Kansas City Regional Health News

Subscribe rss

History of welfare agency replete with changes

“The only thing constant in life is change.” - Francois de la Rochefoucauld

The French writer is long dead so he probably doesn’t care that the Kansas Department of Social and Rehabilitation Services has proved him right many times over.

Since the state welfare agency was created on July 1, 1973, with the first executive reorganization order ever issued by a Kansas governor, its history has been one of constant change and reorganization generally accompanied by controversy.

A growing agency
For almost two decades, under the direction of Robert Harder, a former legislator and Methodist minister, the major changes at SRS were ones that increased the agency’s size and responsibilities.

When Harder became the first SRS secretary, the administration of welfare programs had for the most part been a job handled locally by the state’s 105 county governments with each county levying a tax for social services.

But with Harder and ERO 1, policy development and administration of Kansas social services moved to Topeka. County taxes were gone and with them county welfare directors. Before ERO 1, the local directors had their own association and had lobbied against the reorganization as did the Kansas Association of Counties.

“It was a fairly big change,” said Harder, typically understated when talking about government.

Under Harder, for the first time in Kansas, there was a single umbrella agency for the state hospitals and institutions and the delivery of a range of local social services ranging from Food Stamps to cash aid and medical care for the state’s poorest and sickest. Throughout the 1970s and early 1980s, SRS continued to grow. In 1983, Kansas became one of four states in the nation to implement a Medicaid waiver for Home and Community Based Services (HCBS).

"In that transition, in the early years, we picked up additional work because the governor and Legislature liked the idea of an umbrella organization," Harder said, "and I think felt comfortable with what we were doing."

Harder, still the longest serving SRS secretary, left in 1987. During his tenure, SRS came to run all the major social service programs in Kansas, many of which by the end of the 1990s had been divided among a half dozen other agencies, including the Kansas Department on Aging (1996) and the Juvenile Justice Authority (1997).
A shrinking agency
The downsizing of SRS has continued in fits and starts since 1988, as Kansas policymakers joined the then prevailing trend among states to move away from having a single, large welfare agency toward multiple, smaller entities, each in charge of a specific welfare population.

SRS, which had about 11,000 employees when Harder departed, now has fewer than 4,000.

Major consolidations and cutbacks occurred under the administrations of Govs. Bill Graves, a Republican, and Kathleen Sebelius, a Democrat. State welfare reforms in 1994 and federal reforms in 1996, also brought major changes to the agency. In 1997, when Kansas policymakers were caught up with the idea of "privatizing" public services, the care of children in state custody was turned over to contractors under SRS supervision.

In 2003, as the result of a Sebelius administration efficiency initiative, the number of SRS regional offices was reduced from 11 to six and a number of county offices were also shuttered. Now, the agency has local service centers in 37 towns and regional offices in Kansas City, Emporia, Topeka, Garden City, Chanute and Wichita.

In 2006, acting on orders from the Legislature, major components of the state Medicaid program along with hundreds of employees were transferred from SRS to the then-new Kansas Health Policy Authority, which is now slated for consolidation July 1 with the Kansas Department of Health and Environment.

"If we continue to be serious about the idea of one-stop shopping and one location in the major towns and cities where you could get social services of all kinds," Harder said. "We’ve moved away from that concept and its become much more splintered over time."

Many new faces
Even this brief and incomplete recounting of SRS history makes it clear that it has been replete with changes and reorganizations.

So, when current Secretary Rob Siedlecki moved from Florida to take the job in January and pledged to “transform,” the agency, the early reaction of many people within and outside the agency was, “here we go again” or “been there, done that.”

Now, five months later, many agency workers and others in the agency’s still-large social service network are beginning to see some details of what Siedlecki and his new executive team intend to change. It's too soon to know how the new administration will mark the agency compared to earlier ones, but some things are taking shape.

The new secretary has replaced an unusually large number of agency managers, firing or pushing out a number of long-time SRS workers and replacing them with former associates or colleagues from his stints in federal and Florida government.

SRS secretaries, except for Siedlecki and Winston Barton, have all been from Kansas. And usually, they have been veterans of the Kansas Legislature, which means they have come to the job knowing the state and key legislators quite well.

The number of new faces at the top at SRS has created some confusion or culture shock among people accustomed to dealing with the agency and a steeper-than-usual learning curve for its leadership team.

For example, some contractors and others who deal almost daily with the agency on technical or operational issues, suddenly found the SRS managers they had been working with gone without notice. The replacements, in some instances, either hadn’t had time or didn’t bother to change the messages on their answering machines.

Some long-time, rank-and-file employees have complained privately that the new managers tend to keep to themselves and offer little or no explanation to subordinates of changes that have set phones ringing with questions from the public and legislators.

Learning curve
Janet Schalansky was SRS secretary from 1999 to 2005 after starting with the agency in 1973. While she was deputy secretary under Rochelle Chronister, the pair pushed to have top agency jobs declassified, which meant those in them could be fired at the will of the secretary. But neither Chronister or Schalansky used that power as extensively as Siedlecki has.

"Anytime someone takes over leadership, they’re going to get a team of people they know and respect," said Schalansky, who recently retired a second time as chief executive of Kansas Children's Service League, a major SRS contractor. "That happens in the private sector, too. People are saying they’re all coming from Florida or Washington D.C., that isn’t necessarily bad. But as a Kansan, we want to be sure they learn who Kansas is and do they understand rural Kansas and understand our state."

Schalansky said understanding the "profoundly rural" nature of Kansas and what that means for delivery of social services is something the new team must learn.

"At our farmhouse in Smith County," she said, "there's not another farmhouse for five miles and there are parts of Kansas more rural than that. Do they learn how to deliver services in rural Kansas and respect that? That's the learning curve they have and I guess that's how I would measure going forward whether they're the right persons."

The new team will also need time to forge relations with key legislators and players in the welfare system, she said.

Understandable caution
"Coming here where they don’t know the landscape and don’t know the players, there's an understandable degree of caution (from them) of how we’ll do and based on the (new administration's) political rhetoric, there's an understandable amount of caution from the community networks as well," said Tom Laing, executive director of Interhab, a group that represents most of the providers of community services to the developmentally disabled.

For example, Siedlecki and the governor have both repeatedly talked about their interests in "strengthening families" and in faith-based initiatives.

The contract offered by SRS to the CDDOs requires that the community organizations agree to support those and any other initiatives put forth by the secretary in 2012.

"I don’t have reasons to be pessimistic," about dealing with SRS, Laing said, " so I’m not. But I do believe there's a wariness on the table just as people get to know each other.

"You can’t predict what’s going to happen with new people until you’ve worked with them a little and even then predicting is a slippery game," Laing said. "They don’t have the deep well of confidence they might develop in the coming year."

Information flow

Details about the administration’s planned changes have been sparse in the first five months. But more are becoming known as the agency enters contract talks and other negotiations and more will be known as agency officials decide how they will make millions of dollars in additional budget cuts ordered by the Legislature.

“There are many providers right now in the community that are struggling with the lack of information,” said Shannon Jones, executive director of the Statewide Independent Living Council of Kansas, a group that advocates for and provides services to the disabled.

SRS officials earlier this month announced they had found a way to increase the average hourly pay for in-home caregivers for the disabled while reducing the amount paid to agents who coordinate the caregiving. The changes are slated to start Sept. 1.

News of the changes were made with a brief press release that raised more questions than it answered.

Jones said SRS officials then gave the providers a week's notice of the training session for the changes.

"It's really hard for a lot of providers to send all their case managers on a moment's notice," Jones said. "And providers still don’t know what to tell their consumers about what their attendants are going to be paid."

Likewise, operators of the state’s psychiatric residential treatment facilities for children, recently learned indirectly and belatedly that SRS has urged community mental health centers to cut costs by using the facilities less. The treatment centers found out what was going on only after they saw a quick and dramatic drop in the number of mentally ill children referred to them.

“We didn’t know what was going on,” said Cheryl Rathbun, vice president of clinical services for St. Francis Community Services, which has a 33-bed PRTF in Salina and a 34-bed facility in Ellsworth.

No information at this time
Agency officials have pledged transparency, but state senators began hearing complaints about the agency’s opaqueness during the past legislative session and wrote into their version of the budget bill a proviso requiring the agency to submit quarterly reports to the Legislature.

Gov. Sam Brownback vetoed the proviso, saying it unfairly required more reporting from SRS than other state agencies, which report to the Legislature yearly.

KHI News Service requested an in-depth interview with Siedlecki or any other top agency official. The request was declined but the news service was invited to submit questions via email.

A list of 12 questions were emailed, including a request for information about new contract language dealing with the faith-based initiatives and whether or not the secretary intended to resume or continue monthly public meetings with stakeholders. After more than a week, the agency responded:

"After reviewing your questions with our staff, we don’t have the information you’re looking for at this time."

Related Story
SRS chief expects more downsizing

Document
SRS-CDDO contract (1st draft)

SRS and a team representing the 28 Community Developmental Disability Organizations (CDDOs) are starting contract negotiations this week.
With proposed contract documents now on the table, some of the new SRS expectations are now explicit.

SRS Contract Language

CDDOs will:

Support the initiatives of the Secretary of SRS. Currently those initiatives are:

Healthy Marriage

Children are generally healthier, better adjusted and perform better in school when they have the security of a home with a married mother and father. The goal of SRS is to give couples who choose marriage for themselves, the skills and knowledge necessary to form and sustain a healthy marriage.

Healthy Fatherhood

The Healthy Fatherhood initiative will encourage all fathers to play an involved, committed, and responsible role in their children’s lives.

Healthy Adoption

The Healthy Adoption initiative will focus on providing all children with loving, stable, and permanent homes where they can grow up.

Faith Based and Community Outreach

This initiative will promote outreach and partnerships with faith-based and other community organizations.

CDDO’s will:
Support the future initiatives of the Secretary of SRS. During FY2012, it is the intent of the Secretary of SRS to implement additional initiatives related to;

• reduction of conflicts of interest that currently exist in the MR/DD system
• increased efforts to reduce waste, abuse and fraud in the MR/DD system
• increasing transparency and timely reporting related to critical incidents.

Health News

National

  • MSNBC News, March 7, 2011
  • Wall Street Journal, July 14, 2011
  • The Wall Street Journal, July 13, 2011

Regional

  • Fox 4 News, July 11, 2011
  • Fox 4 News, July 7, 2011
  • KHI News, July 7, 2011