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Sept. 11, 2013
TOPEKA Gov. Sam Brownback and other state officials held a press conference today to announce the release of state funds to begin reducing the waiting lists for home- and community-based Medicaid services.
The $18.5 million in additional state spending — first announced in April and subsequently approved by the Legislature — will allow the move of about 400 physically disabled and 250 developmentally disabled Kansans into services, the governor said.
"It's my hope that we'll be able to continue to do this and do more of it," Brownback said. "It's my effort and desire to get those waiting lists pulled down as rapidly as we can."
Currently there are 5,027 Kansans on the waiting lists to receive in-home services — about 3,000 are developmentally disabled and about 2,000 are physically disabled, according to End the Wait, a group pushing for elimination of the waiting lists.
Tim Wood — campaign manager for the group — said upwards of 250 Kansans are added each year to the developmentally disabled waiting list and even more to the physically disabled list. He said some families have waited eight or more years to begin receiving services.
There are at least 30 states that have similar waiting lists, according to the Kaiser Family Foundation. Of those, Kansas has the fifth longest waiting list per capita, after Illinois, Texas, Ohio and Indiana.
Wood praised the Brownback administration's move to reduce the waiting list, but said much more remained to be done.
"This was by far the largest effort in a long time, so we're very pleased with that. That said, with the influx of folks that come into the system each year, we need to take off at least double that amount each year to see some progress," he said. "If we stayed at this pace, we're looking at 20 years — which ultimately means we'd probably never eliminate the waiting list."
Wood said members of his coalition are stressing to legislators the need to work with the administration and advocates to develop a comprehensive long-term care plan.
"KanCare savings could be a huge piece of the puzzle, especially for the next five years. But beyond that, you've got to look at the system as a whole," Wood said. "With the resources we have now, we really need to find innovative ways to stretch those dollars."
The governor characterized the reduced costs as "dividends" from the enactment of KanCare, the initiative he launched Jan. 1 that expanded managed care in the state Medicaid system. State budget analysts attributed much of the foregone spending or savings to fewer people receiving Medicaid services.
When federal officials approved the administration's KanCare plan, one of the "special terms" of the agreement was that if money were saved, some of it would be used to reduce the waiting lists.
Tom Laing — executive director of Interhab, an association that represents most of the state's in-home service providers for the developmentally disabled — also offered praise with a caveat.
"Remember, this is a challenge (Brownback) inherited from two previous administrations that didn't do enough on it," Laing said. "This is a good step. We need to make a lot more steps on the waiting list, but this is a good one."
Dr. Bob Moser, secretary of the Kansas Department of Health Environment, which oversees KanCare, said people could begin coming off the waiting lists around Jan. 1, now that the state funds are available.
At the press conference, Brownback was asked about recent complaints by hospital executives that the state’s transition to a Medicaid program run by private managed-care companies has significantly increased their costs.
The hospital executives have said their administrative costs this year have been higher due to the increased rate of disputed claims filed with the state’s KanCare managed care companies, which means fewer or stalled payments for the medical center’s services.
Moser fielded the question.
"Prior authorizations are used to try to limit overutilization," of services, he said. "We don't want that to be the way that managed care companies are making a profit, so to speak. We want it to drive improving health care outcomes and controlling cost in the long run. And there's a way of doing that, but it's important to engage providers in those discussions to help determine what should be required in that prior authorization so it can be done in a more expeditious manner."
The following video was produced to present to Kansas legislators by the advocacy group End The Wait, which is funded by the Kansas Council on Developmental Disabilities.
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