Employment, training services for disabled face cloudy future

Aug. 27--CHIPPEWA FALLS -- Beven Hartfield has worked at Chippewa River Industries since February and said she enjoys her job at the Chippewa Falls site.

"It's hands-on, and there's a lot of help, and that's what I like about it," Hartfield said. "They teach us job skills, people skills (and) how to act, so it's a good thing."

For months the future of such facilities as CRI, REACH and the L.E. Phillips Career Development Center, which provide employment and training services to people with disabilities, has been up in the air. Some proponents of those businesses worry about how new federal regulations may affect funding.

A Centers for Medicare & Medicaid Services, or CMS, ruling regarding those businesses, known as sheltered workshops, garnered attention in January when CMS issued instructions on how to comply with new funding rules. The federal agency gave states five years to develop transition plans for compliance.

Local agencies currently are responding to the state Department of Health Services' Family Care Medicaid Waiver plan released in late July. That plan is incomplete, CRI director Dave Lemanski said.

"They don't address how they're going to deal with facility-based prevocational services," Lemanski said, noting the waiver states multiple times it needs more information from CMS.

DHS Secretary Kitty Rhoades said nothing in this waiver submission changes anything regarding operations of sheltered workshops, but when CMS issues more information, they will have to comply.

Without that information included in the plan, Lemanski and others worry facilities such as CRI and REACH could cease to exist.

"We're trying to not illustrate it as worst-case scenario illustrations, but in the same breath we have to be realistic that if it's not in the plan it's not going to exist," Lemanski said.

DHS is accepting public comment from involved parties on the transition plan through Sept. 2 before it is submitted to CMS in October.

It is unfair to ask for comment without all the pieces, Lemanski said, which is why many are pushing for CMS to give more information so DHS can issue a revised plan and open it up for another public comment period.

"Also in the same breath to continue to preserve the full array of services, which includes community based services and facility based services," Lemanski said.

Some clients, many of whom also have worked in a community setting, said they prefer sheltered workshops and are concerned about what would happen if they close.

"If they close this, where are the people going to go?" asked Gina Koepke, who has worked at CRI for nine years.

Without her job at CRI, Koepke said, "I would probably just stay home and do nothing."

Parents and caretakers shared similar concerns. Kathleen Brown, whose 42-year-old daughter with Down syndrome uses services at Indianhead Enterprises in Menomonie, said she doesn't think her daughter would be able to return to a community-based setting.

"My daughter worked in the community for over 18 years, but it was always limited hours. She didn't really have peers, it was fast-paced, and it got to be hard and frustrating," she said. "Eventually she came to the workshop later and has peers and has a safe environment."

Diana Wiesner agreed and said her daughter Tonya, who has cerebral palsy, is excited about the opportunities the workshops provide her.

"When she wakes up in the morning she has a purpose," Wiesner said. "We all need that."

Workshop opposition

Others are not as supportive of workshops. Groups such as the Association of People Supporting Employment First said the state needs to do more to integrate individuals with disabilities into the community.

"Wisconsin spends twice the amount of public dollars on facility-based employment than on community employment and has considerably many more providers statewide offering and emphasizing facility-based employment over integrated employment supports," Andrzej Walz-Chojnacki, public policy liaison for the Wisconsin APSE chapter, said. "Issues related to poor employment support quality, waiting, or limited choice in communities can be tied directly back to this severe imbalance in funding and prioritization by Wisconsin."

Walz-Chojnacki said the notion that choices will be taken away by the DHS change is false.

"If anything, expanded choices should be available to families and individuals who have been waiting for new options in their communities," he said.

Lemanski said the debate shouldn't be about community-based versus facility-based services, noting about half of CRI clients work in community-based settings.

"What we're saying is don't throw the baby out with the bath water," he said. "Don't force a one size fits all policy. Let the full array (of services) continue."

Rhoades said she supports a "compendium of employment," noting individuals should have the choice of where they want to work. She submitted a letter to CMS, but said DHS is limited since the waiver is due in October.

Miels can be reached at 715-833-9214, 800-236-7077 or emily.miels@ecpc.com.

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