Seeking to lay to rest one of the most persistent concerns about privatizing state support for the developmentally disabled, the head of the state’s disability services department vowed late Tuesday that all of the people served will be able to keep their current case managers after KanCare takes over their home- and community-based services.
Maintaining the relationship between the developmentally disabled and case managers they’ve worked with – in some cases for many years – has been a go-to-war issue for many in the disability community as the state moves toward providing all Medicaid-funded services through three private insurance companies.
Two Wichita meetings sponsored by the Kansas Department for Aging and Family Services on Tuesday left family members and service providers expressing frustration at what they said were vague answers on case management at the forum.
Later Tuesday night, department Secretary Shawn Sullivan guaranteed that all developmentally disabled people who want to keep their case managers after KanCare takes over on Jan. 1 will be able to do so, even if it means that KanCare providers have to hire them as subcontractors.
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“We’ve consistently said for two years people will be able to keep their case manager,” Sullivan said. He said he has the backing of Gov. Sam Brownback, and it’s been written into the KanCare contracts and the state budget law.
Confusion about case management arose in a big way Tuesday at meetings held in Wichita by state and insurance company officials who are implementing the plan.
At issue was a concept called a “medical home,” which will be phased in as KanCare adds disability supports to the system it already runs providing medical care to the disabled, low-income families with children and pregnant women.
Kim Brown, director of managed care for the department, calls the health home “care coordination on steroids,” because it oversees virtually all of the medical, behavioral and long-term care services that a covered person receives.
People with certain long-term physical and mental conditions will be assigned a medical home to oversee their care.
While officials at Tuesday’s meetings repeatedly assured attendees that they would not be forced to change case managers, confusion entered the picture when the discussion turned to medical homes.
Because medical homes and the state’s current system of targeted case management offer many of the same services, federal Medicaid officials won’t pay for both. State officials initially said Tuesday that clients would be able to opt out of the medical home in order to keep their case managers. But they could not provide details on how that would happen.
Christine Gafford, chief operating officer of MCDS, a service provider based in McPherson, said she thinks the answers given at the meeting were vague and “it actually has me more concerned” than when she got there.
Likewise for Kevin Fish, executive director at ARC of Sedgwick County. He said he thought the opt-out system would cause a lot of confusion among clients.
Dennis George, father of a 27-year-old man with autism, said he was reassured by the commitment that his son will be able to stay with the case manager who has known him for years and is deeply familiar with his care needs.
“I didn’t want to wind up with some kind of manager who doesn’t even know him,” George said. “Change is something autistic people don’t do well with.”