Yeah, right! Income tax just went up..... Where IS the money coming from, and why wasn't it used before this? http://articles.chicagotribune.com/2...atric-patients

State authorities say they have found a way to raise hundreds of millions of dollars annually to carry out safety reforms in nursing homes without dipping into Illinois' depleted coffers.

Under a bill passed by the General Assembly early Wednesday, the state will significantly increase the bed tax it currently levies on nursing homes, bringing in an estimated $145 million next year.

Government health care funding rules will allow Illinois to match that money with nearly the same amount collected from Medicaid.

Gov. Pat Quinn and nursing home executives say those funds will enable them to increase staffing at nursing facilities, hire more state inspectors and finance other reforms in Illinois' troubled long-term care system.

The AARP and some leading advocates for the elderly and disabled had opposed the bill, arguing that it will provide a windfall for substandard, profit-making facilities and hamper efforts to move thousands of younger mentally ill adults out of nursing homes and into community settings where they could get better care.

Passed with Democratic support largely along party lines, the bill is part of a yearlong effort to undo a legacy of violence and abuse in Illinois nursing facilities. Lawmakers acted after a Tribune investigation last year found many poorly staffed facilities were housing dangerous psychiatric patients alongside more vulnerable geriatric and disabled residents, sometimes with deadly consequences.

In July, Quinn signed a sweeping reform law that requires nursing homes to meet more stringent safety standards and will also create an array of smaller, residential programs to provide intensive therapy and supervision for mentally ill patients currently housed in nursing facilities.

Still, there was no consensus on how to pay for increased staffing at the homes and other measures mandated by the new law. Nursing home operators for years have complained that Illinois provides among the lowest reimbursement rates in the country for government-funded patients.

According to state officials, 86 percent of the estimated $290 million Illinois would collect next year under the bill would be given back to the facilities. The money will be needed to meet a new state mandate on staffing levels and other requirements, state officials said.

State authorities would use the rest of the funds — an estimated $40 million — to beef up state safety inspections and fund smaller, more therapeutic community settings for psychiatric patients.

AARP Associate State Director David Vinkler said his group had hoped to see less money flowing back to the nursing homes and more going to the state.

"We need to commit more money to the home- and community-based programs and less to the facilities," Vinkler said.

Julie Hamos, director of the state Department of Healthcare and Family Services, which runs the state Medicaid program, said she also wanted more money for community programs and enforcement.

But Hamos added that the new bill will be augmented by other, ongoing policy reforms that will ensure Illinois meets its commitment to move psychiatric patients out of the institutions and into community programs.

"This bill is not by itself solving all the problems of the state, but it does take care of a few of the really pressing issues that we face, providing for higher-quality health care inside of nursing homes," Hamos said Wednesday.

Because much of the bed tax will be returned to the homes via the Medicaid program, which funds health care to the poor, facilities with fewer Medicaid patients will recoup less money. Illinois' nonprofit nursing homes, which generally serve fewer Medicaid payments, argue that the bill unfairly penalizes them. They describe the rate increase as a "granny tax" that could be passed on to residents.

Hamos countered that the Medicaid-funded homes needed the additional revenue to boost their staff to levels mandated by the reform law Quinn signed last year. "The bill ensures that homes can meet the new staffing standards," she said.

That point was echoed by Terry Sullivan, regulatory director of the Health Care Council of Illinois, the state's largest nursing home trade association. "These are the homes that most need the help ... and it will go toward staffing," Sullivan said. "This is something Medicaid homes have desperately needed in order to provide the quality of care that we all want to see."