WHEREAS:

AFSCME is the leading union representing employees working in institutional and community-based facilities servicing developmentally disabled individuals. Over 100,000 members provide quality care for our nation's most vulnerable population; and

WHEREAS:

Through national conferences, local meetings and seminars, and publications, AFSCME has aggressively advocated the developmental of "active-treatment" in facilities across this country. Where states have relinquished their mandate to provide quality institutions, AFSCME has fought for both capital improvements and staffing increases; and

WHEREAS:

Spurred by rising costs and by the rising number of deficiencies, the federal Health Financing Administration has increased its oversight of public and private ICF/MR facilities. All large public ICF/MR facilities have undergone federal "look-behind" surveys in the past two years. Often definitions of "active-treatment" have varied from survey team to survey team and survey deficiency reports have deviated significantly from federal regulations; and

WHEREAS:

For over four years, Senator Chafee and supporters have sought to enact an alleged Medicaid reform measure which, in essence, is a massive contracting-out scheme. The proposed legislation would cap Medicaid funding to ICFs/MR, arbitrarily limit facility size, allow states to develop their own rules and regulations for community care to replace current ICF/MR regulations, and completely disregard the skills and experience of existing workforces by failing to adopt meaningful worker protections; and

WHEREAS:

Continuing cost pressures in the ICF/MR program have generated additional legislative interest in improving Medicaid services to the developmentally disabled. Congressman Waxman, a long-standing proponent of Medicaid reform, has recently circulated a draft Medicaid ICF/MR reform bill; and

WHEREAS:

There is considerable support among advocates and experts in the field of mental retardation and developmental disabilities for an institutional care system as part of a continuum of residential and treatment services.

THEREFORE BE IT RESOLVED:

That AFSCME continue to adamantly oppose any Medicaid ICF/MR legislation, like the Chafee-style measure, which fails to address the needs of residents and workers and ultimately would only lead to large-scale privatization; and

BE IT FURTHER RESOLVED:

The AFSCME scrutinize any Medicaid ICF/MR reform legislation to insure funding for existing institutional facilities and future improvements is preserved, any funding shifts to the community must be accompanied by satisfactory worker protections, and any reform must include improvements in the quality of services in ICF/MRs of any size; and

BE IT FURTHER RESOLVED:

AFSCME will work closely with advocacy groups, parent groups, and professional associations to guarantee the delivery of quality services and to lobby strenuously against irresponsible closures and deinstitutionalism; and

BE IT FURTHER RESOLVED:

That AFSCME build upon its success in establishing comprehensive continuums of publicly-operated services. Fourteen states have now developed state-run community-based mental retardation services: Arizona, Colorado, Connecticut, Florida, Kansas, Louisiana, Massachusetts, Mississippi, Minnesota, New Jersey, New York, Oklahoma, Rhode Island and South Carolina. Additional states are presently considering the option. AFSCME will continue to provide technical assistance to councils and locals working on the developmental of such services; and

BE IT FURTHER RESOLVED:

AFSCME will closely monitor interpretations and guidelines, regarding Medicaid disallowances, active treatment issues, "look-behind" deficiency reports, and federal audits which directly affect working conditions and the quality of ICF/MR care; and

BE IT FINALLY RESOLVED:

AFSCME will work toward implementation of substantive employee protections through federal law for major financing programs such as Medicare and Medicaid, and toward the improvement of staffing ratios, career ladders, training programs and worker protection at the state and local level.

SUBMITTED BY:

Dick Tonjum, President
Irene Thibodeau, Secretary
AFSCME Local 607, Council 6