The state could lay off three janitors, sell off some real estate and vehicles and otherwise cut about $800,000 in costs at the Kansas Neurological Institute “with little or no effect on the hospital’s residents,” auditors reported today.
Or the state could save $5 million by closing the Topeka facility outright, though that likely would shift costs from the state to the communities and hospitals that subsequently would provide care to KNI’s 150 severely disabled residents.
Auditors said the potential savings detailed in the report were “from the state perspective” and that the report did not attempt to account for the potential cost shifting that would occur if the facility were mothballed, as Gov. Sam Brownback proposed soon after taking office in January.
The facility cost taxpayers $28.6 million in fiscal 2010. Most of that, about $24 million, came from the federal government in the form of Medicaid payments.
The governor’s plan to close KNI over a period of 23 months starting this July was rejected by the Legislature, drawing particularly stiff opposition from Topeka legislators both Republican and Democrat. The hospital is one of Topeka’s major employers.
Brownback announced in September that he would not ask the 2012 Legislature to agree to closing the hospital.
KNI, one of two institutions operated by the state for the developmentally disabled, has lost 40 percent of its staff and residents since 1995, when new policies emphasized placing the disabled in community settings considered more home-like than the state hospitals. KNI now employs 491 people and is home to 153 residents, according to the audit.
The second state facility is in Parsons.
Auditors said KNI’s population has decreased by an average of three residents per year since 2000 and new admissions are rare or temporary.
“At this rate of decline, KNI will eventually reach a point at which operating the facility won’t be feasible,” auditors wrote.
Then-Gov. Mark Parkinson in January 2010 rejected a commission report recommending the facility be closed but called for a gradual reduction of its residents.
Many KNI residents are in their 50s or older, according to Superintendent Barney Hubert.
The audit report drew sharp questions from several members of the Legislative Post Audit Committee, which includes three Topeka lawmakers, all Democrats.
Sen. Laura Kelly of Topeka said she thought more detailed information about the costs of “transitioning” KNI residents to community programs were needed before legislators could reconsider closing the hospital.
KNI is overseen by the Kansas Department of Social and Rehabilitation Services. SRS Deputy Secretary Pedro Moreno, whose division is in charge of state services for the developmentally disabled and mentally ill, told committee members that the agency needed at least 60 days to consider and respond to the cost-savings recommendations outlined in the audit.
“We would like some time to look at this carefully,” Moreno said. “It is not an easy time now for us. We want to do this cautiously, carefully.”
Among the potential savings described in the audit:
- Bill Medicare for the durable medical equipment used by residents to obtain $266,000 in annual state savings and $546,000 in one-time savings, with “little or no effect” on residents.
- Eliminate three custodians and replace a full-time physical therapist with a part-time person.
- Sell various tracts of land from the hospital campus and 16 hospital vehicles.
Auditors also concluded that the state could save about $388,000 annually by eliminating several staff positions. The layoffs could “potentially affect residents but would not eliminate any essential services.”
The state could save about $539,000 annually by closing a residential building and eliminating its medical unit, but that would likely affect most residents. Topeka hospital officials also told auditors they could not handle KNI residents that would be sent to them if the medical unit were closed.