The Survival Coalition thanks the committee for the opportunity to provide comment on SB 155. Survival Coalition recognizes the significant burden many long-term care residents face finding a place to live, a challenge that is compounded when they must move within a specific period of time.

We support improving notification requirements and allowing more time for residents to locate another placement. However, disability and aging advocates caution the proposed changes in this bill will not be applicable to many residential settings in which older adults and people with disabilities live, and as such residents in these settings will receive no additional notice. See full letter here

The cross-disability Wisconsin Survival Coalition is comprised of more than 20 statewide disability organizations in Wisconsin with a mission of improving services and supports so people with disabilities can fully participate in their communities. We appreciate the opportunity to provide public comment on the Ensuring Access to Medicaid Services rule (file code CMS-2442-P) and the interest CMS has in ensuring state Medicaid LTSS programs are maximizing the use of home and community-based services so people with disabilities can live healthy, safe, community-connected lives. Our experience in Wisconsin demonstrates that to ensure access to appropriate home and community-based long-term care services and supports (LTSS) we need federal regulations and more federal guidance to:  

• ensure rates reflect the actual cost of care,  
• address the care worker shortage with multiple strategies,
• ensure the provider network can provide the level of authorized services,
• drive states to evolve service systems, lower cost, less staff intensive, more inclusive, and best practice approaches, including community supported living and integrated employment as the first and preferred option,
  Read complete list of comments.

The Legislature’s Joint Finance Committee last night voted on disability priorities in the Department of Health Services (DHS) section of the state budget that takes some first steps toward addressing the most pressing needs of the disability community: adequate supports to live in their homes and communities and freedom from abuse and neglect. Another critical issue– mental health supports–were mostly left out of the budget, and it is Survival Coalition’s hope that mental health and other important initiatives can move as stand-alone bills in the months ahead.

“The vote demonstrates recognition of concerns advocates have been expressing for decades and potentially a start to more re-investments that ensure Wisconsinites of all ages and abilities have access to the right care, at the right time and in the place, they most often prefer – in their own home,” said Patti Becker, Survival Coalition co-chair.

Among actions Joint Finance took:

• Continued the 5% increase for Home and Community Based Services providers that were initially part of federal pandemic response legislation. These increases impact providers in Family Care, IRIS, and Children’s Long Term Support Services (CLTS) waivers.
• Increases of 5% for  direct care workers in Family Care. However, no increases for IRIS participant-hired workers.
• Increase of 4.3% to the Medical Assistance Personal Care Services
• Requirements that Family Care managed care organizations report publicly amount of care needed (authorized hours) and the amount of care provided by service category and MCO, thus quantifying unmet needs.

“The Legislature’s attention to the direct care crisis through rate increases and better quantifying the state’s needs are important initial investments,” said Beth Swedeen, Survival co-chair. “With average direct care worker wages in the state of $13.53/hr. and fewer than half earning benefits, we have a long way to go in paying the true cost of care.” Read full press release here.