Gov. Sam Brownback and his top welfare officials called a press conference today to announce they are moving forward with the administration's plan to reorganize the state's three main social service agencies.
The deadline for the Legislature to nix the agency shifts came and went last week. The proposed changes were presented to lawmakers in February as Executive Reorganization Order 41. Legislators had 60 days to consider it. Had either the House or Senate rejected the order, the reshuffle would have been halted. But in the House, support for it was strong enough that no hearings were held on the proposal. The Senate Ways and Means Committee took testimony and heard some opposition to the plan but took no action.
Brownback officials called the reorganization "historic" and said it was "crucial" to the administration's broader Medicaid makeover plan, which is called KanCare.
In particular, they said moving long-term care services from the Kansas Department of Social and Rehabilitation Services would cement their efforts to better coordinate care for elderly and disabled Medicaid beneficiaries.
Brownback has forecast at least $850 million in savings over five years for the state and federal governments thanks to KanCare. Administration officials have said improved care coordination and elimination of duplicated or unneeded services will provide most of the savings.
The strongest opposition to the KanCare plan has come from parents of developmentally disabled people and their service providers. They have said non-medical living assistance for those with developmental disabilities should not be included in the plan, which would farm out virtually all the state's Medicaid services to three for-profit managed care companies.
Opponents say the insurance companies have no track record of providing those types of services to the developmentally disabled and that they anticipate new layers of bureaucracy and complication will result from having to deal with three companies in addition to the state.
Even as the press conference was being held, the Shawnee County Commission was approving a resolution asking Brownback officials to not include services for the developmentally disabled in the KanCare plan. More than 20 of the state's 105 counties have endorsed similar measures.
But Secretary on Aging Secretary Shawn Sullivan, whose agency will take charge of those long-term care programs as part of the reorganization, said the administration was convinced that the programs should stay within KanCare. Otherwise, he said, the Medicaid system would remain "fragmented."
The governor also said his administration was committed to keeping the developmental disability services in KanCare. He said he believed the opposition resulted from fear of change despite the administration's assurances that the services will remain intact.
"I really believe we need to go to the structure we've chosen to get better outcomes," Brownback said.
Despite the opposition to some elements of KanCare, advocates for the disabled signaled early in the process that they would not fight the agency reorganization.
"We are concerned with how things will be set up, due to a sad lack of experienced personnel, but we decided early on that we would work cooperatively with them to reorganize their departments," said Tom Laing, executive director of Interhab, an association that represents most of the state community programs for the developmentally disabled. "We believe the secretary (Shawn Sullivan) wants a collaborative process."
Others were more enthusiastic.
"The SILCK (Statewide Independent Living Council of Kansas) and the network of Centers for Independent Living are so excited to work with Secretary Sullivan," said Shannon Jones, SILCK's executive director. "He is very ambitious and works hard to address the critical needs of people with disabilities and seniors. Under his leadership, we believe we can take independent living to the next level, ensuring all Kansans have the right to choose where their long-term services are delivered."
Jones represents groups that serve the physically disabled.
A few new details about the agency changes, first outlined at a press conference in November, were revealed at today's event.
Sullivan said that his agency, which will be renamed the Kansas Department for Aging and Disability Services, would eliminate 10 administrative positions (most of which are already vacant) as it merges what were two divisions at SRS into one at the new agency. The two divisions oversaw mental health services and substance abuse services. Sullivan said they were closely enough related they could exist in a single division.
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He also said that Craig Kaberline, previously director of information and community resources at the Aging Department, would become commissioner on aging effective immediately. Gary Haulmark, currently the deputy secretary at SRS who oversees Medicaid waiver programs, will answer directly to Sullivan.
SRS Secretary Phyllis Gilmore, whose agency will become the new Department for Children and Families, said the downsizing would allow improved focus on working with troubled families. She said five additional people would be hired in each of the agency's four districts to work with families that otherwise might see their children become wards of the state. She also said there would be a statewide initiative to streamline access to agency services modeled on a successful pilot project in Wichita.
Officials said they hadn't determined yet if any office locations would change for the few hundred state workers in Topeka who are slated to move from one agency to another as part of the reorganization.
The changeovers are expected to be complete by July 1, officials said.
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