SHARE

By of the

Cost-saving measures proposed by Gov. Scott Walker's administration to Family Care programs for frail elderly and people with disabilities are coming under fire by critics who say the changes could hurt those the program is meant to help.

County Executive Chris Abele told legislators Thursday at the Capitol that proposed efficiencies could endanger some elderly residents by imposing a barrier to residential care that could leave "some citizens at increased risk for unchecked abuse." Abele also said the county didn't have the staff to do "intensive prevention efforts" envisioned by the state reform ideas.

Abele also called for lawmakers to approve a measure that would lift an enrollment cap on the Family Care program that was approved as part of the 2011-'13 state budget. The cost-saving moves were proposed by the state Department of Health Services to help pay for an anticipated surge in enrollments once the cap is lifted.

The state's proposed sustainability modifications to the program include an emphasis on shifting clients from publicly financed help to "natural supports" - meaning a greater reliance on family members for care.

That's an unrealistic policy, said Stephanie Sue Stein, director of Milwaukee County's Department on Aging.

Families typically are tapped out - emotionally and financially - by the time a family member becomes eligible for Family Care, Stein said.

"Once they get to be served, families are so burned out and so poor that to do more would be really hard," she said.

Walker has said he is seeking Family Care efficiency reforms to ensure the program remains in place for the long run. A state review of the program was ordered last year in light of increased demand for Family Care and an expected doubling of the state's over-65 population by 2035.

Subhead

The state's cost saving ideas also could force Milwaukee County to hire additional staff to perform extra tasks, such as intervening shortly after people are placed in a nursing home to find out whether they could be capable of living on their own with community support. Counties also would work more actively with seniors and people with disabilities to arrange volunteer help, minor home repairs and cleaning in their homes to stave off more costly institutional placements.

Another cost-saver the state is eyeing is placing medication dispensers in homes of seniors, preloaded to spit out a month's worth of daily doses. Those could help avoid nursing home placements, hospital visits and other costs that come from skipping needed medication, according to a state memo on "living well at home and in the community." The memo says 23% of nursing home admissions result from seniors not properly taking needed pills.

The state reforms "mean you are making it so hard you are basically making it so people don't qualify anymore" for Family Care, said county Supervisor Marina Dimitrijevic, also a member of the county's aging board. "Seniors are smart enough to see through this."

Low-income guidelines for qualifying for Family Care already ensure that families aren't shirking their moral duty to help aging parents or younger adults with disabilities, Supervisor Lynne De Bruin said.

She said the state reforms were a stretch, "both morally and legally." The suggested moves might not meet federal standards, she said.

The host of proposed changes issued by the state in January would save an estimated $72 million in taxpayer dollars and also save $105 million in federal aid. The cost-saving suggestions followed Walker's announced removal of a seven-month freeze on enrollments in the program in late December, two weeks after federal officials ordered the state to do so immediately.

Enrollment cap still on

But the freeze remains in place. It would take a law change to undo it, said Stephanie Smiley, a spokeswoman for the health services department.

Smiley said the federal Centers for Medicare and Medicaid Services had not given the state a deadline for lifting the enrollment cap for the care program. The state hopes to be able to do so by spring, she said.

Smiley said the state was open to modifications of its cost saving ideas.

Family Care and related home care programs have about 40,000 people enrolled statewide, including some 8,600 in Milwaukee County. The county has 600 seniors and about 1,600 younger adults with disabilities on waiting lists for Family Care. Without the aid, some remain in their own homes, with relatives or potentially shifted to costlier nursing home care.