Hays (June 11, 2002):

• 16 individuals from Independent Living, DD, MHC, parent, USD 489, United Way. Pretty much weighted toward Link and DD.
• Reporter present and article in the next day's paper.
• Went very well, especially the Goossen tape. That, coupled with the current and understandable information, seemed to impress those in attendance that SRS is now an open organization and very much a part to the community .

Questions and Comments:

• Families who accept HCBS services are all served?
• Who will inform families of financial situation as they change?
• Is there any kind of education materials available to hand out to families?
• Who's responsible for collection of these monies?
• Can't force families to pay however a vendor can refuse to participate in the program.
• Whoever figures the family fee should look at more than just the family income.
• There is a proviso in place of SB421 that speaks to the Secretary not being able to deny service to kids.
• How long does it take for SS disability to be approved after application?
• Do co-pays for SED HCBS waivers apply to just waiver mental health services or all Medicaid covered mental health services? All health care services covered by the waiver Medicaid Card?

Hays (July 3, 2002):

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

• Waiting lists for the HCBS have gotten longer, thus putting some individuals at greater health and safety risk without services.
• Some persons are placed in the difficult position of choosing between the PD waiver services and hospice services.

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

• It should be a fiscal policy of the State of Kansas that in all Long Term Care services the money should follow the person into either institutional services or home and community based services of the person's choice. To implement ths policy, Kansas policy makers should encourage and promote the passage of a Federal amendment to the Medicaid law, called MiCASSA, (HB 3612, SB 1298) which requires States that participate in Medicaid to offer both institutional and HCBS. The Kansas US House of Representatives and US Senators should promote and encourage this important reform of Medicaid law.
• It should be a fiscal policy of the state of Kansas that any waiting list for HCBS should be no longer than the waiting list for residential or institutional services.
• It should be a policy of the state of Kansas to use discount or volume purchasing strategies to control the Medical expenditures. When trends develop in the usage of DME and prescription drugs by Medicaid beneficiaries that the state of Kansas should negotiate with the manufacturers of such drugs and DME for volume discounts.
• It should be fiscal policy and Medicaid policy of the State of Kansas to enlist the cooperation and support of both beneficiaries and providers in the control of Medicaid expenditures by providing information and health wellness programs targeted to acute care and maintenance care.

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

• Waiting lists for HCBS must be reduced and passage of MiCASSA would provide the State increase in Federal funding and infrastructure monies to achieve the goal of no waiting lists.
• Working Healthy for persons with disabilities needs continued financial support in the initial years, especially in light of the development and implementation of the Personal attendant Services.
• Protected income levels must stay the same and co-pays must stay the same or be decreased.
• Medicaid policy should promote cost control by discount purchasing of medical supplies or prescriptions in high demand.
• Long term care assessment eligibility scores should not be raised.
• With every annual HCBS and institutional review, the consumer or beneficiary should be given a choice of institutional care or HCBS and the money for service should follow the individual.
• The Working Healthy program, which encourages employment and asset growth, should be used as a model for other State Medicaid programs to provide incentive for "welfare" dependent persons to move in to the working world and off welfare rolls.

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 policy makers need to continue to take positive steps to show that they believe Medicaid beneficiaries are intelligent people who will cooperate and be helpful in the design of Medicaid programs and can assist in controlling Medicaid expenditures.
• SRS staff must take the budget crisis personally, just as the beneficiaries do when the services are cut, and reduce the cost of administration in the same proportion, as the beneficiaries must make cuts in services.
• Immediately negotiate with drug companies for discount rates for prescription drugs in high demand by Medicaid beneficiaries.
• Establish a MiCASSA policy team to evaluate the potential benefit to the State of Kansas if Federal law is changed and encourage the Kansas Representatives and Senators to take the lead role in the passage of the MiCASSA before January 1, 2003.

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