Wichita (June 6, 2002):

• 83 people signed up. More attended. Cathy Holdeman, City Managers Office; Ron Paschal, DA; Judge Langston's office; and reps from Newton, Osawatomie State Hospital, and most Wichita social service agencies.
• Three legislators: Rep. Huy, Rep. De Castro, Rep. Flaharty.

Questions/Comments:

• Foster care case rates.
• Family preservation funding.
• Several related to Medicaid changes.
• Where CSE collections are deposited.
• Mental Health funding.
• GA/Medikan
• HealthWave
• Administrative overhead.
• Waiting lists.
• Some people wanted to make statements about the impact of the budget on schools, JJA, courts, health services, social services.
• Lots of positive comments about the Goossen videotape and how helpful the overall presentation was.

Wichita (July 11, 2002):

• There were 36 non-SRS participants.
• General questions asked were 1) Terminally ill Kansans can no longer access hospice, can decisions made in "02" be reversed, money be restored in "03"? Yes, the purpose of today's meeting was explained. 2) Will there be local collection for family fees? No, Topeka will do the family fee collection. Our workers don't expect to be handling the exchange of money.
• WAO divided participants into three groups each responding to all four questions.

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.

(Group 1)

• Reliance on one-time funding.
• Family fees for HCBS Waivers and Family Preservation-perception may differ from reality.
• HealthWave Enrollment Increase.
• Targeting services to most at-risk families.
• PD Waiver & Unavailability of Hospice Services: Definition of "terminal", Aging of population, Burial Policy, Could be worse in future, Foster Care/Child Support Pilot.

(Group 2)

• 24 month lifetime cap on MediKan-affects severely MI and other low income consumers.
• Pharmaceutical reduction in generic prescriptions seems counter productive-cut should be in brand name drugs.
• Drug formulary change is a positive change.
• Family Preservation cuts.

(Group 3)

• HealthWave and changes in CHIP.
• PD Waiver issues-especially hospice.
• Heavy reliance on one-time funding.
• Time limited service provisions for GA-MediKan.
• Waiver co-pay issue may create barriers for accessing services related to SED wiaver (may also affect family preservation).
• Comments: PD waiver/attendant care-agencies absorbing the reduction, not reducing attendant care wages. Pain management vs attendant care-must make choices. It's about real people and their needs-must serve most vulnerable. Few options available-fewer community and social corrections. Long term implication beyond FY 03. Length of time it takes for someone to be approved for services. Individuals remain in the community and need services provided locally. Lack of service may lead to needing other types of services.

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

(Group 1)

• Rescind PD Waiver/Hospice/Terminally Ill- clarification needed.
• Community service funding increased for mental illness, but what about affordable, "intensive" housing? (Closing state hospitals and nursing facilities).
• Many of these policy changes seem to negatively affect those with mental illness. Need policy that says it is okay to have small, group home type settings for those needing support and stabilization. Should allow mental health center personnel in the nursing homes, to help residents.
• If only focus on most "at risk", others may then end up in foster care

(Group 2)

• Restore or increase family preservation funding.
• Look at generic prescription cuts-is it cost effective?
• Extend MediKan until SS takes effect.

(Group 3)

• Hospice-allows both services to be provided to same persons if needed.
• Future changes must make citizens' health and welfare a priority.
• General Assistance-time it takes to process, time delays, etc creates gaps in making services available while needs increase.
• Consequence of tax decisions-only so much can be cut-perhaps need tax increases-reconsider tax structure/increase issues.
• Comment: Reactive government costs $; proactive government saves $. Prevention vs intervention.

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

(Group 1)

• Adequately fund populations affected by closing (MI).
• Need affordable housing and meds for mentally ill.
• Gaps in community services when person returns.
• MICASSA-$ portability-money and service follows person into his/her community.
• HealthWave Enrollment-$ are there, need to get people signed up.

(Group 2)

• Need for increased dental care for children and adults.
• Family Preservation funding increase.
• Keep family participation fee.
• PD Waiver cuts restored.
• Question: HealthWave enrollment goals-to increase payments-factored into overall picture?

(Group 3)

• Most vulnerable-physically disabled, those eligible for waiver services, those where other services are not available.
• Children in general-K through 12.
• Services for substance abuse (treatment reduces need for other services).
• Preventive services in general.
• Higher education.
• Capitol improvement projects-low priority.

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.

(Group 1)

• Get people involved enough, in the communities, in political process-register to vote, talk to legislators, etc.. Consumers need direct involvement with legislators.
• Sending notice to affected clients/customers of changes, to lessen crises: Notice needs to be timely, clear, refer to person who can help. Can SRS Customer Service help?
• Town Hall meetings.
• Notices to providers, who can in turn inform consumers.
• SRS Community Project help identify steps.
• Talking about increasing revenue earlier in the budget process-grass roots involvement needed.
• Need to present reality of: "if you give me less $, I have to provide less". $ funds services, not government excess-already frugal.
• Provide legislators with impetus to not simply blame SRS. Maybe (we) SRS and consumers appear together.

(Group 2)

• Identify local financial resources for meeting co-pay type of needs, etc.
• Identify needs for volunteers (doctors, treatment providers, dentists, etc)
• Recruit more volunteers-something United Way may be able to assist with
• Community education regarding needs- what community can do (churches and community organizations)

(Group 3)

• More community education re: fiscal crisis and how it affects people.
• Continue Community Project and increase its efforts.
• Personalize the problem to show how it affects the community.
• Explore short-term agency and group collaboration to address specific community needs.
• Identify community priorities-community must agree on what those are, make them known, and focus efforts accordingly. Make community aware of the priorities.
• Provide for ongoing community input -develop a plan to provide this.

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