Gov. Scott Walker proposed budget is a $68 billion two-year spending plan that calls for an expansion of private school vouchers, control over environmental regulation and natural resources, cuts for the University of Wisconsin System, defunding public television and radio and drastic changes to programs and services for older adults.
HOW DOES THE PROPOSED BUDGET AFFECT OLDER ADULTS?
The proposed budget would:
1) Eliminate IRIS — the largest self-determination Medicaid waiver program in the country
2) Radically change the Family Care system and replace all of the 8 existing regional, homegrown Wisconsin LTC managed care organizations (MCOs) with 2-3 out-of-state, for-profit health insurance companies providing both health care and LTC services (using no-bid contracts)
3) Give the Department of Health Services (DHS) sweeping authority to change the package of LTC services at any time
4) Give DHS the authority to undermine county-run Aging & Disability Resource Centers (ADRCs) with the option of removing and contracting out many of the ADRCs’ major functions.
WHAT IS THE HISTORY AND IMPACT OF THESE PROGRAMS/SERVICES?
The current LTC system was the outgrowth of four years of intensive reform planning in the late 1990s (“Keep the Community Promise” campaign) involving consumers and families, aging and disability advocates, counties, and state officials. This process led to the pro-posed creation of Family Care in five pilot counties (with locally governed MCOs) by Gov. Tommy Thompson in the 1999-2001 budget, which was adopted by the legislature with resounding bipartisan support. The idea of “inte-grated care” (combining health care and long-term care) was strongly rejected at that time. Older persons on Medicare should not be forced to change their doctors in order to access long-term care services. The reforms were designed to eliminate waiting lists, reduce admissions/utilization of nursing homes and other institutions, “bend the curve” on Medicaid spending increases while maintaining quality, reduce the portion of the state’s Medicaid budget spent on LTC, and create locally-based, one-stop ADRCs to provide objective information and other valuable functions for all Wisconsin citizens independent of the MCOs. The reforms have worked — Wisconsin has made huge progress on all of these fronts. Implementing the reforms was complex, so they were phased in gradually between 2000 and 2015. In 2008, Wisconsin added IRIS — a non-managed care model — for people who want to self-direct their LTC services. Letting people choose how they receive their services is a key component of Wisconsin’s successful LTC system. The choice of Family Care or IRIS will soon be available in 64 counties. The proposed budget would radically change the Family Care System.
Many people want help managing their care as provided by Family Care. But a significant number of people (over 11,500 in IRIS at present) don’t feel the need for a care manager or a multi-disciplinary team. IRIS enables people to self-direct their own LTC budget and all of their LTC services through individual budget and employer authority. It allows them to use their individual LTC budget on the supports that make sense to them. IRIS participants are accountable for managing their budget and care within the rules set by DHS. The program’s flexibility allows participants to authorize the purchase of services directly without incurring third-party agency overhead costs, resulting in more funding used for direct services. IRIS is an essential option in the LTC system. The proposed budget would eliminate IRIS.
Aging & Disability Resource Centers (ADRCs). were first piloted in Wisconsin beginning in 1998. Since then, this nationally recognized model has been used to meet the needs and reduce the expenses of a growing LTC population. ADRCs are the first place to go for unbiased information on all aspects of life related to aging or living with a disability. These “one-stop shops” have made an impact in reaching seniors, adults with disabilities, and their caregivers sooner — helping them conserve their personal resources, remain in their homes, and delay or prevent the need for expensive institutional care. ADRCs are governed by the people they serve and attribute much of their success to community partner-ships and local volunteers. Customers of Wisconsin’s ADRCs have been very satisfied with the services they have received. The proposed budget would give DHS the authority to change the county-run ADRC's with the option of removing or contracting many of the ADRC's major functions.
To view the full document providing much of the information above please click Here
To view the Wisconsin Long-term Care Coalition Resolution click Here
To view the Wisconsin Aging Advocacy Network Press Release click Here
To view the Wisconsin Aging Advocacy Network Letter click Here
To view a video describing what an ADRC provides click Here