Testimony
to
Senate Ways and Means Committee
Senator Steve Morris, Chair
January 23rd, 2001
My name is Gina McDonald and I represent the Kansas Association of Centers for Independent Living (KACIL). KACIL represents 13 Centers for Independent Living (CIL’s). Centers provide services to people with disabilities of all ages. Centers for Independent Living also provide assistance to businesses and all other entities in the community to assist them in offering services to people with disabilities. We advocate at a state and national level for the rights of all people with disabilities to live in the communities of their choice.
Thank you for the opportunity to speak to you today regarding the SRS budget. KACIL is aware that you have a difficult job and that there are no easy choices. All of the people who will come before you today have priorities and we know you can’t meet them all. The programs we ask you to fund will act as seed money to keep people at home, help them become more independent, and assist them in finding employment that will lead to freedom from state support. As our “theme” states, if you fund these programs, “Oh, the Places We’ll Go”
1a. SRS HCBS – PD WAIVER Budget.
As you know, KACIL believes that all Kansans should have the option to live and receive services where they choose. The Home and Community Services Waiver offers that option for many individuals, but too many are now on a waiting list for services. As of January 1st there were 277 people waiting for services, and that number will rise. These numbers include only those individuals who have been determined eligible and are waiting for needed services now. It is currently taking an average of 13 weeks from the date of assessment for people to receive services.
Those individuals could choose to liquidate everything they own and go into a nursing facility. The state would be required to pay for services for them in a nursing facility with no waiting time. But they have chosen to remain at home, and struggle each day to accomplish what you and I
might take for granted such as getting out of bed, getting dressed and feeding ourselves.
Once again, we come to you asking you to provide services to those who are most in need in the community. If they are eligible, pay for community-based services as you do for institutional care. Don’t make people wait to get assistance to get in and out of bed. Don’t make people wait for assistance that will prevent more serious medical services later that you will have to pay for in a facility or an emergency room.
RECOMMENDATION:
KACIL commends the Governor and SRS for adding an additional $5 million dollars to the Waiver for people with Physical Disabilities. We request your acceptance of his recommendation. We recognize that the additional funding proposed by the Governor will still require a waiting period for services for about 100 people next year, but we believe that is reasonable.
According to SRS figures, if we were to fully fund the waiver for 2002, we would need an additional $1.2 million state general funds over the Governors recommendation to cover the waiting list for FY 2002. We do not request that at this time.
Finally, KACIL also requests that you provide full
funding for the MR/DD and Head Injury Waivers.
2. HCBS Policies.
A. KACIL asks that this legislature consider adding the following language to the policies for Home and Community Based Services. KACIL believes that this language would ensure compliance of the state with the Olmstead decision, and it would provide for fair and equitable treatment for all Kansans. It would force the state to look at the long-term care budget as a whole, instead of the piece meal approach now used. As those of you who have been working on this budget know, the following language will create an entitlement to community based services, just as we currently have an entitlement to institutional services.
shall be afforded the choice to receive appropriate services in the community in the most integrated setting.
B. We are very disappointed to report that for three years now we have come to you asking that people who are using waiver services under the physical disability (PD) waiver be afforded the same rights as those on the MR/ DD Waiver. That is when they turn 65, they be allowed to remain on the waiver that was designed to meet their needs.
We are aware that SRS has begun working on this issue and so far has not received positive responses from Health Care Finance Administration (HCFA).
Perhaps there is another way to look at and resolve this issue. KACIL believes that the waiver for people with physical disabilities (PD Waiver) meets the needs of all Kansans with disabilities, regardless of their age.
The Frail Elderly (FE) Waiver however does not appear to meet the needs of people who start out on the PD waiver and are forced to move to the FE Waiver when they turn 65.
Recommendation:
Require that SRS put together a task force to look at how
to combine services for all Kansans with Physical disabilities regardless of
age and make recommendations for change back to this committee no later than
May 2001. Changes could be written and
budget implications could be determined this summer and reports could be made
back to the 2002 legislature.
The task force should consist of no less than equal numbers of representatives from SRS, KDOA, AARP, AAA’s, KACIL, ADAPT of Kansas and the SILCK.
3. Medicaid Buy In.
KACIL supports this concept that in many ways resembles the positive aspects of Welfare reform. Advocates from Kansas worked hard to pass federal legislation that would allow states this option.
If the Kansas legislature implements this option, many people with disabilities can seek employment without risk of losing needed health insurance. KACIL will work with SRS to do everything we can to support the program, to encourage individuals with disabilities to seek employment and to remove barriers the state identifies which would deter from the program.
More Kansans seeking and finding employment will further strengthen the Kansas economy. New taxpayers will add to resources to the state.
People with disabilities will have the dignity of earning a salary and being part of the community. This program is a win – win opportunity.
Thank you for the opportunity to speak with you today. I’d be happy to attempt to answer any questions.