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State's slow payments putting addicts on waiting lists

Posted November 29, 2007 10:00 pm

Dean Olsen

Illinois substance-abuse treatment centers are suffering through the worst backlog of state payments in at least eight years while Gov. Rod Blagojevich diverts $400 million from state coffers - not to pay the centers, but to expand health-care coverage for poor adults and middle-income families.

That situation frustrates Stephen Knox, chief executive of Springfield's not-for-profit Triangle Center, which hasn't received a substantial payment from the state since mid-August.

"The governor is on the road, trying to expand health-care programs in Illinois," Knox said Thursday. "I would like to remind him that alcohol and drug care is health care. The debt needs to be paid down before you expand."

Triangle, a 47-year-old agency based at 120 N. 11th St., serves 1,700 adult and adolescent clients a year with inpatient and outpatient services to combat substance abuse. It gets about 60 percent of its funding through a direct contract with the Illinois Department of Human Services.

Triangle is owed almost $700,000 in state funding, or 22 percent of its $3.2 million annual budget, Knox said.

The backlog is the worst Knox has seen in his 20 years at Triangle, which has obtained a line of credit from a bank to survive the shortfall and now must ask for that line to be extended.

"In effect, we're subsidizing the state's activities," he said, adding that the backlog and lack of a cost-of-living rate increase have contributed to a growing waiting list for Triangle's services.

"I haven't thought of expansion for three or four years because it's just impossible," Knox said.

The average wait at Triangle is 60 days. When people with drug and alcohol addictions want treatment but must wait, they are at high risk of medical problems, drunken driving, domestic abuse and suicide, Knox said.

Because of the financial strain, Triangle hasn't been able to give its 70-member staff a general pay raise for four years.

"That's put a real strain on the organization," Knox said.

Like Triangle, most of the state's 130 treatment centers are waiting at least 60 days to be paid by the state for serving low-income clients, said Peggy Powers, chief operating officer of the Springfield-based Illinois Alcoholism and Drug Dependence Association.

The centers, which depend on the state for $163 million a year in direct funding, are waiting for $27 million of the total, she said.

They are getting loans to meet payroll, dipping into their reserves and seeing their own waiting lists grow, she said.

"The system is in a health-care crisis," she said.

The cash-flow problem has caused one Chicago-area agency to lay off five people, Powers said.

The association, she said, supports the concept behind Blagojevich's Illinois Covered program. The governor is putting in place parts of the plan - including a FamilyCare expansion and a new program called Illinois Covered Assist for childless adults - despite the plan's failure to receive General Assembly approval this year.

But Powers said existing health-care providers should get help before state money is spent on expansion.

She noted that the $400 million budget diversion made by Blagojevich this summer to fund parts of Illinois Covered this fiscal year included $6.6 million that would have given substance-abuse treatment providers a 3 percent rate increase - their first boost in five years.

"It's absurd to cut health care to bolster health care," she said.

Rikeesha Cannon, spokeswoman for the Department of Human Services, declined to comment on the statements by Knox and Powers about Illinois Covered's funding.

Cannon referred a State Journal-Register reporter to another agency controlled by the governor, the Department of Healthcare and Family Services. Spokeswoman Ruth Igoe didn't return two telephone messages Thursday.

It's unclear why drug treatment centers are seeing long delays in payments. These providers also receive Medicaid payments from the state, but the longest delays are occurring in their direct-contract payments, which don't come from Medicaid.

Health-care providers that depend on Medicaid - including hospitals, doctors and pharmacists - aren't experiencing any unusual delays, according to various groups that represent them.

Cannon said the Human Services department is processing payment requests from treatment centers within five days and forwarding those requests to Comptroller Daniel Hynes' office, where payment checks are written.

Hynes' office, which processes bills based on revenue available in state coffers, is mailing out checks to state vendors - including treatment centers - up to 36 days after receiving bills from state agencies, Hynes spokesman Alan Henry said.

That backlog isn't any longer than at the same time last year, according to Henry.

The payment cycles reported by Human Services and the comptroller don't explain the long delays, Powers said.

She said the backlogs may start affecting other organizations that depend on state funds if predictions come true about a potential slowdown in state tax receipts.

Cannon said she doesn't know the reason for the payment delays reported by treatment centers.

"DHS is doing its part … to make sure providers are getting paid on our end," she said. "Our commitment, the administration's commitment, to the existing health-care network - that includes treatment providers - is solid."

State Sen. Larry Bomke, R-Springfield, a frequent critic of the Democratic governor, said he isn't surprised that the Blagojevich administration can't come up with a reason for the delays.

"It's typical," Bomke said. "They don't want to explain it. We're not in any position to expand programs at the expense of current programs."

Dean Olsen can be reached at (217) 788-1543 or dean.olsen@sj-r.com.

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