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A pharmacist pours pills to count them while filling a prescription. State Journal archives

FENNIMORE — When Anna Moffit's son stopped talking at age 2, her private health insurance wouldn't cover speech therapy, which Moffit said she couldn't afford.

She got help from the state, which paid for the therapy through a Medicaid program she fears might be cut as state officials trim $500 million from Medicaid over the next two years.

"I do not want them to be targeting children with disabilities," Moffit, of Madison, said at a "town hall" meeting Tuesday at Southwest Technical College.

Department of Health Services Secretary Dennis Smith and Deputy Secretary Kitty Rhoades listened to concerns and suggestions about Medicaid, the state-federal health plan for the poor. Medicaid has an annual budget of $6.7 billion, roughly 60 percent from federal money, and covers 1.2 million people in Wisconsin, or one in five residents. It includes BadgerCare Plus, Family Care, SeniorCare and other services.

Gov. Scott Walker's proposed biennial budget calls for $500 million in Medicaid cuts. Smith and Rhoades will take public input on the cuts in at least two more meetings, in Green Bay and Milwaukee. Thirty people spoke in Fennimore, many of them representing people with disabilities; 65 spoke at the first meeting last week in Eau Claire.

Smith, repeating earlier statements, said he will seek federal permission to review patients' Medicaid eligibility more frequently and increase patient fees instead of dropping higher-income people from the program or eliminating optional benefits such as prescription drugs.

Moffit said she hopes the state doesn't cut the Katie Beckett program, an optional Medicaid benefit that covered speech therapy for her son, Felix, now 4. "The services helped tremendously," she said.

Felix was diagnosed with autism at age 3, and the family's private insurance now covers his care.

Smith said in an interview he won't make changes to the Katie Beckett program.

Will Buros, a youth services coordinator at Passages, a program for abused women and their children in Richland Center, said he worries about Smith's plan to encourage more people to use "self-directed" longterm care instead of getting services through an agency.

Self-directed care gives people with good cognitive abilities more control over their care, Buros said, but it also allows people posing as friends or caregivers of vulnerable patients to make extra money.

"To me it's kind of a scam," Buros said. "They milk the system for everything it's worth."

Safeguards prevent fraud in Family Care, the state's main longterm care program, and its self-directed alternative, known as IRIS (Include, Respect, I Self-Direct), Rhoades said. She noted that an audit on Family Care is to be released soon.

Tina Pohlman questioned Family Care's decisions in helping her live with lupus, an autoimmune disease, and antiphospholipid antibody syndrome, or APS, which causes clots and strokes.

She said Family Care pays too much for a nurse to review her paperwork but has refused cardiac rehab that could improve her condition. She runs the nonprofit APS Foundation of America out of her La Crosse home.

"I try to do as much as I can on my own because I know the state budget is tight," she said.

Smith suggested she go on IRIS, the self-directed program.

Herb Thomas, a real estate broker from Richland Center, said Medicaid should encourage more disabled people to work when they can and make them use some of the earnings to pay for their care.

"Most would welcome the opportunity to give back and contribute," he said.