August 20, 2015
To the Honorable Members of
The Illinois House of Representatives,
99th General Assembly:
Today I return
House Bill 3398 with a specific recommendation for change.
House Bill
3398 would allow the Department of Public Health to grant nursing homes a
waiver to certain nurse staffing ratio requirements if the facility
demonstrates that it is unable, despite diligent efforts, to employ the required
number of registered nurses.
For nursing
facilities in certain regions of our State, it is difficult to find enough
qualified nurses to meet mandated staffing ratios. This results in these
nursing homes facing fines and loss of funding, forcing them to cut services to
their residents. House Bill 3398 is an important tool in allowing flexibility in
the face of an across the board, “one size fits all” government mandate, while
still ensuring that elderly Illinoisans receive safe and high quality care.
As drafted, however,
the waiver provisions of House Bill 3398 do not comply with federal law. While
federal law allows states to grant registered nurse staffing waivers to
Medicaid-certified facilities, only the federal Centers for Medicare and
Medicaid Services has the authority to grant waivers to Medicare-certified
facilities. As drafted, House Bill 3398 runs
afoul of federal law by allowing the Department of Public Health to grant
waivers to both Medicaid- and Medicare-certified facilities.
Therefore,
pursuant to Section 9(e) of Article IV of the Illinois Constitution of 1970, I
hereby return House Bill 3398, entitled “AN ACT concerning regulation”, with
the following specific recommendation for change:
On
page 2, by replacing line 15 with “(c) Upon application by a facility that is not certified to participate
in the Medicare program under Title XVIII of the Social Security Act, the
Director may grant”.
With this
change, House Bill 3398 will have my approval. I respectfully request your concurrence.
Sincerely,
Bruce Rauner
GOVERNOR