November 15, 2011
KANSAS DEPARTMENT ON AGING
By: Nicole Dube, Associate Analyst
You asked for background information on the Kansas Department on Aging organizational structure and programs and services.
The Kansas Department on Aging (KDOA) was created in 1977 as the single state agency for administering elderly programs and receiving and disbursing federal Older Americans Act (OAA) funds. Its mission is to “promote the security, dignity, and independence of Kansas seniors.” The department is administered by a secretary appointed by the governor. It has three divisions: (1) Long-Term Care; (2) Mental Health and Residential Care Facilities; and (3) Licensure, Certification, and Evaluation. It administers a variety of state- and federally-funded programs and services that provide medical and long-term care, nutrition, legal assistance, and in-home services, among other things. It also licenses “adult care homes,” which include nursing homes, nursing facilities for mental health, intermediate care facilities for the mentally retarded, assisted living facilities, residential care facilities, homes plus, boarding care homes, and adult day care facilities.
KDOA is a cabinet level agency administered by a secretary appointed by the governor. The secretary is the chief executive officer who oversees all agency operations. Staff reporting directly to the secretary include the:
1. deputy secretary;
2. directors of Public Affairs and Human Resources;
3. commissioners of Program and Policy; Administrative Services; and Licensure, Certification, and Evaluation; and
4. chief legal counsel.
(A copy of KDOA's organizational chart is attached.)
The department has three divisions: Long-Term Care; Mental Health and Residential Care Facilities; and Licensure, Certification, and Evaluation. The Long-Term Care Division provides consultation to consumers, adult care home providers, health care surveyors, and other long-term care stakeholders. Services include education and training, technical support, and workgroup participation.
The Mental Health and Residential Care Facilities Division evaluates assisted living facilities, intermediate care facilities, and “state-licensed only” facilities for state licensure and federal certification.
The Licensure and Certification Division licenses adult care homes which, under Kansas law, includes nursing homes, nursing facilities for mental health, intermediate care facilities for the mentally retarded, assisted living facilities, residential care facilities, homes plus, boarding care homes, and adult day care facilities. It also conducts annual surveys to ensure compliance with federal and state regulations including facility requirements, residents' rights, and residents' protection from abuse, neglect, and exploitation.
According to its website, KDOA envisions communities that empower seniors to make choices about their lives and its mission is to promote the security, dignity, and independence of Kansas seniors. It established the following goals to advance this mission:
1. enhance the state's expectations towards person-directed options in the community and long-term care facilities (e.g. individual choice in care planning);
2. enable more seniors to remain in their homes by promoting an array of high quality community services and supports;
3. help seniors achieve healthier, more active lives through prevention and intervention; and
4. enable more seniors to live a dignified existence by promoting senior rights and reducing the incidence of senior abuse, neglect, and exploitation.
MAJOR PROGRAMS AND SERVICES
KDOA administers several state and federally funded programs and services. The following provides a summary of some of the major programs and services.
In 1997, Medicaid long-term care programs serving mostly seniors age 65 and older were transferred from the Kansas Department of Social and Rehabilitation Services to KDOA. These programs included the Medicaid Home and Community Based Services for Frail Elderly (HCBS/FE) waiver program, targeted case management for HCBS/FE waiver participants, and the Nursing Facility program. The Nursing facility program enrolls nursing homes and hospital-based long-term care units providing Medicaid services to frail elderly and disabled residents, and provides reimbursement for those services.
In addition, KDOA sets Medicaid nursing home rates and performs desk reviews and field audits on nursing home cost reports to ensure Medicaid reimbursement rates comply with state and federal regulations. Medicaid rates are case mix adjusted based on residents' acuity levels (e.g. based on the severity of residents' medical conditions). Nursing homes expenditures are 40% federally funded and 40% state funded.
OAA Funded Programs
KDOA administers several OAA funded programs, including:
1. Title III-B programs, which provide information and assistance, case management, transportation, and legal services; in-home attendant care, homemaker, respite care, and adult day care services; and community services, including program development, legal assistance, recreation, and counseling.
2. Title III-C nutrition programs, which provide congregate meals and meals-on-wheels to eligible participants.
3. Title III-D funding provides disease prevention and health promotion services grants to Area Agencies on Aging for certain health-related services, including health risk evaluations, screening for physical or mental health conditions, nutrition counseling, health promotion programs, and exercise programs.
4. Title III-E programs provide family caregiver support services such as information and assistance, counseling, respite, support groups, and training.
Other Federally Funded Programs
Aging and Disability Resource Center (ADRC). ADRCs provide a single-point of entry for individuals to access program information, applications, and eligibility determination for all aging and disability services. It is funded through an Administration on Aging grant with 5% state matching funds.
Client Assessment, Referral and Evaluation Program. This program provides an assessment to identify consumer preferences on long-term care service options to determine appropriate placement in long-term care facilities. It also collects data on individuals being assessed for possible nursing home placement. The program is 75% federally funded and 25% state funded.
Hospital Discharge Model Grant Program. This program creates a pilot hospital discharge model that includes (1) patient input and encourages patients to request discharge planning; (2) develops caregiver supports; and (3) builds a collaborative discharge team to support the patients and caregivers during the discharge planning process. The program is 95% funded by the federal Centers for Medicare and Medicaid with a 5% local match.
Money Follows the Person (MFP). MFP is a federal demonstration program under which states receive enhanced reimbursement rates for moving people out of nursing homes into community settings.
Program for All-inclusive Care for the Elderly (PACE). PACE is a managed care program that combines Medicare and Medicaid medical care and long-term care services. The provider accepts a capitated payment rate to provide all these services, including in-home services that may otherwise be accessed through the Medicaid Home and Community Based waiver program. The program is 70% federally funded and 30% state funded.
Senior Health Insurance Counseling for Kansas. This program provides volunteers to help seniors understand their Medicare benefits. Counselors provide information and assistance with Medicare claims and appeals, Medicare Part D Prescription Drug Coverage, Medicare supplemental insurance policies, and long term care options and financing.
SMP (formerly called the Senior Medicare Patrol). This program educates Medicare and Medicaid beneficiaries and providers on how to recognize and report medical error, fraud, and abuse. It is funded through an Administration on Aging grant with 25% state matching funds.
Seniors Together Enjoy Physical Success. This program provides instructor training and exercise equipment for community fitness classes geared toward seniors age 60 and over. The program is funded through a private grant.
Case Management. This program provides long-term case management to non-Medicaid frail seniors who want to remain in their own homes. Services include developing and updating care plans, assisting seniors in acquiring needed services, and ensuring efficient use of public and private resources.
Senior Care Act. This act provides a coordinated system of in-home services for seniors age 60 and older who need assistance with activities of daily living (e.g. bathing, dressing, and house cleaning) so that they are not inappropriately or prematurely placed in nursing homes. The program is funded through state and local funds and participant co-payments.
Kansas Department on Aging, Kansas State Plan on Aging: Federal Fiscal Years 2010-1013, http://www.agingkansas.org/Publications/State_Plan_2010-2013.pdf, website last visited on November 14, 2011.
Kansas Department on Aging 2010 Annual Report, http://www.agingkansas.org/Publications/AnnualReports/2010_Annual_Report.pdf, website last visited on November 14, 2011.