Here's why Rock County still doesn't have Family Care

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Catherine W. Idzerda
Thursday, April 24, 2014

JANESVILLE—Rock County and state officials have been talking about Family Care for more than eight years.

Here's how those discussions have gone:

Get ready for Family Care.

No, wait, we're not sure about the program.

Maybe it's time to get ready now.

Or not.

On Monday, Gov. Scott Walker said his administration was ready to extend Family Care to seven northern counties.

If approved, Family Care would be implemented in 64 of Wisconsin's 72 counties, with Rock County being one of the remaining eight without the program.

When will it be Rock County's turn? And why does it matter?

Family Care is a state program that changes the way health services are funded for the frail elderly and adults with developmental or physical disabilities.

Rock County residents who need such care are served by the Rock County Developmental Disabilities Board and Long Term Support Programs.

Federal medical assistance dollars flow to the county and are used to care for people at home or in the community rather than in institutions. In Rock County, local tax dollars supplement the federal funding.

Under Family Care, the federal medical assistance dollars go to a managed care organization that provides services.

State officials argue that by taking the burden of services away from counties, Family Care saves money, eliminates waiting lists and improves services.

The state piloted Family Care in 2000 and launched it in 2006.

“Rock County has been on a roller coaster ride for so many years,” said Jennifer Thompson, Rock County Long Term Support division manager. “We've done a lot of planning.”

-- In 2008, then Gov. Jim Doyle asked Rock County to be ready for Family Care by 2010.

-- In 2009, the county asked the state to delay implementation until 2011 because of the state of the local economy.

-- In 2010, after months of planning for the transition, the state asked the county to hold off for seven months. The 2011-13 state budget included a provision asking the Department of Human Services to complete a study of the long-term financial feasibility of the plan.

-- In June 2011, Family Care expansion was capped.

--  In December 2011, the cap was lifted. Rock County officials said they were waiting to hear from the state.

-- In March 2013, the Rock County Aging and Disability Resource Center, a requirement of Family Care, was opened.

-- On Monday, state Department of Human Services spokeswoman Stephanie Smiley told the Associated Press that it was “unclear” when the program would come to the remaining eight counties: Adams, Dane, Forest, Florence, Oneida, Rock, Taylor and Vilas.

In an e-mail Wednesday, Smiley said counties in northern Wisconsin were picked because “they were ready to proceed and were geographically located together.”

For Rock County to go forward with Family Care, it would have to show the state that the program would be “cost neutral," Thompson said. The federal money available would have to cover all costs and eliminate the waiting lists.

Rock County Developmental Disabilities Board Director John Hanewall said about 250 people are on waiting lists and money isn't the only challenge.

“There's the capacity issue,” Hanewall said. “Let's say we had the money to fund 125 additional people for day services programs. There aren't 125 vacancies in day programs in the community.”

Another option to eliminate waiting lists would be to reduce services to current clients. But that would come with additional challenges. A person who loses a spot in a day program would have to be cared for in a residential setting, increasing costs there.

Thompson acknowledged that the managed-care model isn't supported by everyone.

“It depends on who you talk to,” Thompson said.

Cindy Simonsen, executive director of VIP Services in Elkhorn, said that when Family Care was implemented in Walworth County, she was afraid that many of her clients would lose services.

VIP provides a variety of services to people with developmental disabilities.

“There really hasn't been a huge, dramatic change,” Simonsen said. “Yes, some people did lose some hours, and others gained.”

In a 2009 Gazette story, Simonsen said, “Some people who were getting Cadillac services now will be getting Chevy services. Something has to give to free up money for people who weren't being served.”

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