First Round of Meetings:

From June 5th through June 17th , 18 public meetings were held across the state. 494 non-SRS persons attended these meetings. Representatives from the Centers for Independent Living attended 11 of the meetings with 15 representatives from Southeast Kansas Independent Living Center at the Parsons meeting. Ten meetings had representatives from Community Developmental Disability Organizations. Other persons included child welfare and mental health representatives at nine of the meetings, county health department representatives at five meetings, and NFMH representatives at four of the meetings. There were other organizations in attendance but the above were those most widely represented.

Judge Canaday attended the meeting in Independence and a representative of Judge Langston's office attended in Wichita. Six legislators were in attendance across the state. Senator Derek Schmidt in Independence; Representatives Bonnie Huy, Willa De Castro, and Geraldine Flaharty in Wichita; Senator Greta Goodwin in Winfield; and Representative Mary Kauffman in Hutchinson.

Six newspapers reporters covered the meetings and included articles in their local newspapers. A radio station in Manhattan was in attendance at that meeting.

There were a wide variety of questions asked. Some of the most widely discussed issues were:

• Family fees for Family Preservation and HCBS Waivers - what will be the process to collect these?
• Reduction in PD waiver attendant care wages - concern that only the PD waiver was targeted.
• Pharmacy co-pay - concern that consumers cannot afford the co-pay.
• Terminally ill patients served through the PD waiver will no longer be able to access hospice service - concern that the hospice received under the waiver is different than hospice received under medicaid and that people will not be allowed to die in their homes.
• Administrative costs - concern about bonuses, state employees receiving raises when there is no increase in rates to community providers, whether cost-savings measures are in place in SRS central office, why SRS pays rent for an office that is only open one day a week.

The Duane Goossen video was well received at the meetings. In Garden City two individuals asked if they could check out the video and show it to their agency's staff so they all understood the situation as well.

Overall the meetings seemed to be a success and much interest was shown in the topics of the 2nd round of meetings.

Second Round of Meetings:

There were 17 Area Public Meetings from June 24th - July 15th, 2002 with 335 stakeholders attending. As in the first round of meetings, there were more representatives from CILs in attendance than any other organization. In the Southeast part of the state the meetings had 8 to 10 CIL representatives per meeting. The others attending were representative of a wide variety of stakeholders. The media was present at the Chanute and Manhattan meetings. Senator Greta Goodwin attended the Winfield meeting and participated in the discussions. She stressed that SRS needs to make the lawmakers understand how one decision may impact other programs. She also suggested that the detailed schedule of legislative policy changes and information from these meetings be sent to all Legislators.

The following questions were asked at the meetings, and below are the issues discussed the most.

1. 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).

• Pharmacy - The major concern voiced was that the co-pay would result in financial hardship on clients and they would stop taking some of their needed medication. Another concern was that the changes to pharmacy reimbursement would result in smaller profit margins which would be passed on to the consumers.
• Family Participation - Many felt that parents may forgo accessing health care and family preservation services for children because of the co-pays, and that changes make the poor pay even more. They felt that the targets for these fees were very vulnerable populations. There was also questions of how the fees would be collected and whether the collection of the fees would be cost effective.
• Family Preservation - The reductions will increase risks to child safety. Families referred are too close to "past the point of no return", and the result will be more children going into out of home placement. If this happens there won't be a savings as Foster Care is more expensive than Family Preservation.
• Time-limited GA and MediKan - This reduction affects the severely mentally ill and other low income consumers. It takes a long time for a person to qualify for SSI and SSDI because of the back log in system, and legal services is a very key player in this process. A drain on community resources will occur if these persons are no longer on GA and MediKan.
• State Hospitals - The reductions in the beds and funding at the State Hospitals may force persons to be discharged too early. This could result in increased crisis situations in the community and place further burdens on local community agencies. Community services may be depleted by costs if more persons are served with the same dollars. There was also concern of what services would be available for the level of care provided by the Hospitals.
• HCBS Waiting Lists - The concerns were that waiting lists eliminate choices and services. Persons receiving HCBS receive a better level of care at a lower cost. Plus increased time on waiting list could cost more as conditions left untreated will worsen and while waiting on services more people will go into nursing homes.

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

There was a wide variety of responses to this question. Those few that had a common thread are:

• Some of these decisions just transfer the problems to other areas - Points addressed were that Legislators need to fully understand how the decisions they make will impact other programs, some changes result in transferring higher expenditures to other arenas, and SRS should keep data on the impacts of cuts in one program on other programs.
• Rescind PD Waiver hospice - SRS should reconsider forcing people to choose between hospice and waiver services as these services are not overlapping. Agencies should be allowed to jointly develop a plan to avoid duplication. It was mentioned that clarification of this change is needed as no one really understands which services are or are not available.
• Extend GA/MediKan until SS takes effect - The time limit should be revisited as this change does not produce large cost savings because the state is reimbursed by SSI or SSDI. SRS should extend assistance until SS takes effect. The time it takes to process the applications creates gaps in making services available while needs increase.
• Tax increase or change in tax structure should be made instead of reductions - The comments were that only so much can be cut and taxes should be increased, restore previously cut tax levels to what is realistically needed, or reconsider tax structure issues.

• Highest priorities - Increase dental care services and providers, reductions at state hospitals, pharmacy, maintaining existing services, keep HCBS services as intact as possible and reduce the waiting lists , spending more on prevention services result in cost avoidance in the future, all children's services, maximizing federal funds.
• Gaps - Prescription coverage for Medicaid, coordination of services in communities, gap between Foster Care and Adoption, growing waiting lists, support for KAN Be Healthy, PD Waiver change to stop allowing hours for supervision, better & open interactions between KDHE and SRS, transportation, and interpretation and translation services.
• Low priorities - Sexual Predator Program enhancement, SRS staff reductions, parking garage, Capitol statute, Legislative raises, school violence for KDHE.

4. 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.

There was a very wide variety of opinion on this question. The underlying themes of the responses were:

• Keep communication open between SRS, communities, and consumers.
• Educate consumers on issues and encourage them to vote.
• Keep Legislators informed of needs and desires.
• Educate the public about services and those who are served by them.
• Expand the use of electronic communication resources between community and all agencies.
• Improved community collaboration - eliminate turf issues.
• Promote community volunteerism to assist agencies in meeting needs of people.
  

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