Disability service providers were bracing themselves Thursday after the state announced it had received the go-ahead from the federal government to bring long-term services for the developmentally disabled under the state’s privatized KanCare health program.
Gov. Sam Brownback announced Thursday that the home- and community-based services for 8,500 developmentally disabled Kansans will become part of KanCare as of Saturday. Disabled Kansans already receive their medical and behavioral care services through KanCare.
“Coordinating those two elements of care with their other support services will further enhance the care provided to them, improving both their physical well-being and their quality of life,” the governor said in a statement.
Not everyone’s convinced.
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“We continue to have a lot of confusion about how the care coordination of Kancare will work into the system already in place,” said Colin McKenney, chief executive of Starkey Inc., a major Wichita provider of disability services.
“It’s supposed to provide better coordination of services, leading to better outcomes. We’re not exactly sure what that means – we think people are getting excellent care – but we’re going to find out over the next couple of months.”
The approval from the federal Center for Medicare and Medicaid Services marks the end of a nearly three-year fight over the program.
Providers, clients, guardians and parents have expressed fear that KanCare – a managed-care system run by three for-profit insurance companies – is too rigid a framework to handle the myriad of individual needs for people with intellectual and developmental disabilities. They’ve also raised concerns over potential service cuts as the insurers try to maximize profits on their state contracts, which pay a set amount per client.
Services shifting from state control to KanCare include job training, nutrition, transportation and assistance from in-home aides for those with daily living challenges.
With the issue now decided, Interhab – a statewide organization for the developmentally disabled and their caregivers – is switching gears from opposition to collaboration to make the transition as smooth as possible, said Matt Fletcher, associate executive director.
Still, the state pushed the change and “now the responsibility is squarely on their shoulders to make sure not a single person is harmed,” he said. “They are the dog that caught the car, and we sincerely hope they’re ready …
“We will all be holding our breath to see what the next few weeks hold.”
State lawmakers are still divided over whether it’s a good idea.
“I’m cautiously optimistic,” said Sen. Ty Masterson, R-Andover. “We put that in their camp, and I trust that they’ve put in the due diligence and they’re ready to go.”
“Any time that there’s changes you’re always hoping it goes smoothly,” added Sen. Michael O’Donnell, R-Wichita. “We’re obviously optimistic that things are going to turn out well.”
But Democrats, who were instrumental in keeping disability services out of KanCare last year, see the coming implementation as a looming debacle.
“Not one advocate, not one family, not anyone who’s been involved in developmental or intellectual disabilities came forward and said this would work,” said Rep. Jim Ward, D-Wichita. “So this is very much a concerning day for people who depend on help from the state to get basic services from the state.”
“Even for individuals without disabilities to go underneath that (KanCare) umbrella, we are already finding that people are not being reimbursed and services are not being provided in an adequate manner,” added Wichita Democratic Sen. Oletha Faust-Goudeau. “This is just going to devastate an entire community.”
Shawn Sullivan, secretary of the Department for Aging and Disability Services, expressed confidence KanCare is up to the task.
“Together we can maintain the good qualities of the current system while enhancing the ability to increase employment opportunities, reduce waiting lists and promoting that individuals served should have a valued role in the community,” he said in the statement released by the governor’s office.
Overall, the $3 billion-a-year Medicaid program provides medical coverage for about 345,000 poor and disabled Kansans.
Since taking over the medical side of the state’s Medicaid services 13 months ago, KanCare has been dogged with complaints of delayed and denied claims. Hospitals reported multimillion-dollar shortfalls on payments and had to expand their administrative staffs to handle all the billing appeals.
If the checks don’t come on time, it could mean closure for the smaller disability service providers who don’t have deep resources to ride out months of delays in getting paid, said Fletcher, the Interhab official.
Contributing: Associated Press