WAITING IN WISCONSIN A bulletin about the disability waiting list in Wisconsin written by Gerry Born March 2003 Vol. 2, No.3 WAITING LIST NUMBERS UPDATED The Wisconsin Council on Developmental Disabilities (WCDD) has now essentially completed its review of county DD programs for 2002 with the exception of Family Care counties. Since Family Care counties do not have waiting lists for adult services, the Waiting List data from WCDD for 2002 is complete. The Department of Health and Family Services (DHFS) is also compiling data about the Community Options Program (COP) and the Community Integration Program (CIP) waiting lists as well as Family Support waiting lists. For the most part the numbers on the different waiting lists are quite consistent. There are about 3,600 adults with developmental disabilities waiting for a variety of services. This is an unduplicated total. When considering individual service areas where someone may be on more than one of the waiting lists, there are 2,500 people waiting for various community living services, nearly 2,000 individuals waiting for work or developmental services, and over 1,000 waiting for intake assessment or service coordination. DHFS also has identified about 3,600 people with developmental disabilities waiting for COP or CIP services. In addition, DHFS has identified over 2,800 people with a physical disability waiting for COP or waiver funded services. Since so many of the additional CIP 1B slots were vetoed from the last budget, the impact on waiting list numbers has been very limited. In terms of Family Support, there are about 2,400 families receiving services. Over 600 additional families have received one-time assistance or are underserved. With a few counties still not reporting, there are over 2,700 families receiving no services and on the waiting list. While the last budget provided a significant increase in funding for Family Support, the demand is still outpacing the available funds. With these numbers continuing to be so high, the advocacy effort to reduce the number of people on the waiting list remains very crucial. While there are many needs that must be addressed, people not receiving services after finishing high school and elderly parents not being able to secure a placement for sons and daughters are examples of the serious consequence of individuals and families being on waiting lists. Funds to address waiting lists are being proposed in the Governor's Budget. Advocates concerned about developmental disabilities waiting list problems had hoped that the number of new slots to address the CIP-1B waiting lists would be more than the 476 that are proposed at this time by DHFS. However, the proposed increase in the CIP-1B rate for state-funded slots to $83.14 per day along with a proposed county maintenance of effort requirement should enable counties to serve more than 476 new people by the transfer of county funding into new locally-matched slots. DHFS WORKING TO OBTAIN IGT FUNDS There is no question that obtaining approval for the community Intergovernmental Transfer (IGT) funds for Wisconsin from the federal Medicaid authorities is critical to the success of the numerous proposals to increase funding for disability services in the Governor's Budget. At this time DHFS is continuing to work cooperatively with the federal officials around this issue. While the advocacy community would like to assist, at this time it really is more of a technical issue best left to DHFS to work on as opposed to a political issue that needs citizen support. This bulletin will keep everyone informed if this would change and will let everyone know if there is an effort needed by the advocacy community. SSI MANAGED CARE INTIATIVE IN THE BUDGET An item in the Governor's Budget that may not be getting much attention but that may be quite significant over a long period of time is the Supplemental Security Income (SSI) Managed Care initiative. DHFS proposes to expand managed care opportunities for SSI/Medicaid eligible adults receiving SSI with disabilities living in the community on both a mandatory and voluntary basis. DHFS has operated I-Care in Milwaukee for the past eight years and found that the care and service outcomes are equal to or better than fee-for-service care (regular MA program not part of a managed care program). This is also proposed to be done at less cost with savings mainly achieved through a reduction in emergency room use and unnecessary hospitalizations as well as increased access to preventative services, care coordination, and disease management. A reduction of $1.6 million in state funds is projected in the budget. While oftentimes an immediate reaction to managed care is negative, state staff describe this program as an almost early intervention program, helping individuals not yet in comprehensive long term care services to remain as healthy and independent as possible through service coordination and intervention. Managed care can cause some substantial adjustments for providers such as home health, personal care, and medical equipment and supply organizations, since they would have to contract with each managed care organization, but these types of organizations can develop effective working relationships with the managed care organizations. DHFS has very high expectations for this program including improving quality of care available, increased choice of service providers, high level consumer satisfaction, and reducing the need for high cost nursing home care, to name just a few. DHFS also will be creating a stakeholders group that involves consumers to review and monitor the implementation of this program. While this approach may be a major change for SSI/MA recipients not now in managed care or waiver programs, it may have both benefits and limitations. This is a proposal that this bulletin will keep everyone informed about. LEGILATIVE FISCAL BUREAU ANALYZES BUDGET In early March, the legislature's Fiscal Bureau (LFB) released its analysis of the Governor's Budget. The next bulletin will provide more information from this analysis and other budget information. For now, anyone interested in the LFB's analysis can review it at their Website, www.legis.state.wi.us/lfb. More next month..... PEOPLE CAN'T WAIT ... SURVIVAL COALITION OF WISCONSIN DISABILITY ORGANIZATIONS 16 North Carroll Street, Suite 400 Madison, WI 53703 608-267-0214 voice/tty 608-267-0368 fax