Progressive Thinking

Wisconsin lawmakers tweaked Gov. Scott Walker's plan to expand the state's Family Care program and wrap the IRIS program into it on Wednesday, ignoring advocates for the elderly and disabled who have balked at the plan. Change made to allow ADRCs to be operated by out-of-state corporations.

MADISON - Republicans on the Legislature's budget committee Wednesday backed some but not all of Gov. Scott Walker's sweeping proposals to overhaul the state's long-term care system for elderly and disabled people.

The Joint Finance Committee voted 12-4 along party lines to clear the way for major changes to Family Care and IRIS (Include, Respect, I Self-Direct), two programs that care for tens of thousands of vulnerable individuals outside nursing homes. They also made significant changes to the Aging and Disability Resource Center (ADRC) program.

The action ignored much of the testimony at recent hearings. Advocates for the elderly and disabled have said the budget proposal could force vulnerable people into turmoil by eventually requiring them to change doctors, care workers who visit their homes, or even the group homes where they live.

They also have pointed to problems that the state encountered after a separate change that shifted to a single statewide provider of medical rides. An audit released earlier this month confirmed complaints about "no-show" and late arrivals for nonemergency medical rides by the contractor, MTM Inc.

Family Care provides long-term care outside nursing homes to some 41,000 elderly and disabled people throughout Wisconsin using state and federal money. Lawmakers backed Walker's proposal to expand Family Care by Jan. 1, 2017, to the state's eight remaining counties without it, including Dane County.

In the biggest change to Family Care, the proposal approved Wednesday would aim to combine both long-term care and ordinary medical care. The program would even seek to coordinate the state program with federal Medicare coverage — an effort that critics said would be difficult to achieve without the consent of patients.

Lynn Breedlove, a leader of the Wisconsin Long-Term Coalition, said he remained concerned that the proposal would shift the system to large out-of-state insurance companies and away from its current network of regional nonprofits that provide most of the care.

"Let's be clear, this new plan is just the governor's proposal in sheep's clothing," Breedlove said. "Thousands of people expressed opposition to dismantling the current system, but the Legislature is doing it anyway."

“Wisconsin ranks 8th in the nation for the quality of our long-term care due in large part to the success of our community-based Family Care program," said Senator Dave Hansen (D - Green Bay). "It makes no sense to change it over to a for-profit system unless you are a politician who places the pursuit of corporate profits over the lives of everyday Wisconsinites."

The IRIS Program is a Medicaid Home and Community-Based Services (HCBS) which allows adults with long term care needs to self-direct, including hiring their own caregivers, which is not currently available to the same degree in Family Care. The budget proposed would effectively eliminate the IRIS program, requiring the 11,000+ participants to enroll in Family Care if they wish to continue receiving long-term care.

“IRIS has proven to be a strong, family supporting plan for those that are elderly, disabled, and otherwise unable to live on their own without support of their community and family. We heard over and over again at the four public hearings around Wisconsin how IRIS was a lifeline for those that contribute in our communities working and volunteering, without IRIS those doors close, we know this works and anything short for a full repeal is not acceptable for our most vulnerable adult communities,” said Senator Jon Erpenbach (D-Middleton).

The ARDC program operates like efficient, locally based one-stop shops for people with disabilities. Under the budget proposal, functions of ADRCs could be operated by different for-profit entities that may no longer be local, creating barriers to access.

"ADRC’s open their doors to our frail elderly and their families, helping guide them in their own communities when tough decisions need to be made, working to keep people in their homes for dignity and cost savings. It is incredible that Governor Walker ever thought his plan was a decent idea for Wisconsin,” said Erpenbach.

Recent action taken by majority party members on the Joint Finance Committee on funding for public education provided limited additional revenue to public schools while opening the door for expansion of private vouchers. It will take dollars away from public schools.

ALMA, WI - “Our number one priority gotta to be make (sic) sure that we make K-12 schools, public education in the state, a priority to make sure they’re held whole,” said Governor Walker on April 23rd, as quoted by Wisconsin Radio Network.

I agree, Governor! Let’s make public schools “whole.”

In a recent late night session, the state’s budget writing committee took up public school funding. Many advocates expected a turnaround in the governor’s proposed funding for local schools. Instead folks got a big surprise: lots of changes asked for by private school lobbyists. Not so for public schools.

In a press release, State Superintendent Tony Evers described the actions this way:

• For the first time ever, there is no increase in state imposed revenue limits over the next two school years, while voucher and independent charter school payments are increased in each year.
• State general equalization aid to public schools is cut in the first year to pay for voucher expansion and increased independent charter school payments. This leaves public schools with less state general aid than in 2010.
• Continues the freeze on state special education aid for what will be the eighth consecutive year, covering roughly a quarter of district special education costs while creating a new voucher program that drains funds from public schools.
• Essentially eliminates teacher licensing standards by allowing public and private schools to hire anyone to teach, even those without a bachelor’s degree, planting Wisconsin at the bottom nationally, below states with the lowest student achievement levels.

Republicans on the Joint Finance committee opened wide the spigot of state money flowing to private schools. Created in late night actions was a new statewide special education “voucher” program with $12,000 per student leaving the local school district; permission for the multiplication of some privately-operated independent charter schools and statewide expansion of private vouchers for all students with a cap of 1% of the local district’s enrollment in the first year and moving to unlimited expansion after several years. Money for this statewide subsidy would come from the local public schools.

In addition, to keep competitive sports programs, public schools would be required to accept private and home-schooled children into their sports programs and extracurricular activities and not charge these students any more than a public school student would be charged for sports or extracurricular activities. This rule would essentially ask public school parents to underwrite the cost of these private school children coming back into the public schools to partake of after-school activities – as the school would receive no additional fees from the state for these students.

Republican Finance Committee members also voted to create a new private school take-over of Milwaukee public schools. This system would leave no public school alternative in many Milwaukee neighborhoods. Many residents are concerned this action violates the state’s constitution to require an equal and public education for all children.

Left far behind was the governor’s promise to make sure public schools are “held whole.”

Ironically the day before, the governor spoke to a pro-private school group in New Orleans - the American Federation for Children - according to a Wisconsin State Journal report.

Had the governor been here, I would have told him that to make schools “whole” means returning the money cut from public schools.

The cumulative cut to public schools since 2011 – the first Governor Walker budget – is nearly $1.7 billion. These cuts happened at a time when Wisconsin collected and spent a cumulative increase in revenue of nearly $13.8 billion.

These staggering cuts – at a time when the state was spending much more – drained the savings of school districts, delayed maintenance, caused pay cuts and freezes to staff and left children with fewer resources.

As state school aid dropped and districts used up all available budget cutting measures, many districts were forced to go to referendum. The Wisconsin Taxpayer recently reported 78% of referenda passed in April of 2015 – a significantly higher rate than prior years. Property taxpayers, committed to their local schools, are picking up more of the burden.

Local public schools are at a breaking point. These new private school proposals will hasten their demise. Governor, it’s time to stand by your promise and make our public schools “whole”.

While the plan increases K-12 funding, it also expands School Choice in Wisconsin and approves Milwaukee Public Schools (MPS) Reform Plan allowing the County Executive to appoint a commissioner to run a type of recovery program for public schools.

MADISON - In a long debate Tuesday night, legislative Republicans on the Joint Finance Committee (JFC) proposed an extreme plan for dismantling the public education system in Wisconsin. Finally, at about 1:30 in the morning Wednesday, the omnibus education motion came to the JFC. There it passed 12-4 on a party line vote just as it would have before the debate.

The Republican plan comes straight out of Gov. Scott Walker's campaign rhetoric. While the plan does include some additional K-12 public school funding, it also expands both Racine and the statewide school choice programs with an enrollment cap of one percent per district until total enrollment is 10 percent higher than it is now.

In a further slap at Milwaukee Public Schools, it creates the Opportunity Schools and Partnership Program (OSPP) in which County Executive Chris Abele appoints a commissioner to run a type of privatized recovery program for public schools. The commissioner would select one to three schools in the first few years and up to five schools starting in 2017 to be handed over to the OSPP program. The program would select an operator, public or private, to run the selected schools. Existing staff at these schools would have to reapply for employment and the commissioner would have discretion over employment at the schools.

According to the right wing MacIver Institute, "JFC Republicans introduced the package to deal with the entire K-12 education agenda in one fell swoop."

According to Assembly Democratic Leader Peter Barca (D-Kenosha) in a statement released this morning:

"Last night, legislative Republicans proposed an extreme plan for dismantling our public education system that not only harms education – it also undermines the will of voters. As part of an extreme budget proposal, Republicans will drastically change the system of educating children with disabilities without even holding a public hearing to shovel more funds to the private voucher school community. Overall, the net effect of the changes is the millionaires who fund Republican campaigns were popping champagne corks celebrating their great fortune last night.

“This Republican plan further defunds public schools and destroys local control. The taxpayers of Racine certainly did not ask for 12 Republican legislators to dismantle their way of electing their local, democratically created school board. And that sort of disrespect and knee-capping of local control will be happening in communities across Wisconsin. It is clear this Republican education budget is not meant to serve our Wisconsin communities and values – it is meant to curry favor with Republican presidential primary voters and out-of-state special interest groups that bankroll legislative Republican campaigns.

“So-called ‘Opportunity Schools and Partnership Programs’ were not requested by Milwaukee or any of the other large cities that could be affected, no hearings were held and the effects could be devastating to our large school districts.

“Republicans continue to mislead the people of Wisconsin by claiming they have made schools ‘whole’ while they are only funding one element of our school formula and draining public schools of tens of millions of taxpayer dollars they are giving to private schools. The Republican end goal to allow unlimited taxpayer dollars to go to private schools signals the end of public education as we know it in this state.

“There are so many bad aspects of this Republican education budget, but I am especially appalled by their creation of a special education voucher system that takes additional money out of public schools and leaves parents and special needs students with no resources or rights. It is clear that by not requiring services for children with severe needs or complicated medical issues that this burden will still fall upon public schools. It is the height of arrogance to add an entirely new approach to educating children with disabilities without so much as a public hearing to allow educators an opportunity to offer their insights.

“Republicans’ arrogance of power knows no bounds and their disrespect of the citizens of this state to undermine local control and make dramatic and even radical changes to education late in the night without any notice, hearings or consultation with the communities they disrupt is a terrible abuse of power.”

New questions about a $500,000 loan granted by Gov. Scott Walker's troubled Wisconsin Economic Development Corporation to a donor follow allegations that nearly $585 million of the $975 million in taxpayer assistance provided by WEDC went to companies that had contributed to Walker’s campaign.

MADISON - Over the weekend, the Wisconsin State Journal broke another story about Gov. Scott Walker's troubled Wisconsin Economic Development Corporation (WEDC). This time, it appears that WEDC may have granted at least one loan totaling $500,000 as a favor to one of the governor’s campaign contributors.

The State Journal reported that Gov. Scott Walker’s top aides and a powerful lobbyist pressed in 2011 to award a $500,000 unsecured loan to Building Committee Inc., owned by William Minahan, for a proposed project to retrofit bank and credit union buildings for energy efficiency. The taxpayer-funded loan eventually lost the state half a million dollars, created no jobs and raised questions about where the money went.

This recent revelation follows allegations that nearly $585 million of the $975 million in taxpayer assistance provided by WEDC went to companies that had contributed to Governor Walker’s campaign either directly or indirectly.

Equally troubling was the recent audit that found that staff at WEDC ignored both WEDC policy and state law while providing taxpayer assistance to companies under questionable circumstances. A number of companies actually outsourced Wisconsin jobs to foreign countries after receiving taxpayer assistance that were supposed to be used to create jobs here in Wisconsin.

Senator Dave Hansen (D - Green Bay) has been a consistent critic of the Governor's use of the WEDC as the State's primary economic development tool since 2011.

According to Hansen  “Recent news stories concerning the approval of a $500,000 loan from WEDC to a wealthy donor of the Governor serves to confirm what we have been saying for years, that WEDC is a failed model for economic development that is ripe for corruption."

“Unfortunately those of us who said that WEDC was a failed model from the start have seen our prediction come true. After wasting millions of taxpayer dollars amid numerous scandals and changes in staff, it is time to admit that the WEDC model is a failure and scrap it in favor of a more open and transparent model that is truly accountable to the taxpayers," Hansen added.

Short of closing down WEDC the Governor should clean house from top to bottom, put in place stronger methods of accountability that hold all company officers accountable for failing to repay taxpayer loans or create Wisconsin jobs, and close the loopholes that allow taxpayer dollars to be used by companies that outsource Wisconsin jobs.

Or maybe, as Sen. Kathleen Vinehout (D - Alma) argued recently, we should just go back the a Department of Commerce.

Hansen's conclusion: "With Wisconsin’s economy still continuing to lag our neighbors and the nation we can no longer afford the kind of failure that WEDC has become synonymous with.”

Sen. Kathleen Vinehout writes about the recently released audit of the Non-Emergency Medical Transportation Program, used by many in Wisconsin for rides to medical appointments.

MADISON - Last April I wrote about many complaints I received concerning rides to medical appointments for folks in BadgerCare and other Medicaid programs.

People complained drivers didn’t show up, rides were late, drivers didn’t arrive for the return trip home and – at least in one case – the heater did not work in a van taking an elderly woman for her dialysis appointment.

Often patients were told no drivers were available. But local transportation companies told me they were not getting enough business. Local drivers thought the St. Louis-based contractor, Medical Transportation Management, Inc. (MTM) favored a few large companies over small local ones. MTM is the statewide Non-Emergency Medical Transportation ‘broker’ the state hired to arrange rides for eligible patients.

Complaints about poor service helped my colleagues and I convince other legislators to approve a full investigation of the program.

Over 300 people called the Legislative Audit Bureau’s (LAB) hotline to share their complaints. These calls and over 50 interviews conducted by LAB staff were used to analyze problems with the Non-Emergency Medical Transportation Program. In addition, a survey was sent to 5,000 patients and their families. Also 311 transportation providers completed an internet-based survey.

The results of the year-long investigation are now in.

The new LAB report shows evidence of late rides, drivers’ failure to pick up people for their return ride home and the tendency of MTM to choose a few large transportation companies over smaller, local companies.

Despite problems, of the 773 riders who responded to the questionnaire, almost 87% were satisfied or very satisfied with their overall experience.

During the audit study period (August 2013 through June 2014), MTM provided 2.3 million trips and, by its own standard, estimated 99.6% of these trips were complaint free.

The LAB reviewed 12,748 complaints filed with MTM. Two-thirds of the time the company did not provide patients timely updates on their investigation of complaints.

The most common substantiated complaint was that the patient had to reschedule a trip because the driver never arrived. Second most common was the driver was late.

Analysis by auditors showed problems, particularly in rural areas, with no vehicles available to transport patients.

A majority of transportation providers surveyed reported they were dissatisfied with MTM’s trip scheduling, poor trip volume and poor compensation.

Drivers complained they were given a request for a ride after the time and date of the appointment. Since drivers were penalized for late rides, this led to time and energy spent by the provider to correct MTM’s mistake.

The audit also provided unexpected insight into a significant cost of drug abuse – in this case transporting recovering patients to treatment for addiction. Trips to drug treatment programs accounted for almost a quarter of the cost of services paid to providers during the audit period. In addition, 91 of the top 100 high cost patients had at least one drug addiction treatment visit.

Auditors mentioned that the lack of drug treatment services in rural areas contributed to high costs. In one case an individual made 540 trips between Ashland County and Eau Claire for treatment. In another case, an individual traveled 321 times between Polk County and Eau Claire. Recently enacted legislation to create new treatment programs in underserved and rural areas should help bring down future transportation costs.

Auditors found there was clearly a difference in patient satisfaction levels measured through an independent survey and the complaint rate of patients directly to MTM. These findings suggest a future independent survey could provide a more accurate perspective in determining actual patient satisfaction.

Nearly all complaints I heard leading up to this audit were verified by auditors. At the same time, most patients were satisfied with the ride service they received.

Some state programs might be pleased with such high satisfaction. But given the seriousness of the patients’ conditions – needing renal dialysis for example – it makes sense that we should hold MTM to a very high standard.

As Representative Peter Barca testified at the hearing that began this audit process, “When people are in the most sensitive period of their life, we must ensure they receive services and are treated with respect and dignity.”