k5491 BC-KS-MedicaidOverhaul 2ndLd-Writethru 12-27 1153
By JOHN HANNA
AP Political Writer
TOPEKA, Kan. (AP) -- Kansas is postponing the last part of an overhaul of its Medicaid program as it addresses questions from the federal government about in-home services for the developmentally disabled, state officials announced Friday.
The announcement means that the state won't bring long-term care services for developmentally disabled under the administration of three private health insurance companies on Jan. 1 as planned. Advocates for the disabled have been vocal critics of the move.
The state's $3 billion-a-year Medicaid program covers health care for about 344,000 needy and disabled residents, and Kansas turned over the administration of most of it to three private health insurance companies at the start of 2013. Resistance to the changes from advocates led Republican Gov. Sam Brownback's administration and the GOP-dominated Legislature to delay including long-term, in-home services for the developmentally disabled for an additional year, until January 2014.
State officials said they hope to have an agreement with federal officials by Feb. 1, though it's not yet clear how quickly after that Kansas could finish overhauling its Medicaid program, now called KanCare. Federal officials must sign off because the federal government provides a majority of funds for states' Medicaid programs.
"This is a temporary delay," said Angela de Rocha, spokeswoman for the state Department for Aging and Disability Services. "This is a postponement of the launch date."
Late last year, the U.S. Department of Health and Human Services allowed Kansas to turn over the administration of most of its Medicaid program to the private companies, which offer competing plans to Medicaid participants.
Brownback's administration has said Medicaid participants are getting better-coordinated care, improving services for them and decreasing the state's costs. Some hospitals have complained about delays in payments, and critics of the overhaul have questioned whether participants will receive lesser services, though the companies and the administration say more is being covered through their contracts.
"We're seeing improvements, and we're going to keep at it," Lt. Gov. Jeff Colyer, a reconstructive plastic surgeon who led the administration's work on overhauling Medicaid, said during an interview last week. "We are working for the patient, and we are trying to get good value for the taxpayer."
In a statement issued Friday, Colyer said both federal and state officials still have a strong "shared commitment" to "comprehensive, integrated care" for Medicaid participants.
The state's announcement Friday came two weeks after the National Council on Disability, a presidential advisory group, called for delaying the last part of the Medicaid overhaul. The council had a hearing in Topeka in early December.
Tom Laing, executive director of InterHab, which represents groups providing services to the developmentally disabled, said he and other advocates are still wary of having for-profit companies administer services. He said Brownback's administration should abandon attempts to make the changes on "a magical calendar" date.
"If it's a victory for one thing, it's a victory for the reality that citizen feedback makes a difference," Laing said of the delay. "We're a long ways from having a resolution."
In a letter Friday, a regional HHS administrator in Kansas City, Mo., said a key issue for federal officials is the state's practice of maintaining a list of developmentally disabled Kansans who are seeking additional services. The "underserved" list includes about 1,700 people.
Shawn Sullivan, the state's secretary for aging and disability services, said Kansas will attempt to keep people off the list going forward, but added that the KanCare changes are "key to solving that longstanding issue."
The state has maintained the list for about 10 years. The Disability Rights Center of Kansas questions whether federal law allows the practice, though the state says there's no basis for such a claim.
The regional HHS administrator's letter said Kansas must develop a "corrective action plan" so that people on the list have their current needs assessed and "needs are met." The letter also said Kansas must provide weekly reports on its progress.
Rocky Nichols, executive director of the Disability Rights Center, said the letter shows the state faces "considerable heavy lifting" in addressing the issues holding up federal approval of the Medicaid overhaul's final piece.
"This suggests it's going to take a long time to get these problems corrected," Nichols said.