Report on Special Olympics Wisconsin’s Role in the Rosemary Collaboratory Initiative

Advancing Global Health Equity for Individuals with Intellectual and Developmental Disabilities (IDD)

Special Olympics Wisconsin has formally engaged in the Rosemary Collaboratory, a global initiative launched by Special Olympics to enhance the quality and accessibility of healthcare for individuals with intellectual and developmental disabilities (IDD). This initiative directly supports the United Nations Sustainable Development Goals (SDGs), particularly those focused on health, equality, and partnership. Wisconsin is designated as one of only 11 “health system assessment sites” worldwide and one of three in the United States, positioning the state as a key contributor to this international effort.

Alignment with Sustainable Development Goals (SDGs)

The Rosemary Collaboratory’s mission is fundamentally aligned with several core SDGs, aiming to create a more inclusive and equitable world.

• SDG 3: Good Health and Well-being: The primary goal is to ensure healthy lives and promote well-being for all by addressing the significant health disparities faced by people with IDD. The initiative seeks to improve access to quality essential healthcare services for this marginalized population.
• SDG 10: Reduced Inequalities: By focusing on a group that frequently experiences discrimination and barriers to care, the project directly targets the reduction of inequalities within communities. It aims to empower and promote the social and economic inclusion of persons with disabilities.
• SDG 4: Quality Education: A key objective involves strengthening medical education to ensure health professionals are equipped with the skills to care for patients with IDD, contributing to inclusive and equitable quality education and lifelong learning opportunities for healthcare providers.
• SDG 17: Partnerships for the Goals: The initiative is built on a multi-stakeholder partnership model, bringing together Special Olympics, state policymakers, healthcare providers, and advocates to achieve its objectives, exemplifying the collaborative approach needed to realize the SDGs.

Strategic Objectives for Wisconsin

Special Olympics Wisconsin, in its role as a health system assessment site, has outlined three long-term objectives to drive systemic change. This work expands the organization’s traditional focus from athletes to the approximately 42,000 individuals with IDD across the state. Chad Hershner, president of Special Olympics Wisconsin, stated, “By participating in the collaboratory, it enables us to expand our scope to all individuals with IDD in Wisconsin.”

1. Strengthen Medical Education: To ensure health professionals can effectively and respectfully care for patients with IDD.
2. Improve Medicaid Reimbursement Rates: To address financial barriers that limit access to necessary medical and dental care.
3. Enhance System Navigation: To partner with the state and advocates to simplify and improve the integration of healthcare and social services.

Analysis of Current Healthcare Challenges and Disparities

Initial research, including surveys and interviews with individuals with IDD and healthcare providers, has identified significant barriers to achieving SDG 3 and SDG 10 in Wisconsin.

Deficiencies in Patient Care and Provider Training

Data reveals a critical gap in patient-provider relationships. A 2024 survey indicated that only 54 percent of respondents with IDD felt their healthcare providers gave them sufficient attention. This is exemplified by the testimony of Drew, a Special Olympics athlete with epilepsy, who reported that his neurologist “doesn’t believe” him regarding his seizures, insisting on third-party verification. “I know my body,” Drew stated. “I’m the best resource when it comes to my seizures.”

Systemic and Financial Barriers to Access

Significant disparities exist in healthcare utilization. Individuals with IDD were found to be 33% and 49% more likely to lack annual primary and specialty care visits, respectively, compared to those without disabilities. These challenges are compounded by financial obstacles.

• Medicaid Reimbursement: Low reimbursement rates for providers often fail to cover the cost of care, limiting the availability of services.
• Private Insurance and Care Avoidance: The experience of Travis, another athlete, highlights long-term impacts. His past reliance on Medicaid for dental care, where only extractions were adequately reimbursed, has led to a persistent fear of dentists. “I’m still fearful of going to the dentist… because they don’t know how to deal with people with intellectual disabilities,” he explained.

Navigational Complexity of Support Systems

Individuals with IDD must often navigate dozens of disconnected systems for healthcare, social services, and employment. Hershner described this landscape as “painfully overwhelming” and “very confusing,” noting that these systems were not designed to work effectively for the people they are meant to serve.

Implementation and Path Forward

Special Olympics Wisconsin has initiated several actions to address these challenges and advance its strategic objectives.

• Educational Outreach: Leveraging a 2023 state grant, Special Olympics Wisconsin athletes have already trained over 1,300 medical students and providers on how to work effectively with individuals with IDD.
• Stakeholder Collaboration: The organization is actively engaging physicians, nurses, physical therapy professionals, and policymakers in conversations to build a coalition for change.
• Advocacy and System Reform: The initiative will continue to advocate for improved Medicaid policies and work with state partners to streamline the complex web of support services.

The success of this initiative relies on a concerted, collaborative effort. As Hershner concluded, “Together, we can improve the lives of individuals with IDD here in our state and be leaders in this movement across the globe to make lasting and transformational change.”

1. Which SDGs are addressed or connected to the issues highlighted in the article?

SDG 3: Good Health and Well-being

The core of the article revolves around improving healthcare quality and access for people with intellectual and developmental disabilities (IDD). The initiative by Special Olympics Wisconsin directly targets health outcomes, access to services, and the quality of care for a vulnerable population, which is central to SDG 3.

SDG 10: Reduced Inequalities

The article explicitly highlights the disparities in healthcare experienced by people with IDD compared to those without disabilities. The initiative’s goal is to reduce these inequalities and promote the inclusion of people with IDD in the healthcare system, ensuring they have equal opportunity and access to care. The article states people with IDD are “33 percent and 49 percent more likely to lack annual clinic evaluations and management visits for primary and specialty care,” which is a clear inequality of outcome.

SDG 4: Quality Education

A key objective mentioned in the article is “strengthening medical education to ensure health professionals can effectively care for patients with disabilities.” This focus on training and educating medical students and providers is a direct link to SDG 4, specifically in the context of professional development and acquiring skills for inclusive practices.

SDG 17: Partnerships for the Goals

The entire effort described is a multi-stakeholder collaboration. The article mentions the “Rosemary Collaboratory” as an international initiative and details how the Wisconsin chapter is working with “policy makers, health care providers and advocates.” This collaborative approach is the essence of SDG 17.

2. What specific targets under those SDGs can be identified based on the article’s content?

SDG 3: Good Health and Well-being

1. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

   The article’s focus on improving access to primary and specialty care, addressing issues with Medicaid reimbursement, and enhancing the quality of care (e.g., ensuring providers listen to patients) directly relates to achieving universal health coverage for people with IDD. The story of Travis, who avoided dental care due to past experiences with Medicaid and fear, illustrates challenges with both financial protection and access to quality services.

SDG 10: Reduced Inequalities

1. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.

   The initiative aims to empower individuals with IDD within the healthcare system. Drew’s statement, “I know my body. I’m the best resource when it comes to my seizures,” reflects a call for empowerment and inclusion in his own healthcare decisions, which his provider was denying him.

2. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.

   The article highlights significant “inequalities of outcome,” noting that people with IDD are far more likely to miss annual clinic visits. The effort to improve Medicaid reimbursement rates and partner with policymakers is a direct attempt to change policies and practices that lead to these unequal outcomes.

SDG 4: Quality Education

1. Target 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for… human rights… and appreciation of cultural diversity…

   One of the project’s three main objectives is “strengthening medical education.” The article provides a concrete example of this in action: “a 2023 state grant already allowed Special Olympics Wisconsin athletes to train more than 1,300 medical students and providers on how to work with individuals with intellectual and developmental disabilities.” This training provides skills that promote the human right to health for a diverse group.

SDG 17: Partnerships for the Goals

1. Target 17.17: Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships.

   The article describes the initiative as a “team effort between stakeholders, ranging from state policymakers to health care providers.” It details the partnership between Special Olympics Wisconsin (civil society), state policymakers (public), and healthcare providers (public/private), which perfectly aligns with this target.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

SDG 3: Good Health and Well-being

1. Target 3.8
   • Indicator (Implied): Proportion of people with IDD receiving essential health services. The article provides a baseline disparity: “Persons with intellectual and developmental disabilities were 33 percent and 49 percent more likely to lack annual clinic evaluations and management visits for primary and specialty care, respectively, than those without disabilities.” Progress would be a reduction in this gap.
   • Indicator (Mentioned): Patient satisfaction and quality of care. The article cites a “2024 survey of people with intellectual and developmental disabilities in Wisconsin,” where “only 54 percent of those people with IDD reported that their health care providers gave them enough attention to meet their needs.” An increase in this percentage would indicate progress.

SDG 10: Reduced Inequalities

1. Target 10.3
   • Indicator (Implied): Reduction in the disparity of healthcare access. The aforementioned statistic that people with IDD are “33 percent and 49 percent more likely to lack annual clinic evaluations” serves as a direct indicator of inequality of outcome. Measuring the reduction of this disparity over time would track progress.

SDG 4: Quality Education

1. Target 4.7
   • Indicator (Mentioned): Number of professionals trained. The article states that the program has already trained “more than 1,300 medical students and providers on how to work with individuals with intellectual and developmental disabilities.” This is a direct output indicator.

SDG 17: Partnerships for the Goals

1. Target 17.17
   • Indicator (Mentioned): Number of organizations and chapters participating in the partnership. The article mentions that “Wisconsin is one of 11 Special Olympics chapters worldwide — and one of just three in the United States” participating as a “health system assessment site.” This quantifies the scale of the partnership.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article. In this table, list the Sustainable Development Goals (SDGs), their corresponding targets, and the specific indicators identified in the article.

Source: wpr.org