The federal Centers for Medicare and Medicaid Services (CMS) have renewed Wisconsin's Family Care program, which provides support for elders and people with disabilities to live in their communities rather than nursing homes. In the process, they once again took the Walker administration to the woodshed for the Family Care enrollment freeze that was imposed in Walker's 2011 biennial budget and lasted 9 months. The freeze, said the CMS in a letter to Wisconsin Medicaid director Brett Davis on Monday, violated the terms of the federal waiver agreement for Family Care. Therefore, Wisconsin "should reimburse the individuals improperly placed on a waiting list for any health care costs incurred while on the waiting list."
The Walker administration responded with a big raspberry:
State Department of Health Services officials said Monday they didn't believe that any individuals on the waiting list actually missed out on services and didn't believe the state would have to pay out any reimbursements.More of this tale of pretzel-weaseling beyond the pretzel-ly icon:
The groundbreaking Family Care program actually began during the Republican administration of Governor Tommy Thompson, with bipartisan support. As Disability Rights Wisconsin summarized the program in a press release yesterday,
Family Care and its related long-term care programs provide essential daily supports, like help with bathing, dressing, meals, getting to work and community participation for eligible elderly and people with disabilities. Wisconsin’s waiver agreement with CMS serves as a contract with the federal government and a promise for how the 60% federal share of funding will be spent.This support helps keep people living in their communities, at significant savings over nursing home care (about $1200/month more cost-effective, according to State Sen. Tim Carpenter, new chair of the Senate Committee on Seniors, Public Health, and Human Services). It's a win for quality of life too!
The program expanded under Gov. Jim Doyle (D), and was making significant progress on reducing waiting lists. County Executive Scott Walker was a proponent of the program as well. But then along came Governor Scott Walker and the 2011 biennial budget, and suddenly Family Care enrollment was frozen in its tracks. No new enrollments for two years, said the budget legislation. The impact was immediate, as described in the Milwaukee Journal Sentinel a year ago:
The cap began July 1, and already, we feel the pain in Milwaukee County. Within one week, the Aging Resource Center received desperate calls from families of three elders aged 98, 100 and 108, all of whom counted on receiving services from Family Care. They had spent down their limited savings, believing in the promise of Family Care - but now that promise has been broken.In December of 2011 the CMS first pointed out the broken agreement that the freeze represented, and ordered the Walker administration to lift the cap. This order led to the incredible spectacle of Walker holding a Dec. 28 press conference announcing "his" intention to lift the caps -- trying to take credit without mentioning the order from the feds!
The actual lifting of the cap, of course, wasn't something that Walker could do unilaterally via press conference. It took legislative action, which dragged out until the very last week of the legislative session in March, and was opposed by the powerful Republican co-chair of the Joint Finance Committee, Wisconsin ALEC Chair Robin Vos.
In total, the Family Care freeze was in effect from July 1, 2011 through April 3, 2012. Between the imposition of the freeze and Feb. 2012 (the most recent data available, the waiting list grew by 985 individuals.
So let's review. The freeze was imposed to save money. The waiting list grew by around 1000 people. And the Walker administration has the gall to say that they don't owe anybody anything, even after being ordered to make reimbursement to those harmed by the freeze?
Since this news is so new, there are a lot of unknowns right now. One crucial unknown is the yet-to-be-determined mechanism for consumers to appeal to the state for reimbursement. Here, from today's press release from the Survival Coalition of Disability Organizations, is the information on whom to contact with questions in the meantime:
Individuals 18-59 years of age who are applying for or are a member of Family Care, Partnership or IRIS can reach a Disability Rights Wisconsin Family Care and IRIS ombudsman at 800-928-8778. An ombudsman is an advocate who will listen to a consumer and help them understand the Family Care process as well as any next steps they can take related to their questions or concerns.
The Board on Aging and Long Term Care advocates for people aged 60 and older who receive funding through Family Care. Consumers can reach a BOALTC Ombudsman Intake Specialist by calling 1 800 815-0015.