The Wisconsin Department of Health and Family Services (DHFS) appears to be on a mission to end long term care at ALL intermediate care facilities for the mentally retarded (ICFs/MR).  Unfortunately, they are hiding behind the claim that it is all the counties' doing.

It does appear that the counties are being heavily pressured by the DHFS to remove residents from ICFs/MR.  Yes, the county may be doing it but what or who is the force behind it?  Have all the counties suddenly decided this is the best thing to do?  Or could we suspect some incentives?

There are currently only about 1,000 persons receiving long-term care and servcies in ICFs/MR statewide.  DHFS has already planned that 330+ of these 1,000 will move out of the few remaining ICFs/MR "voluntarily" under a new "rebalancing" grant received from the federal government.  The "rebalancing" grant means that Wisconsin will receive about 78 cents, instead of the usual 57 cents, for every Medicaid dollar spent for the first year that a person has been moved out of an institution.  Money talks!

When do we think the Wisconsin Department of Health and Family Services will consider that long-term care of developmentally disabled persons has been adequately "rebalanced" ?  My gut feeling is that "rebalancing" will not stop until all 1,000 persons developmentally disabled persons in ICFs/MR have been placed in community based settings.

We hear tons about numbers of persons moved out of institutions.  Hear nothing about quality of placement. 

Some of these residents require the highest level of skilled nursing care available.  Will a community based setting result in a higher quality of life or an earlier death?