Nursing home

Opposition is mounting to derail Gov. Scott Walker’s budget proposal to overhaul and/or dismantle programs that are national models in providing long-term care to 55,000 older and disabled individuals in the state.

Walker’s plan, which blindsided long-term care stakeholders — including officials in the state Department of Health Services — would expand Family Care services from 57 counties to all 72.

In the process, it would revamp the way services are delivered through Family Care and abolish county-run Aging and Disability Resource Centers (ADRC) and a program called Include, Respect, I Self Direct (IRIS) credited with saving millions of federal Medicaid dollars each year.

A DHS report issued in February praised the programs for increasing “the availability of cost-effective community supports and services, which decreased the use of costly nursing home services.”

That echoes praise that ADRCs have received from other sources, including one lauding them as “welcoming and accessible places where older people and people with disabilities can obtain reliable and objective information, advice, assistance in locating services, and applying for benefits.”

Ironically, that comment is from Walker’s proclamation of May as ADRC Month, which also praises ADRCs for helping individuals explore options and choose ways to maintain self-sufficiency without using nursing homes or other more expensive solutions.

Walker’s budget proposal, which he says would save millions in state and federal money, ultimately would shift ADRCs from county supervision to private agencies and eliminate managed-care organizations, including Western Wisconsin Cares, in favor of large private insurers.

Legislators on both sides of the aisle question the plans.

“If it’s not broken, why fix it?” said State Rep. Steve Doyle, D-Onalaska, also a county supervisor who was involved with making La Crosse County one of the pilot projects for Family Care and ADRCs in 1998.

Hundreds of people were on waiting lists for home care and other services at that time, but Family Care and ADRCs erased the queues by pooling money, Doyle said.

Although the future of Walker’s plan is uncertain, the opposition is bipartisan, with some sentiment for less drastic changes, observers say.

“I would prefer remaining hands off,” Doyle said.

Walker’s proposals “really turned the system on its head,” said State Sen. Jennifer Shilling, the Senate minority leader.

La Crosse County Aging Unit Director Noreen Holmes is concerned about replacing regional ADRCs with large insurers statewide, saying, “Are they going to fairly represent the options to people? If they are for-profit, I fear that they would steer people to things that would be better for their own bottom lines.

“ADRCs are very fair in talking to people to help them make the best choices,” she said.

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“This is a quality-of-life issue to provide care and keep people in their homes,” Holmes said. “That is the cheapest place to give care.”

ADRCs help people’s funds last longer and aids them in staying in their homes, she said.

Audra Martine, the La Crosse County Health Department employee who directs the ADRC serving La Crosse, Jackson, Monroe and Vernon counties, said the office assists nearly 10,000 people a year.

Holmes, who said about 2,000 people in La Crosse County rely on Family Care, cited the example the potential impact on her niece, an adult with developmental disabilities for whom she is guardian. Her niece has had the same doctor throughout her life, Holmes said, but she might have to change if jurisdiction went to a statewide insurer.

“I’m not saying we are perfect, but it worries me to change for no reason,” she said.

Similar concerns come from Tim Garrity, executive director of Western Wisconsin Cares, a regional MCO based in La Crosse that serves about 3,800 members in eight counties, about half of whom are in La Crosse County.

The agency is one of four MCOs statewide that would be forced out of business under Walker’s plan, and there is a possibility that all eight MCOs would be wiped out.

“The bottom line is that the people we serve are the most vulnerable in the state,” Garrity said.

The current system has saved hundreds of millions of dollars in Medicaid money, he said.

“The program has worked well, and we are way ahead of other states,” he said. “If people in government want to change policies, they should do it through the normal channels,” instead of injecting such major changes in the budget.

During budget comment sessions, hundreds of people spoke against Walker’s plan, and nearly 300 local and state organizations have signed a resolution asking the Legislature to block the changes.

Walker also proposed major changes to SeniorCare, but most observers see bipartisan support to reject those plans, although there may be some tweaks.

The program helps about 85,000 Wisconsin residents 65 and older pay for prescription drugs. Walker wanted to force those applying for SeniorCare to enroll in Medicare Part D for prescriptions.

SeniorCare costs $30 a year, with copays of $5 and $15, while the average cost for Part D is $61 a month. That would increase out-of-pocket costs more than $700 a year, opponents say.

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(20) comments


This exact same budget and long term care plan was put in place in Kansas 2 years ago the economy in Kansas is a bust they are robbing Peter to pay Paul and in order to save money they want to change their long term care to a system with administrative fees like the IRIS system only Walker would follow a bad idea of the Koch brothers tell them to mess up their own state and leave Wisconsin alone


Replacing ADRC's with large insurers can cause several problems that can affect businesses and long-term care recipients. Proposed changes to SeniorCare can also hurt consumers financially due to the increased out-of-the-pocket payments. If this is the case, then people should start planning ahead in order to avoid inconveniences like this. Long term care insurance is the best solution according to experts but there are also alternatives available like hybrid or combination products. Life insurance long term care rider is a good option for people who have multiple concerns and on a tight budget because according to fpsinsurance, this product offers both death benefit and long term care benefit.

Relying on government programs can be risky, especially now that there is no long term solution to long-term care. Instead of facing the future with nothing but hope that the government will help you, why not prepare for your future needs as early as possible.


dumb move scott, very dumb


Walker's plan: turn them into Soylent Green.


We will be screwed if Scooter Hitler gets to Washington.......


As a former resident and educator, it pains me to follow the rise of Governor Subterfuge onto the national stage. Conservatives are enamored with Walker's merciless dismantling of public employee unions and now his cruel designs on the elderly in the state. His behavior and love affair with the Koch brothers MUST become the inspiration for the middle class to rally against ANY of his future political aspirations.


It all comes out of the Koch machine playbook, ultimately. If government money is going to go to a specific group of people, they want it to be filtered through private enterprise so that the money boys can skim what they want from it, first. When their own, monied interests run off the rails and turn the program into graft, then they will tsk, tsk about the waste of public expenditure and piously close the program down, probably after throwing a few government bureaucrats under the legal bus while letting the monied interests guilty of the graft off the hook. I am retired, and I am dumb-founded by how many retirees are hoodwinked by this sort of stuff. Voting three times for Scott Walker. Good grief!

Mr Bluejeans

From another Tribune article in today's paper - "A company that provides home and respite care to elderly and disabled people around Wisconsin plans to end operations next month and lay off its 700 employees.

GeminiCares, based in Slinger, has employees in 11 communities in Wisconsin."

Way to go Walker! On the presidential election trail to talk up about how great his Wisconsin success is.


I have niece who works/worked for Gemini and she is now job hunting. It sucks.


"welcoming and accessible places where older people and people with disabilities can obtain reliable and objective information, advice, assistance in locating services, and applying for benefits.” Ironically, that comment is from Walker’s proclamation of May as ADRC Month, which also praises ADRCs." This is still ANOTHER example of Walker saying one thing and doing the other. Man, I'm sick of that. Before and during the Great Depression of the 1930s, the poverty rate for seniors was huge, like 70% or something. Then Social Security started, and pulled huge numbers of seniors out of poverty. It still does. I've said it before: It's okay for government to help people who need it. If Walker succeeds in removing the programs in this article, then he is not moving the state forward. He's moving it backward, and he is the biggest con artist to come down the pike since the traveling medicine shows.

First base

Round up all the old farts put them in camps feed them bread and water, and burn them when they die. Sound familiar.


First, yes it sounds like another group of Fascists in another time and place.


Throw Grandma off the cliff!


Sounds like a big score for Scooter's friends in the private sector whom he owes favors. That's what you get with CONservatives. I can't believe people allowed themselves to be hood-winked again by Scooter - the great con-artist. The current system, although not perfect, works well and helps those most vulnerable in our society. I hope there are enough of his crony Senators and Representatives that will come to their senses before it's too late and reject this in the budget.


I wonder how many of the poor and elderly voted for Scooter??


None I would imagine. He attacks anyone that doesn't benefit him or that party he belongs to. And it seems the only way he governs is by blindsiding people with a surprise they really don't want.

Clara Fying

lookout, I wish you were right, but I think many did. My elderly in-laws are among those receiving help who could be seriously hurt by this. They voted for him and others with the same message because they believed the krap about protecting us by keeping the so-called lazy welfare types from wasting our tax dollars. They didn't believe that included them because they worked so hard all their lives and need help now that they are very old and have problems. "I told you so" isn't fun.


There is no open talks with Walker and his crew.

Condor Kid

Walker's war against poor people rages on. In Scooter's mind the poor and elderly are just another group of terrorists like the peaceful protesters!


Walker's attitude toward the middle class and poor seems to be: "If you don't have a million dollars or more in your bank account, you are SOL, chump. I only take care of those who do, cuz I want their campaign money."

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