What a charlie foxtrot Illinois is

[ProwlerturnGas]

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Just looked into getting a illinois license. Some financial tiff between Illinois Medical Society and Professional licensing? Told that it would take 18-24 months for a license? Anyone else ran into this? Currently practicing could experience delays and may not renew on time?

Wow

 

[pie944]

Just looked into getting a illinois license. Some financial tiff between Illinois Medical Society and Professional licensing? Told that it would take 18-24 months for a license? Anyone else ran into this? Currently practicing could experience delays and may not renew on time?

Wow

Heard that from someone going there this summer for ophthalmology fellowship. I believe she was told 12-18 months around 4-6 weeks ago.

 

[geogil]

I have heard the same thing from the pain fellows here who are looking to work in Illinois

 

[Meds1]

what can be done about this?

http://www.idfpr.com

 

[chessknt]

Typical Chicago--extortion for more money. We didnt get more money for "rising costs" that we do not care to explain? I guess we'll just have to barely fulfill our purpose and put a huge portion of physicians in this state out of work by our immense inefficiency. Or you could give us that money.

 

[Arch Guillotti]

Here's a copy of the letter that was apparently sent out:

This a copy and paste from sermo.

Dear Healthcare Provider:
Please be advised that effective January 15, 2013, the Department of Financial and Professional Regulation’s Medical Unit (“Department”) will reduce its head count from 26 to eight employees. The
Department has worked tirelessly to avoid these lay-offs, which will negatively impact the medical profession.
Beginning in the summer of 2012 and continuing through January 8, 2013, the Department repeatedly
informed the Illinois State Medical Society (“ISMS”) that it required an infusion of $9.6 million to avoid
the significant reduction in personnel. On multiple occasions, the Department informed ISMS of the dire
consequences of allowing these layoffs to occur -- delays between 12 and 18 months to process a
medical license and severe constraints to the Department’s ability to prosecute physicians who pose a
risk to the health and safety of Illinois citizens.
Despite these calamitous consequences, ISMS actively lobbied against a bill to preserve the
Department’s Medical Unit; the proposed bill would have allocated the required $9.6 million enabling
the Medical Unit to maintain its 26 employees. Although the Department will now have significantly
less resources, it will continue to prioritize and protect the welfare of the citizens of Illinois to the best of
its ability.
Physicians’ fees have remained the same since 1987. Since this time, the Department’s required costs
have approximately doubled. Due to these rising costs, the Department spends approximately $1.8
million more in responsibly administering the mandated duties of the Medical Practice Act than it
collects from the licensing fees paid by physicians.
As a direct result of ISMS’ actions, the layoffs will occur. Please be further advised that the Department
will have one employee to handle all physician licensing requests in Illinois. Licenses for new
physicians and for physicians transferring to Illinois will take between 12 and 18 months to process.
Graduating medical students seeking to match with hospitals in Illinois will experience the same delays.
Currently licensed physicians will need to renew their licenses in 2014, and will experience delays of up
to 18 months to renew their license. Physicians’ current licenses will almost certainly expire before a
renewal can be processed. It is unlawful for anyone to provide medical services without holding a valid
medical license.
Physicians may wish to contact their employer, affiliated hospital(s), and insurance company to make
the necessary preparations in advance of the lengthy licensing delays. Nurses, physicians’ assistants,
pharmacists, and other healthcare professional may wish to discuss this situation with any physicians
with whom they affiliate, as it may affect their ability to provide services to these physicians.
Sincerely,

Manuel Flores Jay Stewart
Acting Secretary Director

 

[Noegrus]

Typical Chicago--extortion for more money. We didnt get more money for "rising costs" that we do not care to explain? I guess we'll just have to barely fulfill our purpose and put a huge portion of physicians in this state out of work by our immense inefficiency. Or you could give us that money.

They are standing up for their employees. It is a good thing, ya know. Everything isn't black and white. Threats work in politics.

 

[chessknt]

They are standing up for their employees. It is a good thing, ya know. Everything isn't black and white. Threats work in politics.

It is one thing to stand up for your employees, another to essentially render the institution inefficient to the point of nonexistence with enormous consequences for the entire field. How many people will lose their jobs if this bluff gets called?

 

[ProwlerturnGas]

I grew up in Illinois. I shouldn't be surprised.....I feel bad for the physicians in Illinois that have to deal with this. In the future, maybe it is wise to keep more than one state license.

 

[countingdays]

Here's a copy of the letter that was apparently sent out:

This a copy and paste from sermo.

Dear Healthcare Provider:
Please be advised that effective January 15, 2013, the Department of Financial and Professional Regulation’s Medical Unit (“Department”) will reduce its head count from 26 to eight employees. The
Department has worked tirelessly to avoid these lay-offs, which will negatively impact the medical profession.
Beginning in the summer of 2012 and continuing through January 8, 2013, the Department repeatedly
informed the Illinois State Medical Society (“ISMS”) that it required an infusion of $9.6 million to avoid
the significant reduction in personnel. On multiple occasions, the Department informed ISMS of the dire
consequences of allowing these layoffs to occur -- delays between 12 and 18 months to process a
medical license and severe constraints to the Department’s ability to prosecute physicians who pose a
risk to the health and safety of Illinois citizens.
Despite these calamitous consequences, ISMS actively lobbied against a bill to preserve the
Department’s Medical Unit; the proposed bill would have allocated the required $9.6 million enabling
the Medical Unit to maintain its 26 employees. Although the Department will now have significantly
less resources, it will continue to prioritize and protect the welfare of the citizens of Illinois to the best of
its ability.
Physicians’ fees have remained the same since 1987. Since this time, the Department’s required costs
have approximately doubled. Due to these rising costs, the Department spends approximately $1.8
million more in responsibly administering the mandated duties of the Medical Practice Act than it
collects from the licensing fees paid by physicians.
As a direct result of ISMS’ actions, the layoffs will occur. Please be further advised that the Department
will have one employee to handle all physician licensing requests in Illinois. Licenses for new
physicians and for physicians transferring to Illinois will take between 12 and 18 months to process.
Graduating medical students seeking to match with hospitals in Illinois will experience the same delays.
Currently licensed physicians will need to renew their licenses in 2014, and will experience delays of up
to 18 months to renew their license. Physicians’ current licenses will almost certainly expire before a
renewal can be processed. It is unlawful for anyone to provide medical services without holding a valid
medical license.
Physicians may wish to contact their employer, affiliated hospital(s), and insurance company to make
the necessary preparations in advance of the lengthy licensing delays. Nurses, physicians’ assistants,
pharmacists, and other healthcare professional may wish to discuss this situation with any physicians
with whom they affiliate, as it may affect their ability to provide services to these physicians.
Sincerely,

Manuel Flores Jay Stewart
Acting Secretary Director

So only 1 of 8 employees handles physician licensing.
It's 9.6 million dollars to keep 18 employees.
How much to keep 1 or 2 more to handle physician licensing?

 

[cchoukal]

I don't know anything about how this office is funded, but if they don't have the money to pay the people to do the work, what do you all expect them to do? Maybe it's a bluff (what do they think is gonna happen in July when all those interns show up without licenses?), but it's the 31st, so it would seem that these people have already been laid off (as opposed to being threatened with layoff after the 15th if funding isn't restored).

Incidentally, this sounds like the kind of waste-cutting, small-government that a lot of the fiscal conservatives on this board would celebrate, if only it didn't affect them individually.

 

[bearfan99]

This is frightening for those of us with post residency jobs in Illinois starting this July. It normally takes 3-5 months for an Illinois license and they are already 6 weeks backlogged. Best case scenario means a July license for those with applications already sent in.

 

[NightNight]

I don't know anything about how this office is funded, but if they don't have the money to pay the people to do the work, what do you all expect them to do? Maybe it's a bluff (what do they think is gonna happen in July when all those interns show up without licenses?), but it's the 31st, so it would seem that these people have already been laid off (as opposed to being threatened with layoff after the 15th if funding isn't restored).

Incidentally, this sounds like the kind of waste-cutting, small-government that a lot of the fiscal conservatives on this board would celebrate, if only it didn't affect them individually.

I am also unfamiliar with this office or Chicago 🙂scared🙂, however, I think what that might actually look like would be, instead of holding every physician in the state hostage for your "required" $10 mil, you really examine your office and see what fat can be trimmed (this would be the waste-cutting) so that you could still perform your fairly significant duties of public office with a more limited budget.

 

[pgg]

So only 1 of 8 employees handles physician licensing.
It's 9.6 million dollars to keep 18 employees.
How much to keep 1 or 2 more to handle physician licensing?

$9.6 million for 18 employees? They're really paying clerks $533K/year to process applications? What am I missing? Is that $9.6 million a 10 year figure? Are some of those 18 people highly paid professionals who don't process applications?

What does it cost to get licensed in Illinois?

Physicians’ fees have remained the same since 1987.

Maybe fees should have increased to keep pace with actual licensing costs. 25-years of escalating costs but no changes in the fees to support those costs suggests that the agency's insolvency wasn't a sudden, unpredictable consequence.

Due to these rising costs, the Department spends approximately $1.8 million more in responsibly administering the mandated duties of the Medical Practice Act than it collects from the licensing fees paid by physicians.

Sounds like this crisis has been brewing a long, long time.



When I initially got my CA license, it was during some budget disputes and The Governator had furloughed many state employees (I think) 1 day per week. It took 7 months to process my license application (to the tune of $1500+ IIRC), but they got it done.

18-24 months is ridiculous.

 

[notinkansas]

I don't know anything about how this office is funded, but if they don't have the money to pay the people to do the work, what do you all expect them to do? Maybe it's a bluff (what do they think is gonna happen in July when all those interns show up without licenses?), but it's the 31st, so it would seem that these people have already been laid off (as opposed to being threatened with layoff after the 15th if funding isn't restored).

Incidentally, this sounds like the kind of waste-cutting, small-government that a lot of the fiscal conservatives on this board would celebrate, if only it didn't affect them individually.

Actually, no. It is an example of the natural consequence of a bloated, union thug dominated, over reaching, out of control progressive government.

 

[cchoukal]

Actually, no. It is an example of the natural consequence of a bloated, union thug dominated, over reaching, out of control progressive government.

Are employees of the licensing board unionized?

 

[Per4mer8]

actually, no. It is an example of the natural consequence of a bloated, union thug dominated, over reaching, out of control progressive government.

+1

 

[Stank811]

Is it standard procedure that a society of any kind has to infuse the state govt with money to pay employees of the state to do a job required by the state....what am I missing. Sounds similar to when the governor of WI attempted to take 200million dollars from a state trust set up by WI physicians designed to help pay for medical malpractice cases. The governor used the 200 million to help pay down the budget deficit which was thankfully overturned by the US supreme court.

 

[chessknt]

Are employees of the licensing board unionized?

The more accurate question is: Are employees of the Dept of Financial and Professional Regulation unionized? Are any employees of the government in Illinois not unionized?

 

[heronmd]

http://www.isms.org/NewsRoom/newsreleases/Pages/MedicalLicensure.aspx

Legislation Introduced to Avert Medical Licensure and Discipline Crisis
Medical society backs measure to restore funding for IDFPR Medical Unit

FOR IMMEDIATE RELEASE FOR INTERVIEWS CONTACT:
January 30, 2013 John Maszinski
312-580-6440
312-608-3620

Chicago, IL –The Illinois State Medical Society urges General Assembly support for House Bill 1001, which restores previously swept monies to the Medical Disciplinary Fund. Recently, the Illinois Department of Financial and Professional Regulation (IDFPR) reassigned Medical Unit employees to other positions due to a Medical Unit funding shortage. The lack of staff has caused a backlog in new medical licensure applications. Further threatened is Illinois residency matching for the approximately 2,500 medical school graduates expected to begin training in our hospitals later this year. This bill restores IDFPR Medical Unit funding, secures necessary future revenue, and provides stability to Illinois' medical practice environment.

"ISMS urges quick passage of H.B. 1001," said Society President William N. Werner, MD. "Without immediate action, Illinois stands to lose physician recruits and medical residents who are interested in training here. Graduating medical students are currently ranking their preferences for medical residency positions that begin this summer."

ISMS is extremely concerned that many students will opt for out-of-state placements leaving Illinois residency positions unfilled. Residents provide direct patient care during training and their loss will diminish health care access."

ISMS-backed H.B. 1001 will:

Transfer $9.6 million from the General Revenue Fund to the Medical Disciplinary Fund to return previously swept monies that were used to finance other state programs. This funding enables the IDFPR Medical Unit to fully operate until new licensure revenues are received in 2014,
Increase physician initial licensure and renewal fees to $500 (a 67% increase) to ensure that the Medical Unit is well-funded in the future, and
Extend the sunset date of the Medical Practice Act for 10 years for consistency with other regulated professions.

Dr. Werner added, "The consequences of inaction are too great. ISMS urges quick consideration for H.B. 1001, which will reopen Illinois for physicians seeking to provide medical care here."

ISMS is a professional membership association representing 11,000 physicians practicing in all medical specialties statewide. Dr. Werner is a Chicago internal medicine specialist.

 

[periopdoc]

$9.6 million for 18 employees? They're really paying clerks $533K/year to process applications? What am I missing? Is that $9.6 million a 10 year figure? Are some of those 18 people highly paid professionals who don't process applications?

What does it cost to get licensed in Illinois?Maybe fees should have increased to keep pace with actual licensing costs. 25-years of escalating costs but no changes in the fees to support those costs suggests that the agency's insolvency wasn't a sudden, unpredictable consequence.

Sounds like this crisis has been brewing a long, long time.

As I understand it, the IDFPR Medical Unit is funded by the Medical Disciplinary Fund which is entirely funded by physician licensing fees. I am fairly certain that this is the only source of funding for the IDFPR Medical Unit, but the Illinois budget report is pretty dense and I could be reading it incorrectly.

The IDFPR claims that the annual cost of doing business is $1.8 million greater than the annual income from physician licensing fees the cost of which has not increased since 1987. If I am reading the 2012 Illinois State Budget correctly, the Medical Unit budget is $4.687 million per year.

There was a fund surplus of $8.9 million over the past several years, but this was "swept up" into the general budget by previous administrations.

The Illinois State Medical Society has resisted any increase in fees that is predicated on the idea that the money which was "swept" from the fund should be restored by physician licensing fees. They are willing to, and in fact have a bill pending that would, increase fees to cover the $1.8 million per year deficit, but they feel that the missing funds should be restored from the general fund, not additional licensing fees. Current licensing cost in Illinois is $100 per year and the proposal would increase that to $166.

I believe that the $9.6 million figure comes from the combination of the $8.9 million of swept funds and the additional $1.8 million needed to fund the department this year (with rounding errors).

Looking at the budget info, the highest paid employee of the IDFPR is the director at $125,500.

Any corrections to the above are appreciated.


THE IDFPR has said, regarding the retained employees, "The remaining eight jobs likely will include three attorneys, one medical coordinator, two or three investigators and one licensing position.."

The ISMS memorandum regarding the issue and HB 1001

Either way, I would have second thoughts about where I ranked any Illinois residency slot until this is resolved.

- pod

 

[Consigliere]

I knew they'd introduce some legislation that would restore funding. There is NO WAY they are going to allow tens of thousands of physicians to go unlicensed.

 

[heronmd]

Current licensing fee is $300, NOT the $100 reported by the Chicago Tribune. The fee will go to $500 per the new legislation. This is for a 3 year licensing cycle.

 

[periopdoc]

Current licensing fee is $300, NOT the $100 reported by the Chicago Tribune. The fee will go to $500 per the new legislation. This is for a 3 year licensing cycle.

The Chicago Tribune is accurate in that they are talking about the per year cost for a license ($300/3). They should have been more clear about the fact that it is a 3 year licensing cycle which is 3 years for $300.

It isn't misleading per se, but they could be more precise.

-pod

 

[countingdays]

The Chicago Tribune is accurate in that they are talking about the per year cost for a license ($300/3). They should have been more clear about the fact that it is a 3 year licensing cycle which is 3 years for $300.

It isn't misleading per se, but they could be more precise.

-pod

$300 to process per license, the vast majority of which are new grads or renewals; and somebody above acted like this fiasco is an argument for big government. 😆 😆 😥

 

[urge]

This is frightening for those of us with post residency jobs in Illinois starting this July. It normally takes 3-5 months for an Illinois license and they are already 6 weeks backlogged. Best case scenario means a July license for those with applications already sent in.

Mine took like 3 weeks. Fastest license ever. It was a few yrs ago.

With FCVS I don't see what is the deal with state medical boards. I don't even know why they charge the outrageous fees they used to charge when they had to do the verification themselves. They don't do anything nowadays (for new licenses). Just check the requirements are fulfilled and approve the license. Shouldn't take more than 10 min per applicant. Shouldn't be more than $50 either.

 

[urge]

Here's a copy of the letter that was apparently sent out:

This a copy and paste from sermo.

Dear Healthcare Provider:
Please be advised that effective January 15, 2013, the Department of Financial and Professional Regulation’s Medical Unit (“Department”) will reduce its head count from 26 to eight employees. The
Department has worked tirelessly to avoid these lay-offs, which will negatively impact the medical profession.
Beginning in the summer of 2012 and continuing through January 8, 2013, the Department repeatedly
informed the Illinois State Medical Society (“ISMS”) that it required an infusion of $9.6 million to avoid
the significant reduction in personnel. On multiple occasions, the Department informed ISMS of the dire
consequences of allowing these layoffs to occur -- delays between 12 and 18 months to process a
medical license and severe constraints to the Department’s ability to prosecute physicians who pose a
risk to the health and safety of Illinois citizens.
Despite these calamitous consequences, ISMS actively lobbied against a bill to preserve the
Department’s Medical Unit; the proposed bill would have allocated the required $9.6 million enabling
the Medical Unit to maintain its 26 employees. Although the Department will now have significantly
less resources, it will continue to prioritize and protect the welfare of the citizens of Illinois to the best of
its ability.
Physicians’ fees have remained the same since 1987. Since this time, the Department’s required costs
have approximately doubled. Due to these rising costs, the Department spends approximately $1.8
million more in responsibly administering the mandated duties of the Medical Practice Act than it
collects from the licensing fees paid by physicians.
As a direct result of ISMS’ actions, the layoffs will occur. Please be further advised that the Department
will have one employee to handle all physician licensing requests in Illinois. Licenses for new
physicians and for physicians transferring to Illinois will take between 12 and 18 months to process.
Graduating medical students seeking to match with hospitals in Illinois will experience the same delays.
Currently licensed physicians will need to renew their licenses in 2014, and will experience delays of up
to 18 months to renew their license. Physicians’ current licenses will almost certainly expire before a
renewal can be processed. It is unlawful for anyone to provide medical services without holding a valid
medical license.
Physicians may wish to contact their employer, affiliated hospital(s), and insurance company to make
the necessary preparations in advance of the lengthy licensing delays. Nurses, physicians’ assistants,
pharmacists, and other healthcare professional may wish to discuss this situation with any physicians
with whom they affiliate, as it may affect their ability to provide services to these physicians.
Sincerely,

Manuel Flores Jay Stewart
Acting Secretary Director

Sounds like they plan to screw a lot of physicians on purpose because some were fired.

 

[BigLawChicago]

For one, the IDFPR is an executive agency of the State of Illinois. It is under the executive branch of the Illinois State Government. The funding, appropriations, monetary control, and executive mission/allowance is decided purely by the Illinois Legislative bodies, with a power of veto vested in the Governor of Illinois. The budget of the Medical Unit comes from a fund that is wholly controlled by legislation, and IDFPR has no hand in curating. The fund is populated every 3 years by licensing fees from doctors (the vast majority of funding), fines from prosecutions cases, and by cash injection when needed (rare). This fund covers license issuing, investigations, and prosecutions in the medical unit. The "surplus" that can be seen in the budgets are not a surplus per se, but is a result of the fee being collected every 3 years. No organizations, certainly no private organizations, contribute any money to this fund, and no infusions of any kind have ever been brought in from ISMS, the public, or any other source except the legislation, the Governor, and through fines and fees.

The Illinois State Medical Society (ISMS) is an interest group, and lobbying membership organization comprised of Illinois medical professionals. ISMS expended a great deal of effort and money lobbying against a bill providing two items that IDFPR needed to keep employment levels. These items were a cash injection of almost $10 Mil and an increase in the licensing fee for Illinois Medical Professionals. ISMS based their efforts on the idea that IDFPR's financial issues were a result of a "sweep" which is when a governor pulls cash funds out of one agency and injects it into another. There were many sweeps, both in and out of IDFPR, performed by our previous Governor, who is now in prison. Our current Governor has not performed a single sweep. The only sweep that affected the Medical Unit at IDFPR, the sweep that ISMS is complaining about, was a sweep performed in support of ISMS's lobbying efforts, to pay backlogged Medicare invoices to Illinois doctors. The licensing process is not a 10 minute process, and is not cheap. Yes, for the vast majority of license renewals, the process it is mostly automated, but for every new license, every license with an exception, and every license with any sort of discipline or other circumstances, the process is slow and expensive.

The IDFPR is not bluffing with layoffs or using layoffs as a tactic. These people were laid off, and the positions are now permanent vacancies. There is no "fat" to trim, as this fund is primarily a personnel payroll fund, and if there's no money, there's no paychecks. The IDFPR has no power to pull money from other Units within its control, and if the Legislation doesn't give the money, the layoffs stay in effect. no one is trying to screw any physicians, this is a problem that has been brewing for some time, that IDFPR has been vocal about, but that many lobbying organizations have continually, purposefully tanked solutions.

IDFPR is between 96 and 98% unionized at any given time, and all of the positions included in the Medical Layoff were unionized positions. Of the remaining employees, only 1, the Medical Coordinator, is non-union. None of the Medical Board members are unionized, and these positions are not employed, per se, by IDFPR.

Without a solid solution, both the case injection and the increase in the fee, the medical licensing process in Illinois will collapse. Delays for licenses will get to the point that Illinois will no longer have a competitive medical market, and residency programs will either end or be put on hiatus. While those are big issues, it is far scarier that the investigations and prosecutions staff have been cut drastically as well. The State's ability to regulate licensed doctors and to prosecute doctors is a vital aspect of IDFPR.

While there are a few options on the table and all parties are working together to some extent, a solution needs to come now and it needs to be comprehensive. I won't give you the "contact your legislator" spiel, but you should understand that only the legislators can solve this problem.

 

[Per4mer8]

I find it interesting that it is not the fact that Illinois may lose the ability to license new Docs or train new Docs that scares you but the idea that the investigation and prosecution of Docs may be impacted. :/

 

[ProwlerturnGas]

After reading BigLaw's post...I stand by the title of this thread. I think I'll steer clear of Illinois. The overall tone speaks loudly to me.....adversarial.

 

[BigLawChicago]

I find it interesting that it is not the fact that Illinois may lose the ability to license new Docs or train new Docs that scares you but the idea that the investigation and prosecution of Docs may be impacted. :/

I believe this is a bit of a misreading of my post. I find the entire situation scary. I use the relative term "scarier" to express just that.

My reason for thinking the investigations and prosecutions losses are of more concern are twofold. First, knowing what I know, having seen what I've seen, I can say that IDFPR's role in revoking licenses from professionals and its ability to investigate complaints from the public is absolutely essential to the protection of the Illinois public. Second, there will be a substantial amount of lobbying and effort, from very well funded sources, to get the licensing issuing process back on track. Once a large hospital sees that it might have to shut down its residence program, their outrage will get the Legislators' attention overnight. There will not be such a push to save the investigations and prosecutions process, because there is no lobbying money. My fear is that there will be a band-aid solution that will bring back licensing employees and not other, necessary employees.

 

[periopdoc]

. The only sweep that affected the Medical Unit at IDFPR, the sweep that ISMS is complaining about, was a sweep performed in support of ISMS's lobbying efforts, to pay backlogged Medicare invoices to Illinois doctors. The licensing

Could you expand on this a little more? I have heard this claim made, but haven't heard any details.

I agree that "surplus" is an imprecise term in this situation, but I'm not sure what term to use to describe it. There was money in the account that was budgeted to pay the bills (less than was necessary apparently) and this was swept. Not exactly a surplus, but what would you call it?

Are my numbers above fairly close to accurate?

Thanks

-pod

 

[BigLawChicago]

The medical fund budget is, by nature, cyclical. There is very rarely a "surplus," but because of the cyclical nature, there is a "reserve" that is created every 3 years upon collection of the licensing fee. That reserve is essentially 3 years worth of operating costs, at 1986 (the year the budget for the 1987 licensing fee was based around) levels. The money is held in a cash fund and is approrpiated, per annum, into the medical fund. Across IDFPR there have been enormous reductions in operating costs, in general, since 1987, but the overall cost has increased.

Sweeps are done into "GRF" or general funds. So technically, there was a perceived surplus (which was really just a cyclical reserve), that surplus was removed into a GRF for use in other places. In reality, Illinois needed money to pay its Medicare bills, legislators care more about "now" than "later," so the money was taken.

As far as the dollar values, I don't know how much was swept. I don't even know where I would find that information, I'd imagine only the Illinois Comptroller or Office of the Governor would have that available. The operating costs are about $1.8 Mil greater than the money generated by the licensing fee. There are also fines and other administrative revenues, but these are relatively insignificant. The Medical budget is about $4-4.5 Mil annually. You can get a better idea of the I/O on the fund on page 2-43 of the 2012 Illinois Budget. Though not the greatest website in the world, you can check out http://accountability.Illinois.gov for the expenditures.

 

[periopdoc]

Is that a 1.8 million per year shortfall or a 1.8 million per 3-year shortfall?

Even the term reserve doesn't work to well, although it is much better than surplus. You aren't going to keep a politicians hands off of a reserve or a surplus in the Illinois environment.


- pod

 

[BigLawChicago]

I believe the $1.8 Mil is every 3 years, or $600k per year. I am not 100% sure on that.

Yes, reserve isn't a very good term either, but that's the term I've heard. The State Comptroller would call it a "cash balance," but that's even less accurate, because it is not a balance, it is a holding. From the perspective of the "account" that hold the money, it's a balance. Truthfully, it doesn't make any specific sense to budget on an annual basis for something that is paid in 3 year cycles, but the expenditures are typically calculated by the year.

I would generally agree that any unused money very would typically get snatched up in Illinois, and in the past that has been the case, but in the last few years, under the Quinn administration, I'd say everyone has been pretty impressively responsible with the budget. I credit, primarily, Pat Quinn the Governor, but the State Treasurer's office, the Comptroller's office, and the Office of the Executive Inspector General have all played a major role in maling some very difficult but necessary decisions. I'm not naive enough to think that Illinois Politics have changed in any meaningful way, but, in the recent short run, it's been head and shoulders above its reputation.

 

[periopdoc]

What's your take on HB 1001? Seems like a pretty good way to get things back on track.

Oh and were the employees really laid off? Seems to me they were transferred to other governmental positions.

- pod

 

[BigLawChicago]

HB 1001 is a good start. Personally I think the licensing fee needs to be set up on a progressive schedule. There's no reason to sunset a bill in 10 years and write it to be flat. If the fee increased (say, for example, 10% every 3 years), that would be superior to a flat rate hike. I don't know if the 66% is the correct increase, but I do know that Illinois has one of the lowest medical licensing fees in the country.

Yes, the employees were laid off. The Collective Bargaining Agreement between the State and AFSCME (the Union that represents the laid off employees) provides, in Article XX, Section 3 (c)-3(j), that employees can transfer or take voluntary reductions in lieu of layoff. The employees exercised these rights. This has nothing to do with the fund or the IDFPR, this is a contract provision for all AFSCME member employees that work for Illinois.

 

[bedrock]

Is it standard procedure that a society of any kind has to infuse the state govt with money to pay employees of the state to do a job required by the state....what am I missing. Sounds similar to when the governor of WI attempted to take 200million dollars from a state trust set up by WI physicians designed to help pay for medical malpractice cases. The governor used the 200 million to help pay down the budget deficit which was thankfully overturned by the US supreme court.

WOW. Glad they won and established some kind of precedent.

 

[periopdoc]

So, they weren't laid off... They exercised their right to transfer to another position.

Still interested in hearing more details about the ISMS lobbying to sweep from the Disciplinary Fund to pay for the Medicare backlog.

- pod

 

[BigLawChicago]

Well, probably pure semantics, but the were laid off from their jobs. If you're asking if they are unemployed now, the answer is no. It is nearly impossible for a government employee in a unionized position to lose their job all together. Many of them are in lower position titles and lower classifications.

As far as ISMS's lobbying, I have only heard that second hand. I wish I could be more specific, but I don't know the details. I'm not necessarily saying that ISMS is responsible in any way for the sweep, just that it's not like this was some shady dealing done behind their back. It was the State that failed to budget properly for the Medicare invoices, but the problem was "solved" then, just as this problem needs to be solved now.

 

[chessknt]

Well, probably pure semantics, but the were laid off from their jobs. If you're asking if they are unemployed now, the answer is no. It is nearly impossible for a government employee in a unionized position to lose their job all together. Many of them are in lower position titles and lower classifications.

As far as ISMS's lobbying, I have only heard that second hand. I wish I could be more specific, but I don't know the details. I'm not necessarily saying that ISMS is responsible in any way for the sweep, just that it's not like this was some shady dealing done behind their back. It was the State that failed to budget properly for the Medicare invoices, but the problem was "solved" then, just as this problem needs to be solved now.

Idk what field you are in, but to the vast majority of everyone being laid off=being unemployed. Switching to a different position is not being laid off. What you call semantics is an important distinction--they want to make it sound like these poor people have joined the legion of unemployed because they were laid off due to the evil ISMS lobby against the funds they needed to stay employed. This is not the case.

 

[BigLawChicago]

Idk what field you are in, but to the vast majority of everyone being laid off=being unemployed. Switching to a different position is not being laid off. What you call semantics is an important distinction--they want to make it sound like these poor people have joined the legion of unemployed because they were laid off due to the evil ISMS lobby against the funds they needed to stay employed. This is not the case.

From the contract governing employment in the affected positions, Article XX "Layoff", Section 3. "Bumping":
a) An employee who is subject to layoff is defined as
that employee who is scheduled to be laid off by
the employing Agency or removed from their
position, even though they still may be on the
Agency's payroll.

They are laid off. By any accurate definition. Many people misuse the term laid off, but it is a term that comes from union contracts, and it has a very specific meaning. There is a big difference between a layoff, a reduction in forces, a discharge, a discharge for cause, and the many many other means of separating an employee. The fact that there is a contract provision that allows union members to land another job is irrelevant. No one that is unionized, and I mean no one, becomes unemployed in Illinois Government employment.

This is not about those employees and their jobs, any such argument is emotional rhetoric. While it's never good for people to lose their jobs, it is the service they provided that is the problem in this case. ISMS didn't lobby for people to lose their jobs, ISMS lobbied to prevent a licensing fee increase. The result was the loss of essential services. The fact is, some of the employees are now in better jobs, some are in very similar jobs, and some are in worse jobs. That's not really all that important. Realistically, a few dozen jobs mean nothing, but the tens of thousands of licenses those jobs support, those matter.

 

[periopdoc]

Well you are using even worse political semantics to claim the ISMS lobbied against fee increases. They did not.

They lobbied against using licensing fees as a retroactive revenue stream for the general fund in the form of repopulating what was swept from the disciplinary fund. Their opposition was due to the fact that the fee increase that was being requested was to pay back the approximately $8.9 million that was swept from the disciplinary fund, not the fee increases that were necessary to fill the $1.8 million shortfall.

Do you really believe that licensing fees should be used (even retroactively) as a revenue stream for the general fund? Would it even be legal?

Clearly the State is at fault in the swept funds, not the IDFPR nor IDFPR employees, but to lay this on the backs of ISMS, or even paint them as complicit in the sweep, seems to be a pretty big fairy tale. Lots of folks claiming they heard from someone else that the ISMS was complicit, but no first hand accounts of exactly how they were complicit. No news stories of ISMS lobbying for Medicare backlog payments from the general fund. It may be true, but I can't find anything to support this supposition.

And yes, there may be union legalese in the exact definitions of laid off, but in common usage, it means now unemployed. You know this, your union buddies know this, but it isn't going to keep you from misleading people by purposely using the term in a way to garner sympathy.

I could be equally "accurate" and state that these individuals, after discovering some financial problems with the division, requested and were granted reassignment to another division within the government.

If you care for accuracy, reassignment would be a much more specific and correct term, and would convey to the public what actually happened. Leave the mechanistic legalese for the union lawyers negotiating with the city lawyers.

- pod

 

[chessknt]

I truly wonder if people have their heads so far up their own profession's ass to actually think that way, or if they know it and are just doing it to be annoying.

 

[periopdoc]

To be clear, I have no problem with funding the licensing and discipline of a profession by the state government with fees generated from licensing the professionals in that field.

What I have a problem with is the idea that it is legitimate to increase fees for any reason except that the cost of administering the program has increased. I specifically have problems with the following attitudes.

• Let's charge them more because if they were in another state they would be paying more. Why should they pay less here.
• They are doctors and they can afford it.
• Let's use it as a backdoor tax on the rich. We will use licensing fees as a revenue stream for the general fund.

- pod

 

[periopdoc]

Ran the numbers and realized the IDFPR proposal would have cost physicians closer to $18.6 million for repayment of swept and borrowed funds PLUS the monies needed to go forward.

No wonder you didn't have specific numbers that you wanted to share with us.

The *****ic thing is the whole all physician's licenses have to be renewed in the same year idea. Just go to a rolling renewal like most states and the problem of reserve, surplus, whatever you want to call it is solved.

What a hellhole of a state. Last in job creation, asinine gun laws, horrendous gun violence in the main city, probably the second most dysfunctional and corrupt state government.

No thanks.

- pod

 

[pgg]

What a hellhole of a state. Last in job creation, asinine gun laws, horrendous gun violence in the main city, probably the second most dysfunctional and corrupt state government.

NY and IL are doing their best to outdo CA of late.

 

[BigLawChicago]

When I say that the employees were laid off, I mean they were laid off from their roles with IDFPR. I don't see how that is any way an attempt at garnering sympathy. Yes, the unions (who are so far from my "buddies" it's almost comical) may be making an argument like that, but no one with any real interest in the situation is making that argument at all. I am not "conveying a message to the public." I'm sure IDFPR has PR people and Media Relations people to do things like that. As I said above, the issue is the removal of the positions and the services they provided. There are now 18 empty desks at IDFPR. The desks that used to process licenses, investigate crimes against patients, and prosecute scumbag doctors are now no longer in service. I'm not making a pathos argument, it's not about the people, it's about the jobs.

ISMS did lobby against the fee increase. That is a fact I know and saw first hand. House Bill 1001, ISMS's current "approved" bill is stunningly similar to what IDFPR had requested in the first place (not that IDFPR has any say in the matter). It wasn't until the story became "news" that ISMS became so generous. Whether the funds are recouped from a GRF, from a fee, or from a cash infusion is essentially irrelevant. It is all the same money, tax payer money. The issue is that the GRFs are all insolvent as well. Illinois hasn't had two nickels to rub together for a decade. Yes, the legislature could pull money from a fund and the problem is solved, but they money has to come from somewhere. Seeing as doctors tend to pay a lot in taxes, it's either allocate some of that to the Medical Unit, or raise the licensing fee, six of one, half a dozen of the other.

I don't know where you're getting the $18.6 Mil number, but I don't doubt it. You can feel free to point fingers all you like. NO ONE, certainly not me, is denying that the money was swept and it should not have been. That's undisputed. I don't think anyone is putting the sweep on ISMS's back, either. ISMS lobbied for payment of the Medicare backlog. ISMS very openly lobbies for prompt Medicare payments through their Hassle Factor Program. There is no lobbying for a sweep, that's not how sweeps work. It boils down to: "The money is gone, it's not coming back, and now we need new money." You can wrestle with the merits of it all you want. At the end of the day, the Medical Fund was less than a year from insolvency, drastic measures were needed to maintain minimum operations, and now the system will crawl until a comprehensive solution is reached.

Also, I take offense that you think Illinois is the second most corrupt state. We've had 6 governors charged with multiple felonies, we have Chicago, the birthplace and childhood home of corruption, and we are literally run, mafia style, by two families. We are not second to anyone. California and New York are goddamn Federalist utopias compared to Illinois.

 

[ICd8U]

When I say that the employees were laid off, I mean they were laid off from their roles with IDFPR. I don't see how that is any way an attempt at garnering sympathy. Yes, the unions (who are so far from my "buddies" it's almost comical) may be making an argument like that, but no one with any real interest in the situation is making that argument at all. I am not "conveying a message to the public." I'm sure IDFPR has PR people and Media Relations people to do things like that. As I said above, the issue is the removal of the positions and the services they provided. There are now 18 empty desks at IDFPR. The desks that used to process licenses, investigate crimes against patients, and prosecute scumbag doctors are now no longer in service. I'm not making a pathos argument, it's not about the people, it's about the jobs.

ISMS did lobby against the fee increase. That is a fact I know and saw first hand. House Bill 1001, ISMS's current "approved" bill is stunningly similar to what IDFPR had requested in the first place (not that IDFPR has any say in the matter). It wasn't until the story became "news" that ISMS became so generous. Whether the funds are recouped from a GRF, from a fee, or from a cash infusion is essentially irrelevant. It is all the same money, tax payer money. The issue is that the GRFs are all insolvent as well. Illinois hasn't had two nickels to rub together for a decade. Yes, the legislature could pull money from a fund and the problem is solved, but they money has to come from somewhere. Seeing as doctors tend to pay a lot in taxes, it's either allocate some of that to the Medical Unit, or raise the licensing fee, six of one, half a dozen of the other.

I don't know where you're getting the $18.6 Mil number, but I don't doubt it. You can feel free to point fingers all you like. NO ONE, certainly not me, is denying that the money was swept and it should not have been. That's undisputed. I don't think anyone is putting the sweep on ISMS's back, either. ISMS lobbied for payment of the Medicare backlog. ISMS very openly lobbies for prompt Medicare payments through their Hassle Factor Program. There is no lobbying for a sweep, that's not how sweeps work. It boils down to: "The money is gone, it's not coming back, and now we need new money." You can wrestle with the merits of it all you want. At the end of the day, the Medical Fund was less than a year from insolvency, drastic measures were needed to maintain minimum operations, and now the system will crawl until a comprehensive solution is reached.

Also, I take offense that you think Illinois is the second most corrupt state. We've had 6 governors charged with multiple felonies, we have Chicago, the birthplace and childhood home of corruption, and we are literally run, mafia style, by two families. We are not second to anyone. California and New York are goddamn Federalist utopias compared to Illinois.

BA, is that you?

 

[Random Anesthesiologist]

I don't know anything about how this office is funded, but if they don't have the money to pay the people to do the work, what do you all expect them to do? Maybe it's a bluff (what do they think is gonna happen in July when all those interns show up without licenses?), but it's the 31st, so it would seem that these people have already been laid off (as opposed to being threatened with layoff after the 15th if funding isn't restored).

Incidentally, this sounds like the kind of waste-cutting, small-government that a lot of the fiscal conservatives on this board would celebrate, if only it didn't affect them individually.

The important thing is the reason for cutting that number of employees.

And why IL isn't cutting pensions or salaries of higher-ups.

Been here 35 years. Looking to get out.