1. House Social Services Budget Committee Meeting February 6, Overview of the Kansas Department for Aging And Disability Services
Presented by:
Shawn Sullivan, Secretary
Kansas Department for Aging and Disability Services

2. Agency Overview
Established on July 1, 2012 through Executive Reorganization Order
2,650 people employed by the Agency.
Formerly known as the Kansas Department on Aging
Goal of reorganization was to streamline state services and provide structure to allow affected agencies to operate more efficiently and effectively.
Paved the way for reforming Medicaid system, now known as KanCare
November 7, 2018

3. Mission & Vision
Mission: The Kansas Department for Aging and Disability Services mission is to foster an environment that promotes security, dignity and independence, while providing the right care at the right time in a place called home.
Vision: The Kansas Department for Aging and Disability Services envisions a community that empowers Kansas older adults and persons with disabilities to make choices about their lives.
November 7, 2018

4. Budget
FY 2013 budget:
Approved budget totals $1.541 billion, including $642 million from State General Fund (SGF)
FY 2014 budget:
Proposed budget totals $1.499 billion, including $628 million from SGF.
November 7, 2018

5. Agency Responsibilities
Programs and services to assist older adults
Behavioral health and disability services formerly housed in the KS Department of Social and Rehabilitation Services
Oversight of the 5 State Hospitals
Some licensure programs previously part of the Kansas Department of Health and Environment
November 7, 2018

6. Organizational Structure
November 7, 2018

7. Office of the Secretary
Includes:
-Chief Counsel
-Communications Director
-Human Resources
-Legislative/Policy Director
-Special Assistant to the Secretary
Supervision of State Hospitals
Administratively supports the KanCare Consumer Ombudsman
November 7, 2018

8. Organizational Structure
Department Commissions:
Commission on Aging
Community Services and Programs Commission
Survey, Certification, and Credentialing Commission
Financial and Information Services Commission
November 7, 2018

9. Commission on Aging
Administer a variety of community-based programs for the aging population through contracts and grants of state and federal funds
Older Americans Act
-Quality Assurance programs
Congregate and home-delivered meals
Caregiver programs
In-home Services
Senior Care Act Services
Client Assessment, Referral and Evaluation (CARE) program
Aging and Disability Resource Centers (ADRCs)
November 7, 2018

10. Commission on Aging Oversee and implement grants:
Senior Health Insurance Counseling for Kansas (SHICK)
-Assist individuals with questions related to Medicare
Senior Medicare Patrol (SMP)
-Educates community about reporting Medicare/Medicaid fraud and how to identify scams
Lifespan Respite
Community Transition Opportunities
-Works with nursing facilities to identify residents who desire to return to living in a community setting
November 7, 2018

11. Commission on Aging Budget Proposal
Shifting of $1.5 million to fund ADRC contract
Sequestration possibility of 8% cut or $1.48 million dollars
Will be able to cover between March 1 and Oct. 1 if sequestration happens to prevent cuts to programs
Will be working with stakeholders for July bids for OAA changes
November 7, 2018

12. Community Services and Programs Commission
Provides care and services to 157,000 clients
Responsible for:
Behavioral health programs
-mental health, substance abuse, addiction and prevention
Home and Community Based Services
PACE
Managed Care division
-Coordinates intra-agency KDADS activity around managed care.
-Coordinates with all three KanCare Managed Care Organizations regarding KDADS-specific program areas
November 7, 2018

13. Community Services and Programs Commission
Budget Proposal for CSP Commission
HCBS Waivers
Behavioral Health Programs
Problem Gambling and Addictions Fund
Mental Health Initiative
PACE
November 7, 2018

14. Community Services and Programs Commission
Budget Proposal for HCBS Waivers
I/DD Waiver
7,825 served
3,176 on waiting list
Caseload is flat. SGF is lower due to FMAP change. All funds budget is flat.
PD Waiver
5,685 served
2,385 on waiting list
FE Waiver
5,012 served
KDADS proposed, and the Governor recommended, a reduction in funding for the HCBS/FE Waiver program of $7,490,205, including $3,250,000 from the State General Fund.
This amount represents savings already gained through program efficiencies and WILL NOT affect the services provided.
There is no wait list for FE waiver services, nor do we anticipate establishing one.
November 7, 2018

15. Community Services and Programs Commission
Budget Proposal for HCBS Waivers
TBI waiver
454 served
Caseload is flat. SGF is lower due to FMAP change. All funds budget is flat.
Autism Waiver
45 persons served
283 on waiting list
TA Waiver
391 served
November 7, 2018

16. Problem Gambling and Addictions Fund
Problem Gambling and Addictions Fund (PGAF) receives 2 percent of state gaming revenues.
Less state gaming revenues than projected have led to decreased resources.
Governor’s Budget keeps funding level for FY 13 but reduces funds in FY 14 for the Substance Use Disorder Grants, which are funded through PGAF.
$946,336 is proposed reduction.
KDADS is exploring options to backfill the revenue.

17. Governor’s Mental Health Initiative Funding
$10 million dollar initiative
$5 million of grants Community Mental Health Centers (CMHCs) receive will be re-focused to support at-risk consumers.
Administration proposal will stabilize funding resources for CMHCs
Proposal recognizes the loss of Children Initiatives Fund (CIF) dollars that will occur this year that impacts CMHCs.
As a result, Administration proposes to preserve the $5 million CIF dollars with special revenue funds
Proposal ensures no overall loss of resources to public mental health system in FY 2014

18. Regional Recovery Support Centers
Creation of regional recovery support centers
5-7 community mental health centers will be chosen to serve as the regional recovery support center
The regional system will allow CMHCs to have access to resources that they can not always afford to provide.
$5 million will be used to enhance or develop programs for target at-risk populations.

19. Increased effectiveness for at-risk consumers
More effective programs for at-risk consumers
$5 million will continue to be allocated to the 27 Kansas Community Mental Health Centers to support at-risk consumers. 
CMHCs must demonstrate outcomes for this targeted population
Tax dollars must support effective programs

20. Mental Health Task Force
Creation of a taskforce to comprehensively study Kansas’ mental health system
New taskforce will comprehensively evaluate our current mental health system and make recommendations to transform the system.
Taskforce will look at best practices to increase protective factors for person with or at risk of mental illness 
Taskforce members will include persons who have experienced recovery as well as professionals from broad multi-disciplinary expertise.

21. Community Services and Programs Commission
Budget Proposal for PACE
Two programs through Via Christi Hope and Midland Cares
Working towards PACE expansion as dual enrollment option to KanCare
Budget Neutral
November 7, 2018

22. Survey, Certification, and Credentialing Commission
Key function is to protect public health through the licensure and inspection of adult care homes.
Develop and enforce state regulations related to adult care homes
Implement federal certification activities for Medicaid or Medicare-certified nursing homes
Conduct Inspections
-Annual Inspections
-Unannounced Inspections resulting from consumer or provider complaints
Credentialing of various licensed and certified health professions.
-Adult care home administrators
-Certified nurses aides
-Dieticians
-Other professions
November 7, 2018

23. Financial & Information Services Commission
Responsible for various administrative functions that support other KDADS commissions
Accounting
Budgeting
Information Technology
Technical Support to Agency staff and business partners.
Fiscal and Program Evaluation Division is KDADS’ auditing, reporting, and data analysis group.
Manages nursing facility reimbursement programs
November 7, 2018

24. Financial & Information Services Commission
Budget proposal for FISC and Administration
Reduction in salaries and wages expenditures of $659,760 from all funding sources in FY 2013 and $1,551,131 in FY 2014 resulting from elimination of duplicative positions in reorganization, implementation of KanCare, and other restructuring within KDADS.
Budget includes a reduction in rent expenditures totaling $250,000, of which $125,000 is from the State General Fund, due to reorganization.
November 7, 2018

25. Nursing Facility Provider Assessment

26. Nursing Facility Provider Assessment
Nursing facility Provider Assessment rate is scheduled to drop to 60 percent in FY14 and be eliminated in FY15.
A reduction rate in the assessment rate would result in a decrease of $7.5 million in receipts to the Quality Care Fund in FY 14, which could result in corresponding payment cuts to nursing homes of $16.6 million.
Allowing the Assessment to sunset would require and increase in SGF to maintain NF rates.
Alternately, NF rates would be reduced by 2.2 percent.