By DIANE ROSS and SHELLEY DAVIS Legislative Action

Reapportionment commission: Democrats win the tie breaker

AT LEAST reapportionment won't be at issue when the General Assembly returns for its fall veto session October 1. The Democrats won the August 25 lottery, much to the chagrin of Republican Secretary of State James Edgar, lottery superintendent for the day. Caught up in a melodrama of his own making, Edgar astounded no one more than himself when he pulled Sam Shapiro — not Dick Ogilvie — out of Abe Lincoln's hat. The tie-broken, nine member commission has until October 5 to draw the new legislative districts. But thanks to the luck of the Irish or the divine right of the Daleys, it will be the Democrats' map the Republicans take to court this winter and not vice versa.

PUBLIC HEALTH

Dealing with nurses' shortage

ILLINOIS is currently short about 6,000 nurses. The General Assembly's Commission on Critical Health Issues found that the shortage is due to an exodus of nurses who are either leaving the profession for more lucrative careers or moving to neighboring states for more favorable working conditions. The commission made 13 recommendations which would attempt to solve this problem.

The major nursing package which included some of these recommendations was S.B. 920-925, sponsored by Sen. Arthur Berman (D., Evanston), the commission's chairman.)

Regions in the state with a shortage of nurses would be identified and student nurses in those areas would be given priority for student loans under S.B. 920, which survived only as an amendment to H.B. 109, sponsored by Rep. Alfred Ronan (D., Chicago). H.B. 109, as amended, would also allow student nurses in undergraduate programs to borrow up to $2,500 a year for tuition and fees and up to $1,000 a year for living expenses under the student health care loans administered by the Illinois Department of Public Health.

Berman's substantive Senate bill passed the Senate but not the House. The Senate then rewrote Ronan's House bill to do the same as Berman's. Ronan's "old" bill had passed the House 157-2 May 4; his "new" bill passed the Senate 47-7 June 25; the House concurred 103-58 June 28; it went to the governor July 27.

Berman's appropriation bill, S.B. 921, would have provided $270,000 for nursing loans in fiscal 1982. But, like the substantive bill, it passed the Senate but not the House. The Senate likewise rewrote Ronan's appropriation bill, H.B. 108, to do the same as Berman's, but the governor vetoed it July 21.

Two bills in Berman's package did pass: S.B. 922 would have created a statewide Nursing Education Commission to study the long-term effects of Illinois' nursing "shortage" and to report its findings by April 15, 1983. S.B. 925 would authorize the Illinois Board of Higher Education to consider funding preferences for nursing schools located in areas with a shortage of nurses. S.B. 922 passed the Senate 45-5 May 27, the House 104-51 June 18, but the governor vetoed it August 21; S.B. 925 passed the Senate 49-1 May 27, the House 145-11 June 18 and was signed by the governor August 19 (P.A. 82-259).

Berman's bill to allow registered nurses from others states to practice in Illinois for up to six months without having passed the Illinois exam did not pass. This bill, S.B. 924, also would have allowed registered nurses licensed in Canada to be licensed in Illinois without taking the state exam, but only until June 30, 1983. S.B. 924 passed the Senate 30-23 May 22, but it was killed in the House Personnel, Pension and Veterans Affairs Committee.

Nurses aides who pass proficiency tests would no longer be required to complete training courses under provisions of two bills: S.B. 220, sponsored by Sen. John Maitland (R., Bloomington), and H.B. 580, sponsored by Rep. A. T. McMaster (R., Galesburg). Maitland's bill passed the Senate 52-21 May 19, the House 160-5 June 11, but was vetoed August 14; however, the governor signed the day before McMaster's bill, which passed the House 147-3 May 20, the Senate 51-3 June 23 (P.A. 82-184).

Graduates of vocational education nursing programs would be allowed to take the state's licensed practical nurse exam before age 18 but would not be able to be licensed until age 18, according to the provisions of S.B. 575 as amended. The provision in the House Amendment 2, sponsored by the House Committee on Registration and Regulation, was recommended since a student graduating at age 17 does not currently qualify for taking the state test scheduled in early summer; a 17-year-old graduate may have to wait several months for another test to be scheduled. S.B. 575 passed the Senate 57-0 May 29, the House 137-0 June 15 and went to the governor July 27.

Ambulances must pass safety tests

Ambulances would have to pass safety tests twice a year to retain their licenses under a bill designed to follow up on legislation passed last year to regulate this sometimes controversial service industry.

Last year the General Assembly passed the Illinois Emergency Medical Services (EMS) Act. It authorizes state government, via the Illinois Department of Public Health (IDPH), to regulate the medical capability of all ambulances except those owned, operated or otherwise regulated by local government. The act also allows the department to set comprehensive standards for ambulance equipment and personnel. This year the General Assembly passed a bill authorizing the state to regulate the safety of all ambulances.

S.B. 401, sponsored by Sen. John Davidson (R., Springfield) and supported by Secy. of State Jim Edgar, would requite that ambulances pass two safety tests administered by the Illinois Department of Transportation in order to retain their licenses. The bill would also increase the required liability insurance per ambulance from $50,000 to $100,000. S.B. 401 passed the Senate 54-0 May 20, the House 159-1 June 10, and went to the governor July 27.

A related bill, H.B. 1789, sponsored by Rep. Carol Moseley Braun (D., Chicago), would authorize the IDPH to waive certain provisions of the new EMS act for up to one year to allow more time to meet the department's new comprehensive equipment and personnel standards. In its original form, the bill would have rescinded the provision in the EMS act that exempted ambulances regulated by local government from more comprehensive regulation by state government. Although the entire bill passed the House 138-4 May 20 and the Senate 33-15 June 26, the provision rescinding the exemption was deleted in conference committee. Thompson signed H.B. 1789 July 27 (P.A. 82-103).

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INSURANCE

Borrowing on whole life insurance

INTEREST RATES would probably rise on life insurance loans if Thompson signs a bill designed to stop the drain on insurance company cash reserves caused by an increase in these loans.

Policyholders can borrow on the cash value of whole, but not term, life insurance policies. The ceiling on interest rates on each loans is set by state law at 8 percent. The recession has prompted many policy-holders to switch from term to whole life insurance in order to take advantage of the low-interest loans; they borrow at the low statutory rate and invest at the high market rate. The resulting drain on the cash reserves for many insurance companies has forced them to raise premiums.

H.B. 963, sponsored by Rep. Gerald Bradley (D., Bloomington), and an identical bill, S.B. 913, sponsored by Sen. James Rupp (R., Decatur), would allow insurance companies to raise the interest rates on whole life loans within the fluctuations of the corporate bond market. That is, the interest rates would be allowed to rise to the level of the average monthly interest rates on corporate bonds, as published by Moody's Corporate Bond Yield Average — Monthly Average Corporate (Moody Investors Service, Inc.). In 1980 the average monthly interest rates on corporate bonds ranged from 12½ to 14 percent. The bills would, however, allow insurance companies to retain the option of charging only 8 percent interest on whole life loans — if they can afford it.

Neither H.B. 963 nor S.B. 913, however, dealt with whole life loan interest rates to start with. The legislation was actually introduced as H.B. 1695, sponsored by Rep. John Birkinbine (R., Northfield). It had reached third reading in the House but was eventually consigned to the spring calendar. With the failure of H.B. 1695 to pass its house of origin, the Senate amended the legislation onto H.B. 963, Bradley's bill, and the House amended onto S.B. 913, Rupp's bill. Both bills followed the same route. H.B. 963 passed the House 137-3 May 7; the Senate (in amended form) 58-0 June 24; the House concurred 132-5 June 29; it went to the governor July 28. S.B. 913 passed the Senate 57-0 May 29; the House (in amended form) 133-19 June 18; the Senate concurred 43-5 June 29; it went to the governor July 27.

Political contributions by individual insurance companies

Individual insurance companies would have been allowed to contribute directly to political campaigns under a bill that passed the House only to fail in the Senate.

Insurance is the only industry which Illinois currently bars from making direct corporate contributions to political campaigns. Insurance companies can contribute indirectly, however. A group of companies can contribute through a common Political Action Committee (PAC), or an individual company can contribute through its holding company's PAC.

Illinois law has prohibited other corporations from making direct political contributions, but over the years the General Assembly has lifted the ban on many — most recently the liquor and banking industries.

In 1977, individual insurance companies succeeded in gaining legislative approval of direct contributions, but Thompson vetoed the bill. In 1979, the measure was shelved for interim study and eventually died. In 1981, H.B. 372 passed the House but not the Senate. Sponsored by Rep. John Birkinbine (R., Northfield), the measure passed the House 90-44 March 26, the Senate Executive Committee 11-4, but failed on the third reading in the Senate by eight votes, 22-29 on June 18.

Senior drivers

Some drivers over age 55 would receive a one-time reduction in liability insurance rates under a successful bill patterned after a New York model. The American Association of Retired Persons estimates New York drivers who qualify will save an average of $150.

Under H.B. 781, sponsored by Rep. Thaddeus Lechowicz (D., Chicago), insurance companies would be required to reduce liability rates for three years for drivers over age 55 who complete an accident prevention course approved by the secretary of state. Standards for such courses would be based on those for the National Safety Council's Defensive Driving Course, which include a minimum of eight hours of classroom instruction.

H.B. 781 passed the House 125-28 May 15, the Senate 44-9 June 24, and went to the governor July 23.

PURCHASED CARE

Medicaid reimbursement to hospitals

THE COST to the state of reimbursing hospitals for Medicaid patients would be contained to some extent, saving the state an estimated $50 to $60 million a year, under a major budget-related bill passed this session.

H.B. 811, sponsored by Rep. John Mati-jevich (D., Chicago), would cap the per piem reimbursement to hospitals and require Medicaid patients to pay part of the [cost for health care purchased by the state. Rhose were among several reimbursement revisions Gov. James R. Thompson wanted the General Assembly to make this year to cut or at least control Medicaid costs. Unemployment's effect on the welfare caseload, especially during a recession, makes Medicaid the state's single most uncontrollable cost. Containing Medicaid costs is vital if the state is to continue balancing its budget during the recession.

H.B. 811 would temporarily reduce the number of days a Medicaid patient stays in the hospital for which the hospital could be reimbursed by the state by 14 percent. From October 1, 1981 to July 1, 1982, the last nine months of fiscal 1982, hospitals would be reimbursed for 86 percent instead of all of the days Medicaid patients stay in the hospital. And the bill would limit increases in the per diem reimbursement during fiscal 1982 to 8 percent.

H.B. 811 would also establish a system of "co-payments," whereby Medicaid patients would be required to pay the first $1 per prescription, the first $1 per visit to optician or dentist, and the first $3 per outpatient visit to hospitals and clinics. (Certain chronic conditions requiring long-term care would be exempt.)

H.B. 811 passed the House 144-0 May 8, the Senate 50-2 June 26 and went to the governor July 29, in what Thompson claims as a major victory in his efforts to balance the fiscal 1982 budget.

. . . to nursing homes

The state would have increased reimbursement to some nursing homes for support services for Medicaid patients under another purchased care bill.

Costs for support services, such as food and laundry, are considered "nonvariable" and more controllable than other "variable" services such as nursing. The state currently reimburses nursing homes for support services on a regional basis, with maximum reimbursement rates set roughly equivalent to the average cost within a region.

Under S.B. 181, sponsored by Sen. John Maitland (R., Bloomington), the state would have reimbursed nursing homes on an individual basis, but with a ceiling of 70 percent of the individual cost. The new reimbursement system would have taken effect January 1, 1982, and would have cost the state $8.5 million in fiscal 1982 and $21 million in fiscal 1983.

S.B. 181 passed the Senate 56-0 May 19, the House 134-20 June 11, but the governor vetoed it August 14.

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THE ELDERLY

Abuse of the aged

ATTEMPTS to solve the child abuse problem have exposed an equally tragic situation: abuse of the elderly. But legislative action on this issue was postponed this session pending completion of a comprehensive study by Sangamon State University's Center for Legal Studies. The study will be released by the Department on Aging, and is expected to describe the characteristics and estimate the incidence of abuse and neglect of the elderly in Illinois.

There were two major bills introduced for the first time in 1981: S.B. 674, sponsored by Sen. Adeline Geo-Karis (R., Zion), and H.B. 837, sponsored by Rep. Josephine Oblinger (R., Sherman), a former director of the Illinois Department on Aging.

The Geo-Karis bill would have created the Illinois Elder Abuse Act, making abuse, neglect or exploitation of aged or disabled adults a Class A misdemeanor, subject to a year in jail and a $1,000 fine, and making failure to report suspected cases of elderly abuse to law enforcement agencies and the Illinois Department on Aging a Class C misdemeanor subject to 30 days in jail and a $500 fine. It passed the Senate 38-5 May 29 but was held in the House pending release of the report.

Oblinger's bill was similar in its intent, but it was also amended to allow the Department on Aging to operate a number of pilot projects on reporting elderly abuse. But it was evidently the consensus of the House to hold over the Oblinger bill along with the Geo-Karis bill until the report on abuse is completed.

A less comprehensive reporting bill, which follows up on the 1979 Illinois Nursing Home Care Reform Act, did pass this session. H.B. 1118, sponsored by Rep. Lee Preston (D., Chicago), would require nursing home employees to report abuse, neglect or exploitation of aged or disabled patients to the Illinois Department of Public Health, which would be required to investigate the reports. H.B. 1118 passed the House 137-3 May 8, the Senate 58-0 June 24, and Thompson signed it August 10 (P.A. 82-120).

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