WHO calls for audit of Family Care

January 26, 2010

To: Joint Committee on Audit

Subject: Legislative Audit of Family Care

During the rapid expansion of Family Care, issues of concern about the program have been raised by Family Care members, families, advocates and provider agencies, many of which were voiced at last month’s Assembly Committee on Aging and Long-Term Care hearing. Wisconsin’s home care providers believe a legislative audit is necessary for a full and objective consideration of these issues. This request echoes the similar request we made in 2008.

We understand that Representative Kerkman and Representative Rhoades have already requested an audit of Family Care. Rep. Kerkman’s request that various provider concerns be addressed in the audit has our fullest support. Rep. Rhoades’ main concerns — inappropriate service cuts to people with disabilities and elderly people and the ability of MCOs to maintain required reserves – are also vitally important considerations.

Other considerations necessary to a meaningful audit include: the DHS capitation rates for MCOs do not cover the real cost of providing services, thereby denying an increasing number of providers the opportunity to work with Family Care; the ratio of direct care costs vs overhead costs at the MCOs; and the inequitable application of service contracts among providers.

As home care did in 2008, the Survival Coalition of Wisconsin also recently submitted a recommendation for a Family Care audit. The additional areas of focus recommended in that request seem prudent to Wisconsin’s home care providers as well:

  1. Service quality: Is Family Care helping to reduce the number of people in institutions in Wisconsin (as required in the Olmstead decision regarding the Americans with Disabilities Act); and are people living in less restrictive settings than before Family Care; is a higher proportion of the Family Care population in community-based employment (rather than work centers) than before Family Care; has access to medical and dental care gotten better or worse; what are the trends since Family Care started regarding the achievement of the Family Care desired outcomes (especially the consumer choice outcomes)?
  2. Long Term Care Workforce Issues: Is DHS making any efforts in Family Care to enhance the wages, benefits, working conditions or turnover rates of direct service workers; and if so, are these efforts producing any tangible results?
  3. Self Directed Supports: Are Family Care members supported to fully direct their Self-Directed Support benefit, as required by the Family Care enabling legislation?

Your careful consideration of this request is deeply appreciated.

Sincerely,

Russell King
President and executive director
Wisconsin Homecare Organization

cc: Senate Majority Leader Russ Decker

Assembly Speaker Mike Sheridan

Senator Jon Erpenbach, Chair, Senate Committee on Health, Health Insurance, Privacy, Property Tax Relief, & Revenue

Representative Peggy Krusick, Chair, Assembly Committee on Aging & Long-Term Care

Janice Mueller, State Auditor

Terry Anderson, Legislative Council

DHS Secretary Karen Timberlake