Home and Community Based Services in Kansas
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).