AAAs to take on assessments of in-home Medicaid needs

New system intended to reduce potential for conflicts of interest, state officials say

0 | Agencies, Health Care Delivery, KanCare

— Officials at the Kansas Department for Aging and Disability Services today signed a contract with the Southwest Kansas Area Agency on Aging, putting the organization in charge of determining which Medicaid-funded services are needed to keep the state's low-income frail elderly, physically disabled or brain-injured out of nursing homes.

Southwest Kansas AAA Executive Director Dave Deist said the agency intends to subcontract for the same services with the other 10 AAAs throughout the state.

Geist is president of the Kansas Area Agencies on Aging Association.

The one-year contract requires the state to pay the AAAs $3.9 million, starting on Jan. 1, a date that coincides with the scheduled start of KanCare, Gov. Sam Brownback’s plan for letting managed care companies run virtually all of the state’s Medicaid programs. The launch of KanCare remains contingent upon federal approvals.

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Kansas Secretary for Aging and Disability Services Shawn Sullivan.

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The contract with Southwest Kansas AAA includes two optional, one-year extensions.

KDADS Secretary Shawn Sullivan said the contract was “not intended to save the state money.” Instead, he said, it is meant to ensure a “conflict-free system” for determining which Medicaid-funded services a person needs to avoid a move to a nursing home.

Previously in Kansas, there’s been little to stop local programs that serve the physically disabled from assessing a person’s needs, serving as the client's case manager, and providing the person in-home services.

That arrangement, Sullivan said, had created situations in which an agency – an independent living center, for example – could inflate needs assessments in ways that would generate more work and more revenue for itself.

“We don’t believe it’s good practice,” he said, referring to the potential conflicts in the current system. The changes had been urged by federal Medicaid officials.

After Jan. 1, the AAAs also will be responsible for helping Medicaid beneficiaries figure out which of the KanCare managed care companies might best meet their needs.

Though the AAAs will determine the services an individual needs, the managed care companies’ case managers will decide how many hours of services will be provided, Geist said.

The managed care contractor could then subcontract with a local service provider.

The state's AAAs historically have done needs assessments for the frail elderly. They will continue in that role but also will be doing assessments of the physically disabled or brain injured. Needs assessments for people who are developmentally disabled will continue to be done by the state's 27 local Community Developmental Disability Organizations

Geist said the AAAs were not planning to hire additional workers.



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