I don’t often get mad about public policy matters. But I did as I watched a gray-haired mother guide her adult son with Down syndrome to their seats at a recent forum about out-of-state insurance companies managing the long-term care of developmentally disabled Kansans.
How dare the Brownback administration force an untested, ill-considered policy experiment on this population?
Administration officials made assurances at the forum that the developmentally disabled would be protected and wouldn’t have to change service providers or case managers. But I’m still skeptical and concerned.
I’m not alone.
Families throughout the state are worried that the change will disrupt the lives of loved ones who need stability. Parents are scared about what will happen after they die and their children have to depend on a for-profit insurance company for assistance.
Service providers complain that they were never consulted about the reform, and that they get different answers each time they ask how the new system would work.
“This process has been anything but open and transparent,” Deb Voth, president of Rainbows United, told The Eagle editorial board.
It would be one thing if the current care network for the developmentally disabled were inefficient and ineffective. But the partnership between state and local governments and service providers works well overall. Its main problems have been chronic underfunding and waiting lists.
State lawmakers also are frustrated. To their credit, some are taking action.
Rep. Jim Ward, D-Wichita, introduced a bill that would “carve out” long-term care for the developmentally disabled from the administration’s plan to privatize oversight of Medicaid services. “We must ensure that critical services for our most vulnerable citizens are not jeopardized,” Ward said in a statement.
Sen. Dick Kelsey, R-Goddard, thinks the entire Medicaid reform plan is being rushed and has called on the administration to delay implementation by six months, from Jan. 1 to July 1, 2013. “It is going to be a disaster of a magnitude that we can’t even imagine,” he told me. Kelsey also wants the developmentally disabled population removed from the proposal.
But lawmakers have limited ability to stop the administration, which is using its executive authority to reform Medicaid without any legislative approval. Kelsey sees committee opposition as the first step in getting the administration to change course. If that doesn’t work, he wants a resolution from the full Senate, which he thinks would pass. The final step would be a budget battle to restrict the use of funds.
“I’m hoping that we don’t get there,” he said.
But when asked last week about delaying the overhaul, Lt. Gov. Jeff Colyer responded, “Why would we?”
And after Senate hearings last week about the reform, Kansas Department on Aging Secretary Shawn Sullivan said, “I don’t believe I’ve heard a compelling reason to carve out services for the developmentally disabled.”
If the pleas of parents, lawmakers and service providers aren’t compelling, the administration should at least be humble enough to question whether it has the skill and experience to overhaul the entire Medicaid system without major problems or disruptions.
Matt Fletcher, associate executive director of the Topeka-based advocacy group InterHab, gave lawmakers a map last week that illustrated the arrogance of the administration’s plan. It showed all the states that have reformed long-term care for the developmentally disabled in the manner the administration is attempting.
The map was blank.