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Tuesday, January 27, 2015 |  Madison, WI: 24.0° F  Fog/Mist
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Health option for poor shutting down
Fiscal woes prompt group to end managed-care program
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Marti Umhoefer calls the soon-to-be-axed Health Advantage ‘a positive approach to my health care.’
Marti Umhoefer calls the soon-to-be-axed Health Advantage ‘a positive approach to my health care.’
Credit:Mary Langenfeld

Last summer, for the first time in 15 years, Marti Umhoefer was able to go to the dentist. The 60-year-old Madison resident, who is disabled with arthritis and other health problems, was also finally able to see a physician instead of going to the emergency room for treatment.

"I've been treated like a regular client, not someone to be looked down on," she says. "It was nice to be a human being again."

Umhoefer receives about $700 a month in Social Security benefits and, until this year, relied on Medicaid for health care. But few dentists accept Medicaid, and Umhoefer often felt like health-care workers treated her differently. "They'd check my coverage first, before deciding on a treatment," she says.

Then last summer, Umhoefer joined Health Advantage, a new managed-care program run by Community Living Alliance, a Madison-based nonprofit group. The program covered all her health-care costs - with no co-pay - and assigned her a caseworker. And Health Advantage offered full dental coverage.

"It's been a positive approach to my health care," says Umhoefer.

But Umhoefer will lose all her benefits on July 1, when Health Advantage shuts down. The program, which served 1,500 clients in Dane County, was "unable to achieve the financial stability we needed to continue it," says Owen McCusker, head of Community Living Alliance. "There were a lot of unforeseen challenges."

The program was swamped with demand from people on Social Security who hadn't been to a dentist or a doctor "for decades." And McCusker says the state, which was paying a monthly rate ranging from $100 to $1,200 per client, didn't offer more funding. Community Living Alliance poured $4 million of its own money into Health Advantage, but as a nonprofit couldn't afford to do more.

"Our pockets were not sufficiently deep," says McCusker. "The rate structure did not adequately remunerate us based on actual need."

A spokesperson for the Department of Health and Family Services, which funded Health Advantage, did not return calls.

The state wants managed-care operations like Family Care (not yet offered in Dane County) to run many services for people with disabilities and the elderly, but McCusker thinks nonprofits will have a hard time filling this role.

"We operate on slim margins," he says. "A lot of community organizations that provide services may end up being supplanted by larger, multinational organizations with deeper pockets."

Umhoefer has a more immediate concern. "My hope is my dentist will let me stay as a patient," she says. Community Living Alliance is moving clients back to Medicaid, but Umhoefer knows most dentists don't accept it. Losing Health Advantage, she says, "is just another chance for someone to say, 'Oh well, they're disabled. They don't matter.'"

Hire education

Madison Ald. Brenda Konkel is calling for a formal review of the city's hiring practices. Her resolution, introduced this week, is inspired by the controversial hiring of Jeanne Hoffman, a former mayoral aide with no engineering experience, as the city's new facilities manager. But Konkel has heard about hiring problems throughout the city.

"It seems to be bigger than just Hoffman," she says. "There are multiple questions about other hirings."

Konkel has fielded complaints from workers in Madison Metro, the Water Utility and other departments. "A lot of people are afraid to talk," she says, adding that workers can give the city council anonymous feedback. "I'm sure we're going to get some interesting information."

The resolution does not specifically address Hoffman's hiring. Says Konkel, "I just don't know how we undo somebody's decision."

Meddlers on the roof

Mike Kohn put solar panels on a 103-year-old house he's renovating on Madison's east side because "it's altruistic, saving our planet." But the city says the panels have got to go.

The house, at 315 S. Baldwin St., is in the Third Lake Ridge Historic District. And the city's Landmarks Commission requires houses there to maintain the roof's "original" look.

"The Landmarks Commission is not in any way opposed to solar collectors," says Kitty Rankin of the Planning Department. "They just want it to be compatible with the historic district."

State law says municipalities cannot restrict solar panels, unless doing so protects public health. But another law says cities can impose conditions on buildings in historic districts. The City Attorney's Office is investigating which law prevails.

Kohn says he'll abide by the city attorney's decision. But he rejects the city's suggestion that he move the panels to another part of the roof, not visible from the street.

"That the was the only space that could access enough sunlight," he says. "I didn't think solar panels would be a problem."

D'Angelo probe continues

A federal grand jury met recently to investigate allegations against former Overture Center president Bob D'Angelo, a source with inside knowledge tells Isthmus.

A "handful" of witnesses have been subpoenaed, the source says, including current and former employees of the Overture Center and some vendors who have had business dealings with Overture. Grand jury investigations are secret and witnesses are forbidden to discuss what happens there. But the source says investigators were likely concentrating on allegations that D'Angelo received free meals and special deals.

D'Angelo abruptly resigned in September 2005, amid allegations of sexual harassment. It was later revealed that D'Angelo received hundreds of dollars' worth of free meals and drinks from Madison businesses that had contracts with Overture and the Madison Civic Center. D'Angelo also allegedly made $6,500 in trade deals with two local businesses, for which no city records could be found.

D'Angelo's attorney, Stephen Hurley, did not respond to a request for comment.

Dave Travis' gas pains

Don't believe everything you read in the newspaper (except this one). State Rep. Dave Travis (D-Waunakee) says he never told the Alliance of Automobile Manufacturers it could use his name in newspaper ads urging Congress to reject an increase in fuel-efficiency standards.

"I never would have put my name on a public letter to Herb Kohl or Russ Feingold," he says. "I don't know how it got there."

The full-page ad, which ran in both daily papers, included the names of Travis and several other state legislators. It opposed a bill to raise fuel-efficiency standards from 25 to 35 miles per gallon.

Travis says he did tell the trade group it could use his name - but only with regard to the General Motors plant in Janesville. As he sees it, increasing fuel efficiency could cost jobs: "The vehicles they produce down there are big SUVs. [They] don't get the greatest gas mileage."

But Carla Klein, director of the Sierra Club's Wisconsin chapter, rejects the suggestion that higher fuel efficiency standards will force automakers to close plants.

"It's not going to put car companies at a disadvantage," she says. In fact, with rising gas prices, "some might argue that because American companies haven't provided efficient cars, that's why Toyota and Honda have done so well."

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