There are 94 elderly and disabled people in Door County waiting for health services – some have been on the waiting list for months or longer, some for more than 10 years. If those people lived in other Wisconsin counties, they would already have care.
That’s because other counties, 57 out of the state’s 72, have already implemented Family Care, a long-term care system for elderly and disabled individuals that eliminates the waiting list.
“Counties that have Family Care no longer have people waiting,” said Joe Krebsbach, director of the Door County Department of Human Services. “As county taxpayers, we are all paying for the same service somebody can get somewhere else, but our individuals are waiting on wait lists.”
Family Care was created in 1998 to help the state pay for long-term health care for elderly and disabled people. Its services can range from in-home help with housekeeping to providing access to group nursing facilities, and can often keep people in their own homes, a big plus for young, disabled individuals.
In 2006, former Governor Jim Doyle announced he would expand Family Care statewide, but in 2011 Governor Scott Walker and the Wisconsin legislature capped the program until studies could prove it was effective. That decision has left Door County and the rest of Northeast Wisconsin with the old legacy waiver program, which has counties organize services.
That could change this year, since the Wisconsin Department of Health and Human Services issued a report on the future of Wisconsin’s publicly funded long-term care.
The report said Family Care is cost-effective, delays entry into nursing homes and rewards innovations in care and cost control, and projected the state would save almost $35 million over 10 years by expanding Family Care. The positive conclusion could be enough to convince the Joint Finance Committee to let Northeast Wisconsin implement Family Care.
“Family Care provides the foundation for the next phase in the department’s work to transform the long-term care system from one dominated by institutional care in nursing homes to one where people with long-term care needs have the opportunity to receive less intensive and less expensive services in their homes and community-integrated settings.” – Department of Health and Human Services’s Long-Term Care Expansion report.
“The way we get this Family Care started is for the Department of Human Services to give permission, and even now they were waiting the Joint Finance Committee to give the go-ahead,” said Susan Kohout, Door County Board supervisor and chair of the county Legislative Committee. “All the lobbying we did before was to convince the Joint Finance Committee to do that during their last budget session. They didn’t do it, but said they wanted a report from the Department of Human Services to see how Family Care was working throughout the state of Wisconsin.”
Two bills in the legislature could also bring Family Care to Northeast Wisconsin. One was written by Senator Robert Cowles, the other by Representative Garey Bies of Sister Bay.
Bies said Wisconsin’s projected $1 billion surplus should help convince other legislators expanding Family Care is the right thing.
“There’s some initial cost [with implementing Family Care], but our new financial status, the state financial report projects a surplus, could make startup costs easier,” Bies said. “It isn’t an instant savings, it’s down the line you start saving the money.”
If Door County is allowed to implement Family Care, the Wisconsin Department of Health Services would choose a Managed Care Organization (MCO) to run the program for the region. Krebsbach said MCOs can keep costs down because they’re large organizations.
“It’s a change in the system,” Krebsbach said. “They’re buying things in more of a bulk rate, they’re probably more aggressive with how they’re managing contracts with vendors so they’re trying to bring the prices down.”
Under Family Care, wait lists have to be eliminated in three years, which Krebsbach expects will mean some people see fewer services in order to accommodate more people in the program. He also expects to see a bump in jobs needed to provide care and the region’s elderly and disabled getting access to the same care given to the rest of the state.
“I’ve been a strong proponent of getting Family Care here, primarily because I see that huge inequity of individuals,” he said. “If they lived across the right border of a county, they could get services they can’t get here.”