For families, Medo said, the larger hope is that adults with intellectual disabilities are able to make more of their own choices — where they live, who they live near, how they spend their time and how they participate in the community around them.
The post Door2Dreams aims to build independence, connection in central Wisconsin appeared first on WPR.
Advocates say the federal rule for implementing new Medicaid work requirements includes stringent requirements that may make it more difficult for people who could qualify for an exemption to meet those requirements. (Getty images)
Wisconsin healthcare advocates have been worrying for months that new work requirements for some people on Medicaid that will take effect next year will make it harder for people who are eligible to get on, or stay on, the health insurance program.
Those worries increased this week now that the federal government has issued its rules for states to implement the new requirements.
“More people are going to have a harder time complying with the bureaucracy, and they’re going to get caught up in that,” William Parke-Sutherland, government affairs director at Kids Forward, told the Wisconsin Examiner Tuesday. Kids Forward is a Wisconsin research and advocacy organization for children and families of color and facing barriers to opportunity.
Medicaid — known as BadgerCare in Wisconsin — provides health insurance primarily for people with incomes below the federal poverty guideline: $15,960 for one person and $33,000 for a household of four. Medicaid is regulated and partially funded by the federal government, with the states administering the program and sharing responsibility for its costs.
Work requirements were among changes to Medicaid included in HR 1, the tax and spending megabill that congressional Republicans passed a year ago and President Donald Trump signed July 4, 2025. HR 1’s cuts to Medicaid will total more than $900 billion over 10 years, according to KFF, a health policy research and news nonprofit.
The new Medicaid work requirements apply to people who were added to the program as a result of Medicaid expansion under the Affordable Care Act, the federal health insurance law enacted in 2010.
Under the ACA, states were able to get additional federal funds by expanding Medicaid to cover families with incomes up to 138% of the federal poverty guideline — $45,540 for a family of four.
Wisconsin didn’t adopt the full ACA expansion, however. Instead, under former Gov. Scott Walker, the state extended Medicaid healthcare coverage to childless adults with annual incomes up to $15,960, the federal poverty guideline.
About 190,000 childless adults in Wisconsin were covered by BadgerCare in April, according to the state Department of Health Services. Nationally at least two-thirds of people under Medicaid expansion are already working, Parke-Sutherland said.
Starting in 2027 those additional Medicaid recipients must show they are working or engaged in community service at least 80 hours a month, or enrolled in an education program at least part time. The 2025 tax-cut law provided exemptions for people with disabilities or in frail health, as well as for pregnant women and caregivers for other people with disabilities.
We're looking at how many people with disabilities aren't going to be qualifying for an exemption and are at risk for losing their healthcare.
– Tamara Jackson, Wisconsin Board for People with Developmental Disabilities
The federal rule that the Centers for Medicare & Medicaid Services issued Monday outlines how states must implement those requirements.
“We have been preparing to implement the requirement for almost a year based on limited verbal guidance we received from CMS as well as information we learned by collaborating with other states and learning from their approaches,” Elizabeth Goodsit, spokesperson for the Department of Health Services, said Wednesday.
DHS has spent months developing policies, procedures and system changes to implement the requirement, Goodsit said. “Our goal is to reduce the administrative burden on current and future Medicaid members to meet the new federal red-tape work requirements.”
Healthcare advocates contend that stringent terms in the newly released federal rule will make it more difficult for people to remain covered by Medicaid, even if they fully qualify.
For example, the rule presents “a much more restrictive definition of ‘medically frail’ than what appears to be in the statute of HR 1, and what people had been hearing from CMS,” Parke-Sutherland said.
Advocates said the rule also makes qualifying for an exemption more complicated for people with disabilities.
“We’re looking at how many people with disabilities aren’t going to be qualifying for an exemption and are at risk for losing their healthcare,” said Tamara Jackson, public policy analyst for the Wisconsin Board for People with Developmental Disabilities.
Unpaid family caregivers are supposed to be exempt, but Jackson said the relevant language in the federal rule “is, I think, really confusing and really difficult for unpaid family caregivers [to navigate].”
Jackson said the state will face “a tremendous amount of problem-solving that has to be done in a very short amount of time.”
It appears the federal rule doesn’t permit states to automatically declare a person exempt from the work requirement on the basis of a particular illness or diagnosis — such as Parkinson’s Disease, multiple sclerosis, HIV-AIDS or cancer.
Many of those conditions are cyclical, with patients alternating between times when symptoms seem mild and times when they’re deeply debilitating, Parke-Sutherland said.
Patients “[are] going to have to prove that they can’t work in order to qualify” for coverage, he said. “That’s a big change, and it’s going to make it harder for individuals and it’s going to make it harder and more costly for the state.”
In a statement issued earlier this week, Lisa Lacasse, president of the American Cancer Society Action Network, said the new restrictions collide with cancer patients’ essential need for health coverage.
“Knowing 1 in 3 children diagnosed with the disease and 1 in 10 people with a history of cancer currently count on Medicaid for their health insurance, this coverage is a matter of life or death for millions of people nationwide,” Lacasse said.
The restrictions in the new federal rule “link the definition of medical frailty to a person’s ability to work,” Lacasse said. The “debilitating side effects of the disease or treatment” complicate the task of fulfilling a work requirement or proving they can’t work, however.
Many cancer patients want to work between rounds of chemotherapy, she said, but instead, they “will have to choose between losing their Medicaid coverage, working the required 80 hours per month, or giving up working altogether to qualify for an exemption.”
Parke-Sutherland said the work requirements alone are expected to cut Medicaid nationwide by $326 billion over 10 years.
“That will not make people healthier and will not make people more likely to work,” he said. “The only way it reduces costs is because people who are currently eligible are not going to be eligible any more, not able to prove they’re working, not able to prove they have a condition [that makes them exempt], or they’re going to get caught up in the bureaucratic red tape of trying to prove those things.”
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Getty Images
The Wisconsin Legislature’s budget committee authorized $7 million in state funds Tuesday so that a state agency that supports Wisconsinites with disabilities entering the workforce can draw down a waiting list of more than 7,000 people.
The Joint Finance Committee voted unanimously for the funding, but members first argued over why the panel didn’t act sooner to provide the money.
The Division of Vocational Rehabilitation in the Wisconsin Department of Workforce Development reported in November that it faced a shortfall under the current state budget.
For people with disabilities who are seeking work, DVR provides career services including training as well as technical assistance for employers. The agency typically works with about 19,000 clients at a time, according to DWD. DVR receives federal funds to cover 78.7% of its annual costs, with the state required to cover the remaining 21.3% under federal law.
The 2025-27 state budget added $3.8 million for the agency, bringing state funding to $21.3 million, according to the Legislative Fiscal Bureau.
In November, the agency announced it was $4.6 million short of what was needed for the 2025-26 fiscal year. Because of that shortfall, the agency instituted a waiting list for people needing the DVR’s services.
“While we’ve been able to support existing program participants, all new applicants have been forced to wait for services, leaving over 7,600 Wisconsinites with disabilities currently on the waitlist to receive career services,” said DWD Secretary-designee Amy Pechacek in a statement Tuesday from the department. About 1,000 people seeking services are added to the waitlist each month, according to DWD.
DWD asked the finance committee for $4.6 million for the budget’s first 12 months, 2025-26, and another $6.4 million for the second 12 months, 2026-27.
Tuesday, the budget committee’s Republican majority on a 4-11 vote rejected a bid by the committee’s four Democrats to honor that request.
“It just stuns me that this committee wouldn’t take every opportunity to make sure that we have a zero waitlist opportunity so that people with disabilities can enter the workforce, pay taxes, and contribute to our economy,” said state Rep. Deb Andraca (D-Whitefish Bay) after the vote. “Are we really saving money by preventing people from working and not doing everything we can so that there’s no waitlist for this program?”
Instead, the majority proposed a $600,000 appropriation for the first year, which ends June 30, and the full $6.4 million sought for the second year. The Legislative Fiscal Bureau projected the appropriation would enable the waitlist to be closed by the end of June 2027. The proposal passed 15-0.
The funds were made possible in part because a $20 million appropriation for dairy farm aid that passed the Senate died in the Assembly, said Sen. Rob Stafsholt (R-New Richmond).
DWD will draw down the waitlist by first giving priority to people with the most serious disabilities, followed by people with less severe but significant disabilities and finally people whose disabilities do not seriously limit their functional capacity or require people with multiple services.
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The Lyndon Baines Johnson Department of Education Building pictured on Nov. 25, 2024. (Photo by Shauneen Miranda/States Newsroom)
WASHINGTON — U.S. senators across the aisle pushed back Tuesday against President Donald Trump’s proposal to eliminate funding for programs serving disadvantaged students.
Education Secretary Linda McMahon defended those and other proposed cuts to her agency outlined in Trump’s fiscal 2027 budget request, which calls for $75.7 billion in new discretionary budget authority for the department that would mark a $3.2 billion, or 4.1%, reduction from fiscal 2026 levels.
The administration has taken major steps to dismantle the 46-year-old Department of Education as part of the president’s quest to send education “back to the states.” That effort continues despite much of the funding and oversight of schools already occurring at the state and local levels.
“We’ve been clear: Shifting authority back to the states will not come at the expense of the central federal programs (and) support, much of which predate the department itself,” McMahon told lawmakers at the hearing of the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.
The panel shares jurisdiction over Education Department spending with the corresponding subcommittee of the House Appropriations Committee. The president’s budget request is generally considered a starting point for negotiations, but Congress is responsible for deciding federal spending.
Republican and Democratic senators took particular aim at the administration’s proposal to eliminate Federal TRIO Programs in fiscal 2027.
The Federal TRIO Programs — funded at $1.19 billion this fiscal year — help support groups including low-income students, first-generation college students, individuals with disabilities and veterans.
Sen. Susan Collins, chair of the full Senate Appropriations Committee, said she opposes the president’s proposal to eliminate TRIO, noting that these programs have “changed the lives of countless first-generation and low-income students in Maine and across the country.”
The Maine Republican added that TRIO “enjoys robust support and has made such a difference in the lives of children.”
Arkansas GOP Sen. John Boozman also emphasized his support for TRIO, noting that in his state, these programs “have been a game-changer in helping low-income and first-generation students not only access higher education, but also succeed once they are there.”
Sen. Jeff Merkley was the first in his family to go to college and said he comes from a “very blue-collar, frontier, homesteading, timber background.”
The Oregon Democrat said it’s from that perspective he believes that “having conscious programs to help people overcome the cultural chasm that exists between blue-collar kids like myself and that college world that you have very little contact on is enormously valuable in America, and the stats from these programs are pretty damn impressive.”
The secretary told the panel that while “there are many instances where the TRIO program has been very beneficial … as we look across the country in how to spend these dollars and how to have similar results by maybe not necessarily focusing students towards college degrees, maybe there’s another way for them to have their path to success.”
McMahon said her agency was in the process of spending “about $2.1 million” for investigating and evaluating the TRIO programs.
In its summary of Trump’s fiscal 2027 budget request, the department said that TRIO “has failed to meet the vast majority of its performance measures, and studies of program effectiveness have shown that it has not increased college enrollment.”
Meanwhile, McMahon took heat from the leading Democrats on the subcommittee and the broader Senate Appropriations panel over the administration’s ongoing efforts to dismantle the agency.
Part of those efforts include several interagency agreements between Education and the departments of Labor, Health and Human Services, Interior, State and Treasury that transfer many of Education’s responsibilities to those agencies.
Sen. Tammy Baldwin, ranking member of the subcommittee, said Education “is transferring the vast majority of its programs to other federal departments, agencies with little experience or expertise or capacity to administer them.”
The Wisconsin Democrat said that instead of “reducing bureaucracy” — a major goal of the administration across the federal government and the department in particular — the transfers are creating “another layer of it.”
She added that “where states previously primarily dealt with the Department of Education, they will now have to deal with multiple federal agencies.”
Sen. Patty Murray of Washington state, the top Democrat on the full Appropriations Committee, pressed McMahon on the status of the administration mulling the transfer of special education services out of the Education Department amid its dismantling efforts.
The possible move to transfer programs out of the department’s Office of Special Education and Rehabilitative Services has stoked widespread concern from disability advocates.
McMahon said her department was “still evaluating where those programs would best be located, and we have not made that determination yet.”
“I can assure you that the intent of this administration is not to put these students at risk in any way whatsoever,” McMahon said.
But Murray was not satisfied with the secretary’s response, saying she is “deeply concerned that your answer sounds like you’re still moving ahead — let’s make it clear that will break the law, and it will make it a lot harder for these students with disabilities to get the education and understanding that their country will stand behind them with that.”
CONCORD, N.C. — School bus aides are often under-recognized for the roles they serve in student transportation, particularly for children with disabilities, but they provide much-needed assistance to school bus drivers regardless of the route being driven, industry leaders said during a session at STN EXPO East.
Panelists at the conference last month emphasized that school bus aides — often referred to as attendants, monitors or, in New York City, matrons — are responsible for far more than child supervision. Their duties include supporting students’ social and emotional needs, managing behavior, assisting with medical situations, and ensuring safe transportation from stop to stop. School bus routes operated for children from birth to kindergarten are required by federal Head Start regulations.
“We aid and support those students … regardless [of] what disability,” said Stephanie Walker, a transportation leader and certified instructor from Habersham County Schools in Georgia. “Our goal is to have a safe and positive ride.”
The panelists highlighted a shift in terminology, reflecting the evolving role. Many districts have moved away from bus monitor or attendant, which suggests passive observation, toward bus aide, a title that better captures the hands-on responsibilities required.
Training and clear expectations are critical, said Teena Mitchell, special needs transportation coordinator for Greenville County Schools in South Carolina and past-president of the National Association for Pupil Transportation. She stressed that detailed job descriptions help prevent confusion and improve safety outcomes.
“The safety of these kids depends on what they know they have to do and what the expectations of them are,” Mitchell said.
School bus aides are expected to perform tasks such as securing wheelchairs, assisting with emergency medications, monitoring student behavior and helping students safely board and exit the bus. Panelists said aides should be actively engaged, including greeting students and ensuring proper seating at every stop.
The discussion also underscored the importance of proactively staffing buses based on student needs, not just legal requirements. Mitchell referenced a South Carolina case in which a district faced a multimillion-dollar settlement after a student was harmed on a bus without an aide.
“You need to know who’s on your bus,” she said, urging transportation departments to collaborate more closely with special education teams.
Comprehensive training programs are essential, the panelists agreed. Some districts require several days of instruction covering disability awareness, equipment securement, emergency response and de-escalation strategies. Ongoing evaluations, including written and physical tests, help ensure aides can perform under pressure.
Emergency preparedness was a major focus. Panelists cited demonstrations showing how quickly a bus fire can escalate, emphasizing the need for regular evacuation drills.
“If you can’t evacuate them in one minute and 16 seconds, they’re going to die,” Mitchell said.
Beyond safety, school bus aides also contribute to students’ emotional well-being. Building trust through consistent, respectful interaction can improve behavior and communication, particularly for students with special needs.
“If you’re not pouring into that child, that child’s not going to build that bridge with you,” Walker said.
Panelists encouraged districts to leverage resources such as school nurses, behavioral specialists, and classroom aides to provide consistent support across all settings. They also highlighted the importance of ongoing oversight, including reviewing bus video footage and conducting spot checks to ensure aides are following procedures.
Despite the critical nature of the role, staffing and compensation remain ongoing challenges. Many districts struggle to recruit and retain qualified aides, in part due to lower pay compared to other positions.
Mitchell said some districts have improved wages by classifying aides as “safety-sensitive” employees, helping to elevate the role’s importance.
Speakers also urged transportation leaders to collect and share data demonstrating the value of aides, including reductions in behavioral incidents, improved student attendance and increased rider confidence.
“We do a lot that we do not sell,” said session moderator Launi Schmutz Harden. “You guys are the ones that can speak the story.”
As schools face increasing mental health needs and tighter budgets, panelists agreed that investing in trained school bus aides is essential to maintaining safe, supportive transportation systems.
Written with assistance from AI.
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