Bill Summaries

Nursing home reform

S.B. 316, sponsored by Sen. Richard M. Daley (D., Chicago) and Rep. Thaddeus Lechowicz (D., Chicago), is the state's first comprehensive nursing home reform in more than three decades. It gives the state real power to regulate the billion-dollar industry for the first time. Pro-reform lobbies say Illinois' Nursing Home Care Reform Act of 1979 has already become the model nationwide, leaping ahead of Michigan, New York, New Jersey and West Virginia, which pioneered reform earlier this decade.

The new law is designed to weed out — finally — a handful of nursing homes that have successfully sidestepped charges that they are substandard. The state has been able to close some substandard homes, but the process usually takes two to three years. Meanwhile, abuses have grown, camouflaged by the red tape inherent in "due" process.

Written with the help of the industry, including such groups as the Illinois Health Care Association, the new law is considered a vital victory for the legal aid lobby (Legislative Support Center) and other new advocates of the rights of nursing home residents, such as the Chicago-based Citizens for Better Care, a statewide coordinating group. The new law gives advocates access to residents as well as the right to take legal action on behalf of public-paid residents.

"The industry has grown rapidly. Changes in the federal Medicaid and Medicare programs and in various approaches to caring for the aged, infirm and disabled have frequently compounded the problem," Gov. James R. Thompson said, signing the legislation. "The overall quality of care in Illinois . . . has improved in the past five years, but much remains to be done," he said.

The reform doesn't set any new standards, but it does put real teeth in the state's enforcement tools, affecting nearly 900 licensed nursing homes, which employ about 90,000 to care for about 100,000.

One key change gives the state the power to enforce long-set minimum standards for nurses aides who provide 90 percent of patient care. The new law requires the state to pay part of the cost of the training for the first time, but doesn't specify how much. Some observers put the cost at $1.4 million per year, but others say it's closer to $3.2 million per year. Pro-reform lobbies argue the state should pick up more than half the tab because more than half of residents are public-paid through Medicaid or Medicare.

But the major change gives the state the power to put about 20 substandard homes out of business by fining them a minimum of $1,000 a day per violation, getting courts to name receivers to take over operation, and holding owners as well as staff liable for injuries or damages due to negligence.

The new law also extends to private-paid residents the rights required under federal law for public-paid residents. Provisions include private visits from advocates as well as family and friends, free expression of religion, retaining personal physicians, private medical and personal care, personal clothes, private storage of personal possessions, managing personal money and protection when the home manages the money.

The rights also prohibit transfer without consent, restraint as punishment, and experimental treatment without consent The rights also require access to personal records, confidential records, and written contracts for care. P.A. 81-223, effective March 1, 1980.

The Daley-Lechowicz reform package includes two other bills: S.B. 309, which drops licenses for administrators of homes which have lost licenses, (P.A. 81-222, effective March 1, 1980) and S.B.310,which would authorize tax-exempt public bond money to help private homes meet standards (still before the governor).

Local government

H.B. 2730, sponsored by Rep. Larry Bullock (D., Chicago) and Sen. Robert Egan (D, Chicago) smoothes the transition from the oil corporate personal property tax to the new surtax on corporate income tax for local government which depend on the revenue and tax base for short-term and long-term borrowing power. (See Illinois /ssues, August 1979, pages 25-26.)

Revenue from the old corporate personal property tax will be available to schools and other local governments for the last time in fiscal 1980, Revenue from the new surtax on corporate income tax will be available for the first time in fiscal 1981.

The new law increases short term borrowing power, or ability to issue tax anticipation warrants to meet operating expenses. Local governments now are able to borrow as much as 85 percent (up from 75 percent) of the revenue they expect the next year's taxes to generate. And the law increases long-term borrowing power, or ability to issue general obligation bonds to cover capital improvements. They now still are able to borrow as much as 20 percent of their assessed property valuation.

"Without this legislation, local governments and school districts would lose up to 15 percent in debt limitation and borrowing power," Gov. James R. Thompson said, signing the legislation. "This would create an intolerable cash flow problem for most." P.A. 81-165, effective August 13, 1979.

26/ November 1979/ Illinois Issues