This article is adapted from the July 2009 State Bar Elder Law News, published by the Elder Law Section.
Anne De Leo, Plaintiff’s Attorney, Nelson, Irvings & Waeffler, SC, Wauwatosa
Aug. 5, 2009 – Beginning Jan. 1, 2010, Milwaukee County will be the only county in Wisconsin where the State of Wisconsin directly administers applications and continuing eligibility for the Medical Assistance and FoodShare programs. The Department of Health Services (DHS) is taking over the direct administration of these programs in Milwaukee County. The takeover is a direct result of a lawsuit filed by a group of Milwaukee County residents whose applications, reviews and other documents were either not processed or not timely processed.
The DHS announcement was contained in a letter from Secretary Karen Timberlake to County Executive Scott Walker. Secretary Timberlake’s strongly worded letter cited a number of examples of inadequate performance by the Milwaukee County Department of Health and Human Services over a long period of time, including failing to answer more than 95 percent of telephone calls from clients, processing only 70 percent of applications on time, and closing cases and then reopening them within 60 days. The initial response from Milwaukee County officials was anger. Some members of the Milwaukee County Board of Supervisors blamed DHS for failing to adequately fund the Milwaukee County income maintenance operations. Others asked for more time to correct the problems.
DHS was not willing to back down and proceeded quickly to draft and lobby for the necessary legislative authority for DHS to begin to supervise and discipline the hundreds of Milwaukee County employees who staff the Milwaukee County Department of Health and Human Services. Gov. Doyle signed 2009 Wisconsin Act 15 on May 26, 2009, authorizing DHS to administer the income maintenance programs in Milwaukee County using state employees as supervisors and county employees as staff. Wisconsin Act 15 also clarifies employment and benefit rights of former county employees who may be hired as state supervisory staff.
DHS held public hearings in Milwaukee County in February and March to take testimony from clients, advocates, elected officials and other interested persons. At each hearing, DHS officials repeated this clear and unequivocal message: every client who is seeking help will be treated with dignity and respect and DHS will do everything it can to get eligibility and reviews done correctly.
The takeover is proceeding along a phased-in process. Beginning in May, DHS employees began processing all applications from Milwaukee County residents that are received on-line via accesswisconsin.gov. Beginning in July, DHS began taking all telephone calls to the Milwaukee County Department of Health and Human Services from a new call center staffed with 62 employees. Beginning in January, 2010, the entire income maintenance operation will be the responsibility of DHS.
DHS has established a Community Advisory Group to review the progress of the takeover and make recommendations. Its first monthly meeting was held in May. Members of the Community Advisory Committee include several Milwaukee County supervisors, representatives of organizations that serve persons with disabilities, representatives of medical providers and insurance companies, individuals who receive benefits, and the union that represents the county employees.
DHS has set several overall goals for the takeover. Some are basic customer service goals that every income maintenance agency should adhere to: answer the phone; don’t lose documents that are mailed in; and be respectful to members and to each other. Additional goals include processing 90 percent of applications, reviews and FS six-month reports on time and processing 90 percent of verification documents within 10 days of receipt.
The lawsuit is required to be dismissed in March 2011 if certain terms set forth in a stipulation signed by counsel for the plaintiffs and DHS officials are met. The stipulation requires dismissal if DHS has timely processed 90 percent of applications, 90 percent of reviews, 90 percent of FoodShare six-month reports and 90 percent of verification documents, averaged over the months of November 2010, December 2010, and January 2011. The stipulation also requires DHS to revise its letters regarding missing verification in order to comply with the detail required by federal regulations.
Milwaukee County residents who currently need to apply for MA or FoodShare benefits or complete reviews should be advised to use accesswisconsin.gov rather than completing paper applications. A number of community organizations in Milwaukee County assist clients in applying on-line. Milwaukee County residents applying for institutional MA or Family Care should continue to use the special unit of workers that handle these applications.
On July 10, 2009, Judge Stadtmueller issued an order staying all further proceedings in the litigation and postponed approval of the settlement agreement subject to a fairness hearing under Rule 23(e) of the Federal Rules of Civil Procedure.
Anne L. De Leo is a shareholder in Nelson, Irvings & Waeffler. She concentrates her practice in advance planning for illness and incapacity; nursing home and home care issues; and eligibility for Title XIX and other public benefits.
This article is published courtesy of the Summer 2009 State Bar Elder Law Section. The State Bar offers its members the opportunity to network with other lawyers who share a common interest through its 26 sections. Section membership includes access to newsletters, email lists to facilitate information sharing, and other resources.