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Tuesday 14 June 2005
For some time now, people with disabilities and their families have been
urging the West Virginia Department of Health and Human Resources (DHHR)
to ensure that service providers are held accountable for the
implementation of treatment plans under the MR/DD waiver program.
While those Individual Program Plans (IPPs) may – and I
stress may as there is currently no quality control inherent to
their development – represent a program which would meet federal
requirements*, without accountability for
implementation such plans aren’t worth the paper on which they’re printed
much less the time and energy expended by interdisciplinary teams for
their development. That fact hit me right between the eyes this morning
as I received news of a friend who, as a direct result of the utter
failure of the service provider to implement his IPP and appropriately
supervise his staff, experienced a behavioral episode which seriously
jeopardizes what little independence he has achieved.
Setting aside the obvious human and civil rights issues, the core
objective of the waiver program is to increase
independence and decrease reliance on public assistance. Well,
it’s one thing to have laudable goals. It’s quite another to develop
policy which supports the furtherance of those goals. Just as IPPs are
rendered ineffectual by the lack of accountability for implementation, so
too is the waiver program prevented from achieving its objectives by the
lack of sound policy. Trickle-down negligence is alive and well in West
Virginia.
Even now, instead of the aforementioned service provider being required to
take a long, hard look at the ways in which the IPP could have been more effectively implemented, my friend will be
blamed. His disabilities will be emphasized over his abilities. The
service provider will not have to shoulder any of the
responsibility for its failure to ensure proper program development or
implementation. His rights under Olmstead and the ADA will
continue to be eroded, and we will each pay for it with our tax dollars as
the costs of his long-term care rise rather than fall.
Are there ANY winners in this situation? It sickens me to witness a
program geared toward increasing independence quite literally hindering
it. It amazes me that those responsible for the administration of
this program at its highest levels cannot see the costs associated with
such impotence. It makes me fear for the lives of those dependent
upon this warped system with its short-sighted priorities. Such
ignorance costs most only money. It costs the participants so very
much more: their health and well-being are compromised, and their most
basic rights – life, liberty, and the pursuit of happiness – are
threatened.
And yet this is the system that DHHR perpetuates while bemoaning its cost.
This is the system that DHHR claims will be made person-centered by adding
a layer of bureaucracy which will confine participants to service tiers.
What, exactly, is accomplished by throwing more money into the process
surrounding the development of program plans when there is absolutely NO
assurance of their implementation?
The potential for cost savings across the MR/DD waiver
program is staggering in terms of long-term care, but it can ONLY be
achieved if program plans are implemented. Any costs associated with
accountability would be more than recovered through improved health,
enhanced productivity, and decreased dispute resolution expenses.
From a purely pragmatic perspective, you’d think DHHR policymakers would
realize that quality and consistency are critical to success in any
endeavor. It takes more than a pretty plan on paper, blessed by a
bureaucracy. It takes a commitment to make that plan a reality.
~ Debi Lewis
*
Individual Program Plan (IPP) (42 CFR 483.440(c)). The
interdisciplinary team must prepare an IPP which includes opportunities
for individual choice and self management and identifies: the discrete,
measurable, criteria based objectives the individual is to achieve; and
the specific individualized program of specialized and generic strategies,
supports and techniques to be employed. The IPP must be directed toward
the acquisition of the behaviors necessary for the individual to function
with as much self-determination and independence as possible and the
prevention or deceleration of regression or loss of current optimal
functional status. |
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The West Virginia Medicaid Recipients' Union
relies on volunteers to support its advocacy efforts. Thus,
donations in any amount are gratefully accepted both electronically via
credit card (left)
and via U.S.Mail to cover the costs of postage, copying, bumper stickers, ads,
operating expenses, etc. Checks or money orders should be made payable to "MRU WV." Thank you! ~*~ Contributions are NOT
(yet) tax deductible. ~*~ |
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MRU WV will never share
its members'
personally-identifiable information (name, address, phone, or e-mail address)
with any outside person or organization without express consent.
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