By Tim Carpenter, Topeka Capital-Journal, March 09, 2010
Prospects of implementing a new method of financing services for people with developmental disabilities diminished Monday when skepticism was expressed about obtaining federal authorization for a special state fee on home and community-based care providers.
Members of the Senate's budget committee learned the mechanism being considered to secure additional Medicaid funding for disabled Kansans likely wouldn't pass federal review by the Centers for Medicare and Medicaid Services. The idea was to collect a fee from service providers and leverage the cash to qualify for extra Medicaid payments, which would be funneled to people receiving treatment from the home and community-based providers.
"Based upon our research and exploration of issues related to provider assessment, we would anticipate it would be difficult to get CMS' approval," said Ray Dalton, deputy secretary of the Kansas Department of Social and Rehabilitation Services.
The stumbling block for Senate Bill 562 emerged during a hearing of the Senate Ways and Means Committee.
Under the bill, home and community-based service providers with more than 10 clients would contribute to the state fund 3 percent of gross revenues tied to providing treatment of developmentally disabled people. It is unclear how much the fee would generate or how much federal aid might have been available.
Rep. Bob Bethell, R-Alden, said the surprise assessment of the Centers for Medicare and Medicaid Services' sentiment about the provider tax meant Kansans were less likely to get services they deserve.
"That is the entire interest. We have individuals who need services," Bethell told the Senate committee.
There is a waiting list of people who are eligible for services but can't receive assistance due to the state's ongoing budget problems.
Several organizations representing people with disabilities urged adoption of the Senate legislation in anticipation federal officials might soften opposition.
"There is an excellent chance that further CMS interpretations may enable us to go forward," said Tom Laing, executive director of Interhab, an association of organizations serving the disabled. "We believe you and we owe it to persons we serve and those who wait for service to find additional resources."
Mike Oxford, executive director of the Topeka Independent Living Resource Center, said the state's budget deficit, projected to be greater than $400 million in the fiscal year starting July 1, made it imperative Kansas officials weigh all options for financing services to disabled persons.
"Given that the economy is expected to remain weak for some time, it makes sense to try to explore new sources of funding," Oxford said.
Nick Wood, representing the Disability Rights Center of Kansas, said the bill's language should be broadened to provide additional resources to children with mental health problems.
"We would challenge the committee to examine the reasons for, and if any, the reasons against including the children," he said.