – for a reported savings of just $3 million – was “characterized by poor planning, mismanagement, inaccurate information, and profound insensitivity to clients,” according to a new report from the Mental Health Movement and AFSCME Council 31.

That meant a rocky transition for many clients, while the Chicago Department of Public Health seems to have lost track of as many as two thousand clients whose transition it had pledged to monitor.

According to the report, “Abandoning the Most Vulnerable,” the city listed 5,337 clients in October 2011 when the clinic closings were announced, but its report on the transition this July gave the total as 2,798.

Asked about this, the city told researchers that a March review found only 3,282 “active” cases.  The difference includes clients who weren’t currently seeing a therapist but expected to be able to if necessary – and in any case, between March and July, nearly 500 clients “disappeared” entirely, according to the report.

One problem was that therapists who were being transferred from closing clinics weren’t informed of their new assignments until the very last minute, making it impossible to keep their clients in the loop, said Jo Patton of AFSCME.

The failure to monitor all the city’s clients “represents a signficant lapse at the top echelons” of CDPH, while “the attempt to cover up that failure by simply revising the total number of clients raises serious ethical concerns,” the report charges.

No comprehensive effort

“There was not a comprehensive effort to reach each client and provide them with the information they needed to continue to receive services,” according to the report.

Nor was the transition smooth – as shown by a spike in the rate of psychiatric hospitalizations of CDPH clients in April, the year of the closing. In that month, hospitalizations were nearly twice as high as the average over the previous year and a half.

There were other problems, according to the report.  Two private agencies to which clients were referred closed their doors in the two months following the closings.  Only 43 percent of clients transferred to private agencies were reported by CDPH as receiving services from them.

Meanwhile, with half of CDPH therapists laid off but 85 percent of clients continuing to attend the remaining clinics, caseloads and waiting times increased dramatically.

This all takes place at a time when national and state surveys have revealed increasing demand for mental health services and huge gaps in the capacity to provide services.

Needs assessment

The report calls for reopening the six clinics closed in April and adequately staffing the remaining six clinics, rehiring African-American and bilingual therapists to ensure culturally competent care, and implementing an outreach program to let people in need know about CDPH services.

At a budget hearing held by the Progressive Caucus of the City Council in South Shore on Tuesday, mental health advocate Badonna Reingold said she’s “very, very concerned about  a dramatic turnback of care for people with mental illness” on the part of the state and the city.

While the city has promised to provide care for people without insurance, it is only planning for 2,000 clients, she said, at a time when and increased unemployment and violence are certainly adding stress to the lives of many more people.

She called on the City Council’s health committee to hold a hearing and sponsor a full-scale needs assessment.

Margaret Sullivan of the Mental Health Movement criticized the aldermen for voting for last year’s budget after 28 council members signed a letter opposing the mental health cuts.

]]>
http://www.newstips.org/2012/10/patients-disappeared-in-mental-health-clinic-closings/feed/ 2
Warning on Social Security, Medicare cuts http://www.newstips.org/2012/10/warning-on-social-security-medicare-cuts/ Tue, 30 Oct 2012 00:43:23 +0000 http://www.newstips.org/?p=6723 Seniors, people with disabilities, and the poor shouldn’t be pushed over a “fiscal cliff” manufactured by politicians.

That’s the message of a coalition of senior, disability, community and labor organizations that is hosting an accountability sessions with local members of Congress, Tuesday, October 30, 4 p.m., at the Chicago Temple, 77 W. Washington.

Representatives Danny Davis and Jan Schakowsky have confirmed their attendance, and others are expected, said Gary Arnold of Access Living.

Sponsors of the event include Access Living, Illinois Alliance of Retired Americans, IIRON, Jane Addams Senior Caucus, Jobs With Justice, and the Lakeview Action Coalition.

They’ll ask legislators to oppose cuts to Social Security, Medicare, and Medicaid in any resolution of the impasse over the debt ceiling to be considered in Congress after the November 6 election.

Neither Democratic nor Republican proposals – nor automatic cuts set to go into effect if no deal is reached – are good options, said Tom Wilson of Access Living.

Democrats would reach deficit reduction goals with a mix of heavy budget cuts and increased taxes on the wealthy; Republicans have proposed only spending cuts.  A “sequestration” plan if no deal is reached would involve 8 percent across-the-board cuts in domestic and military spending.

“Any of the solutions they’re talking about would drive us right back into recession, throw a lot of people out of work, and send the economy into a downward spiral,” said Wilson.

He said for people with disabilities, sequestration would actually impact Medicaid less than either the Democratic or Republican proposals.

The coalition is calling on legislators to back the expiration of the Bush tax cuts for all taxpayers and a financial transaction tax that could raise billions of dollars, he said.

The groups are also backing Schakowsky’s Emergency Jobs Act (HR 2914) and the Principal Reduction Act (HR 3841), which would require Fannie Mae and Freddie Mac to reduce principal on loans to underwater homeowners.

Those bills “would give millions of people the tools and resources to stay in their homes, get back to work, and contribute to their communities,” said Arnold.

]]>
Sheriff Dart to speak on impact of clinic closings http://www.newstips.org/2012/09/sheriff-dart-to-speak-on-impact-of-clinic-closings/ http://www.newstips.org/2012/09/sheriff-dart-to-speak-on-impact-of-clinic-closings/#comments Tue, 04 Sep 2012 22:28:14 +0000 http://www.newstips.org/?p=6597 Sheriff Tom Dart’s warning last year that closing the city’s mental health clinics would add to the burden of the Cook County Jail is coming true, according to the Mental Health Movement.

Joined by mental health professionals and consumers, Dart will discuss the impact of the clinic closings on the jail — including people who could avoid incarceration if they had access to mental health services — at a forum on Wednesday, September 5, at 6:30 p.m. at Episcopal Church Nuestra Senora, 2610 N. Francisco.

Dart will be joined by Crystal Colon of Iraq Veterans Against the War and psychologist Rebecca Paz-Ford of Lurie Children’s Hospital and Northwestern University.  According to MHM, psychiatric hospitalizations doubled in April, after half of the city’s clinics were closed.

In addition, former clinic patients will talk about the devastating impact the closings had on their lives, including people suffering severe anxiety who are unable to make the long trek to clinics to which they were transferred.

Two nonprofit mental health agencies – which were supposed to pick up the slack when six city clinics were closed this spring – have gone out of business since the clinic closings, in part due to cuts in state funding, according to Matt Ginsburg-Jaeckle of MHM.   Hundreds of patients from the South Side’s Community Mental Health Closing, which closed in July, are flooding the city’s Englewood clinic, he said.

In response, the city is said to be considering opening two additional lightly-staffed “satellite clinics,” he said, though rehiring laid-off staff is not planned.  A city promise to keep the Woodlawn clinic open as an “outpost” has not materialized, he said.

MHM activists arrested when they occupied the Woodlawn clinic in April are slated to go to trial on trespassing charges on October 15.

MHM is pushing to get full funding for the clinics restored to the city’s budget.  The group is also highlighting “the multiple ways people are denied access to services,” including a shortage of social workers and psychologists in CPS schools for students traumatized by violence, and long waiting lists at the Veterans Administration, Ginsburg-Jaeckle said.

]]>
http://www.newstips.org/2012/09/sheriff-dart-to-speak-on-impact-of-clinic-closings/feed/ 1
In Springfield, no solutions http://www.newstips.org/2012/06/in-springfield-no-solutions/ http://www.newstips.org/2012/06/in-springfield-no-solutions/#comments Sun, 03 Jun 2012 20:26:24 +0000 http://www.newstips.org/?p=6321 Sad to say, nothing they’re doing or talking about in the General Assembly will have a significant impact on the state’s chronic budget crisis.

Not draconian Medicaid cuts, not possible pension cuts or casino expansions.  The legislature is barking up the wrong trees, and doing it over and over.

That’s because the state doesn’t have a spending problem.  In real terms, Illinois has been steadily cutting spending on education, human services, health care, and public safety for the past decade.  Medicaid is not the problem: general revenue funds going to Medicaid are down over the past five years.

According to Ron Baiman of the Center for Tax and Budget Accountability, Illinois is one of the nation’s wealthier states, looking at the state’s gross domestic product per capita.  But it has been one of the nation’s lowest-spending states, looking at state spending as a percentage of GDP.

So the problem isn’t overspending, and cutting doesn’t get us closer to a solution. The problem is a regressive tax system that doesn’t tax where the money is.

Regressive

Illinois has one of the most regressive tax structures in the nation.  As noted here last year, the bottom 20 percent of households pays twice as much of their income in state and local taxes as the top 20 percent does.

Even the flat income tax is regressive, since it imports all the federal tax code’s loopholes; of the current nominal rate of 5 percent, households earning over $1 million a year pay an effective tax rate of just 2.1 percent – the same as households earning over $10,000.  The squeeze is on the middle.

And especially with the surge of income inequality in recent decades, that means the state asks more and more from people who are doing less and less well, and fails to capture the gains of economic growth, which are increasingly found at the top.

It can’t go on forever.  At some point Illinois leaders are going to realize there’s no alternative to a progressive income tax.  The constitution, which mandates a flat tax, will have to be amended.

All our neighboring states have progressive systems – and that’s the reason their budget problems are so much less than ours.  If we took Iowa’s income tax rates and applied them to Illinois’s tax base, we’d raise $6 billion more a year – and 54 percent of taxpayers would get a tax cut averaging 24 percent, according to CTBA.  If we took Wisconsin’s we’d raise $3.6 billion more a year and cut taxes for more than half our residents.

Tax cut

The Illinois constitutional amendment will have a straightforward appeal: nearly all taxpayers’ rates will go down.

CTBA has fashioned a proposal for a progressive tax system for Illinois that raises an additional $2.4 billion yearly (even after allowing for increased tax avoidance by wealthy taxpayers) and reduces the tax rate for 94 percent of taxpayers.

Everyone earning under $150,000 would get a tax cut.  Starting to sound good?

It’s not even very tough on the wealthy; CTBA figures the effective tax rate (after deductions, credits and offsets) would top out at 6.3 percent for those earning over a half million a year.

There’s other money the legislature is leaving on the table, as it cuts public services to the bone.  A restructuring of the corporate income tax in 2001 – an unsuccessful attempt to encourage job growth — means most Illinois corporations pay no income taxes.

And an antiquated sales tax which applies to goods but not services – so if you buy a lawnmower and gas to mow your own lawn, you pay a sales tax, but if you hire a lawn service you don’t – costs the state between $500 million and $1 billion a year.

Corporate welfare

Then there’s corporate welfare – an area in which Illinois is a leader.  The Responsible Budget Coalition identified six corporate tax loopholes which don’t make economic sense — and where Illinois departs from federal policies and practices in other states — costing Illinois nearly $700 million a year.

These include a deduction for dividends paid by foreign corporations to parent corporations here ($386 million a year) and a domestic production credit, which reduces corporate tax bills here for production in other states ($200 million).

Then there’s a $75 million tax break for oil companies because, unlike the federal government, Illinois defines the outer continental shelf as outside the national boundaries.

On top of RBC’s proposals, CTBA and others have highlighted the accelerated depreciation allowance, a federal provision that other states have decoupled from.  It costs over Illinois $300 million a year (more here).

Altogether that’s well over a billion dollars, maybe two billion, maybe more, that the  General Assembly has left untouched, apparently preferring to throw sick children out into the street.

“Everybody’s talking about how this was such a hard, courageous vote,” said Lynda DeLaforgue of Citizen Action Illinois after the $1.6 billion Medicaid cut was passed.  “Wouldn’t it have been more courageous if they had taken on the oil companies?”

Medicaid

That $1.6 billion isn’t the final figure, since kids from 26,000 families thrown off Family Care – and thousands of individuals to be thrown off Medicaid — will cost more when they end up in emergency rooms.

And the $17 million cut from home health care will cost the state more when people with disabilities are forced into nursing homes.

“You’re going to end up spending any money you save,” said Gary Arnold of Access Living.  “It’s very shortsighted.”

The elimination of Illinois Cares RX drops prescription coverage for 160,000 low-income seniors and people with disabilities. “This sudden and extreme elimination of benefits for a very vulnerable population will most surely put peoples’ lives and health at risk,” according to Citizen Action Illinois.

The group is among several asking Governor Quinn to restore the funding – or at least to postpone elimination of the program, now set for July 1, until next January to allow providers to help identify options and potentially save lives.

Pensions

There was no pension deal, to the chagrin of many mainstream commentators.  Here, too, there are legal obstacles.  The deal under consideration – which would require public workers who’ve paid for their pensions to bear the burden of politicians’ profligacy — would seem on its face to violate constitutional protections of state employees’ pension rights.

Quinn wants to push on, but the matter is more likely to be addressed in the veto session, after the November election.

Through extensive grassroots pressure, public workers succeeded in countering some of the biggest myths around the pension crisis, said Anders Lindall of AFSCME Council 31.  Chief among these is the notion that exorbitant public employee pensions are driving the budget crisis.

In fact most public workers’ pensions are modest – they average $32,000 a year, and 80 percent of state workers don’t get Social Security.  That’s after contributing 8 to 10 percent of each paycheck to their pension.

“You don’t hear anything about ‘gold-plated pensions’ anymore,” said Lindall.  “More and more people understand it was the politicians who caused the problem.”  They caused it by using pension funds as a credit card to paper over an inadequate revenue system, he said.

It turns out the revenue crisis — the regressive tax system — is driving the pension shortfall.

Public worker unions in the We Are One Illinois coalition have worked with legislators, offering ideas toward a solution “that’s fair to workers who have paid their share and puts the retirement system on a strong footing in a sustainable way,” said Lindall.

Public workers “recognize the scale of the shortfall and are willing to be part of a solution,” he said.  “No one has a greater stake in securing the future of the retirement system.”

One of their demands is “an ironclad guarantee that pension fund contributions can’t be skipped or shorted,” he said.

Governor Quinn said he’ll meet with legislative leaders to keep pressing for a resolution.  Public workers unions hope they’ll be included in the process, Lindall said.

That might save on lawyers’ bills down the road.

Casinos

The GA passed a casino expansion bill, but it contains features (including slots at racetracks and gaps in oversight) that led Governor Quinn to veto a similar bill a year ago.  It could end up part of the horse-trading in the fall veto session.

If it does come to pass, expect the benefits in terms of jobs and public revenues to fall short of what’s being promised now, said Doug Dobmeyer of the Task Force to Oppose Gambling in Chicago.  “Proponents always lie about the benefits,” he said.

What we do know is that gambling takes money out of the consumer economy.  A Chicago casino with 4,000 slot machines, each taking in $100,000 a year, would remove $400 million from the consumer economy, U. of I. Professor John W. Kindt explained last year (see Slot Machines Kill Jobs for more).  That’s a heavy blow to a struggling economy – and a lot of lost sales tax revenue.

And the money the state takes in comes, by and large, from moderate-income people.  Like the new cigarette tax, like the speed cameras and higher water bills, it’s just one more grab for revenue from people who are struggling, by politicians who can’t see past the next election.

]]>
http://www.newstips.org/2012/06/in-springfield-no-solutions/feed/ 3
Mental health closures causing hospitalizations http://www.newstips.org/2012/04/mental-health-closures-causing-hospitalizations/ Sun, 29 Apr 2012 21:00:22 +0000 http://www.newstips.org/?p=6086 With four more mental health centers slated for closing Monday, clinic users and supporters will seek a “pardon” from President Obama tomorrow – and highlight psychiatric hospitalizations that have resulted from the closure of two clinics earlier this month.

The Mental Health Movement will march on Obama’s campaign headquarters, 130 E. Randolph, at 11 a.m., Monday, April 30, to ask for “presidential pardon” for the condemned clinics – and for the clinic users they say will die as a result of the closures.

At 5:15 p.m. on Monday, therapists from the city clinics joined by health advocate Quentin Young will hold a press conference outside the mayor’s office in City Hall to discuss the impact of the closures.

One immediate outcome has been a surge of psychiatric hospitalizations for clients of two clinics closed earlier this month.  MHM knows of 18 such hospitalizations, said organizer Matt Ginsburg-Jaeckle.

One client – who was hospitalized after attempting suicide when she lost her long-time therapist – has been released and is telling her story for a video that MHM will be releasing, Ginsburg-Jaeckle said.

The cost of such hospitalizations (averaging $13,000 each) will eat up any taxpayers savings from clinic closings, according to an MHM report issued earlier this year.

Other issues highlighted in the report include the firing of all bilingual therapists at a time when immigrant communities increasingly need mental health services; the closure of four clinics in South Side communities that have a critical shortage of mental health services; and the diminished capacity of nonprofit providers that are supposed to take up the slack.

MHM members and supporters have been occupying the lot across from the Woodlawn Mental Health Center, 63rd and Woodlawn, since 23 were arrested at a sit-in at the clinic on April 12.  The Woodlawn center is slated for closure Monday.

]]>