Eagle editorial: Ready for I/DD care?

12/04/2013 12:00 AM

08/08/2014 10:20 AM

The privatization of long-term care of Kansans with intellectual and developmental disabilities launches in less than a month and is getting national attention. Here’s hoping the experiment goes well – unlike what some other Kansans and providers have experienced this year.

The National Council on Disability will hold hearings and panel discussions Wednesday and Thursday at the Statehouse in Topeka. A big focus will be long-term I/DD care, which shifts to KanCare starting Jan. 1.

This shift was strongly opposed by parents and other advocates for the disabled. They worry that the three private insurance companies that manage KanCare aren’t experienced with these services and may put profit before proper care.

Only two other states, Michigan and Vermont, use a form of managed care for long-term I/DD services, the Washington Post reported. And Kansas is the only state to turn exclusively to national managed-care companies.

“No state has ever taken a developmental disability population and placed it in an arrangement like this, with an out-of-state managed-care system, all at once,” Rocky Nichols, executive director of the Disability Rights Center of Kansas, told Kaiser Health News. “It’s almost like throwing everyone into the deep end of the pool.”

Other states are now watching to see whether Kansas sinks or swims.

Though Brownback administration officials promise that the move will be closely monitored to make sure it goes smoothly, the transition to KanCare this year for other Medicaid services has been bumpy. Many Kansans were assigned to different doctors or have struggled to receive approvals for care. A big ongoing problem has been slow payments to providers by the insurance companies.

Large hospitals such as Wesley Medical Center and Via Christi Health in Wichita have seen big increases in unpaid claims. The payment problems have been even harder on smaller hospitals, pharmacies and nursing homes.

Kevin Unrein, chief executive of the LakePoint nursing homes in Wichita, Augusta and El Dorado, has called KanCare “a mess.”

“I think it’s like Obamacare,” he recently told the Kansas Health Institute News Service. “It wasn’t ready and they pushed it and made it work.”

LakePoint was owed about $500,000 from the KanCare insurance companies for services provided, and Unrein said that KanCare had significantly increased his billing costs.

“What Medicaid used to take one hour a week to do (in nursing home staff time), it now takes 40 hours,” he said.

After months of pleading by parents and others, Gov. Sam Brownback finally agreed last year to delay privatizing long-term I/DD care until January 2014. Thank goodness he did.

But have enough of KanCare’s problems been fixed to ensure that Kansans with intellectual and developmental disabilities and their providers won’t face similar struggles? We’ll find out soon.

For the editorial board, Phillip Brownlee

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