House Social Service Budget Committee- SRS Budget
Representative Bethell, Chair
February 8, 2007

Thank you for the opportunity to speak to you today regarding the SRS budget.  I am Jennifer Schwartz, the Director of the Kansas Association of Centers for Independent Living (KACIL).  KACIL represents Centers for Independent Living (CILs) across Kansas.  KACIL is driven by the following mission statement:  To coordinate efforts within Kansas and the United States to the extent that these efforts will further independent living for all.  KACIL will advocate for the civil rights of Kansans with disabilities. 
 
Centers for Independent Living provide services to people with any disability, of all ages.  CILs provide information and assistance to businesses and other entities in the community to increase opportunities for people with disabilities to live, work, and play in all aspects of community life.  

KACIL is a member of the Big Tent Coalition (BTC) and supports the BTC Budget Requests and policy initiatives.  We believe all of these items are necessary to build our infrastructure of community based services, and provide individuals the necessary stepping stones to productivity and independence. 

Governor’s Budget Recommendation
KACIL fully supports the Governor’s Budget Recommendation for FY 2008 SRS Budget. 

Base Funding For CILs
Included in the Governor’s Budget Recommendation is $800,000 for base funding for Centers for Independent Living (CILs).  This base funding provides five core services at each Kansas CIL to any individual with a disability:

• Advocacy
• Information and Referral
• Peer Support
• Independent Living Skills Training
• Deinstitutionalization 

Often core services are only needed by persons with disabilities for a short amount of time.  In many situations these core services mean the difference between maintaining independence in the community and moving to a more restrictive environment. 

In addition CILs offer a number of other services, generally depending on specific needs of consumers and lack of availability elsewhere in the community.  Examples of additional services that CILs offer are equipment loan programs, computer training, employment services, housing assistance, attendant care payroll services, and a variety of others.  

There are a variety of organizations that serve people with disabilities in Kansas; community developmental disability organizations, mental health centers, home health agencies, nursing homes, senior centers, rehab hospitals, group homes, and so on.  These agencies and organizations provide valuable services and are important in the network of services that assist people with disabilities. 

What makes Centers for Independent Living significantly different from these other organizations is that CILs have substantial involvement of people with disabilities making policy decisions and delivering services.  Why this emphasis on control by people with disabilities? The philosophy behind independent living is that the ones who know best what services people with disabilities need in order to live independently are people with disabilities themselves.  CILs are also unique because they provide services that fill in the gaps in people’s lives. Thus, a person may access a mental health center for counseling, but access a CIL for independent living skills training

Centers for Independent Living in Kansas served more than 18,700 individuals in 2006.  Many of the individuals that walk through the door of a CIL are likely to receive more than one service of the multitude of services offered.  What a cost effective investment this is for the state of Kansas.

The Governor’s recommended budget includes a request to bring each CIL up to the base funding level of $250,000.  This amount is necessary to sustain a free standing CIL offering the five core services. 

As Kansas shifts its view of Long Term Care supports and services, it is important that we identify cost effective solutions to serve individuals in the communities where they choose to live.  An effective stable network of Centers for Independent Living across Kansas is one important key to the infrastructure that must be cultivated to sustain this shift.   

HCBS Personal Assistance Services Rate Parity
KACIL believes the rates paid for similar services should be equal among the HCBS waivers. The rates paid for services such as personal assistance vary in both amount and type of payment depending on whether they are provided through the Developmental Disabilities, the Physical Disabilities, the Frail Elderly or the Traumatic Brain Injury waiver. The level of staff providing the service and the type of service itself, however, does not vary greatly depending on which waiver pays for the services.

Reimbursement rates for the various HCBS waivers Personal Assistance Services (PAS) are different depending on the waiver an individual qualifies for.  The current reimbursement rates are as follows:
Traumatic Brain Injury PAS rate = $13.25/hour
Physical Disability PAS rate = $11.94/hour
Developmental Disability PAS rate = $11.64/hour

PAS is the same service provided on each of the waivers.  This is assistance with things such as dressing, bathing, eating, or cleaning house.  The service is the same whether it is provided to someone with a traumatic brain injury or someone with a developmental disability.  A consistent, hourly rate across these three waivers would be equitable to anyone needing PAS on any waiver. 

The total amount required is $7.2 million in state general funds to achieve parity in the reimbursement rates for personal assistance services provided through the HCBS waivers.

Home and Community Based Services Waivers
KACIL supports additional funding to home and community based services waivers to continue efforts to decrease, and eventually eliminate waiting lists.  The people CILs serve often qualify for Kansas Medicaid and receive services through the various HCBS waivers in our state.  These waivers are vital answers to the question of needing support services.  If a particular waiver has a waiting list, the person might ultimately end up in a more costly setting such as a nursing home.  Kansas needs to make a commitment to choice and independence through providing access to community based waivers if this is what a person chooses.  We must move to the next phase of a commitment to No waiting lists, and making sure that our public policies always offer a rotating door for someone that might need acute care or rehabilitative services, for a period of time, and the provide the door, from the inside, for the person to get out of the nursing home just as easily as they came in. 

Vocational Rehabilitation KAN-Sail
KACIL would like to provide some comment on the Vocational Rehabilitation (VR) portion of the SRS budget.  VR currently administers funds for KAN-Sail, a program that provides services to older adults that have lost their vision.  Programs such as these can again be vital in individuals learning to function in their community environments and remain independent.  This program is currently stretched and unable to reach all of the rural communities in our state.  It would be a recommendation from KACIL that VR be given time and direction to look at this program and evaluate the way to most efficiently serve this group of individuals.  We would suggest that VR spend time in the next year studying this program and gather information on other options of providing the services.

Conclusion
KACIL would ask for your thoughtful consideration on the items we have highlighted.  We recognize your job is enormous, and want stand ready to continue our work with the state of Kansas on adequately forming this infrastructure to long term care supports and services.  Quick access to community based long-term care supports and services is essential to provide Kansans with the services they require.

I would be glad to stand for any questions.

Jennifer Schwartz
Executive Director