Kansas Health Institute | Information For Policy Makers. Health for Kansans.

TOPEKA — The Medicaid reform plan announced Tuesday by the administration of Gov. Sam Brownback includes a major restructuring of the Kansas Department of Social and Rehabilitation Services.

Officials said they plan to move all the state’s home- and community-based services for the disabled from SRS to the Kansas Department on Aging, which will become the Department for Aging and Human Services.

SRS would continue to oversee the state’s child welfare and poverty programs. The agency’s name would change to the Kansas Department for Children and Family Services.

'Spectacular'

“This is going to be spectacular,” predicted SRS Secretary Rob Siedlecki. “We’re excited about it.”

Currently, SRS has about 5,000 employees; after the restructuring it expects to have about 2,600.

SRS’ all-funds spending is expected to fall from $1.7 billion to $750 million.

About 2,300 of the SRS employees who are expected to move to the new Department for Aging and Human Services now work at the state hospitals for the mentally ill or physically disabled.

The Department for Aging and Human Services would run the five hospitals.

Initially, the plan does not include laying off any SRS employees, officials said.

No Layoffs

“For SRS, I do not anticipate any layoffs whatsoever,” Siedlecki said. “That’s consistent with what I’ve done in the past when we went through regional alignment and office closure. I did not and have not laid off any classified employees.”

In early July, SRS announced it would close nine of its local offices. It later agreed to keep four of the offices open after local governments agreed to cover the offices’ rent, utilities and copy-machine costs.

SRS employees affected by the closures were allowed to transfer to other offices.

Earlier this fall, about 350 SRS workers took advantage of the administration's buy-out program and took early retirements.

Also moved from SRS to the Department for Aging and Human Services would be Medicaid-funded services for the physically and developmentally disabled and the mentally ill.

SRS’ substance abuse programs would be moved, too.

SRS, in turn, would assume responsibility for nine programs for pregnant women, infants, toddlers and young mothers that currently are administered by the Kansas Department of Health and Environment. It also would take over prevention programs now housed at the Juvenile Justice Authority.

In an email to SRS employees Tuesday (PDF), Siedlecki called the restructuring “… a unique opportunity to put our principles into practice. We will be able to better coordinate the policies that help children and other vulnerable Kansans, to work to strengthen Kansas families and to encourage economic self-sufficiency.

“The new configuration,” he wrote, “gives Kansas an agency that targets one of the principal goals set out in the Governor’s Road Map for Kansas: reducing the number of Kansas children who live in poverty.”

Reaction

“I’m hopeful that the restructuring that was announced today allows SRS to become an agency that's more focused on what’s best for children and families,” said Shannon Cotsoradis, chief executive of Kansas Action for Children. “But at the same time, I have to say I’m troubled by the Brownback administration saying they want to reduce childhood poverty and yet, at the same time, proposing cuts in services for children. As Kansans, we can’t expect return on investments we don’t make.”

Since its creation in 1973, SRS has undergone several reconfigurations, including the agency turning over its regulation of the state’s nursing home industry to KDHE and administration of the state’s juvenile detention facilities to the Juvenile Justice Authority.

Much of the SRS-run foster care system was privatized in 1997, and in 2005 its oversight of Medicaid payments to doctors, hospitals and pharmacies was taken over by the now-defunct Kansas Health Policy Authority, which is now part of KDHE.

“The idea – back in July of 1973 – was to put all human services under one umbrella,” said Robert Harder, SRS secretary from 1973 to 1987 and for seven months in 1991. “The advantage was rather than having to deal with a lot of overlapping agencies, there was one. When there was a problem, we could respond much quicker that when everything was spread out over several agencies.”

Over time, legislators complained that SRS had grown too large and difficult to manage.

“In 1991, we had 8,500 employees,” Harder said.

Whether the latest configurations prove more efficient remains to be seen, he said.

“I find it interesting that back in 1973, a family receiving service would have had to deal with a single agency,” Harder said. “Now, it’s entirely possible for that family to find itself dealing with SRS, KDHE and the Department for Aging and Human Services.”

According to Brownback officials, the governor will submit an Executive Reorganization Order to the Legislature after it convenes in January, outlining the agency changes. The House and Senate then have 60 days to reject the ERO. If it is not rejected by either chamber then the reorganization would become effective July 1, 2012.

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