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Ideas for improving the waiver

 
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IndParent



Joined: 24 Oct 2005
Posts: 6
Location: Evansville

PostPosted: Wed Oct 26, 2005 11:30 am    Post subject: Ideas for improving the waiver Reply with quote

I attended one of the family forums where the waiver system was referred to as "broken". The recent program changes were said to be the state's first attempt to fix a broken system, but what struck me as missing was input from families.

I think we'd all agree that the system could be much better. We see a lot of what's wrong from our view here "in the trenches", but there doesn't seem to be a suggestion box for us in the system.

So here's my idea: if you have suggestions for ways to improve the system (cost savings, better accountability, shorten the waiting list, quality care, and so on), post it here by responding to this message. THANKS!
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IndParent



Joined: 24 Oct 2005
Posts: 6
Location: Evansville

PostPosted: Wed Oct 26, 2005 11:37 am    Post subject: Reply with quote

I'll kick things off with a suggestion I heard elsewhere but I think is a great one: report cards for providers.

There are good providers out there, mediocre ones, and some truly lousy ones as well. As consumers we don't have anywhere to turn when we're shopping for caregivers for our loved ones and need information and advice. And under the new plan we're stuck with our providers until the annual review rolls around, so it's very important to make the right choice the first time.

It would be great if the state or some truly impartial third party would post ratings of providers based on consumer feedback, incident reports, and other measures of quality.
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Shallandersen



Joined: 24 Oct 2005
Posts: 5
Location: Ft Wayne

PostPosted: Wed Oct 26, 2005 3:09 pm    Post subject: Reply with quote

Last year during the legislative session and prior to the session, A grassroots movement was trying to get information to legislators about the non-nutritive beverage fee. This is not a quick fix for the people being affected starting week after next, but it is an idea of how to raise money for the 15, 000 waiting and those losing services due to this "ANNUAL PLAN" The non-nutritive beverage fee would raise money by attaching 1/2 cent or even one cent to soda pop. soft drinks. It would be collected at the point of manufacture or distribution. "of course it would end up coming from all of us who drink pop, even those being served by the waiver" Those proponents of this fee believe it could raise an estimated 61 million dollars from the state. This could be used to leverage additional medicaid dollars from federal government. Legislators are always afraid of being in favor of raising taxes, let alone discussing the issue, but if we want services and what others to have services the money has to come from somewhere. I don't like what is happening now. As a case manager, I see the people I serve losing choice, losing services and becoming only a statistic. I'd pay a penny or even 5cents more for a pop along with anyone else who wants to drink a pop for choice and services to come back into the lives of the people I serve and their families.
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IndParent



Joined: 24 Oct 2005
Posts: 6
Location: Evansville

PostPosted: Fri Oct 28, 2005 1:35 am    Post subject: Reply with quote

That's a great proposal! As someone who enjoys the occasional soft drink, I wouldn't mind paying a "sin tax" on this luxury. Non-nutritive beverages don't do wonders for my health, so it seems appropriate to put some of the money I'm wasting on them toward better care for someone! ;)

Here's an interesting study, a review of Indiana's Medicaid waiver budget that I found on the web. It is apparently the genesis of the current round of cuts. The interesting thing to me is not only the measures from the study that were adopted, but those that were overlooked. For example, the provider "report card" that I kicked this thread off with is in the report, but not in the plan that rolls out November 1.

http://www.iidc.indiana.edu/cclc/products/High_Cost_Review_Preliminary_Report_5_31_05.pdf

TJT
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El LoBo



Joined: 31 Oct 2005
Posts: 2

PostPosted: Mon Oct 31, 2005 11:14 am    Post subject: Reply with quote

I believe there needs to be some measure to create funds for the waiver. We were told 2 years ago there would be no more cuts, and here we are again. (The State, of course, says this is not a cut.) Well the issue is lack of funds and no one looking into funding sources. I am no an advocate for the non-nutritive beverage tax for one reason...reallocation. I predict that within 2-3 years of its inception, the State will determine a "more appropriate" use for revenue, and it will be removed from the Waiver. This wouldn't be the first time. The tobacco settlement had this happen. As soon as that money was reallocated, all the deficits with the waiver program began to happen on a mass scale. The only way I would promote a taxation to create revenue for the waiver is if it could be a "locked in" funding source that cannot be reallocated. Think about it. You would be okay if 1-2 cents went to the waiver, but would you be okay if 1-2 cents went to the Colts stadium. I dare say you would not.
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IndParent



Joined: 24 Oct 2005
Posts: 6
Location: Evansville

PostPosted: Mon Oct 31, 2005 1:25 pm    Post subject: Reply with quote

Yes, I would agree. With a waiting list as long as Indiana's (is any state's list longer than ours?) it would be foolish to pin a couple of pennies of the price of a soda toward the waiver today then reallocate it to a stadium tomorrow. But it does happen.

More funding is needed, not just cuts. My guess is that there is waste in the system that could be cut, but it should be identified first instead of arbitrarily slashing everyone's budget across the board.

tjt
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lsdockter



Joined: 07 Nov 2005
Posts: 2

PostPosted: Mon Nov 07, 2005 3:18 pm    Post subject: Repairs to Waiver Services Reply with quote

Hundreds of thousands of dollars are being paid to agencies in Indiana that are operating FOR PROFIT to "provide services to individuals with disabilities". If anyone thinks that is money well spent- that those agencies are not allocating as little of those funds for the direct care of individuals as they legally can I want to hear about them. My 23 year old daughter was attending a "Day program- one program fits all type" in Wabash County in a building and area I wouldn't take my dog to be groomed in! I know how many thousands of dollars this agency was taking from the government in my daughter's name- and that -when multiplied by the 17 -20 persons that sat in this dismal room day after day amounts to so much this agency should hang its head in shame at the "care and caregiving they were providing". My husband and I pulled our daughter from these deplorable surroundings and did several other parents- I reported them to the state but I was told they could not be expected to "inspect" and agency's building as long as the "paperwork" was correct. How can "paperwork" completion be the lone factor- does the state ever talk to clients kept in these decrepit surroundings? I believe the dollars allocated for my daughter's Waiver services would be imminently better spent if she/we could directly receive and "hire" our agency or caregiver. Believe - those disgusting "Day services" that warehouse individuals would be out of business in no time and only quality agencies would be surviving. Has it never occurred that letting the consumer make decisions and "purchase" services/care would only enhance the system and likely save thousands of dollars?!
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