Last night the Legislature’s Joint Finance Committee (JFC) completed its work on the Department of Health Services (DHS) section of the state budget, which oversees many important disability programs and issues—including Family Care, IRIS, direct care worker wages, abuse and neglect prevention and investigation, and other important priorities.
The Committee’s decision begins to recognize the depths of the challenges people with disabilities and their families are facing across the state and address critical needs.
Wisconsin has been a leader in helping people with disabilities live independently in their own homes and stay out of expensive Medicaid-funded facilities.
The budget writing committee continued the 5% increase for Home and Community Based Services providers that were initially made possible in federal pandemic response legislation. BPDD is pleased JFC has continued the investment in the small businesses across the state that provide personal care, home health care, and other supports for people in Family Care, IRIS, and Children’s Long Term Support Services (CLTS) waivers.
Family Care, IRIS, and CLTS rely on skilled care workers; unfortunately, the workforce cannot meet needs in all parts of the state. Low pay and no benefits make it difficult to recruit and retain workers so people with disabilities, older adults, and families across the state cannot find anyone to hire.
This spring, DHS released new data about Wisconsin’s care worker shortage which found the average worker wage is $13.53 per hour—the lowest among Midwestern states–, 60% of workers do not have employer-sponsored health insurance, there is a 50% worker turnover rate each year, and 66% of provider agencies are turning away people who need help because of workforce shortages.
The JFC committee raised rates for direct care workers in Family Care and personal care workers. Advocates appreciate the continued effort to improve care worker wages, although establishing parity across all programs that help people live in the community (Family Care, IRIS, and CLTS) remains a priority. BPDD and aging advocates look forward to working with the legislature on bold system change ideas to grow the care workforce this session.
“We need bold change. We need to create jobs quality workers can afford to stay in,” said Beth Swedeen, Survival Coalition Co-Chair. “The consequences of doing nothing are astronomical to the state. “People who can live in the community are being forced into expensive Medicaid funded nursing homes because they can’t find the help they need to stay independent. A major investment is still needed to protect the health and safety of our state’s most vulnerable residents.”
BPDD appreciates the committees’ interest in reporting the difference between the amount of care needed (authorized hours) and the amount of care provided by service category and MCO. This requirement will quantify the unmet needs in the state.
Families are bearing the brunt of the care worker shortage. Almost 80% report spending most of their time caregiving, coordinating caregiving, or filling in for missing caregivers. The daily consequences of a missing care worker workforce on people with disabilities, older adults and family caregivers, was illustrated in Survival’s Coalition’s statewide survey results.
“It’s all consuming,” said Beth Swedeen, Survival Coalition Co-Chair. “When there is no one to hire or workers do not show up, families are scrambling to fill in the gaps, or people are going without care. When authorized care hours aren’t delivered it points to a missing workforce and inadequate provider network capacity.”
BPDD leads a federal grant (Living Well) aimed at finding policy solutions to address abuse and neglect: people with intellectual and developmental disabilities nationwide are 7 times more likely to be the victim of abuse and neglect and we know abuse and neglect in this population is vastly underreported.
Although funded at a lower level than the $15 million BPDD requested, increases of $7.5 million for Adult Protective Services funding is the first increase since 2016 for county units. The motion also included modest increases to staff within the Office of Caregiver quality which are desperately needed to increase capacity to investigate complaints that occur in group homes and other settings where people in long term care live or receive services.
The budget motion to increase Bureau of Assisted Living staff relies on increased fees on certain types of facilities, which does not include all the Medicaid-funded places people with disabilities live. Funds to investigate abuse and neglect should be used to respond to all complaints regardless of whether the abuse or neglect occurred.
BPDD is shocked at the low investigation rates the Legislative Fiscal Bureau budget papers (Paper #461 and #462) cite including the rates for the Office of Caregiver Quality which have dropped from 69% to 4% over the last 20 years as reports of caregiver misconduct have risen by 602%. We look forward to working with the legislature to improve strategies to prevent and respond to abuse and neglect of people with disabilities.
We are disappointed that $100K for Guardian Support Center was not included. Currently, one attorney provides technical assistance for the entire state of Wisconsin while the number of contacts and complexity of questions increases.
“We hear frequently from people who are experiencing overreach or guardians who need support in their role as a guardian,” said Swedeen. “People need a trusted source in the state to give accurate information, and to make sure individuals can exercise their civil rights.”
