Danedri Thompson
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Between 40 and 50 Johnson County developmental disability advocates  will rally in Topeka April 25. They hoped to garner support for a budget provision that would carve the developmentally disabled from Gov. Sam Brownback’s executive reorganization of Medicaid.
Brownback, who issued the order to reorganize on April 12, said it is a crucial first step toward reforming the state’s Medicaid system. The reforms are set to go into effect on July 2012, with implementation beginning in January 2013.
“It is a crucial component of KanCare, the administration’s plan to improve the quality of care and the health of Kansans who depend on Medicaid,” Brownback said in a statement.
As part of the reforms, the state will request a waiver from the federal Medicaid program, and the day-to-day administration of the state’s program will become a private-public partnership between the Kansas Department of Aging and Disability Services and private insurance companies.
Lurena Mead, Community Relations Manager at Johnson County Developmental Supports, said the developmental disabilities community is worried that for-profit insurance companies have limited experience dealing with long-term care.
For example, a person with a developmental disability might live in a group-living setting where they have staff support.
“They are now going to be monitored by insurance companies,” Mead said. “…And we don’t feel that insurance companies really know anything about long-term care. They tend to handle acute care. They don’t know anything about long-term, life-long care.”
The plan is expected to save the state several million over five years without cutting eligibility or services, but Mead said she doesn’t see what savings can be realized by including services for the developmentally disabled in the program.
“They said no services, and no hours are going to be cut. We’re kind of raising an eyebrow over this,” Mead said. “How are these insurance companies going to make money from this? We’re adding one more layer of bureaucracy and we’re told that nothing is going to change. They’re implementing this to save money.”
Legislators had 60 days to reject the executive order, but that deadline passed on April 6, however, Mead said she is hopeful that a budget proviso that would exempt the developmentally disabled from the executive order until 2014 will be approved by legislators.
As they return to the Capitol this week, they’ll be greeted by a rally of more than 250 members of the developmentally disabled community in red t-shirts on April 25.
“Our message is we want to be excluded from KanCare,” Mead said. “Take the long-term care for folks with disabilities out. There’s no money to be saved. The system we have is efficient, effective, and it works. Why fix it, if it ain’t broke?”
The budget proviso would only create a one-year carve out, but that’s time that can be used by legislators, the administration and the developmentally disabled community to examine the reorganization.
“That would give us time to ask some questions. There have been no studies done that we can see. And that will give the administration time to review our concerns. Maybe it will give us time for us to look at it and maybe we will see that it might really work,” Mead said.
The Governor’s Office is remaining mum on the topic, but House Majority Leader Arlen Siegfried will write a budget proviso.
If passed by the Legislature, it could still be vetoed by the Governor.

Update: Gov. Brownback and Dr. Jeff Colyer, Lt. Governor, announced their support for a one-year delay in the inclusion of the developmentally disabled in the KanCare program.

“Dr. Colyer and I are dedicated to improving the health and well-being of all Kansans.  We are confident the new KanCare system will work for the greater good of those who depend upon Medicaid.  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,” Brownback said.
Lt. Gov. Colyer said the administration feels strongly the KanCare reforms will work to improve the health and social outcomes for our most vulnerable Kansans and in the long run will help the state address the waiting lists for waiver services.
“We have heard the concerns expressed by family members of developmentally disabled individuals about the coming reforms and the pace of the change in particular. 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,” Colyer said.