Look Around and Decide What Do You Want – What's the Solution?
Dohn Hoyle, Partners in Policymaking Faculty Member, Activist and Organizer
22. Look Around and Decide What Do You Want – What's the Solution?
We discovered that nobody was doing what we wanted, but there were people doing parts of it in different places that were better than we were doing it. So we concentrated on some of those, and then we let the maps people help us design what it ought to look like, not what can we find elsewhere and we can do in Michigan but instead how good could we envision it? How good could we do it?
And I'll do this briefly, but we worked through things until we got all the way to a new waiver. And our department was so happy with it, when they titled it, they called it the renewed waiver. Capital R, small E, capital N, capital E, capital W, small E, small D. ReNEWed waiver. Renewed 1915 C waiver. The department was proud enough of what it represented and it incorporated everything from person-centered planning to people making decisions about where they lived, all kinds of things that we've learned from the speakers who talked to us and what the maps group envisioned, et cetera.
And here, this group was working on a waiver that looked like that. Our department invited us to sit in on a couple waiver meetings, and we learned from that who in the department was on the other side of where we wanted to be and who in the department was kind of on our side. Who was our friend. And that's something you can use, although you didn't put it in those terms ever. And we learned that, what we learned from other states, was that you're probably better off asking for forgiveness after you've submitted something that they don't like, instead of asking for permission in the beginning.
It turns out that when you're asking for forgiveness, they try to accommodate you as best they can, whereas if you ask for permission, they'll lead you down the path they want to go that looks a lot like what they've done before and not like anything new. And that sort of theme rang throughout the move from a renewed waiver that had some stuff in it to considering a brand new waiver that would do something that we wanted, which was end the waiting list. And what did we have to give up to end the waiting list? Well, we probably have to buy into what was then being termed managed care.