ORC Industries to sell Bell Canoe Works
On the Threshold of great things
July 28 Opportunities Inc. 45th Anniversary Gala
ASPIRO motorcycle ride benefit Sept. 11
St. Coletta renovation project
Lawmakers push for full funding of IDEA
Are people with I/DD still living in the shadows?
VA benefits for survivors
Senate considers ways to boost disability employment
Medicaid funds shifted to
Employment and intellectual and developmental disabilities
Integrating financial education into family support services
ADA Proclamation by President
Lawn chair wheelchairs
SAVE the DATES RFW Economic Summit Oct. 26-27
Statewide training events for people with disabilities
2011 Recall Forums
2012 Rehabilitation and Transition Conference Call for Proposals
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Stepping Away From the Survival Coalition
The RFW in Action Board of Directors firmly believes that advocates and providers should make every attempt to work together to advance the interests of people with disabilities. At its July 6 meeting in Madison, however, the RFW in Action Board made a difficult decision about its membership in the Survival Coalition. The Board expected that the leadership of the Coalition would assist its members in reaching a consensus on its positions, as called for in its bylaws, which would accommodate the various points of view of its membership, to bring advocacy and provider organizations together. Over time, the public positions adopted by the Coalition have made it clear that the provider perspective is not valued. In fact, the Coalition’s leadership has not even sought input from its members before issuing press releases and reports in recent months. Therefore, the RFW in Action Board of Directors decided it could no longer remain a member of the Coalition and instructed me to send them a letter of resignation. RFW in Action has had differences of opinion with the co-chairs of the Survival Coalition for some years now about the role of center-based services. After these disagreements boiled over during the debate on the definition of prevocational services that the Department of Health Services (DHS) and Pathways to Independence proposed in 2009, an uneasy truce was reached and some efforts were made to develop a position paper on the continuum of habilitation supports, from day programs, to prevocational services, to supported employment and competitive job placements. Significant differences emerged about the following issues over the past year:
Executive Director RFWiA
In summary, the RFW in Action Board of Directors has reached the conclusion that the participation of our association in the Survival Coalition would give policy makers the impression that we agreed with partisan positions taken by the group. At some point in the future, if the leadership of the Survival Coalition demonstrates that it can manage the messaging from the coalition in a more transparent and bi-partisan manner, RFW in Action will consider rejoining. Until then, our differences dictate that we must go our separate ways.
- The funding cuts and decreases in authorizations for services to people with intellectual and developmental disabilities being made by Managed Care Organizations (MCOs). Although the Coalition was made aware of specific rate cuts and service reductions to people with intellectual and developmental disabilities that were planned by Community Health Partnership (CHP) through a phone conference that I arranged in November 2010 between the Survival Coalition co-chairs and CHP’s Chief Executive Officer Paul Cook, there was no action taken by the Coalition (i.e., no letters were written, no meetings were held with DHS to express concern, or to ask for their intervention, no position statements were issued, etc.). The Coalition has remained silent on the continued cuts in funding and service authorizations being made by MCOs throughout the state to this day. As a result, RFW in Action began producing learning materials to help consumers, families, and guardians exercise their rights in the Family Care program.
- Tort reforms to help long-term care providers reduce their liability insurance costs. This bill was proposed by the Wisconsin Health Care Association and supported by RFW in Action because of the high cost of insuring residential service providers and the inability of some nursing homes to get coverage. After our positions were made public, one of the Coalition co-chairs co-authored an op-ed that appeared in the Journal Sentinel describing the bill as the “Abuser Protection Act of 2011.” The specific provisions to which the op-ed objected concerned information that is shielded from disclosure in court. This information did not include an incident report or the medical records of a particular patient, but rather, the peer reviews that are done by organizations in order to try to remedy systemic issues that lead to incidents that can still be investigated. An identical bill was passed by the legislature in a previous session, including when the Senate was under Democratic control, without opposition from the organizations that contributed to the op-ed. That bill was vetoed by Governor Doyle under pressure from the trial lawyers association.
- The provisions in the budget repair bill that authorized DHS to study the Medicaid program and make changes in regulations with review by the Joint Committee on Finance. Although this was a controversial bill, mostly because of its collective bargaining provisions, RFW in Action supported the provision in the legislation for an expedited review process for achieving $500 million in Medicaid funding reductions and restructuring of Medicaid programs. We did so knowing that the longer it would take for changes to be made in the Family Care program and other Medicaid-funded services the deeper the cuts would have to be to bring the state’s budget into balance. The Survival Coalition took a position opposing the bill, without seeking consensus from its members, and despite the fact that the previous legislature and governor had made even larger cuts in the Medicaid program with less legislative review and without being criticized by the Coalition. In fact, just before the Coalition came out in opposition to the budget repair bill, lobbyist Michael Blumenfeld and I urged the co-chairs to take a few days to analyze and discuss the Governor’s budget address before taking a position on it.
- Medicaid cuts to prevocational services. The Survival Coalition cited a controversial Pathways-funded study that was conducted at the height of critical threats to prevocational services in 2009 in its recommendations for Medicaid efficiencies. They suggested cutting prevocational service rates to Community Rehabilitation Programs as a way to help achieve $500 million in Medicaid savings. Furthermore, they wrongly presumed that this approach would also increase integrated employment services in long-term care, which would somehow save money. These conclusions would not withstand a rigorous economic analysis from a qualified expert and RFW in Action members were completely blindsided by the Coalition’s issuance of this set of recommendations. This is another example of how the Coalition has neglected communicating with its members.
- The Governor’s budget, which called for a halt to the expansion of Family Care, until DHS could restructure the program to make it financially and programmatically sustainable. RFW in Action supported the compromise position that was adopted by DHS, which provided for emergency funds for those most in need of long-term care services, while DHS focused its attention on reforms to the program before its continued expansion. By contrast, the Survival Coalition pushed for the expansion of Family Care, irrespective of the impact it was having on people with disabilities. The expansion was done much too rapidly and without building the systems needed to protect consumers from the unintended consequences of the program. The Coalition pushed for expansion, even after they were made aware of allegations by Attorney Rock Pledl about civil rights violations committed by financially distressed MCOs against people with intellectual and developmental disabilities.
- Issuance of a “report card” and press release stating that the biennial budget passed by the legislature “contains the worst consequences for people with disabilities in recent years.” Governor Walker made the Medicaid program a priority, sparing it from $3.25 billion in cuts that might have been made had he not replaced the enhanced FMAP that expired on June 30, 2011 with every dollar in new revenue the state expects to receive during the next two years, plus additional funds that were taken from other areas of state spending. It is hard to imagine how much worse things might have been for people with disabilities if Wisconsin had taken actions similar to other states that have made extreme cuts in their Medicaid programs. To the majority of our membership, the press release and report card appeared to be a partisan attack on the budget that was passed by the Republican legislature and signed by the governor. After issuing the documents, the Coalition sent an e-mail to members which read, “in the past we would [have sent] the publication out for members to approve.” The e-mail asked for members’ permission to add their organizations names retroactively to the document. Again, the Coalition did not provide an opportunity for its members to review its position in advance.