KHI News Article:
By Dave Ranney
"TOPEKA — The administration of Gov. Sam Brownback is considering another major reorganization that would move many wide-reaching programs out of the Kansas Department of Social and Rehabilitation Services.
According to people who work closely with state government and confidential administration sources, the reorganization would move services for the physically and developmentally disabled from SRS to the Kansas Department on Aging, which likely would be renamed.
Mental health and substance abuse programs also would be shifted from SRS, most likely to the Kansas Department of Health and Environment, an agency that earlier this year was merged with the Kansas Health Policy Authority, overseer of the state's Medicaid program.
Pedro Moreno
The anticipated changes would leave SRS, which has been downsized several times over the last few years under successive administrations, in charge of protecting abused and neglected children and administering various assistance programs for the poor such as Temporary Assistance for Needy Families.
The reorganization would essentially dismantle the SRS division of Disability and Behavioral Health Services, which currently is managed by Deputy Secretary Pedro Moreno. The division spends about $942 million of the agency's $1.6 billion annual budget.
'Can't speculate'
Administration spokespersons said they wouldn't or couldn't comment about the proposed changes.
"I can’t speculate on the considerations," said Miranda Steele, KDHE communications director. "The administration is still a few weeks out on finalizing and announcing the Medicaid reform plan."
Under the direction of Lt. Gov. Jeff Colyer, a group of cabinet secretaries for the past several months has been developing a Medicaid makeover plan that is intended to save the state money and improve services for the program's beneficiaries. Apparently, the plan for reorganizing SRS would fit within that broader reform effort. The programs that would be moved under the plan rely heavily on Medicaid dollars.
"Nothing has been finalized regarding the administration’s plan to reform the state’s Medicaid program," said Sherriene Jones-Sontag, the governor's chief spokesperson. "The administration is still a few weeks away from announcing the reform plan."
"I haven't heard anything final," said Sara Arif, communications director for Kansas Department on Aging. "In a lot of the Medicaid forums that were held over the summer, we kept hearing it was somewhat difficult for families to access the system and we kept kind of hearing over and over that it would be nice if we consolidated. But I don't know if anything is happening with it, necessarily."
Nonetheless, some high ranking administration officials have talked privately with various service providers who would be affected by the possible changes at SRS. And administration sources told KHI News Service that the plan was well advanced.
“That’s certainly what the chatter has been coming out of the Statehouse,” said Mike Hammond, executive director at the Association of Community Mental Health Centers of Kansas.
“We’ve heard that we might be headed to (Department on) Aging,” said Matt Fletcher, associate director at Interhab, an association representing the state’s home and community based programs for people with developmental disabilities.
'Communication slow or lacking'
Some who have been frustrated by what they consider poor communication with SRS managers said a reorganization along the lines proposed would be an improvement.
"I would have to say we would welcome the opportunity to interact with an agency (KDHE) that’s open and transparent and wants to communicate with vendors and providers," said Sarah Hansen, executive director of the Kansas Association of Addiction Professionals. “We’ve been very impressed in our dealings with KDHE. They’ve gone out of their way to seek stakeholder input and they’ve truly been willing to listen. With SRS, there’s always the opportunity to sit down with the secretary but in the last few months, communication has been slow or lacking.”
The reorganization, should it happen, would be similar to one proposed more than a year ago by Rep. Bob Bethell, an Alden Republican. Bethell chairs the House Committee on Aging and Long-term Care.
'Room for increased efficiency'
“It would eliminate a lot of the silos that are prominent in the system we have now and it would give us the opportunity to better coordinate the services that we offer now,” Bethell said. “The way it is now, we can have people whose disabilities are very similar receiving different levels of services because they’re in the PD (physical disability) silo, the DD (developmental disability) silo, or the FE (frail elderly) silo.
“Let’s put it this way, there’s room for some increased efficiency,” he said.
Bethell also serves on the Joint Committee on Home and Community Based Services.
Legislators have long complained that SRS, one of the largest bureaucracies in state government, is unwieldy, inefficient, and resistant to reform.
Lawmakers in 1996 voted to privatize most of the department’s services for foster children. In 1997, oversight of youth detention centers was moved from SRS to the then-new Juvenile Justice Authority. In 2005, lawmakers moved the processing of Medicaid payments to doctors, hospitals and other medical providers from SRS to the Kansas Health Policy Authority, which following a fresh reorganization in July this year became the Division of Health Care Finance at KDHE.
The health policy authority also assumed from SRS the administration of HealthWave, the state’s health insurance program for children in low- and modest-income families.
Despite agency reductions that started in earnest under the administration of Gov. Bill Graves, SRS still has almost 5,500 employees, down from its peak of more than 11,000. About one-third of the remaining SRS workers are employed at the five state hospitals for people with severe mental illness or developmental disabilities.
Sources said they weren't sure whether SRS would remain in charge of the state hospitals if and when the reorganization happens.
SRS' proposed budget for fiscal years 2012-2013, does not reflect the changes being considered.
The proposed budgets for KDHE and KDoA have not yet been made public."
The KHI News Service is an editorially-independent program of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment.
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