KHI News Service

Mental health centers voice conditional support for Medicaid makeover

"Devil is in the detail," lawmakers are told as part of ongoing hearings on KanCare plan

By Mike Shields | January 18, 2012

In a fourth day of hearings on Gov. Sam Brownback's proposed makeover of the Kansas Medicaid program, a spokesman for the state's community mental health centers voiced conditional support for the plan.

"We see opportunities for the mental health system in Kansas and those we serve," said Mike Hammond, executive director of the Association of Community Mental Health Centers of Kansas, testifying before the Senate Public Health and Welfare Committee.


CMHC Testimony

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Hammond said the governor's plan among other things could promote "integrated, person-centered care" and more jobs for the disabled as the result of cash incentives paid to employers who hire them.

But when Hammond finished talking he was scolded by Sen. Roger Reitz, a Manhattan Republican who has been one of the most vocal skeptics of the proposed reform, which the administration is calling KanCare.

Reitz, a family practice doctor, said he thought Hammond's optimistic remarks were made to please the administration and didn't accurately reflect the concerns of local mental health workers.

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Sen. Roger Reitz, a Manhattan Republican and physician.

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'Put in a corner'

"The people calling me from Manhattan don't feel that way about it," Reitz said. "I think your comments are being made for the people who want to hear them.

"I'm very uneasy that we're being put in this corner with no opportunity to reverse it," he said of the governor's proposal, which already has been put out for bids and apparently does not require the approval of the Legislature.

Hammond acknowledged there were differing opinions about KanCare among those working at the state's 27 community mental health centers.

He said the association as a whole was generally supportive of the plan but that the "devil was in the details," and those details wouldn't be known until the administration has signed contracts with the managed care companies. Final bid proposals from the companies are due Feb. 22. Administration officials have said they would like to have the contracts awarded by summer.

"Devil indeed," Reitz responded.

Sen. Dick Kelsey, a Goddard Republican, also questioned Hammond's support for the governor's plan after Hammond said he didn't know how the managed care companies would pay the mental health centers for services. That, he said, would be subject to later negotiations between the centers and the managed care companies.

"Basically, you're indicating you're for this whole thing," Kelsey said. "Looks to me like you're buying a pig in a poke."

"We're going to ask that they at least cover our costs," Hammond said.

The Kansas Medicaid program currently provides services to about 350,000 people at an annual cost of about $2.8 billion in combined federal and state spending.

Doctors and hospitals endorse KanCare

Brownback officials have said the program is financially unsustainable and, if left unchecked, will squeeze out state spending on education, public safety and other programs.

The administration plans to turn over day-to-day management of Medicaid services to a trio of large companies, each operating statewide.

Officials say KanCare would safeguard the state's existing provider system and the rates they are paid while improving the health of Medicaid patients. And it would cut costs by $850 million over five years through better care coordination, which they say will decrease unnecessary but expensive hospitalizations and redundant services.

Administration officials began working publicly on the plan soon after Brownback took office about a year ago and have said it will be operational statewide by Jan. 1, 2013.


TILRC Testimony

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'Radical experiment'

Mike Oxford, executive director of the Topeka Independent Living Resource Center, told committee members that the governor's plan was "radical."

"This is a radical experiment," he said. "I don't mean that negatively. I mean that literally. This is big-scale, rapid, massive change. I'm worried about the scale and speed this is happening with."

Committee members also heard from Doug Funk, owner of Funk Pharmacy in Concordia and the new president of the Kansas Pharmacists Association.

"I must admit considerable trepidation knowing that Medicaid will be run by MCOs," Funk said, using the acronym for managed care organizations.

Kansas currently has two companies providing managed care services for the state's HealthWave program, which provides medical services for children and pregnant women from low-income families.

Funk said he recently analyzed his pharmacy's financial reports for 2011. He said the records showed that the state's current managed care contractors had paid him between 19 percent and 52 percent less than standard Medicaid.

He said he and his employees had to spend a lot of time "jumping through hoops" with the companies in order to get needed medications approved. Time spent doing that, he said, takes away from the time he can spend advising customers on their prescriptions and other medical concerns.

The committee is scheduled to continue its hearings on KanCare on Thursday and again on Monday.