Republican legislators voted today to revise or reject significant aspects of the Governor’s proposals to change community-based long-term care for the elderly and people with disabilities. However, they left enough of the Governor’s ideas intact to alarm advocates and people who rely on the Family Care and IRIS programs.

A guiding principle for disability groups is summed up by the slogan “nothing about us without us.” In other words, no policy should be decided without the full and direct participation of members the group affected by that policy. After seeing the majority party’s plan that was unveiled and approved this afternoon, many advocates with disability groups complained in essence that the latest version of “reforms” to long-term care does not respect the fundamental principle of providing meaningful stakeholder involvement.

Lisa Pugh, Public Policy Director of Disability Rights Wisconsin (DRW) summed up the concern about the process: “Families, individuals, small business providers and advocates clearly asked to be at the table… from start to finish to develop a plan. This request was not respected.”

Four GOP members of the Finance Committee issued a press release today making arguments for their plan. In the words of JFC co-chair John Nygren, “We listened to people from around the state and heard their concerns loud and clear. The governor’s long-term care plan was lacking in detail; it’s for this reason that we are rejecting his proposal in favor of a new plan.”

However, many advocates were unimpressed with the new substantive details, as well as the lack of stakeholder involvement. For example, Lynn Breedlove of the Wisconsin Long-term Care Coalition said: “Let’s be clear, this new plan is just the Governor’s proposal in sheep’s clothing.” The coalition’s press release expands on the substantive concerns:

The secret plan approved by the Committee creates new, unknown entities called Integrated Health Agencies (IHAs) that will replace our Wisconsin-based Managed Care Organizations (MCOs) and does not maintain IRIS as a separate, non-managed care program.

The Joint Finance Committee is expected to finish up its work on the budget later this week, perhaps working into the weekend. After all the elements of the JFC changes are consolidated into a new version of the budget bill, it will be reviewed by both houses of the legislature. Additional changes are possible at that time, but in recent years there have been relatively few changes after the JFC work is completed.

Jon Peacock