SPRINGFIELD — Health care experts appeared before Illinois lawmakers Monday to discuss disparities in access to hospitals and outcomes based on ZIP code.
Witnesses discussed solutions to financial obstacles facing safety-net hospitals, the lack of preventative care for underserved communities, and massive disparities in outcomes based on race and income at a joint hearing of the state Senate Public Health and Human Services committees.
Safety net hospital is a term for a medical center that generally provides health care for individuals regardless of their insurance status, legal status or ability to pay. The Illinois Department of Healthcare and Family Services determines whether or not a hospital qualifies for a safety net designation based on the percentage of inpatients using Medicaid.
Because the safety net model is not an inherently profitable one, safety net hospitals rely on government funding and are consistently financially challenged, leading to cuts in services such as pediatrics or obstetrics and gynecology, or, in some circumstances, closure of the facility.
In many parts of the state, safety net hospitals are the only locally accessible supplier of health care, particularly in low income, majority Black and majority Latino communities based in the south and west sides of Chicago and the Metro East area near St. Louis.
In 2014, there were 40 safety net hospitals in the state. According to IDHFS, 24 hospitals currently meet that designation.
Ben Lazare, a lobbyist for the Association of Safety Net Community Hospitals, said safety net hospitals also provide an economic lifeline to the areas in which they are located by providing employment — also a major socioeconomic factor in health outcomes.
“They are the largest employers in areas of the state with the highest unemployment rates,” Lazare said. “Safety net hospitals employ over 25,000 people across the state of Illinois … These are high quality jobs and when safety nets do leave if they are forced to close, they leave craters that are absolutely devastating to those communities.”
Policy suggestions from witnesses included allowing outpatient Medicaid users to also count toward a safety net designation and procuring more funds either through federal or state programs to keep safety net hospitals in vulnerable communities in business.
Multiple IDHFS officials testified at the joint hearing, covering the agency’s position and available data on safety net hospitals and health care disparities based on ZIP code. Referencing a study by the Robert Wood Johnson Foundation, IDHFS officials told lawmakers 40% of an individual’s health status is determined by socioeconomic factors, such as education, employment and income. Health behaviors such as diet and exercise impacted 30%, while access to health care and quality of care impacted just 20%.
Regarding the Illinois Legislative Black Caucus’ agenda to combat systemic racism in Illinois, which prompted the joint hearing, IDHFS Director Theresa Eagleson said the department was open to partnering with lawmakers to address disparities discussed in testimony.
“We would be very willing to collaborate in any fashion that (lawmakers) deem appropriate,” Eagleson said.
The Black Caucus intends to submit legislation addressing health care, criminal justice reform, education and economics during the upcoming veto session that runs from Nov. 17-19 and Dec. 1-3.