◊ JOB MATCH

MR/DD WAIVER REDESIGN

DHHR claims to have notified waiver program members that PCG, Inc. was collecting data on the MR/DD Waiver Redesign.  This came as a surprise to many, who have yet to receive such a notice.  Here are MRU WV's comments.

1. What philosophy would I like the system re-design to reflect?
   
   Philosophy on paper and philosophy in practice are two entirely different critters.  We are now hearing DHHR parrot terms like "person-centered," yet there is nothing about the MR/DD waiver renewal or draft regulations that is person-centered.  In fact, by adding an ASO to the mix, DHHR is effectively hobbling the interdisciplinary team process.  That is NOT person-centered.
   
   "Person-centered" has, unfortunately, become yet another buzz word (like "choice") that is not worth the paper on which it's printed.  MRU WV would like the system re-designers to abandon the core hypocrisy and truly embrace the philosophies they claim to support.  Until this is demonstrated in policy and practice, the words themselves are meaningless.
    

2. What are my expectations for the re-design?
   
   Expectations?  MRU WV expects that DHHR will continue its attempts to weasel out of as many services as it possibly can while wrapping the re-design with a big, red ribbon and presenting it as "the new & improved person-centered waiver program."  MRU WV expects DHHR to continue to express its surprise when stakeholders do not fall all over themselves expressing their gratitude for such benevolence.
   
   Ideally, MRU WV expects the bureaucracy to actually LISTEN to stakeholders, rather than simply go through the motions of soliciting public input.  MRU WV expects true DIALOGUE with policymakers, rather than condescending and disingenuous proclamations.  Are we bitter?  You bet your boxers we're bitter -- and with damned good reason.
    

3. What key components of the current waiver are working well?
   
   That varies so much from provider to provider that it's difficult to pinpoint with any accuracy.  The program, without true accountability, is a crap shoot for consumers.  "Choice" is NOT working because, in reality, it only exists on paper.  Program plans are NOT implemented because there are no penalties for failure to do so.
   
   If a consumer has good services, it is almost always the result of dedicated and responsible direct care staff, service coordinators, and/or QMRPs.  The system neither rewards those individuals nor penalizes those who do the least work possible.
    

4. What are the major gaps in the current system?
   
   Accountability for the implementation of individual program plans (IPPs).  As long as DHHR is allowed to throw up its hands and claim it has no authority to compel providers to actually deliver services, the consumers are just shit out o' luck.  End of story.  No one -- not CMS, not DHHR, not providers -- is being held accountable TO THE CONSUMERS.
   
   True choice of service providers.  (Per DHHR, an agency is only supposed to be allowed to turn a client away for capacity reasons -- and, if that occurs, the agency is supposed to develop a plan to increase capacity.  We all know that's NOT how things work.)
    

5. What would make the re-design successful?
   
   MRU WV does not believe the re-design CAN be successful.  There are serious flaws in the system's foundation, and DHHR continues to throw good money after bad with its insistence on shoving APS HealthCare down stakeholder throats.
    

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This page last updated Saturday 29 April 2006