March 18, 2003

The Appropriations committee heard most of the report from the SRS Subcommittee today.  Some of the high (or low) lights include:

1. They seem to be supporting the concept of reducing CDDO's from 28 to 13 or fewer and that CDDO's would no longer provide direct services, similar to language in SB 242.

2. Recommend exploring the "future role and function" of state Mental Health and MR/DD Institutions and ICF/MR's. Discussion should include:
a. identifications of models that would provide services in a community based setting rather than a state hospital and the impact those models may have on these facilities;
b. exploration of public private partnerships;
c. identification of alternative models for facilities, and the financing implications of a different model of service, including the need to move existing funding from hospitals to community based services and
d. Identification the financial, policy and program implications.

3. Added a proviso creating a Hospital Closure Commission for possible closure of a MH and MR/DD hospital.

4. SRS look at more cost effective means of purchasing Durable Medical Equipment and report back. (...Gina's note...seems to me our problems with purchasing come from Dept. of Admin., not SRS, but what do I know)!

5. Family Preservation should be included in Caseload estimates. (That means they are less likely to be cut as across the board cuts occur.)

6. Interim study to develop incentives to encourage people to purchase long term care insurance.

7. SRS should develop "service Access Points" prior to closing 22 local offices.

8. Contract with Kansas Legal Services to provide case management services and legal assistance for GA and TANF adults, as well as disabled children served by SRS who are seeking SS benefits.

9. No further cuts to foster care or adoption contracts.

10. They added language to say that SRS and Aging has taken enough cuts. If any additional funds become available they would first go to DOA and SRS. If any more cuts have to occur, SRS and Aging budget should be exempt.

They also referred some items to Omnibus. They include:

1. Review capping HCBS waiver payments. I think this means if your POC is over what the average cost is in an NF, you would have to go to an NF.

2. Review increasing PASSAR (They really mean Level of care score) from 26 to 32 and grandfather in the increased scores.  (whoops, thought they weren't gonna cut SRS any more. I guess they meant after this!)

3. Review policy of separating spousal income for waiver eligibility and report back.

4. Review combining all waivers into one. Three services would be available, PAS, Training and Assistive Services.

5. Review legibility for MR/DD Waiver.

6. Review and recommend legislation to allow the agency to place a lien on a Medicaid recipients home after they have been in an NF for one year or when they begin receiving HCBS services...In addition, explore the possibility of requiring reverse mortgages on property for persons in NF's to assist in paying for their care.

7. Look at legislation to prevent hiding of assets to achieve Medicaid spend down.

That's the bad and the bad of it.  More to come, I'm sure.  More incentive to get PAS as part of the Working Healthy program and get folks off Medicaid whenever they can. For those who can't, and I know there are many, we'll keep seeing erosion of services, limitations on who can get services until we are the people who elect officials.

Gina 

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