Saving IRIS…one more time

About a year ago, in my role as a member of the Board of the Autism Society of South Central Wisconsin, I joined with other disability advocates to encourage the Joint Finance Committee to reject Governor Walker’s budget proposal to eliminate IRIS, which stands for, “Include, Respect, I Self-Direct.” IRIS is Wisconsin’s self-directed, community- based, long-term care program for adults with disabilities & older adults with long-term care needs. People using IRIS have the flexibility to self-direct their plan of care within an authorized budget based upon their individual needs and desired outcomes. IRIS participants choose and direct the services and supports that make it possible for them to live, work, and participate in their communities, allowing more people to stay in their homes and avoid costly nursing homes and other institutions.

Save Iris

We were partially successful. Both the Joint Finance Committee and the Wisconsin legislature rejected Gov. Walker’s radical upending of Wisconsin’s long-term care system. However, in doing so, the budget which ultimately passed directed the Wisconsin Department of Health Services to obtain public input and propose a new system that would be managed by private health insurance companies, instead of the current non-profit care management organizations. This has become known as Family Care/IRIS 2.0.

Yesterday, I co-signed a letter from the three Autism Society affiliates to the Joint Finance Committee in which we state that we:

do not believe the Department of Health Services has justified the disruption of care to the 55,000+ people currently enrolled in Family Care and IRIS programs.

Specifically, we are concerned about:

  •   The uncertain future of self-direction and the IRIS Program: The concept paper does not reflect the level of self-direction of the current IRIS program. There remain significant questions as to how current IRIS participants will experience self-direction as they do now.
  •   The uncertain future of Behavioral Health Services: The concept paper is lacking details on how behavioral health services may be integrated in the new model.

    We also share many of the conclusions made by the Wisconsin Long Term Care Coalition in their Analysis of the Numbers behind Family Care/IRIS 2.0 on May 11, 2016.

    Given that there are no projected savings in long term care as a result of Family Care/IRIS 2.0 and there are still significant questions about the concept plan, we believe that moving ahead at this point would unnecessarily disrupt the lives of over 55,000 Wisconsin residents.

    We are writing to ask members of the Joint Finance Committee not to move forward with the Family Care/IRIS 2.0 concept plan as currently written.

The good news is that since Family Care and IRIS operate under a federal Medicaid waiver, they cannot be modified without federal approval. The Walker administration has already conceded that it understands this cannot happen until at least 2018. Hopefully, the next President will accept the recommendations of Wisconsin elders and people with disabilities, their families and friends, who are generally satisfied with the current Family Care/IRIS long term care system and do not want their lives disrupted, their independence lost, and their futures controlled by for-profit health insurance companies.

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For more information on how Jeff Spitzer-Resnick can help you accomplish effective, progressive systems change contact him by visiting his web site: Systems Change Consulting.

 

 

Respect: Where Systems Change Starts

Aretha Franklin, the Queen of Soul, said it best in her anthem, Respect, written by the late, great, Otis Redding.

All I’m askin’
Is for a little respect

In my nearly 3 decades of civil rights work seeking systems change for a better world for many disenfranchised people, the lack of respect for basic human rights is what repeatedly brings clients to me seeking help.

Many years ago, I was meeting with Wisconsin Native American leaders from the Great Lakes Inter-Tribal Council.  I asked them how best non-Natives could work with them.  They gave a simple and quite appropriate response: “Just give us respect.”

While it seems simple, the sad truth is that our world would not be in the sorry state that it is in, if everyone simply respected everyone else’s right to live life with basic human decency. Just imagine a world where:

  • Elders were treated respectfully instead of with the disdain that results in abusive treatment in many nursing homes;
  • People with disabilities were treated respectfully so that they could obtain a quality education and good employment and health care;
  • People of color were not subjected to the disrespect of racial profiling demeaning them on a daily basis;
  • and of course, the list could go on & on.

recent study of 26 high-achieving, high-poverty schools in Texas bolsters decades of effective schools research. Effective schools exhibited the following characteristics: a strong focus on ensuring academic success for each student; a refusal to accept excuses for poor performance; a willingness to experiment with a variety of strategies; intensive and sustained efforts to involve parents and the community; an environment of mutual respect and collaboration; and a passion for continuous improvement and professional growth.

When I am successful on behalf of my clients, I not only obtain justice for my clients, but a new found respect from their former adversary. It is this respect that brings real systems change.

It really does not matter what the environment is because respect is the root of progress. Indeed, business leaders recognize that a workplace without respect cannot succeed. All leaders must build a culture of respect.  To do so, they must:

  • Teach respect.
  • Adapt respect to the environment.
  • Model respect, and
  • Praise respect.

Whether in school, the work place, or on the street, increasing respect for each other can only improve the human condition.

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For more information on how I can help you accomplish effective, progressive systems change e-mail Jeff Spitzer-Resnick or visit Systems Change Consulting.

Time to Reform State Taxes–Pt. 2: Property Tax Reform

As news leaks out about Gov. Walker’s desire to cut Wisconsin income taxes, it is remarkable that there has been an absence of serious discussion about property tax reform for over 2 decades.  This is surprising given that property tax revenue is the single largest source of tax revenue in Wisconsin and many other states, providing critical funding for schools and other municipal and county based services, including police, fire, and public health services.

Former Gov. Tommy Thompson recognized that there was a property tax problem in Wisconsin when he attempted to put a lid on property taxes over 20 years ago by restructuring how Wisconsin funds schools and local services, instituting revenue caps, which deny school boards and local governmental bodies the power to raise sufficient revenue to fund critical programs.  At the time this system was instituted, the trade-off was that state government pledged to provide much greater support for schools (2/3 funding) and other local services.  Unfortunately, his successor, Gov. Jim Doyle, reneged on that pledge of more state support, and then in Wisconsin’s current budget, Gov. Scott Walker went one step further by reducing the revenue limits drastically (amounting to an $800 cut to schools alone in revenue authority on top of an $800 million state funding cut).

But that is only one side of the story.  What about the people who pay property taxes?  Are they being taxed fairly?

The simple answer is that property taxes are the most regressive tax that Wisconsin and most other states use.  This is for one basic reason.  Unlike centuries ago when property wealth virtually always correlated very closely with income wealth, we no longer live in such a world.  Many examples abound, including:

  • The elderly homeowner who has fully paid off her home, but the value has risen tremendously in the 50 years since she built the home, and now her only earnings are from Social Security.
  • The divorcee, whose divorce agreement left her with a home for which she can make her mortgage payments, but after 5 years of rising property values, she can no longer afford to stay in her home due to rising property taxes.
  • The formerly comfortable middle class family, whose primary bread winner lost his job just before the $7,500 property tax bill came due.

Most of us, myself included, have lost one or more neighbors such as these.  This creates unstable neighborhoods, one of the hallmarks that works against the creation of safe and sustainable places to raise healthy, happy and well educated children.

The problem, of course, is that while virtually everyone agrees that Wisconsin’s property taxes are too high, almost no politicians are willing to make the hard decision about how to replace the revenue which would be lost if we reduced property taxes for those whose incomes clearly cannot afford them.

The answer is actually quite simple.  We can make state property taxes equitable by adjusting them up or down based on the property owner’s income. Of course, many variations could be instituted, including the number of adjustment categories and the percentage of adjustment.  However, any such system can be aligned to be revenue neutral to taxpayers. Moreover, Wisconsin’s system of shared revenue which moves property tax revenue from property rich tax districts to property poor districts can continue to be utilized to provide equity in such a system so that property/income rich neighborhoods contribute to the ability of less wealthy neighborhoods’ ability to fund schools and local services.

Here is an example of how a simple 3 tier property tax system with income adjustments would work:

  • Betty is a 78 year old widow who has lived in the mid-sized 3 bedroom home she and her husband built 45 years ago for $12,000.  She lives in a safe middle class neighborhood with good schools, and her home, though fully paid for, is now valued at $325,000.  That valuation results in a $7,000 property tax liability, which she cannot afford because her only income is her monthly $700 Social Security check.  She will need to sell her home once she has exhausted all her savings by the end of this year because she cannot afford her property taxes. Under my proposal, taxpayers with Adjusted Gross Incomes under $50,000/year would have their property taxes reduced by 50%, reducing Betty’s property taxes to a manageable $3,500.
  • Joe and Tammy have the exact same property value and tax situation, but they both work and each earn $60,000/year for a total of $120,000/year in family income.  Under my proposal, taxpayers with Adjusted Gross Incomes between $50,000-$250,000 would receive no adjustment since those with Joe and Tammy’s income while certainly not wealthy, can afford to pay their property taxes.
  • Sally and Don live in a house with the same property value, but they both hold very high paying jobs, each earning $200,000/year.  Under my proposal, their property taxes would increase 50%, to $10,500, which they can still afford, and which offsets Betty’s discounted property taxes.  Keep in mind that their property tax payment is fully deductible under federal tax law so they will actually receive a larger federal tax deduction under this plan.

In sum, while property taxes are indeed too high, they remain a critical component to funding critical local programs and services, including public education, so eliminating them is not really an option without a steep hike in income or other taxes.  By making them equitable as I have suggested, we will allow more people to remain in their homes, helping to maintain and create stable neighborhoods, without any loss of revenue.

Now the question is whether political leaders will have the courage to adopt real Property Tax Reform, such as the system I have proposed.


For more information on how I can help you accomplish effective, progressive systems change e-mail Jeff Spitzer-Resnick or visit Systems Change Consulting.

One Step Back from the Fiscal Cliff

As Democrats and Republicans jockey for political position on the so-called fiscal cliff negotiations, I can’t help but wonder how many of our elected representatives truly care about moving the American economy and the federal budget forward in a sensible manner, and how many others are just measuring the political outcome of whatever deal is made vs. falling off the figurative fiscal cliff.  From my vantage point, most members of Congress are simply calculating political outcomes rather than examining what is truly best for the vast majority of Americans going forward.

One example of how politics seems to override common sense is the debate over whether the age for Medicare eligibility should be raised.  One thing I have learned in conducting effective systems change advocacy for over 27 years is that partisan rancor rarely gets resolved by creating sound policy.  Building consensus amongst those who differ has a much better chance of creating sound fiscal and social policy. Indeed, I started my career doing elder advocacy, including writing a popular handbook, Your REAL Medicare Handbook.

As of the moment, some Republicans have suggested that one way to secure Medicare’s viability in the future is to raise the eligibility age to 67.  Most Democrats have viewed such suggestions as an attack on the social contract of Medicare.

As a strict non-partisan working on effective Systems Change, I invite readers to look at the facts:

  • When Medicare was established by the Social Security Amendments of 1965, men’s life expectancy was approximately 67 years and women’s life expectancy was approximately 73 years.
  • Current estimated life expectancy for men is about 76 years for men, and 81 years for women.
  • In 2011, the oldest baby boomers—Americans born between 1946 and 1964 started turn 65. Today, over 40 million people in the United States are ages 65 and older, but this number is projected to more than double to 89 million by 2050. Although the “oldest old”—those ages 85 and older—represent somewhat over 15 percent of the population ages 65 and older today, their numbers are projected to rise rapidly over the next 40 years. By 2050, the oldest old will number 19 million, over one-fifth of the total population ages 65 and older.
  • By 2025, the U.S. Census Bureau and the Bureau of Labor Statistics (BLS) projects that there will be almost 50 million persons over 65 and not in the labor force—about twice the number in 1995.
  • The US Labor Force grew rapidly from the 1950s through the 1970s and has steadily declined since then.  The Bureau of Labor Statistics does not anticipate a rise in the US Labor force until the 2030s and then only returning to the levels of 2010.

So, even without discussing the problem of controlling health care inflation, it is clear that a shrinking workforce cannot continue to support  the booming Medicare population through Medicare payroll taxes.   It is worth noting that Congress resolved this problem for Social Security by slowly raising the retirement age.  There simply is no sound reason not to duplicate this gradual rise in the Social Security retirement age, in the Medicare eligibility age.  This will avoid any retirees suddenly having retirement and anticipated Medicare coverage change without reasonable time to plan.  I suggest raising the age to 67 over 4 years (i.e., 6 months/year).  Other time tables could certainly be adopted.

While this may appear to be a Republican idea, Democrats can brag that raising the Medicare eligibility age is made possible by Obamacare as those caught in the rising age group will have health insurance available to them under the Affordable Care Act. Moreover, it is worth noting that way back in 1999, the National Bipartisan Commission on the Future of Medicare concurred with this recommendation, calling for linking the Social Security retirement age with the Medicare eligibility age. Sadly, politics has gotten in the way of sound policy ever since.  It is time for brave politicians to figure out how to declare a win-win for the American people and stop playing win-lose politics with our future.


For more information e-mail Jeff Spitzer-Resnick or visit Systems Change Consulting.