Wisconsin slows long-term care reorganization; advocates worry about pooling program funds

State officials in Wisconsin are decelerating their plans to funnel millions of government dollars for nursing home and outpatient services through a single point of entry.

"The reason we’re slowing down is a political concern, frankly," says long-term care policy analyst Lorraine Barniskis in the state’s Department of Health and Family Services. "We’re down to the wire, and support is not unqualified."

The massive Family Care initiative would funnel approximately $200 million of the state’s $2 billion long-term care budget through "one-stop" shopping entry points at the county level. Information and assistance about available services will be funneled through clearinghouses called Aging and Disability Resource Centers. The heart of the proposal envisions "care management organizations," entities that will receive a capitated amount based on an enrollee’s level of functional disability and broker the wide variety of services available to that person. An enrollee’s participation in the program is voluntary.

The plan proposed by Gov. Tommy Thompson in his State of the State address in late January lowers the mid-2001 target covered by Family Care from 50% of the state’s population to 25%. The revised schedule calls for 12 resource centers serving 14 counties by then.

Two major concerns appeared to slow implementation. Counties have the right of first refusal to serve as care management organizations, and may operate without competition for two years. After that, however, counties will have to compete with other entities for the job.

"They were concerned that they’d come in and work out all the bugs, and then have to turn it over," says Rob Gundermann, public policy coordinator for the Wisconsin Alzheimer’s Association Chapter Network.

The Alzheimer’s association and many others involved in long-term care services are worried that that the impact of currently restricted funds may be diluted when the money is combined in a larger budget item. For example, the Alzheimer’s association is fighting to keep the state’s $1.8 million Family and Caregiver Support Program separate.

"It’s not a big number, but it’s important. We would support Family Care if we could keep the [support] program separate," says Mr. Gundermann.

The revised program calls for $11.8 million in planning, information technology, and other start-up costs in the next two years, Ms. Barniskis says. Approximately 100,000 people are receiving some publicly funded long-term care, according to state estimates.

Contact Ms. Barniskis at (608) 267-5267.