Lawmakers scale back Scott Walker’s plan on long-term careMadison — Republican lawmakers committed Thursday to scale back Gov. Scott Walker’s proposal to disassemble and then rebuild Wisconsin’s long-term care system, again balking at a piece of the likely presidential candidate’s budget bill.
In a series of votes Thursday affecting some of Wisconsin’s most vulnerable citizens, lawmakers on the budget committee approved a bigger increase than was sought by Walker to help address the crisis in the state-run child welfare system serving Milwaukee County.
In addition, the panel essentially voted along party lines, with all Republicans for and all Democrats against, to lower from five years to four years the lifetime limit for receiving training and employment assistance through Wisconsin Works, the state’s successor program to welfare.
Legislators said they backed some of the basic principles in Walker’s proposal to overhaul the way tens of thousands of elderly and disabled people are cared for outside of nursing homes, such as closely coordinating in-home care and medical care. But they declined to sign off on such sweeping changes — such as switching from the current nonprofit providers to national for-profit insurers — without seeing the details and giving those affected more opportunity to weigh in.
“We’re not for blowing up everything,” said Sen. Alberta Darling (R-River Hills), co-chairwoman of the Joint Finance Committee.
Instead, GOP lawmakers said they would require the Walker administration to flesh out a more modest restructuring of the care programs and then bring it to the budget committee for an up-or-down vote in the coming months.
As GOP lawmakers have for the past four years, they are still sticking with Walker on most issues in the state Capitol. But as the governor travels in preparation for his presumed presidential bid — he was in Israel this week — Republicans at home are increasingly staking out different positions on key issues.
“We may have a crap budget, but we’re going to make it better,” state Rep. Rob Brooks (R-Saukville) said on the Assembly floor Wednesday.
Brooks was responding with the candor of a freshman lawmaker to comments Wednesday by Democrats such as state Rep. Andy Jorgensen of Milton, who likened Walker’s proposal to a “Dumpster fire.”
The state’s Family Care program provides long-term care outside nursing homes to roughly 41,000 elderly and disabled people in Wisconsin and uses funding from both state and federal taxpayers. GOP lawmakers said they would still expand Family Care to the state’s eight remaining counties without it, including Dane County, as Walker had proposed.
The governor’s proposal would have restructured Family Care to move away from its eight individual nonprofit managed care organizations, similar to HMOs, that operate in different regions of the state.
Walker had wanted to operate Family Care through still unidentified statewide insurers — likely national companies — providing not just long-term care for recipients but also medical care.
Advocates for the elderly and disabled said the budget proposal could have forced vulnerable people to change their doctor, the care worker who visits their family home or even the group home where they live with other disabled recipients of the program.
Darling and other Republicans said Thursday that they supported integrating medical care and in-home care such as preparing meals and help taking prescriptions. But they said they didn’t support eliminating a related long-term care program called IRIS, which allows roughly 11,000 low-income elderly and disabled recipients to develop and carry out their own plans to live independently.
Sen. Leah Vukmir (R-Wauwatosa) said lawmakers also didn’t support ending Family Care’s regional approach or making it difficult for existing providers to compete for their current clients and contracts.
Instead, lawmakers will direct the administration to develop a new plan by working more closely with federal officials, advocates for patients and the existing providers. Before the plan is submitted to federal officials for approval, the Joint Finance Committee will have to sign off on it, Rep. John Nygren (R-Marinette) said.
Walker spokeswoman Laurel Patrick said the governor’s administration would “continue working with members of the state Legislature and the Department of Health Services to maintain these vital services and explore reforms to improve health outcomes for our most vulnerable.”
Taking on child abuse
The budget committee Thursday also decided to enlarge Walker’s proposal to increase spending to address the growing backlog of possible child abuse cases at the Bureau of Milwaukee Child Welfare, which investigates claims of abuse or neglect and can decide whether to remove children from their homes.
The committee approved Walker’s proposal to add $1.9 million over the next two years to hire 11 more workers in Milwaukee and then provided an additional $1 million over two years to help keep existing caseworkers from leaving the office. Both Republicans and Democrats support those changes.
GOP lawmakers voted down a Democratic motion to spend $690,000 more over two years to hire aides to help caseworkers.
The share of reported abuse cases that get investigated within the 60-day deadline in state law has fallen in recent years, according to the Legislature’s nonpartisan budget office.
In the first half of 2012, just over half of the allegations were reviewed within 60 days, the Legislative Fiscal Bureau found. From August 2014 to January 2015, only one in five was handled on time by the agency.
During that time, children are potentially being exposed to more abuse, the analysis noted.
“The department is leaving children in horribly dangerous situations,” Rep. Chris Taylor (D-Madison) said.
The number of delinquent unclosed cases jumped from 149 in February 2013 to 2,918 in June 2014, according to the fiscal bureau. Average caseloads doubled over that period.
The Milwaukee Journal Sentinel has reported on those problems and the constant staff turnover at the child welfare bureau. Over each of the past four years, about one-third of the bureau’s 100 staff members have left.
In response to a 1993 lawsuit and a 2002 settlement, the state took control of Milwaukee County’s child welfare services.
Memos obtained by the Journal Sentinel showed that Arlene Happach, then the bureau’s director, worried that the backlog threatened child safety and repeatedly expressed her concerns to her supervisors, writing in April 2014 that she believed the state was “putting children at risk.” Happach resigned in July.
On Thursday, the budget committee voted, with all Republicans in support and all Democrats opposed, to reorganize the office and make Happach’s former position a political appointment rather than a civil service position.
The committee also unanimously approved Walker’s proposal to provide $2 million in 2016-’17 to purchase or provide residential and community-based social services for victims of sex trafficking.
In the pilot program, the Bureau of Milwaukee Child Welfare contracts with Lad Lake, a Dousman treatment center, to provide services for victims of sex trafficking.
Also Thursday, Republicans and Rep. Gordon Hintz (D-Oshkosh) voted to direct the state Department of Children and Families to seek bids from private contractors to keep newly released prisoners in Milwaukee from returning to crime and incarceration.
Any contract would have to be approved by the budget committee. The contractor could seek both charitable donations and private investor money and would be paid by the state only if the goals of the program are met.
The panel also supported Walker’s budget proposal to increase spending for victims of domestic abuse and their children by $5 million to $14.6 million.