In the early morning hours of Saturday, May 8, the Kansas Legislature passed a budget that included an appropriation of funds to be used for an increase to the Protected Income Level (PIL) for Home and Community Based Services (HCBS) and the Program for All-inclusive Care for the Elderly (PACE) Medicaid waivers. Raising the protected income level was a top legislative priority for many individuals, advocates and organizations. After a difficult legislative session, the inclusion of this budget appropriation was a huge success for individuals with disabilities in the state of Kansas.
What is the Protected Income Level?
The Protected Income Level (PIL) is the amount of monthly income protected from medical expenses to allow recipients to meet their maintenance needs. This standard is established by the state of Kansas. The idea is that the Protected Income Level should be sufficient to pay for all living expenses not covered by Medicaid: This includes food, rent, utilities and basic needs such as clothing.
Currently, the Protected Income Level is $1,157 per month. This means that if an individual receives Medicaid services on the HCBS or PACE waivers, any income they receive over this amount must be paid to the State of Kansas. This is referred to as a “client obligation.”
You can see how difficult it can be to live on only $1,157 a month. Our friends at Kansas Advocates for Better Care shared this example: A widow is receiving HCBS/FE waiver services in the modest home she owns. Property taxes and homeowners insurance consume about $300 per month, plus she has utilities – trash, water, gas, electricity, telephone – that average about $600 per month. With the PIL at $1,157, she has only $257 for food, clothing, transportation, toiletries and anything else she needs.
How much has the PIL increased?
Included in the budget for fiscal year 2021, the PIL will increase from $1,157 a month to $2,383 a month, which is 300% of federal Supplemental Security Income. It is important to note that the federal SSI amount is adjusted regularly based on increases in the cost of living, as measured by the Consumer Price Index. These are called Cost of Living Adjustments (COLA).
How will the PIL increase benefit Kansans with disabilities?
Let’s revisit our example above for our elderly widow: Her monthly expenses for shelter (property taxes, insurance and utilities) totaled $900. With the PIL of $1,157, that only left her $257 for food, clothing, transportation and toiletries for the entire month. Figuring for the increase in PIL to $2,383 a month, the same widow with shelter expenses of $900 per month now has $1,483 per month to cover food, clothing, transportation, toiletries and anything else she may need during the month!
The PIL increase is also helpful for individuals with disabilities who earn income from employment. For example, a young man on the I/DD waiver works part-time and receives SSI each month. His total income per month is approximately $1,400. With the PIL of $1,157 per month, he had a monthly client obligation of $243 to the State ($1,400 monthly income – $1,157 maximum PIL= $243). He doesn’t want to quit his job because he likes working. He would like to save up some money to buy a new mattress for his bed, but no matter how many hours he works, he can only keep $1,157 in income each month. That income is used to pay for his rent, utilities, transportation to work and food. After those bills are paid, he does not have any money left at the end of the month to save for his mattress.
When we refigure this scenario to include raising the PIL to $2,383 a month, his situation drastically improves! With the PIL of $2,383, his client obligation is reduced to zero. He can pay his bills as usual, and the $243 a month he used to pay for his client obligation to the State can now be saved for his new mattress.
It is easy to see how the increase in PIL removes a huge barrier to employment for individuals with a disability. Our friend Rocky Nichols at the Disability Rights Center of Kansas supplied written testimony to a legislative committee on this specific issue. He said, “Kansans with disabilities are great, hard-working and reliable employees. Unfortunately, as long as the PIL is less than 300% of SSI, you will have a built-in barrier to having Kansans with disabilities on HCBS Waivers working any amount over the Protected Income Level.”
Will the PIL change again?
When the PIL last increased in Kansas in 2019, it was indexed at a specific dollar amount ($1,157). This time, the budget included the provision that it be set at a percentage of the federal SSI amount, not a specific dollar amount. Once the percentage is included in the State Rules and Regulations for determining KanCare eligibility, any time there is a Cost of Living Adjustment, the PIL amount will adjust with it.
Thank you, advocates!
We are so grateful to the individual advocates, organizations, and legislators who made sure the increase in PIL was passed this legislative session. Countless hours of written and verbal testimony were given to legislative committees. Letters were written and personal stories were shared. Thank you to everyone involved for their hard work and continued dedication to improving the lives of Kansans with disabilities!