Valadictory

This document, authored by John O’Brien, explores the transition of Dane County’s developmental disabilities support system into Wisconsin’s Family Care managed care program. ​ It reflects on the perspectives of local leaders—people with developmental disabilities (DD), families, advocates, and administrators—who worked to preserve the county’s innovative, community-centered approach to individualized support. ​ Dane County’s system, built over decades, achieved exceptional outcomes in employment, independent living, and self-directed care, far surpassing state and national averages. ​ However, the state’s shift to Family Care, driven by cost-saving goals and uniformity, risks disrupting these achievements. ​

The paper contrasts Dane County’s relational, values-driven model with the state’s transactional, cost-focused managed care approach. ​ It highlights concerns about losing specialized supports, trusted relationships, and the flexibility that enabled individualized care. ​ Local leaders organized efforts to educate families, sustain critical capacities, and advocate for collaboration with state officials, but faced resistance and bureaucratic barriers. ​

Ultimately, the document serves as a valedictory for Dane County’s system, emphasizing the importance of preserving its legacy of inclusion, innovation, and citizenship for people with DD. ​ It invites readers to consider the broader implications of managed care and the need for policies that prioritize dignity, community, and self-determination. With hope for the future, it underscores the resilience of committed individuals and organizations in shaping a new system that builds on the strengths of the past. ​