KANSAS

Severe budget problems in Kansas have forced cuts in programs and services for people with disabilities, and waiting lists for services are growing. Due to budget shortfalls, for example, the Senior Care Act and the Home and Community-Based Services for Frail Elderly programs had waiting lists reported at the end of 2002 at about 650 people and 1,072 people, respectively.

Then-Governor Bill Graves (R) ordered state agencies to reduce their budgets by 5 percent in August 2002, with an additional 3.9 percent reduction in November 2002. (Since only six months remained in the fiscal year at that time, the actual reduction was 7.8 percent.) For the Department of Social and Rehabilitation Services (SRS), which administers many of the programs for people with disabilities, this meant a $26.6 million cut in November. (The cut totaled $49 million if the federal match were taken into consideration.) The SRS secretary said there had been reductions in services in some areas, rate reductions in other areas, and changes in eligibility for programs.

However, the state did receive a federal Real Choice Systems Change grant for almost $1.4 million for the "Kansas 21^st Century Long-Term Care Project," which calls for the development of a strategic plan and an action plan to guide in expanding self-determination and in providing additional control over supports and services for all individuals with disabilities. The strategic plan will address legal, regulatory and policy barriers to community-based services, funding issues, capacities of service providers and employment-related issues.

A three-year action plan for implementing the strategic plan will be the next step. Both plans will be drafted by a Strategic Planning Committee, composed primarily of consumers, with providers, and funding and regulatory stakeholders. The committee was expected to convene in September 2003.

A second goal of the grant is to develop a two-year pilot diversion project to provide short-tem case management services for individuals at risk of institutional placement when discharged from a hospital. A contractor is being hired to train two case managers to perform discharge planning in two pilot hospitals in Kansas. The focus will be on community placement upon discharge.

In the fall of 2002, SRS began field testing a Screening for Continued Stay (SCS) process for residents in nursing facilities for mental health. The SCS is a tool that community mental health centers use to assess whether a resident can be transferred into the community if he or she wishes. Eighty-seven people were recommended for community living of the 439 nursing home residents who were screened as of June 30, 2003.

As part of the Systems Change grant, 45 consumers have been trained to be facilitators, accompanying screeners as they conduct the screening process. The consumer facilitators provide encouragement and information to nursing home residents about community options and resources.

The Department of Mental Health and the Department of Aging met throughout 2003 to plan how to assess residents who have disabilities in regular nursing facilities. The planning was put on hold until results were in on the screening for continued stay process in the nursing facilities for mental health.

In addition to some funding through the Systems Change grant, the 2003 Legislature also appropriated funds to move 75 individuals from nursing homes into home and community-based care programs (House Bill 2444).