2. Presentation to The Medicaid Leadership Group David Carvalho Deputy Director Office of Policy, Planning & Statistics, Illinois Department of Public Health November 3, 2005

3. Outline The Problem The Health Care Justice Act (HCJA) The Task Force and the Health Care Access Plan The Final Report Task Force Highlights and Timeline Next Steps How to Get Involved Questions

4. The Problem A persons ability to access the health care system influences his or her treatment, outcomes, and health status. Access to health care is most affected by the ability of those seeking care to afford the services that they need. The uninsured, working poor, racial and ethnic minorities, and undocumented immigrants in the Illinois are least likely to be able to afford to pay out-of-pocket for many health care services.

5. The Problem (cont.) Many Illinoisans lack access to the health care system because they lack health insurance. Approximately 1.8 million Illinoisans are uninsured. A growing number are under-insured. The consumer's share of the cost of health insurance is growing. While Illinois has many safety net providers, many uninsured Illinoisans lack access to a usual source of preventative and comprehensive care. Public and private clinics, public hospitals, and charity care administered by private hospitals

6. The Health Care Justice Act Sponsored by Illinois Senator Barack Obama Signed into law by Governor Blagojevich in August 2004 Goal is to Ensure Access to Quality and Affordable Health Care for All Illinoisans Created the Adequate Health Care Task Force Not funded in FY05, but $1M was appropriated in the FY06 Budget Task Force appointed in Summer 2005

7. 29-Member Task Force Governor appointed 5 President of the Senate appointed 6 Minority Leader of the Senate appointed 6 Speaker of the House appointed 6 Minority Leader of the House appointed 6

8. Illinois Department of Public Health is the lead state agency, working cooperatively with representatives from: Department on Aging Department of Healthcare and Family Services (formerly Public Aid) Department of Human Services Division of Insurance

9. Charge of the Task Force – To develop a comprehensive health care access plan for Illinois Must provide for access to a full-range of preventive, acute, and long-term health care services to all Illinois residents

10. Recommendations are to be submitted to the General Assembly General Assembly is strongly encouraged to enact the plan by December 31, 2006 The Plan is to be implemented by July 1, 2007

11. Criteria for Health Care Access Plan: 1)provides access to a full range of preventive, acute, and long-term health care services; 2)maintains and improves the quality of health care services offered to Illinois residents; 3)provides portability of coverage, regardless of employment status; 4)provides core benefits for all Illinois residents;

12. Criteria for Health Care Access Plan (cont.): 5)encourages regional and local consumer participation; 6)contains cost-containment measures; 7)provides a mechanism for reviewing and implementing multiple approaches to preventive medicine based on new technologies; and 8)promotes affordable coverage options for the small business market.

13. Other Items to Note – 19 or More Public Hearings (at least one in each Congressional district) to Collect Public Input Health Care Justice Act and Adequate Health Care Task Force Website – www.idph.state.il.us/hcja/index.htm

14. Other Items to Note – Research Entity To be contracted by IDPH At the Task Forces disposal (given available funds) to assess health care reforms, health care financing, and health care delivery models Can be called by consensus of 8 members of the Task Force

15. Final Report must make recommendations for a health care access plan or plans that would provide access to a full range of preventive, acute, and long-term health care services to residents of the State of Illinois by July 1, 2007

16. Recommended Plan(s) Must Include: 1)an integrated system or systems of health care delivery; 2)incentives to be used to contain costs; 3)core benefits that would be provided under each type of plan; 4)reimbursement mechanisms for health care providers;

17. Recommended Plan(s) Must Include (cont.): 5)administrative efficiencies; 6)mechanisms for generating spending priorities based on multidisciplinary standards of care established by verifiable replicated research studies demonstrating quality and cost effectiveness of interventions, providers, and facilities; 7)methods for reducing the cost of prescription drugs both as part of, and as separate from, the health care access plan;

18. Recommended Plan(s) Must Include (cont.): 8)appropriate reallocation of existing health care resources; 9)equitable financing of each proposal; and 10)recommendations concerning the delivery of long- term care services.

19. Adequate Health Care Task Force Highlights Elected Chair, Vice-Chair, and Steering Committee (each from different appointing authorities per the Task Force Bylaws) Wayne Lerner, Chair –Appointed by Minority Leader of the Senate David Koehler, Vice-Chair –Appointed by Speaker of the House Joe Roberts, Steering Committee Member –Appointed by Minority Leader of the House Ruth Rothstein, Steering Committee Member –Appointed by the Governor Quentin Young, Steering Committee Member –Appointed by the President of the Senate

20. Adequate Health Care Task Force Highlights Adopted Bylaws Absent Task Force members may be represented by surrogates, but these surrogates cannot vote; Task Force decisions will be made by majority vote; and Amending bylaws requires a 2/3 vote of present Task Force members.

21. Task Force Timeline Engage in Deliberative Process from August 2005 through September 2006 Complete 21 Public Hearings by April 2006 One in each Congressional District (19) One in Collinsville One in Springfield Complete Final Report between July 1, 2006 and October 1, 2006

22. Whats Next? Substantive Presentations before Task Force Leading Health Policy Experts from Illinois and across the United States State Coverage Initiatives Illinois Health Forum – Wednesday, December 7 th Future Public Hearings (4 pm – 7 pm): Wednesday, November 9 th in Homewood (2 d District) Wednesday, November 16 th in Bourbonnais (11 th District) Tuesday, December 13 th in Naperville (13 th District) Wednesday, December 14 th in Aurora (14 th District) Contracting with a Research Entity

23. How to Inform and Influence the Process Attend Task Force and Steering Committee Meetings to observe Task Force Proceedings Participate in Task Force Public Hearings Contact Members of the Task Force to express your views Watch the Website: www.idph.state.il.us/hcja/index.htm

24. If you have more questions about the HCJA or the Task Force, please contact – Ashley Walter, MBA, MPH Policy Analyst, Division of Health Policy Illinois Department of Public Health 100 West Randolph Street, Suite 6-600 Chicago, IL 60601 Phone: (312)814-4730 Fax: (312)814-1503 Email: awalter@idph.state.il.us

25. Questions?