With the proposed closing of nine local SRS offices, Gov. Brownback's administration is trying to sell us the notion that restricting access to basic life-sustaining programs is sound public policy. As advocates for high-quality long-term care for all older adults, Kansas Advocates for Better Care isn't buying their claim and joins Kansas communities and organizations across the state in opposing the closing of those offices.

The bitter pill prescribed by Secretary Siedlecki and Gov. Brownback claims the closures are the only cure to "saving" $1 million in Medicaid spending. While the medicine may be hard to swallow, they claim that Medicaid is too large, serves too many people and is unaffordable. But what is the "right size" for Medicaid? KABC believes that by restricting access, the needs of elderly, disabled and uninsured Kansans are not factored into the administration's diagnosis.

Too large? Kansas has fewer Medicaid recipients as a proportion of population than most other states. Too many people? For the uninsured – the part-time worker with cancer, the retired farmer with Alzheimer’s, those with developmental disabilities – Medicaid is the only assistance that meets their desperate needs. Closing offices does not alleviate our neighbors' needs; it simply ignores them.

Unaffordable? It’s only unaffordable if our leaders are too inert to lead in the true rebalancing of our Medicaid program by expanding the availability of home and community-based services and supports to serve elderly and persons with disabilities. The Brownback administration has made no mention of rebalancing Medicaid funding from institutional to community care.

By shifting the emphasis to home-based services, Kansas could be efficient AND compassionate with its Medicaid dollars. More than half of Kansas Medicaid dollars pay for institutional care. But in-home care is almost always less expensive and almost always more desirable to the recipient than institutional care.

Cutting Medicaid spending only pours salt on the wound. About 60 cents of every Medicaid dollar come from federal funds, and only 40 cents come from our state general fund. When we cut State Medicaid dollars, we lose important federal dollars which results in fewer Kansans being served.

Closing SRS offices does nothing to reduce the need for Medicaid assistance absent the cynical assumption that the most impaired won’t be able to access Medicaid services. Gov. Brownback and Secretary Siedlecki expect us to blindly accept the premise that a reduction of $1 million in Medicaid spending is critical to the economic survival of the state. We are to believe that the only way to save money on this front is to enroll fewer Kansans, regardless of their needs. It has to hurt if it's to heal.

These closures produce little savings in terms of dollars compared to the services they provide to our friends and neighbors. Those who are bearing the brunt of this cure-all are entirely blameless and very, very poor. The Brownback administration is trying to convince us that there are too many of "them" and that they are unworthy of our consideration and support. Otherwise, who’d agree to swallow such an expensive poison pill?

In the meantime, we’re told that the closing of the nine offices will shave $1 million off the SRS budget and all the employees will be reassigned. Setting aside the fact that these reassigned workers must absorb the cost of commuting, relocating, or finding another job, logic tells us this is not the panacea to balancing the budget.

KABC respectfully calls for Secretary Siedlecki and Gov. Brownback to reconsider this decision. Restricting access to our state's most vulnerable and marginalized is bad medicine.

Molly Wood

Board Member, Kansas Advocates for Better Care