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News & Press: Family Care

Providers, DHS, and MCOs Met To Discuss Family Care Funding Budget Increase

Wednesday, January 3, 2018   (1 Comments)
Posted by: Sarah Bass
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On December 21, 2017, WALA, along with other long-term care associations and providers met to discuss how the funds from the Family Care funding increase in Act 59 would be distributed. Each year of the biennium Wisconsin allotted $12.5 Million GPR with additional federal matching funds a total of  $60.8 Million in the 2017-2019 budget to increase the direct care and services portion of the capitation rates to address the direct caregiver workforce challenges in Wisconsin.

At the meeting, Grant Cummings, Section Chief of the Benefit Rate & Finance Section of the Bureau of Long Term Care Financing in the Division of Medicaid Services, reviewed the scope of the workgroup, timeline, and some options that may be available to reimburse providers.


The managed care rule provides states with the following options for a state to direct MCOs how to reimburse providers:

1.       PMPM increases (per member per month)

2.       Percentage increase

3.       Minimum rates

4.       Maximum rates

5.       Fixed rates

The workgroup will reconvene again, possibly twice in January and again in February to finalize the approach for submission. The goal of the Department is to have a finalized approach deadline of February 16, 2018 and a report to CMS no later than March 1, 2018. CMS has then a 90-day review period for submissions.

The workgroups goals and concerns include the following:

·       That 100% of the monies shall be passed on to the providers.

·       Transparency is evident within the process and allocation of funding from MCOs.

·       No additional or minimal reporting requirements.

·       Providers have flexibility on how the funds shall be used.

·       Funding shall be sustainable.

There was also assurance from the MCOs that their role is only as a pass-through and are not profiting from this additional funding.

As defined by DHS and the MCOs, a direct care worker is: CNA, home health aides, or personal care aides, in the following settings: adult day care, day habilitation services, residential, respite out of a nursing home, supportive home care, and supportive employment - small group employment support services. They did exclude state plan services, Nursing Homes and Personal Care, because they received separate increases.

Additionally, DHS released the results of the provider survey conducted in the fall of 2017 by the MCOs. Below are the slides from the meeting showing the results of the survey questions.



Rainbow House says...
Posted Thursday, January 4, 2018
I tried to read the member survey slides even with a magnifying glass. I could not. Could you fax me the 3 slides blown up first so I can read them ? Marcia Christiansen Rainbow House

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