Integration of special-needs groups into program starts Saturday

Jan. 31--In what can be considered a win for the state and a loss for grassroots advocates, individuals with intellectual or developmental disabilities will be integrated into KanCare on Feb. 1.

A news release from the Kansas Department for Aging and Disability Services announced the federal Centers for Medicare and Medicaid Services agreement to include services for those individuals into the privatized insurance program Thursday afternoon.

The federal agency required a delay in the inclusion in December to address concerns regarding the last part of Kansas'$3 billionMedicaid overhaul. While state officials are celebrating the decision, advocates for the I/DD population, which includes approximately 8,500 Kansans on the I/DD waiver, fought against the KanCare carve-in for more than a year.

Although doubtful of the Feb. 1 deadline when it was first announced by the state on Jan. 17, Brenda Maxey, Training and Evaluation Center of Hutchinson president and chief executive officer, said she started hearing rumors that CMS might give its approval this week.

Those against the carve-in feared that private insurance companies, or managed-care organizations, determining care for the I/DD population would result in fewer and lower-quality services.

With CMS' approval, Maxey said she's at least "out of limbo."

For the past year, Maxey and I/DD care providers have worked against KanCare, while at the same time preparing for it. She said at this point, "the decision has been made," and her agency will work with the state to make for an easy transition for clients.

Despite CMS' decision, Maxey doesn't regret the effort she and other advocates put forward in delaying KanCare.

"I think it was crucial to those in authority to know of our concerns and that to people at the ground level, this looks very different from people 30,000 feet up," she said.

In addition to agreeing to the Feb. 1 inclusion, CMS also agreed to the state's plan to eliminate the I/DD waiver program's underserved waiting lists, which is comprised of Kansans with developmental disabilities already receiving services, but who have requested additional services. There are currently 1,400 people on that list.

The waiting list won't be necessary, KDADS Secretary Shawn Sullivan said in a teleconference last week, because plans of care and services provided will be evaluated and approved individually.

Maxey and other care providers are doubtful how the underserved list will be eradicated without allocating more funds for services. She also wondered what the state would do to address the waiting list for people who are totally without services.

No detailed plan was included in the news release, other than to state that plans of care for the undeserved will be reassessed to ensure that all consumers will get the care they need.

The release also assured that individuals will keep their targeted case managers and will continue to receive information regarding services through their Community Developmental Disability Organization.

In the state's news release, Sullivan thanked individuals served, family members and guardians and providers for their engagement in the transition and welcomed their ongoing involvement.

"I know that they will hold us accountable to the protections that we have built into KanCare for persons served and providers," he said.

"Together we can maintain the good qualities of the current system while enhancing the ability to increase employment opportunities, reduce waiting lists, and promoting that individuals served should have a valued role in the community."

Long-term services provided under the I/DD program include residential and day supports, assistive services, medical-alert rental, financial management services, personal assistance services, overnight respite, sleep-cycle supports, specialized medical care, supportive employment, supportive home care and wellness monitoring.

Lt. Gov Jeff Colyer called the transition "monumental," stating "no commitment this large has been made to Kansans with intellectual disabilities since the Developmental Disability Reform Act of 1995."

Gov. Sam Brownback called the inclusion "an important step forward for KanCare and the I/DD community."

"We are witnessing improved outcomes that have resulted from coordinating the behavioral and medical-care needs of people with I/DD," Brownback stated in the news release. "Coordinating those two elements of care with their other support services will further enhance the care provided to them, improving both their physical well-being and their quality of life."

CMS' decision does not come without regulations. The federal agency's continued approval of the program, a letter to Kansas Department of Health and Environment Medicaid Director Susan Mosier read, is reliant on the state's compliance with 106 pages of special terms and conditions.

Maxey said she'd start reading that letter Thursday evening.

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