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92_SB0165gms
State of Illinois
OFFICE OF THE GOVERNOR
Springfield, Illinois 62706
George H. Ryan
GOVERNOR
August 1, 2001
To the Honorable Members of
The Illinois State Senate
92nd General Assembly
Pursuant to Article IV, Section 9(b) of the Illinois
Constitution of 1970, I hereby veto and return Senate Bill
165, entitled "AN ACT in relation to public aid."
Senate Bill 165 allows the Department of Public Aid (DPA)
to undertake a disease management pilot project for patients
with chronic diseases. The bill is permissive regarding
establishment of a disease management program at DPA and
makes any such program subject to appropriation. A disease
management program may cover, but is not limited to,
diabetes, congestive heart failure and chronic obstructive
pulmonary disease. If a program is implemented, the bill
mandates DPA to work with medical experts, advocacy groups
and academic institutions to develop criteria for selecting
an outside operating vendor. The selected vendor may not be
in the business of marketing services other than disease
management to DPA. Also, Senate Bill 165 requires DPA to
assess the outcomes of any pilot project to determine if
patient health improves and Medical Assistance costs decline.
Although the intent of this legislation is laudable,
there are several factors concerning Senate Bill 165 that
trouble me as Governor. First, Senate Bill 165 is
unnecessary legislation, as DPA can pursue disease management
projects within its current statutory authority. The
Department has been examining the possibility of developing a
disease management pilot as a means of both improving client
health and controlling Medicaid liability. Absent
limitations imposed by this legislation, I believe such a
program can be crafted to achieve these goals and still fit
within DPA's fiscal year 2002 budget.
Second, the bill's marketing limitation might reduce the
available vendor pool and could increase the operational cost
of any disease management project. This runs counter to one
of the main goals of disease management programs; lowering
costs. In tight budgetary times, we should be looking to
achieve high quality services at the best available prices.
Third, limits on appropriate vendors may restrict the
Department's ability to target disease management programs in
certain areas of Illinois. I believe the state should be
free to direct potential programs to areas most in need of
disease management services.
Finally, while making any disease management project
subject to appropriation, Senate Bill 165 may cause pressure
to fund a program of a type and scope not assumed in the
fiscal year 2002 budget. Any further spending proposals will
put more stress on an already tight Medicaid budget. In
addition, significant Medicaid cost savings resulting from
such disease management efforts will likely not be realized
until after fiscal year 2002.
If the honorable members of the General Assembly wish to
encourage the development of successful disease management
programs, I would suggest a cooperative effort with the
appropriate state agencies, rather than enactment of
restrictive legislation.
For these reasons, I hereby veto Senate Bill 165.
Sincerely,
George H. Ryan
GOVERNOR