Chanute (June 11, 2002):

• 28 non-SRS stakeholders: Unidentified affiliation - 8; NFMH - 1; CDDO - 3; NF - 1; CIL - 8; Community Hospital - 2; JJA - 1; Assisted Living Center - 1; County Health Dept - 1; CMHC- 1.
• Newspaper reporter - 1.

Questions and Comments:

• Comment: the state has done a great job helping her; she had nothing and with help is now doing wonderfully. Commented that she does not "need a lot" and does not want to take too much as others might need it, but she is grateful for the help she has received.
• Clarification whether "tobacco money" refers to the lawsuit.
• Will the medical program still cover per prescription and will additional medicines become eligible for payment.
• Why is it so hard for an individual with physical disabilities to access vocational rehabilitation services in Neosho, Allen, and Woodson counties, when they are able to work or be accommodated in a work setting?
• Is there a waiting list for VR services in southeast Kansas?
• Will medication needs and treatments become like the present SRS dental services for consumers with a medical card, i.e. nonexistent?
• Individuals with disabilities who are on a low/fixed income and take 10 - 20 different meds a day will not be able to afford the co-pay increase.
• All those girls who stay on SRS and have 3 - 4 babies should stop that. That costs more which could be used for other things [programs?].
• One of the proposals that really gets me upset is taking the rights away from someone who is going to die and will die in a home where they don't know their way around or anything about it. Hospice is something that reminds one of home and hope in their final days in this world. No one wants to die alone. Even if it is just a worker, we do build relationships with our customers and we do care. Being a P.C.A. we can provide more one-on-one care instead of being just a number on a door, like in a nursing home or hospital.
• This might not make sense, but if you make more money, won't you spend more? Why not raise minimum wage to a more liveable wage so we can afford to spend and pay more in taxes. I am a P.C.A at SKIL and I very much enjoy working with people who need a hand in being free to do what they want when they want.
• I think we need to develop a statewide plan to allow individuals to develop an individual independent living health savings plan, so consumers can have a better self determined care plan to help pay all aspects of their health care. This is something to look at in long range plans.
• Look at state billing system and billing insurance in a timely fashion.
• Why do we allow people that are able to work remain on Medicaid. They never have to reimburse the state when they get money back.

Chanute (June 25, 2002):

• There were a total of 21 non-SRS participants; 12 CIL (SKIL, 3 CDDO, 1 Community College, 1 home care provider, 1 newspaper reporter, 2 NFMH, 1 County Health Department.

Identify the most significant (3-5) impacts and implications related to policy changes made by the 2002 Legislature in order to meet FY 03 budget reductions, in your community(s). List specific examples.

(In order of priority)

• Increased Rx co-pays will create severe financial hardship for consumers.
• Kansas has a history of taking care of their elderly. Service cuts will result in elderly at home without services and/or being forces into more costly NF when community based services could have kept them safely at home.
• Long waiting lists will preclude seriously ill from ever getting care.
• Increased time on waiting list costs more/doesn't save money as conditions left untreated will worsen, requiring more costly care.
• Changes make the poor pay even more - hitting the populations who can least afford it.
• Rx program changes will make pharmacist even more reluctant to serve the vulnerable population.
• In order to serve the most vulnerable, will have to let others go w/o services. Many of these "notch people" need case management and services to be at all productive in society.
• "Small" raises in costs to the poor are LARGE in proportion to their income.
• Concern of impact for SED kids going without services due to self-pay requirements.
• People won't be able to afford needed non-covered medicines when providers shift costs to make up for reduced reimbursement rates.
• A positive change: As of July 1st PD/Elderly at age 65 will have choice of CIL or AAA services.
• QUESTION: Has SRS cut its own employees pay? (Attempted to explain that total agency FTE has been cut approximately in half over the past few year, plus staffing vacancies that Areas/Institutions are having to endure, etc.)

Should the 2003 Legislature change any of the policy decisions that were made?

(In order of priority)

• Repeal decrease in attendant care reimbursement rate. Provide/raise funding available for in-home care. People get and stay healthier in the environment of their own homes. In home care is less costly.
• Put things back the way they were so people can stay at home with needs met.
• Do long team planning with eye toward incremental tax increases to keep up with program costs.
• Repeal some of previously granted tax breaks and but the money into reducing waiting lists.
• A written comment received: "We don't need tunnels under the state capital or a statue on the dome until we can take care of the citizens of Kansas and not take away programs from the poor, disabled, and elderly."

For consideration of the 2003 Legislature, what are the lowest and highest priorities for continued services? What service gaps exist?

(In order of priority)

• HCBS for elderly/disabled...provide more funding for PD persons.
• Transportation services for PD/FE...the decreases minimize individuals' ability to be independent. Maintain at least at the 2001 levels.
• Housing - persons moving from institutions to communities need housing. Need programs/grants to spur growth of housing for special needs populations.
• Availability of quality child care. Also, regulation of child care.
• Support CASA programs - more dollars to services in home; more like an entitlement program.
• Coordinate between MH/MRDD and other waiver services to better serve the dual diagnosed individual.
• Stabilize MR/DD budgets to provide continuity of funds and regulations so they can operate more effectively.
• POSITIVE: Family participation in JA, Family Preservation, HCBS is positive change - holds users responsible.

Identify what steps the community needs to take to prepare for the immediate budget crisis and what steps can be taken to deal with the policy changes likely to be taken by the 2003 legislature.

• Community education to help develop community supports and services; do away with stigmas.
• Communities feel their obligations are met by their tax contributions. Need to help understand that more is needed (than just paying the taxes).
• Maintain open lines of communication.
• Educate/encourage people to vote/vote in who support what we know we want/need.
• Educate employers to hire PD individuals.
• Have more community forums to increase awareness of needs - roving community forums. Invite Chamber of Commerce, business world, etc.
• Advertise in "friendly ways" to encourage all to come and speak up.
• Reach out to educate other partners.

Independence (June 7, 2002):

• 22 non-SRS stakeholders: NF - 4; CDDO - 2; Centers for Independent Living (staff/consumer) - 5; Kaw Valley Center - 2; CMHC - 5; OSH - 1; Unidentified affiliation - 1; Judge Canaday.
• Sen. Derek Schmidt.

Questions and Comments:

• GA time limits, is it a lifetime limit?
• What will happen if revenue continues to decline?
• Comment from SKIL consumer about concern for FY-03 and 04 and how the decline in tax revenues are hitting the most vulnerable; individuals having to wait to receive needed services to remain in own homes may have potential need for emergency medical services which actually increases the costs; "what has happened has not really solved the problem and won't save any money."

Independence (June 21, 2002):

• There were a total of 9 non-SRS participants; 3 County health Department/Home Health, 3 NF, 1 CMHC, 1 CIL, 1 OSH.

Identify the most significant (3-5) impacts and implications related to policy changes made by the 2002 Legislature in order to meet FY 03 budget reductions, in your community(s). List specific examples.

(In order of priority)

• Medication costs will force low income clients to forego purchase of needed prescriptions.
• Positive impact on children's mental health programs (comment from CMHC Director).
• Family Preservation - places more children at risk; increased cost for families will lead to families not accessing services. Concern over long-term effect (of not accessing services and future costs to society).
• Parents may forego accessing health care for children because of co-pays (family fees for HCBC).
• Potential for pharmacies backing out of Medicaid program (due to reduced reimbursement rates).
• Concern over reduction in quality child care providers (due to changes in child care provider grants).

Should the 2003 Legislature change any of the policy decisions that were made?

(In order of priority)

• Restore funding to senior medical services.
• Specialized mental health needs for elderly need funding.
• Consider satellite funding to regions for state hospital services - funding regions throughout state to establish satellite state hospital service centers to provide some of services currently provided by OSH.
• More equitable distribution of payments among CDDOs.
• Move more money (state revenue) into social service programs.

For consideration of the 2003 Legislature, what are the lowest and highest priorities for continued services? What service gaps exist?

(In order of priority)

• Children's mental health, family preservation, family services, etc. - all children's services.
• Funding for all waiver programs.
• Target funds - SGF to programs to maximize federal matching funds.
• Programs for elderly.
• Continue/improve resources for dental services.

Identify what steps the community needs to take to prepare for the immediate budget crisis and what steps can be taken to deal with the policy changes likely to be taken by the 2003 legislature.

• SRS ask community partners for input on money/budget issues during planning stages - what program are most effective, what funding is needed rather than just allocating out the money.
• Community partners/providers can use established program time lines more effectively (in program services, residential care, employment, home care, etc.).
• Use existing "tools" with specific goals in mind.
• Maintain communication within communities/among partners.

Parsons:

• The general consensus among our staff who attended is the meeting went very well.
• There were 16 non-SRS partners in attendance; at least 15 of those from Southeast Kansas Independent Living Center (SKIL).
• There were very few questions posed verbally by the attendees, and those were very general in nature.
• A SKIL employee actually publicly complimented us on our having scheduled these meetings in several (four) sites in the area, and pronouncing it as, in his opinion, an example of "good government".

Questions and Comments:

• The fiscal impact of reducing attendant care wages on the PD waiver is really minimal. Due to the small amount of savings realized as a result of this change, it smacks of discrimination toward those who have no other choice but to accept it.
• Concern about loss of services as we "take away programs from the NF-MHs and SKIL". She had misinterpreted some of the conversation on reductions to CMHCs and NFMHs. One of the SKIL staffers helped by reassuring her, her services were secure at this time.
• "One of your 'Mission' components is to promote self-sufficiency. In light of that, why do many adult patients receiving home health care have to be 'home bound'? They could access local, natural supports for many services, if not held to this standard."
• "You spoke of 'shrinkage'. What is the shrinkage percentage in SRS Central Office?" (This question did not come from an agency employee, but is consistent with comments made by one participant that they hoped that cost-saving measures, to include staff vacancies, extends to the higher levels of state government, including over to the Capital.)
• "Why complicate HCBS terminally ill patients lives by forcing a choice between keeping HCBS support and receiving Hospice care, when the average contact with Hospice is only a few days prior to death?"
• "Can you please explain point #7 in Sec'y Schalansky's letter which states '7. Limiting funding increases in critical areas where they were necessary to avoid undermining program integrity or putting consumers at great risk.' What does this mean?"

Parsons (June 18, 2002):

• There were a total of 9 non- SRS participants; 8 CIL (SKIL), 1 NF staff

Identify the most significant (3-5) impacts and implications related to policy changes made by the 2002 Legislature in order to meet FY 03 budget reductions, in your community(s). List specific examples.

(In order of priority)

• Hospice/PD waiver choice, one or the other...complimentary services, NOT duplication of services.
• Waiting lists (PD/FE/SED/HCBS) - potential for increased medical costs for treatment of conditions while awaiting services.
• Rx $$ increase out of pocket -Don't take needed Rx meds due to increased cost.
• Family disruption from lack of services (family pay obligation, waiver/family preservation, family service...family refuse services.)
• Forces people into nursing homes earlier
• Closes door to HCBS or family pres services (parental pay requirement)
• Increases costs in future (when preventative services not received, cost more later to treat.)
• Extremely high cost of assistive devices
• Reduced pharmacy services:
Smaller pharmacy providers quit Mcd
Smaller profit margins
• Drug formulary changes
• PD waiting lists lead to increased costs due to need to access more expensive services/more acute medical conditions

Should the 2003 Legislature change any of the policy decisions that were made?

(In order of priority)

• Streamline and deprofessionalize the MRDD and community based service delivery systems - more emphasis on people, less on paper.
• Increasing tax revenue thru providing people with disabilities more opportunities for employment.
• Restoring and keeping crucial programs.
• Better education of public and legislators of services available (and client needs).

For consideration of the 2003 Legislature, what are the lowest and highest priorities for continued services? What service gaps exist?

(In order of priority)

• Adequate funding to reduce all waiting lists - (Waiting lists eliminate choices and services)
• Restoring family services and family preservation dollars and Children's Initiative Funds - "Leave no child behind".
• Drug programs - elderly and disabled /all people needing drugs
• Home care services and community based services funding met
• Full funding for MediKan recipients and mental health services

Identify what steps the community needs to take to prepare for the immediate budget crisis and what steps can be taken to deal with the policy changes likely to be taken by the 2003 legislature.

• Continue keeping legislators apprized of community needs and desires.
• Keep it people focused, not provider focused. Keep "human face" on it.
• Educate the public of programs, services, and how it affects lives.
• Vote and educate customers.
• Willing to budget to get more for the buck.
• Keep it need based priority rather than political.
• Improved community collaboration - eliminate the turf issues.

Pittsburg:

• 25 non-SRS participants. A great cross-section; CIL, CDDO, NF, Greenbush/RPC, Elm Acres.
• Very few questions raised.

Questions and Comments:

• "Family preservation cuts. Is the reduction before or after the $2.5M was put back in?"
• "Cuts for attendant care for PR. Are we cutting people what work for handicapped and elderly or are cuts in salaries and reductions being imposed on state employees as well?"
• "Why did they choose attendant care wages to cut and not others?"
• "How long are the waiting lists for those needing services on waivers?"

• There were a total of 17 non-SRS participants; 9 CIL (SKIL), 2 Greenbush, 1 Child Advocacy Center, 5 of unknown affiliation.

Identify the most significant (3-5) impacts and implications related to policy changes made by the 2002 Legislature in order to meet FY 03 budget reductions, in your community(s). List specific examples.

(In order of priority)

• Institutionalization vs. HCBS (cost more but lower, less personal level of care) (due to waiting lists)
• Length of waiting period for HCBS waiver services.
• Reduced mental health services will over-burden community resources - people won't get the services they need.
• Uncovered medications (concern pharmacies will shift cost to non-covered meds to make up lost revenue).
• Reduced payments to pharmacies - cost passed on to consumers.
• Forego necessities to afford medical care - lead to early death.
• Other community agencies will feel impact of budget cuts.
• Co-pay increase for prescriptions (increased financial burden).
• Increased risks to child safety due to reduction in Family Preservation.

Should the 2003 Legislature change any of the policy decisions that were made?

(In order of priority)

• Cost analysis of HCBS vs. nursing home.
• Increase level of care hours.
• Policy changes: look for additional ways to access federal matching funds.
• Increase nursing home and HCBS reimbursement rates.

For consideration of the 2003 Legislature, what are the lowest and highest priorities for continued services? What service gaps exist?

(In order of priority)

• Keep HCBS services as intact as possible.
• All disabled programs.
• Reduce length of time of waiting list.
• Transportation for disabled.
• Medications (adequate access and reimbursement for all who need).
• Enhance consumer choices (between community/home based services, HCBS, NF).
• Mental health services for children.
• Maintain current premiums and access to HealthWave.
• Increase funding for income eligible child care.

Identify what steps the community needs to take to prepare for the immediate budget crisis and what steps can be taken to deal with the policy changes likely to be taken by the 2003 legislature.

• Listen to all (keep lines of communications open).
• Support community application for FQHC (Federal Qualifying Health Care??)
• Work together to find ways to fill gaps.
• Educate the public about services and those who are served by them.
• Awareness (and participation in) of political process.
• Continue to work with school districts and non-profit entities.

Back to Map