How the Budget Bills Affect People with Disabilities April 2011 Distributed by

State Budget 1 in 5 Wisconsinites use Medicaid in some form; Medicaid accounts for 10% of state spending. $594M new funding for Medicaid Budget Currently no across the board rate cuts No plans for reductions in optional services (yet) –Such as Personal Care and Prescription Drugs No plans to change coverage (yet) The same number of children’s waiver slots will continue Mixed News for Medicaid

State Budget $500 million in unspecified savings needs to be found from Medicaid (and about $750 to $800 million federal match), relative to a cost-to-continue budget $96 million from centralizing, automating, and privatizing the “income maintenance” – these services will no longer be at the county level Concerns about Medicaid

State Budget Potentially limits public input about proposed Medicaid changes If Wisconsin’s proposed changes aren’t federally approved, possibly up to 70,000 people may lose coverage on BadgerCare (133% over Federal Poverty Level, FPL) Concerns about the Medicaid Decision-Making Process

State Budget Increased premiums and co-pays in BadgerCare Changing standards for state residence Revising retroactive eligibility & eliminating grace periods Allowing providers to deny care or services if an enrollee is unable to share costs Establishing different benefits or packages for different recipients Requiring enrollees to participate in managed care Restricting or eliminating presumptive eligibility Restricting eligibility of non-citizens More frequent review of eligibility Changes DHS is Considering

State Budget A freeze on long term care programs like Family Care and IRIS means creating new waiting lists for services in counties that ended waiting lists years ago. Effects on Family Care

State Budget Family Care, Partnership, PACE and IRIS are all frozen at the number of participants in the program in June 2011 –Enrolled participants can still switch between programs ADRCs planned to be statewide June 30, 2013 Results of the Family Care audit may determine the future of Family Care Family Care/IRIS independent Advocacy/Ombudsman Program continued with no cuts Proposed increase in participants enrolled in Self- Directed Support options, including IRIS Effects on Family Care (continued)

State Budget $15 million reduction for SeniorCare People enrolled in Senior Care will also be required to enroll in Medicare Part D The effects could vary based on individual situations DHS states that Senior Care only (without Medicare Part D) could result in twice the cost for co-pays and cost sharing Effects on Senior Care

State Budget Most community-based services and supports for the public mental health system are county funded. Decrease in funding to counties by $36.5M could puts local mental health programming at significant risk –Community Support Program, Comprehensive Community Services, and Community Recovery Services Effects on Mental Health

State Budget $800 million cut in general school aids; K-12 funding makes up 40% of state spending Children with disabilities are general education students first; large cuts to education will result in big changes for all students regardless of disability Cuts to general school aids will make it very difficult for schools to pay for special education services Students with disabilities are more likely to spend time in segregated settings as general education classes become larger Estimated average cut: $750/child Effects on Education

State Budget No increase for special education funding –Resulting in reduction in reimbursement rates for Special Education services (rate will change from 27.9%-24.5%) Reduces revenue cap by 5.5% $40 Million increase in choice, charter and open enrollment options. No income requirements –Students with disabilities don’t typically benefit from these options. State funding that supplements federal Head Start in Wisconsin would continue, but with a 10% cut. Effects on Education (continued)

State Budget Moves public transportation to the shrinking general fund in the budget – making public transit compete with other programs for funding Reduces transportation aids by 10% - will result in big cuts in accessible transportation for those who rely on it Loss of $44 million in federal transport aid Specialized Transportation (85.21) is level-funded Implementation of a statewide transportation broker $350 Million increase for highways/roads Effects on Transportation

State Budget $20/person/month cut in maximum Wisconsin Works payment to low income families $74 million in cuts to the state Earned Income Tax Credit (EITC) for low-income working families Eliminates all state family planning funding –This is the main access to health care for many low-income women with disabilities Eliminates the Wisconsin Quality Homecare Authority Other Budget Effects

State Budget Wisconsin taxes are average in the U.S. The Governor proposed a NO TAX Budget. Some receive tax cuts Corporations $115 million Health Savings Accts. $49 million Investors $36 million TOTAL $200 million less revenue Places where the budget puts additional money Road builders $350+ million Private schools $40 million Considering Taxes

A Wisconsin Policy Research Institute Poll shows 72% favor income taxes on those above $150,00/year 67% believe revenue should be part of a balanced budget solution Examples of revenue generators: Collect tax on investment profits - $140 million Surtax on incomes over $250,000 - $168 million Sales tax on business and professional services - $322 million No cuts to business and investor taxes - $176 million Collect uncollected taxes - $1.2 billion per year State Budget Taking a Balanced Approach

State Budget Reduce Administrative costs in Family Care/IRIS/Partnership Reduce unnecessary institutionalization Streamline program eligibility for children's services Increase investment in recovery oriented consumer run services and peer support Better coordination between DHS, DPI, DVR for transition age youth Increase use of self-directed services and supports Target education investments Consider revenue generators – a balanced approach. Increase investment in recovery-oriented consumer-run mental health services and the certified Peer Specialist Program Possible Recommendations

State Budget 1. Develop a relationship with your legislator/ policymakers. Share your story and your concerns. 2. Write letters to the editor. 3. Talk to your friends, family and co-workers; testify at hearings. 4. Join public actions or coalitions. 5. Remember to Vote! What You Can Do to Make Your Voice Heard

State Budget To continue to have your voices heard, stay up-to-date and get informed about issues that affect you and your family, visit: The WI Board for People with Developmental Disabilities’ Facebook page ( Take Action!

State Budget Lynn Breedlove, Disability Rights Wisconsin: Maureen Ryan, Wisconsin Coalition of Independent Living Centers: Beth Swedeen, Wisconsin Board for People with Developmental Disabilities: Survival Co-Chairs