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Jan. 18, 2011
TOPEKA Disability groups have come up with a two-fold plan for significantly reducing the state’s years-long waiting list for home and community based services for adults and children with developmental disabilities.
The plan, outlined before the House Committee on Children and Families on Tuesday, calls for closing two state hospitals for the developmentally disabled - Kansas Neurological Institute and Parsons State Hospital - and using the savings to underwrite services in the community. Estimated savings from the hospital closures, according to the plan, range from $25 million to $40.4 million a year.
“If Kansas were to close both of these institutions, it would create a revenue neutral way to pump millions of dollars into services for people who are on the developmental disability waiting list, to serve people who have been waiting three, four, five, six and even seven years to get the services they need,” said Rocky Nichols, executive director of the Disability Rights Center of Kansas.
Long waiting list
More than 3,400 developmentally disabled adults and children are currently on the waiting list.
Last week, Gov. Sam Brownback, a Republican, proposed closing KNI over the next two years. He did not suggest closing Parsons State Hospital. A commission formed under Gov. Kathleen Sebelius, a Democrat, also recommended closing KNI and downsizing Parsons.
“Both hospitals should be closed,” said Nichols, a former legislator from Topeka. “More than a dozen states have already closed their DD (developmental disability) institutions.”
On Tuesday, Parsons State Hospital had 192 residents; KNI had 156.
Each resident’s care, on average, costs taxpayers almost $150,000 a year. Similar services in community based settings would cost about $36,000 a year, advocates of community services say.
The plan also calls for using a so-called provider tax on local programs to raise an additional $25 million in federal aid.
The tax would be similar to one that became law last year that is expected to eventually generate an additional $43.3 million in federal aid for the state’s nursing homes.
“There is massive support for this initiative,” said Matt Fletcher, a spokesman for Interhab, a state association that represents most of state's community based programs for the developmentally disabled.
The plan is similar to one that stalled during the 2006 legislative session. The earlier plan called for eliminating the waiting list over a three-year period.
“There are lots of things that need to be looked at,” Fletcher said. “Back in 2006, the talk was about eliminating the waiting list and building up our capacity over a three-year period. Now, it looks like it might take five years. And there are a lot of things that would have to be put in place for that to happen."
For one thing, federal officials have yet to approve letting programs for the developmentally disabled use state-imposed provider taxes to bring in millions of dollars in matching federal Medicaid assistance.
More to be found
The committee’s chairman, Rep. Mike Kiegerl, R-Olathe, said he welcomed the plan but doubted it would generate enough revenue to eliminate the waiting list.
“It is very tempting and pleasant to say we can do something in a revenue-neutral fashion,” Kiegerl said. “But the numbers I’ve been given say that we need $75 million SGF (State General Fund). The savings from closing both state hospitals would be $40 million. That’s not sufficient. More will need to be found.”
Kiegerl did not comment on the proposed provider tax.
Officials with the Kansas Department of Social and Rehabilitation Services have said clearing the waiting lists for developmentally disabled children and adults would cost $115.3 million, all funds; $49 million, state funds.
The committee also heard from Tim Wood, who’s managing a grant-funded “End the Wait” campaign in Kansas. He urged committee members to embrace the plan.
Wood provided committee members with a chart that showed how many adults and children were on the waiting list in each of the counties they represent.
He cited a compilation of SRS waiting-list data showing that the person “next in line” on the list has been waiting more than four and a half years for full services.
Wood called the delay “utterly cruel.”
The committee did not hear testimony on the state’s waiting list for services for people with physical disabilities.
Last year, then-Gov. Mark Parkinson issued an executive order, directing SRS to determine which of the 344 residents at KNI and Parsons could safely live in community settings. The order also stipulates that as funding becomes available, residents able to live in the community are to be moved out of the hospitals. Those found to be too fragile were to remain at a hospital.
Eventually, as the hospitals’ populations decline, one of the two facilities likely would be closed. The Parkinson administration estimated the closure process would take three or four years.
The Brownback administration, in its proposed budget for 2012, has singled out KNI with the expectation that closure would take two years.