Testimony to
the
SB 218: Money
Following the Person
Chairman Umbarger and
members of the Committee, I am very pleased to be here today to provide
testimony regarding SB 218. 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.
CILs are also the points
of entry for the Home and Community Based Services (HCBS) Physical Disabilities
waiver. We provide most of the case management services for persons on the
waiver, which means we are involved in putting together the plans of care for
each person.
At the
beginning of FY 2004, the state of
This same
concept has existed in law for Kansans with developmental disabilities since
passage of the 1995 Developmental Disabilities Reform Act. This Act provides
that anyone who lives in a state developmental disabilities hospital and
chooses to live in the community will have funds follow them from the state institution
to HCBS services. It is now time for money to follow people from any
facility-based setting to community-based services.
To ensure
Kansans will continue being able to choose to move from nursing homes into the
community, KACIL has proposed this legislation to 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 way in which
This bill is
about good public policy. It simply makes sense to allow people who need
long-term care services to receive them in the setting of their choice.
Medicaid regulations allow anyone who is Medicaid-eligible to receive long-term
care services in a nursing home. A nursing home is a valid and good choice for
services for many people. But, not everyone who needs long-term care services
funded by Medicaid would choose to live in a nursing home. SB 218 allows people
to make a choice between either service setting.
The mechanics
of SB 218 would only apply when there is a waiting list for Frail Elderly
and/or Physical Disability waiver services, because it allows people in nursing
homes to choose to live in the community without having to wait for services.
Currently there is no waiting list for the Frail Elderly waiver. The number of
people on the Physical Disabilities waiver has been steadily declining over the
past year as more people have begun receiving services. So, it is conceivable
to see a day in the not so distant future when there is no waiting list for
either waiver. If that day arrives, SB 218 would not be needed. But, if
enacted, SB 218 would always be there as both the public policy for the state
of
When the
proviso was introduced in FY 2004, it was a collaborative effort between
Centers for Independent Living, SRS, and the Department on Aging. Since it was
a new concept, it was developed as a sort of pilot project. A cap of 75 people
per year who would be allowed to use the money following the person mechanism
was included in the proviso. In the first year, the number of money following
the person slots was divided between the Frail Elderly and Physical
Disabilities waivers. This meant roughly 37 elderly people and 38 people with
physical disabilities were able to access this mechanism in the first year. We
are mid-way through the second year of the proviso. Since there is no waiting
list for Frail Elderly waiver services, all 75 of the slots were allocated to
the Physical Disabilities waiver. As of
This year, SB
218 was developed by Centers for Independent Living, with the help of Sen.
Derek Schmidt. As we have begun working on the details of the bill, we have
begun developing a collaborative relationship with representatives of nursing
homes across the state. It is no small feat for nursing homes and Centers for
Independent Living to work toward agreement on such an issue. I believe it is
safe to say that the Centers for Independent Living and the nursing homes
generally believe it is the right public policy to offer people a choice
between nursing home and community-based services. I believe it is also safe to
say that advocates on both sides of the fence believe the processes of
identifying people who may want to move to the community and successfully
facilitating that move could operate more smoothly. To that end, KACIL is
initiating meetings between the Statewide Independent Living Council of Kansas,
the Kansas Association of Area Agencies on Aging, the Kansas Health Care
Association, and the Kansas Association of Homes and Services for the Aging. We
want to work more closely together now and in the future to ensure all the
parties can work together amicably to help people who wish to transition to the
community. When the proviso was first put into place, SRS and the Department on
Aging brought together advocates from the independent living and the nursing
home arenas to develop the policy described in line 31 of SB 218. This marked
the beginning of these groups working together on a unified public policy. We
want this collaboration to continue, and we plan to work with our colleagues to
develop processes which can ensure transitions take place smoothly now and in
the future.
Because the
aim of SB 218 is to enact public policy which preserves the right of people to
choose to receive long-term care services in the setting of their choice, KACIL
now proposes an amendment to the bill which removes the cap of 75 people per
year who are allowed to make the transition. Public policy should be based on
what is right for the people of the state of
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.
On behalf of
the members of KACIL, I ask for your support of SB 218 and our amendment. This
legislature has already shown its commitment to providing a cost-effective
choice in long-term care services for Kansans. I ask you to continue showing
that commitment by supporting this bill.
Thank you for
the opportunity to provide this testimony. I am happy to stand for any
questions.