Budget uncertainties cloud Family Care plans

More than 100 people affected by the Family Care expansion into Shawano and Menominee counties learned more about the program Tuesday night.

Family Care offers a variety of programs through Medicaid for long-term care for the disabled and elderly, helping to keep them out of nursing homes and institutions by providing care in their homes and communities.

Residents’ questions at the community forum at the Shawano Lake County Park pavilion included how Gov. Scott Walker’s proposed biennial budget will affect the Family Care program and the managed care organizations that help its participants.

“Many of the same questions that came at this forum were the same as those around the state,” said Jody Brassfield, manager of Include, Respect, I-Self Direct, a state program facing elimination under Walker’s proposal.

Walker’s plan would change the way services are delivered through Family Care and abolish county-run aging and disability resource centers and IRIS, which has been credited with saving millions of federal Medicaid dollars each year.

The proposal, which Walker says would save millions in state and federal money, eventually would shift ADRCs from county supervision to private agencies and eliminate managed-care organizations in favor of large private insurers.

Margaret Kristan, Family Care bureau director for state Department of Health Services, noted the Legislature is not slated to pass the budget until July. There appear to be bipartisan concerns about at least the Family Care portion of the plan.

“The governor’s budget has not gone before the legislators yet,” Kristan said. “About whether some managed care organizations will dissolve, we just don’t know yet.”

Walker announced in 2014 the Family Care program would expand to Shawano, Menominee, Oconto, Marinette, Brown, Door and Kewaunee counties. About 4,000 people are expected to qualify.

The program currently serves about 48,000 people in 57 counties. Walker’s goal is to bring the program to all 72 counties by 2017.

In Shawano County, 436 people receive long-term support from the county Human Services Department; 58 of them reside in community-based residential facilities. Under the Family Care program, care for those people will transition to two managed care organizations: Madison-based Care Wisconsin and Fond du Lac-based Lakeland Care District.

The Aging and Disability Resource Center of the Wolf River Region will provide pre-enrollment counseling to residents from May until Sept. 1, when both organizations will begin accepting applicants.

Residents also asked on Tuesday whether they would have to change health care providers and care managers under Family Care.

“In a short answer, maybe,” said Carrie Molke, aging and disability director of the state Department of Health Services. “Sometimes you can have the same case manager, but there is no guarantee.”

After a person enrolls in Family Care, a social worker/care manager and a registered nurse will conduct an onsite health assessment and prepare a six-month treatment plan.

IRIS is a self-directed support program for older adults and adults with physical and developmental disabilities. TMG Wisconsin administers the program.

“They are going to help you navigate based on your intentions and desires,” Brassfield said. “They don’t make decisions about your supports and services.”

TMG representative Ann Miller Holman stressed that the consultants are not care managers.

“They have similar credentials, but we like to call them partners, because they are a self-directed model,” she said.

People residing in skilled nursing facilities interested in joining IRIS are required to live in an adult family home, community-based residential facility or their own residence, Brassfield said.

Molke said participants can switch programs at any time if they are not pleased with services of either Family Care or IRIS.