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Family Care could be coming to Rock County

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Catherine W. Idzerda
December 30, 2011
— For more than three years, Rock County has been working with the state to implement Family Care, a program that changes the way some health services are funded.

First, the state insisted that the county get on board.


After the county was ready to go, the state asked it to hold off for six months.


In June, the Legislature passed a budget that capped Family Care enrollment and shut out Rock County.


On Wednesday, Gov. Scott Walker announced a plan to lift the Family Care enrollment cap, prompting county officials to dust off their implementation plan. Walker said he was lifting the cap because he was "confident that Family Care can continue to be implemented efficiently and cost effectively."


He did not mention the recent order from the federal Centers for Medicaid and Medicare Services, directing


him to lift the enrollment cap, the Milwaukee Journal Sentinel reported Wednesday. Walker's office replied that it had planned to lift the cap all along.


Whatever the reason, the policy change still has to be approved by the Legislature.


It's probable Rock County will have Family Care, but it's not clear when.


"We're waiting to hear from the state," said Phil Boutwell, deputy director of the Rock County Human Services Department. "They'll come up with the timeframe."


Family Care is the state-mandated program that changes the way some health services are funded. It is an alternative to Medicaid wavier programs for people who need long-term care including the frail elderly and people with developmental or physical disabilities.


Now, Rock County residents who need those services go to one of three county organizations: long term support, the developmental disabilities board or the council on aging.


Under Family Care, residents would go through a single clearinghouse called the Aging and Disability Resource Center.


"It makes sense from a customer service standpoint," Boutwell said.


Many clients might fall under more than one program, for example. A person with developmental disabilities might need long term care, or that person's needs might change as they age.


Instead of a "confusing array of doors to knock on," the resource center would provide information and referrals to community programs that could help, Boutwell said.


If the person qualified for services, he or she would be sent to a managed care organization, a private company that would provide case management services.


Those services—housing, nursing home placement and work placement—are now provided by the county using county, federal and state money. When Family Care is implemented, the state would contract with a managed care organization that in turn would contract with individual service providers to work with clients. The state is in charge of finding the contractor.


Rock County already has taken several steps toward the implementation of Family Care.


It developed a plan for its resource center, which has to be open for 60 days before Family Care starts.


Rock County's center would be located in the Rock County Job Center on Center Avenue in Janesville. That way, clients also could be referred to other economic support specialists.


The resource center would take over space now occupied by the long-term support program.


The long-term support program, which employs about 15 people, would be dissolved. The developmental disabilities board, which employs about eight people, would be reduced.


Many people have questioned what would happen to the county workers in those positions. While the funding source for the work would change, the work itself would not, Boutwell said in an earlier interview. Jobs could be available with the service providers who are contracted by the managed care organization or in the aging and disability resource center, he said.


FAMILY CARE TIMELINE

Family Care is a state-mandated program that changes the way some health services are funded. It is an alternative to Medicaid wavier programs for people who need long-term care including the frail elderly, and people with developmental or physical disabilities.


For more than three years, Rock County and the state have been going back and forth about if and when the program should be implemented.


2009: Rock County is scheduled to start Family Care in 2010 but asks the state for a delay. The state initially agrees, but later tells the county that its wavier programs, which provide funding for services, would be taken away. That leaves the county with no option but to switch to Family Care mid-2011.
July 2010: A 15-member steering committee meets to learn about Family Care and develop a plan for the Aging and Disability Resource Center. The center must be operational for 60 days before the county can move to Family Care. County officials say they hope to open the center in April 2011 and start Family Care in June 2011.
August 2010: State officials ask Rock County to delay the switch to Family Care for an additional seven months. They say the delay is necessary to allow the state and contracted organizations to recoup human and financial resources after "significant" expansion of the program in the last two years.
June 2011: Gov. Scott Walker's state budget caps Family Care enrollment at 43,000 people, effectively shutting out counties that are not already part of the program.
Dec. 13: Federal authorities send a letter to Walker's administration ordering that Wisconsin lift the Family Care enrollment cap.

Wednesday: Walker announces that the cap on Family Care enrollment will be lifted.



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