Progressive Thinking

Sitting by the window and waiting. Elderly and disabled stranded when company did not deliver rides.

MADISON - “Just how many ‘no shows’ are acceptable?” I asked Medicaid Director Kevin Moore at a recent Audit Committee Hearing. “Is 4,154 people left without a ride too many?”

Wisconsin needs a different system for getting seriously ill elderly and disabled to their medical appointments. A recent audit showed poor services provided by a private company contracted to give rides to some elderly and disabled.

A Rock County resident arranged for a wheelchair van. But the vehicle sent did not have a wheelchair lift. The wheelchair bound person missed their appointment. A developmentally disabled Dane County person walked home in a thunderstorm after being stranded at the clinic. A paralyzed Richland County resident could not get a ride to a surgery appointment.

These are just a few of the cases from a recent audit conducted by the nonpartisan Legislative Audit Bureau. Auditors wrote, “from August 2013 through June 2014, we found 4,154 instances in which transportation providers did not arrive to provide a scheduled trip and 55,320 instances in which they arrived more than 15 minutes late to take recipients to their appointments.”

The State Medicaid Director has a contract with a private St. Louis-based firm, Medical Transportation Management (MTM), to provide non-emergency medical transportation to almost 70,000 people in Wisconsin. MTM is a “broker” which organizes rides to pick up and deliver Medicaid recipients to medical appointments.

I have received many complaints from families, patients and local transportation companies. One disabled resident in Black River Falls told me about traveling in a van with no heater on a cold Wisconsin winter day. An Eau Claire woman waited more than an hour for a ride with her sick daughter. When constituents tried to complain they ended up getting the run-around.

Medical transportation companies – hired by MTM – were so discouraged that over half of them responding to an Audit Bureau survey said they were dissatisfied or strongly dissatisfied with MTM. Scheduling was one area of concern.

The audit reported on many problems, including examples of poor management. Auditors found that MTM sent faxes to transportation companies requesting a ride after the trip was supposed to be provided. They then charged the company with failing to provide the trip.

The disastrous treatment of Wisconsin transportation companies has led to a huge exodus of companies willing to provide rides for medical visits to Medicaid recipients. Prior to the brokerage system, Janet Zander testified, “Wisconsin had approximately 200 specialized medical vehicle (SMV) providers. Today, there are only about 80 providers operating in the state.” Especially hard hit are rural areas.

Mr. Moore, the Medicaid Director, testified he accepted the auditors’ recommendations and was amending the contract with MTM. “We know there are challenges that we didn’t know before the audit,” he told the committee. “We’ve taken aggressive action.” He also encouraged people to let him know if things were not working. “If we don’t know what’s wrong, we can’t fix it. If they [riders] don’t complain, we won’t know. Please call us.”

Many advocates testified that the system was not set up to succeed. “The broker is paid for all rides, regardless of whether the ride shows up or gets a rider to their destination late,” said one advocate. This system creates a “perverse incentive” that encourages MTM to skimp on providing services. When they skimp, others sometimes pick up the cost. Molly Nolte from Rock County told of services so poor the county dipped into its own limited funds to provide rides.

Ms. Zander and many other advocates told committee members that without an adequate transportation system for the elderly and disabled to get to medical appointment, more folks would end up sicker, in the hospital, with the state spending more.

“We need a complete overhaul of this system,” testified Representative Peter Barca who spearheaded efforts to approve the audit. He listed several ways in which the current system rewards MTM to discourage riders and pay for fewer rides. “We need to look at a different type of contract.”

I agree. Even majority party members of the Joint Finance Committee agree. They added a pilot study to explore a new system into the state budget. The governor vetoed the idea.

National data says letting insurers set their own rates has led to the 4th highest insurance premiums in the nation for silver plans, and cost inflation 7% to 9% higher for Wisconsinites. The average premium for a Wisconsin silver plan is $780 more per year than the national average.

STATEWIDE - The Walker’s Administration’s Office of the Commissioner of Insurance recently defended Wisconsin’s lax approach to reviewing health insurance rates, but national data refutes their claims.

According to the Milwaukee Business Journal, Deputy Insurance Commissioner Dan Schwartzer said “letting insurers set their own rates” has led to “minimal” rate increases in Wisconsin.

However, a recent report by the Commonwealth Fund found that Wisconsin had among the highest health insurance rates in the nation on the individual insurance market, and inflation rates that are well above average.

The Commonwealth Fund report found Wisconsin had the 4th highest insurance premiums in the nation for silver plans, the plans that federal government uses to calculate tax credits to make health insurance more affordable. Wisconsin also had inflation rates 9% above the national average for silver plans, and 7% above the national average for all plans on the individual market. The average premium for a Wisconsin silver plan is $780 more per year than the national average.

Citizen Action of Wisconsin has repeatedly pointed to the Walker’ Administration's lax approach to rate review as a factor in high Wisconsin health insurance costs. In June the federal government called on Wisconsin and other states to more carefully scrutinize large rate increases.

States such as Minnesota have reduced health insurance premium increases by implementing more robust rate review.

“The Walker Administration’s refusal to police excessive health insurance rates is a disaster for Wisconsinites struggling to afford rising premiums,” said Robert Kraig, Executive Director of Citizen Action of Wisconsin. “Simply allowing insurance companies to set their own rates violates the intent of the federal health care law. It’s long overdue for the Walker Administration to move beyond its endless efforts to sabotage health care reform, and take advantage of the tools available to hold health insurance companies accountable for unjustified premium hikes.”

This week Sen. Kathleen Vinehout writes about the lack of K-12 Teachers in Wisconsin.

PLUM CITY, WI - “Please sound the alarm,” Superintendent Mary Baier wrote to me. “We are not able to find people to fill positions in Wisconsin.” She needed a special education teacher and only one applicant had applied to her rural Plum City district.

When the school bells ring across Wisconsin, parents expect classrooms to be filled with qualified teachers. But a dramatic decline in education majors at university-based programs and an exodus of both newly minted and experienced teachers have left Wisconsin parents asking, “Who will teach our children?”

The “impending crisis” is here.

Schools are scrambling to find qualified teachers. For example, less than a month before school started, News 8 WKBT reported the La Crosse district needed to fill 23 positions.

Districts have done more with less for years. Existing teachers covered more classes and received cross training. Districts asked current teachers to go back to school and obtain certification in different subjects. Local schools already share many teachers, guidance counselors and other staff. Teachers move between schools, between districts and even across state lines during the course of their workweek.

Some districts use special “waivers,” or permission to bend the rules on teacher certification, allowing a district to place an unqualified teacher in a position as long as that teacher seeks proper certification.

But the teacher shortage is growing and it affects urban, suburban and rural schools.

Christine Hedstrom works in Human Resources for the Waukesha School District. She told the Milwaukee Journal Sentinel, “You could technically start a school year without an administrator in place, but you need to have a teacher in the classroom.”

But rural schools are particularly hard hit.

Rural schools often have fewer options and already greatly diminished choices for students. They’ve already combined, shared, downsized and cross-trained. Having a teacher in the classroom may not even be possible in some local rural classrooms.

A rural western Wisconsin district board member told me, “We are starting the school year with two positions unfilled”- one of the positions was a Spanish language teacher. “I guess we’ll have to use some type of video/distance learning option,” the board member told me. “But that’s not a good way for students to learn a language.” Spanish is the only foreign language available to students in this rural district.

When I asked folks why we had a teacher shortage, I heard several comments over and over. “Fewer students going into teaching.” “New graduates not staying in Wisconsin.” “More teachers retiring or leaving the profession.” “Teaching is no longer a valued profession.”

The Wisconsin Budget Project reported over the last eight years the number of teachers in Wisconsin public schools fell by nearly 3,000 even as school enrollment increased.

They also reported on a troubling decline in experienced teachers. "In the 2013-14 school year, teaching staff of 39% of school districts had an average of 15 or more years of experience. That share has fallen dramatically since the 2004-05 school year, when 58% of school districts has a teaching staff with an average of 15 or more years or more of experience.”

Not surprisingly, fewer students are entering the education profession. Statistics from the United States Department of Education show a dramatic drop in the number of university students learning to be teachers in Wisconsin. In 2011, 12,624 education majors were enrolled in all types of university-based programs. By 2014, this number had dropped by almost a quarter to 9,563 education majors.

Of course, in 2011, we saw the passage of anti-public employee legislation in Act 10 and the largest cut to public education in Wisconsin’s history. It’s not hard to imagine why a college student might decide to change majors following the words and actions of many elected leaders.

The future troubles many education professionals with whom I spoke. Just who will teach the children born in 2020?

“As we move forward, my largest concern is the quality of teachers. We have become a state that doesn’t value quality education. Why would anyone go into teaching?” Superintendent Baier asked.

I remind my colleagues who voted for Act 10 and the budgets that created this problem just what my mother told me eons ago as I answered that first school bell.

Actions have consequences.

LA CROSSE, WI - With the ringing of school bells and the roar of high school football games, students across Wisconsin are heading back to class. But in many classrooms, the start of school is also marked by the rumbling of empty stomachs.

Amid all of the headlines about state budget cuts and teacher shortages, many schools are struggling to deal with the challenge of student hunger. It is a crisis that has worsened dramatically over the past several years as participation rates for free and reduced school meals have skyrocketed. Over 350,000 Wisconsin children, more than 43 percent of all students, now qualify for free and reduced meals.

Schools and communities across Wisconsin are doing their best to address this issue despite declining state support. Many parents, teachers and local businesses have stepped up to organize their own school meal programs, stock student food pantries and supply backpacks with meals for children struggling with hunger at home.

The community efforts being undertaken to combat student hunger are commendable, but they are a sign of the larger economic and financial challenges facing our state. Combined with Wisconsin’s shrinking middle class and the decline in family wages, state budget cuts to school funding are having a noticeable impact.

One proposal to help address the crisis of student hunger was recently introduced by Rep. Andy Jorgensen (D-Milton) and Sen. Janis Ringhand (D-Evansville). Commonly referred to as the “Food for Thought Act,” Assembly Bill 234 seeks to increase school breakfast program enrollment and provide more children with access to a quality meal. Given the well-established correlation between hunger and low academic achievement, the “Food for Thought Act” is helping to spark a much-needed discussion about this important topic.

It’s clear that we need to take a close look at how student funding cuts and increasing poverty rates are affecting classroom learning. Instead of taking more resources away from Wisconsin children, we must work together to invest in local schools, reduce student hunger and improve student achievement.

For too long, Republicans have prioritized tax cuts for the wealthy at the expense of funding for our schools and communities. In recent months, Gov. Walker’s presidential ambitions have overshadowed the real challenges facing families and distracted from our ability to find solutions to this growing crisis.

It is high time we focus on the important issues affecting Wisconsin families and local schools. Together, we can work to end childhood hunger in Wisconsin and provide all hardworking students the opportunity to succeed.

Jennifer Shilling serves as the Senate Democratic Leader and represents the 32nd District which covers La Crosse, Vernon, Crawford and parts of Monroe County.

Assembly Republicans have been meeting in secret on a plan to merge the state’s 2-year UW campus system and the Technical College system. Such an important plan should not be hatched behind closed doors.

MADISON - According to recent news outlet reports, Assembly Republicans have been meeting in secret on a plan to merge the state’s 2-year UW campus system and the Technical College system. The plan could have a huge impact on the students, faculty, staff and the local communities the campuses serve.

Two Democratic leaders in the State Senate’s Universities and Technical Colleges Committee don't think such an important plan should be hatched behind closed doors. And they are doing something about it.

In a letter to the committee's chair, Senator Sheila Harsdorf (R-River Falls), State Senator Dave Hansen (D-Green Bay) and State Senator Janet Bewley (D-Delta) called today for a public hearing on the impact of the plan. In the letter they said it was “disturbing to learn that meetings on the proposed merger have been held out of the public eye. Such a significant change in our system of higher education is deserving of public input early on in the process rather than waiting until a deal has been struck behind closed doors.”

The senators are questioning why details of the plan, how it would work and how it would impact the campuses and the people and communities they serve have not been available to the public.

“The public hearing and committee process exists to provide people with not only an understanding of legislative undertakings but to make their voices heard during the legislative process," they say. "Certainly such a substantial and significant change to our system of higher education merits early and significant public input.”

Recently Republicans tried to slip major changes weakening the state’s open records laws and the board that oversees the Wisconsin Retirement into the state budget. It was only after the public became aware of those secret efforts that they were dropped from the budget. Hansen and Bewley believe given the complexity that would surround merging the two systems the public should be given a chance to weigh in before a plan is rushed through the legislature.

“We respectfully request that a public hearing be held as soon as possible so that the committee can hear firsthand from all stakeholders about the potential impacts of merging the UW 2-year Campus and Technical College systems," their letter continues.  "This hearing should include testimony from administrators, faculty, staff, students, parents and community leaders.”

Despite major changes made to the UW System including cutting $250 million from UW Campuses and making major changes to tenure and shared governance, to date the Universities and Technical Colleges Committee has held only one public hearing. The hearing was held on June 4th during which the committee heard testimony on five appointments and one senate bill.

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Legislative staffer Jay Wadd contributed to this article.