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By Lisa Bailey - Lawrence

March 8, 2010

To the editor:

Let’s talk about the Legislature’s shortsighted cuts to Medicaid. A program funded through Medicaid with a 70 percent match from Washington, the traumatic brain injury waiver, saves the state money with focus on community-based services for TBI survivors versus more costly maintenance in a nursing home. Beyond acute care, rehabilitation services and community supports are provided for those learning to live again with a life-changing injury. The waiver is time-limited, based on progress toward the individual’s goals for independent living, and comes with a client obligation (premium) determined by income over $750/month.

If the person recovering from a TBI is you, it’s time to grow up again. You must relearn how to walk, talk, think, recall and behave. Recovery varies greatly, influenced by many factors, but your best outcome depends on availability of services. Most of these aren’t covered by insurance.

The good news, at least for now, comes with the TBI waiver giving you the opportunity to live with dignity and respect as part of the community. You’ll have a case manager to navigate the details; personal care attendants if needed; physical, speech, occupational, and cognitive therapists to help you figure out new ways to do things, and transitional living specialists to help you use the new strategies in daily life.

Contact your representative today; the 20 percent cut hurt us badly with more planned. Remind them that a $200,000 cut to this program takes away $800,000 when matching funds are lost. Ask the going rate for a nursing home.

Dear Editor,

Two days before Thanksgiving Governor Parkinson made sweeping 10% cuts to Medicaid in Kansas that began on January 1, 2010. Those cuts were to every person using Medicaid, every provider accepting Medicaid and every citizen who is one car wreck away from needing Medicaid.

We are now in mid March and see that durable equipment providers have stopped taking Medicaid, many home health agencies are no longer taking Medicaid and nursing homes are limiting admissions. Every agency in Kansas has cut staff and pay. The cuts have been deep and have damaged the infrastructure Kansas has developed over the past 30 years. The stress has become palpable.

I believe there was some hope on the part of Governor Parkinson that all those affected by the Medicaid cuts would band together and implore the legislature to look at tax exemptions and push for a sales tax. Unfortunately, most agencies are so busy scrambling to help the people affected by the cuts it has been a challenge to organize. Additionally, those who are trying to educate legislators are being rebuffed with comments that the cuts are just eliminating waste and looking at sales tax exemptions is the devil's work. Even churches have rallied behind the call to leave taxes alone, at the expense of those needing Medicaid.

Can you please tell me how severely limiting people's access to wheelchairs, physicians and medical care is anything less than a death panel? Isn't it sad that when people are down and out they are moved to the middle of a battle between ideologies of the left and right? When will someone stand up for the person in the middle and restore the Medicaid cuts?

This isn't a battle between right and left. It's a battle between right and wrong. Continuing to use people on Medicaid to balance the budget is a blemish on both the Democrats and Republicans in Kansas.

Sincerely,
Janet Williams
7189 Conser Place
Overland Park, KS 66204

There ought to be a law...

I am currently in Iowa getting ready for Part II of a presentation on Community at the Brain Injury Association of Iowa's annual conference. There are 300 people here for the conference, a combination of people with personal experiences, professionals and providers. There are a lot of programs in Iowa and, like all states, they are experiencing budget cuts.

Now here's the maddening thing that has been going on since the early 1980s. States send people with brain injuries out of state for services, using precious tax dollars, with no plan to bring people home. Iowa has 50 people with brain injuries out of state for services, costing 4x more per person than in state. Kansas has 22 people out of state at a cost of over $700 per day, when the average of instate services is only $120 per day for comparable services. There are some people who do need short term hospitalization for medication stabilization but once someone leaves the state, they are usually gone for a year or more.

There are several reasons states continue to use this avenue. First, archaic laws make institutional services an "entitlement" and community based services an exception or "waiver." Second, heavy marketing from out of state providers and no accountability for said providers combined with state agency staff who are overworked already and you have a formula for more people going out of state. And finally, there are providers who think it's just easier to send someone out of state rather than train staff on how to provide positive behavioral supports or address the individual needs of the person.

You would think someone would pay attention to millions of Kansas dollars going out of state. We can serve 300 people at home for a year for the same amount of money as 22 people out of state. There ought to be a law...