We had a great discussion about the State Budget and the future of Wisconsins Long-Term Care programs on the Coffee BreakWednesdaymorning! Special thanks to Lynn Breedlove, board president forInControlWisconsin,for joining us as our special guest again! We really appreciate it. We encourage you to take a look at our one-page summaryof the budget items affecting Long-Term Care. There were several points discussed in the chat. Some of them include:

• The final proposal from the Joint Finance Committee was similar to the Governors proposal.
• Lynn said the only good thing that came from it was that Adult Disability Resource Centers (ADRCs) were saved.
• The version of IRIS thats in the final budget differs greatly from the IRIS we know now.
• According to the budget, the changes will take effect statewide by January 2017, but some people think it may take longer to complete.
• Theres no clear process for stakeholder input in the budget. Lynn says we may have to push legislators to make sure the Department of Health Services (DHS) has an input process.
• Theres great concern about how medical care will be managed under the new plan.
• Theres also a big concern about how the insurance companies wont have any incentive to provide quality care because any surplus will be their profit. Profit-taking will be a big dangerwe will have to fight for quality care.
• The term Integrated Health Agencies (IHAs) appears to be an invention of legislature. Lynn mentioned California has something similar.
• The new Medicaid Waiver process includes a 60 day comment period. DHS is required to submit ALL comments to the Center for Medicaid and Medicare Services (CMS).
• Lynn pointed out that there will be some attempts to influence CMS publicly and through back channels. However, CMS is agreeing to similar waivers in other states involving insurance companies. So, it's hard to tell whether or not they will object to Wisconsin's plan.
• Many elderly people are unaware of these changes that will potentially affect them.
• It's hard to tell CMS our concerns when we don't actually know what the IHAs will look like yet.
• The Managed Care Organizations (MCOs) have been prohibited from telling people what all this means. Lynn noted that AARP has done some good work getting the word out.
• If MCOs are making cuts now, it would be hard to blame that on the budget. DHS still says the new plan isn't done yet.
• CMS is approving these type programs in other states across the US. Beth pointed out one opportunity to influence what happens is the work being done on home and community-based waiver quality outcomes. She gave us this link to learn about the national process. Lynn mentioned the Medicaid Managed Care Forum that the National Council on Disability is holding in Madison on August 31^st would have some national allies at it.
• Lynn thinks that Dane County and the other counties rolling out to Family Care by 2017 (due to the legacy wavier) should be ready to lose adult Long-Term Care funding in 2017.
• Patti pointed out that United Cerebral Palsy has published a report that shows some good data related to how states are doing. Wisconsin is ranked 32^nd in this report. Lynn mentioned that Wisconsin has dropped in the rankings. You can report by clicking here.
• IRIS participants arent guaranteed to be able to self-direct in the IHAs. Its unclear what the eligibility criteria for self-direction will be. Lynn said that there is some fear that people with severe disabilities may be excluded. Shared-decision models from other states could help. This needs be a priority item for stakeholders input on the plan.
• Any change in leadership in the Governor's office or at DHS could create an opening to revisit what happened in the budget.
• Lynn said that some of the fears regarding the budget are based on what the budget is silent about. He points out that DHS may have plans to fill in those blanks in a positive way, but that's why we have to be active in the planning process to make sure that thats the case. He said that we should remain hopeful--there will be many ways we can influence the final result!

Share your questions, as well as your resources, information, experiences, and ideas about the future of Wisconsins Long-Term Care programs in this discussion.

updated by @sd-network: 02/23/16 04:43:48PM