DLTC INFO MEMO 2008-03
STATE OF WISCONSIN
Department of Health and Family Services
Division of Long Term Care
DLTC Info Memo Series 2008-3
Date: February 21, 2008
For: County Departments of Human Services Departments
County Departments of Social Services Directors
County 51 Directors
County Fiscal Contacts
County COP and Waiver Coordinators
Human Service Area Coordinators
Community Integration Specialists
From: Sinikka Santala, Administrator
Subject: LTC Fiscal Update Memo #6
This informational memo provides additional details on when, how, and by
what means the county contribution will be collected from counties
transitioning to Family Care. A previous communication (LTC Fiscal Update
Memo #4) detailed the contribution requirements for counties participating
in managed long-term care expansion, as defined by 2007 Wisconsin Act 20.
LTC Fiscal Update Memo #4 also provides each county with its maximum
county contribution amount on an annualized basis.
For year one, which is the 12 month period beginning when a county's
first waiver recipient transitions to managed long-term care, a county's
annual contribution will be pro-rated based on the county's approved
Family Care enrollment plan. The Department will provide each county with
the details of its calculated county contribution amount by that county's
transition start date. (There may be some slight delay for the initial
counties that are transitioning as this policy must now be implemented.)
The Department will also monitor a county's actual transition of
individuals from the waivers to Family Care to ensure the county
contribution that was initially calculated based on the enrollment plan is
consistent with actual enrollment. This will help ensure an appropriate
portion of county contribution remains with the county to support
individuals who remain on the waivers while the county transitions to
After year one, the on-going annualized county contribution amount will
be based on the annual contribution amount shown in LTC Fiscal Update Memo
#4. That schedule reflects a buy-down formula, set in statute, to reduce a
county's contribution amount to no more than 22% of a county's CY 2006
Basic County Allocation (BCA) within five years of the county's transition
start date. If the original county contribution is greater than 22% of the
county's BCA, the contribution is adjusted to reflect the buy down formula
and the county retains the difference.
The Department's goals in developing a method for collecting county
- Provide counties with ample time to address the required county
contribution amounts in their county's budgeting process.
- Ensure sufficient funding remains with counties to serve individuals
on the waivers until Family Care transition is complete, while making
sure that funding related to persons served by Family Care is
transferred to the State for use in Family Care.
- Simplify the calculation of the contribution amount owed in year one
by collecting the final year-one contribution after a county's waiver
transition is complete.
With these goals in mind, the Department will allow a county to make
its first contribution payment in January of the calendar year following
the start of Family Care in that county, or the month after the transition
of waiver clients is completed, whichever is later. This will allow
counties beginning their transition early in a calendar year to
appropriately budget for the payments that must be made (in the subsequent
year). This also allows counties beginning their transition late in the
year, and whose transition spans calendar years, to complete the
transition before making their initial payment.
Counties may pay their county contribution in a lump sum, in advance,
for the year, or on a quarterly basis. A county may begin making its
payments any time after its transition start date. However, by January of
the calendar year following the Family Care start date, a county will be
expected to have made the full payment of contribution for the prior
calendar year. This payment will be pro-rated, based on the month that a
county began its transition and how rapidly individuals enrolled into
Family Care from the waivers, as described above.
After this initial payment, it is expected that a county will do one of
- Make a lump sum annual payment of the required county contribution
by the anniversary of the initial start date of Family Care, or
- Make quarterly payments of the required county contribution with the
total annualized amount made by the county's anniversary date.
To help clarify, below is an example of how this would work for a
County A has a Family Care transition start date of April 1, 2008, and
both an initial and ongoing annual county contribution of $12,000. County
A's waiver rollover process will take 6 months.
- For the Year 1 Payment
County A could make the initial county contribution payment of $9,000
(9 months of Family Care x $1000 per month = $9,000) anytime before
January 31, 2009. Note that the $9,000 amount is an absolute maximum
and is not pro-rated for this example.
- For the Ongoing Payments County A has two options:
Option 1: County A would continue to make one lump sum payment to the
Department annually, no later then March 30th of each calendar year,
beginning with March 2009.
Option 2: County A could begin making quarterly payments of $3,000 (4
x $3,000 = $12,000) in April, 2009.
LTC Fiscal Update Memo #4 provided three options for counties
transitioning to Family Care to pay their county contribution to the
1) Through a reduction to their BCA contract.
2) Through a direct payment to the Department, i.e., payment with a check.
3) Directing the state to net the payment from a county's monthly
reimbursement for state/county contract allocations in the CARS system.
Counties choosing a reduction to their BCA contract need to take into
account other obligations to their BCA amount, including WIMCR and the
upcoming split of BCA funds due to the new Department of Children and
Families. If a county chooses this option and the county's BCA is not
sufficient to cover the Family Care contribution, the county will be
responsible for paying the remaining balance of its Family Care
contribution by check or by a reduction of the county's monthly
reimbursement for state/county contract allocations.
Thirty days prior to a county's start date to Family Care, the
Department will send a letter to the county notifying them of the
- The date when the first contribution payment will be due,
- The maximum amount of that first payment,
- When payments will be required after the first payment,
- How the payments will be recorded in the Community Aids Reporting
This letter will also (i) give counties the opportunity to select the
method of payment from the three options listed above and (ii) ask
counties to indicate whether they will be paying in a lump sum or with
This letter will need to be signed by a county representative and
returned to the Department prior to a county's Family Care start date.
This letter will serve as a binding agreement between the Department and
the County in regard to collecting county contribution. Again, there may
be some slight delay in the timing of this letter for the initial counties
that are transitioning, as this policy must now be implemented.
Counties will have the opportunity to change payment methods annually
and can do so by submitting written notice to the Director of the Office
of Family Care Expansion. However, once a method is selected for a year,
meaning each twelve month period following the county's transition start
date, the method may not be changed mid-year.
Please feel free to contact staff from the Fiscal Management and
Business Services Section with questions on calculating and paying the
annual county contribution.
cc: FMBS Team
Fredi Bove, Associate Administrator, DLTC
Judith E. Frye, Director, OFCE
Beth Wroblewski, Director, BLTS
Irene Anderson, BLTS
Mike Linak, BLTS
Cheryl Thompson, BFS
MEMO WEB SITE: http://www.dhs.wisconsin.gov/dsl_info/
Last Revised: September 13, 2010