When the state announced Friday that it would delay bringing long-term support services for people with intellectual and developmental disabilities into KanCare – the state’s privatized Medicaid program – Aldona Carney was thrilled.
That move had been scheduled to take place Jan. 1, despite the efforts of advocates of the developmentally disabled to delay or prevent it.
“I’m hoping they’ll carve it out completely and come to their senses,” said Carney. She and her husband, Pat, have a 19-year-old son, Neil, with severe autism.
Since KanCare went into effect for medical services last January, Carney said, their son has had issues with getting the proper medications and with his Medicaid card being terminated without notification.
They were later told it must have been a computer glitch, and he was re-entered into the system, Carney said.
Those problems have made her worry that her son’s day-to-day care could also suffer if it is included in the program.
The delay came after the state received a letter from the federal Centers for Medicare and Medicaid Services saying it would not approve an amendment to a waiver that would allow Kansas to include services for the developmentally disabled in KanCare.
A state spokesperson said the delay is temporary and is not related to the readiness of the state to transition the developmentally disabled to KanCare.
Under KanCare, three managed care companies – United Health Care, Amerigroup and Sunflower, a subsidiary of Centene – oversee medical care for the state’s Medicaid population.
Gov. Sam Brownback has said the goal of moving to privatized Medicaid is to cut $1 billion in spending over the next five years and add services.
“We’re seeing improvements, and we’re going to keep at it,” Lt. Gov. Jeff Colyer, a reconstructive plastic surgeon who led the administration’s work on overhauling Medicaid, told the Associated Press last week. “We are working for the patient, and we are trying to get good value for the taxpayer.”
In a statement issued Friday, Colyer said both federal and state officials still have a strong “shared commitment” to “comprehensive, integrated care” for Medicaid participants.
Some advocates for those with developmental disabilities have tried to block KanCare from expanding to residential, job training and living assistance for the developmentally disabled, saying they were concerned that private insurers would reduce services to save money.
Earlier this month, the National Council on Disability, appointed by the president to advise his administration and Congress on national disability policy, urged a delay after holding hearings in Topeka.
Rep. Jim Ward, D-Wichita, called the delay positive for families who are concerned about the inclusion of in-home services in KanCare.
He said he plans to introduce an amendment to carve out developmental disability services for at least another year as soon as the Legislature begins its session Jan. 13.
More than 8,600 people statewide use developmental disability services, said Colin McKenney, CEO of Wichita-based Starkey Inc., which provides services for the developmentally disabled, and president of Interhab, the statewide association for developmental disability service providers.
“The biggest fear was the overarching plan to save tens of millions from the system without any real explanation on how that would be accomplished. ... We heard other systems’ services were being cut and what people had become reliant on for support services were being changed,” McKenney said.
“Peoples’ lives depend upon these services.”
Providers have also expressed concern over reimbursements slowing down after hearing about issues large medical providers have had since KanCare took effect last January.
Officials at Via Christi Health and Wesley Medical Center have said the number of accounts receivable past due by 90 days or more for Medicaid patients has doubled since KanCare went into effect.
Reasons for delay
Last year, the Legislature voted to delay including services for the developmentally disabled in KanCare until Jan. 1, 2014.
In order to add those services, the state needed the federal Centers for Medicare and Medicaid Services to approve an amendment to a waiver for its Medicaid program.
On Friday, CMS sent a letter to the state saying it would not approve the amendment, and that it required additional information about how the program will identify a person’s needs, how those needs will be addressed and how a person can appeal denial of services.
The letter also said the agency has concerns about the state’s underserved list.
The underserved list includes roughly 1,700 developmentally disabled people who receive some Medicaid services but are in need of additional services, said Angela de Rocha, spokeswoman for the Kansas Department for Aging and Disability Services.
The delay is not related to the readiness of the state to transition services for the developmentally disabled to KanCare, de Rocha said.
“Going forward, this administration aims to keep Kansans off the underserved list and reduce the (physical disability and developmental disability) waiting lists, and KanCare’s integrated care coordination is key to solving that longstanding issue,” said Shawn Sullivan, secretary for the Kansas Department for Aging and Disability Services, in a statement.
The state said it will work with CMS toward an agreement by Feb. 1, determining an implementation timeline during that process.
The state is sending letters to consumers who are affected by the delay, de Rocha said.
The extra time will also allow for more consideration of public comments, which were cut short because of website problems with CMS, de Rocha said.