Your Turn: Cuts will impact Cottonwood clients
Most days, there is news about the governor’s attempts to stem the state’s massive tax-cut-induced hemorrhage. School payments are delayed, highway funds are seized, KPERS loans are unpaid, and Medicaid reimbursements are cut 4 percent across the board.
School and hospital voices are big and loud, correctly speaking out on the devastating effects administrative actions will have on their constituents. But let me tell you about a smaller proposed cut that will have an equally life-altering impact on Kansas residents.
Cottonwood Inc. provides essential services to people with intellectual/developmental disabilities 24 hours a day, 365 days a year. We never close.
These individuals are unique. Some need a constant, 24-hour support staff presence to minimize risk and maximize their inclusion in our community. Others don’t need someone with them at all times. They are visited by a staff person anywhere from once to several times a week to buy groceries, do banking, check health conditions, perform safety checks, etc.
Should something unexpected arise outside of these appointments — conflict with a neighbor, alarming mail or phone messages, furnace breakdown, personal conflicts, illness — they call us for help. Often, the problem is resolved remotely by calling the landlord, explaining what the correspondence is, contacting maintenance personnel, or reviewing the correct over-the-counter medication. If needed, we guarantee that staff will go to the individual immediately and provide whatever support necessary to divert an impending crisis.
Historically, we have been able to bill daily for Medicaid-funded Home and Community Based Services, whether or not we met face to face with the individual, as long as the service was available if needed. The payment structure allowed us to maintain sufficient staff capacity to nimbly respond to emergent demands remotely or in person. This capacity is threatened by a policy change proposed by the Kansas Department of Aging and Disability Services (KDADS).
The state cavalierly says: Why should we pay for “on-call” time? We will only pay you for time the direct support staff are in the presence of the person, effectively discounting all of the remote and behind-the-scenes costs.
With this new policy, there are 40 people living in our community who will be directly impacted. They will not have access to the 24-hour-per-day on-call support. They will have reduced health care coordination, which is included in residential service rates (shamefully underfunded). Without daily billing for 365-day wrap-around services, we cannot afford to maintain our already lean staffing levels.
The impact will spread beyond this group. We estimate a $285,000 per year loss, which includes the 4 percent Medicaid cut that affects I/DD case management. This sizeable cut on top of all of the many hidden cuts and obstacles presented by KanCare continues the erosion of community non-profit safety nets.
We don’t face this threat alone. Statewide, many people will lose their safety nets. Maybe family members will be able to step in to fill some of the holes. Concerned neighbors, coworkers, parishioners, etc., will do what they can. I don’t know about you, but I wouldn’t want to rely on the kindness of others to maintain the independent life I know today.
Kansans are weary of the ongoing struggle to plug countless holes in the levee. It is tempting to just sit back and watch the train wreck. Then I get a call from a person served by us who has a co-occurring mental illness diagnosis and refuses to let anyone in his apartment and I immediately engage his team to intervene, and then another call from an individual whose weekly pillbox hasn’t been delivered and she is concerned about where it is … Today, I can help and Cottonwood can bill. If the policy is approved, we will not be paid to help. We have maintained service levels in spite of many consecutive years without rate increases and ever escalating state funding reductions. No longer.
KDADS estimates they will save $1.5 million statewide by enacting this policy. Tell KDADS, your legislators, and the governor that the “savings” are unacceptable compared to the damage it will inflict on vulnerable Kansans.
— Kara Walters is director of residential services at Cottonwood Inc., a local not-for-profit organization established in 1972 to provide services to individuals with intellectual/developmental disabilities.