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Statement of Ann E. Koci, Kansas Commissioner of Adult and Medical Services Kansas has provided Home and Community Based Services (HCBS) to individuals with disabilities since 1984. Since that time, Kansas has implemented six HCBS waivers to meet the needs of various special populations including Physical Disabilities, Frail Elderly, Head Injured, Developmentally Disabled, Technologically Assisted and Severely Emotionally Disturbed. Based on a Nursing Facility (NF) expenditures model, Kansas has successfully demonstrated cost- effectiveness for fourteen years for individuals with physical disabilities. In Kansas, this past year, the HCBS alternative saved the state $24,579,932. This savings includes a "woodwork" factor of 25%. The 1997 data reflects a substantial change in the service delivery of HCBS for individuals with physical disabilities. The changes are a result of a collaborative effort that began in 1995 with consumers, advocates, providers, provider associations (including NF's), state and local government officials. The success of this collaborative effort resulted in the implementation of a new HCBS waiver designed specifically to meet the needs of individuals with physical disabilities. The idea was to create a program which focused on 1.) consumer directed care; 2.) day-to-day administration through private organizations at the local level; 3.) education and training rather than regulation; and 4.) consumer satisfaction as the key indicator of quality. The new program was designed to: Allow maximum flexibility in service definitions to ensure individual needs could be met. Allow services to be purchased and arranged for at the local level where the most cost- efficient utilization of resources and funding can be coordinated. establish an approved "range" of reimbursement for services. Allow individuals with disabilities to provide Independent Living (IL) Counseling in place of traditional case management. peer counseling concept plus provisions of traditional case management. lower administrative costs by using CIL core services. Allow for the provision of Assistive Services (Technology, Durable Medical Equipment, Home Modification) as a cost-effective alternative to attendant care services. Allow care plans to be developed which meet individual life goals as well as ensuring health and safety needs are met. annualized care plans with consumer choice in disbursement. As demonstrated on the 1997 HCBS/PD Annual report, the program design was successful. The Kansas HCBWD program offers consumer directed community based services without waiting lists or geographical limitations. There are no individual cost ceilings or "caps". Individuals receive the services they need in order to maintain or improve their independent living goals. A 96% overall satisfaction rate with services loudly demonstrates the success of the program in the first year. Obviously, consumer control and choices which empower individuals are goals worthy of pursuing in and of themselves. The fact that it can be accomplished and be fiscally responsible and cost- effective is an added bonus to taxpayers. March 12, 1999 --  Testimony  in favor of HR2020 (Medicaid Community Attendant Services Act) presented to the U.S. House of Representatives Committee on Commerce Subcommittee on Health and Environment by Ann E. Koci, Kansas Commissioner of Adult and Medical Services   Freedom Clearinghouse is a project of Free Hand Press, publisher of Mouth magazine. Website developed by Cliffwood Organic Works. Website hosted by DIMENET. | E-mail | Home |