An official with the Kansas Department of Health and Environment said Tuesday that the department still expects the Legislature to pass a bill that will allow agency officials to regulate mental health drugs.
State law currently bans prior authorization or other regulatory tools for antipsychotic drugs covered by Medicaid. An attempt to roll back that ban this year failed due to opposition by mental health advocates, but a compromise measure that would establish an independent advisory panel to develop guidelines for antipsychotic regulations has passed committee and is awaiting House and Senate votes once the full Legislature returns Wednesday for what’s known as the veto session.
“Hopefully as soon as you guys get back in full force, we can get that through,” Aaron Dunkel, deputy secretary of KDHE, told the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.
Dunkel said the advisory panel established by Senate Substitute for House Bill 2149 would meet quarterly and examine issues like the unusually high rate of antipsychotic medications prescribed to Kansas children on Medicaid.
Gov. Sam Brownback’s administration formed its budget proposal under the assumption that the Legislature would allow for mental health drug regulation, which was estimated to save the state general fund about $8 million.
Mental health advocates have expressed skepticism that the state will realize those savings.
KEES to go live within months
KDHE officials told the committee that a long-delayed computer system for determining eligibility for services including Medicaid is nearly ready.
Dunkel and Glen Yancey, KDHE’s information technology chief, said the Kansas Eligibility Enforcement System should be online by late June.
The system originally was slated to go live in October 2013, and legislators’ patience with the continuous delays has run thin. Last month a committee voted to order an audit of the computer upgrade.
The state contracted with Accenture in 2011 on the project, which was estimated to cost about $135 million. Much of that money has come from the federal government, but state funds have been used as well.
Dunkel said despite the delays, the project has not involved large cost overruns.
“By the time we go live in July, we will be very close to our original estimate,” he said.
Yancey previously has said that testing revealed bugs in the software code, and KDHE delayed the KEES launch to ensure that employees are adept at using the new program.
On Tuesday he said that system testing continues and there are “still some defects we’re working to resolve with Accenture.” The agency also is identifying “work-arounds” to help employees speed use of the new program when it goes live.
KEES is designed in part to knit together the state’s Medicaid eligibility programs with the new federal health insurance exchange, which also flags users eligible for Medicaid.
Sen. Jim Denning, a Republican from Leawood, said that the federal Centers for Medicare and Medicaid Services sent a letter this month outlining struggles other states are having in getting similar programs online.
“States are having trouble rolling it out because it’s so technically complex,” Denning said. “It’s kind of like a mini healthcare.gov.”
Healthcare.gov is the federal exchange website that got off to an infamously rocky start and needed expensive trouble-shooting before it began enrolling millions of Americans in health insurance plans.
Still no inspector general
The Brownback administration is still looking for an inspector general to serve as a watchdog over KanCare, almost a year after the initial pick resigned amid questions about his qualifications.
Dunkel said KDHE continues to recruit for the position but has been challenged to find a good candidate willing to take the job at the current salary level, which last year was $77,000.
Senate Bill 182 as originally introduced would make the position unclassified, he said, which would allow the administration to offer a higher salary. It also would remove civil service protections that prohibit the executive branch from firing state employees for political reasons.
A revised version of the bill would eliminate the inspector general position.
Rep. Jim Ward, a Democrat from Wichita, said he was skeptical of KDHE’s commitment to filling the position.
“I just know there’s prosecutors out there who would take this job,” said Ward, himself a former prosecutor.
Dunkel said KDHE has advertised the opening “in a number of different publications” and solicited applications from professional organizations.
Those efforts yielded four interviews, and KDHE offered two people the job. Both declined, he said.
Dunkel said KDHE is looking for a candidate with experience working with Medicaid and, preferably, as an inspector general.
Ward said that’s a big leap from the candidate previously hired, a former Republican legislator with no legal experience.
He said executive branch offices like that of the KanCare ombudsman do little of the watchdog work that an inspector general would do, and the legislative committee charged with KanCare oversight meets only four times per year.
That leaves little scrutiny for the $3 billion KanCare program, Ward said.
“I’m concerned,” he added.