Provisions in the 2011-2013 budget passed by the Wisconsin State Assembly early Thursday morning will restrict Sauk County's ability to provide care for frail seniors, and those with physical and mental disabilities, officials say.

The budget is slated to take effect July 1 once it is passed by the state Senate and signed by Gov. Scott Walker.

A proposal put in the budget by Walker cuts funding for a state program called Family Care that provides long-term managed care for vulnerable people, said Sauk County Human Services Director Bill Orth.

Sauk and other counties have lists of people who have qualified for care, but are waiting to receive the services they need, he said. Under the original plan for Family Care, the county was slated to get everyone off its waiting lists by September, but that is now changed, Orth said.

Under the budget provision, the number of people receiving care will be capped at the present number, Orth said. The only way someone will get off the waiting list is if someone vacates their long-term care slot by death, moving out of the county or for some other reason.

"It's only by attrition that someone could come on," Orth said.

Sauk County has about 80 people waiting to get care, said Jim Pritzkow, a social worker with the Sauk County Aging & Disability Resource Center. About half are frail elderly with the remaining 50 percent split between people with physical disabilities and those with developmental disabilities.

Each month Sauk County adds 10 to 12 people to the waiting list and about half that number find placement, he said.

"As we go through, our waiting list is going to get bigger and bigger and bigger," Pritzkow said about the Family Care cap. "And, again, these are people who are eligible."

The idea behind Family Care is to save the cost of placing people in nursing homes or other institutions by finding other options for their care, Orth said.

"(The program provides) assistance in living independently, assistance in work programs, assistance in basic shopping," Orth said. "That's one of the biggest cost savings of these long-term care programs is they do a very good job of keeping people in the community rather than in nursing homes or other residences."

With the Family Care Program, the state pays only a portion of the total costs of housing a person in a nursing home. As a result, the cap threatens to shift costs from the state onto Sauk County, Orth said.

"If they can't get into Family Care, they or their guardian or a family member can go into court and have services ordered," he said. "Then the county is responsible to pay for that."

Sauk County doesn't have the money to pay for court-ordered care, Orth said. It gave up more than $7 million annually in federal and state funds to the state when it joined the present system of long-term care in 2008.

Orth said while the budget was in the legislature's Joint Finance Committee, legislators added about $12.6 million annually to Gov. Walker's original proposal so human service agencies could provide care for some people on the waiting lists.

"Say you run into somebody in the county system who desperately needs care for their physical well being and safety," he said. "You can apply for those funds to care for that person until a slot becomes available."

However, the additional amount is not likely to meet the demand for care, Orth said.

"The rough estimate is that may fund 400 slots statewide and there are several thousand that are anticipated to be needed," he said. "It's going to be hard to figure out how can we keep these people safe at home."