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How to Contact Liberty Health Care

Fri, 07/21/2017 - 10:55
Liberty Health Care is now officially conducting the independent assessment for personal care.

You can contact Liberty Health Care here: http://www.libertyhealthcare.com/

Important Information on the Personal Care Rate Increase

Fri, 07/21/2017 - 10:53
Why Isn’t DHS Reimbursing Agencies for the New Medicaid Personal Care Rates?
As you know, the 2017-19 state budget bill included a 2% per year increase to the personal care rate. The state budget is a like a typical piece of legislation and must be signed into law by the Governor before it can take effect. The state budget bill has yet to reach the Governor's desk due to ongoing negotiations over transportation and K-12 education funding. So while the proposed budget says that the personal care rate should increase by 2% on July 1, 2017, the increase hasn’t taken effect yet because the budget has not become law. We will keep you updated as the state budget process continues.
Will The New Rates Be Retro-active Once the Budget is Passed?
Yes.However, you must bill the new rate in order to receive the adjustment.  Staff from the Department of Health Services has confirmed to WPSA that once the budget is signed into law, Wisconsin Medicaid will do system-generated adjustments to correct the reimbursement amount to the new rate ($16.40) for all claims that have processed since July 1, 2017.
How Can I Make Sure that I Will Receive a Rate Adjustment?

Staff from the Department of Health Services has told WPSA that personal care agencies must bill their usual and customary fee in order to receive a retro-active rate adjustment. Providers who bill at or in excess of $16.40 should get the retroactive rate adjustment to $16.40 after the rate becomes effective—even for past claims beginning July 1, 2017.   Unfortunately, providers who bill  the current rate of $16.08 will not get a rate adjustment. It is permissible to review your usual and customary charges and make adjustments.

Professional Homecare Providers Prevail in Declaratory Judgment Action: Court Protects Medicaid Providers’ Payments from Unfair Recoupment Efforts

Tue, 04/25/2017 - 09:30


Papa v. Wisconsin Department of Health Services, Waukesha County Case No. 2015 CV 2403
On Friday, August 12, 2016, the Waukesha County Circuit Court ruled that the Wisconsin Department of Health Services (“DHS”) exceeds its legislative authority when the DHS Office of the Inspector General applies a perfection standard, then uses that standard as a basis for recouping Medicaid payments that were made for necessary services provided to Medicaid enrollees.  The Court declared that DHS's authority under Wis. Stat. § 49.45(3)(f) is limited to circumstances where either: 1) DHS is unable to verify from the provider’s records that services were actually provided; or 2) the payment was inaccurate or inappropriate for the service provided (such as a mathematical error or duplicative charge).   The ruling independent nurses from efforts by DHS to take back Medicaid income that the nurses had earned over the last five years for mere imperfections—such as documentation shortcomings—when there was no question that the services were provided. Under the DHS policy, even when providers have actually administered necessary and appropriate care and been reimbursed the proper amount for their services, DHS has based audit findings on minor documentation or other flaws--with a “gotcha” mentality--as a basis to order Medicaid providers to pay back months or years of the reimbursements the nurse earned for these services, going back up to five years.  
The Court found that DHS is not authorized under law to enforce this policy and can no longer do so unless and until DHS properly promulgates such a policy through the legislative rulemaking process. The Court noted that although compliance with Medicaid policies is important, DHS may now only recoup past payments based on a provider’s inability to verify that a service was provided or on evidence that the reimbursement made for it was inaccurate. The Court indicated that DHS is authorized is take other sanctions where a provider does not fully comply with Medicaid policies, including for example: issuance of a corrective action plans, departmental monitoring, or suspension from the Medicaid program. The Court expressed concerns about the impact of the DHS policy on the availability of home-based health care for medically complex individuals. The Court also made a point to state that nothing in the ruling should impede the agency’s ability to combat fraud, waste, and abuse and admonished DHS to focus on compliance, not perfection. 
Attorney Diane Welsh brought the suit on behalf of Kathleen Papa and the Wisconsin Professional Homecare Providers. The Court recognized that the DHS Office of the Inspector General had specifically targeted independent nurses. The ruling is a significant victory for the nurses and other home care providers and for the Medicaid enrollees with complex health needs who rely on this care.  WPSA members with pending audits may benefit from the Court’s declaration.
  
The Court’s written decision is here.
Following the issuance of the decision, the Plaintiffs, Kathleen Papa and the Wisconsin Professional Homecare Providers, submitted a motion for supplemental relief because the Department had not discontinued its recoupment practices, which the Court had determined to be contrary to its authority under Wis. Stat. sec. 49.45(3)(f).  The Court ordered supplemental relief and ordered DHS to pay Plaintiffs’ attorneys’ fees for bringing the motion.
The Department has appealed all orders to the Wisconsin Court of Appeals. The matters are currently being briefed.
The Department has requested that the Division of Hearings and Appeals stay all pending Medicaid recoupment cases, and DHA is doing so.
The DHS Office of Inspector General is continuing its audits of providers, including personal care agencies.  OIG has continued to issue preliminary audit findings calling for recoupment.
Attorney Welsh will monitor events and keep WPSA members posted.

WLTCWA: Spread the word about the Workforce Crisis

Tue, 09/06/2016 - 12:01
From the Wisconsin Long-Term Care Workforce Alliance - Thank you for supporting efforts to strengthen Wisconsin’s direct care workforce! You can help spread the word about the workforce crisis by sending a personalized Legislator Alert Message to your local legislator (see attached for a fillable form).

You will join other allies - we are direct care workers, people receiving support, families, provider agencies, and community members. While the message is the same for all of us, we each experience it differently. So we want to make sure the Wisconsin Legislature hears from people all over the state.

Share your story: Legislator Alert Message form

Click here for more information and to learn how you can tell your legislator about the workforce crisis: http://wiworkforcealliance.com/index.php?option=com_content&view=article&id=57&Itemid=71






Professional Homecare Providers Prevail in Declaratory Judgment Action: Court Protects Medicaid Providers’ Payments from Unfair Recoupment Efforts

Mon, 08/15/2016 - 14:52


Professional Homecare Providers Prevail in Declaratory Judgment Action: Court Protects Medicaid Providers’ Payments from Unfair Recoupment Efforts
Papa v. Wisconsin Department of Health Services, Waukesha County Case No. 2015 CV 2403
On Friday, August 12, 2016, the Waukesha County Circuit Court ruled that the Wisconsin Department of Health Services (“DHS”) exceeds its legislative authority when the DHS Office of the Inspector General applies a perfection standard, then uses that standard as a basis for recouping Medicaid payments that were made for necessary services provided to Medicaid enrollees.  The Court declared that DHS's authority under Wis. Stat. § 49.45(3)(f) is limited to circumstances where either: 1) DHS is unable to verify from the provider’s records that services were actually provided; or 2) the payment was inaccurate or inappropriate for the service provided (such as a mathematical error or duplicative charge).   The ruling independent nurses from efforts by DHS to take back Medicaid income that the nurses had earned over the last five years for mere imperfections—such as documentation shortcomings—when there was no question that the services were provided. Under the DHS policy, even when providers have actually administered necessary and appropriate care and been reimbursed the proper amount for their services, DHS has based audit findings on minor documentation or other flaws--with a “gotcha” mentality--as a basis to order Medicaid providers to pay back months or years of the reimbursements the nurse earned for these services, going back up to five years. 
The Court found that DHS is not authorized under law to enforce this policy and can no longer do so unless and until DHS properly promulgates such a policy through the legislative rulemaking process. The Court noted that although compliance with Medicaid policies is important, DHS may now only recoup past payments based on a provider’s inability to verify that a service was provided or on evidence that the reimbursement made for it was inaccurate. The Court indicated that DHS is authorized is take other sanctions where a provider does not fully comply with Medicaid policies, including for example: issuance of a corrective action plans, departmental monitoring, or suspension from the Medicaid program.
The Court expressed concerns about the impact of the DHS policy on the availability of home-based health care for medically complex individuals. The Court also made a point to state that nothing in the ruling should impede the agency’s ability to combat fraud, waste, and abuse and admonished DHS to focus on compliance, not perfection.
Attorney Diane Welsh brought the suit on behalf of Kathleen Papa and the Wisconsin Professional Homecare Providers. The Court recognized that the DHS Office of the Inspector General had specifically targeted independent nurses. The ruling is a significant victory for the nurses and other home care providers and for the Medicaid enrollees with complex health needs who rely on this care.  WPSA members with pending audits may benefit from the Court’s declaration.
 
The Court will issue a written decision within the next few weeks. DHS has the opportunity to appeal the Decision to the Wisconsin Court of Appeals. Attorney Welsh will monitor events and keep WPSA members posted.
             

Election Update: Wisconsin's Primary Results

Thu, 08/11/2016 - 10:36


August 10, 2016 - Wisconsin’s Fall primary held on Tuesday decided the winners of many state legislative races.   About half of Wisconsin’s State Senate and State Assembly seats have now been filled for the 2017-18 Legislative session since many state-level races were either uncontested or decided by Tuesday’s primary.  Statewide turnout was estimated at 16%.

On the ballot for the November 8 General Election are U.S. President,  U.S. Senator, U.S. Representative, even-numbered Wisconsin State Senate seats, and all Wisconsin Assembly seats.
State Assembly Races
Republicans currently control the Assembly with a 63-36 majority. Of the 99 Assembly seats, only 52 seats are up for grabs in the General Election.  Republicans are expected to maintain their majority next session since Democrats would not only need to defend all of their current seats but also pick up 14 additional seats on November 8.
Several key races were decided by primaries yesterday, including:
Chuck Wichgers (R-Muskego) will fill Representative David Craig’s (R-Big Bend) seat in Assembly District 83 after winning a crowded Republican primary.  Craig left his Assembly Seat to run for retiring State Senator Mary Lazich’s (R-New Berlin) seat in Senate District 28;  Craig did not face a primary challenge and is uncontested in the General Election.
Former State Representative Jason Fields (D-Milwaukee) reclaimed his Assembly seat after winning the Democratic primary in Assembly District 11 to fill the seat vacated by Representative Mandela Barnes (D-Milwaukee).  Fields lost his Assembly seat in 2012 after losing a primary challenge from Barnes.
Former Capitol staffer David Crowley (D-Milwaukee) will fill State Representative La Tonya Johnson’s (D-Milwaukee) Assembly seat after winning the Democratic primary. Johnson gave up her Assembly seat to run for Senate.
Jimmy Anderson (D-Fitchburg) will fill State Representative Robb Kahl’s (D-Monona) open seat in Assembly District 47.
Democratic Representatives JoCasta Zamarripa (D-Milwaukee), Josh Zepnick (D-Milwaukee), Leon Young (D-Milwaukee),  Christine Sinicki (D-Milwaukee), Lisa Subeck (D-Madison), and Sondy Pope (D-Mount Horeb) will all hold on to their Assembly seats after surviving primary challenges.
State Senate Races
Republicans control the Senate with a 19-14 majority.  After Tuesday, only 8 of the 16 even-numbered Senate seats up for grabs in the General Election.   
In the biggest race of the night, State Senator Lena Taylor (D-Milwaukee) held on to her Senate seat after easily fending off a primary challenge from State Representative Mandela Barnes (D-Milwaukee), 61%-39%. Barnes had to give up his Assembly seat to challenge Taylor, so he will not be returning to the Legislature next session.  Senate Minority Leader Jennifer Shilling (D-La Crosse) now faces a tough re-election bid against former State Senator Dan Kapanke (R-La Crosse) after both candidates prevailed in their primary races Tuesday.  And State Representative La Tonya Johnson (D-Milwaukee) will fill Senator Nikiya Harris Dodd’s (D-Milwaukee) Senate seat after winning the Democratic primary.
U.S. Senate
There is now officially a re-match for one of Wisconsin’s U.S. Senate seats after former Senator Russ Feingold (D-Middleton) easily defeated his primary challenger Scott Harbach, 90%-10%. Feingold  faces off against Senator Ron Johnson (R-Oshkosh) in the General Election.
U.S. House of Representatives
In one of the more interesting races of the August primary, Speaker of the House Paul Ryan (R-Janesville)) handily defeated his primary challenger Paul Nehlen (R-Williams Bay), 84%-16%, in District 1.  Ryan will face Ryan Solen (D-Mount Pleasant) in the General Election.
In District 2, U.S. Representative Mark Pocan (D-Black Earth) did not have a primary Tuesday but is being challenged by Peter Theron (R-Madison) in the General Election.
U.S. Representative Ron Kind (D-La Crosse) won his primary against Myron Buchholz (D-Eau Claire), 81%-19%,in District 3.  Kind is uncontested in November.
U.S. Representative Gwen Moore (D-Milwaukee) won her primary against Gary George (D-Milwaukee), 85%-15%, in District 4. Moore has a Libertarian challenger,  Andy Craig of Milwaukee,  in the General Election.  
In District 5, U.S. Representative James Sensenbrenner (R-Menomonee Falls) did not have a primary Tuesday but is challenged by Khary Penebaker (D-Hartland) in the General Election.
Sarah Lloyd (D-Wisconsin Dells) will face U.S. Representative Glenn Grothman (R- Glenbeulah) in the District 6 General Election after winning the Democratic primary on Tuesday.
U.S. Representative Sean Duffy (R-Wausau) bested his primary challenger Donald Raihala (R-Superior), 89%-11%, in the District 7 Republican Primary. Duffy will face Mary Hoeft (D-Rice Lake), the winner of Tuesday’s Democratic Primary, in November.
State Senator Frank Lasee (R-De Pere) failed advance to the General Election in District 8 after winning only 20% of the vote in the Republican Primary. Lasee will remain in the State Senate as he did not have to give up his seat to run for Congress.  Mike Gallagher (R-Green Bay), the winner of the Republican Primary,  will face Outagamie County Executive Tom Nelson (D-Appleton) in the race to fill U.S. Representative Reid Ribble’s (R-Sherwood) open seat.

Milwaukee Journal Sentinel Primary Results

Governor Walker Appoints Linda Seemeyer to Lead the Department of Health Services

Thu, 08/04/2016 - 12:43
From the Office of the Governor
-
Thursday, August 4, 2016 - Press Release

Madison -- Governor Scott Walker today appointed Linda Seemeyer to lead the Wisconsin Department of Health Services (DHS) as its next secretary following the passing of Secretary Kitty Rhoades.
“Linda’s experience in health and human services at the county level, along with her career in management, makes her the right fit for this job,” Governor Walker said. “I thank Linda for her willingness to once again serve the people of Wisconsin.”

Linda Seemeyer comes to DHS from the Walworth County Department of Health & Human Services where she served as its director from 2007 to 2015. Seemeyer’s prior experience includes serving as the director of the Milwaukee County Department of Administrative Services, and deputy secretary of the Wisconsin Department of Administration under Governor Tommy Thompson.

“I thank Governor Walker for placing his trust in me to lead DHS,” Linda Seemeyer said. “I look forward to working with department staff, legislators, and stakeholders to promote the health and safety of Wisconsin’s citizens.”

Linda Seemeyer will begin on August 22, 2016. Interim Secretary Tom Engels will resume his duties as deputy secretary.

DHS to expand Family Care and IRIS statewide

Mon, 08/01/2016 - 07:48



FROM: Wisconsin Health News 

DHS to expand Family Care and IRIS statewide

The Department of Health Services plans to expand Family Care and IRIS statewide by 2018, according to a Thursday statement.
The move will provide services to nearly 500 adults with disabilities and frail elders in seven counties who are currently waiting for long-term care services. Those counties operate under an older program. 
The department will expand Family Care and IRIS to Adams, Forest, Florence, Oneida, Taylor and Vilas counties beginning in the third quarter of 2017. It'll expand the programs to Dane County during the first quarter of 2018
"This expansion means members all across the state can take advantage of services that offer dignity and independence, and allow them to make their own care decisions," said Tom Engels, interim DHS secretary in a statement.
DHS will work with Aging and Disability Resource Centers, managed care organizations and others to "ensure a smooth and successful transition" for nearly 3,000 people who receive long-term care under the seven counties' current programs. 
The state's 2015-'17 biennial budget directed DHS to expand Family Care and IRIS statewide. It also called for integrating long-term care with healthcare and having licensed insurance companies oversee the programs rather than managed care organizations. 
In June, the state withdrew the plan after submitting it to lawmakers for final approval. But the budget gave the department authority to expand the programs without having to go through the Legislature.  
Beth Swedeen, executive director of the Wisconsin Board for People with Developmental Disabilities, said the board supports the department's decision to eliminate the wait lists for services in the remaining counties.
She called it an "effort to create equity and ensure all people with disabilities eligible for long-term care have access to the critical supports that can allow them to live, work and participate in their communities and avoid costly institutional care."
Swedeen also urged DHS to adopt many of Dane County's current practices. The county is often recognized for having one of the highest-performing long-term care programs in the nation, she said. 
The county's focus on integrated employment had led to a more than 70 percent employment rate among long-term care participants, compared to under 10 percent in the rest of Wisconsin, according to Swedeen. 
That in turn has led to $4 million in wages and reduced reliance on public benefits, she said. Swedeen also praised the county for a "unique paratransit program." 
"These are national models that should be available to all Family Care/IRIS members statewide," Swedeen wrote in an email. 
Kit Kerschensteiner, managing attorney at Disability Rights Wisconsin, said they're pleased with the decision to expand the program statewide. 
"I'll certainly agree that Dane County has a good system compared to most places in terms of resources, but we still have waiting lists in Dane County," Kerschensteiner said. "And this will give more people the ability to access community services." 
Lynn Breedlove, co-chair of the Wisconsin Long-Term Care Coalition, said they admire the "excellent performance" of Dane County's system for people with developmental disabilities and hope that it can be preserved. 
He said the coalition has always supported the elimination of waiting lists for long-term care.
"We believe this is a good thing," Breedlove said. "That is now going to happen after basically a 20-year campaign to get that done." 
Breedlove added that the programs are cost-effective. According to DHS, the approximate Medicaid cost to serve an individual under the legacy waivers is $3,900. Under Family Care, the cost is $3,340 per member, about $550 cheaper.
The Dane County Department of Human Services did not return a request for comment by deadline. 

Three Wisconsin MCOs to Merge

Mon, 07/11/2016 - 09:52


From Wisconsin Health News:
Three MCOs to merge
Three managed care organizations in western Wisconsin are becoming one.
Community Care Connections of Wisconsin, ContinuUs and Western Wisconsin Cares plan to merge into one organization "strategically positioned to compete within the current long- term care system, as well as within any reformed system considered by the state of Wisconsin in the future," according to a statement last week. 
A movement to privatize the market and increased competition drove the merger, according to a statement. The MCOs anticipate merging at the start of next year. They received approval from the Office of the Commissioner of Insurance in May.
The new organization will provide long-term care services to about 15,000 Family Care members in 46 counties. It will employ roughly 1,100 people. 
"As single entities, we do great work. As joined partners, we will have even greater impact," the three companies noted in a statement.

Family Care/IRIS 2.0 wouldn't be implemented before 2018

Mon, 05/16/2016 - 13:16

Wisconsin Health News --Family Care/IRIS 2.0 wouldn't be implemented before 2018
Department of Health Services Secretary Kitty Rhoades said Sunday that the department wouldn't implement the budget's proposed changes to the state's long-term care programs before Jan. 1, 2018.
The last state budget calls for a series of changes to Family Care and IRIS, including expanding the programs statewide, integrating healthcare with long-term care services and having insurers oversee the programs.
The budget calls for DHS to implement the program Jan. 1, 2017 or after the federal government approves the changes, whichever comes later.
In an editorial published in the Journal Sentinel Sunday, Rhoades said they have a "a long way to go" until the first members would transition to the new program.
"Given the numerous steps after Joint Committee on Finance approval, we anticipate the first transition to happen no sooner than Jan. 1, 2018, and for the statewide transition to take as long as 18 months to complete," Rhoades wrote.
Claire Yunker, DHS spokeswoman, said they first publicly shared that they anticipated beginning implementation in 2018 last week in response to questions from JFC.
"To be clear, we are not pushing back the implementation date by a year," Yunker said in an email to Wisconsin Health News. "2015 Wisconsin Act 55 required the department to make Family Care available statewide by January 1, 2017, or a date determined by the Department, whichever is later. We have said from the beginning that we would work with all affected parties to make sure that implementation of Family Care/IRIS 2.0 is appropriately executed."
Before any transition to the new program, DHS will meet with Aging and Disability Resource Centers, managed care organizations and integrated health agencies to develop a timeline. They'll be in regular contact to evaluate the process, Yunker said
"Based on this regular communication, DHS may modify the timeline and plan by either slowing down or speeding up the transition as appropriate to ensure a transition that introduces minimal disruption and ensures member health and safety," she said.

DHS will begin drafting amendments, developing RFPs for those interested in becoming integrated health agencies and writing contract language when JFC approves the concept paper, she added.
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Milwaukee Journal Sentinel: Family Care changes wouldn't take effect until 2018
Secretary Rhoades Op-ed: Family Care changes will protect program for years to come

DHS Releases Family Care and IRIS 2.0 Concept Paper

Wed, 03/02/2016 - 13:12
DHS has released their draft concept paper for Family Care and IRIS 2.0.You can read the full paper here:  https://www.dhs.wisconsin.gov/familycareiris2/familycare-irisconceptpaper.pdfThere are two chances to testify on the paper on March 7. Details are provided below. DHS will accept written testimony about the concept paper through 5 p.m., on March 7.Send written testimony to DHSFCWebmail@dhs.wisconsin.gov.
DHS plans to submit the concept paper to the Joint Finance Committee by April 1, 2016.
Monday, March 7, 2016
9 a.m. – 11:30 a.m.
Florian Gardens Conference Center
2340 Lorch Avenue
Eau Claire, WI 54701
Monday, March 7, 2016
4:30 p.m. – 7 p.m.
Alliant Energy Center Exhibition Hall
1919 Alliant Energy Center Way
Madison, WI 53713

Gov. Walker Signs Worker's Comp Bill into Law

Tue, 03/01/2016 - 14:46
Governor Walker signed Assembly Bill 724 into law yesterday as 2015 Wisconsin Act 180. Act 180 updates to the worker’s compensation program and was agreed to by the Workers' Compensation Advisory Council.  Changes include reducing the statute of limitations for workers seeking compensation for injuries and increasing the money workers may receive. 

Of particular interest to WPSA is a provision in Act 180  that impacts self-directed long-term care services. Act 180 makes the financial management services entity liable for any injury sustained by a worker providing self-directed supports to a long-term care program participant. It also requires the financial management services entity to insure that the worker is covered either by an insurance policy or by self-insurance. The LRB analysis of that provision is below.

Long-term care providersThis bill provides that an individual who is performing services for a person receiving long-term care benefits under certain long-term care programs administered by the Department of Health Services, including the Community Options Program, the Community Integration Program, Family Care, the Family Care Partnership Program, a self-directed program commonly referred to as IRIS, or the Children's Long-Term Support Home and Community-Based Medicaid Waiver Program, on a self-directed basis and who does not otherwise have worker's compensation coverage for those services is considered to be an employee of the entity that is providing financial management services for the person who is receiving the benefits. As such, the financial management services entity is liable for any injury sustained by the individual while performing those services and is required to insure payment of that liability either by purchasing insurance from an insurer authorized to do business in this state or, if permitted by DWD, by self-insuring for that liability.The bill also prohibits an individual providing long-term care services who is considered an employee of a financial management services entity for purposes of worker's compensation coverage and who files a claim for worker's compensation from bringing an action in tort against the person who received the long-term care services from which the claim arose.


Article from Wisconsin Health News:

Walker signs workers' compensation bill

Gov. Scott Walker has signed this session's agreed-upon bill for workers' compensation into law.

It's the first proposal signed into law from the Workers' Compensation Advisory Council in two legislative sessions. A previous bill placing a fee schedule on providers treating injured workers did not gain traction last session.

The bill makes a series of changes to the law like reducing the statute of limitations for workers seeking compensation for injuries and increasing the money disabled workers receive.

Walker also signed into a law a bill that would loosen requirements in state law and allow the health departments for Ozaukee and Washington counties to merge.





Family Care/Iris 2.0: Benefits and Self-Direction

Mon, 02/22/2016 - 09:32
Family Care/IRIS 2.0: Benefits and Self-DirectionReform focused on maintaining, improving long-term care benefits now and for the future

MADISON – The Wisconsin Department of Health Services (DHS) is working on the planned redesign of the Family Care/IRIS 2.0 initiative, to protect and improve long-term care services for some of the state’s most vulnerable citizens, as required by Act 55.  Today, as DHS works to finalize the Family Care/IRIS 2.0 concept paper, Secretary Kitty Rhoades reconfirmed the Department’s commitment to self-direction of services through IRIS (Include, Respect, I Self-Direct).“The Department of Health Services remains committed to not only sustaining, but improving the services seniors and individuals with disabilities need, while ensuring financial stability of the program for the long-term,” Department of Health Services Secretary Kitty Rhoades said. “One of the goals of Family Care/IRIS 2.0 is to coordinate all aspects of an individual’s long-term health and behavioral health care needs.  I want to reassure current Family Care and IRIS members that self-direction benefits available today will still be available when we implement Family Care/IRIS 2.0.”In preparation for drafting the concept paper for Family Care/IRIS 2.0, DHS collected written testimony and gathered public input at eight public hearings across the state in locations including Green Bay, Hayward, Wausau, La Crosse, Milwaukee and Madison, which were also available by webinar.  DHS also met with multiple advocacy groups, boards, councils and committees.  “Through the process of developing our concept paper for Family Care/IRIS 2.0, we received feedback from providers, stakeholders, and members about the importance of maintaining the ability to self-direct long-term care services the way members are able to do today through the IRIS Program,” said Secretary Rhoades. “Under the redesign, we will require all Integrated Health Agencies to allow members to self-direct all long-term care services that are currently able to be self-directed.”Family Care/IRIS 2.0 Concept Paper Design: Self-Direction
  • The Integrated Health Agency will be required to develop an individual’s IRIS budget for self-direction based on assessment of the member’s care needs.
  • An IRIS specialist will perform the same functions as the current IRIS consultant agency and will assist IRIS members in identifying long-term care needs and developing an individualized plan to meet those needs.
  • Members will continue to have budget authority and full employer authority.  
  • Individuals who are currently eligible to self-direct will have the choice to self-direct under Family Care/IRIS 2.0.
Family Care/IRIS 2.0 Concept Paper Design: Benefits
  • Behavioral Health benefits will be covered and managed by the Integrated Health Agency.
  • Institutional care, including nursing home care, will continue to be available both through an Integrated Health Agency and through traditional fee-for-service, depending on the individual’s choice.
  • Transportation will be managed by the Integrated Health Agency.
  • The range of benefits for people enrolled in long-term care programs will remain the same after the implementation of Family Care/IRIS 2.0.
Family Care/IRIS 2.0 Public HearingsThe Department of Health Services hosted eight public hearings (two required under statute), gathered written testimony, and met with many groups and organizations over the past several months to offer interested parties an opportunity to participate in the redesign process. To further build on this collaboration, DHS has scheduled two additional public hearings to be held after the concept paper is released the first week of March.  Written comments are also welcome through March 7, 2016.  Implementation of Family Care/IRIS 2.0 is subject to federal approval.Monday, March 7, 2016
9 a.m. – 11:30 a.m.
Florian Gardens Conference Center
2340 Lorch Avenue
Eau Claire, WI 54701Monday, March 7, 2016
4:30 p.m. – 7 p.m.
Alliant Energy Center Exhibition Hall
1919 Alliant Energy Center Way
Madison, WI 53713
Public hearings will be streamed live.  To access, go to the Family Care/IRIS 2.0 web page.

DHS Announces March Public Hearings on Family Care and IRIS 2.0

Fri, 02/05/2016 - 15:56
The Department of Health Services will hold two additional hearings on FamilyCare/IRIS 2.0 on March 7!

Here is the announcement from their website:

"The Department will hold public hearings to solicit comment regarding the concept plan that will be submitted to the Joint Committee on Finance on April 1, 2016. A draft of the concept plan will be published on the Family Care/IRIS 2.0 webpage the first week of March. The hearings will be live streamed so all may participate. Free parking will be available at both events.

Please note: Due to the limited time to make revisions before submission of the concept paper, and extensive public comments received previously, the Department will not accept written or verbal testimony before or after the hearings."

See below for exact times and locations as well as the timeline posted by DHS.

Eau Claire Public Hearing
March 7, 2016
9:30 am - 11:30 am
Florian Gardens Conference Center
2340 Lorch Avenue
Eau Claire, WI 54701

Madison Public Hearing
March 7, 2016
4:30 pm - 6:30 pm
Alliant Energy Center Exhibition Hall
1919 Alliant Energy Center Way
Madison, WI 53713

DHS plans to implement the new program statewide by January 2017. Here is their timeline for developing the new program:

  • First Quarter of 2016: Draft the Concept Plan
  • March 2016 - Hold public hearings to solicit comment regarding the concept plan
  • April 1, 2016 - Submit concept plan to Legislature 
  • Upon Legislative Approval - Draft waiver for public comment 
  • September 30, 2016 - Submit waiver to federal government 


See announcement on DHS website. 

March 7th, Family Care/IRIS 2.0 Public Hearings Announced by DHS

Thu, 02/04/2016 - 12:12
The Department of Health Services has announced that they will be holding two additional hearings on FamilyCare/IRIS 2.0.

Here is the announcement from their website:

"The Department will hold public hearings to solicit comment regarding the concept plan that will be submitted to the Joint Committee on Finance on April 1, 2016. A draft of the concept plan will be published on the Family Care/IRIS 2.0 webpage the first week of March. The hearings will be live streamed so all may participate. Free parking will be available at both events.

Please note: Due to the limited time to make revisions before submission of the concept paper, and extensive public comments received previously, the Department will not accept written or verbal testimony before or after the hearings."

See below for exact times and locations as well as the timeline posted by DHS.

Eau Claire Public Hearing
March 7, 2016
9:30 am - 11:30 am
Florian Gardens Conference Center
2340 Lorch Avenue
Eau Claire, WI 54701

Madison Public Hearing
March 7, 2016
4:30 pm - 6:30 pm
Alliant Energy Center Exhibition Hall
1919 Alliant Energy Center Way
Madison, WI 53713





See announcement on DHS website. 

Bipartisan RAISE Family Caregivers Act Passes the Senate

Wed, 12/09/2015 - 08:36
The RAISE Family Caregivers Act has passed through the U.S. Senate by Unanimous Consent. The act now awaits the consideration of the House of Representatives. See below for the full press release from Senator Baldwin's office. 
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U.S. Senator Tammy Baldwin’s Bipartisan RAISE Family Caregivers Passes Senate
More than 50 national and state advocacy groups have joined in support of bipartisan legislation 
WASHINGTON, D.C. – U.S. Senator Tammy Baldwin, a member of the Health, Education, Labor and Pensions (HELP) Committee, today applauded the passage of her bipartisan Recognize, Assist, Include, Support, and Engage, or RAISE Family Caregivers Act, by the United States Senate. Introduced with U.S. Senator Susan Collins (R-ME), the legislation would direct the Secretary of Health and Human Services to establish and sustain a National Family Caregiving Strategy to support family caregivers. The legislation will now move to consideration by the House of Representatives.
Over the past few months, Senator Baldwin has toured the state of Wisconsin, promoting the legislation and hosting listening sessions in Milwaukee, Green Bay and Wausauwith family caregivers. 
“I applaud the Senate’s move to advance the bipartisan RAISE Family Caregivers Act forward, and I’m proud of the widespread support, nationally and in Wisconsin, that this critical, bipartisan bill has received,” said Senator Baldwin. “In so many instances, family caregivers put their own health, livelihoods and financial security at risk to tend to the needs of their loved ones, many of whom require full-time assistance and care. If we are serious about ensuring that our older adults and loved ones with disabilities receive the highest quality care in their own homes, we must formally recognize and support family caregivers. The bipartisan RAISE Family Caregivers Act creates a national strategy and plan to assist family caregivers. This effort is especially personal to me as I was raised by my maternal grandparents and later served as my grandmother’s primary caretaker as she grew older, and I will continue to work to ensure that everyone has access to the care and assistance they need and deserve.”
“Our family caregivers are an invaluable resource to our aging society,” said Senator Collins. “As our aging population continues to grow and the need for round-the-clock care for our seniors increases, uncompensated family caregivers will continue to be the most important source of support for people who need long-term care. At some point most of us will likely either be family caregivers or someone who needs one. The RAISE Family Caregivers Act will launch a coordinated, national strategic plan that will help us to leverage our resources, promote innovation and promising practices, and provide our nation’s family caregivers with much-needed recognition and support.”
“Caregiving was once a very personal and private matter, but now with over 578,000 family caregivers in Wisconsin alone - it is a public issue. Today, caring for an older relative, a spouse, a parent is affecting people in all walks of life – boomers, men, women, millennials.  It really is an ageless and nonpartisan issue.  Family caregivers face huge responsibilities in keeping loved ones in their homes and communities – and they need and deserve support.  With today’s passage of the RAISE Family Caregivers Act we are now on our way to developing a national strategy to recognize and support family caregivers.  Thank you Senator Baldwin for your leadership on this issue,” said AARP Wisconsin State Director Sam Wilson.
"We wholeheartedly endorse Senator Baldwin’s bipartisan RAISE Family Caregivers Act and applaud its passage in the Senate," said Robert Kellerman, Executive Director of the Greater Wisconsin Agency on Aging Resources. "Family caregivers are an incredibly important yet often undervalued component of our health and long-term care systems. This initiative recognizes, supports, and honors their efforts."
“The Alzheimer’s and Dementia Alliance of Wisconsin applauds and congratulates Senator Baldwin for passing the RAISE Family Caregivers Act in the U.S. Senate. We greatly appreciate all of the hard work Senator Baldwin and her staff have put into this important legislation which will significantly improve the lives of people with dementia and their caregivers,” said Rob Gundermann, Public Policy Director, Alzheimer's & Dementia Alliance of Wisconsin.
“Coming off of November as the Alzheimer's Caregiver Awareness month, family caregivers are the glue that hold our families together.  Let's face it, all of us are aging. Many more of us are finding ourselves caring for mom or dad who may be struggling on their own. We simply cannot offer enough education about healthy aging, caregiving techniques and approaches, and ways to connect caregivers to resources in our community. I applaud the U.S. Senate’s passage of the RAISE Family Caregiver Act and Sen. Baldwin's commitment to the families of Wisconsin,” said Kari Paterson, Alzheimer's Association South Central WI. 
At present, there are about 40 million family caregivers in the United States, who, in 2013, provided an estimated $470 billion in uncompensated long-term care. This is more than the total Medicaid spending that year.
In addition, Americans 85 and older are the fastest growing segment of the population. This population is most at risk of multiple and interacting health problems that can lead to disability and the need for round-the-clock care.
This summer, a coalition of national organizations sent a letter of support for the RAISE Family Caregivers Act to Senators Baldwin and Collins, applauding their efforts to work on a bipartisan basis to support family caregivers.
“Family caregivers are the backbone of services and supports in this country. They help make it possible for older adults and people with disabilities to live independently in their homes and communities,” wrote the supporters. “By supporting family caregivers, we can help people live at home where they want to be, helping to delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars. We appreciate your bipartisan leadership and are committed to working with you to pass the RAISE Family Caregivers Act.”
The RAISE Family Caregivers Act is also supported by the Greater Wisconsin Agency on Aging Resources (GWAAR), the Wisconsin Aging Advocacy Network (WAAN), Alzheimer's Association Wisconsin Chapters, Alzheimer’s & Dementia Alliance of WI, Inc, and Interfaith Older Adult Programs, Inc.  Learn more about the RAISE Family Caregivers Act here.
View an online version of this release here

Save the Date! Disability Advocacy Day is March 15th in Madison

Thu, 12/03/2015 - 13:22
March 15th is Disability Advocacy Day in Madison
This is a day meant to connect you with your legislators so you can discuss the issues that matter to you and your community. After all, you are the expert at how legislative policies affect the everyday lives of those with disabilities. 
Stay tuned for more information for this year's event. 

Informational Hearing on Aging and Long Term Care

Thu, 12/03/2015 - 09:37

On November 18th the Assembly Committee on Aging and Long Term Care held an informational hearing.
  • To watch the full hearing and testimony click here
  • To review slides from the Tennessee Division of Health Care Finance and Administration's testimony click here
  • For slides from the Greater Wisconsin Agency on Aging and Long Term Care click here

Alert: Sept. 9th Hearing on Family Care/IRIS

Fri, 09/04/2015 - 11:01
ALERT: Department of Health Services (DHS) to Hold First Public Hearing on New Long-term Care System (Family Care/IRIS) September 9 in Green Bay!On Wednesday, September 9, the Department of Health Services will hold the first of 8 public hearings on the long-term care system redesign at the Brown County Public Library (5:00 pm - 8:00 pm, 515 Pine Street Green Bay, WI 54301). 

While we are encouraged by DHS’s decision to hold public hearings around the state, we are very concerned that the new system will not preserve key elements of the current Family Care and IRIS programs.

This is your chance to tell DHS what types of supports are important to you and your family! We need to have a big turnout at every public hearing to make sure the new long-term care program is good for people with disabilities and older adults. For those who cannot attend, written comments can be submitted to DHS at DHSFCWebmail@wisconsin.gov by October 11th. For more information on how to submit comments to DHS, visit their website.
We have attached a talking points document created by Wisconsin Long-term Care Coalition on key principles that must be included in the new system. Here is what you can do to help:
  •  Send an action alert to your networks and encourage them to attend the public hearings
  • Contact your state legislators and members of the Joint Finance Committee and ask them to attend the hearings (see information on how to contact them below)
  • Attend one or more of the hearings and submit comments!
  • Phone.  You may leave a message for your legislator’s Capitol office or indicate your position on legislation through the toll free Legislative Hotline, at 1-800-362-9472.

Need a reminder of what types of changes are being made to Family Care and IRIS? Here is a summary:  Frequently Asked Questions document created by the Survival Coalition. 

How can I contact my legislator? The first step in contacting your legislator is knowing who your legislator is. The easiest way to do this is the tool found on the Legislature’s home page, athttp://legis.wisconsin.gov. In the right-hand side of that page is a link that says Find My Legislators!  Type your address in the box below that link to get the names of your state representative and senator.

DHS Public Hearing:Changes to Family Care and IRIS

Thu, 09/03/2015 - 07:38

The Department of Health Services will be holding 8 public hearings on changes to the Family Care and IRIS programs proposed by the 2015-2017 State Budget (Act 55). 

The public will be able to participate either in person, via webcast, or through written testimony(Due Oct. 11th). See below for dates and details. 


September 9, 2015
5:00 pm - 8:00 pm
Brown County Public Library
515 Pine Street
Green Bay, WI 54301
September 14, 2015
9:00 am - 12:00 pm
Goodman Community Center
Evjue Community Room D
149 Waubesa Street
Madison, WI 53704
September 14, 2015
5:30 pm - 8:30 pm
Milwaukee Medical College
HRC Auditorium
8701 Watertown Plank Road
Milwaukee, WI 53226
September 15, 2015
12:30 pm - 3:30 pm
La Crosse Public Library Auditorium
800 Main Street
La Crosse, WI 54601
September 21, 2015
9:00 am - 12:00 pm
Northcentral Technical College
Rooms: E101/E102
1000 W. Campus Drive
Wausau, WI 54401
September 21, 2015
Location to be determined
In or around Hayward, WI
Written testimony/comments should be sent to DHSFCWebmail@wisconsin.gov or to the address listed below by Oct. 11th Department of Health Services
Division of Long Term Care
Family Care and IRIS 2.0
P.O. Box 7851, Room 550
Madison, WI 53707-7851

https://www.dhs.wisconsin.gov/familycareiris2/index.htm

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