Oct 7 2011

Analysis of Proposed Medicaid Reforms

Posted by BPDD at 3:58 PM
- Categories: DAWN Website Updates | Miscellaneous

The Department of Health Services (DHS) has released a list of 39 proposed Medicaid reforms to find $554 million in savings to balance the Medicaid budget as part of the Governor’s 2011-2013 budget. Disability advocates have identified four proposed reforms that could have a significant impact on people with disabilities in Wisconsin. These reforms are:

Personal care: Travel reimbursement for direct care workers will be cut in half.

  • Cutting the travel reimbursement in half amounts to a rate cut and will be devastating for individuals in rural counties where direct care workers drive long distances.
  • Personal care agencies will have reduced funding for wages and benefits to direct care workers. Low wages and no benefits result in costly turnover and disruption to individuals receiving services.

Family Care Cap: Maintains freeze imposed by biennial budget.

  • Waiting lists have grown by over 500 people since the freeze began July 1.
  • Youth in transition will graduate without supports, causing parents to become full-time caregivers, unless DHS is able to find a way to serve them with the cap in place.
  • Over $24 million is available for individuals in urgent situations, however, the individual has to meet both of the following criteria:
    • The individual is incapable of providing for their own care and is at risk of serious harm to themselves or others.
    • There is no one to provide the needed care or supervision.
  • It is unclear if transitioning youth qualify for urgent needs funds even if a parent has to quit work and stay home with the young adult.
  • There are also concerns whether individuals on the wait list are informed about the urgent needs funds.

Medical Transportation – Logisticare: Logisticare is the company that serves as a centralized transportation broker for individuals on Medicaid.

  • The proposal expands the use of a centralized transportation broker to southeast Wisconsin HMO consumers.
  • Complaints point to consumers feeling harassed and guilty by scheduler for needing a ride.
  • Complaints that individuals are missing necessary medical appointments, including children with mental health issues no longer allowed to ride unattended, and not being informed about the complaints process.
  • Concern that cost savings actually result from consumers not using the broker system because it doesn’t work for them.

Medicaid Maintenance of Effort Waiver: Maintenance of effort means a state cannot spend less on Medicaid than it has in previous years.

  • DHS is proposing to request a waiver from the federal government so the State can cut spending on Medicaid, with BadgerCare as the primary target.
  • DHS wants to restrict eligibility for Medicaid for families with access to employer-based insurance if the premiums are below 9.5% of household income.
  • Employer-based insurance may not have all the benefits families with disabilities need.
  • Families with low income, many with members with a disability, could see premiums rise from $10 to $210 per month for decreased benefits.
  • Young adults age 19 to 26 would be removed from Medicaid and be required to enroll in their parents’ health insurance plan.

Advocates Support Medical Home Models of Care

There has been a lot of confusion about the term “medical home.” Medical home is a model of consumer-centered services that encourages partnerships between all caregivers and the consumer and family. Medical homes can create better access to care and increase consumer satisfaction. Medical home does not have any impact on where the consumer lives.


Denise Lewis

Denise Lewis wrote on 10/10/11 2:13 PM

Having a child with a disability is not something a family financially prepares themselves for when deciding to bring a child into the world. Expensives medications, continued trips to hospitals and specialists take it's toll on a parent.
Having the Medicaid waiver program has lessened the the financial strain we are faced with each week. Our children and adults deserve to maintan the care that has been provided to them to help improve their quality of life without further financial strain on the parent. I implore you to rethink these cuts. As a parent and a home owner with other children and college to think about, taking away benefits that help supplement the financial burden we face paying for the rest of our child's life would cause great fiancial hardship to our family.
On behalf of my family and many other families please do not cut funding that would directly impact people with disabilities.
sandra frye

sandra frye wrote on 10/10/11 7:38 PM

I am an adult care home family provider for 2 level 4 developmentally disabled adults. I take care of them 24/7/366. I get one third the amount and most possible less than that for their cares than a nursing home would. I provide them with daily baths, 3 home made meals, one on one time, and they go everywhere I go. Including music concerts, surf and turf buffets etc. I pay for all the transportation for their medical care. I am appalled at this budget cut for the disabled. Scott Walker can propose a 400 million dollar give away to venture capital when the last such venture that he supported was a travesty. Yet he caps family care, costing tax payers huge amounts in nursing home care which is devistating to the disabled. people lose their homes once they enter a nursing home. He cares not. He cares not about the people in this state just in his egotistical boasts. this cutting for the disabled will cost jobs, not make them. It's a terrible feeling to feel so helpless that nothing any of us care givers can do can change what politics does. I love my two girls. Girls still in mind, can't walk, talk, but can giggle and I hope to be able to give them some semblence of life. something Scott Walker will take from others. May he never need help, may someone he loves never be born disabled. May God forgive him I can't.
michele grasso

michele grasso wrote on 10/11/11 1:53 PM

I can't beleive the poor and low income people are going to be hit again. I work in an agency that helps people apply for benefits and to take away medical treatment for our clients will be devistating to our community. The poor are poor and the rich get richer Governor Walker. It is easy to target the poor, elderly, and disabled and that is what is happening today. How about our legislatures giving up there insurance and pensions jjust liek the public sector!! Lets start with the rich and leave those in need alone for once.
david Lewis LCSW

david Lewis LCSW wrote on 10/13/11 1:36 PM

I find these proposed changes to be classically"Penny wise and pound foolish". They also, as is often the case, don't consider the unique challenges of rural areas with few services and long distances to travel to get to what services are available. I would urge policymakers to reconsider these changes and recognize that in many instances funds used in a reasonable way now will save far more money in the long run.

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