Friday, May 30, 2014

Legislature adjourns for 2014

Rep. David Crum, one of three House
members not seeking re-election.
During the brief House session today, four-term Rep. David Crum, R-Augusta, two-term Rep. Kelly Meigs, R-Lenexa, and two-term Rep. Jim Howell, R-Derby, said goodbye to the House, announcing they will not seek re-election.

The Senate also passed a resolution congratulating retiring Revisor of Statutes staffer Ken Wilke for more than 40 years of service to the state.

Thursday, May 22, 2014

Bruffett to replace Sullivan as KDADS secretary

Kari Bruffett named new
KDADS Secretary
Gov. Sam Brownback's office announced on Tuesday that Shawn Sullivan, secretary for the Department of Aging and Disability Services will become the new state budget director and Kari Bruffett, currently head of the division of healthcare finance at the Kansas Department of Health and Environment, will step in as the new KDADS leader.

“Kari’s experience with the KanCare program and her ability to forge collaborations will serve the citizens of Kansans well. I am grateful to both Shawn and Kari for their dedication to the state and appreciate their willingness to serve," Brownback said in a prepared statement.

According to KHI News Service, reactions to the staffing changes are mixed, though both Sullivan and Bruffett are generally well regarded by those familiar with the state's two leading Medicaid agencies.

"We are very thankful for Shawn Sullivan's willingness to work so closely with the intellectual and developmental disability community," said Tom Laing, Executive Director for InterHab. "The work done at KDADS often times directly impacts persons with disabilities and the organizations that serve them. We are looking forward to building a close relationship with the new secretary."

Tuesday, May 13, 2014

2014 Legislative Session Wrap-Up

Tom Laing, Executive Director
InterHab


The 2014 legislative session will be remembered in the disability arena as one in which virtually no forward motion occurred.  

The final nail was pounded into the coffin of managed care carve-out advocacy, a Federal directive was reluctantly heeded to end the under-served waiting list, a few dollars were thrown at the un-served waiting list, and no action was taken to address our low reimbursement rates.  

In other words, our experience was similar to many groups.  Ask teachers, environmentalists, children’s groups, fair tax advocates and you will hear the same story.  The 2014 session was mostly frustrating and fruitless and sometimes downright destructive.

KanCare:  Some talk was promoted in the Capitol regarding KanCare vigilance but the only outcome worth noting was a “prompt payment act” (HB 2552) to assure that vendors have a legal right to demand prompt payment from MCOs.  Otherwise, with rare exceptions – for example Rep. Jim Ward continued to offer the active voice of opposition – most legislators had the same shoulder-shrug as in the past, as if to say, “What can we do? The deal is done.”

Waiver Stewardship: As in prior years, our quality-based (Q-base) expansion message was heard (allocate new resources equally for waiver expansion and for capacity expansion via improved reimbursement rates) but the message was ignored. Some money was spent, grudgingly, to end the under-served waiting list (because the Federal government insisted) and at the end of the session, funding for 77 of the more than 3000 on the unserved list was appropriated...  an embarrassingly paltry effort. No money was provided for rate enhancements. The outcome? Quality expansion of waiver services will be hampered by depressed rates and the resulting workforce shortages; and the waiting list will grow, not shrink, due to the ongoing ambivalence to the size of the waiting list.

Family advocacy remained alive on the autism front: Some new success was achieved in the passage of legislation encouraging autism insurance coverage. This was a tribute to organized autism family advocacy and a handful of legislators who would not be told NO despite the active opposition of the insurance industry. Some will assert that they continue to have some problems with the legislation, but the forward motion of this effort will certainly create an evidentiary record that this (and other) disability insurance mandates are not the industry-wrecking laws that some insurers claimed.

InterHab member energy is already being gathered for new mission-renewal initiatives in 2015: With this round of KanCare debate settled for now, for better or worse, InterHab members have already begun to make plans to revitalize Q-Base advocacy for 2015. This State’s performance must simply be brought into the light, so that the public and policymakers can weigh the inadequacy of current reimbursement rates, and the increasingly shocking neglect so demonstrated by growing waiting lists.

What is our assignment for the coming weeks and months? Relationship building and electoral accountability come to the front of the discussion.

Two groups of legislators demand our immediate advocacy attention. The first group consists of Senators, none of whom are required to run for reelection in this election cycle. These men and women uniformly need to be reminded of the importance of disability initiatives. The second group would be House members who are running again in November, but who find themselves unopposed. They will almost certainly be back in January for another term of office.  Since they have no campaigns to run, they have time to see you and talk to you. From this day forward, make it a priority to meet and confer with them to remind them of your concerns, reintroduce them to their neighbors with disabilities and their families whom they may have forgotten about, and emphatically describe for them the cost of neglect when it comes to the needs of the disability service network. 

And then there is the election: As you know, we do not advocate for or against any candidate or question on the ballot. Your organizations, also, are politically neutral in the tug of war that is the election process. HOWEVER, we all have a right and a responsibility to inform one another about the actions of the legislature, and legislators, and governors.

You all know, for the most part, whether your legislators or governor have been good or bad for disability services. You know whether they have been accessible and receptive. You also know that your actions have a direct bearing on how a legislator responds. 

Legislators who support you: You know these men and women. They take your calls. They visit your organizations AND they usually vote WITH you when they are asked to do so. Each of them is entitled to the most appreciative words of encouragement from all of us, and your stakeholders should be told of those legislators who do support you.

Legislators who are adrift: Some legislators, when they do not hear compelling information about our issues, have drifted away into an uninformed position, and have not been reliable supporters of your efforts. They are on-again, off-again at best. These are legislators for whom we want to redouble our educational efforts. Each of them could become a “friend” in the coming session if we all do our jobs. 

Legislators who turn their backs on you: These are the ones who most frustrate us. They know the issues, they have been reached out to, touched, educated, connected with your stakeholders, but they usually do NOT vote with you, and sometimes they are openly HOSTILE to your advocacy.  What do we do with these legislators? There is one sensible approach. Get to know the candidate that has chosen to run against them. Educate those new candidates and introduce them to the constituents that you work for.  And, if you like them, as citizens you have a right, on your own time, to act in accordance to your electoral instincts.


As for the Governor’s race? Do what you think is best, unless your “best” is a rocking-chair position. Our government works well only when we the people make it work well. The time for action is now. 

Friday, May 2, 2014

To: Members of the Kansas House of Representatives and the Kansas Senate

May 2, 2014

Dear Legislator: 

This session, as in the past, we have urged a more responsible and humane allocation of resources for community services for persons with intellectual and developmental disabilities (I/DD).  We are however disappointed once again in the outcomes that we will have to report to Kansans around the State who had been hoping for progress.  We will report little progress on waiting lists and no progress on reimbursement rates for community organizations. 

We are glad for the I/DD waiting list funding for 77 persons in the final budget considerations, and glad that Federal officials demanded the State address the underserved waiting list. But, please recognize that serving 77 persons from a waiting list which currently numbers in excess of 3,000 is not progress. 
The waiting list in the coming year will get longer, not shorter.   

Additionally, community service providers will once again fail to secure any relief for reimbursement rates that have not been increased in more than 6 years. Only once during this administration’s tenure has a reimbursement rate been proposed by the state agency which oversees our programs, and even that tiny 1% recommendation – 60% of which would have been paid by the Federal government – was removed from the Governor’s budget for 2014-2015 recommendations. Add to that the greatly increasing administrative costs for all organizations in their dealings with the three managed care insurance companies, and you can better understand the financial pressures they face. 

This excerpt from the Kansas Developmental Disability Reform Act spells out the law that has been routinely ignored:

39-1806. Establishment of system of funding, quality assurance and contracting. To carry out the provisions of this act, the secretary shall establish after consultation with representatives of community developmental disability organizations and affiliates thereof, and families and consumer advocates:
(a) A system of adequate and reasonable funding or reimbursement for the delivery of community services.. 

No one who votes for this budget can claim it is either adequate or reasonable … no can they claim they have met their obligations under the law.   Six years of rates unadjusted to keep up with increasing costs is inadequate and unreasonable. The needs of our most vulnerable citizens cannot be met when the care-givers for those citizens are treated with such ambivalence.  The needs of vulnerable Kansans with I/DD can only be met if each of you prioritizes their lives and their needs.  

Before you write your final newsletters, remember this: 
You will deceive yourselves if you believe those who claim that progress was made in this two-year budget for persons with developmental disabilities. Everyone affected knows the truth, and they will be asking you to work harder in the future to direct your executive and legislative leadership to reverse this pattern of neglect.   
We have not, and will not, lay this matter solely at your feet. Previous legislatures and governors had their chances to do better but didn’t. This cycle has to change, and it has to start with each of you. 
Two final thoughts:
  • We urge you to begin preparing for the coming interim as a time for planning, and that you insist upon the Administration’s assistance, to meaningfully reduce the waiting list, and to make good on the promise of restoring reasonable reimbursement rates for your community’s organizations that do this valuable work. Both goals must be addressed, in tandem.
  • We urge you also to look at the many millions in KanCare savings that have been touted, as a source for your enhancements to our budget. We all have a right to know whether those savings are real, and if so, then to utilize them as a funding source to re-invest in programs which are currently struggling. 

We appreciate the many responsibilities you are asked to carry, and the hard work you are asked to perform; and we believe you are owed an honest assessment of this session’s performance on behalf of the community I/DD network. 

We ask for your thoughtful consideration of these concerns.  


Respectfully, 


Tom Laing, (Topeka) Executive Director 


On behalf of the Executive Committee of InterHab:
Lori Feldkamp, President (Manhattan)
Alice Lackey, Vice President (Seneca)
Doug Wisby, Treasurer (McPherson)
Brenda Maxey, Secretary (Hutchison)
Jerry Michaud, Board Member-at-Large (Hays) 
Shelia Nelson-Stout, Board Member-at-Large (Salina)
Ron Pasmore, Board Member-at-Large (Wichita)
Colin McKenney, Past-President (Wichita)