Wichitans, nonprofits skeptical of plan to overhaul services to disabled

Some Wichita families and nonprofits remain skeptical of the state’s plan to overhaul the way it provides services to disabled people.

The proposed change could impact those with a physical disability, developmental or intellectual disability, who are frail and elderly, have a traumatic brain injury or have a serious emotional disturbance and who receive services through Medicaid – a government health insurance program paid by state and federal dollars.

State officials are touring the state to present updates about the change. They were in Wichita this week.

At issue are Medicaid waivers, which offer medical services, help with day-to-day living, residential services and transportation not normally covered by Medicaid. Currently there are seven waivers based on disability such as physical disability, traumatic brain injury, intellectual and developmental disability and frail elderly.

The plan is take the seven waivers and combine them into one by January of 2017.

What the state says

Officials from the Kansas Department of Health and Environment and Kansas Department of Aging and Disability Services told about 100 people gathered in Wichita that the universal waiver would reduce the wait list and offer more services to current recipients without costing the state more money.

The state does not have detailed actuarial data to show how the plan will work.

But Becky Ross, Medicaid initiatives coordinator for the Kansas Department of Health and Environment, said actuaries would analyze the data before implementation in about a year.

“We believe we can demonstrate that people will be healthier, transitions will be smoother and that we can improve and expand community services,” Ross said.

She said the change would move toward more person-centered care, make it easier for people to receive additional services and make the transition easier from child to adult services as clients age.

She assured people at the meeting that they would not lose their services under the change.

“We believe services should be based on person-centered care around the individual’s needs rather than the individual’s disability,” Ross said.

The change will make it easier for clients to transition from child to adult services as they age, she said.

What the public says

Many of those attending questioned the state’s premise of the plan: to expand services without spending more money.

“It makes no sense,” said Kevin Fish, executive director of the Arc of Sedgwick County – a provider for the intellectual and developmental disability waiver. “How do you offer the world and have no money tied into it? Someone is going to have to lose something.”

“These presentations are so vague that who would disagree with these ideas?” said Allison Lemons, a sister and guardian of a 64-year old man with cerebral palsy who receives the intellectual and developmental disability waiver.

Some worry clients would fall through the cracks in such a large bureaucratic overhaul and worry continued budget restraints would lead to a drop in services.

“The evidence of the need for this change is unclear or elusive,” said Kris Ehling, whose 15-year old son receives the intellectual and developmental disability waiver.

“Qualified providers must receive competitive wages or we won’t get qualified providers,” Ehling continued. “Providers haven’t seen a rate increase in eight years,”

Another concern is whether case managers who decide what services people receive would work for the insurance companies that provide the services.

The state still needs to have “an ethical division between who’s paying and who’s making that determination,” said Justin Anderson, division manager of Arrowhead West, a nonprofit that serves people with developmental disabilities.

What’s next?

Ross, from the health department, said the state would no longer set a timeline for the draft proposal and public comment periods.

Ross said the final draft would likely be submitted to the federal government for approval six months before implantation. That puts the comment period and final amendment submission sometime before June.

When the draft is posted, Ross told those at the meeting, “it’s not going to have the level of detail you want with limitations and qualifications.”

This story was originally published November 14, 2015 at 7:55 AM with the headline "Wichitans, nonprofits skeptical of plan to overhaul services to disabled."