By Dave Ranney, KHI News Service, July 18, 2008
TOPEKA — State officials reviewed their plans Friday for making sure that, four years from now, more Kansans with disabilities will be living in community settings. Fewer will be in nursing homes.
“We’re ready to start building bridges into the community,” said Deb Schwartz, director of transition and client assessment, referral and evaluation at the state Department on Aging.
Testifying before the Joint Committee on Home and Community Based Services Oversight, Schwartz said KDoA and the Department of Social and Rehabilitation Services expect to move about 963 people out of institutional settings and into community settings by 2012.
The initiative — called “Money Follows the Person” — is part of a federal demonstration project aimed at reducing the state’s reliance on institutional care, which tends to cost considerably more than programs that help the frail elderly and people with disabilities live in the community.
Included in the 963 slots:
The four groups are subject to waivers that allow the home and community based program to receive Medicaid funding.
Schwartz said “community bridge building teams” have begun meeting with nursing home residents who have expressed an interest in returning to their homes or apartments in their communities.
Though less costly, many of these moves will be time-consuming and difficult to arrange.
“We know housing will be an obstacle,” Schwartz said. “Transportation will be a challenge.”
The initiative includes money for covering utility deposits, buying basic furniture, and making a residence handicapped accessible.
As the 963 individuals move to community settings, most of their institutional beds are expected to remain vacant.
These empty beds, said KDoA Secretary Kathy Greenlee, will be among the “changes in the long-term care marketplace over the next 10 to 15 years.”
The state’s nursing home industry, she said, will need to adapt.
“The next four to six years could be difficult for some of the rural areas, I suspect,” said Rep. Jerry Henry, D-Cummings.
“Upkeep on a lot of empty beds is not going to be a fun thing,” said Rep. Bob Bethell, R-Alden.
The industry, Bethell said, knows it has to change.
“We’ve all heard the expression about how doing the same thing over and over and expecting a different result is the definition of insanity,” he said. “Well, nursing homes can’t keep doing the same thing and expect a different result. They’re going to have to change.”
Bethell, the committee’s chairman, is a licensed nursing home administrator.
Greenlee assured the committee that she expects to be able to cut KDoA’s budget by 1 to 2 percent without having to institute a waiting list for home and community based services for the frail elderly.
But the department, she said, may have to ask for additional funding for meal programs that have been hard hit by increased in fuel and food prices.
“Right now — gasoline prices, that’s all I’m hearing about,” Greenlee said.
Last month, Gov. Kathleen Sebelius directed her cabinet secretaries to begin the processes for trimming their budgets 1 to 2 percent.
SRS Secretary Don Jordan declined to predict whether his department could avoid a waiting list for people with physical disabilities or traumatic brain injuries.
“In the past, we’ve been able to shift money around to keep (waiting lists) from happening,” Jordan said. “Whether we’ll have the flexibility to do that this year, I don’t know at this point.”
Later, he added: “I think we will, but I can’t guarantee it.”
The department’s long-standing waiting list for people with developmental disabilities is expected to remain in place.
Committee members agreed to meet again Aug. 27.
Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at dranney@khi.org or at 785-233-5443, ext. 128.