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Presented by: Shawn Sullivan, Secretary Kansas Department for Aging and Disability Services

House Social Services Budget Committee Meeting February 6, 2013 Overview of the Kansas Department for Aging And Disability Services. Presented by: Shawn Sullivan, Secretary Kansas Department for Aging and Disability Services. Agency Overview.

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Presented by: Shawn Sullivan, Secretary Kansas Department for Aging and Disability Services

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  1. House Social Services Budget Committee MeetingFebruary 6, 2013Overview of the KansasDepartment 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

  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.

  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.

  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

  6. OrganizationalStructure

  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

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

  9. 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)

  10. 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

  11. 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

  12. Community Services andPrograms 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

  13. Community Services andPrograms Commission Budget Proposal for CSP Commission • HCBS Waivers • Behavioral Health Programs • Problem Gambling and Addictions Fund • Mental Health Initiative • PACE

  14. Community Services andPrograms 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.

  15. Community Services andPrograms 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 • 45persons 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.

  16. 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. • KDADSis 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 ofresources to public mental health system in FY 2014

  18. 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.

  19. 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

  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 andPrograms 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

  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

  23. 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

  24. 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.

  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.

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