WALA President & CEO had the honor of being invited to attend the budget signing ceremony today wherein Governor Evers signed the 2023-25 Wisconsin State Budget which includes an additional $38m (ALL FUNDS) into the Direct Care Workforce Funding Initiative along with a continuation of the 5% Family Care Rate Increase that went into effect January 1, 2022. As noted in our press release:
“I am truly grateful for the state budget investment of an additional $38,432,600 (All Funds) over the biennium in caregiver funding,” stated Michael Pochowski, President & CEO. “In addition, we are very appreciative of the continuation of the 5% rate increase to providers that went into effect on January 1, 2022. As Wisconsin’s workforce crisis continues many assisted living facilities face significant staffing and financial challenges. These investments are necessary to maintain quality care and services to elderly individuals and those with disabilities. A special note of thanks to Governor Tony Evers, Senator Mary Felzkowski (R-Irma), Senator Howard Marklein (R-Spring Green) and Rep. Mark Born (R-Beaver Dam).”
Here are the notable budgetary actions pertaining to assisted living providers:
Item #17. Family Care Managed Care Organizations Report
This section requires the Department of Health Services to collect and make publicly available the financial summaries of the managed care organizations for the Family Care program, the Family Care Partnership program, and the Program for the All-Inclusive Care for the Elderly. Specifically, the department is required to report the executive leadership salaries for the organizations, as well as the amounts retrieved by the state under the contractual risk corridors.
MAINTAINED IN 2023-2025 BIENNIAL BUDGET
Home and Community-Based Services Rate Increase Cost-to-Continue (LFB Paper #420):
Governor proposed: Provide $43,115,000 ($15,405,600 GPR and $27,709,400 FED) in 2023-24 and $183,816,000 ($65,570,900 GPR and $118,245,100 FED) in 2024-25 to fund costs associated with the American Rescue Plan Act (ARPA) home and community-based services (HCBS) 5% rate increase from April 1, 2024, through June 30, 2025.
Final: Joint Finance/Legislature: Increase funding by an additional $592,300 ($1,788,900 GPR and -$1,196,600 FED) in 2023-24 and reduce funding by $1,864,200 ($5,954,100 GPR and -$7,818,300 FED) in 2024-25 to reflect updated assumptions regarding utilization and fund source adjustments to reflect the standard federal Medicaid matching rate, rather than the two-year enhanced matching rate that would have applied with adoption of full Medicaid expansion under the Governor.
Family Care Direct Care Reimbursement (LFB Paper 420)
Governor proposed: Provide $44,802,900 ($15,000,000 GPR and $29,802,900 FED) in 2023-24 and $43,949,600 ($15,000,000 GPR and $28,949,600 FED) in 2024-25 to increase the direct care and services portion of the capitation rates the Department provides to managed care organizations (MCOs) to fund long-term care services for individuals enrolled in Family Care.
Final: Joint Finance/Legislature: Reduce funding by $31,809,100 (-$10,000,000 GPR and -$21,809,100 FED) in 2023-24 and $18,510,800 (-$5,000,000 GPR and -$13,510,800 FED) in 2024-25. As modified, including fund source adjustments to reflect the standard federal Medicaid matching rate, rather than the two-year enhanced matching rate that would have applied with adoption of full Medicaid expansion under the Governor, this provision would provide $12,993,800 ($5,000,000 GPR and $7,993,800 FED) in 2023-24 and $25,438,800 ($10,000,000 GPR and $15,438,800 FED) in 2024-25.
WisCaregiver Careers (LFB Paper 428)
Governor proposed: Provide $8,000,000 in 2024-25 to increase funding for WisCaregiver Career program. This program is a workforce development program that provides free nurse aide training and certification testing, as well as a retention bonus after six months of employment as a nurse aide.
Final: Joint Finance/Legislature: Reduce funding by $6,000,000 in 2024-25. As modified, this provision would provide $2,000,000 in 2024-25, on a one-time basis, to fund the WisCaregiver Careers program.
Alzheimer's Family and Caregiver Support Program (LFB Paper 430)
Governor proposed: Provide $500,000 annually to increase the maximum amount of funding the Department may provide under the Alzheimer's family and caregiver support program from $2,808,900 to $3,308,900 annually. Modify the financial eligibility limit for the program to specify that a person is eligible for assistance under the program if the joint income of the person with Alzheimer's disease and that person's spouse, if any, is $60,000 per year or less.
Final: Joint Finance/Legislature: Reduce funding by $250,000 annually. Increase the maximum amount of funding the Department may provide under the Alzheimer's family and caregiver support program from $2,808,900 to $3,058,900 annually. In addition, delete the provision that would modify the financial eligibility limits for the program.
Dental Services for People with Disabilities
Final: Joint Finance/Legislature: A provision of the 2017-19 budget (Act 59) required DHS to increase reimbursement rates by a factor of two for dental services rendered by facilities that that provide at least 90% of their services to people with cognitive and physical disabilities. Funding for this change, as well as a related increase in special-needs dental reimbursement was provided under the 2019-21 budget. As of June, 2023, this increase has not been implemented. The Joint Finance provision would require DHS to implement the reimbursement change by October 1, 2023.
Bureau of Assisted Living Staff
Final: Joint Finance/Legislature: Direct DHS to submit a plan to the Joint Committee on Finance, within six months of passage of the 2023-25 biennial budget act, to increase licensing fees for assisted living facilities and outpatient mental health clinics to cover the cost of staffing within BAL necessary to ensure adequate protection of the health and well-being of vulnerable individuals, as determined by DHS.
Office of Caregiver Quality
Final: Joint Finance/Legislature: Provide $135,800 ($54,300 FED and $81,500 PR) in 2023-24 and $168,000 ($67,200 FED and $100,800 PR) in 2024-25, to fund 2.0 (0.8 FED and 1.2 PR) four-year project positions in OCQ, beginning in 2023-24.
You can find the 2023-25 biennial budget, veto message and the enacted budget here