Blog Posts - Wisconsin State Budget Impact on Women & Girls

Joint Finance Committee Leaders Announce They Will Reject Many of Governor Walker's Proposed Changes to Long-Term Care Programs

5/14/2015

Leaders on the Joint Committee on Finance (JFC) made an important announcement today that the committee will reject many of the Governor's proposed changes to vital long-term care programs such as Family Care, IRIS (Include, Respect, I Self-Direct), and Aging and Disability Resource Centers (ADRC's), which provide assistance to the elderly and individuals with either developmental or physical disabilities at their homes rather than at long-term care facilities.

The JFC leaders who made the announcement include: Rep. Dean Knudson, Senator Leah Vukmir, and JFC Co-Chairs Rep. John Nygren and Sen Alberta Darling.

The Governor’s proposed budget would have expand the Family Care program to all 72 counties in the state.

However, the proposed budget would also have made sweeping changes to the delivery of the Family Care program and eliminated the IRIS program . Advocates for people with disabilities and older adults raised significant concerns that the proposed expansion program will be a pared down version of the current Family Care program. Under the proposed budget, administration of Family Care would have been restructured from a regionalized, not-for-profit system to a statewide system open to for-profit insurers. In addition, current IRIS participants would not have had the same authority and flexibility to self-direct their care under the newly proposed Family Care model.

The JFC leaders' announcement outlines how the committee will amend the Governor's proposal. Rather than a dramatic overhaul of the entire long-term care system, the committee will likely approve a more modest approach that guarantees input from all relevant stakeholders. One of the main criticisms from advocates about the Governor's proposal was that key stakeholders were not consulted about the dramatic changes proposed by the Governor. The JFC will also require that ADRC services be preserved and that the JFC must give the Wisconsin Department of Health Services (DHS) approval of any waiver plan that DHS hopes to submit to the federal government for approval.

This proposal represents a significant change to the Governor's proposed budget. For more background information on this issue, please see our issue section on Family Care and our previous blog posts on the the issue.

Walker, GOP Leaders Prioritize K-12 Education Funding

5/8/2015

After the Legislative Fiscal Bureau (LFB) announced Wednesday that there would not be an increase in projected state tax revenue, Assembly Speaker Robin Vos, Senate Majority Leader Scott Fitzgerald, and JFC Co-Chair John Nygren said that their top priority in the ongoing budget deliberations will be to fully fund K-12 education. Although Governor Walker’s budget proposed a $127 million cut to K-12 education during the first year of the biennium, the Governor expressed his support this week to fully fund K-12 schools and to make “our schools whole.” Democratic legislators have also identified public K-12 education funding as a priority, along with reducing proposed cuts to the University of Wisconsin system and rejecting significant proposed changes to long-term care programs.

No specific revenue source has been agreed upon to increase K-12 funding, but lawmakers from both sides of the aisle have proposed a variety of options. Vos, Fitzgerald, and Nygren suggested using money the governor had set aside for the school levy credit to instead fully fund K-12 education. Fitzgerald said Republicans would be interested in plans that would increase revenue and lower bonding. The four Democratic members of the Joint Finance Committee (JFC) have suggested other methods of funding K-12 education, such as delaying the phase in of manufacturing and agriculture credits, forgoing property tax cuts, and accepting federal Medicaid expansion money. Republican members of the JFC warn that these ideas would meet resistance in the GOP caucus.

Although the funding source remains unclear, it is clear that Wisconsin lawmakers are making increased funding for K-12 education a priority in the 2015-2017 state budget. The WAWH budget blog will continue to provide more details on the K-12 budget as the JFC votes on these provisions. For more information on Governor Walker’s proposed public education budget and its impact on Wisconsin women and girls, visit our issue page on K-12 education here.

Joint Finance Committee Chairs Announce Plans to Reject Governor's Plan to Convert UW System to a Public Authority

5/5/2015

The co-chairs of the Joint Committee on Finance (JFC)--Rep. John Nygren and Sen. Alberta Darling--announced today that the Legsiature would not support Governor Walker's budget proposal to convert the University of Wisconsin System into a public authority model. The Governor's proposal caused controversy both within the UW System and with many legislators.

The co-chairs also indicated that the JFC hoped to reduce the Governor's proposed $300 million dollar funding cut for the UW System. However, they indicated that the size of the reduction would depend on how much revenue will be available based upon the new revenue estimates that are due out likely at the end of this week or early next week.

The Wisconsin Alliance for Women's Health budget blog will provide more details on the UW System budget when the JFC decides to take up these provisions. In the meantime, readers who are interested in this issue and how it impacts Wisconsin's women and girls can check out our issue page on the UW-System here.

Rep. Born Makes Motion to Remove Long-Term Care Changes from the Governor's Budget

5/4/2015

On April 3rd, Rep. Mark Born (R- Beaver Dam) made a budget motion request to the Joint Finance Committee (JFC) to remove provisions from the state budget that would eliminate the IRIS program and significantly change the FamilyCare program and Wisconsin’s Aging and Disability Resource Centers (ADRC’s). For more information on the budget’s proposed changes to these important programs, check out our blog post and the FamilyCare issue area on this site.

The changes to FamilyCare, IRIS, and the ADRCs in Governor Walker’s budget are concerning both because they will affect thousands of Wisconsinites and because they were included in the budget proposal without knowledge or input from disability rights advocates, legislators, current program coordinators, or people currently served by the programs. Rep. Born’s concerns echoed those of his constituents and residents across the state who depend on these current long-term care programs to provide quality and cost-effective care for their families. Furthermore, the budget does not propose a clear plan or funding source for the proposed changes to Family Care and ADRCs. Advocates for people with disabilities and seniors claim the proposed changes need further research by DHS and stakeholders before they go into effect and change the established long-term care plans of Wisconsinites. Rep. Born’s proposal is supported by multiple disability rights advocacy groups, including Disability Rights Wisconsin, the Survival Coalition of Wisconsin Disability Organizations, and the Wisconsin Board for People with Developmental Disabilities.

At this time, it is unclear whether the JFC will pass Rep. Born’s motion, pass more modest changes to the Governor’s long-term care proposals, or adopt the Governor’s proposals in whole. Please stay tuned to our blog for more updates as the Joint Finance Committee continues to debate and vote on the Governor’s proposed budget.

Updates on WI State Budget Impact on Women and Girls Website

4/27/2015

Now that the Joint Finance Committee (JFC) is beginning to vote on specific sections of the 2015-2017 proposed state budget, we will start providing more frequent updates on the the Wisconsin Budget Impact on Wisconsin Women and Girls Blog. The JFC held its first votes on the budget on April 15 and has conducted a total of three executive sessions on different portions of the budget. As of now, the JFC has not voted on many sections of the department budgets that we are following closely on this website.

However, we know that the JFC will likely start conducting hearings on many of the departmental budgets that affect the issues we follow closely on this site. As a result, we are updating our different issue pages with more thorough information regarding each program. The information contained on each issue page will more closely resemble the format of previous Wisconsin State Budget Impact on Women and Girls reports (see here for the 2013-2015 report on the Governor's proposed budget). These new issue sections will contain much of the same existing information that was already on each page, but will now also include information about how previous budgets affected each issue, more complete information about the substance of the Governor's proposals how the proposals will affect Wisconsin's Women and Girls, and more interactive graphics. For a good example of what the new sections will look like, take a look at the updated BadgerCare section.

When the JFC makes changes to any of the Governor's budget proposals that we are covering on the website, we will provide updates both here on the budget blog and on the appropriate issue's page.

Finally, our website will undergo some formatting changes over the next couple of weeks, so please visit us again soon to check out all of the important budget news and our new look!

Legislative Fiscal Bureau Draws Attention to Several Policy Changes in Proposed Budget that Affect Women's Health

4/9/2015

The Legislative Fiscal Bureau (LFB) released a memo to Republican State Senator Rob Cowles on Monday that lists 49 proposals contained in the Governor's 2015-2017 state budget recommendations that are primarily non-fiscal policy changes. This means that these proposals do not have much connection to the the state's budget outlook and more closely resemble a proposal that would be introduced as separate, stand-alone legislation.

The memo lists 49 such items, some of which are incredibly important policy changes, such the proposal to convert the Natural Resources Board to the Natural Resources Advisory Council, thus greatly diminishing that body's influence on environmental policy.

Interestingly, the memo also separately mentions four items that do have a fiscal impact, but also represent significant policy changes. Three of these issues have been covered extensively by the Wisconsin State Budget Impact on Women and Girls project. These changes include:

Drug testing for childless adults participating in BadgerCare, FoodShare employment and training (FSET), and other social safety net programs.
Changes to existing long-term care programs for people with disabilities and the elderly, including Family Care and IRIS. We have covered these changes extensively on this site and will continue to do so.
Providing significantly more administrative independence for the University of Wisconsin System by creating a UW-System Authority.

Democrats serving on the Joint Finance Committee support removing all non-fiscal items from the budget. It appears that at least one Republican agrees with them, as Sen. Cowles made a similar statement to the media.

It remains to be seen whether those legislators calling for the removal of non-fiscal policy items from the budget include the four items listed separately in LFB memo. We will continue to follow this closely and provide any other relevant updates regarding any potential changes to these provisions that impact Wisconsin's women and girls.

Civil Legal Aid Providers Call for Increased State Funding for Legal Services to Low-Income Families

3/27/2015

Most people are familiar with a criminal defendant's 6th Amendment right to have an attorney assist in their defense in felony cases, even if they cannot afford legal representation. However, a key aspect of the American justice system that is often overlooked by the media, TV shows and movies is our noncriminal legal system (our court system refers to noncriminal cases as civil cases). With some exceptions, most people involved in civil cases do not have a right to be represented by an attorney. This is true even though the stakes in civil proceedings are often exceedingly high, ranging from the prospect of home foreclosure to seeking protection from domestic violence.

Wisconsin used to provide state funding for civil legal services to low-income people. However, Governor Walker's first budget in 2011 shifted all of the state funding for civil legal services that were provided by a legal surcharge to other programs. This cut approximately $2.5 million per year in funding for civil legal services. In fact, Wisconsin is only one of three state in the country that does not provide any state funding for civil legal services. Florida and Idaho are the other two.

Civil legal aid providers in Wisconsin assist a wide array of low-income clients, including victims of domestic violence, people with disabilities, senior citizens and children. They provide assistance in family law, disability insurance, health insurance, consumer protection, and many other vitally important legal areas.

Civil legal aid agencies also provide essential legal representation for women. For instance, one civil legal aid agency in Wisconsin served 9,772 women clients the previous two years, 2,480 of whom were victims of domestic violence.

The Governor's current proposed budget does not include any restoration of direct state funding for civil legal aid. However, civil legal aid providers are asking for $10 million over the biennium ($5 million per year) for legal services to low-income families and individuals. We will certainly keep on eye on these important efforts and provide relevant updates now that the Joint Committee on Finance is beginning to hold public hearings on the Governor's proposed budget and will likely start voting on specific budget provisions in the relatively near future.

Attend a Joint Finance Committee Public Hearing!

3/13/2015

Each budget cycle the Joint Finance Committee hosts public hearings to allow Wisconsinites to share their feedback on the budget. Attend a hearing and share your priorities, concerns, and opinions!

JFC Public Hearing Schedule:
Wednesday, March 18th, 10am - 5pm
Brillon High School
Endries Performing Arts Center
W1101 County Road HR
Brillion, WI 54110

Friday, March 20th, 10am - 5pm
Alverno College
Pitman Theatre
3400 South 43rd Street
Milwaukee, WI  53234

Monday, March 23rd, 10am - 5pm
University of Wisconsin-Barron County
Fine Arts Theatre
1800 College Drive
Rice Lake, WI  54868

Thursday, March 26th, 9:30am - 4pm
Reedsburg High School
CAL Center Auditorium
1100 South Albert Avenue
Reedsburg, WI  53959

Can't make it in person? Written comments on the budget can be sent to BudgetComments@legis.wisconsin.gov, or via mail to:  Joe Malkasian, Room 305 East, State Capitol, Madison, WI  53702.

Elimination of IRIS and Expansion of Family Care Causes Uncertainty for Wisconsinites with Long-Term Care Needs

2/24/2015

In the weeks since the budget’s release, disability advocates across Wisconsin have voiced their concerns about the potentially damaging effects of the Governor’s proposed changes to long-term care options. Gov. Walker’s budget proposes the expansion of Family Care to all counties by 2017, while simultaneously eliminating the Include, Respect, I Self Direct (IRIS) program.

IRIS is Wisconsin’s self-directed, community-based program for adults with disabilities and elderly adults who have long-term care needs. Participants are able to choose and direct the services that they need to participate in their communities, instead of being forced to look to nursing homes and other institutions for long-term care solutions. According to the Department of Health Services, more than 11,000 Wisconsinites rely on the IRIS program to design flexible, personal care plans that allow for cost-effectiveness and individual priorities. The proposed elimination of the program came as a shock to many, as IRIS has been incredibly popular with program participants and organizations that advocate on behalf of people with disabilities and older adults.

Current IRIS participants fear that the elimination of the program will completely change their lives and remove their ability to self- direct their long-term personal care . Other concerns include uncertainty about whether caregivers currently employed by IRIS participants will lose their jobs, and a decrease in choice and competition in long-term care that could have detrimental effects for those who need the services the most. The Save IRIS campaign has been started by a group of IRIS participants, family members, and care providers to raise awareness and to advocate for the continuation of the program in Wisconsin.

The simultaneous expansion of Family Care across all 72 counties of Wisconsin may seem like a welcome change at first glance, but the program that will be expanded is a pared down version of its current form. Administration of Family Care will be restructured from a regionalized not-for-profit system to a statewide system open to for-profit insurers that may result in individuals having to change their doctors, caretakers, and even the group homes where they reside. Furthermore, it is unclear how Family Care will allow for self-directed care that is comparable to that offered under the current IRIS program.

Disability and Wisconsin Women
These proposed changes are particularly important to elderly Wisconsin women as they are more likely than their male counterparts to need long-term care services. Women over 65 are both more likely to have functional impediments that inhibit their ability to live independently and to lack a social network than men over 65 . Furthermore, women live longer than men on average and make up a larger share of the over 65 population. This combination of disability prevalence, old age, and lack of support makes elderly women particularly in need of programs like IRIS.

On the other side of long-term care, women make up 65% of caregivers and more than eight in ten are caring for a relative or friend age 50 or older. The future is uncertain for Wisconsin’s female caretakers and family members providing services and support to IRIS participants.

Full Medicaid Expansion Would Cover 81,000 More People and Save Wisconsin Taxpayers $345 Million

2/17/2015

New estimates from the nonpartisan Legislative Fiscal Bureau (LFB) provide compelling evidence for both the human and fiscal benefits that would be gained if Wisconsin chose to expand Wisconsin's Medicaid program (known as BadgerCare) under the Affordable Care Act (ACA). Under such an expansion, the income eligibility threshold for childless adults would increase from 100% to 138% of the Federal Poverty Line (FPL).

Governor Walker and the Legislature have consistently refused to fully expand BaderCare under the ACA. Instead, the Legislature approved the Governor's recommendation to set the BadgerCare eligibility limit for childless adults at 100% of the FPL. This decision cost the state enhanced federal Medicaid funding that is offered to states that expand their Medicaid programs to previously ineligible people. As a result, Wisconsin taxpayers pay 42% of the costs of covering the approximately 148,000 childless adults covered by the program. A full BadgerCare expansion under the ACA would have resulted in substantial savings for Wisconsin taxpayers by substituting federal for state expenditures. Under this scenario, the federal government would pay 100% of benefit costs for newly eligible enrollees in 2015 and 2016, 95% in 2017, 94% in 2018, 93% in 2019, and 90% in 2020 and subsequent years.

Even more importantly, the full BadgerCare expansion would cover 81,000 more people who currently are without health care coverage. Many of these people are working but do not earn enough income to afford private health insurance and are likely to delay necessary health care services.

Alternative Proposal Introduced

At the same time the new information about full BadgerCare expansion was released, some Democratic legislators introduced a compromise expansion proposal based on the model recently implemented in Iowa that uses federal Medicaid money to provide a subsidy to childless adults earning between 100-138% of the FPL so they can afford to purchase private health insurance plans in the federal health insurance Marketplace. According the LFB estimates, the "Iowa Model" would still cover an additional 81,000 childless adults, but would only result in savings of $241 million because it is more expensive to subsidize private plans than to simply enroll people in BadgerCare. The federal government would have to approve a state waiver in order for the Iowa Model to be implemented in Wisconsin.

The Governor's proposed budget does not include any proposals to expand BadgerCare under the ACA and Republicans who currently control the Legislature seem reluctant to pass any form of Medicaid expansion. However, whether to expand BadgerCare in one form or another is likely to be a hot topic of discussion as the budget process continues to unfold.

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Authors

Mike Murray is the Policy Director at the Wisconsin Alliance for Women's Health. Through his work at WAWH, Mike engages in a broad range of policy issues that affect the health of women and girls in Wisconsin.

Caroline Cooney is a policy intern at the Wisconsin Alliance for Women's Health working on the 2015-2017 biennium budget report. Caroline is a senior at UW-Madison majoring in International Studies and Global Health with a strong interest in health policy.

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