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Why Not

I am a husband, father, son, brother, uncle and friend. I believe in sharing my talents and experiences by giving back to the community by giving my time to coaching, church and especially to the disability community. I truly believe that all men and women are created equally.

Clearing Up Misinformation Surrounding CMS Rule Changes to Home and Community Based Services Part 1

There are a lot of rumors and misinformation going around in regards to the Centers for Medicare and Medicaid Services (CMS) rule changes to Home and Community Based Services (HCBS).  I thought I would clarify misinformation that is going around and point out the positives of these changes.

Q. I have heard people will lose their services with this proposed change.

The bottom line is no provider will be forced to close and no funding cuts are being proposed by the Department of Health Services (DHS). You will not find these ultimatums in any DHS materials. An individuals’ levels of services should not change or be reduced. Their supports will continue to be based upon individual needs identified in their plan. If a person has an employment goal in their individual plan, the Managed Care Organization (MCO) must ensure continued employment supports.

The message being put out by workshops to families and individuals with disabilities is designed to scare them into thinking that these federal and state changes will force people to sit home with nothing to do.

The intent of the rule change DHS is responding to is far from that: it is to provide people with disabilities the full range of opportunities afforded by people without disabilities. The scare tactics are coming from providers that don't want to change their business model to a more appropriate set of supports.

Q. I have heard that the changes being proposed by Wisconsin DHS will take choices away from people.

No, in fact, there is significant lack of choice now in Wisconsin communities for people with disabilities to live less isolating and segregated lives. There is no continuum of choice. Any notion that choices will be taken away by this DHS change is false; if anything, expanded choices should soon be available to families and individuals who have been waiting for new options in their communities.

Several statewide disability organizations are using a tool to collect public comments for DHS on this change: http://www.takeastandontheplan.org/index.html.  The questions asked are objective in outlining the intent of the change and ask people related questions to assess their experiences and concerns.

The public comment collection tool has more than 300 responses and a great majority indicate there is little choice for community employment or community living options in their area of the state.

Respondents have either indicated a workshop (a segregated employment option) was the only thing offered, there was a long wait for community supports or a particular provider, or the quality of community supports was severely lacking.

Q. Can’t people choose community employment or employment other than a sheltered workshop now?

Wisconsin spends twice the amount of public dollars on facility-based employment than on community employment and has considerably many more providers offering and emphasizing facility based employment over integrated employment supports.  Issues related to poor employment support quality, waiting or limited choice in communities can be tied directly back to the severe imbalance in funding and prioritization by Wisconsin. 

People who say the federal changes will take away choice are neglecting that people who want a community life/community employment currently have no choice in a majority of Wisconsin communities. Department of Public Instruction (DPI) data demonstrates that significant numbers of youth with intellectual disabilities and autism are still moved right from school into workshops across Wisconsin. This leads to a lifetime of significant Medicaid dependence.

The proposed DHS change aims to create a true continuum of choice where one does not currently exist. Younger families, many with children with Down syndrome or autism, are experiencing inclusion in school and have no idea that the adult world is not prepared (due to Wisconsin’s imbalanced funding system and lack of incentives) to continue community participation and inclusion. 

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