Promises don't sway Kane health care workers fearful of downsizing

With promises from CEOs of private health care providers that they can handle the resultant added caseload, Kane County's plan to downsize its health department appears to be back on the fast track.

Paul Kuehnert, executive director of the county's health department, Tuesday brandished written commitments from the Visiting Nurse Association of Fox Valley and Aunt Martha's Youth Service Center saying they will gladly take over the county's clients. The health department is looking to relinquish its family management caseload because the state is at least $1.5 million behind in payments for services already rendered. Family case management provides access to Medicaid services for about 6,000 low-income young mothers and their babies.

The Greater Elgin Family Care Center is the third organization to which the county plans on shifting services. CEO Robert Tanner was on hand Tuesday to pledge his organization's commitment to not letting any of the 6,000 people fall through the cracks.

"I want to assure you that we are willing and able, as an organization, to accept this responsibility," Tanner said. "We realize it's a significant change. The facts are that we have the space and the capacity and the wherewithal to not only absorb the responsibility, but to competently and professionally execute it."

If the majority of the county board believes that pledge, then the health department would be in place to move ahead with laying off 62 employees and downsizing in about two months. A handful of local doctors and union health department employees again tried to dissuade the county from shifting its programs to private companies. They expressed concerns about the quality of care and ability of the private providers to handle such a large influx of new clients at one time. But as of Tuesday there didn't appear to be any other options on the table.

AFSCME Spokeswoman Carla Williams said the 30 days the county board gave the union and state lawmakers to find the $1.5 million Illinois owes the health department are unlikely to bear fruit. Williams said the county is not assisting with the search. Without the county at least saying it needs the money immediately, the request for emergency funds from the state lacks the necessary weight, Williams said.

Gerald Jones, chairman of the county board committee overseeing the pending health department downsizing, said looking for state money is mostly a waste of time.

"What we would say if they found the money now is, 'Thank you for paying the money that you us,' " Jones said. "Now we're made whole for this year. But what about next year? It's great to have the money you owe us, but if you're still telling us it's six or seven months out before we get our regular payments, then we can't keep going from crisis to crisis."

And Jones said once family case management is transferred over to the three private providers, it's never coming back.

"We would not get case management back unless someone surrendered it," Jones said. "And they are not likely to want to surrender it in the future because it is a revenue source for them."

Just how long it will take to be a revenue source for the private agencies is up for speculation. The groups rely on the same state reimbursements the county receives for the same services. Tanner said federal money flowing to his agency will allow the Greater Elgin Family Care Center enough cushion to deal with up to an eight-month lag on the state payments.