Senate Ways and Means Sub-committee on KDOA
Senator Jean Schdorf, Chair
February 28, 2008

Thank you for the opportunity to speak to you today regarding the Kansas Department on Aging budget.  I am Jennifer Schwartz, the Executive 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 all of the BTC budget requests and policy initiatives.  KACIL would like to highlight a few items on the 2008 Governor’s Budget Recommendations and the KDOA Enhancement budget request.

Governor’s Budget Recommendation
KACIL supports the Governor’s Budget Recommendation for FY 2008 KDOA Budget.  The budget provides the funding needed to add dental services and denture coverage for individuals on the Frail Elderly (FE) waiver.  The funding request includes funding for preventative dental services and dentures.  KACIL has advocated for these essential services for years and we strongly support these enhancements.  Dental services are some of the most important preventive medical services available, but without access to them, individuals who are elderly on the HCBS-FE waiver are not able to stave off many preventable medical conditions.  We commend the Governor and KDOA for including this important service in the FY 2008 budget, and we urge the Committee to ensure elderly Kansans do not have to go without preventive dental services for another year.

2008 KDOA Enhancement Budget Requests
KACIL would like to take a moment and thank Secretary Greenlee for her 2008 Enhancement Budget Requests and the way that she worked with stakeholders and constituents in Kansas to put the departments budget requests together for 2008.  KACIL has participated in many of KDOA

stakeholder initiatives that we believe look at rebalancing the Long term care system in Kansas.  Many of these workgroups and initiatives are working to create the infrastructure needed to establish strong community based services.  Some of these initiatives are reflected in the KDOA 2008 Enhancement Budget Request, such as:  

1. HCBS/FE 24 Hour Service Delivery

Currently, individuals that qualify for the HCBS/FE waiver are limited to 8 hours per day of in home supports.  The need for short-term expanded in-home supports is not available.  There are situations, although rare, that individuals may require 24 hour support, 12 hours per day of personal assistant services, and 12 hours of ‘night support’.  Currently, offering 12 hours of personal assistant services on a plan of care goes against FE Waiver policy.  In order for KDOA to make this policy change, they requested additional funding to support those situations where an individual might need constant support.  These might be individuals transitioning from a nursing home, or going through an acute stage of disability or injury. 

1. HCBS, Expedited Services

KDOA requested funding to support statewide implementation of expedited direct services to individuals, age 65, in hospitals, nursing facilities or the community who would otherwise wait up to 45 days for completion of Medicaid eligibility determination.  During this time frame some individuals end up being referred to a long term care facility because the paperwork process is too long.  A stakeholders group did work on creating a one page form to quickly determine if a person will likely be eligible for Medicaid services, and can get services and supports going instead of the person transitioning to a nursing home for a brief amount of time. 

1. HCBS, Rapid Referral and Case Management

KDOA requested funding to support an enhancement to augment the current CARE program by supporting a rapid referral and early intervention case management system between hospital discharge planners and community-based case managers.  This request was based on results of a pilot project funded by a Real Choice Systems Change grant that was awarded to the North Central-Flint Hills Area Agency on Aging.  According to the reports conclusion, early intervention at hospitals, by case managers, proved beneficial in being bale to set up services before the customer went home and made for a smoother transition between settings.  The ability to set up services also was effective in preventing some individuals from going directly to a nursing facility.

KACIL believes that all of these enhancement requests above work to empower Kansas seniors to make choices about their lives.  KACIL supports these item requests and know they are next steps for Kansas to take in our efforts of rebalancing our long term care system.

Conclusion
KACIL would ask for your thoughtful consideration on the items highlighted in our testimony.  Quick access to community based long-term care supports and services is essential to provide Kansans with disabilities and those who are aging the services they require.

I would be glad to stand for any additional questions.

 

Jennifer Schwartz
Executive Director