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Lawmakers: KanCare for developmentally disabled or $4 million cut

Updated: 2013-05-10T04:58:29Z

By BRAD COOPER

The Kansas City Star

— Kansas lawmakers moved forcefully Thursday toward placing the developmentally disabled in the state’s new managed-care program.

Without the shift, a key committee threatened, it would cut millions aimed at reducing waiting times to get services.

Critics charged that such a move pits the disabled against the disabled.

“I was shocked,” said Republican state Rep. Barbara Bollier of Mission Hills.

It’s as if, she said, lawmakers are saying, “If you get this, we’re going to take away from you here. You get to pick.”

The developmentally disabled now receiving services through Medicaid must shift from Medicaid to KanCare, the House Appropriations Committee voted. If not, the committee decided, $4 million will be cut from efforts to speed up waiting times for thousands with developmental disabilities to receive care.

Republican Rep. Dave Crum of Augusta proposed the tradeoff and argued that the state needs the savings from moving the developmentally disabled into a managed care system run by three private insurance companies.

He said those savings could be used to further pare down the 2,900 people who are now awaiting services and another 1,200 who are waiting for more services.

“This is an opportunity to clarify the importance of retaining the (developmentally disabled) population under KanCare,” Crum said after the meeting.

The budget proviso essentially reflects the view of the House and represents yet another schism with the Senate. The chambers are trying to negotiate a tax and budget deal over the next week.

The start of KanCare has been a flash point for the families of the developmentally disabled for more than a year.

They worry how private insurance companies might serve someone who has autism, cerebral palsy or Down Syndrome and needs help with housing, employment or other daily activities beyond medical care.

Services for the developmentally disabled were planned to be merged into the new program this year. But after hundreds protested at the Capitol in 2012, the governor agreed to delay the start date until 2014.

The turbulence has continued into this year with hundreds of developmentally disabled and their advocates rallying against KanCare at the Capitol on Wednesday morning. They later filled the halls of the Statehouse as they made their case to lawmakers.

The outcry prompted Reps. John Rubin of Shawnee and Arlen Siegfreid of Olathe to organize a hearing last week at Olathe’s City Hall. A few hundred people filled the City Council chambers to make their case to state officials and executives from insurance companies.

Rubin and Siegfreid, both Republicans, have been working to further delay moving the developmentally disabled into KanCare or carve some of their services out of the managed-care program.

However, the two legislators have not been able to gain much ground, especially with budget talks starting to wind down as the legislative session nears a close.

Rubin is worried about the experience managed-care companies have in dealing with nonmedical services for the developmentally disabled, such as helping them get proper nutrition, personal hygiene and transportation to daily activities.

“I have never seen any evidence of any experience that health insurance companies have at managing that kind of care,” Rubin said.

State officials have stressed that the developmentally disabled will not lose their case managers or providers and that managed-care companies cannot arbitrarily reduce services.

Nevertheless, Rubin said he thinks there is growing support in the House for carving out at least long-term services for the developmentally disabled from KanCare.

He said he thought there were more than enough votes in the House to delay the merger for another year. Rubin said he would prefer to see the results of a pilot program that’s now underway for the developmentally disabled to participate in KanCare. So far, 500 people and 20 providers have enrolled in the pilot program.

Republican Gov. Sam Brownback, however, is “fully committed” to moving the developmentally disabled into KanCare starting Jan. 1.

“The governor believes that reducing waiting lists is directly tied to the full implementation of KanCare,” spokeswoman Sherriene Jones-Sontag said in a statement.

She said KanCare is now expected to save $68 million more than anticipated over two years, of which $16 million is being plowed back into reducing waiting lists for the developmentally disabled and physically disabled.

To reach Brad Cooper call 816-234-7724 or send email to bcooper@kcstar.com

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