Kansas looks to Wisconsin for ADRC model

System there has helped reduce waiting lists for services, officials say

0 | Health Care Delivery, Medicaid-CHIP

— In Wisconsin, it’s easy for frail seniors or people who are physically disabled to find out if they are eligible for the Medicaid services that could help them live at home and avoid or delay the move to a nursing home.

All they have to do is call the Aging and Disability Resource Center (ADRC) in their county. They’ll be hooked up with someone who can assess their conditions, figure out how to pay for the services and put them in touch with the providers who can make it happen.

The local ADRC is the one-stop shop for finding the services they need.

The system in Kansas doesn’t work that way.

Here, the physically disabled are expected to call one of the state’s 10 centers for independent living for a needs assessment. The frail elderly are supposed to call their county’s Area Agency on Aging.

'Confuzing maze'

Those familiar with the system say it is not the easiest to navigate.

“It can be kind of a confusing maze,” said Michelle Morgan, executive director at the Northwest Kansas Area Agency on Aging in Hays. “It’s confusing because people aren’t sure what services they need until they’re in crisis and they need help right away. If they call and they’re told, ‘Oh, we can help you with this part, but you have to call somebody else for that part and somebody else for something else,’ it can be very frustrating. A lot of times, people just give up.”

Kansas Department for Aging and Disability Services Secretary Shawn Sullivan said he wants Kansas to be more like Wisconsin.

“Wisconsin has one of the best ADRC networks in the country,” he said.

It’s also the oldest.

“(Wisconsin) came up with the concept about 15 year ago,” said Tim Sheehan, executive director of the Center for Independent Living for Western Wisconsin in Menomonie.

Today, 61 of the state’s 72 counties have an ADRC. The 11 counties that don’t are sparsely populated. They’re expected to have an ADRC in two to three years, Sheehan said.

'Work in progress'

The ADRCs are funded and administered by the Wisconsin Department of Health Services, the counterpart to the Kansas Department for Aging and Disability Services.

“This is a work in progress,” Sheehan said. “We’re about as close to neutral assessments as you can get, but I don’t want to paint an overly rosy picture. The challenge now is administering the screenings in urban Milwaukee like they are in Radisson (a town with 222 residents). Of course, the other challenge is being able to find the services after the care plan (for an individual) is put together.”

Earlier this year, Sullivan issued a request for proposals to contract with a private or public organization to create a statewide ADRC designed to break down some of the barriers to receiving home and community-based services, which typically are less expensive than nursing home care. He said he expected the contract to be awarded sometime next month.

Unlike Wisconsin, the Kansas plan does not call for opening dozens of offices across the state. Instead, the services would be folded into an existing organization’s catchment area, which may include several counties or even the entire state.

The Northwest Kansas Area Agency on Aging catchment area, for example, includes 18 counties. The Kansas Area Agencies on Aging Association covers all 105 counties.

January launch date

The launch of the Kansas ADRC is scheduled to coincide with the Jan. 1 launch of KanCare, Gov. Sam Brownback’s plan for letting managed care companies run the state’s Medicaid programs.

Wisconsin’s Medicaid programs for the aged and disabled, Sullivan said, also have a managed care component.

Brownback officials estimate KanCare will save the state and federal governments about $1 billion over five years with much of those savings realized from less reliance on nursing homes and more on home care. But Sheehan cautioned against assuming that managed care would save money.

“There is absolutely no doubt that when you subject folks to a robust managed care system, you save money,” he said. “But what also happens is as outcomes improve and people end up doing better over time, you end up spending less money (per person) on more people.

Waiting lists reduced

“You don’t really save money because you’ve got all these people on waiting lists who, at some point, you’re going to have to take on,” Sheehan said, noting that in the early 2000s Wisconsin had 13,000 people on its waiting lists for Medicaid-funded home and community-based services. Today, there are fewer than 3,000 on the lists.

In western Wisconsin, Sheehan said, the waiting lists have been eliminated.

In Kansas, more than 3,500 people are on the state’s waiting list for services for the physically disabled. The state does not have a waiting list for the frail elderly.

Kansas’ waiting list for the physically disabled was the subject of a federal investigation that was turned over to the U.S. Department of Justice earlier this year, a move that many say increased the likelihood the state would be sued in federal court for allegedly being in violation of the Americans with Disabilities Act.



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