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1. What is happening with IRIS? Will I still be able to self-direct my services?

The proposed state budget eliminates the IRIS program. If the current budget

proposal is signed into law people will no longer be able to use IRIS. !eople who

want to self-direct their services will need to use the self-direction option in "amily

#are.

$. Is the self-directed services option in "amily #are the same as IRIS?

It is not clear if or how the self-direction option in "amily #are will change under this

proposal. "amily #are is not the same as IRIS. The current self-direction option in

"amily #are does not allow participants to self-direct all their services as they now

can in IRIS. In IRIS people can both choose to hire and train their own care

providers and they can purchase goods and services that ma%e sense for them.

&. Will my service options remain the same in "amily #are and IRIS?

'nder the current proposal the IRIS program is eliminated. It appears that all IRISparticipants would need to enroll in a new long-term care program to continue

receiving services. It is unclear if the current set of long-term care services

currently available in "amily #are and the non-"amily #are counties (employment

transportation home health personal care durable medical e)uipment residential

services etc.* will remain the same. The +epartment of ,ealth Services may choose

to change what services are oered and what level of services is provided to

participants.

. Will my current level of services remain the same?

It is unclear if the current levels of long-term care services (employment

transportation home health personal care durable medical e)uipment residential

services etc.* will remain the same. The +epartment of ,ealth Services may ma%e

changes to "amily #are that will impact the types and levels of services that people

receive. This means that the +epartment could change the types of services that

are currently available and/or set limits on the duration of services the hours of

services provided cap the number of visits a participant may have with a given

provider etc.

0. +oes this budget proposal add any services to "amily #are?

es. 'nder the 2overnor3s plan acute and primary care (medical-type* serviceswhich are currently accessed through the 4edicaid card will be added to the "amily

#are bene5t pac%age if +,S receives federal approval. It is unclear how the addition

of these speci5c health care services will be balanced with the current "amily #are

long-term care services which are designed to help people live and wor% in the

community.

6. If my managed care organi7ation goes away what does that mean to me?

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#urrently Wisconsin has eight managed care organi7ations (4#8s.* The 9udget

calls for the four regional 4#8s to be dissolved in $:1; they are< Western

Wisconsin #ares #ommunity #are #onnections of Wisconsin =a%eland #are +istrict

and #ontinu's. It is unclear if 4ilwau%ee #ounty could continue providing "amily

#are under the proposed budget. The remaining three 4#8s would need to e>pand

their business model to provide services statewide unless this re)uirement iswaived by +,S meet any new re)uirements put in place by the 8ce of

#ommissioner of Insurance (8#I* and also be certi5ed and approved by the

+epartment of ,ealth Services to provide "amily #are. If your current 4#8 goes is

dissolved and you want to continue receiving long-term care services you will need

to select and enroll with one of the managed care options provided by the

+epartment of ,ealth Services. It is unclear how many (and what %ind* of choices

will be available to participants.

;. If our regional Wisconsin-based 4anaged #are 8rgani7ations are gone who will

run Wisconsin3s long-term care programs?

It is un%nown and will be up to the +epartment of ,ealth Services to decide this.

The budget re)uires all 4#8s to be regulated as insurers and be able to operate

statewide unless granted special permission by +,S. !otentially this could mean

the ,48s or other nationally-based insurance companies could be eligible to run

Wisconsin3s 4edicaid-funded long-term care programs.

@. If I must change 4#8S will I be able to %eep my primary care doctor and other

current longterm care providers?

It is unclear. 9ecause the new long-term care program may now include medical-

type services people may be re)uired to switch doctors or other supports if theplans oered do not include all the providers they use today. #urrently Wisconsin-

based regional 4#8s have their own regional provider networ%. 8nce statewide

entities begin providing "amily #are it is unclear which (and how many* providers

will be part of their provider networ%s. Aach statewide entity will li%ely have

dierent providers in their networ%.

B. If I am unhappy with my new statewide 4#8 can I switch?

es but not whenever you want. C "amily #are enrollee will only be allowed to

change his or her 4#8 during a set open enrollment period (unless an allowable

e>ception occurs*. 4oreover enrollment in IRIS will no longer be an option as analternative to your 4#8. It is unclear how often these open enrollment periods will

be oered. It is also unclear how much time an enrollee will be given to choose a

new 4#8. It is uncertain what information will be provided to enrollees as they

choose between 4#8s.

1:. I live in a county that is currently transitioning to "amily #are. ,ow does this

budget impact me?

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#urrently 9rown +oor Dewaunee 4arinette 4enominee 8conto and Shawano

counties are transitioning to "amily #are and IRIS. =a%eland #are +istrict one of

the two 4#8s that are providing "amily #are in this region is eliminated in $:1;

under this budget proposal. The budget also eliminates the IRIS selfdirection option

that is being oered to enrollees in these counties. It is unclear how the +epartment

of ,ealth Services plans to transition people in these seven counties from thecurrent system to the new system proposed in the state budget. 'nder the budget

proposal some "amily #are members and all IRIS participants in this region would

need to transition to a new statewide entity by $:1; to continue receiving long-term

care services.

11. I live in a county that currently does not have "amily #are. What does this

budget mean for me?

Residents of +ane Roc% Cdams Taylor "lorence "orest 8neida and Eilas counties

currently receive long-term care services through the county. This budget ends the

county-based longterm care program and re)uires these eight counties to transitionto "amily #are by Fanuary 1 $:1;. !eople currently on county waiting lists will begin

the process of moving into long-term care programs. It is not clear how long these

counties will have to transition to "amily #are or what the process will be for

current participants and those on the waiting list to enroll in statewide "amily #are.

1$. I am a current participant in "amily #are !artnership or !C#AG does the budget

change these programs?

The proposed budget ma%es the revised "amily #are bene5t available statewide. It

is unclear if this impacts "amily #are !artnership or !C#A.

1&. Will I still use my local Cging and +isability Resource #enter to access services?

Cging and +isability Resource #enters were originally designed as Hone-stop shops

to help people with disabilities and the elderly have easy access to information

about programs and services. 'nder the budget proposal C+R#s would no longer

need to be oered in each county and services could be provided regionally or

even on a statewide basis. !rivate entities could begin oering services currently

provided by C+R#s such as the long-term care functional screen or bene5ts

counseling. . It is unclear whether all services will continue to be oered by C+R#s.

In addition to these changes C+R# governing boards would be eliminated.

2overning boards which included appointed people with disabilities and olderadults are important decision ma%ing voices.

1. Cre these proposed changes 5nal?

Jo.

Right now these changes are part of the $:10-1; state budget as proposed by

2overnor Wal%er. The =egislature will vote on these changes in the coming months.

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The =egislature could choose to approve these changes as they are currently

written modify them or completely remove them from the state budget. The bill

would then go to the 2overnor as his 5nal approval is re)uired. If the budget is

approved as it is written now many of these changes will go into eect in $:1; and

the +epartment of ,ealth Services will need to get permission from the federal

government to implement many of the changes.

10. If I have concerns about these proposed changes who should I contact?

The best thing you can do right now is contact your state legislators and 2overnor3s

oce to share your concerns and tell them why IRIS and "amily #are are important

programs for people with disabilities. ou can 5nd out who your legislator is by

going to in the

upper right hand corner. ou can also reach your legislators by calling the

=egislative ,otline toll free. #all 1-@::-&6$-B;$.