November 6, 2015

To the Honorable Members of

The Illinois House of Representatives,

99th General Assembly:

Today I return House Bill 2482 with specific recommendations for change.

The State of Illinois provides important support services to elderly and disabled individuals through the Community Care Program, the Home Services Program, and State-funded nursing care. At a time when the State is struggling to afford its past promises, we have an obligation to make the economic and government reforms needed to continue providing these services to the neediest among us.

Unfortunately, while well-intentioned, House Bill 2482 takes a step in the wrong direction. The bill would lock into statute that an individual with a particular threshold score on the Determination of Need (DON) assessment tool would be eligible for both institutional and home and community-based long term care services. Instead, an individual with the threshold score should be entitled to institutional or home and community-based care. Retaining flexibility to determine whether an individual is eligible for institutional or home and community-based care – as opposed to both – will ensure that the State is compliant with Medicaid waiver regulations and protocols and maximize federal matching funds.

For too long, Illinois has over-prescribed institutional care to lower-need individuals when less expensive and more appropriate care options are available. In order to provide the best particular care for each individual, to ensure that our support services remain affordable, and to maximize the number of individuals served, we must rebalance the services being provided with greater precision. Prescribing institutional care for individuals who do not need it is wrong for the individual and wrong for taxpayers. Moreover, over-prescribing institutional care is inconsistent with the direction being taken across the country.

Therefore, pursuant to Article IV, Section 9(e) of the Illinois Constitution of 1970, I hereby return House Bill 2482, entitled “AN ACT concerning public aid”, with the following specific recommendations for change:

On page 10, line 17, by replacing “institutional and” with “institutional or”; and

On page 21, line 5, by replacing “institutional and” with “institutional or”; and

On page 50, line 21, by replacing “institutional and” with “institutional or”; and

On page 55, line 17, by replacing “institutional and” with “institutional or”.

With these changes, House Bill 2482 will have my approval. I respectfully request your concurrence.

Sincerely,

Bruce Rauner

GOVERNOR