Client(s):
Milwaukee County Department of Health and Human Services
Working with Milwaukee County policymakers and our project partner, the Public Policy Forum, we examined services for people with IDD following the state’s shift to a managed care framework for long-term services and supports. We provided a comprehensive view of how the system was performing after the shift and developed a blueprint for improvement.
In addition to producing a comprehensive view of system performance and recommended actions for improvement, the process we undertook drew stakeholders together to exchange perspectives and discuss what they might do together to maintain the momentum of the effort.
Over the past two decades, Wisconsin’s system of long-term care services and supports has undergone significant change, affecting seniors and people with intellectual and developmental disabilities (IDD). A shift to a managed care framework was a central focus of these changes.
Change inevitably requires that policy choices be made that have impacts, positive or negative, on the system. As a result, it is prudent to pause and take stock of what has been achieved, take measure of the challenges that remain, and make informed plans for pressing forward. In this spirit, we assisted Milwaukee County policymakers to explore circumstances surrounding services for people with IDD in the county and develop a “blueprint” for improvement while meeting the challenges ahead.
As part of our review, we examined relevant literature and data available at the national, state, and county level, and conducted interviews with more than 30 informants. We found that the system, while accomplishing important goals with respect to system access, faced significant challenges going forward:
While Wisconsin policymakers had invested heavily in expanding service capacity and successfully eliminated waitlists, there was now a perception among key informants that the service mix may have become more standardized and somewhat less ample.
These challenges were made more complicated by the existing managed care framework that includes multiple managed care entities, alternative service response emphasizing self-direction, and county involvement to determine initial service eligibility and guidance to service recipients.
With our project partner, the Public Policy Forum, we suggested several strategies to shore up services for people with IDD in Milwaukee County. The actions suggested targeted four areas:
Milwaukee County Department of Health and Human Services
Public Policy Forum