Testimony to
Senate Ways and Means Sub Committee on SRS
Senator Steve Morris, Chair
February 11, 2002
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. We recognize that there are no easy choices. All of the people who will come before you today have priorities and we know you cannot meet them all.
KACIL asks that as you make decisions on this budget; take into account that real people are affected by cuts in services. We really believe there is no more administration cuts to make in SRS. We can assure you that SRS does not travel anymore. Our staff and consumers have to come to Topeka for trainings, so we know there is no big travel budget.
KACIL supports the Governor’s revenue enhancement package as described in his State of the State address. KACIL recognizes that reinstating revenue enhancements are not an easy task for legislators, but without increases, the Secretary and her staff identified the terrible options that will occur.
KACIL has been working with the Disability, Elderly and Workers Coalition (DEW) since last November to attempt to educate the public on the need for revenue enhancements to adequately fund social services, aging and education. We have worked with SRS for many years and do not see the ability for them to make more major cuts in their budget without cutting services to the neediest populations.
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. However, there are too many people on a
waiting list for services. As of
December 2001 there were 412 people on the waiting list and they wait an
average of 15 weeks.
You have been reminded
that community based services are less expensive. You know that you will be paying at least $2,310.00 per month for
each individual who has to enter a facility.
You will not save, but will spend more money in a facility.
By not funding this
waiting list, your only hope is that people will die at home rather than go to
a facility. That is the only way to
save money. What are the priorities for
long-term care? What are the priorities
for citizens of this state? Is it to
hope they will die, or to ask people to pay a penny more for gasoline?
We support the Governors enhancements that
would simply reduce the amount of time people are waiting to receive needed
services such as getting out of bed, personal hygiene and eating.
As people wait longer
periods to get services, the potential for secondary conditions increase and
their medical costs increase. It costs
the state approximately $11.00 per hour to have an attendant go and move
someone in bed or in their wheelchair.
Without that service, people develop decubitus ulcers. They require acute care stays and ongoing
treatment. The last time I checked, a
very small tube of ointment to help heal an ulcer costs over $200.00.
RECOMMENDATION:
Add $2.5 million to the PD Waiver waiting list. This will keep the list at
about 400 people. With that funding
they will wait for services for approximately 15 weeks.
SRS has already reduced the payments for attendant wages by over 90 cents per hour. The immediate result is many of the CIL’s report that they have had to fire staff who provide supports to consumers and attendants on the waiver. This can have an impact on the quality of the services. Oh, and by the way, many of these staff are people with disabilities who without employment will have additional needs.
We are very proud of the quality we have provided on the HCBS Waiver. We have had fewer turnovers than other waivers with regard to attendants.
The long-term results of this reduction will be that attendants will be paid lower wages and ultimately it will be very difficult to find people to perform tasks that allow individuals to remain at home. Turnover will be higher and the quality will be diminished.
RECOMMENDATION:
Reinstate the cuts made January 1st. This will cost an additional
$1.6 million dollars for FY 2003. If
you do not reinstate that funding, you will save money in the short run and it
will cost more money later.
Other recommendations KACIL would make to you today include the following:
1. Direct SRS ands DOA to develop a community checklist format that would be adapted for each community. It would require the Case Manager or Independent Living Specialist who is developing the Plan of Care to demonstrate that they attempted to use community services before writing a plan of care. They would have to demonstrate why that individual could not use the services available in the community. The checklists would be reviewed to ensure that they were properly reporting success and failures. Accumulation of unmet needs could be a catalyst for identifying community deficits that should be addressed by the CIL’s.
2. Review funding sources for people with developmental disabilities. There is a strong disincentive for people with mental retardation and other developmental disabilities to become independent. The majority of all funding is tied up in matching the waiver using Title XIX funds. The regulations written around that funding source give very little options for community providers to be reimbursed for teaching people to become independent. Rules and regulations encourage and support dependency models.
KACIL recommends a review of programs that were implemented by community providers prior to the development of the current funding systems. There were programs out there that fostered independence. Direct SRS to provide funding for model programs that are effective at promoting independence. They work, but they must be funded. KACIL believes that current funding can be used. It will require a change in regulations and in thinking.
We must also look at the invasive and sometimes discriminatory regulations used as part of the DD Reform Act that prevent Community Based Agencies from being reimbursed for providing real integrated services for people with developmental disabilities.
Finally, KACIL recommends that you set a goal to close at least one more institution for people with developmental disabilities and use money to provide community based services.
4. KACIL requests that this committee add the same language that the Subcommittee on Aging added to ensure that consumers on the PD waiver have the option to remain on that waiver when they turn 65. We request that whatever budget amendment needs to be made gets accomplished so this option is available beginning July 1st, 2002.
This is a cost neutral request. The DOA did a study last year and determined that there is no significant difference in the cost of providing services on the FE or PD Waiver.
It is a simple book keeping change that will significantly impact the lives of people with physical disabilities. Please do not make 80 more people have to change their lives because of a bookkeeping change.
Thank you for the opportunity to address you today.
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