KHI News Service

KanCare MCOs to take on case management role

By Dave Ranney | August 17, 2012

State officials are encouraging people currently employed as case managers for physically disabled and elderly Medicaid enrollees to apply for similar jobs with the three insurance companies chosen to implement KanCare, Gov. Sam Brownback's Medicaid makeover plan.

The insurance companies are expected to take over Medicaid services on Jan. 1, pending federal approval of the governor's plan.

Earlier this week, officials at the Kansas Department for Aging and Disability Services sent a memo to managers of local agencies that provide Medicaid case management services, urging them to have their workers apply for jobs with the KanCare managed care companies.

According to the memo, each of the three companies – Amerigroup, United Healthcare and Sunflower State Health Plan, a wholly owned subsidiary of Centene – plans to hire between 120 and 150 case managers.


KDADS Case Management Memo

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State officials said the companies will be hosting job fairs in several locations across the state between Aug. 27 and Sept. 27.

Under KanCare, the managed care companies would take responsibility for Medicaid case management services for the frail elderly, physically disabled and those with traumatic brain injuries. The local programs will give up their case management responsibilities under the new system.

The three insurance companies also have the option of subcontracting with existing programs that offer case management.

But KDADS spokeswoman Angela de Rocha said subcontracting by the companies likely would occur only in instances where it would "meet a unique need - clinically, geographically or otherwise.”

The shift in case management responsibilities is expected to cause local programs to lay off many of their case managers.

“We will provide our employees with information about these employment opportunities,” said Chris Owens, executive director at Prairie Independent Living Center in Hutchinson. “We will give them every opportunity to find other employment, and whenever possible we will find ways to repurpose them in other positions that might be available.”

Prairie Independent Living Center has four case managers.

Janet Williams, who owns communityworks, an Overland Park company that provides case management and rehabilitation services for about 500 people with brain injuries, said she expected to lay off 26 case managers.

The firm is the state’s largest provider of in-home services for the brain injured.

Williams said the company would continue to provide direct-care services, which are a distinct service from case management.

Currently, many local agencies that serve the physically disabled and brain injured determine which and how many Medicaid-funded services a person needs to continue living in a community setting. They also employ the person’s case manager and provide the in-home services.

The state’s 11 Area Agencies on Aging assess the needs of the frail elderly and provide case management services, but they are not providers of in-home services.

According to the memo, the shift in case management responsibilities is meant to “mitigate as much as possible” the potential conflict of interest that comes with evaluators, case managers and service providers working for a single agency.

KDADS is negotiating a contract for putting a single agency in charge of assessing the needs of the elderly, physically disabled or brain injured, screening them for Medicaid eligibility and helping them choose which managed care company is best to meet their needs.

KDADS Secretary Shawn Sullivan has said he expects to finalize negotiations on the contract later this month or early next month.

Also outlined in the memo:

• The state’s community mental health centers – rather than the managed care companies – will continue to provide case management services for adults with serious and persistent mental illness.

• The state’s Community Developmental Disability Organizations will continue to oversee Medicaid-funded services for the developmentally disabled.

The memo also said that KDADS and the managed care companies would take “active steps” to make sure that “no community service system is destabilized by this transition.”

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