Walker budget proposal would impact how health care works in state
Wisconsin Governor Scott Walker meeting with Lieutenant Governor Rebecca Kleefisch and Mike Huebsch, state Secretary of the Department of Administration in this January file photo. JOHN HART — State Journal
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Gov. Scott Walker's budget repair bill would give the state "sweeping authority" to alter Medicaid with little public input, advocates say.
Health care workers, meanwhile, say Walker's plan to prohibit them from collective bargaining could hurt not only them but their patients.
The bill, to be discussed by the Legislature at a public hearing Tuesday, contains a plan to "significantly modify" Medicaid, the state-federal health plan for the poor, according to a Legislative Fiscal Bureau analysis released Monday. The plan would "supersede most statutory provisions," the analysis said.
The proposal would allow the state Department of Health Services to restrict eligibility, increase premiums, modify benefits and revise reimbursements, the analysis said. Those changes typically are made by the Legislature.
"We're alarmed that the bill would grant such sweeping authority to an agency to make the sorts of Medicaid policy decisions that we elect legislators to make," said Jon Peacock, reseach director of the Wisconsin Council on Children and Families.
The state's Medicaid programs, which cover 1.2 million people, or one in five residents, face a $214 million shortfall this fiscal year and a $1.8 billion deficit over the next two years, Dennis Smith, health department secretary, testified before Congress last month. He, Walker and Republican leaders in the Legislature have said changes are needed to save money.
"While the provision may result in significant savings in the future," the fiscal analysis said, "it would remove the entire Legislature from determining substantial elements" of the program.
Health care workers, including home care workers who only recently got the right to unionize, criticized Walker's plan to prohibit them from collective bargaining, saying it could harm patient care.
"You need people who are dedicated, and not concerned about their livelihood, so they can be in the present moment for their patients," said Ann Louise Tetreault, a leader of the Service Employees International Union Healthcare Wisconsin. It represents 16,550 workers, including 1,800 nurses at UW Hospital, where Tetreault is a nurse.
Lynn Breedlove, executive director of the advocacy group Disability Rights Wisconsin, said Walker's proposal to do away with the Wisconsin Quality Home Care Authority — another provision of the bill — could harm people with disabilities. The home care authority screens and places workers in homes, where they bathe, prepare meals and provide other assistance for the elderly and people with physical or developmental disabilities.
"Some people with disabilities are vulnerable, and the free, open marketplace can be dangerous," Breedlove said.
Walker's bill would transfer the home care authority's services to the state Department of Health Services. The authority, which started in Dane County in 2009, was set to expand statewide this July, said director Patti Becker.
The authority trains and does background checks on workers and places them in homes, which helps keep clients out of nursing homes, Becker said. Most of the care is paid by Medicaid.
If more people end up in nursing homes, "it's going to be more expensive," Becker said.
Last year, 5,500 home care workers joined SEIU under legislation passed the year before, but they haven't been able to get a contract with the state approved. It would guarantee a wage of $9 an hour.
Walker's bill strips most public employees of their right to collectively bargain for benefits. That includes workers at UW Hospital and other public institutions, such as nursing homes, mental health facilities, disability centers and public health departments.
At UW Hospital, a nurses' contract approved last year lasts until 2014. A contract with the Wisconsin State Employees Union — which covers 2,800 administrative employees, technical staff and environmental and food service workers — goes until 2015. A contact covering 160 chemists and medical technologists with Wisconsin Science Professionals expires in 2013.
Donna Katen-Bahensky, chief executive officer of the hospital, said in an e-mail to employees Friday that "we believe we will be able to honor those agreements as written."
But Tetreault, who said SEIU has helped nurses maintain good wages and get rid of mandatory overtime, said she worries that Walker will find a way to terminate the contracts. "I'm not going to be lulled into thinking that's going to protect us," she said.
Health care workers, meanwhile, say Walker's plan to prohibit them from collective bargaining could hurt not only them but their patients.
The bill, to be discussed by the Legislature at a public hearing Tuesday, contains a plan to "significantly modify" Medicaid, the state-federal health plan for the poor, according to a Legislative Fiscal Bureau analysis released Monday. The plan would "supersede most statutory provisions," the analysis said.
The proposal would allow the state Department of Health Services to restrict eligibility, increase premiums, modify benefits and revise reimbursements, the analysis said. Those changes typically are made by the Legislature.
"We're alarmed that the bill would grant such sweeping authority to an agency to make the sorts of Medicaid policy decisions that we elect legislators to make," said Jon Peacock, reseach director of the Wisconsin Council on Children and Families.
The state's Medicaid programs, which cover 1.2 million people, or one in five residents, face a $214 million shortfall this fiscal year and a $1.8 billion deficit over the next two years, Dennis Smith, health department secretary, testified before Congress last month. He, Walker and Republican leaders in the Legislature have said changes are needed to save money.
"While the provision may result in significant savings in the future," the fiscal analysis said, "it would remove the entire Legislature from determining substantial elements" of the program.
Health care workers, including home care workers who only recently got the right to unionize, criticized Walker's plan to prohibit them from collective bargaining, saying it could harm patient care.
"You need people who are dedicated, and not concerned about their livelihood, so they can be in the present moment for their patients," said Ann Louise Tetreault, a leader of the Service Employees International Union Healthcare Wisconsin. It represents 16,550 workers, including 1,800 nurses at UW Hospital, where Tetreault is a nurse.
Lynn Breedlove, executive director of the advocacy group Disability Rights Wisconsin, said Walker's proposal to do away with the Wisconsin Quality Home Care Authority — another provision of the bill — could harm people with disabilities. The home care authority screens and places workers in homes, where they bathe, prepare meals and provide other assistance for the elderly and people with physical or developmental disabilities.
"Some people with disabilities are vulnerable, and the free, open marketplace can be dangerous," Breedlove said.
Walker's bill would transfer the home care authority's services to the state Department of Health Services. The authority, which started in Dane County in 2009, was set to expand statewide this July, said director Patti Becker.
The authority trains and does background checks on workers and places them in homes, which helps keep clients out of nursing homes, Becker said. Most of the care is paid by Medicaid.
If more people end up in nursing homes, "it's going to be more expensive," Becker said.
Last year, 5,500 home care workers joined SEIU under legislation passed the year before, but they haven't been able to get a contract with the state approved. It would guarantee a wage of $9 an hour.
Walker's bill strips most public employees of their right to collectively bargain for benefits. That includes workers at UW Hospital and other public institutions, such as nursing homes, mental health facilities, disability centers and public health departments.
At UW Hospital, a nurses' contract approved last year lasts until 2014. A contract with the Wisconsin State Employees Union — which covers 2,800 administrative employees, technical staff and environmental and food service workers — goes until 2015. A contact covering 160 chemists and medical technologists with Wisconsin Science Professionals expires in 2013.
Donna Katen-Bahensky, chief executive officer of the hospital, said in an e-mail to employees Friday that "we believe we will be able to honor those agreements as written."
But Tetreault, who said SEIU has helped nurses maintain good wages and get rid of mandatory overtime, said she worries that Walker will find a way to terminate the contracts. "I'm not going to be lulled into thinking that's going to protect us," she said.
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