A struggle over dollars results in lost lives

What’s at Stake

Posted December 7, 2011 by Mandy Smith in


I talk to people a lot about the proud history of the disability community in Kansas. The progress that was made in the state by dedicated advocates placed Kansas in the forefront on disability rights. We have constructed a system that, while not perfect, works to empower Kansans with disabilities, helps them acquire gainful employment, and honors their choices and right to make them.

It is a system that stresses the Independent Living Philosophy and utilizes grass roots organizations like Consumer Run Organizations (CROs) and Centers for Independent Living (CILs) so that folks with disabilities are working with other folks with disabilities. This system has ensured that we have had a place at the table when decisions have been made regarding services, programs, and funding for the disability community. Kansas is known across America as a place with an active and vocal disability rights base.

Over the last year, this voice has been stymied. Decisions and entire program changes have been made in secrecy, the grand unveiling of which are shrouded in confusion, urgency, and completely overlook the very real needs of the people they claim to protect. One of the biggest changes thus far is the plan for bringing Managed Care to Medicaid services. The Governor and Lt. Governor are proud to present this to Kansas as a way to cut costs and improve the care that Kansans receive.

To do this, 3 out-of-state corporations, who have a responsibility to their shareholders to turn a profit, will now be paid millions and millions of dollars to manage your care. Instead of peer based service delivery that we now have in Home and Community Based Services, for instance, a clinical team will determine what care you need for everything from medications to your long term care services. The State claims that this will result in an $853 million savings.

It seems difficult to believe that much money can be cut from the existing Medicaid budget, these corporations will make a profit and potentially earn up to $250 million in bonuses and services will get better. Not only are cuts in service going to be necessary in order to meet the fiscal realities of this plan, but we stand to lose the very thing that makes Kansas a leader in disability issues, the belief that the person with the disability is a competent decision maker in their own care; that people with disabilities don’t need to be “managed” they need to be empowered to make their own decisions and supported while doing so. The benefits of a system that stresses these core beliefs include a disability community strongly connected with the community at large, working, playing, loving, raising families, and contributing to society.

Please contact your State legislators and let them know that any reform of Medicaid must contain a way for consumers of the services to have a voice in the implementation. Centers for Independent Living, Consumer Run Organizations, and other consumer advocacy groups must be funded if people with disabilities are to have a fair representation in decisions made regarding their lives.

Mandy Smith

Mandy has worked at RCIL since June of 2009. She is a Certified Orientation and Mobility Specialist and provides services in 32 counties to individuals who are blind or have low vision and are 55 years and older.

Related Articles

Interviews to help with HCBS outcomes

By Mandy Smith | February 15, 2022

Rehabilitation and Research Training Center on HCBS Outcome Measurement along with the Institute of Community Integration from the University of Minnesota are looking for research participants for interviews.They are testing measures to improve person-centered Home and Community-Based Services (HCBS) outcomes for people with disabilities. Getting services at home or in the community is important for people with disabilities. Providers strive…

Advocacy Services

By Beth | January 18, 2022

Do you know that one of the five Core Services that RCIL offers is Advocacy?  RCIL offers two forms of advocacy services and they are individual advocacy and system advocacy.  Individual advocacy services help people with disabilities develop the skills they need to represent themselves.  These skills help them act on their own behalf to obtain support services from agencies…

Attention! Self-Directing Consumers Learn how to be a better employer!

By Beth | September 9, 2019

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…