Friday, January 22, 2016

CJ: Advocates critical of Sam Brownback for invoking disability services to oppose Medicaid expansion

Kansas Gov. Sam Brownback
Photo Courtesy of the Topeka-Capital Journal
The Topeka Capital-Journal this week published an article on how a Kansas advocacy group responded to the Brownback administration's justification on their opposition to Medicaid expansion.

"Advocates for individuals with disabilities on Thursday rejected Gov. Sam Brownback’s argument that Kansas shouldn’t expand Medicaid because it prioritizes able-bodied adults before those with disabilities.

The Big Tent Coalition chided the governor and other opponents of expansion for invoking individuals with disabilities in arguing against increased eligibility for KanCare, the state’s Medicaid program.

“We can walk and chew gum at the same time and we expect Kansas policymakers to do the same,” said Rocky Nichols, executive director of the Disability Rights Center of Kansas. “We expect that they can focus on waiting list issues, reducing the waiting list while at the same time expanding Medicaid.”

Nichols said that while the coalition’s priority remains eliminating waiting lists for services for people with disabilities, it also supports Medicaid expansion.

In October, a Brownback aide invoked the governor’s moral opposition to expanding Medicaid while a wait list exists. Expanding KanCare could add more than 150,000 low-income Kansans to Medicaid.

“Medicaid Expansion creates new entitlements for able-bodied adults without dependents, prioritizing those who choose not to work before intellectually, developmentally, and physically disabled, the frail and elderly, and those struggling with mental health issues,” Melika Willoughby, Brownback’s deputy communications director, wrote in the October message. “This isn’t just bad policy, this is morally reprehensible.”

The coalition argues, however, that individuals with disabilities would benefit from Medicaid expansion. The group said many Kansans with disabilities aren’t currently eligible for a waiver for home- and community-based health services under Medicaid and are also uninsured — meaning they would potentially be covered by expanded Medicaid.

Expansion also would benefit direct support workers and personal care attendants who work with individuals with disabilities. The coalition said the shortage of workers is critical.

“Direct support staff and personal attendants are the backbone of the home and community services system,” the coalition said in a statement. “They deserve meaningful access to healthcare; access that will assist with recruiting and retaining workers.”

More than 30 states have adopted some form of Medicaid expansion. So far, conservative Republicans, along with the governor, have blocked consideration of increased eligibility for the program.

Expansion is unlikely to take place before elections in November. But some see potential movement after that.

Sen. Jeff King, R-Independence, told a conference this month that evaluating expansion options and developing legislation would take at least 16 months.

“I think we need to explore it,” King told the gathering. “Saying no to everything is not the answer.”

Read original article here.

Thursday, January 7, 2016

KHI publishes 2016 Kansas Legislative Preview

The Kansas Health Institute has prepared an issue brief entitled 2016 Kansas Legislative Preview, which provides an overview of health policy issues that are likely to receive attention during the 2016 Kansas legislative session.

Click here to access the legislative preview created by the Kansas Health Institute

Wednesday, January 6, 2016

Three Key Questions

Today the Kansas Center for Economic Growth published the following in their blog regarding the Kansas budget.

"Kansas remains in a perpetual budget crisis as another legislative session begins. Lawmakers have already approved budgets for FY 2016 and for FY 2017, but both must be adjusted just to keep the general fund solvent.

Is it possible to get through FY 2016 without further cuts?

A very high risk exists for further mid-fiscal year program cuts.

In November, the state's revenue estimators markedly lowered expectations for the amount of tax revenue that Kansas would receive in FY 2016. The new estimate put the general fund underwater by more than $100 million, even though lawmakers had hiked the state sales tax rate in June and directly transferred more than $200 million from other state funds.

In response, the Brownback administration took emergency action in November to take yet another $50 million from the highway fund and $9 million from early childhood accounts, and imposed deeper spending cuts on programs. These actions just inched the general fund balance above zero by a few million dollars.

If actual tax collections do not meet the lowered targets, further budget cuts will be required. Kansas does not have any reserves left to deal with further revenue erosion.  Even with lowered expectations, the new estimate predicts that tax collections will increase by 5.7 percent in FY 2016. However, through the first 6 months of FY 2016, actual collections have grown less than 2 percent from the previous year. The revenue estimators likely still have the revenue estimate set too high.

What must be done to the existing FY 2017 budget - at minimum?

At least $175 million must either be added to revenue or subtracted from approved expenses to stay solvent. That's the bare minimum required to keep the ending balance above zero, and would only eke the state through to the next year.

Keep in mind that the revenue estimate for FY 2017 already includes $180 million in one-time transfers from other funds.

Doing the bare minimum does not account for any action that may be required from the school finance court case, does not provide any ending balance, and does not deal with understaffed prisons and hospitals. And if the revenue estimate for FY 2016 is still too high, the one for FY 2017 likely is, as well.

What's the fix?

To be financially stable, Kansas must adequately fund key programs, have a balance between income and expenses, and keep a reasonable amount of reserves. Not even one of those three things is occurring now.

The problem rests with unaffordable income tax cuts that dramatically diminished the state's revenue stream and produced a perpetual budget crisis. Fixing the problem requires revisiting those income tax policies and correcting them."

Click here to see the original article by Duane Goossen of the Kansas Center for Economic Growth.

Monday, January 4, 2016

InterHab executive director to retire

Tom Laing, InterHab Executive Director
One of the state's largest human service advocacy groups, InterHab, announced today the beginning of its search process to choose a successor for their current executive director, Tom Laing. The group's goal is to secure a new executive director before mid-year, to bridge the transition in advance of Laing's September retirement. InterHab represents community based organizations that serve persons with intellectual and developmental disabilities.

InterHab's Board President Lori Feldkamp of Manhattan commented on the coming staff change:

"We have valued Tom's leadership and advice during these past twenty plus years, and appreciate that he always encouraged us to maintain an optimistic view of the future of our state, and to find and encourage the positive voices among the elected statehouse leaders. He helped us embrace numerous opportunities and confront many challenges, reminding us that whatever the odds we should never give up on issues we believed to be important."

Laing has served as InterHab's executive director for more than 22 years. Prior to joining InterHab, he had served from 1984 to 1990 as the staff director for the Kansas House Democratic caucus, and from 1991 to 1992 as chief of staff for House Speaker  Marvin Barkis. With his retirement Laing will conclude a period of state government and statehouse activity spanning more than 30 years.

InterHab searches for new Executive Director

InterHab's Board of Directors has embarked on a search process to secure a new executive director for the association.

Interested persons should review the search profile document shown at this link, and all parties are encouraged to forward such link to qualified persons whom you think may be interested in the position.

Click here for full posting

Tuesday, December 29, 2015

LIVE: Highlights from Bethell Committee on HCBS and KanCare Oversight

Rep. Jim Ward signaled a clear legislative concern regarding the recent Federal move to cut off Federal dollars from Osawatomie State Hospital, due to recurring concerns related to substandard care, safety and security issues. His pointed questions resulted in the Chair, Senator Pilcher-Cook, ruling the questions to be not germane.

KDHE Secretary Moser's very general integrated waiver update prompted Senators Kelly and Denning to question the purposes and intended outcomes, and received additional questions from Rep. Ward which could only be described as skeptical as to the State's intention and preparedness.

Numerous positive written statements have been submitted to the committee attesting to the viability and potential benefits of the health home model.

The Osawatomie State Hospital issues resurfaced during KDADS Secretary Kari Bruffett's testimony. Rep. Jim Ward lectured Sec. Bruffett, citing news reports of substandard care, the rape of a staff member, the inappropriate placement of a sexual predator.

"Please tell me we are not conducting business as usual," Ward said.

Ward took exception to the drift of the Osawatomie issues, during which the focus shifted away from client care issues and focused largely on the fiscal issues resulting from the Federal findings.

Wednesday, December 16, 2015

Advocates claim legislation limits rights of mentally ill

A bill (HR 2646) proposed by Congressman Tim Murphy is facing scrutiny among mental health advocates. Included in the bill is a provision that would all but do away with much of the legal advocacy which current law allows  for those who live with mental illness, such as  is provided by the Disability Rights Center in Kansas and led to the investigation and prosecution of the notorious Kaufman House operators in southeast Kansas a few years ago.

This bill also nullifies provisions in the Protection and Advocacy for Individuals with Mental Illness Act, signed into law by President Ronald Reagan in 1986.  HR 2646 would prevent organizations like the DRC from helping veterans and the homeless – two populations prone to mental illness.

The Disability Rights Center of Kansas prepared an action alert  which details why they believe the bill should be stopped in its tracks until appropriately amended.