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Family Care running in Walworth County

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ANN MARIE AMES
December 21, 2009
— The transition to Family Care is the biggest change Cindy Simonsen has seen in her career.

Her positive attitude has raised a few eyebrows, but Simonsen, the executive director of VIP Services of Elkhorn, doesn’t believe failure is an option.


“I get accused of living in Whoville a lot. But I look at this transition as an opportunity,” Simonsen said.


By the end of the month, Walworth County will be halfway through its transition to Family Care, a managed care program for many who depend on public money for support.


Family Care will replace what used to be county-run programs for adults with disabilities and the frail elderly.


VIP Services offers programs for many of those people in Walworth County.


VIP Services, 811 Geneva St., is a nonprofit organization that provides in-house and community-based training and work opportunities for adults with disabilities. In addition, VIP runs day programs and transportation services for adults with disabilities.


Simonsen has worked at VIP Services for 16 years.


Forty-eight Wisconsin counties have made the change to Family Care, according to the Department of Health Services Web site. Walworth County started the transition Oct. 1. Rock County still is researching the transition and has not set a date for the change.


The biggest change between the programs is the funding source, said Phil Boutwell, assistant Rock County administrator.


When counties run developmental disability or long-term care programs, the money comes to counties from federal waivers, Boutwell said.


Under Family Care, the money is funneled through a handful of state-appointed managed care providers, which are similar to HMOs, Boutwell said.


The starting point under Family Care is an Aging and Disability Resource Center.


Each county that gets into Family Care is expected to have a center up and running before the switch.


Walworth County’s center is located in the county campus on County NN in Elkhorn. It opened Aug. 1.


The centers function as one-stop-shops for people with disabilities and their families. There is no income qualification to use the centers, and people can go back if situations change, Simonsen said.


Workers at the center connect clients to the services they need, Boutwell said.


The managed care organization takes on the risk of providing or contracting for the services, Boutwell said. The managed care organizations get a per capita amount of money to do so.


In the county model, the county acts as a funding source and a provider, Boutwell said.


“Not only are we the source of money, people come to us to either provide a service or contract for it,” Boutwell said. “The money follows them to a provider. With an MCO, they would be serving our function.”


The state maintains that the change to Family Care will save money, reduce waiting lists and improve services. That’s been a hard concept for providers to swallow, Simonsen said.


It seems counter-intuitive, she said. Add that to the fact that people don’t like change, and you’ve got a lot of worried service providers, she said.


“It’s hard for people to wrap their heads around,” Simonsen said. “There’s no more money (than when the county was running the programs.) We’re using the same amount of money to serve more people.”


To eliminate waiting lists, some people are going to see service changes, she 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,” Simsonsen said.


No waiting lists mean more people are getting services. And the list of applicants could grow. Some people might have avoided applying because they assumed they would just be on a waiting list, Simonsen said.


As the number of clients increases, service providers constantly find new challenges, she said. One obvious challenge in Walworth County has been a lack of transportation options, Simonsen said.


People are coming off waiting lists and increasing demands, she said. Because the Family Care program is so new, providers have no history to turn to when they run into challenges, Simonsen said.


“I’ve been mentally preparing myself for this for three years,” Simonsen said. “You can’t be prepared enough.”


Family Care closer in Rock County

Rock County could implement Family Care in 2011, Administrator Craig Knutson said.


That’s Knutson’s rough estimate as county officials head back to the Family Care drawing board.


It’s “inevitable” that the county will make the change, he said. The waiver programs that the county currently uses to fund disabled or frail elderly care are becoming more “onerous” and difficult to comply with, Knutson said.


Also, Family Care promises to get rid of waiting lists, which Rock County has, Knutson said.


The county had been expected to implement the program in 2010. But in April, officials sent a letter to Gov. Jim Doyle asking for more time. The letter cited the county’s high unemployment rate and budget restrictions. Dane County made a similar request.


The two counties last year partnered in the Family Care planning process, sharing a $130,000 grant to prepare for the transition. The grant ran out in 2008.


The county still can use the plans to help as it continues researching Family Care, Knutson said.


What is Family Care?

Family Care provides managed care for many people who depend on public funding for their long-term care needs.


Consumers include the frail elderly and adults with physical disabilities or developmental disabilities.


The state-managed program piloted in 2000 and officially launched in 2006.


Currently, 48 Wisconsin counties offer Family Care, according to the state’s Web site. Walworth County launched its Family Care program Oct. 1. Rock County is not participating at this time.


State officials have said that by taking the burden of services away from counties, Family Care will save money, reduce waiting lists and improve services.


To fund the program, counties are required to hand over to the state the amount of money they normally devote to caring for the elderly, disabled and developmentally disabled. Much of that money comes from the state to pay for the mandated programs.


The state then contracts with a managed care provider. That provider contracts locally for transportation, vocational and housing services or any others clients could need.


In Walworth County, the managed care provider is Community Care, 795 E. Geneva St., Elkhorn.


To learn more, visit http://dhs.wisconsin.gov/ltcare.

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