phone numbers for silck

SILCK
Statewide Independent Living Council of Kansas
700 SW Jackson Street, Suite 212
Topeka, KS 66603-3758
785-234-6990 Voice/TDD
785-234-6651 FAX

New SPIL Input
Living by Chance	SILCK	State Plan	Caucus	Centers	Board	Legislative

Legislative Session 2006

**** SB 100, the bill that will make it more difficult for residents to sue nursing homes for abuse and neglect was swiftly manuvered yesterday. The Senate conference committee concurred with the House version early in the morning. It was immediately brought to the Senate floor (where it never had a hearing) and passed 38-1. Senator Barone was the one 'NO' vote. A coalition of advocates then went into action and put together a press conference outside of the Governor's office, urging her to veto this legislation.

ACTION NEEDED: Write letters / postcards or emails to the Governor respectfully requesting her "Veto" on SB 100. Advocates should urge the Gov. to give careful consideration to the protection of nursing home residents who deserve high quality care. Kansas citizens must have meaningful legal protections to ensure they get quality care.

** Meanwhile, the the school finance bill has been sent to the Governor. She is not expected to sign it but send it directly to the Supreme Court for their decision, probably sometime after April 12th.

** The House passed the mega budget bill last night and the Senate is expected to do the same today. The Gov recommendations for social services and HCBS funding are still intact. Critical to this whole process is how the Court reacts to the school finance plan that the Legislature came up with. If the Supreme Court decides that they didn’t do what was needed on the school finance budget, then they may be scrambling to find money elsewhere in the budget! So, we won’t really know until after the April 12 dealine date.

** During budget conference committee this week, a proviso to allow Money Follows the Person for 80 persons was agreed upon. This proviso also calls for SRS to conduct a study on cost effectiveness for the program. Meanwhile, SB 218, which would remove the cap, is still alive for next year.

** The Health Care Reform measures brought by the Senate and Hs (SB 306 & HB 2531) are very similar to the Gov ERO 33 are expected to pass through both chambers by the end of today as well.

** Mike Donnelly, DRC and advocates have been tirelessly working on HAVA requirements. As of late last night they were continuing to work on language with the conference committees.

**The non-discriminatory language in the CINC revision bill will not go to the Senate this year. However, since it has passed the HS, we are halfway there for next year and will need to work the Senate.

(38-1) favorably yesterday. Both chambers have now passed and in a form that was acceptable to most special education advocates. Considering the way this bill was fast-tracked this is a huge victory for us!

The House and Senate are planning to adjourn today until April 27. The Omnibus session will begin on April 18th.

Don't forget, we plan to welcome back all legislators on April 27th at 10:30 am with the Big Tent Coalition Picnic and Rally. The governor is scheduled to speak at

All legislators have received an invitation to attend. I'd suggest calling your Rep & Sen. asking them to meet you on April 27th, south side of the Capitol for a hot dog

and a conversation about the remaining needs of Kansas seniors and people with disabilities.

First, we owe a huge round of thanks to Rep. Paul Davis from Lawrence for putting our amendment for prohibiting discrimination against parents with disabilities onto another bill on the House floor yesterday. The same language of our amendment is now attached to HB 2200. This bill passed the HS unanimously this morning!!!! Many thanks to Rep Davis for keeping this alive! It will now move over to the Senate. Please let your Senators know to support this bill. This action was necessary because the other Child In Need of Care bill was not going to be considered on the Senate this year. This moves us way ahead!

** HB 2331 the Sp. Ed. conformity bill, passed the HS on General Orders this morning. Advocates have done an excellent job so far on this one! It keeps current transition age at 14 years AND requires parental consent for more than a 25% change in placement for a child’s school day. HB 2331 could have a hearing on the Senate side as early as Monday next week. Again, we need all Senators support on this.

**The Senate Ways & Means committee approved the SRS budget report; it includes $30,000 for the Youth Leadership Forum!!! In addition, approval for the Money Follows the Person language for 100 persons and asks that SRS report back in 2006 with expenditure data. They also agreed with the Governor’s budget to add additional dollars for the PD ($1M) & DD ($2.5M) waiting lists. The troubling part as I’ve said before, the report also contains language that there will be NO waiting List for the PD by the end of FY ’06. I have had several conversations with Sec. Daniels and Senator Umbarger on this and will continue to get it corrected, meanwhile, please continue to document the number of folks waiting.

**HB 2482 – is the House’s big budget bill for FY’06. It passed on the Hs floor today with many amendments and much debate. It remains pretty much the same bill however, sweeping funds from higher education, transportation and state employee raises. These dollars that were swept from the Gov budget, the HS believes, will fund K-12 education. So far no monies have been swept from social services.

**The last thing I want to call your attention to is a House Concurrent Resolution HCR 5015 that was introduced in the HS this week.

This is a very BAD idea folks! We need to write letters to the editor and tell ALL Representatives to Oppose. I have attached information from Kansas Action for Children publication on “Why is TABOR a Bad Idea” Please read, then write your letters and call your Rep.!!!

HCR 5015 is what’s commonly referred to as “Taxpayer Bill of Rights” or TABOR.

First enacted in Colorado in 1992, TABOR represents the most restrictive tax and expenditure limitation in the country. In recent years there has been a movement towards expanding TABOR into additional states. At least eight states, including Kansas, had active legislative debates on TABOR in 2004.

TABOR is a constitutional measure. In order to enact TABOR in Kansas, a resolution, HCR 5015, would need to be approved by a two-thirds majority of both houses of the legislature. The measure would then be put to a statewide vote at either the general election or a special election. If a majority of voters in that election approved the measure it would become law. Unlike other legislation, the approval of the governor is not necessary for constitutional amendments. The flip side of this is that once the measure is approved, the same procedure would need to be used to repeal it, making it very difficult if policymakers in Kansas decided that TABOR was not accomplishing the intended goal.

TABOR limits revenue growth for state and local governments to the percentage of growth in population plus the inflation rate. If the current tax structure generates revenues in excess of the limit, the excess revenues are placed into a “budget stabilization,” or rainy day fund, up to a constitutionally prescribed amount and any excess after that is refunded to the taxpayers. If there is a need for the excess revenues to fund current services, voters must approve of this action in a statewide election. Likewise, if there is a need for additional revenues, voters must approve tax increases in a statewide election. In fact, some TABOR proposals even call for a statewide vote to increase fees.

That’s all I can think of for now. Call me if you have questions or need more information to talk to legislators. And if you get a chance let me know how they are responding.

LIMITING GROWTH AND DEMOCRACY:

WHY TABOR IS A BAD IDEA FOR KANSAS

STATEMENT OF PURPOSE

Government spending has come under fire in recent years across the country. It is no different in Kansas. There are those who think that government is greedy, wasteful, and in need of reduction. However, a closer look at government shows that is an integral part of our civilized society and we take for granted all of the ways that it touches our daily lives.

The purpose of this publication is to identify fundamental flaws with rigid tax and budget limitations and demonstrate the importance of government in our everyday lives.

INTRODUCTION

Government is a vague term that is really about hundreds of services that we rely on in our everyday lives and have come to take for granted. Who quibbles about the cost of snow removal when the big blizzard hits? Who doesn’t have an aging parent, neighbor or friend who receives help with healthcare, insurance or in-home services from some level of government, be it federal, state or local? We expect our children to have access to an education, for the police to come when there’s a crime committed, for the local health department to provide flu vaccines, to have safe roads to drive on, and to be able to check a book out of the local library. All of these things are provided by government, and there is a cost associated with them.

While groups wishing to limit the role of government often focus on the allure of tax rebates and the potential for government waste and abuse, the true impact of rigid tax and budget limitations is to reduce the quality and quantity of government services. Is it really a benefit to the average taxpayer to pay lower taxes if the city or county can’t afford to plow the roads when it snows or if class sizes in public schools increase dramatically? Most of us don’t want to go back to the times before government inspected restaurants, licensed doctors, constructed and maintained major highways, and provided funding for the elderly to receive nursing home care when families cannot.

WHAT IS TABOR?

TABOR stands for “Taxpayers’ Bill of Rights.” First enacted in Colorado in 1992, TABOR represents the most restrictive tax and expenditure limitation in the country. In recent years there has been a movement towards expanding TABOR into additional states. At least eight states, including Kansas, had active legislative debates on TABOR in 2004.

TABOR is a constitutional measure. In order to enact TABOR in Kansas, a resolution would need to be approved by a two-thirds majority of both houses of the legislature. The measure would then be put to a statewide vote at either the general election or a special election. If a majority of voters in that election approved the measure it would become law. Unlike other legislation, the approval of the governor is not necessary for constitutional amendments. The flip side of this is that once the measure is approved, the same procedure would need to be used to repeal it, making it very difficult if policymakers in Kansas decided that TABOR was not accomplishing the intended goal.

WHAT IMPACT HAS TABOR HAD ON COLORADO?

The voters of Colorado passed TABOR in 1992. Under Colorado TABOR, voter approval must be given for any new tax, tax rate increase, debt increase, property tax mill levy increase, or any tax policy change that will result in a net revenue gain. However, voter approval is not necessary for fee increase.

As in other TABOR proposals, Colorado TABOR imposes a limit on how much revenue a government can collect and retain. The Colorado Constitution contains different growth formulas for different levels of government. For state government, the formula is the percentage of population change plus the rate of inflation.

Each growth formula is applied to the prior years’ fiscal year spending, which means it is based on actual revenue collections or the formula-limited collections, whichever is lower. This is often called the “ratcheting down effect” and has resulted in dramatic contractions in Colorado revenues and the quality of government services, especially during the economic downturn that began in 2001.

Before TABOR, Colorado generally enjoyed a status near the middle of the pack in terms of national rankings reflecting the quality of government services available. However, in many current rankings, Colorado fares much worse. One of the most dramatic examples of this is the ranking of 50^th in the nation in childhood immunizations as of 2003. This is a state where the average household median income of $50,224 is higher than that of households in 37 states.

The following Table illustrates the change in Colorado rankings among the 50 states in the decade since TABOR’s implementation.

Note: This table was prepared by the Wisconsin Budget Project. For all the measures, a lower number indicates a higher ranking. The data came from many sources, including the KIDS COUNT Data Books, Census Bureau, CDC, Morgan Quitno, and Kaiser Family Foundation.

There are many reasons that TABOR is a bad idea, not the least of which is the impact it has had in Colorado. In fact, recent polling shows that even Coloradoans would like to significantly relax the provisions of TABOR.

According to the Ninth Annual Mind of Colorado Survey of Public Opinion, published by the University of Colorado at Denver in 2003, two-thirds of Coloradoans would support modifying TABOR’s spending limits to make it easier to restore services to pre-recession levels. Likewise, 61 percent of the poll’s participants said that the state “should be allowed to keep more revenues collected when the economy is strong so long as the money goes into a rainy day fund that can only be spent when the economy is weak.”

A fundamental flaw of TABOR is that it does not provide any flexibility for government to address unforeseen costs such as those attributable to natural disasters, diseases, and advances in infrastructure. For example, when TABOR was first enacted in Colorado, West Nile virus was not known to North America. Twelve years later, Colorado led the nation in West Nile deaths but could not provide no funding to local health agencies to address the threat. While the budget stabilization fund, which is a component of the recent TABOR proposals, could ease the impact of one-time crises, it would be limited in scope and certainly could not address ongoing costs such as those in the West Nile example.

TABOR does not take into consideration an increasing need for services based on demographics. For example, TABOR does not recognize the aging of the baby-boomers and the resulting increase in demand for services such as Medicaid, which requires a state funding match.

Another fundamental flaw of TABOR is that it alters the democratic process. When the state constitution predetermines the level of spending for the year, there is no role for elected officials in either the tax or budget process. Unless a taxpayer has significant financial and advocacy resources enabling them to undertake a statewide campaign to retain or increase revenues, there is nothing to be gained by asking for help from their elected officials.

Under TABOR, regardless of the urgency of the need for funding as in the case of childhood immunizations, elected officials are given few choices. They may either cut funding or another worthwhile service or maintain the status quo.

TABOR does not allow for investments in people or technology that require significant costs at the onset but may actually decrease government costs over time. For example, quality early care experiences for children, particularly low-income children, result economic returns that exceed initial cost.

Based on outcomes such as improved school performance, reduced special education placement, lower school dropout rates, and increased lifelong earning potential, the return on investment to society has been estimated t range from a $4 to $7 return for every $1 spent. However, under TABOR new investments in quality early care would not be possible without a statewide vote to increase taxes for this purpose, even though the investment would reduce long-term costs to the state.

Yet another TABOR flaw is that neither the Consumer Price Index (CPI), which is the inflation measure of choice in Colorado, nor any other existing measure of inflation correctly captures the growth in the cost of the kinds of services purchased in the public sector. Specifically, a major part of state spending goes to personnel, technology, and healthcare costs. Costs in all of these areas exceed the CPI.

Is it possible for government to misuse our hard-earned tax dollars? Of course it’s possible, but the democratic process gives us a perfect remedy. Vote for a new governor, new senators, representatives, mayors, or school board members. The answer is not to shift control from the voters to a constitutional provision that is very difficult to amend.

Government is not vague. It’s not a scheme for bureaucrats to steal our money. Among other things government is military reservists, teachers, grain inspectors, librarians, prison guards, nutritionists, and road construction workers. These people and the services they provide touch and enhance our lives daily. The real impact of TABOR, as demonstrated in Colorado, is to reduce the quality and quantity of government services.

As is the case n many states, Kansas has experienced a series of lean years during the recent economic downturn. Budgets have been tightened and new funding has been put off until better times. Kansas can still afford to restrict revenues now. It is clear that TABOR is not in the best interest of Kansas and can only be detrimental to the quality of life Kansas children and their families enjoy.

** The Senate subcommittee for SRS took additional testimony and once again the YLF folks, Julia, Carrie and Zack knocked their socks off! Great Job! The sub committee report with recommendations for funding will be presented next Thursday, the 17th to the full Ways & Means Comm.

** HB 2352-- Amending Child in Need of Care to prohibit discrimination based solely on a parents disability. This bill has passed the full HS, but appears to be stalled in the Senate. The Senate Judiciary committee indicates they will not have time to hear the bill. This is certainly a huge disappointment for all of us. If this bill does not move through the Senate this year, it will still be alive for next years session and only have to pass out of the Senate. We will continue to advocate for hearings, but we are running out of time, so may have to wait until next year. Will keep you all posted.

**SB 218 --Money Follows the Person
Had additional hearings this week in the Senate W&M, with much discussion and debate. It appears the recommendation will be "to pass over the Bill, but include a proviso in the SRS budget to allow $FP up to 100 folks total for either the PD or FE budgets" This bill has generated alot of attention. The good news is that after further study, I believe the legislature will see and better understand the absolute cost savings and Choice provided and will then pass a bill without a cap next year.

** ERO 33, The HS voted down the Governor's plan to reorganize a Health Care Authority. It appears Republican leadership want to propose a new healthcare policy that combines some of the Governors initiatives. Details of the new plan are unknown at this time, however a bill should be drafted this week.

The HS Appropriation Comm approved it's big budget bill for FY'06 and should go to the full HS floor this week.

The Senate Ways & Means should have their budget bill by this Friday. The Senate may also consider a gaming bill this week in order to finance their school finance plan for years two & three.

Don't forget the BIG TENT COALITION RALLY date has changed to APRIL 27th! Hope to see y'all there!

It's been a quite a week! This was turnaround week, meaning all bills introduced in either chamber (unless they were blessed) must be passed out and turned around to the other chamber, otherwise they are considered dead bills. These were the items we followed:

** HB 2352, the Child in Need of Care code (CINC) includes an amendment to prohibit discrimination based on a parents disability passed the full House on a final vote of 118 - 4!! We must now work all Senators to support this most important piece of legislation.

**HB 2241, prohibiting nursing home inspection reports to be admissible in court. This bill was killed on Final Action, vote was 53- 69

** The House Social Services Committee agreed with the Governor on $3.5 M SGF for reducing the waiting list, but did not put in any additional money to eliminate the waiting lists. The Senate will work the SRS budget next week, Tues, Wed & Thurs.

**SB 218 - Money Follows the Person, has not yet had a hearing, but it is a 'blessed' bill, so please stay tuned for upcoming action.

I'm sure I have forgotten something, but will keep you all posted. Don't forget Thursday March 3rd is Independent Living Day at the Capitol.

A Flyer for ALL to distribute for the Big Tent Coalition Rally on March 29, 2005: go to Freedom Day Rally 2005 link at www.bigtentcoalition.org Please make as many copies as you need.

If any of you attend weekend coffees or leg forums, please mention the following items:

SILCK presented testimony on the KDOA & SRS budgets this past week. In general we supported the Governor Budget recommendations for FY'06; no waiting list for FE waiver, add money for the PD & DD waiting lists. However we called attention to the remaining need of $15.7 state general funds to eliminate all those who are waiting for services on the PD & DD. In addition, we highlighted the need for additional $1.2 M for base funding for CILs and recommended policy reforms for Medicaid long term care, 1) Amend the Medicaid State Plan to include HCBS as a mandatory service to ensure CHOICE 2) Reduce or consolidate the number of nursing homes beds.

Youth Leadership Forum----ROCKS!!!! YLF presented testimony to the HS requesting financing for YLF. They did a Fabulous job and received a standing ovation!

There are still deep concerns that both the HS and Senate Education plans do not call for any new revenues for the first year of funding. The possibility of legislators sweeping out all new monies recommended by the Gov. is VERY real. Therefore the only sources of revenue would have to come from social service programs among others. Again, it is important that we stress that we will NOT be pitted against education! Both education and human service programs are ESSENTIAL and equally important to the citizens of Kansas.

SB 171 - terminates out of home services for foster youth ages 16 - 18. The SILCK provided testimony in opposition to this penny wise, pound-foolish proposed policy. Thanks to the folks at RCIL who presented powerful testimony from some of the youth in their area that would be adversely impacted by this proposal.

"Nothing in this chapter shall be construed to allow discrimination on the basis of disability. In cases involving a parent or guardian with a disability, assessments under this chapter shall take into account the use of any accommodation including but not limited to; adaptive equipment, assistive technology and support services, whether formal or informal and shall be conducted by, or with the assistance of, one or more individuals, who posses a combination of experience, training, expertise and knowledge in the use of such equipment and services."

The HS Judiciary Committee and Judicial Council were favorable to the suggested language. We are hoping this moves out of committee today and will go to the House floor next week. This is a big one folks, please talk to all legislators on the need to get this passed!!!!

Chris Owens, PILR and the folks from SKIL have been doing some great work with a group from SRS, Children & Family services on modifying the language in the training manual for social workers as it applies to child custody cases and parents with disabilities. This will certainly help, but we need the language of the law to boost these efforts as well.

Tanya at KACIL has been taking the lead on this one. The bill has not yet had a hearing, but stayed tuned. I know Tanya is working with the Senate Way & Means committee and will have more info to follow.

My plan is to get IL Day packets out to all of the CILs next week so you can prep all of your folks on the issues.

Don't forget, Independent Living Day at the Capitol is Thurs. March 3rd. And the Big Tent Coalition Rally Day is Tuesday, March 29th

Well, now that the important issue of gay marriage is out of the statehouse and soon to be on a ballot near you.....things are getting serious!

If any of you attend weekend coffees or leg forums, please mention the following items:

**SILCK has requested an amendment to KS Child in Need of Care Code (CINC) prohibiting discrimination on the basis of a parents disability. This will be introduced in the Senate Judiciary comm. Hearings should be scheduled shortly. Meanwhile, if any of you have stories to share with the press & legislators on this issue, please do so NOW!

** Disability Rights Center (DRC), formerly KAPS has requested 3 bill introductions

to focus on these issues:
    1. Guardianship #1: Prohibiting Conflicts of Interest with Guardians
    2. Guardianship #2: Limiting Guardians ability to withhold or withdraw life sustaining medical care.
    3. Protection and Advocacy for Kansans with Disabilities Fund
(formerly known as "Access to Justice"): establishing a fund to provide
criminal and civil investigation of abuse, neglect and exploitation of
people w/ disabilities and to advocate for the rights of PWD.
    4. Establishing a state policy that ensures that people living
in a group home of two or more are free from abuse, neglect and
exploitation.

**DRC and Attorney General Phill Kline will be co-hosting a press
conference on Tuesday, February 8, 2005 at 1 p.m. in the Old Supreme
Court Room, Rm 313-S, to announce the Bills introduced in response to the Kaufman
house situation in Newton.

** KACIL has requested Money Follows the Person (MFP) legislation and is currently being drafted to be introduced in the Senate Ways & Means comm. Instead of MFP being considered a demonstration project capped at 75 individual per year, this bill would make MFP a state policy where NF monies would transfer to HCBS programs for all individuals transferring from NF to community, provided the individual resided in the NF for at least 90 days.

Hall talk from the Capitol does not sound good. It appears some HS. legislators from within the HS Appropriation and Social Service Comm want to remove any increases for social services programs back to '04 levels and use those funds to support education.

Dept of Aging (KDOA) presented their budget to HS Social Services committee this week. Hearings are scheduled for Mon & Tues next week. SILCKs testimony basically states we are pleased with KDOA new policy of 'No Waiting Lists' for FY'05 and FY '06, as this truely ensures CHOICE for older Kansans, but believe this policy should not be exclusive to only aging populations. The SILCK recommends a policy of CHOICE for ALL persons who CHOOSE community services rather institutions or NF regardless of their age.

SRS staff will present their budget next week (Thurs. & Fri) to the same HS Social Services comm. Public hearing most likely will be Feb 14 and 15. The SILCK will present:
1)appreciation for the Gov budget recommendations for additional funding targeted to waiting lists on the PD and DD waivers, yet still see hundreds waiting for services in our future with no choice, 2) Express opposition to elimination of out-of home services for foster care kids age 16 -18 this is also in HB 171 that amends the statute.and 3) increase base funding for CILS.

That's all for now, stayed tuned. If you have questions please call or email me. I can't tell you how important it is to me that when visiting with legislators, they tell me that someone back home has already express this same concern! Keep it UP! We are gonna need your energy!

Don't forget, Independent Living Day at the Capitol is Thurs. March 3rd. And the Big Tent Coalition Rally Day is Tuesday, March 29th

Shannon

Centers for Independent Living (CIL) are designed by their mission and philosophy to assist people with disabilities in becoming independent. In addition to providing support to people with disabilities of all types and any age, they also employ a majority of disabled people on their staff.

CILs are mandated to offer five core services to comply with Sec.725 of the Rehabilitation Act as a condition for receipt of state and/or federal independent living funds. The (5) core services are offered free of charge to any person with any disability of any age. Many of these services prevent people from needing other assistance such as Medicaid.

The funding will be allocated to Social & Rehabilitation Services, Health Care Policy and then be distributed among all 12 CIL to provide funds to bring each to a base of $250,000. This amount is necessary to sustain a free standing CIL offering the five core services.

All of the (12) CILs are currently operating under inadequate funding levels. The twelve CILs in Kansas receive $652,058 in State General Funds to operate. CIL have been instrumental in the formation of cost effective and consumer directed community based service system. In addition, CILs initiated efforts for "Money Follow the Person". Through these activities CILs have saved the state and federal government millions in taxpayer dollars.

CILs are non-residential, community based, private non-profit organizations that are designed and operated by individuals with disabilities.

Centers for Independent Living are unique in that they operate according to a strict philosophy of consumer control, wherein people with all types of disabilities govern and staff these organizations. Centers for Independent Living, through employees with disabilities, address the discrimination and barriers that exist in society.

These barriers are sometimes architectural, but more often reflective of the attitudes and prejudices that have been reinforced for generations. They have deterred people with disabilities from working, leaving many in poverty, and too often meant living in institutions. It is logical to recognize that with increased opportunities, individuals with disabilities will participate in the type of community life experiences that their non-disabled counterparts take for granted as a civil right.

Some interesting FACTS about the services CILs provided in 2003

v     Kansas CILs served an unduplicated total of 19,329 people with disabilities, enabling them to achieve goals and live independently in their communities at the level each desires;

v     Kansas CILs responded to 25,875 information and referral calls from citizens with disabilities, their families and communities in which they live;

v     Kansas CILs are often the gatekeepers in the disability community;

v     Kansas CIL staff and volunteers provided 78,612 hours of community education, outreach, advocacy, and other disability related services;

v     Each of the 12 Kansas CILs have innovative programs to best meet the needs of individuals with disabilities in the communities which they serve;

v     Kansas CILs are collaborative agents, not duplicating services that other agencies provide, but working together with all agencies to best serve people with disabilities in Kansas;

v     Part of the mission of Centers for Independent Living is to assist persons with disabilities in either leaving costly institutions or preventing their placement in institutions. Centers for Independent Living use home and community-based programs to assist people with all types of disabilities to become more financially self-sufficient and less dependent on long term government supports. Through Centers for Independent Living services, in conjunction with Kansas Social and Rehabilitation Services, home and community based services such as personnal attendant services, people with disabilities that have been imprisoned in institutions/nursing homes are moving out into the community. These and other support services offered to people result in tremendous cost savings to the state of Kansas, Medicaid, and Medicare each year.

Kansas CILs assisted 4,698 individuals in either moving out of nursing homes or prevented them from going into an institutional setting during FY2003. This effort by the 12 CILs in Kansas has saved $59,363,928.

For Fiscal Year 2004 the
Medicaid Long Term Care Budget

Background
The current Medicaid long-term care system is antiquated, fragmented, overly medicalized, bureaucratic and expensive. The institutional bias unnecessarily places people with disabilities and older Kansans in nursing homes and other institutions. The public overwhelmingly wants long term care services and supports in their own homes and communities. Thousand of people with disabilities and older Kansans currently need or will need long-term services and support to live in the community.

The Supreme Court in the Olmstead vs LC & EW decision ruled in 1999 that people have the right to services in the most integrated settings. The reform of the long-term care system must be a cooperative partnership between the administration, SRS and the disability/older community.

Request
The funding policy for Home and Community Based services should be considered the same as institutional services. If HCB services are readily available to those that need them, the long term services system will rebalance on its own; away from costly institutional services towards the more preferred and cost effective approach in the community.

Justification
HCB services can provide supports on average to twice as many people at half the cost of nursing facility care. By making HCB services as accessible to individuals with disabilities or long term illness as institutional or facility based care, we can eliminate waiting lists and reduce the cost of long term care in Kansas.

Kansas seniors and those with disabilities, who meet the long-term care threshold, meaning that they are eligible for nursing home care, should have a choice in where those long-term care services are delivered.

The Big Tent Coalition (BTC) is working to ensure that Kansas seniors, and people with disabilities get the essential services they need. As the Legislators move toward decision-making on the states budget, we want to highlight the significance of Home and Community Services. It is a program geared to people having their civil right to choose independent life-styles. Community Home Based Services are less expensive to the States budget and most preferred by seniors and people with disabilities.

Proposed Language

(f) Medical Assistance means the payment of all or part of the cost necessary: (1) Medical, remedial, rehabilitative or preventive care and services (including all Home and Community Based Services), which are within the scope of services to be provided under a medical care plan developed by the secretary pursuant to this act and furnished by health care and Home and Community Based Services providers who have a current approved provider agreement with the secretary, and(2)

(5) within the limits of appropriations therefore, the home and community based services program shall serve eligible individuals in need of in-home care throughout the state. To ensure persons eligible have a choice in the delivery of those services, the budget estimating for the operation of this program shall be included in the caseload estimating.

Parenting with a Disability

In recent years, the SILCK has been contacted by a number of parents with disabilities and their advocates who have had their children taken from their homes, in some cases for considerable periods of time by SRS or other governmental intervention. In some cases their parental rights have been terminated. Basically because a social worker questioned whether the parents were qualified to care for their children because of the parents disability. Parents with varying types of disabilities, i.e., parents who are blind or low vision, parents with mental illness, parents with developmental disabilities, parents who are deaf, and parents with physical disabilities have experience these situations.

Kansas child custody and termination of parental rights laws as currently written reflect the historical bias against parents with disabilities and present an unrealistic view of parents with disabilities by their referral to having a disability as a factor in a parents ability to raise their children. Many parents with significant disabilities provide excellent care and stable homes for their children.

1) Amend existing statutes to prohibit discrimination in child custody actions on the basis of a parents disability.

2) Amend existing statutes to provide that parents shall have the right to present evidence and information that supports their abilities as a parent who uses adaptive equipment and supportive services.

The SILCK believes there needs to be legislation protecting the rights of disabled parents. It needs to be illegal to investigate the capabilities of an individual to parent based on the fact that the parent has a disability. There needs to be a presumption of capability. Social workers need to present credible evidence of the inability to parent, not simply of the existence of the disability, before any action to remove children from a home, or to in other ways sanction or intrude on the parents role as caregiver can take place.

Measure			Colorado
	1993				Current
Health Insurance coverage		21st		36th(02-03)
Childhood Immunization		27th (94)		50th (03)
Timely prenatal care		21st (90)		41st (02)
Low-birth-weight babies		42nd		40th (02)
Infant mortality		19th		11th (00-01)
Child death rate		16th		21st (01)
Teen birth rate		30th		36th (02)
K-12 spending per pupil		28th		33rd (02)
K-12 spending relative to income		35th		48th (01)
Per capita higher education appropriations		31st		47th (04)
Percent of teens who are high school dropouts		31st		47th (04)
Idle teens (%neither working nor in school)		13th		32nd (01)
Morgan Quitno rankings:
"Most Livable State"		8th		23rd (04)
"Healthiest State"		9th		27th (04)

$28,524	Cost per year for nursing home
-$15,888	Cost per year for HCBS services
$12,636	Yearly cost savings/ person

$12,636	Yearly cost saving/ person
x 4698	Number of people with disabilities moved out of nursing homes and/or avoided nursing home placement
$59,363,928	Total Annual Savings

	All Funds	State General Funds	# Served
Nursing Facility	$316.5 M	$115.1 M	10,756
HCBS/FE & PD	$124.8 M	$ 45.3 M	9,845

$12,000. ALL FUNDS	$16,000. ALL FUNDS	$28,500. ALL FUNDS
Frail Elderly	Physical Disabled	Institutional Care

	All Funds	State General Funds	# Served
Nursing Facility	$316.5 M	$115.1 M	10,756
HCBS/FE & PD	$124.8 M	$ 45.3 M	9,845