SR0480 100TH GENERAL ASSEMBLY

SR0480 LRB100 12608 MST 25833 r

SENATE RESOLUTION

WHEREAS, Founded in 1995, the Family Health Network (FHN) is the only not-for-profit managed care organization in Illinois; FHN ensures quality healthcare for the underserved minority communities of Cook County through a care network in coordination with FHN's five director hospitals; and

WHEREAS, FHN is directed by five Illinois Disproportionate Share Safety Net Hospitals: Saint Anthony's Hospital, the Norwegian American Hospital, St. Bernard Hospital, the Sinai Health System, and Presence Saint Mary and Saint Elizabeth Hospital; and

WHEREAS, FHN's status as a not-for-profit affords it the ability to direct its profits to supplement the operational budget of its five Hospital Directors instead of that money going into profits of private insurance companies such as other Illinois Medicaid HMOs; in some cases resulting in 10%-15% of the operating budget for the five FHN supported Safety Net Hospitals; and

WHEREAS, FHN's revenue distribution accounts for 10% to 15% of the operating budget for these five FHN supported Safety Net Hospitals; this revenue is critically needed to meet the financial obligations of the hospitals in meeting the healthcare needs of more than 250,000 poor Latino and African American Illinois citizens; and

WHEREAS, Since Medicaid Managed Care replaced traditional fee-for-service for most of the Illinois Medicaid population, these hospitals have seen a nearly 10% reduction in revenue for the same services performed because of claim denials and added costs, both for the benefit of the for-profit insurance companies instead of the poor people the program is designed to help; and

WHEREAS, On February 27, 2017, the Department of Health and Family Services (DHFS) released a Medicaid managed care RFP for a Purchase of Care Contract to arbitrarily narrow the number of managed care organizations contracted in the State; the RFP for a Purchase of Care Contract was released without input from healthcare providers, the General Assembly, or advocates for the underserved communities; and

WHEREAS, This RFP for a Purchase of Care Contract comes at a time of fiscal and regulatory uncertainty on healthcare and the Affordable Care Act in Washington as President Donald Trump calls to radically overturn Medicaid, putting healthcare at risk for hundreds of thousands of Illinoisans, both documented and undocumented children and adults; and

WHEREAS, The State currently owes FHN more than $260 million, severely stressing the financial viability of FHN and the financial health of their safety net directors; and

WHEREAS, The RFP for a Purchase of Care Contract arbitrarily requires all non-exempted respondents to provide statewide care network even though under its current contract with the State, FHN is only required to provide a Cook County network; FHN's current Cook County network provides care for more than 250,000 Medicaid recipients; this radical and highly questionable new statewide requirement was put forward with no explanation from DHFS; and

WHEREAS, If FHN is no longer contracted to provide care for the 250,000 Latino and African-American Illinoisans, these communities will have severely reduced access to critical healthcare, forcing the closure of Illinois-only not-for-profit managed care organizations; the only benefactor of this change will be the profit margin of the for-profit insurance companies bidding to replace FHN, displacing thousands of minority and poor healthcare recipients; and

WHEREAS, Excluding FHN from the Medicaid program in Cook County will severely jeopardize the five safety-net hospitals and the 4,000 employees who operate these essential community anchors; there failures would cause a dramatic negative economic and social impact on their southside and westside communities; and

WHEREAS, The General Assembly has the duty to appropriate expenditures from public funds, including the estimated $9 billion per year RFP for a Purchase of Care Contract resulting in $54 Billion in expenditures over the six-year potential contract term; the General Assembly also has the duty to review actions that have the potential to cause negative impact on the lives of the residents of Illinois through questionable executive branch decisions whether the questions arise from policy or ethical concerns; therefore, be it

RESOLVED, BY THE SENATE OF THE ONE HUNDREDTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we urge the Department of Health and Family Services to immediately suspend the Medicaid managed care RFP for a Purchase of Care Contract for review by the General Assembly to allow for transparency and assurance of non-discriminatory actions and fair competition for all sizes and business models of managed care organizations; and be it further

RESOLVED, That the General Assembly should convene the Special Committee on Oversight of Medicaid Managed Care to meet as soon as possible to review the RFP for a Purchase of Care Contract and seek answers from the Director of Healthcare and Family Services, the Procurement Policy Board, the Office of Inspector General, the Illinois Attorney General, and the individual in charge of the Medicaid managed care RFP for a Purchase of Care Contract; and be it further

RESOLVED, That we urge the DHFS to cooperate and participate in this review to avoid the appearance of impropriety and unethical actions related to the RFP for a Purchase of Care Contract process as well as to provide a positive outcome for the residents of Illinois; and be it further

RESOLVED, That suitable copies of this resolution be delivered to the Governor, the Director of Healthcare and Family Services, and all members of the Illinois General Assembly.