Rising costs and flat revenues are bringing changes at Developmental Services of Northwest Kansas Inc., a community-based service provider for individuals with intellectual and developmental disabilities.

The initial service change -- in agency directed home care -- happened in September, said Jerry Michaud, DSNWK president.

"We've been providing that agency-directed home care since the program began," he said. "It's a sad day."

Before the change, the organization hired the employee who provided support for the individual.

The organization has approximately 475 employees, and provides health insurance for those who qualify and a retirement system.

The hourly rate funding "doesn't support any of that. Our loss in that service is about $135,000 a year. With our budget circumstances the way they are, it is just something that we cannot continue to do -- as painful as that is -- to make that change."

Michaud made it clear the funding for those services isn't being cut.

"Our ability to do that service is stopping," he said.

Approximately 44 families are affected, and the services provided vary depending on need.

Those in need of services can have an alternate provider in some cases or a self-directed model of service.

Some DSNWK employees might have the option to work for an alternate provider who might not offer benefits.

Not offering benefits isn't an option for DSNWK, Michaud said.

In the self-directed model, the family could be the employer of record and work with a financial management service provider to do the billing and process payroll.

The agency also is condensing services in some communities.

Day service and residential support service in Oakley, where DSNWK has been providing services since 1993, is ending. Day service will stop at the end of the year, and residential support services at the end of January.

The office in Oakley also will be closed.

"In Hill City, we are closing one of our group homes," Michaud said. "We will continue to operate the other group home that we have there."

Some individuals might move to a home in Russell.

In addition, Hays, Norton and Russell are experiencing a reduction in staff hours.

The agency also is freezing capital expenditures and reducing monthly expenses agency-wide.

"We are continuing services," Michaud said. "We're doing the same amount of work with fewer hours to do it."

Revenues have been flat since 2008, and costs -- most notably health insurance -- have increased, Michaud said.

Those realities "are creating these very difficult and backward stepping actions that we've had to implement. We're doing the same with less -- trying to have minimal impact on services," he said. "We do our best to manage our expenses, but they rise like they do for everyone. We are at this place where we have to do something. We can't just do nothing."

Michaud isn't sure what effect, if any, Gov. Sam Brownback's allotment cuts announced last week will have.

"The need doesn't go away when there are funding challenges," Michaud said. "The fiscal reality of those needs, and the current structure that we have, they are colliding. It troubles me deeply and other providers across the state."