- Associated Press - Monday, April 21, 2014

MADISON, Wis. (AP) - Wisconsin health officials are ready to begin expanding the Family Care program that provides in-home care to seven additional counties, but it could take as long as three years to get things ramped up.

Gov. Scott Walker said Monday his administration is ready to start work on extending Family Care to Brown, Door, Kewaunee, Marinette, Menominee, Oconto and Shawano counties. The expansion would include 2,434 people who use similar county-based care programs, 977 people on waiting lists for county services and anyone else who resides in the counties and meets the eligibility requirements.

“The expansion of this program allows more people to stay in their homes, where they prefer to be,” Walker said in a statement. “By extending Family Care services, they can have a better quality of life, more independence, and they can avoid the expense of moving into a nursing home before it’s necessary.”

Expansion is contingent on approval from the Legislature’s powerful Joint Finance Committee, which would have to sign off on any contracts with health care providers to cover Family Care services. The Legislature has adjourned for the year but committee co-chairwoman Sen. Alberta Darling, R-River Hills, generally supports the idea, a spokesman said, adding the committee could meet on the matter before the end of 2014. A message left at the office of co-chairman Rep. John Nygren, R-Marinette, wasn’t immediately returned Monday.

Family Care offers a variety of programs through Medicaid for long-term care for the disabled and elderly, helping to keep them out of nursing homes. The program is currently available in 57 of the state’s 72 counties and serves about 41,000 people.

Walker imposed a Family Care enrollment cap in the 2011-13 state budget that began July 1, 2011, but the federal Centers for Medicare and Medicaid Services ordered him to remove the cap that December. Walker announced at the time he wanted to expand the program to the 15 counties where it wasn’t offered.

Since then, the state Department of Health Services has worked to complete a cost-effectiveness study as required in the 2011-13 budget; evaluate whether expansion was feasible statewide; and identify efficiencies, DHS spokeswoman Stephanie Smiley said. The current 2013-15 state budget called for the state Department of Health Services to conduct another cost-benefit study, which found a statewide expansion would be $34.7 million cheaper than the counties continuing their own programs.

“The Department believes that it has the support it needs to move forward,” Smiley said in an email to The Associated Press.

Walker’s administration decided to start with the seven northeastern Wisconsin counties because they’re closest to being ready to put Family Care in place, Smiley said. All seven counties have approved resolutions creating a long-term care district to provide or contract for Family Care services, according to documents from the Legislative Fiscal Bureau.

Smiley said DHS hopes to start enrolling people by the end of 2015, but warned starting Family Care in other counties has sometimes taken up to three years. She said DHS has to select providers, certify their abilities, get finance committee contract approvals and shift county program participants over to Family Care.

Smiley said the state will cover the expansion through cost savings generated through improved efficiencies. She did not elaborate.

Jeremy Kral, executive director of the Brown County Human Services Department, didn’t take issue with DHS’ time frame, saying the switch from county programs to Family Care will require an extensive overhaul of health care delivery models.

But he said the move is historic; it will eliminate waiting lists and save the county tax dollars devoted to long-term care costs.

“It will change lives,” Kral said.

Smiley said it’s unclear when DHS would start moving to expand Family Care into the remaining eight counties: Adams, Dane, Forest, Florence, Oneida, Rock, Taylor and Vilas.

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