David P. Rundle: Don’t break promise to disabled Kansans

03/31/2013 12:00 AM

03/29/2013 6:22 PM

The Legislature is considering a bill that would prohibit places that provide services to people with developmental disabilities from also providing targeted case management. So if you get services through KETCH in Wichita, your case manager could not work at KETCH.

The current case-management system has been in place for many years, but some lawmakers recently have become concerned. They think there might be a conflict of interest – though there is no proof there is a problem.

Senate Substitute for House Bill 2155 would take case management away from agencies that provide other services and give it to the three managed-care organizations operating KanCare.

Might the MCOs provide better case management than is happening now? Based on my experience with the home- and community-based services waiver for individuals with physical disabilities, the answer is clearly “no.”

I receive many services paid for by KanCare, including sleep-cycle support. Every night an aide stays in my apartment from 11 p.m. to 5 a.m. The aide turns me every two hours and helps me in other ways.

Someone involved with KanCare decided I only needed that for 21 days every month. My oldest brother and I learned this on March 6. Together, we spent hours on the phone and writing e-mails trying to resolve this mistake. It wasn’t finally resolved until last week.

John and I are fairly well-educated, and we’re having trouble understanding what my MCO case manager – who will not try to understand me if I call her by myself – can and can’t do and will and will not do on my behalf.

If I were intellectually disabled and by myself and had to resolve a problem with my MCO case manager, could I? I don’t know, but it would be cruel to expect me to.

Under the old system, my case manager knew and cared about me. I needed that. I still do. But someone with an IQ of 70 or lower needs a concerned and caring case manager more.

Nonprofit agencies’ case managers have 50 clients at most. My MCO case manager has 200 clients. She cannot develop a deep relationship with each of us.

I understand this, but, again, I am not intellectually disabled.

Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, should oppose the bill. People opposed to it are already blaming his boss, Gov. Sam Brownback.

The legislation “is one more Brownback promise to Kansans with disabilities that has been broken,” one mother told me. “I want my son’s case manager to be a person who will be his advocate, not an employee of his MCO. If that happens, his case manager’s primary job task will be to save the MCO money.”

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