Robert M. La Follette School of Public Affairs
Thursday, March 31, 2011

Workshop proves beneficial to agency, authors

Students practice Wisconsin Idea

The Public Affairs Workshops are the capstone courses for the La Follette School's two master's degree programs, the Master of International Public Affairs and the Master of Public Affairs. In addressing actual problems faced by clients in the public, non-governmental and private sectors, the students work closely together in teams to produce carefully crafted reports that meet high professional and academic standards. Through these reports, students contribute to the University of Wisconsin-Madison's outreach mission and to the Wisconsin Idea.

Students present 9 workshop reports to local, state, international clients

From suggesting ways to improve food safety to evaluating countries that receive U.S. aid, policy analysis and recommendations by La Follette School students are now on the desks of policymakers across Wisconsin and around the world. Read more

An in-depth look by La Follette School students at services for frail older adults and people with physical and developmental disabilities is helping the Wisconsin Department of Health Services improve those services and the collection and organization of data.

Students in the 2010 public affairs workshop produced a report that compared two Wisconsin Medicaid programs: a self-directed long-term-care program called IRIS (Include, Respect, I Self-Direct) to Family Care, a managed-care program through which people receive services tailored to their needs from an organization that manages a network of long-term care services and contracts with providers. In contrast, individuals in IRIS use their public funding to choose and allocate their long-term care supports, goods and services.

Wisconsin created IRIS under a very compressed timeframe in 2008 to meet federal requirements. "The La Follette workshop project allowed DHS the opportunity to look at IRIS after its first year in a comprehensive way to see if it was meeting expectations" says Fredi-Ellen Bove, who was deputy administrator of DHS's Division of Long Term Care at the time.

Although DHS has adequate resources for operational needs to administer current programs, the agency has limited analytical capability to undertake evaluation, research and in-depth policy analysis, says Bove, who is now with the Department of Children and Families. "So, it was extremely helpful to have the La Follette team delve into a policy area that was of strong interest to us. We had considerable anecdotal feedback from stakeholders in IRIS, and we wanted to understand if the comments were evidence of a systematic trend."

This report was Bove's first experience with the public affairs workshop, but the 2009 cohort produced a report on health disparities for a different program area in the agency. The workshop produced several reports for the Department of Health and Family Services before it was reorganized in 2008 to create DHS and the Department of Children and Families.

One of the 2010 authors, Jake Schindler, says DHS staff advised them throughout the process that the agency would be using the report's results. "DHS told us that drafts of our report were circulating among staff members even prior to our presentation and that many of our findings would have implications for the IRIS program," he says.

DHS assigned a staff person to coordinate with the students and to meet with a larger group of DHS staff to apprise them of the report's progress. She praised the team for its commitment to learning about the issues and their quick turnaround. "They brought with them good analytical skills in working with data," Bove adds. "They also did a good job working together and dividing the work among themselves."

Schindler says the experience has proven beneficial to him in his job as an analyst with the Wisconsin Legislative Audit Bureau. "In the workshop, we improved our writing skills by having to convey complex, program-specific information in a way that made sense to someone who was not a DHS insider," Schindler says. "Teamwork came into play as we tried to share and divide tasks on a large project and decided what we could accomplish versus what we wanted to accomplish and how that would answer our core questions.

"Above all, we practiced operating in a world of incomplete or imperfect information," he adds. "IRIS was a new program in a growth phase, so the analysis proved challenging in a number of ways."

The IRS report has had three outcomes, Bove says. IRIS's independent consultants who help IRIS program participants were told to spend more time discussing employment with clients. "The La Follette report found that relatively few people were engaged in community-based employment, which we had not expected," Bove says. "We asked the consultants to spend more time talking with program participants about their plans and what they needed for support so they would have good employment experiences."

The report also confirmed that program data were fragmented and unwieldy. "The report and the students' experience demonstrated we had to streamline our data systems," Bove says. "We have a project now underway to integrate data systems."

Last, the report reinforced the value of issuing an annual report that outlined IRIS and Family Care client outcomes. "The practice has now been institutionalized," Bove says, "so we can compare measures every year."

Gaining the perspective of people from outside DHS was valuable, Bove says. "In some ways they validated what we knew, but it is good to have an independent party do that. For example, we knew that a significant portion of the client population in both programs have significant mental health needs, and the La Follette report included this same finding.

Schindler and another author are now professional colleagues of the DHS program staff with whom they worked. Schindler is auditing Family Care as part of his job as an analyst with the Wisconsin Legislative Audit Bureau. Grant Cummings is responsible for Medicaid long-term care programs, including Family Care and IRIS, as an analyst with the Wisconsin Legislative Fiscal Bureau. He presented a memo on Family Care and IRIS to the Joint Committee on Finance, which consists of members of the Wisconsin Assembly and Senate. He also is drafting a longer informational paper that will give the Legislature a general overview of the programs and policies under his purview.

"When they joined the state, they both had portfolios that included our program area," Bove says. "From our perspective, they already had program knowledge, so as we have collaborated on projects, we have not had to spend a lot of time briefing them."

Those experiences and relationships have been invaluable to Cummings, whose co-authors also include Patric Hernandez, Jerrett Jones and Andrew Kell.

The workshop and other class projects that involved local and state agencies were excellent opportunities to analyze policy alternatives, write memos and think critically about technical issues, Cummings says. "These projects provided a lot of experience that was useful to recall in job interviews and in day-to-day work. The workshop project is a prime example. My supervisor has told me that he actually did read my team's report on IRIS and Family Care before hiring me."