Julie Anstett
DHS Director of Area Administration
DHS Fiscal Update
May 3, 2017
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DHS
2017
Field Goals
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Wisconsin Medicaid: Current Program
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Wisconsin Medicaid – Projected All Funds Costs under
Current Law, by Eligibility Category (in $ Billions)
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This projections assumes 5.4% growth in costs annually (3.4% PMPM and 2.3% Caseload)
Elderly, Blind, and Disabled members account for 66% of program costs and 21% of program enrollment
Children account for 12% of program costs and 43% of program enrollment
Long-Term Care Investments in the 20172019 Biennial Budget
• Eliminates home and community-based services waiting lists
for children.
• DHS will work with counties on a funding allocation and county
contribution methodology.
• Governor Walker will conclude the long-term care reforms
that Governor Thompson began when Family Care is
expanded to the final county (Dane County) in January 2018.
• Eliminating all home and community-based services waiting
lists for adults and children will make Wisconsin a national
leader.
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Long-Term Care Workforce Challenges
• By 2040, Wisconsin’s population of people ages 65 and
older will increase 72%.
• This means more and more people will need some type of
individualized care, either in a nursing home, assisted
living facility, or in their own home.
• Current challenges:
• In Wisconsin, 1 in 7 caregiving staff positions are unfilled.
• Nearly 50% of providers had no applicants for vacant caregiver
positions.
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Wisconsin Caregiver Career Program
• In March 2017, Wisconsin received more than $2.3 million
to implement this new program.
• Program designed to encourage 3,000 Wisconsinites to
enter caregiver careers by providing training and testing.
• Program developed in partnership with nursing homes,
LeadingAge Wisconsin, Wisconsin Health Care
Association, and Wisconsin Technical College System.
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Wisconsin Caregiver Career Program
• Includes $250,000 for a marketing and recruitment plan
to highlight the program and rewarding aspects of
working as a nurse aide caring for Wisconsin’s elders.
• Includes resources for DHS to work with nursing homes to
explore ways to make working in their facility a desirable
location.
• Flexible hours
• Accommodations for child care
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Personal Care Independent Assessment
• Goal is to ensure the right amount of care is being provided to
members at the right time in the right settings.
• Starting June 1, 2017, Liberty Healthcare Corporation, will
conduct in-person assessments using DHS’ personal care
screening tool to determine a member’s medical needs for
services.
• Includes Wisconsin Medicaid and BadgerCare Plus members
who receive personal care services through:
• Fee-for-service (card services)
• IRIS (Include, Respect, I Self-Direct) program; those who do not selfdirect their personal care services
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CLTS Waiver Renewal
• Three waivers reduced to one waiver.
• Reduced reporting for the counties.
• Wisconsin Provider Management (WPM) state directory.
• State rate setting methodology in development for waiver
services.
• CMS Corrective Action Plan.
• DHS is committed to continuation of services.
• CLTS meeting May 10th in Madison.
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Children’s COP
• Draft guidelines and memo issued to counties 4/4/17.
• CCOP Procedure Guide
• Informational Memo
• All counties submitted their C COP Plans.
• Plans were all reviewed and approved.
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IMD Rebalancing Initiative (RI)
• Background:
• Launched July 1, 2016.
• To assess future collaborative planning and policies.
• Pilot ends December 31, 2017.
• Goals:
• To provide some financial relief to counties.
• To better understand and further promote collaboration with
counties.
• To gather data.
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IMD Rebalancing Initiative (RI)
• In Q3 and Q4 of 2016 fewer Counties participated than
DHS anticipated.
• 71 IMD stays were reported.
• IMD RI paid out $223,769 to counties to date.
• $1.8 million funding available to counties for CY 17.
• DHS is amending the contract to move the county due date from
January 31, 2018 to March 31, 2018.
• DHS will have more data from the MCO’s later in 2017 and will do
further analysis.
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Questions
For questions about this DMS - LTC information please
contact:
• Deb Rathermel [email protected]
• CLTS Waiver Renewal
• Children’s COP
• Vaughn Brandt [email protected]
• IMD Rebalancing Initiative General Questions
• Grant Cummings [email protected]
• IMD Rebalancing Initiative Contract/Fiscal
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Electronic Health Records (EHR)
• DHS received approval in the 2013-2015 biennial budget to
procure an EHR system to support its seven care facilities.
• Benefits to having an EHR:
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Increases continuity of care.
Reduces medical errors.
Standardizes care and facilitates best practices.
Provides the ability to analyze trends and long term changes in
patients.
• Improves medical practice management.
• Enhances physician recruitment.
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Treatment to Competency
• The 2017-2019 biennial budget increases forensic patient
capacity to help DHS reduce waiting time for forensic
patients on the admissions list and reduce population
pressures in county jails.
• Provides funding to staff two additional treatment units for
forensic patients at Mendota Mental Health Institute, totaling 40
beds, which will be operational 2020.
• Adds 73 FTE and $7.2 million All Funds per year.
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Comprehensive Community Services
• Available in 64 counties, two tribes.
• DHS is committed to working with county and tribal
partners to ensure all CCS clients are receiving highquality services.
• Meetings are being held in each DHS region to address
the concerns raised by counties and tribes regarding
programming, recent audits, and technical assistance
provided by DHS.
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Mental Health and Substance Use Initiatives
in the 2017-2019 Biennial Budget
• Invests $1.2 million to develop an eight bed Crisis
Treatment and Stabilization Facility for children to
improve outcomes for children in crisis.
• Intended for short-term (non-emergency detention)
placements.
• Will be community-based and will provide mental health
services to children in the least restrictive setting.
• Develops 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.
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Governor’s Task Force on Opioid Abuse
• In 2016, Governor Walker responded to the epidemic and
formed the Governor’s Task Force on Opioid Abuse,
naming Representative Nygren as a co-chair
• Special Session on Opioid Abuse:
• Keep track of prescription drugs.
• Enable first response.
• Invest in treatment.
• Wisconsin has earned its reputation as a national leader
in the response to this public health crisis.
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21st Century Cures Act Grant
• Wisconsin was awarded $7.6 million of year one funding from
the Substance Abuse and Mental Health Services
Administration.
• 21st Century Cures Act Grant year one is May 1, 2017 through
April 30, 2018.
• Grant purpose:
• Expand access to evidence-based treatment and recovery supports
for opioid use disorders.
• Increase retention in opioid treatment services.
• Improve quality of life and advancing effective opioid misuse
prevention strategies.
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Wisconsin 21st Century Cures Act Grant
Activity Highlights
• Allow up to 25 hospitals with high rates of drug overdose
care to hire contract recovery coaches.
• Expand the state medically assisted treatment centers to
provide assessment, counseling, treatment, and intensive
case management services to many individuals looking for
support.
• Create an addiction hotline.
• Support community coalitions focused on reducing the
nonmedical use of opioids among people age 12 to 25.
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Questions
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