Testimony to
House Social Services
Budget Committee
February 14, 2005
Chairwoman
Landwehr and members of the Committee, thank you for the opportunity to provide
this testimony to you regarding the budget for the Kansas Department of Social and
Rehabilitation Services (SRS). My name is Tanya Dorf, and I serve as the Chair
of the Governmental Affairs Committee for the Kansas Association of Centers for
Independent Living (KACIL). I am also the Executive Director of Independence,
Inc., one of the twelve Centers for Independent Living (CILs) KACIL represents.
Centers
for Independent Living provide services to people with disabilities of all
ages. CILs also provide information and assistance to businesses and other
entities in the community to increase opportunities for people with
disabilities to live, work and participate in all aspects of community life. We
advocate at a state and national level for the rights of all people with
disabilities to live in the communities of their choice.
Governor’s Budget Recommendation
KACIL
supports the Governor’s Budget Recommendation for the FY 2006 SRS budget. The
budget provides funds for the waiting lists for the Home and Community-Based
Services Developmental Disabilities and Physical Disabilities waivers. Much
progress has been made in the past two years to move people off of the waiting
lists and into services in their homes and communities. The amount of time
people wait for services has also been reduced. But, until all Kansans with
disabilities are able to choose between nursing facility or institutional-based
services and community-based services and receive those services in a timely
manner, our work is not done. This is why we would wholeheartedly support
incorporating the waiver services into the consensus caseload estimating
process, much like all other Medicaid and nursing home services are today.
The Governor recommended using one of the agency’s proposed reductions as a way to actually increase the number of persons served on the Physical Disabilities waiver. The proposal was designed to reevaluate the amount of services some people who self-direct their services receive to ensure they do not receive more services than necessary. The Governor, then, designed her budget to put the funds saved through this process back into the waiver, thereby allowing approximately 170 additional people to begin receiving services in FY 2006. KACIL is supportive of any efforts to provide services to additional people who are waiting
for them. But, we ask the Committee to ensure that if this portion of the budget is adopted, attention is paid to ensuring no one loses services he or she truly needs. Taking services away from one group of people to serve another group carries with it the potential to be unfair to everyone. We believe the agency plans to include CILs in the planning process to implement this portion of the budget. We urge the Committee to ensure CILs are an integral part of this process, as we are the organizations who are in the best position to know if people are receiving the amount of services they need.
KACIL also
supports the three percent rate increase for services provided under the
Developmental Disabilities waiver. KACIL supports increased rates for direct
care services, as the people who provide these services are some of the lowest
paid in the state’s economy, and the rates paid under the Developmental
Disabilities waiver are extremely low. As important as this rate adjustment is
though, it is important to remember that reimbursement rates paid for similar
services should be equal among all of the HCBS waivers. The rates paid for
services such basic services as personal assistance vary in both amount and
type of payment, depending upon whether they are provided through the
Developmental Disabilities, Physical Disabilities, Frail Elderly or Traumatic
Brain Injury waivers. 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.
One of the
SRS enhancements was to replace existing fee funds in the amount of $500,000 in
the HCBS Traumatic Brain Injury waiver with SGF. The Governor did not recommend
this funding shift.
Two other SRS
FY 2006 enhancement requests were to provide dental benefits to persons who
receive HCBS waiver services and to all adults who are eligible for Medicaid.
Dental services are some of the most important preventive medical services available,
but without access to them, elderly people, people with disabilities and people
with low-income levels are not able to stave off many preventable medical
conditions. This is a service Kansans have not had for many years, and it is
time to restore it. It is critical that the Committee and the agency remember
how important dental services are and find a place in the budget for the
services as soon as possible.
Another issue KACIL would
like draw the Committee’s attention to is the base level of funding provided to
Centers for Independent Living to provide the core independent living services.
There are two cornerstones to the business of Centers for Independent Living.
First, CILs must have a staff and a board of directors that is made up of 51.0
percent people with disabilities. This provision ensures the mission of the CIL
is carried out by and for people with disabilities. The second cornerstone is
the set of five core services each CIL must provide. These services are:
§
Information and
referral
§
Peer networking
§
Independent
living skills training
§
Advocacy
§
Deinstitutionalization
CILs provide these
services to any person with a disability who requests them. Frequently the core
services are only needed by persons with disabilities for short amounts of
time, and the core services are often contribute to ensuring that people with
disabilities continue to live independently in their communities.
Resources
are, of course, required to provide these important core services. But the
amount of SGF dollars allocated to CILs in
KACIL
proposes a minimum level of $250,000 per CIL be allocated. The base funding for
CILs in the state of
In the agency’s budget overview
last week, they highlighted the success of the Money Following the Person
project that was begun in FY 2004. This is a very simple proviso which was
included in the FY 2004 and 2005 Omnibus Budget bills. The proviso ensures
money will follow people when they transition from nursing homes to HCBS
services. This is truly one small change that has had a significant impact in
the lives of the people who have made the transition out of nursing homes. It
has not affected the ability of other people to choose nursing home services at
all. KACIL is grateful to this Committee for its support over the last two
years for this policy.
KACIL now is working with
members of the Legislature to introduce a bill this Session which will put the
Money Following the Person concept into law. Transitioning this concept from
proviso to law will affirm that it is the policy of the state to allow people
who live in nursing homes to choose community-based services. It is also a key
way in which
During the Committee’s
discussions last week, you talked a lot about Medicaid, its cost-effectiveness
and the importance of the services it provides. In a speech on February 1, new
U.S. Health and Human Services Secretary Mike Leavitt said,
“We can ensure that seniors and
people with disabilities get long-term care where they want it. The President's
New Freedom Initiative points us in the right direction. Home care and
community care can allow many Americans with disabilities to continue to live
at home, where they can enjoy family, neighbors, and the comfort of familiar
surroundings. Medicaid should not force these people to live in institutions.
Just as importantly, we can serve more people.”
As we all know, it’s hard to tell where the federal government is
heading on Medicaid policy, but it is very good to see the new Secretary
acknowledging that choice in where people receive long-term care services is
the right policy direction.
Conclusion
Thank you for
the opportunity to provide testimony about the SRS budget. I would be happy to
stand for any questions.
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