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MADISON, Wis. (AP) — Gov. Scott Walker's proposed cuts to programs that help people with disabilities live independently are being criticized as potentially devastating by advocates and those who use the services.
Walker's proposed budget would expand the state's Family Care program by Jan. 1, 2017, at which point all other long-term care programs would be discontinued, including the IRIS program, which benefits 11,000 adults with long-term care needs. Walker has proposed cutting $14 million in funding to the Family Care program over the next two years.
Changes to the Family Care program and cuts to the personal care program could save the state $33 million over the next two years, the nonpartisan Legislative Fiscal Bureau reported. But advocates say the proposed overhaul would be difficult to execute by 2017 and that questions remain as to how the new statewide system would work.
Theresa Ellis said the proposed changes could force her 31-year-old son Daniel, who has a cognitive disorder, to change doctors and quit the job he works about 10 hours a week.
"He's got dignity and self-respect, and that would be gone," said Ellis, whose son lives with her in Madison.
Claire Yunker, a spokeswoman for the Department of Health Services, said in a statement that Walker's proposal is aimed at preventing fraud and abuse in the existing system and creating a more coordinated care regimen.
But Daniel Idzikowski, executive director of Disability Rights — a group that advocates for people with disabilities — said his organization was not consulted about Walker's plan that the Legislature will debate over the next three months.
It would drastically restructure Family Care, which administers personal care and long-term care services to elderly, disabled and injured Wisconsinites through Medicaid, he said.
"By and large that system's working pretty well," Idzikowski said. "Nobody's saying we need to completely eliminate this system and replace it with a different model. I think everyone was surprised by these changes."
Advocates for the disabled contend that the changes would allow larger for-profit organizations to enter the market, resulting in fewer options for those with disabilities.
Yunker said the state Medicaid fraud unit has been asked to investigate more claims pertaining to IRIS's personal care program, which allows for assistance for bathing, dressing and other cares, than for any other Medicaid benefit. She said the state doesn't keep track how many confirmed cases of such fraud there were.
Beth Swedeen, executive director of the Wisconsin Board of People With Developmental Disabilities, said the cut to personal care funding could be devastating to people who use the service. Personal care services are essential to the participants who receive them, she said.
"If someone doesn't go (check in) every day, they can develop bed sores," Swedeen said. "There's a health concern, a safety concern."
Under Walker's proposal, Family Care would incorporate acute and primary care health services, as well as community-based long-term supports.
"The goal is to ensure that all of an individual's care is coordinated — that there is some assessment to look at the person's overall health," Yunker said.
She said existing care services do not coordinate care services between acute and primary care providers.
Yunker said self-directed care options will still be available for participants, but that it's still unclear how those would function. Upon passage of the budget, the model would be worked out through a waiver negotiation process, she said.
Jason and Julie Endres, of Eau Claire, use IRIS to have help around the house each week. He has spina bifida and his wife has cerebral palsy, so they get help preparing healthy meals and cleaning their home. He said losing the help wouldn't be deadly, but it would change their quality of life.
"We wouldn't go hungry, we could do it ourselves. But it would be a lot of pizza, a lot of order out," Jason Endres said.
And without the help of someone to vacuum or help change light bulbs, "eventually we would be stuck in the dark," he said.
Endres said IRIS has allowed him to make decisions about his independent lifestyle. He said he worries that could change under the expanded Family Care program.
He said, "I'm fearful I'll have someone telling me what I can or can't do."
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