Kari Bruffett, who was confirmed Thursday as secretary of the Kansas Department for Aging and Disability Services, said one of her first goals will be to continue the transition away from institutional care for people with disabilities in favor of home- and community-based services.
The Legislature's Confirmation Oversight Committee approved Bruffett unanimously after she told committee members that her agency's mission fits neatly with a personal mission statement she formulated while working as a government affairs liaison at the University of Kansas Hospital.
"Kansans should have the freedom to choose where and how they want to live, and that choice should not define their outcomes," Bruffett said. "To me, outcomes really meant, broadly, health and well-being."
Bruffett replaces Shawn Sullivan, who is now the state budget director. She had been director of the Kansas Department of Health and Environment's Division of Health Care Finance.
Sen. Ty Masterson, a member of the oversight committee, said his experience with Bruffett in that role made him comfortable confirming her.
"I've always been very impressed with her grasp of the subject matter," said Masterson, an Andover Republican. "I'm glad to see her appointment, partly because she has the ability to articulate complex matters that deal with a lot of emotion, which is what KDADS deals with."
Bruffett said one of her first tasks will be to ensure the state conforms to new regulations from the federal Centers for Medicare and Medicaid Services intended to more clearly define what qualifies as home- and community-based services for the purpose of granting Medicaid waivers.
The regulations, released in March, state that provider-owned facilities must treat live-in clients like tenants, with rights provided under state and local rental laws. Clients must have freedom to eat when they wish, lock their doors for privacy and furnish their rooms within leasing requirements.
In other words, the rules require that home- and community-based providers operate less like health care institutions and more like private homes.
Bruffett said she was confident Kansas' waiver system had that feel, but "it's a great time for the conversation" about moving further from institutionalization.
She also said one of the aims of the state's switch to managed-care Medicaid, or KanCare, was to increase the number of home- and community-based providers so Kansans in all communities can have that choice.
"It has yet to materialize, but one of the hopes for KanCare is that capacity-building is something the MCOs (managed care organizations) can do in partnership with the state and providers," Bruffett said.
Tom Laing, executive director of Interhab, a Topeka-based organization of service providers for Kansans with developmental disabilities, said the state does not yet have enough providers to realize Bruffett's vision of a Kansas in which residents can live wherever and however they please.
"But we are poised to be able to do so if there is a commitment and a recognition to talk honestly about the need for resources,” he said.
“Building capacity includes having the resources to do so," Laing said. "For us, capacity means being able to employ persons to provide services and supports.”
Laing said Bruffett and Sullivan have both been willing to listen to provider concerns. But he said the switch to managed care under three private insurance companies has not helped build the state's home- and community-based provider network, nor has static state funding for that workforce.
“I think Bruffett will look at that issue, though," Laing said, "and she gets a first shot in this upcoming budget.”