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Monday, October 20, 2014 |  Madison, WI: 51.0° F  Fair
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Walker plan on nursing home neglect a boon to bad care
Providers that hurt state residents will get a helping hand
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Family photo of Cynthia and Phillip Wilms.
Family photo of Cynthia and Phillip Wilms.

Phillip Wilms wasn't looking to enrich himself, only to protect others. "Why I filed the lawsuit in the first place is I wanted to be sure people in nursing homes get better care than we did," the former elementary school teacher told The Capital Times last fall.

Wilms' wife of more than 50 years, Cynthia, died in September 2007 at age 72 after receiving substandard care from the Willows Nursing and Rehabilitation Center in Sun Prairie, where the couple lived. The for-profit chain that runs the home ended up paying more than $2.25 million to settle the case, and Wilms was comforted to think he may have helped prevent other such tragedies.

But under changes pushed by Gov. Scott Walker, nursing homes like the one that neglected Cynthia Wilms will have greater protections. The governor and GOP-controlled Legislature, under the guise of reducing "frivolous lawsuits," want to cap punitive damages and shut off access to records regarding abuses, not just to civil litigants but criminal prosecutors as well. The bill passed the state Senate on Tuesday; an Assembly vote is expected on Thursday.

Michele Vaughan, one of the Madison attorneys who represented Wilms, thinks the case could still be brought under the new rules. But it would be harder to prove and lead to a lesser remedy - one that makes it less likely the nursing home would change injurious practices.

Vaughan, of Boller and Vaughan, which specializes in nursing-home abuse and neglect cases, thinks Walker's belief that these facilities can be self-regulating is absurd: "It's not that they don't have the ability to regulate themselves. They just don't do it."

As The Capital Times story by Shawn Doherty describes, Wilms died after a 29-day stay at the Willows, where she went to recover from hip replacement surgery. She developed a treatable staph infection that went untreated at the "chronically understaffed" facility, listed by the federal government as one of the worst in the nation.

Cynthia's infection grew progressively worse, but was not properly diagnosed until after Phillip Wilms removed her from the home; by then, it was too late to keep the infection from killing her.

The Willows, Doherty reported, had "a record of nursing-home violations resulting in serious harm to patient safety, and hundreds of thousands of dollars in fines." These apparently did little to prompt improvements but were instrumental in building Wilms' case. Walker's changes exempt "specific information acquired by an administrative agency in order to help improve the quality of health care" from the state's open records law, shutting off access to information about patterns of bad behavior.

Proponents claim these changes will create jobs. But for nursing homes, it could have the opposite effect.

The Willows is owned by Extendicare Health Services Inc., a Milwaukee-based firm with 175 homes nationwide. Vaughan says such providers maximize profits by taking in patients who require high levels of care - like those recovering from surgery - while trying to get by with minimal staff; to this end, bonuses are awarded to supervisors who meet budget goals.

Officials at the Willows told the Cap Times that the facility now meets all state and federal standards. One administrator said "significant resources have been invested to improve the care and services provided at our center."

John Raihala, of the Madison-based law firm of Clifford and Raihala, cites another example of how Walker's changes could protect those who injure state residents. In 2003, his firm recovered a total of $2.15 million for a man named Otis Williams, who was paralyzed after he was injected with the wrong drug at a local hospital.

The firm discovered, says Raihala, that "the pharmacy supervisor had instructed his staff to violate safety rules." Such information will now be harder to obtain: "Walker's plan would hide dangerous safety violations like the ones we uncovered that put the public at risk."

Moreover, Raihala notes, "when we recover money for our clients, we reimburse their health insurance, including Medicaid and BadgerCare." If that money isn't recovered, the taxpayers lose out.

The governor's staff has declined to address specific criticisms of pending legislation, instead offering platitudes about job creation. Raihala disputes that.

"Walker's plan doesn't create jobs," he says. "That's a scam. He's paying off the big corporations and insurance companies that bankrolled his election, and he's hurting Wisconsin taxpayers."

Tough love, or tough to love?

Madison Mayor Dave Cieslewicz, in a recent blog post, cheered Gov. Scott Walker's cabinet picks as "actually pretty good," noting that some have ties to Madison and Dane County." This includes Eloise Anderson, the new head of the state Department of Children and Families, who Cieslewicz notes "worked for Dane County for many years."

Yes, she did, from 1985 to 1988 as an aide to County Exec Jonathan Barry. She also worked as a social services administrator for the state of Wisconsin and as social services director for the state of California.

But throughout her career, Anderson has drawn criticism from liberals for delivering heaping doses of what is euphemistically called "tough love" to people who need a helping hand. Some examples:

Anderson, in a 1996 column by George Will, on ending the federal entitlement to welfare: "People say, 'The poor won't know what to do!' Tough. They'll learn."

From an interview with the Manhattan Institute, as quoted by Will: "If you tell me, 'I'm pregnant, and I've never worked,' I would say...don't come here, because having a baby is not a crisis. That's a condition, and your behavior caused that."

Anderson drew national attention as the architect of "Bridefare," a state program that used financial incentives and penalties to encourage teen mothers to marry. But in an earlier interview with the Feminist Connection, she offered a less sanguine view of marriage, at least for those with the wherewithal to avoid it: "I always thought of being a mother but I never thought of being a wife. To me, a 'wife' equals a 'slave,' and I wasn't interested."

And, in a 1991 interview with Isthmus, Anderson questioned whether poverty spurs social ills: "I don't know if poverty is causing the problems or inadequate family relationships are causing the problems." She added, "Poverty wouldn't be so great if material goods were not as esteemed."

Still cheering, Mayor Dave?

Long-distance provider

The city of Madison has a new paratransit provider - based 120 miles away in central Wisconsin. As of Jan. 1, Abby Vans of Neillsville became one of three companies serving city residents under contracts collectively worth about $4.5 million a year.

The city entered new three-year contracts with two local providers - Badger Bus and Transit Solutions - but bypassed a bid from Badger Cab in favor of one from Abby Vans.

"We've been doing it a long time," notes Tom Royston, Badger Cab general manager. His company generally provided between 100 and 150 rides per day under this contract, which Royston calls a "significant" but not essential chunk of business. He does wonder, however, if a Neillsville-based company can provide the same level of service.

Chuck Kamp, general manager of Madison Metro, had the same concern until he contacted other communities that have contracted with Abby Vans. "Apparently, this is a model they've used successfully." He's pleased with the reaction to Abby Vans he's gotten so far.

Crystal Martin, Madison Metro's paratransit program manager, says Abby Vans currently has about 20 drivers on the job in Madison. Some are from the Madison area and some have been brought in from elsewhere until new local drivers can be hired and trained. The drivers take their vehicles home at the end of their shifts.

The city has in the past contracted with a national provider (Laidlaw, later First Transit). Martin hopes people who care about keeping business local will credit Metro for sticking with a Wisconsin firm.

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