Future of Long Term Care – December 18th Letter and Actions Steps You Can Take

Seven members of the Assembly Aging and Long Term Care committee submitted a letter to the Department of Health Services (DHS) on Friday, December 18th regarding the redesign of the Family Care and IRIS systems. In the letter, they suggest which items they feel are most important for DHS to consider in the redesign.

They emphasize that adequate planning and transition strategies will be necessary to ensure that Wisconsin is prepared to implement Family Care/IRIS 2.0. This includes establishing specific requirements of “readiness” before an Integrated Health Agency can do business in Wisconsin and establishing quality and performance benchmarks.

In the letter, they detail what they think should be included in the plans and contracts.

  • They feel that stakeholder engagement is essential. Contracts should specify establishment of advisory committees and a system for consumers to provide feedback that includes information on their quality of life.
  • Contracts should require Integrated Health Agencies (IHAs) to collect data to track nursing home admission rates and transition rates from nursing homes to home and community-based settings (HCBS) in order to reduce costly institutional placements and emphasize HCBS for people.
  • Performance and program goals should be tied to payments and financial incentives. The state should regularly review quality benchmarks to determine whether or not IHAs are meeting standards and the IHAs should be compensated accordingly.
  • Support should be available for eligible individuals including options and enrollment counseling provided by an independent source at no cost and ombudsman services to resolve complaints.
  • The Department should ask IHAs questions to determine if they understand how to fully implement self-direction and person-centered planning.
  • The state should establish and monitor benchmarks related to increasing the number of people employed in competitive integrated jobs.
  • The state should document information on provider numbers and readiness to ensure that services will be delivered by qualified providers.
  • The rights of enrollees should be protected including systems to manage incidents and appeals processes (such as the ombudsman program), the ability for enrollees to move from self-direction to directed care and vice versa without being penalized, and flexibility with open enrollment periods when people have a significant change in their care or providers.
  • The state should take an active role in ensuring IHAs understand expectations. Quality and performance benchmarks should be monitored to ensure that services are delivered.

Click here to read the full letter.

If you would like to make sure that what is important to you is included in the new Family Care/IRIS 2.0 system, here are some Action Steps that you can take:

  1. Read the letter from legislators and decide which main points are important to you.
  2. Take the time to thank the legislators who signed onto this letter.
  3. Share a link to the letter with your own legislator and write a message about the points in the letter that are most important to you. Tell them how this impacts your life.
  4. Ask your legislator to contact the Department of Health Services on your behalf to inquire about how their Family Care/IRIS 2.0 plan will address certain points.

You can find legislator contact information by entering your address here (Find My Legislators): http://legis.wisconsin.gov/


Informational Meetings Regarding New Behavioral Treatment Benefit

The Department of Health Services (DHS) has two informational meetings scheduled this week to discuss the changes to coverage of autism treatment services that will take place in 2016. In July 2014, the Centers for Medicare and Medicaid Services (CMS) directed that autism treatment services must be covered under the Medicaid State Plan. Currently, the Children’s Long-Term Support (CLTS) Waiver Program provides funding for autism treatment services that are not covered under ForwardHealth Programs such as BadgerCare Plus, Medicaid, or the Katie Beckett Program; however, starting January 1, 2016 a new behavioral treatment benefit will be provided under ForwardHealth.

Details for the informational meetings that are scheduled this week can be found below. (Please note that the meeting in Green Bay can be attended through a live webcast.)

November 17, 2015
6:00 p.m. – 8:00 p.m.
Brown County Public Library
515 Pine Street
Green Bay, WI 54301
Live webcast: http://livestream.com/DHSWebcast/Autism

November 18, 2015
6:00 p.m. – 8:00 p.m.
Northcentral Technical College
1000 W. Campus Drive
Wausau, WI 54401

For more information, please visit the DHS Behavioral Treatment Transition website at: https://www.dhs.wisconsin.gov/clts/waiver/autism/index.htm

Family Care/ IRIS 2.0 – Share Your Comments

In the 2015–2017 State Budget, the Department of Health Services (DHS) is looking at making significant changes to the Family Care and IRIS Programs. The proposed changes will impact  individuals who utilize long term care services in Wisconsin. The DHS is accepting general advice and counsel from the public regarding the future of Family Care/ IRIS. Several meetings and public hearings have already taken place throughout the state with the last public hearings being held TODAY, October 6th in Milwaukee and TOMORROW, October 7th in Madison. If you would like to submit testimony but cannot attend a public hearing in-person, you can participate via webcast. Click here to participate in a public hearing via webcast or to view recordings of previous public hearings.

You can also submit comments via email or U.S. Mail until October 30, 2015.

Send email testimony to: [email protected].

Send written testimony to:

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

For more information on the proposed changes to the Family Care and IRIS Programs, go to: https://www.dhs.wisconsin.gov/familycareiris2/index.htm

Proposed Changes to Medical Assistance Purchase Plan (MAPP)

Please note that changes have been proposed to the Wisconsin Medical Assistance Purchase Plan (MAPP). MAPP is a work incentive program that allows people with disabilities who are working, or are interested in working, the ability to “buy‐in” to Medicaid. MAPP is intended to support people with disabilities by enabling them to pursue jobs and careers without jeopardizing access to health and long term care coverage.

The MAPP Reform & Sustainability bill (LRB 2576) proposes the following changes:

  • Institute a $25 premium for all participants under 150% of the federal poverty level (FPL), and a $50 or more premium for everyone over 150% FPL based on premium calculation.
  • Treat earned and unearned income the same in regards to eligibility and premium calculations.
  • Recognize in‐kind work as a form of self‐employment.
  • Determine eligibility on the basis of the individual participant’s income and assets.
  • For participants with adjusted income above 250% FPL, deduct all medical, remedial and long term care expenses from income to determine eligibility.
  • Give participants the ability to contribute to their independence/retirement accounts without risking penalty in other Medicaid programs once they can no longer work or they retire.
  • Report annually on the number of participants in the program, hours worked, wages per hour, total income levels, and other metrics that demonstrate increasing employment levels for MAPP participants.

For a PDF of the proposed bill, click here.

If you would like to support the MAPP Reform & Sustainability bill (LRB 2576), you can contact your legislator and ask them to co-sponsor the bill. Your legislator can add their name in support of the bill through the close of business TODAY, September 29, 2015. 

You can find out who your State Senator and State Representative is by typing in your address under the “Find My Legislator” section on http://legis.wisconsin.gov/

SNAP Fraud Alert

Please be advised that there is a risk of fraud concerning the federal Supplemental Nutrition Assistance Program (SNAP). An outside entity has “spoofed” the SNAP toll free information hotline number (1-800-221-5689) and has been making unsolicited calls requesting personal information. These illegitimate calls are not affiliated with the Food and Nutrition Service or SNAP. Never provide personal information or your credit card number over the phone to unsolicited callers.

If you suspect that you are receiving illegitimate calls from 1-800-221-5689, you may file a complaint with the FCC. If you have already fallen victim to this or a similar scam, please visit the Federal Trade Commission Identify Theft Consumer Information website for more information about identity theft.

Click here for more information from the WI Department of Health Services website.

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