Committee plans to reject governor's Family Care plan

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MADISON, Wis. (AP) — Lawmakers plan to reject a proposal in Gov. Scott Walker's budget that would expand the state's Family Care program and end the IRIS program, the leaders of the Legislature's finance committee said Thursday.

Sen. Alberta Darling, R-River Hills, and Rep. John Nygren, R-Marinette, the finance committee's co-chairs, told reporters they want a "better product" than what the budget lays out. They said they plan to vote later this month on a motion that would require the state Department of Health Services to develop a new plan to restructure the state's long-term care programs and prepare a request to the federal government for permission to implement it.

The co-chairs didn't get into specifics on what they would like to see in the reformation. They did say in a statement they want to require public and stakeholder input before any changes are made, require "robust self-directed care and require an independent actuarial study to set rates.

"We want these services to continue," Nygren said.

Family Care, a Medicaid program, provides managed long-term care for the elderly and disabled designed to keep them in their homes. About 41,000 people are enrolled in the program. IRIS, which stands for Include, Respect, I-Self-Direct, is a related long-term care program that provides self-directed assistance with bathing, dressing and other needs. About 11,000 people are enrolled in that program. Both programs are currently available in 57 of Wisconsin's 72 counties and are scheduled to expand to an additional seven counties this calendar year.

The governor's budget calls for seeking a federal waiver to allow the state Department of Health Services to expand Family Care services statewide by Jan. 1, 2017. The budget would cut $14 million from the program to reflect anticipated increases in county contributions. DHS also would be required to seek a federal waiver to repeal state statutes that lay out the parameters for managed care organizations that apply for permits to administer Family Care services. Statutes that require the state insurance commissioner to regulate the care organizations would disappear.

The budget also would eliminate IRIS but allow Family Care enrollees to self-direct services. DHS also would be required to seek a federal waiver seeking to repeal state statutes that lay out the parameters for managed care organizations that apply to for permits to administer Family Care services and require the state insurance commissioner to regulate the organizations.

DHS officials, who serve at the pleasure of the Walker administration, have said the changes would create a better-coordinated care net. Advocates for the disabled, however, have balked at the plan. They say the moves would allow larger for-profit organizations into the market, reducing options for enrollees, the loss of IRIS could be devastating for disabled people who rely on it for help preparing meals and cleaning their homes.

Laurel Patrick is a spokeswoman for the governor's office. She said in an email Thursday that Walker, a likely 2016 presidential candidate, wanted to ensure quality long-term care for residents while improving coordination. She said the administration will continue working with lawmakers "to maintain these vital services and explore reforms to improve health outcomes for our most vulnerable."


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