In a conference call Feb. 11, AIDS Foundation of Chicago (AFC) hosted a policy-update presentationcomplete with online slide showthat covered everything from the state budget to ADAP (the AIDS Drug Assistance Program).
AFC Director of Government Relations John Peller (with Policy Coordinator Pete Subkoviak) started by discussing the political landscape. He talked about the fact that there are 24 new state House (13 Republican, 11 Democratic) and nine new state Senate (seven Republican and two Democratic) members. "There hasn't really been that much of a landscape shift over there, but what's really different about the [state] Senate now is that [Democrats] used to have a supermajority. If they needed a two-thirds vote they could do it without any Republican support; now they need Republican support in order to do that."
Peller then moved to the budget climate, which he described as "still pretty grim." He talked about how Illinois raised taxes in early January to close a $13 billion deficit, but added that the backlog of unpaid bills is a problem. One solution, which AFC endorses, is Senate Bill 3, which would borrow money from the new tax increase to pay providers. However, Peller added, this bill would need two-thirds of the legislators' support to pass.
He then discussed a diagram from the Institute of Government and Public Affairs at the University of Illinois that showed the deficit ballooning to approximately $30 billion in 2022 without a tax increase. With it, the amount hovers around $5 billion to $10 billion for the next decade or so.
Continuing with the budget, Peller talked about Medicaid "reforms" the state instituted in January (Note: Peller added quotes because he sees some "as more harmful than" helpful.) "One of the changes we're concerned about is requiring people to reapply every [year]. That is going to create chaos in DHS offices where case workers already don't answer the phones because they're so busy," he said.
There are also pension-related changes, such as all new state employees now having 401(k)s instead of getting pensions. Peller described this change as "really important and cost-saving." He also briefly discussed the "budgeting for outcomes" plan, which he admitted did not seem that different from "the old way of doing things." However, the practical change, Peller said, is that "every committee will get a sum of money to allocate as [it] sees fit. ... [This] requires programs, agencies, departments to look and see policy changes."
Spending caps are also in the tax-increase bill and, "as a result, spending can only grow 2 percent a year between 2012 and '15," Peller said. "Obviously, this is going to be a major concern when you take into account the fact that the amount the state has to pay into the pension system increases every year by [approximately] $500 million. So what could happen is that the amount that's needed to contribute to pensions grows and grows, eating into other programs, including [those] we care about. In order to overturn those spending caps, [again] you need a two-thirds supermajority."
Another issue Peller tackled involved retiree health and school health costs. "[They're] going through the roof," he said. "There's a trust fund that pays that's going broke."
Regarding the FY 2012 state budget, Peller revealed that Illinois Gov. Pat Quinn's budget plan (scheduled to be released Feb. 16) will highlight $3.6 billion in cuts from FT '09 levels. The likely reality, Peller said, is that there will be additional cuts in DHS (Department of Human Services) and other programsand that there is will be a likely cap amount of ADAP meds per month (from $2,000 to $1,500). Moreover, the eligibility may be reduced from 500 percent to 300 percent of poverty, although current enrollees would be grandfathered. The big message, according to Peller, is that "We're running out of options and will still need additional state funds."
Lastly, Peller discussed several legislative measures, including the EMS Access Act (SB 1701), which would provide someone possessing a drug partial immunity if that person calls 911 for medical assistance with an overdose. He also talked about a bill that would permit optional HIV testing in Illinois prisons and well as one that would allow condoms in jails.
Another measure, which AFC opposes, would allow prosecutors to access HIV-testing records in criminal transmission cases. According to Peller, the "underlying law is flawed, [as] people can be prosecuted for exposing someone to HIVeven if the person uses a condom."
Incidentally, AFC has released its list of Illinois HIV/AIDS policy priorities. Among them are: prioritizing HIV prevention; improving mental-health and substance-abuse treatment services; increasing the number of healthcare professionals offering high-quality HIV primary and specialty care; focusing on emerging populations; reducing HIV's stigma; proving high-quality HIV services in jails and prisons; and increasing housing access for HIV-positive individuals.