Faced with overwhelming need, disability services providers urge more funding from Kansas lawmakers
Several disability service providers said a better funding system would allow for more stability in the field. (Getty Images)
By Rachel Mipro, Kansas Reflector
TOPEKA — When her son’s father died earlier this year, Rachel Neumann had to choose between taking time off to comfort her son or using her PTO to support her mother-in-law, who was diagnosed the same week with terminal cancer.
As the chief operating officer of COF Training Services, a company that serves Kansas with intellectual disabilities, she couldn’t take too much time off due to PTO budget cuts and staffing — issues that most disability support providers across the state struggle with.
Neumann chose to spend the time with her mother-in-law, who died a few weeks later. She and her family needed time to grieve, but Neumann was out of PTO and had to return to her position. Her first week back was difficult.
My first week back I worked an overnight shift, two other direct care positions and I also had to perform CPR on a person that I’ve cared for for many years for 23 minutes after she had a sudden stroke,” Neumann said. “She luckily didn’t die from the stroke initially, and we were able to keep her alive, but unfortunately the damage was too great and she didn’t live long. I’m embarrassed to say that as someone who is committed to the field, that was not the first time I heavily considered leaving the field, and it sadly won’t be the last.”
Neumann was one of several service providers who came to a legislative meeting Monday about the Intellectual and Developmental Disability Waiver to advocate for regular rate increases. To receive Medicaid-funded support waivers from the state, people with intellectual or developmental disabilities are placed on a waiting list supervised by the Kansas Department for Aging and Disability Services.
The support waivers cover a variety of needs, such as in-home care and tuition, but the waitlist has been a longstanding problem in the state. It has reached a crisis point as thousands of families wait for services. According to June KDADS data, 5,100 people are now on the list for the program.
Committee chairwoman Sen. Beverly Gossage, R-Eudora, said there weren’t enough providers to keep up with demand, even if the state had enough funding to enroll everyone currently on the waitlist into waiver services.
Let’s say we had funds to do that,” Gossage said. “There are not enough providers to provide the services.”
Gossage and other committee members are looking at stopgap measures, such as a community waiver that could provide partial services for those on the waitlist.
But with low funding, IDD service providers struggle to find and retain enough people to provide services for those currently receiving services, let alone those on the waiting list.
Medicaid reimbursement rates are set by the state. While Kansas raised rates by 25% last year following years of stagnation, the adjusted rate still isn’t enough to attract new workers.
For comparison, Kansas Medicaid reimbursement rates for applied behavior analysis, a type of behavioral therapy, is $47 an hour. In Nebraska, ABA is reimbursed at $140.24 an hour. Iowa Medicaid pays $65.36 an hour. Oklahoma pays $69.40 an hour.
“I want to work my life in this field, and I want to see a field here when my children are grown and when I’m gone,” Neumann said. “In order to do that, we’re going to need to invest in the long-term stability of this field. And by doing that, we’re going to have to look at that rate regularly and never get to a point that we were when our field was on the brink of collapse.”
Doug Wisby, CEO of Multi Community Diversified Services Inc., said last year’s rate increase provided some relief for his company, allowing the business to increase worker pay, starting direct care staff at $17 an hour. Without continued inflation adjustments, he said he was concerned the company would once again struggle to provide competitive pay in a few years.
Matt Fletcher, executive director of InterHab, said service providers needed regular increases to keep up with inflation, instead of relying on “spurts” and “trickles” of funding.
“While IDD service providers appreciate the hard-fought efforts of legislators during the past few sessions to increase funding, we can surely agree that this should not be how the future funding needs of a vital service system are determined on a year-to-year basis,” Fletcher said.
“The IDD service providers need to be provided with regular funding adjustments that keep pace with rising costs they experience. They also need a sense of stability as they plan for upcoming budget cycles.”
This article was reprinted with permission from the Kansas Reflector. The Kansas Reflector is a non-profit online news organization serving Kansas. For more information on the organization, go to its website at www.kansasreflector.com.