Posted tagged ‘disability’

Effects of Wisconsin Budget ‘repair’ Bill on Direct Care Workers

March 2, 2011

Wisconsin’s Budget Repair Bill Threatens Health Care for Vulnerable Residents

This is a guest post by Mike Bachhuber, Executive Director of the Independent Living Council of Wisconsin.

Senate Bill 11, Wisconsin’s “Budget Repair Bill” gives government officials power to change health care available to the state’s low-income residents without public opportunity for input. The legislature has held this power since the beginning of the program.

State statutes provide most of the details for BadgerCare, the state’s federally-supported “medical assistance” program. Until now, these statutes have defined details such as: 

Which people needing care are eligible;  Types of care available to them;
 How care providers are paid and what people needing care must pay.
 When these details are provided by statute, both the Assembly and Senate must pass a bill with the same language to     change the law. The change becomes effective with the Governor’s approval or over a veto with a two-thirds vote in both   houses of the legislature. This process gives the public an opportunity to give their input and tell policy-makers how the changes will affect them.

Senate Bill 11, however, will give that power to the Secretary of Health Services if passed. The bill allows him to change these details by publishing a rule. Unlike with legislation, these changes could become law before the public is even aware. Giving so much power to make these kinds of law changes has not been seen up to now.

The law provides for only two limits on this power. First, the Secretary must give advance notice to the co-chairs of the Legislative Joint Finance Committee. Both co-chairs are currently from the same party so, unless they let others know, most members of the Legislature will not know about the changes until they are published. The Committee chairs can, however, delay or stop the proposed changes by action of the Committee.

The second limit on the “edict” power is that most changes would have to be approved by the U.S. Department of Health and Human Services. If not approved by the federal government, other cuts to medical assistance will go into effect.

Cuts are most likely to affect individuals and families making more than 133% of the Federal Poverty Level, as little as $1,207 monthly. People with disabilities and others have fought hard for protections that give them care to keep them alive or allow them to live in the community and work real jobs. They are afraid that changes might be made to take away these protections before they even know someone was thinking of particular changes. The two limits on power may not be enough to protect them. Read an excerpt of a memo from Wisconsin’s Legislative Reference Bureau. 

Reposted by permission from the Direct Care Alliance.


The Intersection of Care and Need

May 3, 2009

I remember a disagreement between two of my graduate faculty advisors. Should people who provide care be called caregivers or care workers? This argument reflects a longstanding debate regarding care. There are those who emphasize the work in the caring and those who emphasize the caring in the work. I’ve always interpreted this, to some extent, as debates over whose needs should be emphasized, the care providers or the care recipients?

But it hasn’t been until recently that I’ve begun to understand how closely these needs can intersect. I have yet to bear significant financial and health costs associated with raising my daughter, but the emotional price is becoming clear. Generally, I’ve defined the emotional costs of care work as higher rates of depression among long term care providers, which are triggered by the heavy demands of care. But as a parent of a child with a cognitive disability, the emotional costs are related to things I never really imagined. I’m not depressed. And while I spend an inordinate amount of time trying to hurl myself through varying bureaucracies, from hospitals to the welfare system, what causes the most pain and stress, the thing that keeps me awake most at night, is triggered by the realization that people will be cruel to my daughter as she grows up. Yes, most children have to deal with cruelty, but my daughter will have to deal with more of it.

Negative reactions to those with cognitive disabilities are often strong and seemingly unconscious. President Obama’s slip regarding the Special Olympics is a striking example. He clearly felt badly and I would guess that if he had thought about it–for even a minute–the comment never would have slipped through his lips. Indeed, he apologized profusely, without caveats. But the sentiment is lurking beneath the surface—even among the best of us. And even more concerning was the number of times I heard others excuse the comment by arguing that he was being self-deprecating. The fact that it was self deprecating is not going to make that kind of comments any less painful for my daughter.

So it is here where I’m finding that my needs and my daughter’s needs are one in the same. When she feels pain, I feel that pain. I think this blurring is part of what underlies the stress that many care providers face.