Forum Activity for @sd-network

What Are Your Hot Topics or Challenges?

Hot Topics and Challenges for Self-Determination

We know that there are a lot of you out there in the communities working together to understand, implement and create rewarding lives for elders and people with disabilities. 

We want to hear from you! What's your hot topic for self-determination these days?  Tell us what topics affect your everyday life.  What questions do you have about self-determination or disability related issues?

DHS Releases Concept Paper for LTC Redesign: What Do You Think?

Wisconsin Long Term Care Redesign: Questions & Comments

On March 2nd, the Wisconsin Dept. of Health Services released their concept paper for the redesign of the Long-Term Care System. (You can find that document here.) What do you think of the new system they are describing? How does it affect you or the people you care about? 

***A friendly reminder:We really encourage you to debate the facts and express your feelings regarding this issue. In respect for all individuals, we kindly ask that members refrain from posting anything that personally attacks any individual or reflects on partisan politics. We need to remain a non-partisan network. We reserve the right to remove any personal attack or political comment.

updated by @sd-network: 03/03/16 04:05:05PM

Questions and Comments about the SD Network

Welcome!

We want to hear from members about your experiences with the SD Network. Got questions about how something works? Suggestions for adding something or making something work a bit easier? Not sure why we set things up the way we have? Feel free to leave comments, suggestions, questions, etc. below.

updated by @sd-network: 02/24/16 10:58:53AM

Welcome to the Self-Determination Network

Welcome!

We're glad you've joined the SD Network. There are a few things you need to know.

• Everyone is welcome to join (unless you're trying to sell something or are planning to spam people!)
• Once you join, we hope you will post your questions, ideas, resources, photos, videos and more. Most of your posts will be added by going to your own profile page and clicking on the box that describes the post you'd like to make.
• The only exception to this rule is the Discussion Forum. To add a discussion or to read and respond to discussions that others have posted, go to the Forum link under Connect (in the menu above).

Questions? Contact the SD Network Manager.

updated by @sd-network: 02/24/16 10:59:46AM

2015 Self-Determination Conference

Open Discussion

We were so pleased to see so many of you at this year's Self-Determination Conference. There were a ton of great sessions and events this year. What was your favorite part? What were some things that you learned? Do you have a funny story from the conference? Did something really inspire you?

Lets keep the conversation going! Share your comments, questions, and ideas here.

updated by @sd-network: 02/24/16 11:01:04AM

The Future of Long-Term Care in Wisconsin

Wisconsin Long Term Care Redesign: Questions & Comments

As we all know, Wisconsins Long-Term Care (LTC) system is going through some major changes.In the 2015-2017 budget, Governor Walker and the legislature started a chain of events which will likely lead to major changes inhow people receive LTC support. Lots of informational links can be found on our Resource page.

While a lot of the specifics remain unclear, we encourage you to post your questions and thoughts about LTC in this discussion. We can't promise we'll have all the answers; however, others may have information that would lead to answers.

***A friendly reminder:We really encourage you to debate the facts and express your feelings regarding this issue. In respect for all individuals, we kindly ask that members refrain from posting anything that personally attacks any individual or reflects on partisan politics. We need to remain a non-partisan network. We reserve the right to remove any personal attack or political comment.

updated by @sd-network: 02/23/16 04:43:48PM

Coffee Break Discussion: The State Budget and the Future of Wisconsin’s Long-Term Care Programs

Wisconsin Long Term Care Redesign: Questions & Comments

We had a great discussion about the State Budget and the future of Wisconsins Long-Term Care programs on the Coffee BreakWednesdaymorning! Special thanks to Lynn Breedlove, board president forInControlWisconsin,for joining us as our special guest again! We really appreciate it. We encourage you to take a look at our one-page summaryof the budget items affecting Long-Term Care. There were several points discussed in the chat. Some of them include:

• The final proposal from the Joint Finance Committee was similar to the Governors proposal.
• Lynn said the only good thing that came from it was that Adult Disability Resource Centers (ADRCs) were saved.
• The version of IRIS thats in the final budget differs greatly from the IRIS we know now.
• According to the budget, the changes will take effect statewide by January 2017, but some people think it may take longer to complete.
• Theres no clear process for stakeholder input in the budget. Lynn says we may have to push legislators to make sure the Department of Health Services (DHS) has an input process.
• Theres great concern about how medical care will be managed under the new plan.
• Theres also a big concern about how the insurance companies wont have any incentive to provide quality care because any surplus will be their profit. Profit-taking will be a big dangerwe will have to fight for quality care.
• The term Integrated Health Agencies (IHAs) appears to be an invention of legislature. Lynn mentioned California has something similar.
• The new Medicaid Waiver process includes a 60 day comment period. DHS is required to submit ALL comments to the Center for Medicaid and Medicare Services (CMS).
• Lynn pointed out that there will be some attempts to influence CMS publicly and through back channels. However, CMS is agreeing to similar waivers in other states involving insurance companies. So, it's hard to tell whether or not they will object to Wisconsin's plan.
• Many elderly people are unaware of these changes that will potentially affect them.
• It's hard to tell CMS our concerns when we don't actually know what the IHAs will look like yet.
• The Managed Care Organizations (MCOs) have been prohibited from telling people what all this means. Lynn noted that AARP has done some good work getting the word out.
• If MCOs are making cuts now, it would be hard to blame that on the budget. DHS still says the new plan isn't done yet.
• CMS is approving these type programs in other states across the US. Beth pointed out one opportunity to influence what happens is the work being done on home and community-based waiver quality outcomes. She gave us this link to learn about the national process. Lynn mentioned the Medicaid Managed Care Forum that the National Council on Disability is holding in Madison on August 31^st would have some national allies at it.
• Lynn thinks that Dane County and the other counties rolling out to Family Care by 2017 (due to the legacy wavier) should be ready to lose adult Long-Term Care funding in 2017.
• Patti pointed out that United Cerebral Palsy has published a report that shows some good data related to how states are doing. Wisconsin is ranked 32^nd in this report. Lynn mentioned that Wisconsin has dropped in the rankings. You can report by clicking here.
• IRIS participants arent guaranteed to be able to self-direct in the IHAs. Its unclear what the eligibility criteria for self-direction will be. Lynn said that there is some fear that people with severe disabilities may be excluded. Shared-decision models from other states could help. This needs be a priority item for stakeholders input on the plan.
• Any change in leadership in the Governor's office or at DHS could create an opening to revisit what happened in the budget.
• Lynn said that some of the fears regarding the budget are based on what the budget is silent about. He points out that DHS may have plans to fill in those blanks in a positive way, but that's why we have to be active in the planning process to make sure that thats the case. He said that we should remain hopeful--there will be many ways we can influence the final result!

Share your questions, as well as your resources, information, experiences, and ideas about the future of Wisconsins Long-Term Care programs in this discussion.

updated by @sd-network: 02/23/16 04:43:48PM

Coffee Break Discussion: An Update on the State Budget Proposal

Wisconsin Long Term Care Redesign: Questions & Comments

• The Joint Finance Committee hasbegunvoting on parts of the budget. Theyll likely get to Long-Term Care(LTC)sometime this month. It appears they dislike the budget proposal, but its unclearwhat they will do instead. The co-chairs of the committee, Senator Darling andRepresentativeNygrensaid that theymaysend LTCback tothe Wisconsin Dept. of Health Services (DHS)to rework it.

• Aging and Disability Resource Centers (ADRCs)appear to be well-positioned tobe saved.Fiftycounties have formallyopposed the changes to the ADRCs.

• The IRIS grassroots advocates have done a good jobadvocating. Its not for sure, buttheres a good chance that IRIS will stay a separate program.

• Lynn pointed out that its now known which insurance companies want to take over Long-Term Care. They are United, Anthem, and Molina. None of them are based in Wisconsin.

• Two educational briefings on Long-Term Care were held for legislators and staff. Bothwere well attended by all parties.Legislators and staff who knew very littleabout LTC learned a lot and asked a lot of good questions.

• This budget proposal came as a surprise to all of us.We took Family Care and IRIS for granted and thought they were safe. Unfortunately, we didnt educate the new legislators about them until now. A lotmore peopleat the Capitolnowknow what IRIS is and understand its different than managed care. Personal stories are making people understandwhyIRIS is important.

• DHS continues to say Long-Term Care is eating up the Medicaid budget, but this is not true. In fact, it has actually saved a lot of money.

• Itsnot too late to contact members of the Joint Finance Committee and yourlocallegislators. Several of them are still unsure what to vote for.

• Wisconsin State Budget Briefing: Watcha webinar with John Shaw, BPDD, and Lisa Pugh, DRW, on how the 2015-2017 WI state budget impacts people with disabilities.

• Wisconsin's Long-term Care Coalition: Resources regarding the long-term care system and what you can do about the proposed Wisconsin Budget.

• Wisconsins Long-Term Care Coalition Facebook page

• Contact your state legislatorand share your story.

• ContactLynn Breedlove

updated by @sd-network: 02/23/16 04:43:48PM

Coffee Break Discussion: Self-Determination and the State Budget Proposal

Wisconsin Long Term Care Redesign: Questions & Comments

What a great discussion about Self-Determination and the State Budget Proposal on the Coffee Break yesterday morning! Special thanks to Lynn Breedlove for joining us as our special guest! There were several points discussed. Some of them include:

• DHS says self-determination will be folded into Family Care, but the specifics of that remain unclear.
• This heavily relies on Federal Waivers. Its assumed DHS will get the waivers, although this is uncertain. Lynn pointed out that CMS has become less rigid in what they approve. This budget proposal includes no-bid contracts with new insurance companies. This means DHS can contract with whomever they choose, with no bids.
• The big difference between self-direction in IRIS and Family Care is that in IRIS people have full authority over their budget, full employer authority, and an open market to select services. This is not the case in Family Care.
• Theres a huge concern over people being limited to which healthcare providers they can use. This is especially concerning to older adults as it takes a long time to develop a relationship with a trusted provider. Its also concerning to anyone with significant health care needs or disabilities who has had to work to find a provider who understands their particular health care situation and works well with him/her. Its expected that provider networks will be smaller in the future because the budget removes the any willing provider requirement.
• Another big concern is that its very unclear how this transition would occur if the budget passes as is.
• There are many theories as to why this came up in the budget proposal.
• Lynn encourages people to contact their legislatorsthis is a huge change in Long Term Care that came up overnight, with no input from the people who use services, the organizations that provide support through Family Care and IRIS, or local communities.
• Its not believed there is any continuity of service providers in the budget meaning people would be forced to leave some of their current providers.
• Another huge issue is DHS doesnt think its important to cap the percentage that the new MCOs could make in managing LTC. Many find this very alarming.
• As of now, expansion of IRIS is going forward in Northeastern Wisconsin.
• As far as we know, Kanas is the only other state doing the same thing. Some of the other states doing it exclude people with developmental disabilities.
• Its unclear whether CMS changed its opinion on requiring a self-directed alternative to managed care.
• Questions as to how this would impact community living, integrated employment, etc remain.

Share your questions, as well as your resources, information, experiences, and ideas about the budget proposal in this discussion.

updated by @sd-network: 02/23/16 04:43:48PM

Apps and Websites Rating Accessibility

Open Discussion

This is an interesting concept--having websites and apps where people can rate places based on accessibility. It's a fairly new concept, so there aren't many ratings or reviews yet. What do you think of the idea? What are the pros and cons?

Information courtesy of Huffington Post and AXSmap.com

AXSmap.com helps people with disabilities find accessible spots

For people with disabilities, finding accessible restaurants and stores can be frustrating. Despite review sites like Yelp, there is no way to know if a business is accessible until you go and check it out yourself. A new website, AXSmap.com, aims to change that.

AXSmap is an app and website that allows people with disabilities to rate and review the accessibility of local restaurants, hotels, and other businesses, and find accessible spots reviewed by others.

Once you sign up for an account, you can search for a location and review the accessibility of the entryway and bathroom. You can also mark if the location is quiet, spacious, and well-lit, and if there is accessible parking. There is even a space for extra comments and photos.

There are not many reviews of Indiana locations so far. However, if you think the website is useful, the best way to change that is to add one yourself, and ask a friend to do the same.

Check out AXSmap athttp://www.axsmap.com/.

Watch a video on how to use the site athttps://www.youtube.com/watch?v=DFswxhQj6UI. For questions and more information, contact AXSmap athttp://www.axsmap.com/contact/.

Other websites offering accessible business reviews includehttps://ableroad.com/andhttp://www.jjslist.com.

Information obtained from the Great Lakes ADA Center listserv

updated by @sd-network: 02/23/16 03:06:02AM