Please join us for an informative session on Self-Directing your Home and Community Based Services. Topics will include information on:

  • How to Recruit, Select, Interview, Hire, Train, Supervise and Dismiss Direct Support Workers (DSWs)
  • Understanding Enhanced Care Services (Sleep Cycle Support)
  • KS AuthentiCare (the Electronic Visit Verification Call In System)
  • Having a Backup Plan (of DSWs)
  • Medicaid Fraud
  • Abuse, Neglect and Exploitation

Snacks Provided
Drawings will be held for prizes!

Wednesday, September 18, 2019
1:00 pm – 2:30 pm
El Dorado RCIL Office
615 ½ North Main, El Dorado

Space is limited! Please call Mandy Kline or Becky Brewer at 1-800-580-7245 to reserve your spot!

Please join us for an informative session on Self-Directing your Home and Community Based Services.  Topics will include information on:

  • How to Recruit, Select, Interview, Hire, Train, Supervise and Dismiss Direct Support Workers (DSWs)
  • Understanding Enhanced Care Services (Sleep Cycle Support)
  • KS AuthentiCare (the Electronic Visit Verification Call In System)
  • Having a Backup Plan (of DSWs)
  • Medicaid Fraud
  • Abuse, Neglect and Exploitation

Snacks Provided
Drawings will be held for prizes!

Tuesday, August 27, 2019
1:00 pm – 2:00 pm

Magic Circle Apartments in the south community room

301 Magic Circle Road, Eureka

 

Wednesday, September 18, 2019
1:00 pm – 2:30 pm

El Dorado RCIL Office

615 1/2 North Main, El Dorado

Space is limited!  Please call Mandy Kline or Becky Brewer at 1-800-580-7245 to reserve your spot!

Please join us for an informative session on Self-Directing your Home and Community Based Services. Topics will include information on:

  • How to Recruit, Select, Interview, Hire, Train, Supervise and Dismiss Direct Support Workers (DSWs)
  • Understanding Enhanced Care Services (Sleep Cycle Support)
  • KS AuthentiCare (the Electronic Visit Verification Call In System)
  • Having a Backup Plan (of DSWs)
  • Medicaid Fraud
  • Abuse, Neglect and Exploitation

Snacks Provided
Drawings will be held for prizes!

Tuesday, August 27, 2019
1:00 pm – 2:00 pm
Magic Circle Apartments in the south community room
301 Magic Circle Road, Eureka

Space is limited!  Please call Mandy Kline or Becky Brewer at 1-800-580-7245 to reserve your spot!

Please join us for an informative session on Self-Directing your Home and Community Based Services. Topics will include information on:

  • How to Recruit, Select, Interview, Hire, Train, Supervise and Dismiss Direct Support Workers (DSWs)
  • Understanding Enhanced Care Services (Sleep Cycle Support)
  • KS AuthentiCare (the Electronic Visit Verification Call In System)
  • Having a Backup Plan (of DSWs)
  • Medicaid Fraud
  • Abuse, Neglect and Exploitation

Snacks Provided

Drawings will be held for prizes!

Wednesday, June 12, 2019
1:00 pm – 3:00 pm
Park Place Apartments
207 South 6th Street, Osage City

Space is limited! Please call Mandy Kline or Becky Brewer at 1-800-580-7245 to reserve your spot!

Please join us for an informative session on Self-Directing your Home and Community Based Services. Topics will include information on:

  • How to Recruit, Select, Interview, Hire, Train, Supervise and Dismiss Direct Support Workers (DSWs)
  • Understanding Enhanced Care Services (Sleep Cycle Support)
  • KS AuthentiCare (the Electronic Visit Verification Call In System)
  • Having a Backup Plan (of DSWs)
  • Medicaid Fraud
  • Abuse, Neglect and Exploitation

Snacks Provided

Drawings will be held for prizes!

Monday, May 20, 2019
1:30 pm – 3:30 pm
Broadview Towers Apartments
110 W. 6th Ave, Emporia

Space is limited! Please call Mandy Kline or Becky Brewer at 1-800-580-7245 to reserve your spot!

April 13th and 14th at the Capitol City Plaza, Topeka, KS

KDADS is presenting a HCBS 2015 Educational Summit for HCBS consumers, family members, providers, and professionals.   The Educational Summit is a NO COST event that will give the public the opportunity to learn more about HCBS topics and programs.  Some of the topics of interest include HCBS Final Setting Rule Assessment, Self-Direction, Guardianship, Employment Programs, HCBS Programs, Health Homes, MFEI Assessment, APS/CPS, Social Security Disability/PMDT, Medicaid Fraud, and more!   Attendees will also have the opportunity to meet with MCO representatives to discuss benefits and concerns.  Please join us for a half-day provider and professional track on Monday, April 13th and an all-day consumer, caregiver, and provider track on Tuesday, April 14th.   More details and updates will be provided on the KDADS website. Special room rates are available for those staying at the hotel, mention the conference title “HCBS 2015 Educational Summit” for the rate.

 

For those of you who are receiving Home & Community Based Services, the State of Kansas will be holding meetings to inform consumers, families, advocates, and providers to inform all of  the new changes.  Below is a list of the meeting locations and times.

Federal rules and necessary program changes will be made to the following programs:

  • Autism
  • Frail Elderly
  • Intellectual/Developmental Disability
  • Physically Disabled
  • Traumatic Brain Injury
  • Technology Assisted

Changes to these programs will impact:

  • Who you can hire and how they will be paid
  • Limitations on guardianships
  • What and how services will be renewed
  • How program eligibility will be assessed

Regional meetings are being held  so you can be informed and your voice heard to help decide what changes will be made.  Plan to attend one of the meetings below.  If you need help making arrangements, you are asked to contact your Managed Care Organization case manager/coordinator.

All meetings will be held from 10:00am-12:00pm and from 1:30pm-3:30pm

August 18 – El Dorado – El Dorado Chop House 2529 W Central El Dorado, KS

August 19 – Great Bend – Perkins Restaurant 2920 10th Street Great Bend, KS

August 20 – Salina – Salina Ambassador Hotel (Room A) 1616 W Crawford Salina, KS

August 21 – Topeka – Ramada Convention Center Jefferson Hall 420 SE 6th St Topeka, KS

*August 22 – Kansas City – Hilton Garden Inn (McCarthy Gallery) 520 Minnesota Ave Kansas City, KS
*Morning Session 10:00am-12:00pm

**August 22 – Paola – Paola Community Center 905 E Wea Paola, KS
**Afternoon Session 1:30pm-3:30pm

For questions, concerns, or to request accommodation, call (785)368-3246

Home and Community Based Services (HCBS) became an integral part of the lives of Kansans with disabilities and those who are elderly though legislation passed in 1989 (KSA 39-7, 100). This legislation provided Kansans who wanted to have choice and remain independent with the ability to receive long-term care services in their own home and provided them with the option to self-direct their personal care attendant.

In the mid-1970’s, SRS was paying for approximately 14,000 people to be institutionalized in nursing facilities. The passage of the HCBS legislation along with the dedicated work of Centers for Independent Living (CILs) led to the number of people receiving services through HCBS Physical Disability (PD) and Frail Elderly (FE) Waivers to grow. This reduced the number of people being paid for in nursing facilities to hover around 10,000, even though the number of frail elderly people and people with disabilities in Kansas increased. Additionally, the cost to the state for providing services on the PD or FE waiver was proving to be one-third to one-half of the cost of nursing homes.

In Fiscal Year (FY) 2011, the State’s support of HCBS diminished significantly, which can be shown by the increase of nursing facility residents between 2010 and 2011. As of June 30, 2010 there were 10,561 people residing in nursing faciliites, and 6,964 on the PD waiver.* At the end of FY 2011, the number of people in nursing facilities was 13,699, with 6,368 on the PD Waiver. This is a drop of approximately 600 people. The 13,699 nursing facilities residents cost to the state was $413.1 M (All Funds), the combined cost for indivduals servied through the HCBS PD or FE waiver was $212.8 M (All Funds) for the year.** Approximately 40% of nursing facility and HCBS costs come from the state general fund.

In December of 2008, SRS established a Waiting List for HCBS PD Waiver. As of OCtober 31, 2011 there are 3,254 people on the HCBS PD Waiting List, many of whom have been waiting for almost 3 years. The PD waiver is down to 6,100 people with only people in extreme crisis being allowed to receive HCBS PD waiver services.

If the individuals on the PD waiting list were to go into nursing facility it would cost the state 3,254 x $37,920 (per person/year) = $123.4 M (All Funds) as opposed to receiving services on the waiver 3,254 x $24,120 (per person/year) = $78.5 M (All Funds). HCBS would be a savings of $44.9 M (All Funds) as well as providing Kansans with disabilities and those who are elderly the dignity and respect that comes with independence and the choice of receiving long-term care services in their own homes and communities.

 

*FY 2010 Kansas Medical Assistance Report
**FY 2011 Kansas Medical Assistance Report

This is adapted from advocacy information distributed by the Statewide Independent Living Council of Kansas (SILCK).

Doing More: RCIL and FMS

Categorized: RCIL Updates


There are lots of changes taking place within our state and Home and Community Based Services are not immune. One of the major areas of change is Payroll Services. RCIL is a current Payroll provider for HCBS Waivers; on November 1st, those Payroll services will become Financial Management Services (FMS) and RCIL is ready to hit the ground running as an FMS provider.

We have been preparing for this implementation throughout the last year and are ready to take on the new challenges it brings. RCIL is dedicated to providing the highest quality customer service. Within FMS, payroll agencies will be required to provide Information and Assistance to self directing individuals. This is something that RCIL has been providing all along and we will continue to provide training and resources to assist you in living independently, including the personal care attendant hiring process, and more.

For more information about Self Directing your Home and Community Based Services and FMS Implementation please visit the Kansas Self Direction site. If you’d like to learn more about the Payroll services RCIL offers, including FMS information, please contact Susan Warner, Director of Payroll Services at 1-800-580-7245 or by email at info@rcilinc.org.

Kansas is facing tough economic times, as we confront budget shortfalls, some are looking to cut Medicaid benefits, including home and community based services (HCBS). Home and community based services are vital to helping seniors and people with disabilities stay in their communities and out of institutions. If home and community based services cuts are on the table, please consider the following:

  1. Cutting HCBS would cost Kansas more in the long run.
    • Home and community based care costs less than institutional care. On average, HCBS care costs one-fifth as much per person per year as nursing home care. In addition, average costs for HCBS are rising at a slower pace than costs for institutional care.
    • Cutting HCBS can increase the use of more costly institutional care. Higher state spending on home and community based services reduces the use of institutional care among childless seniors.
    • States that spend more on HCBS see a decrease in Medicaid long-term care spending over time. A 2009 study of Medicaid long-term care spending found that, over a 10-year period, states that offered few Medicaid HCBS options experienced an average increase of nearly 9 percent in Medicaid long-term care spending, while states with well-established home and community based care programs saw an 8 percent reduction in spending.
  2. Cutting home and community based services can be bad for Kansas economies.
    • Cutting HCBS can reduce or eliminate jobs and hurt economic growth. Medicaid brings new money into states in the form of federal matching dollars. These new dollars create jobs and stimulate economic growth. Cuts to home and community based services reduce the amount of federal matching dollars that states receive, resulting in lost jobs and reduced business activity.
  3. Cutting home and community based services increases the burden on informal caregivers, which has implications for U.S. businesses and state economies.
    • Demands on caregivers already affect their financial stability and health. Over the course of a year, it is estimated that more than 50 million people nationwide provide informal care to those who need long-term services. They are vital sources of support for people needing care and a critical supplement to existing care delivery systems. These informal caregivers—mostly family members and friends of those who require long-term care—often risk their own financial stability and health in performing care-giving functions. The typical family caregiver, who already has a job, loses approximately $110 per day in wages and health benefits due to care-giving responsibilities. More than one-third of caregivers cut back on household spending, one-third limit their work hours, and approximately one-quarter postpone personal medical care.
    • Cutting home and community based services increases the burden on caregivers. Medicaid home and community based services such as adult day care can provide essential support to caregivers and give them an opportunity for respite. These services can also reduce caregivers’ stress and help them to participate more fully in the workforce. Cutting HCBS takes away valuable support for informal caregivers and increases their medical, emotional, and financial stress, which can negatively affect state economies.
    • The demands of care-giving cost U.S. businesses billions annually. The workplace accommodations that caregivers must make, such as reducing hours or taking unpaid leave, affect businesses as well. Costs to employers include increased absenteeism, workday interruptions, reduced employee hours, reduced productivity, and costs associated with replacing workers who leave the workforce because of care-giving responsibilities. Businesses lose an estimated $33.6 billion annually because of the demands that care-giving places on full-time employees.
    • The burden on caregivers also has implications for state economies. Demands of care-giving affect caregivers themselves, the businesses they work for, and, in turn, state economies. Economic activity is reduced because caregivers earn and spend less, and their medical costs end up being higher because they postpone their own medical care until their health problems are more advanced and more expensive to treat. Lost business productivity affects business receipts and, ultimately, state revenue.
  4. Cutting home and community based services runs counter to consumer preferences.
    • Most consumers who need long-term care prefer to remain in their homes or in the community. About 80 percent of people needing long-term services would prefer community-based care over institutional care.
    • Kansas can both serve their residents better and save money by shifting their service focus to home and community based care. Kansas has actively shifted their long-term care delivery from institutional to HCBS care have not only given their residents better choices, they have also been able to serve more people at lower overall cost.
  5. Cutting HCBS may violate the Supreme Court’s Olmstead decision.
    • Kansas must have a plan for placing individuals with disabilities in the least restrictive care setting. In the 1999 case Olmstead v. L.C., the Supreme Court held that unjustified institutionalization of people with disabilities who were able to function in the community constituted a form of discrimination that violates the Americans with Disabilities Act (ADA). To comply with Olmstead, states must have a working plan for placing individuals in the least restrictive setting that is appropriate to their needs.
    • Recent court cases challenge state cuts to home and community based services that violate Olmstead. The Obama Administration is taking action to enforce Olmstead. As part of its enforcement activities, the Department of Justice has recently filed briefs in several cases arguing that state reductions in HCBS or failure to provide sufficient home and community based services violate Olmstead and the Americans with Disabilities Act because they place individuals at risk of institutionalization.
    • Patients and their advocates can challenge state HCBS cuts based on Olmstead. Final decisions have not yet been reached in the cases noted above. However, when cuts in home and community based services limit services to the point that individuals are placed at risk of institutionalization, patients and their representatives can argue that the cuts may constitute an Olmstead violation and could consider a court challenge.

Conclusion
State cuts to HCBS in Medicaid can be shortsighted. While they might produce some short-term cost savings, those savings can result in higher costs to states in the long term, including increased use of higher-cost institutional care, lost caregiver wages and the associated negative economic effects, and lost Medicaid matching funds.

In addition to being a bad idea from an economic perspective, cuts are contrary to the wishes of the majority of constituents who need these services, and, in addition, they may violate the Supreme Court’s Olmstead decision.

There are better options for states. Among them is the option to expand home and community based services through new opportunities that are available in health reform. These include improvements to the Medicaid state plan option for HCBS(section 1915(i) of the Social Security Act) as well as two new programs that will start in October 2011.

The new programs, the Community First Choice Option and the State Balancing Incentives Payments Program, include added federal matching dollars to help states expand HCBS. (For more information on these programs, see Families USA’s publication, Helping People with Long-Term Care Needs: Improving Access to Home- and Community-Based Services in Medicaid, available online at http://www.familiesusa.org/assets/pdfs/health-reform/help-with-long-term-health-needs.pdf.)
Rather than cutting home and community based care programs, states should maintain their current programs and explore health reform’s new options to expand home and community based care. This could save money in the long term, provide economic benefits, and better serve state residents.