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KanCare changes loom for disability services





Long-term support for Kansans with intellectual and developmental disabilities will be carved into KanCare on Jan. 1, despite public opposition from service providers and people with disabilities throughout the state.

Advocates asked the Legislature to permanently exclude long-term, home-based supports from the state's revamped Medicaid program, administered by three for-profit companies. When the legislature adjourned June 2, no such action had been taken.

"I wouldn't say our cautions are diminished, but they've changed," said Jerry Michaud, president of Developmental Services of Northwest Kansas. "We know we're on this path, so we're kind of rolling up the sleeves and saying OK to ... the administration. Let's use this time proactively to problem-solve and anticipate where we may have some hiccups and try to get those resolved before you go live."

Medical services for the developmentally disabled and long-term supports for other populations -- such as the physically disabled and elderly -- were folded into KanCare earlier this year. The Legislature opted to give IDD services an extra year.

Annual contract negotiations between service providers and the Kansas Department for Aging and Disability Services also have wrapped up. As part of those negotiations, Michaud said state officials have agreed to work with providers through the transition process.

The state also launched an optional pilot program, which gave providers and consumers the opportunity to experience the new system before Jan. 1. Approximately 500 people and 25 service providers are participating in the pilot, said Angela de Rocha, KDADS spokeswoman.

"A lot of the work we're doing on the pilot project is focusing on the providers and billing system," she said. "We're hoping that by the time Jan. 1 rolls around, that we will have confronted all of what might turn out to be problems and challenges, and resolve them when the entire population in the IDD waiver is included in KanCare."

Gov. Sam Brownback's administration maintains the KanCare program will save money and lead to better outcomes.

"The big thing to remember here is what we're doing is paying for outcomes. Under the (old) system, we're just paying for volume of services," she said. "Under KanCare, we're paying for these people to have better mental health and developmental disability health and overall health to better outcomes for all those three areas of their care they're receiving from the state."

Approximately 82 percent of DSNWK's revenue comes through the state Medicaid waiver.

A small percent of DSNWK's services was incorporated into KanCare this year. The experience thus far has not necessarily been positive, Michaud said.

Early this year, the local organization experienced delayed Medicaid payments of a sum exceeding $125,000. Payment issues seem to be diminishing, he said, but DSNWK has not yet reached contracts with any of the Medicaid providers for the covered services.

Providers were given 90 days after Jan. 1 to finish contract negotiations. Though DSNWK was not able to meet that deadline, the administration has assured full payments will continue as long as the organization is working to establish contracts, Michaud said.

Despite those assurances, one of the managed care organizations recently sent DSNWK a letter advising payments would cease after 180 days, or after June 30. Administrators are working to resolve the issue, he said.

"It's a bit of a roller coaster ride in trying to say this shouldn't be so complicated, but it is and it's been that way," Michaud said. "We're trying to weather that as best we can, but the reality is we still don't have contracts, and we're working to get there."