Hundreds of developmentally disabled people and their advocates gathered today outside the Statehouse to protest the inclusion of long-term care services in KanCare, Gov. Sam Brownback's Medicaid makeover plan.
The rally was in the morning. In the afternoon, the Brownback administration announced it now supports a legislative proposal to delay the inclusion of developmental disability services in KanCare until Jan. 1, 2014.
"We believe that allowing another year of discussion and input from the developmental disability community will make them comfortable with the program and allow us to craft solutions to the concerns they’re expressing," the governor said in a prepared statement issued at 4:20 p.m.
The statement also included this comment from Lt. Gov. Jeff Colyer, the governor's point man in developing the KanCare plan:
"We believe this staggered implementation will allow for more conversations, more public input and a more effective implementation for persons utilizing developmental disability waiver services."
The legislative proposal drafted by House Majority Leader Arlen Siegfreid is expected to be introduced this week as a budget amendment.
Concern over KanCare
"If we lose staff, it makes me sad," said Joe Newton, a disabled man who traveled three hours from Russell to attend the morning rally accompanied by Marsha Niehoff, his caregiver since 1994.
Newton receives community-based services through the Developmental Services of Northwest Kansas — one of the 27 Community Developmental Disability Organizations that provide most of the non-medical Medicaid services available to the developmentally disabled, directly or through subcontractors.
Under KanCare, the CDDOs would work under contract to three managed care companies.
Among the concerns about the KanCare plan is that service providers already operate on tight margins, said Jerry Michaud, chief executive at Developmental Services of Northwest Kansas. Contracting with managed care companies could lead to staff shake-ups and providers being driven out of business.
"Rate studies say the rates paid in the community aren't adequate. If they're inadequate, where do you save money in long-term services? It defies logic," Michaud said. "And managed care companies will take profit and an administrative fee on top of that."
Calls for delay
Speakers at the rally — including Sen. Dick Kelsey, a Goddard Republican — said non-medical services, such as transportation and assistance with daily living, should not be thrust into KanCare.
"The programs we have in place — even though sometimes not funded as well as we'd like — are working well. We don't want to destroy something very good on the hope that maybe we'll get something a little bit better. Let's prove this thing first," he said.
Kelsey was among a group of legislators who earlier this session urged the administration to delay the implementation of KanCare by six months.
The proposed postponement has tentative support from Interhab, the association that represents most of the state's CDDOs.
"We hope for a carve-out, but if we don't get it we hope the delay will give us time," said Tom Laing, the group's executive director. "It's in the interest of the administration. It's a huge job they're trying to tackle and if you try to do too much at once, it's easy for things to come undone. Our piece should be the last piece phased in, if it's got to be in, because it's not medical. It's a unique set of programs that the insurance business has no experience working with."
Disability services distinct from health care
Betse Gage's son Craig had a massive stroke when he was 2 years old, and as a 25-year-old he receives 130 hours of home-based care a month through Medicaid.
"I know there needs to be changes in Medicaid," said Gage, a Leawood pediatrician. "I'm not fighting managed care for the health part of KanCare. But it makes no sense to put disability services under health services. They're completely different."
Gage said her son needs help with job training, residential care and basic case management.
"Health insurance companies don't do that — they don't do developmental disabilities," Gage said. "The (existing) system works for disability services."
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