Long Term Care Reform

• About the issue
• Why does this matter to people with disabilities?
• Are there any proposals that would make a change in this issue?
• Who can I contact with my questions?
• Background Information For This Issue

About the issue: (Top of page)

Long term care is the term used to describe services and supports given to elderly and people with disabilities. These supports can be provided in an institution or the community. Disability advocates refer to the array of services and supports provided in the community as long term care.

The long term care system in this state has included programs that are funded by federal, state, and county government. Some of the programs include the Community Options Program (COP), Community Integration Program (CIP), and Family Care. The major problem with these programs is that they are hard to understand, require multiple applications, and are administered differently throughout the state.

For the past five years Family Care has been piloted in five counties. The Governor is proposing to expand this to all counties in the next five years. If this happens all of the current programs and funding that assist people to live in the community will be folded into this program. Under Family Care, long term care services will be provided by Care Management Organizations (CMO). A CMO may be a part of a county or it could be a private organization. Most counties will combine with neighboring counties to form a regional CMO. This means that counties will no longer provide long term care services directly.

Why does this matter to people with disabilities? (Top of page)

People with disabilities rely on the long term care service system to live in the community. How that new system works will have a big impact on their lives. Since the current system is going to change, people with disabilities may want to participate in planning the new system. One thing Family Care promises is that it will end waiting lists for long term care services by 2012.

People have developed relationships with their county to provide them the supports they need. They will now have to relate to a CMO for their supports. This change creates an opportunity to be more included in the decisions on how services will be provided and how much funding will be available for them. People may want more choice in who provides services and how they are provided. It is important that the new system is designed to allow for peoples choice as well as needs.

Are there any proposals that would make a change in this issue? (Top of page)

• Assembly Bill 213 - Partnership Plan
  This bill requires the state Dept. of Health and Family Services (DHFS) to submit to the secretary of the federal Dept. of Health and Human Services an amendment to the state's MA plan that satisfies the requirements of the State Long-Term Care Partnershi [More on Assembly Bill 213 ]
  Outcome: Hearing held in the Assembly. Failed to get out of the Aging and Long Term Care Committee.
• Assembly Bill 298 - Assisted Suicide
  This bill permits an individual who is of sound mind, is not incapacitated, is at least 18 years of age, is a resident of Wisconsin, and has a terminal disease to request voluntarily, in writing, medication from his or her attending physician for the purp [More on Assembly Bill 298 ]
  Outcome: Referred to the Assembly committee onJudiciary and Ethics. Failed to get out of committee.
• Assembly Bill 417 - Autism Insurance
  This bill requires health insurance policies and self-insured governmental and school district health plans to cover the cost of treatment for autism, Asperger's syndrome, and pervasive developmental disorder not otherwise specified if the treatment is pr [More on Assembly Bill 417 ]
  Outcome: No action was taken on this bill. This issue was addressed by SB 178. See that bill for a status update.
• Assembly Bill 691 - Marriage Penalty
  This bill would allow a single person who receives Medical Assistance (MA) under the medically needy category and then marries to have their MA eligiblity determined as if they were still single. It would disregard the income and assets of the spouse. [More on Assembly Bill 691 ]
  Outcome: Failed to get out of the Assembly committee on Health and Healthcare Reform.
• Assembly Bill 698 - Personal Care Workers
  This bill would require agencies that employ or contract with personal care workers in private residences to tell the client or guardian the information they obtained in a background check. It also requires updated background checks every two years rathe [More on Assembly Bill 698 ]
  Outcome: AB 698 failed to get out of committee in the Assembly but this issue was addressed by SB 393. SB 393 passed both houses and was signed into law on 3-26-08. It became Act 172.
• Assembly Bill 700 - Integrated Service Programs
  This bill makes several changes to state statute 46.56 that covers Integrated Services Programs (ISP). Some of the changes include expanded coverage to include not just children with severe disabilites but other children who use two or more care systems. [More on Assembly Bill 700 ]
  Outcome: Hearing held in the Assembly. Passed out of Assembly committee on Children and Family Law. referred to Joint Finance committee. Failed to get out of that committee.
• Senate Bill 32 - Nursing Home Diversions
  This bill eliminates the current limit on the number of persons (150) who meet MA level of care requirements and are diverted from entry into a nursing home and for whom an enhanced rate of payment for MA services may be made under CIP II. [More on Senate Bill 32 ]
  Outcome: Failed to get out of the Seante committee on Public Health, Senior Issues, Long Term Care, and Privacy.
• Senate Bill 40 - Biennial Budget
  This bill is Gov. Doyle's proposed budget. It covers all state spending and revenue. [More on Senate Bill 40 ]
  Outcome: This bill was signed into law on 10-26-07 and became Act 20.
• Senate Bill 114 - Partnership Plan
  This bill requires the state Dept. of Health and Family Services (DHFS) to submit to the secretary of the federal Dept. of Health and Human Services an amendment to the state's MA plan that satisfies the requirements of the State Long-Term Care Partnershi [More on Senate Bill 114 ]
  Outcome: Failed to get out of Senate committee on Public Health, Senior Issues, Long Term Care, and Privacy.
• Senate Bill 144 - MA Eligibility Changes
  This bill makes a number of changes to assets and divestment rules to conform Wisconsin law to federal law when determining eligibility for Medical Assistance (MA). [More on Senate Bill 144 ]
  Outcome: Failed to get out of the Senate committee on Health and Human Services.
• Senate Bill 151 - Assisted Suicide
  This bill permits an individual who is of sound mind, is not incapacitated, is at least 18 years of age, is a resident of Wisconsin, and has a terminal disease to request voluntarily, in writing, medication from his or her attending physician for the purp [More on Senate Bill 151 ]
  Outcome: Public hearing held. Failed to get out of the Senate's Public Health, Senior Issues, Long Term Care, and Privacy committee.
• Senate Bill 178 - Autism Insurance
  This bill requires health insurance policies and self-insured governmental and school district health plans to cover the cost of treatment for autism, Asperger's syndrome, and pervasive developmental disorders if the treatment is provided by a qualified [More on Senate Bill 178 ]
  Outcome: Had a Senate hearing, passed out of committee, was amended, and passed the Senate. It was referred to the Assembly, where it never got out of committee.
• Senate Bill 268 - Care Facilities
  This bill would change the process by which care facilities are licensed. An applicant for a community care facility, such as a CBRF, would have to form a community advisory committee. The majority of the people on this committee would be people from th [More on Senate Bill 268 ]
  Outcome: Failed to get out of Senate committee on Economic Development, Job Creation, etc.
• Senate Bill 283 - Alzheimer's Treatment
  This bill stops nursing homes, community-based residential facilities, adult family homes, residential care apartment complexes, and hospices from providing special services for persons with Alzheimer's disease or related dementia unless the Dept. of He [More on Senate Bill 283 ]
  Outcome: Hearing held in the Senate, amended and passed out of committee and referred to Joint Finance Committee. Failed to get out of that committee.
• Senate Bill 375 - Mental Health Parity
  This bill requires that insurance policies provide the same coverage for mental health and mental illness as they do for physical, illness or injury. [More on Senate Bill 375 ]
  Outcome: Had a Senate hearing, passed out of committee, was referred to the Joint Finance Committee, and never got out of committee.
• Senate Bill 393 - Personal Care Workers
  This bill would require agencies that employ or contract with personal care workers in private residences to tell the client or guardian the information they obtained in a background check. It also requires updated background checks every two years rathe [More on Senate Bill 393 ]
  Outcome: Hearing was held in the Senate. Amended in Senate committee. Passed the full Senate and Assembly as amended. Signed into law on 3-26-08. Became Act 172.

Who can I contact with my questions? (Top of page)

John Shaw
Wisconsin Council on Developmental Disabilities
201 W. Washington Avenue
Madison WI 53703-2796
Phone: Voice (608) 266-7707; TDD (608) 266-6660
Email: shawj2@dhfs.state.wi.us
Fax: (608) 267-3906

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Background Information For This Issue (Top of page)

• None at this time.