Erpenbach: ADRCs Deserve Legislative Support

Senator Jon Erpenbach has written an op-ed piece about the importance of the Aging/Disability Resource Centers and the long term programs that serve our disabled and elderly citizens:

In the mid-1990s Wisconsin made the decision to create Aging and Disability Resource Centers. These centers have spread throughout Wisconsin and have been used as a model for many other states for best practice in local long-term care support. ADRCs help the elderly and disabled and their families by providing counsel regarding options for in-home services and care that help people stay in their own home and out of nursing homes and institutions.

This model of a "local one stop shop” for the elderly and disabled, managed on a nonprofit basis in local communities, is truly a success story for Wisconsin. ADRCs are charged with helping individuals use their own financial, family and community resources efficiently and effectively. ADRCs are available for all residents to use, regardless of income or personal resources, and have a mission to empower people to make informed choices.

Unfortunately, Gov. Walker has proposed that ADRCs do not need to operate in every county and that services could be provided on a statewide basis managed by a private for-profit company. Local ADRC governing boards, which include elderly and disabled board members, would simply be eliminated.

ADRC boards are not alone; the successful self-directed IRIS program is also slated to be eliminated, and existing local management for Family Care is also set aside in favor of the statewide management program.

For the past 20 years I have volunteered delivering meals on wheels once or twice a month. Many clients are referred to the program by our local ADRC. The relationships I have built with participants have truly shown me that ADRCs are needed and necessary in our communities. You simply cannot substitute local knowledge and support.

Obviously, the first question we would like the governor to answer is why should we throw out programs like ADRCs, which work successfully locally with a core set of volunteers and not-for-profit experts in favor of a statewide program that will be run for profit? These choices make no sense for the people of Wisconsin and should be outright rejected by the Republican-controlled Legislature. I will do my part on the Joint Committee on Finance to repeal Walker’s proposed privatization of ADRCs, IRIS and regional management of Family Care. Elimination of local systems to create bigger private systems of care for individuals seems like a bad idea.

I agree completely with Erpenbach on all but one point. Walker's scheme does not seem like a bad idea - it is a bad idea!

Assembly JFC Dems Stand Up For The Elderly And The Disabled

Last Friday, I, and scores of others, spoke to the Joint Finance Committee against Scott Walker's plan to privatize and decimate the long term support programs for the frail elderly and people with disabilities.

So it was with great pleasure to see that at least two committee members, Representatives Chris Taylor and Gordon Hintz, were not only listening to us, but are willing to fight for this.  The following is a joint press release from Taylor and Hintz:

Prior to the Joint Committee on Finance’s  (JFC) hearing in Rice Lake, the Democratic members of the JFC called for removal of budget provisions that would dismantle Wisconsin’s successful long-term care system.  Governor Walker’s proposal would replace it with a statewide model, likely run by out-of-state corporate insurance companies and without competitive bid requirements for contracts.  Following their request for removal of these changes, Representatives Gordon Hintz (D-Oshkosh) and Chris Taylor (D-Madison) released the following statement:

“The Republicans' dismantling of Wisconsin’s long term care system is throwing Wisconsin families into crisis,” Rep. Taylor said.  “Families served by Wisconsin’s long-term care system want to be treated with dignity and respect, and instead feel surprised and sabotaged.  But it doesn’t have to be this way.  Republicans need to take these changes out of the budget today.”

“Over the last week I have heard from hundreds of families that count on IRIS and FamilyCare for the support they need to be healthy and successful,” Rep. Hintz said.  “We are being asked to adopt a plan that has no details other than dismantling our existing long-term care system.  More than 50,000 Wisconsin families are served by our long-term care programs fear what this means for their loved ones.  This change has no business in the budget, and needs to be removed immediately to avoid any further harm and uncertainty."

Wisconsin’s current long-term care system has been a national model, based on years of trust, accountability, and work built by local stakeholder input. Currently, IRIS and Family Care allow people with a disability and the elderly to choose the type of in-home health services that best meet their needs, through regional providers or self-directed care. These changes were never discussed before they were introduced in the budget and have been met with strong opposition from families who were blindsided by the proposal.  DHS Secretary Rhoades has stated that she was also unaware of the proposal before it was included in the budget.

I thank and commend Representatives Taylor and Hintz for doing the right thing on this issue.

I just hope that their Republican counterparts realize that Walker has put them firmly on Wisconsin's version of the third rail and that they have the common sense to get off of it before it's too late for our state's most vulnerable citizens and for their own careers.

Scott Walker's Most Heinous Budget Stunt Yet

Under Medicaid guidelines, a disabled adult or a frail elderly person would need to go into a nursing home to be able to access Medicaid funding to pay for their care. However, each state has a waiver program that allows the person to divert that money into community-based support services that allows the person to remain in the community, if not in their own home.

In Wisconsin, there are three programs that offer this type of waiver. One is Family Care, which can provide such things as residential services, day programming and personal cares. Another is Partnership, which does the same thing as Family Care, but includes an HMO component for medical care. The third is IRIS, which allows the person to self-direct their services.

At least one of these programs is offered in 57 of the 72 counties in Wisconsin. Many of them have two options, Family Care and IRIS. Of the remaining 15 counties, eight of them are already in the process of transitioning to Family Care.

Until now.

In his 2015-17 proposed budget, Scott Walker wants to make sweeping changes to these programs and the way they are administered.

One of the biggest changes would be the elimination of IRIS. The effect of this will be devastating for a lot of these people and their families:

Beth Swedeen is the Executive Director of the Wisconsin Board for People with Developmental Disabilities. She says one of the biggest concerns they are hearing about is the possible elimination of the Include, Respect, I Self Direct, or IRIS Program. IRIS allows qualifying people the ability to make their own choices about many healthcare options instead of being institutionalized, on Family Care, or regular Medicaid. “People with significant disabilities and older adults are using long-term care where they are self directing their own support, so they’re hiring their own care workers, and they’re making decisions about the budget that they are allowed to have in ways that make sense for them and their families, so we’re really concerned about that. I’ve gotten a lot of calls from folks who are really concerned about the elimination of that program.”

Swedeen says one of the many benefits of IRIS is the member gets to choose who their caregivers are. “When you have people in your home doing things that are very personal to you, like helping you with a bath or helping you get dressed, you want to make sure that’s a person you are comfortable with, and somebody that is safe and that is somebody you’ve chosen rather than somebody that an agency has chosen.”

Other changes include dissolving the regional districts and making Family Care contracts available only to companies that can operate state wide, such as Big Insurance companies. Walker would also allow the state to contract with anyone for for the Aging/Disability Resource Centers (ADRCs), which are currently run by the counties. Walker would also abolish ADRC governing boards and long term care councils.

Walker would also award all of these contracts in a no bid process.
And to show that the care of these vulnerable adults are not his priority, Walker wants to take oversight of these programs from the Department of Health Services and give it to the Commissioner of Insurance.

In other words, Walker wants to force the frail elderly and disabled adults into a single, expensive program. He then wants to give these contracts - worth more than $3 billion - in a no bid process to large for profit insurance companies, who will have little or no oversight.

Gee, do you think he is fishing for the Big Insurance campaign donations with this immoral giveaway?

Ah, but that's not all. With all things Walker, there is more. There is always more.

Walker is not satisfied with just going after the disabled adults and frail elderly. He wants to go after disabled children as well.

Included in Walker's budget is the elimination of the Family Support Program, which helps families with disabled children to get special equipment or services that are not covered under Medicaid.

Just when one might think that Walker has hit the depths of maleficence and greed, he finds a way to prove us wrong.

Walker and his apologists will point out that his budget calls for expanding Family Care to all 72 counties so that no disabled person or frail elderly person would go without these "services."

Don't be fooled by this claim.

The only reason Walker is doing that is that the federal government slammed him a few years ago when he tried to put a cap on Family Care and told him in no uncertain terms that he could not deny services to anyone eligible for them:

Because the currently approved waiver includes and entitlement to waiver services, we are instructing the State to operate the waiver as it was approved by CMS. Therefore, we are directing the State to identify any individuals not currently enrolled onto the Family Care or Self-Directed Supports waivers since the July 1, 2011 implementation of the newly instituted enrollment caps, and immediately enroll those individuals in the waiver programs. This includes individuals living in any counties who had or would have had an entitlement to the waivers as of July 1, 2011, and includes individuals who were or would have otherwise been selected for enrollment from other participating counties.

In ancient history, people would put their frail and disabled people out into the cold for the wolves. Walker is doing a modern day version of this where he is throwing these vulnerable citizens to the corporate wolves.