Rep. Sheri Jesiel (R-Winthrop Harbor) took issue with Democratic-sponsored legislation that says the state would pay 100 percent on bed holds.
HB5286, sponsored by Rep. Sara Feigenholtz (D-Chicago), would lift a Specialized Mental Health Rehabilitation Act (SMART) Act provision on mental health facility bed holds for therapeutic visitation. Jesiel raised concerns about the measure after two witnesses discussed it at Wednesday's House Appropriations-Human Services Committee.
Witness Arnold Cantor of Barton Management said the bill would assist in reintegration after six-month stays on average at mental health facilities.
Rep. Sheri Jesiel (R-Winthrop Harbor)
| www.sherijesiel.com
“What we try to do within that time frame is trying to have them back into the community visiting relatives, friends,” Cantor said of the therapeutic visits approved by an interdisciplinary team.
“We are asking for the limitation of 30 days in a fiscal year,” Cantor said. “The first five days would be at a 100 percent of the prevailing rate that the facility is receiving and thereafter would be 75 percent of the prevailing rate.
Department of Healthcare and Family Services Chief of Staff Shawn McGady stepped up to share his concerns and the fiscal impact HB5286 would have on the state if passed. He said before the SMART Act took place, certain bed hold criteria had to be met, including Medicaid and occupancy levels, both of which are not included in the new legislation.
“If those were included, we may move our opposition,” McCady said.
That's was when Jeisel joined the conversation.
“It’s not clear to me; it sounds like this bed reserve was taken out of the SMART Act. Has it been added back for any other categories?” Jesiel asked.
“I don’t know the answer to that,” McGady said. “I know for long-term care in nursing homes there is no bed reserve.”
Feigenholtz referred to Cantor, who said it is 100 percent for the facilities' current Medicaid per diem for the first 10 days.
“So, your piece of legislation is shortening it to five,” Jesiel confirmed before asking whether Cantor budgets for patients' therapeutic visit absence for up to 30 days. “Isn’t that part of their treatment plan, and shouldn’t that be part of what you are considering in your budget when you are working through your numbers for the year?”
Cantor said they cannot budget specifically because it cannot be determined how long a patient will be housed before release.
“It is much more complex,” Cantor said. “Mental illness is not a linear disease. There are ups and downs and that is one of the issues.”
While Jesiel said she does not dispute the model, a CEO or a comptroller should make allowances for bed debt during therapeutic visits.
“Instead of expecting the state to pay you for the time they are not there, especially at a 100 percent rate, is the point I was trying to make,” Jesiel said.
HB5286 advanced and will move to the House floor.
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