House Social Services Budget Committee MeetingFebruary 6, 2013

Overview of the KansasDepartment for Aging And Disability Services

Presented by:

Shawn Sullivan, Secretary

Kansas Department for Aging and Disability Services

April 19, 2023

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

April 19, 2023

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.

April 19, 2023

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.

April 19, 2023

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

April 19, 2023

OrganizationalStructure

April 19, 2023

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

April 19, 2023

Organizational Structure

Department Commissions:– Commission on Aging– Community Services and Programs

Commission– Survey, Certification, and Credentialing

Commission– Financial and Information Services

Commission

April 19, 2023

Commissionon 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

-Quality Assurance programs Client Assessment, Referral and Evaluation (CARE) program Aging and Disability Resource Centers (ADRCs)

April 19, 2023

Commissionon 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

April 19, 2023

Commissionon 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

April 19, 2023

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

April 19, 2023

Community Services and Programs Commission

Budget Proposal for CSP Commission

• HCBS Waivers

• Behavioral Health Programs• Problem Gambling and Addictions Fund• Mental Health Initiative

• PACE

April 19, 2023

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– Caseload is flat. SGF is lower due to FMAP change. All funds budget is flat.

• 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.

April 19, 2023

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– Caseload is flat. SGF is lower due to FMAP change. All funds budget is flat.

• TA Waiver– 391 served– Caseload is flat. SGF is lower due to FMAP change. All funds budget is flat.

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Problem Gamblingand 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.

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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

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Regional RecoverySupport 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.

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Increased effectivenessfor 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

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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.

April 19, 2023

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

April 19, 2023

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

April 19, 2023

Financial & InformationServices 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

April 19, 2023

Financial & InformationServices 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.

Nursing Facility Provider Assessment

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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.