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News & Press: Family Care

Update on Caregiver Funding State Budget Provision

Monday, March 5, 2018   (0 Comments)
Posted by: Sarah Bass
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From Forbes McIntosh, Government Policy Solutions, WALA Lobbyist


DHS to Submit Plan to CMS for Review \ Approval

Included in the Wisconsin 2-year biennial budget that was passed by the state legislature and signed by Governor Walker last September was a provision to provide $60 million (all funds) to the Family Care direct care portion of the capitation rates in recognition of the direct caregiver workforce shortages. The provision is meant to help Family Care providers deal with the caregiver shortage - and provide funding toward wages, bonuses, time-off or benefits.  Since the provision impacts funding in Medicaid managed care, the federal Centers for Medicaid and Medicare Services (CMS) would have to sign-off on the methodology proposed by the state. 

The Wisconsin Department of Health Services put together an advisory workgroup of stakeholders to provide recommendations on the caregiver funding proposal that will be submitted to CMS.

Please note that the funding plan is not finalized and final CMS approval still needs to be obtained.  Therefore Family Care providers should not assume any financial impacts or final caregiver increase amounts yet.  CMS could deny any or all portions of what is being proposed.

DHS will be submitting a proposal to CMS for the use and implementation of the Family Care caregiver funding initiative included in the Wisconsin state budget. The "proposed" (not final nor approved yet) plan will include the following provisions.

  • Calculation of Funds. DHS will calculate and pay the direct care workforce funding to MCOs retrospectively between June 2018 and June 2019 based on services provided in CY 2018.
  • Allowed Use of Funding. Providers may use the funding to provide wage increases, retention/longevity bonuses, performance bonuses, additional paid time off, staff referral bonuses, sign on bonuses, and to pay the employer payroll taxes associated with these increased payments to workers.
  • Provider Accountability \ Attestation.  Providers need to sign the necessary attestation, complete a brief survey on the effectiveness of the direct care workforce funding, and indicate how much of the direct care funding the provider used for wage increases, additional paid time off, and the various types of allowable bonus payments. Providers will need to report this information after each quarterly payment from the Department. Please note that providers will not need to send documentation to DHS showing the amounts paid to each worker. An example of the table that providers will be asked to complete as part of the survey and attestation is below:

  • It is important to note that providers will still be required to maintain internal documentation that identifies the specific amount of direct care workforce funding that was paid to each direct care worker. Payroll records showing the wage increase or bonus payments to the worker will meet this requirement. This level of detail will be essential if there is ever an audit of this initiative.
  • Providers may count any wage increases, additional paid time off, or bonus payments made to direct care workers since January 1, 2018 as allowable uses of the direct care workforce funding as long as they have evidence that the worker's wage, bonus, or paid time off increased.

Again, this proposal still requires CMS approval before the initiative can be implemented - which CMS can approve, deny and request changes to any aspect of the proposal.

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