Progressive Thinking

Senator Kathleen Vinehout writes about drastic changes to Family Care and IRIS included in the Governor’s budget. If these changes become law, many frail elderly and disabled persons would be put at risk of losing the services that help them stay in their community and out of expensive institutions.

MADISON - “You have got to be kidding!” a Chippewa Valley advocate responded when I told her about a plan to potentially turn Family Care over to a for-profit insurance company.

Family Care and its fee-for-service sister, IRIS, provide thousands of Medicaid-eligible frail elderly and disabled people the help they need to remain in their homes. Services could include help getting places; keeping a job; managing money; preparing meals; keeping healthy; bathing and dressing.

People who benefit from Family Care or IRIS might easily end up in an expensive institution. Personal care and other workers help them stay in their own home – and many times – stay gainfully employed.

If the current version of the governor’s budget becomes law, it will mean big changes to care for frail elderly and disabled people of modest means. For the rest of us, it could mean many more of our neighbors and family members end up in expensive institutions. Worse yet, folks could be stranded at home without the services they need to independently live and work.

Buried in the mammoth state budget is the elimination of IRIS as we know it. IRIS serves more than 11,000 people statewide. The philosophy of the program is in its name: Include, Respect, I Self-direct. People hire their own workers who perform many tasks including meal preparation, bathing, and getting people to work.

As Jason Endres of Eau Claire told me, “Without these services, the way IRIS provides, it would prevent us from being part of our community.”

Also eliminated are local centers to assist elderly and disabled people find services. Known as Aging and Disability Resource Centers (ADRCs), these publically run centers would close and their citizen oversight boards disband. They could be reopened by a private company but with no requirement to be conveniently located or to tell people about all the services for which they may qualify. For example, the woman I wrote about in last week’s column who is served by SeniorCare, said without the help of local ADRC staff she would not have known about SeniorCare.

Family Care is a managed care program serving over 40,000 elderly, physically disabled, and developmentally disabled folks. A large number of developmentally disabled people use Family Care in the Chippewa Valley because of the closure of Northern Center. Services such as residential homes, mental health services and job coaches help folks stay in the community. Local providers work with non-profit Managed Care Organizations that oversee service delivery.

Services are tailored to the needs of the individual as determined by an independently completed functional assessment. This way services are based on the needs of the individual and not on what the provider has available.

Changes in the budget would eliminate most of the Managed Care Organizations. Their job could be taken over by a very large for-profit insurance company. Budget language gives the state Department of Health (DHS) authority to hire the insurance company in a no-bid contract and removes any legislative oversight of the contract between DHS and the insurance company.

This new insurance company could become the gatekeeper for all medical, rehabilitative, personal living and employment services for over 50,000 people (DHS enrollment numbers from 2014).

In essence, every service needed by the disabled or frail elderly person of modest means would need approval by potentially one for-profit insurance company.

“This takes the personal choice right out of it,” an Eau Claire woman told me.

It also makes it more likely people will not receive the care they need. Insurance companies are very good at denying care and shifting the cost of care to patients and families.

Jason said to me, “One for-profit, national insurance company in a no-bid contract? It makes me very sad. It’s no longer about local choices. It’s about big business making decisions about very personal things.”

Advocates are working hard to save these important programs. People can learn more at www.saveiris.org. Jason reminded me to thank Amber and Nancy for this awesome website. Check it out. You’ll see Amber, Jason and read many more amazing stories.

MADISON - Today Republican leaders in the state legislature announced plans for an extraordinary session of the legislature next week to pass so-called "Right to Work"  legislation.

Is this rushed discussion of such a controversial subject necessary? Many in the Assembly and Senate, especially Democrats, do not appear to think so. The move is seen as a distraction by many in Madison, an attempt to talk about anything but Scott Walker’s proposed budget.

Walker’s Budget has stirred up a hornet’s nest all over Wisconsin. As we get into the budget’s details, we have learned it mean a tough road ahead for local schools, the UW and our children who will inherit increased state debt.

"Right to Work"  legislation will do little to solve any of these problems. It does not even have anything to do with the right to work. It is merely a political argument between Republicans and the unions over the collection of union dues.

Scott Walker’s first term has left Wisconsin with a lagging economy and a $2.2 billion deficit. His administration has drained needed funds from public education and state agencies and given it to the wealthy few in the form of a huge tax cut. And now, with Scott Walker a part time governor gone much of the week to campaign for President, the bill to pay for all of this has fallen on the legislature.

Is it any surprise the Republicans would rather talk about “Right to Work” ?

When asked for his response on the Extraordinary Session, Assembly Democratic Leader Peter Barca (D-Kenosha) said in a prepared statement:

"Governor Walker has called so-called `Right to Work' legislation a distraction and apparently that's exactly what he wants. By rushing to pass Right to Work in less than a week, clearly the governor and Republican legislators want to distract from how destructive their budget is for Wisconsin's workers, students and middle-class families.

"Wisconsin is already lagging behind most of the nation in jobs and wage growth and `Right to Work' would only make things worse. In fact, the average worker in Right to Work states makes between $5,000 and $6,000 less than the average worker in other states. And calling an extraordinary session will make the budget disaster Republicans have created worse since we're already scheduled to be in session the following week anyway. What's the emergency?

"There is broad agreement among workers, businesses and everyday citizens that Right to Work is wrong for Wisconsin. Yet the governor and Republican lawmakers have proven they will do anything to change the subject from their mismanagement of Wisconsin's economy, including driving down wages for our workers and further dividing our state."

Our local Senator Dave Hansen (D-Green Bay) went on to say:

"How unpopular is the Governor's budget? Apparently so unpopular that Republican leaders feel the need to hide their members behind RTW to help them avoid having to answer to the voters about their $2.2 billion deficit, their plan to eliminate SeniorCare and assistance for the elderly and disabled, their continued cuts to our public schools and their attack on our UW campuses.

"This is bait and switch politics at its worst that will cost the average Wisconsin family $5,000 - $6,000 per year in lost wages and that will limit the freedom of employers to run their businesses as they see fit.

"Rather than owning up to their failed policies, they are desperately trying to change the subject rather than defend what is proving to be an indefensible budget that puts the Governor's presidential ambitions before the people of Wisconsin."

This week Senator Kathleen Vinehout writes about Governor Walker’s proposed changes to SeniorCare. She is hearing from people who are very concerned about the proposed changes which may cause seniors to pay huge increases in the cost of their prescription drugs.

MADISON - “Please do what you can to keep SeniorCare as is. It is critical to those of us on it.” wrote a rural Buffalo County woman.

“I will be 70 years old in a couple of months and not on any prescription medicines. SeniorCare is perfect for me as I very seldom require a prescription for illness or injury, usually going for a year or more without needing one. I should not have to pay the outrageous high cost of Medicare Part D which I would very seldom use and it would cause a terrible financial burden for me that I could not handle on my fixed income.”

The rural woman I’ll call ‘Dawn’ signed her letter, “Thank you from a very satisfied SeniorCare participant.”

Slipped into the Governor’s state budget is a requirement that seniors sign up for Medicare Part D before they sign up for SeniorCare. The program is a substitute for Part D.

To justify his action, the Governor told the Wisconsin State Journal “It’s not about changing benefits; it’s ultimately about changing who pays for it.”

According to Dawn that is the problem.

She figures under the Governor’s new plan she’d pay $60 a month. Now she pays $30 a year. “I shouldn’t have to pay an outrageous bill for something I won’t use,” she said in a recent phone conversation.

SeniorCare is truly a Wisconsin invention. It is the only state-based alternative to the complicated maze of plans comprising Medicare Part D – the drug benefit for seniors.

To participate in SeniorCare, people must be Wisconsin residents, over age 65, and meet an income requirement. The program has a simple one-page enrollment form and requires a $30 annual fee. Folks pay a deductible and small co-payment of $15 for brand name and $5 for generic prescriptions.

Seniors love the program, as do health care workers, pharmacists, nursing homes and elder advocates. Not only is the program simple, it is also less expensive. In 2011, the Legislative Fiscal Bureau (LFB) estimated that SeniorCare saves the federal government $85.8 million a year.

SeniorCare is a state-run program while Medicare Part D involves the sale of private insurance policies under federal government rules. Part D plans differ quite a bit with different formulas for coverage, different deductibles, different coinsurance and different lists of drugs covered. In addition, plans offer different levels of coverage in the “doughnut hole” — gap in coverage.

Part D plans require seniors to pay a monthly premium, in addition to the per-prescription copayment and the deductible. Seniors tell me the Part D premium alone could easily be 24 times the annual $30 cost of SeniorCare.

SeniorCare depends partly on federal Medicaid funds. To continue to get federal funds, Wisconsin must periodically prove to the feds through a waiver request that they are saving taxpayers’ money. Unlike Part D Medicare, one way that SeniorCare saves money is to negotiate with drug companies.

This is the second time the governor proposed doing away with SeniorCare as we know it. In 2011, a statewide petition drive saved the program.

Spearheading the petition drive was Representative Andy Jorgenson. He was recently quoted in the Milwaukee Journal Sentinel: "What is wrong with Governor Walker? Did he not get the message the first time, or doesn't he care? … Governor Walker is pushing a plan that will hurt seniors financially."

In 2011 people collected over 15,000 signatures. Moments after the signatures were delivered to lawmakers, Republicans pledged their support for SeniorCare.

Dawn knew about the success of the first petition drive and was already at work.

“I spent all day Saturday and Sunday sending emails,” she told me. “Most [lawmakers] sent a letter back saying they were not accepting emails. It was frustrating. Don’t you think if they represent Wisconsin they should accept my email?”

When I complemented Dawn on her persistence she said, “What scares me is that $60 a month,” she paused and nearly whispered, “I’m not going to be able to buy groceries.”

You can get a copy of the SeniorCare petition by calling my office toll free (877-763-6636) or sign the SeniorCare petition at my Senate website.

This week Senator Kathleen Vinehout writes about the importance of citizen involvement in the budget process. She provides background about the budget process and urges people to attend hearings, to write, call or send an email.

MADISON - “What people need to understand is that we are seeing this budget for the first time,” the Republican staff member told me. “There are a lot of things that need to change.”

Recently the Governor made public his proposal for the state’s two-year budget. The day following his speech a Senate page brought around a hand-truck load of budget documents.

When I visited my Republican Senate colleague, the staff had budget papers spread out over a desk and were trying to make sense of it – even as phone calls and emails from constituents were coming in.

As we scramble to find buried details, some constituents already were expressing themselves to lawmakers. The back-and-forth between constituents and legislators is a vital aspect of the political process, and input from citizens is never more important than during the two-year budget process.

We all know the headlines: $300 million cut to the UW; cutting the UW loose from state government; lower funding for K-12 schools; statewide subsidy for private schools; state money to make a small dent in rising property taxes.

But it will take months to identify all the specifics.

That’s where you come in. It’s one thing to see a number on a page. It is quite another to understand the effect of a budget action across the state.

This budget, like in the past, contains hundreds of pages of non-fiscal policy. Said another way, the budget makes law changes unrelated to the money in a budget.

In the last budget, nearly 100 separate pieces of non-fiscal policy were passed. Some were things that might not have passed on their own – like taking away local powers to site TV and cell phone towers or to set protections from erosion on construction sites.

Time and partisanship further complicate our ability to find and react to pieces of the large budget bill. The only documents now available for lawmakers and the public are the summary prepared by the Governor’s own partisan budget staff and the budget legal language itself in over 1,500 pages.

We all must wait for the work of the nonpartisan Legislative Fiscal Bureau (LFB). Analysts are working hard to prepare a plain language summary of the budget including numbers and policy. The work is complex and time consuming. When finished, the summary will be nearly 500 pages. This document is the best single source about details that will affect citizens’ lives for the next two and a half years – sometimes much longer.

As I learn information I will share details in columns and letters. I will hunt down details to put budget policy and fiscal changes in context. I will ask for LFB memos to provide a nonpartisan verified source. But LFB won't always be able to put answering my requests for data at the top of their to-do list.

After the LFB finishes its analysis of the budget, they begin writing memos covering details of the many budget decisions the Joint Finance Committee will ponder. These papers are very useful. Members of the Finance Committee will have first crack at getting LFB to answer their questions (I am not on this committee).

During April I expect the Finance Committee to hold public hearings around the state. These hearings are often held during the day and can be a long drive away. I will be holding town hall meetings about the budget at more convenient times and locations.

Please take the time to learn how the state budget affects you and your family. I will make my town hall meeting locations public. If you want a personal invitation, let me know (877-763-6636).

Please express your opinions about the budget. Write, call, send an email – let your representatives know. Don’t let past disagreements stop you from writing again.

Only about 20% of people contact their representative. But sometimes only one or two letters can change a bill. Telling your story about how budget decisions affect you and your community can make a real difference.

“If there were just 10 people in every congressional district who really pushed on an issue…we could literally change the world.” – Illinois Senator Paul Simon

MADISON - As I left the state capitol yesterday evening, I was thinking about how much I love my job: the service to my constituents, the participation in the legislative process, the great honor it is to work in the people’s house. At the same time, though, I was overwhelmed by a feeling of deep sadness for the substance of Governor Walker’s recently introduced budget. The blatant disregard this proposal shows toward the people of our state and Wisconsin's greatest traditions is shocking and upsetting.

Walker will have a page in the history books, but he will not be judged kindly. He will be seen as the Governor who turned his back on the conservation ethic of Aldo Leopold and Gaylord Nelson, the Wisconsin Idea of Fighting Bob and Lee Dreyfuss, the ideal of an equal and integrated education of Lloyd Barbee and John Reynolds.

There is nothing constructive or forward-looking in his vision for our state, and, therefore, nothing lasting. Governor Walker will have the votes to pass this budget, of course, but the people of Wisconsin still have the opportunity to influence its crafting. In the wake of his destructive leadership - or in the course of it, really - it is our charge to own the task of rebuilding the state we love. It is within our capacity to honor our past and win our future, but these goals can only be accomplished if we all do our part today, tomorrow, and every day forward.

Throughout these next few months, I pledge to do everything I can to raise my voice in opposition to the policies I find damaging to the people of Wisconsin. I will also advance proposals that do justice to our proud, progressive heritage. I ask for and welcome your input and participation during this process and beyond. As always, please feel free to contact me with any and all concerns or questions.