Because the budget itself is so long and complex, it is difficult for voters to discern the influence of a small, organized interest. All things being equal, many now in nursing homes could be living at home. Illinois statutes promise services for Illinois residents in need. But Illinois' state budget determines how those programs will be utilized. And, advocates for people with disabilities say, the budget is written to favor nursing home treatment over in-home care.
State law caps the enrollment in programs that provide in-home care.
To enroll in the Home-Based Support Services or Family Assistance program, applicants must literally win a lottery. The Department of Human Services holds a random drawing each summer to fill available slots. State funding for nursing home residents is based on need, not the availability of funds. The lucky get in-home services. The losers get nursing homes.