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Monday, January 18, 2016

Illinois Seniors and Disabled are Collateral Damage in the state's budget war

Vera Cassata, 84, of Tinley Park, is one of about 300 elderly people who rely on home care assistants to remain independent. Due to a lack of payments from the state, officials with Shay Health Care Services in Oak Forest say by the end of this month they will for forced to cease that part of its operation, laying off 100 caregivers. (Phil Kadner / Daily Southtown)

very nice article by Phil Kantor
The Daily Southtown | January 14, 2018

Vera Cassata, 84, of Tinley Park, depends on a home health care assistant to get her out of bed in the morning, wash her, dress her, buy food and help her go to the bathroom. Five days a week the home health care assistant visits, but due to the state budget crisis that help may disappear by the end of the month.

To the governor and state legislators responsible for the budget impasse, which has resulted in Cassata's life crisis, she would like to say, "How would they like to never be able to go out the door of their homes? All they are doing is making our lives terrible, and they were pretty terrible already."

Shay Health Care Services of Oak Forest provides home health care assistants for about 300 elderly residents of the Southland, which allows them to remain in their homes instead of going into nursing homes if their families can't provide the care they need. Shay has a contract with the state's Department on Aging to provide home care assistants and is supposed to be paid $170,000 a month. But since July 1, when the state failed to adopt a new budget, it has not been paid.

Pat Hayes, the co-founder of Shay, which launched in 1981, said she has taken out $800,000 in personal loans to keep that part of her agency's operation running and can no longer afford to take on debt. If she isn't paid by the end of January, she told me, she will lay off the 100 caregivers who work for her and cease that part of her operation.

Shay will continue to offer nursing services to private-pay clients and those who are covered through Medicare and Medicaid, but not the 300, mostly elderly Southland residents, some in their 90s, who are clinging to the last vestiges of an independent life.

"Many of them will end up in nursing homes on public aid and that's going to cost the state three times as much as this program," Hayes said. "It's just stupid and so unnecessary. This is a program the state claims it's going to pay for when a budget passes, a program supported by the elected officials. But if they don't pay the bills, we can't pay our bills so we can't continue running like this."

State Rep. Robert Rita, D-Blue Island, said he has been contacted by officials at Shay, but there is nothing that can be done.

"It's part of this budget impasse, and unless the governor agrees to something, there isn't anything we can do," Rita said. "The state comptroller refuses to release the funds."

It's the Republican governor. It's the Democratic legislature. Back and forth the accusations fly, and there is Vera Cassata, sitting in her chair, wondering what's going to happen to her life.

She lists her health problems — "arthritis," "diabetes," "a couple of strokes," "a heart attack, "spinal stenosis" — and sighs deeply.

She spends most of each day in a large armchair and uses a walker to go from there a few feet to her bed or the commode.

They won't let her go to the bathroom by herself any more, she told me, because she keeps falling down.

There is no income limit to qualify for the services she receives through the Department on Aging, but there is an asset limit of $17,500, excluding the value of a home or car. Cassata, a widow, lives in a townhouse, "not completely paid for" she tells me, and she never goes out of the house anymore.

"I just can't do it," she said.

She spent most of her life in Chicago's 18th Ward on the Southwest Side of the city, and for several years helped set up "hospital rooms" in the homes of parishioners who had health problems. She worked for the Chicago Park District for about 10 years. She has a small pension and some money from Social Security, and also receives a widow's pension courtesy of her husband, a concrete finisher.

"It's not much, but it's something," she said. "Of course, I couldn't afford to pay for the care I receive through Shay out of my own pocket. It would be too expensive."

In fact, she likely needs around-the-clock attention, but the state does not provide that through its program and she cannot afford to pay for it. Few can.

"The governor probably could," she told me. "I hear he's a billionaire."

Their home care assistants are paid $10 an hour via the state, according to Shay officials. They are not nurses, but do receive some training in how to help the elderly.

"My caregiver treats me like a daughter, like family," Cassata said. "You can't really pay someone to do that. It comes from the heart. And how do you replace someone like that. I rely on this woman for everything, for my life, really."

If Shay discontinues providing the service, it's possible the state could contract with a larger agency, one headquartered out-of-state, that can go unpaid for a longer period of time, assume more debt, to provide care for the elderly.

But the 100 people who work for Shay, who pay state taxes, who provide for their families, will be out of a job.

"It's a domino effect," Hayes said. "And while we're not being paid for the services we provide, the legislators keep getting paid. There's money for that."

Shay has been providing these services to homebound seniors since 1995.

"It's not a big profit center for us," Hayes said. "But it's the right thing to do. It's helping people who really need that sort of help to remain in their homes. Everybody ought to be able to live out their lives with dignity and respect. You don't want to just shove people into nursing homes, and families can't always provide the sort of attention people need. Sometimes, you just need a break, a little help, and that's what we do."

I told the people at Shay and Cassata that I doubted a column about this problem would make much difference.

The political battles between Republican Gov. Bruce Rauner and Democratic House Speaker Michael Madigan are well documented. Although there is no state budget, the state has been spending money on most of its programs and services, things like public education, Medicaid and government employee salaries, through court order or executive decree. But billions of dollars in bills have gone unpaid. These are services provided by private entities that have signed contracts with the state.

The state has reneged on its promise to pay them, promising someday checks will be sent.

There are many people who believe the government wastes money, but this is the sort of program that taxpayers ought to be proud of because it helps people who find themselves in desperate circumstances at the end of their lives. People we ought to care about.

"I paid taxes all my life," Cassata said. "I'm not begging for anything. I worked 47 years and a variety of jobs. We lived a frugal life. We had a son who had some medical problems and that consumed a lot of our savings. My husband worked two jobs to help pay those costs, and I worked a job as well. We did what we had to do.

"I know there are some people who would say, go to a nursing home. They have never been to a nursing home. Never seen how people in those places are treated."

So we can all sit on the sidelines and watch like spectators, enjoying the battle between the governor and the Democrats, or we can tell them when we've had enough. Have your battles, if you must, but do not put people like Vera Cassata and the employees of Shay in the middle to get us to choose sides.

"I pray to God they can find the money to keep this program going," Cassata said.

Late Wednesday afternoon, in response to my inquiries, the Illinois Department of Aging sent the following in an emailed response:

"The Illinois Department of Aging (IDoA) learned today that Shay Healthcare would no longer be contracting with the agency as a result of the super majority in the legislature's failure to pass a balanced budget and their refusal to agree to reforms to improve state government. We are working closely with Shay to ensure that all clients are transferred to other providers with no interruption of services. We are committed to our clients and they are our top priority."

My guess is the state will get some agency to provide the care Cassata and other seniors need to avoid the potential public backlash if the program disappeared. The politicians don't want that kind of problem. So some other firm, one financially able to work for IOUs, will come to the rescue. As for the 100 lowly paid employees of Shay, the caregivers, they are likely collateral damage in this political war.

They cared for others, but no one cares about them.

It's a lousy, stinking thing. And as a taxpayer, I resent it.

pkadner@tribpub.com
Copyright © 2016, Daily Southtown
http://www.chicagotribune.com/suburbs/daily-southtown/opinion/ct-sta-kadner-senior-home-care-st-0114-20160113-column.html?utm_content=buffer50067&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer&sf43843412=1

ACI editor note: This fight has been going on for decades in Illinois. Illinois has a long history of Institutionalizing people with disabilities/seniors, along with pushing people into nursing homes that can live independently.

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