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News & Press: Legislative

Governor Walker Submits Proposed 2017-19 Biennial Budget Provisions Affecting Long-Term Care

Wednesday, February 8, 2017   (0 Comments)
Posted by: Sarah Bass
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From Forbes McIntosh, Government Policy Solutions, WALA Lobbyist

 

Governor Walker provided his biennial budget address today, beginning the Wisconsin state budget process.  While executive and budget-in-brief summaries have been provided, we are still waiting for the actual budget bill - which will include much more detail.

 

At this time it appears rate increases in the area of long-term care are focused on skilled nursing facilities, intermediate care facilities for persons with disabilities and personal care.

 

Further, based on the summaries provided, here is what we have found affecting long-term care so far - but keep in mind analysis of the complete budget bill will be occurring over the next few days and few weeks.

 

According to the Governor's Budget-in-Brief...
 
This budget broadly focuses on connecting certain individuals receiving public benefits to meaningful opportunities for employment and training to help lift families from poverty (see Wisconsin Works for Everyone). Medicaid enrollment remains flat in key categories such as children and parents and caretakers. As a result, compared to the base budget, the cost-to- continue increase totals $279,390,900 GPR over the biennium, the smallest cost-to-continue in recent past. The largest factors in this increase are a result of routine caseload, inflation, and utilization changes. As compared to prior biennia, federal factors, including changes in the state's federal Medical Assistance Percentage and Medicare Part D premiums, make up a smaller proportion of the overall increase.
  • Preserve essential safety net programs by providing $48,817,600 GPR and $231,076,300 all funds in fiscal year 2017-18 and $234,748,600 GPR and $824,527,700 all funds in fiscal year 2018-19, including SeniorCare and Medicaid and maintain essential health care services for eligible populations.
  • Expand Access for Children with Disabilities. Expand access to care by providing $14,067,300 in fiscal year 2017-18 and $25,205,500 in fiscal year 2018-19 to eliminate the waiting list for long-term supports for approximately 2,200 children with developmental disabilities, physical disabilities, or severe emotional disturbances. Also implement reforms to increase efficiency of service delivery and to develop an equitable funding methodology to ensure county funding remains within the program.
  • Nursing Home Rate Increases. Provide an increase of $18,354,900 in fiscal year 2017-18 and $33,118,900 in fiscal year 2018-19 to: (a) increase nursing home provider rates by 2 percent in each fiscal year to support direct care workforce and increased resident acuity in nursing homes; (b) increase provider rates by 1 percent in each fiscal year to intermediate care facilities for individuals with intellectual disabilities; and (c) increase funding for enhanced behavioral and cognitive impairment incentives.
  • Personal Care Rate Increases. Support Personal Care program direct care workforce by providing a 2 percent increase of $5,034,300 in fiscal year 2017-18 and a 2 percent increase of $9,936,300 in fiscal year 2018-19 to address increased program participant acuity.
  • Fully fund SSI Supplemental, Funeral and Cemetery Aid & Chronic Disease Program. Fully fund the ongoing costs of essential safety net programs, including the state supplement to the Supplemental Security Income program, the Medicaid Funeral and Cemetery Aid program and the Wisconsin Chronic Disease program.
  • Lead Poisoning \ Exposure. Update the definition of lead poisoning or lead exposure in statute from 10 micrograms per deciliter to 5 micrograms per deciliter, increase the Medicaid reimbursement for investigations to $800 and provide $61,000 all funds in fiscal year 2017-18 and $122,000 all funds in fiscal year 2018-19.
  • Medigap Helpline and BOALTC Services for IRIS. Strengthen support for Wisconsin seniors by fully funding the Medigap Helpline and providing permanent funding and support for Include, Respect, I Self-Direct ombudsman services at the Board on Aging and Long-Term Care.
  • Salary Guidelines for Certain Medical Professionals. Improve continuity of service and reduce training costs at state facilities by establishing new salary guidelines for certain medical professionals.
  • Inmate Commitment Process. Modify the commitment process for inmates to a state treatment facility to provide more timely treatment.
  • Peer-Run Respite Center for Veterans.  Provide $450,000 in fiscal year 2018-19 to develop a Peer-Run Respite Center for Veterans in the Milwaukee area to improve outcomes of veterans in crisis and those having difficulty coping with mental illness.
  • 8-Bed Childrens Crisis Treatment Facility. Provide $249,100 in fiscal year 2017-18 and $996,400 in fiscal year 2018-19 to develop an eight bed Crisis Treatment and Stabilization Facility for children to improve outcomes of children in crisis. The facility will be community based and provide mental health services to children in the least restrictive setting. In addition, the facility will improve clinical outcomes while also reducing the number of institutional admissions at Winnebago Mental Health Institute.
  • EMT Licensure. Improve retention and recruitment of emergency medical technicians and first responders by creating a new emergency medical technician endorsement and extending the time period for license renewal from two years to four years.
  • Hospice\Home Health Accreditation Process. Streamline the accreditation process for hospices and home health agencies by authorizing the Department of Health Services to recognize accreditation from Centers for Medicare and Medicaid Services approved organizations as evidence for state licensure. The change in process will save $27,000 GPR in fiscal year 2017-18 and $27,000 GPR in fiscal year 2018-19.
  • Travel Costs for Office of Children's Mental Health. Provide $10,000 in fiscal year 2017-18 and $10,000 in fiscal year 2018-19 for the Office of Children's Mental Health to reimburse individuals for travel costs associated with attending meetings to include people with lived experience in the decision making process.
  • Division of Long-Term Cares Savings. Reduce costs and improve management in the Division of Long-Term Care by converting contract positions to 41.5 permanent state employees and saving $1,542,300 in fiscal year 2017-18 and $2,056,400 in fiscal year 2018-19.
  • Forensic Treatment at Mendota. Increase forensic treatment capacity and improve patient services at the Mendota Mental Health Institute by providing 73.0 FTE permanent positions and $7,190,500 in fiscal year 2017-18 and $7,220,100 in fiscal year 2018-19 to reduce the current forensic inpatient caseload and admission waiting list. This is in part due to a renovation of one of the facility halls.
  • Ambulatory Surgical Centers.  Reduce the tax burden on ambulatory surgical centers that participate in the Medicare program by $16,624,300 annually by repealing the Ambulatory Surgical Center Assessment beginning in calendar year 2018. 

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