Kansas governor relents on managed health care for the disabled

In the face of hundreds of protesters outside the Capitol on Wednesday, Kansas Gov. Sam Brownback agreed to delay plans to move thousands of developmentally disabled into a managed-care health plan.

Brownback, along with Lt. Gov. Jeff Colyer, said they would agree to a legislative plan that would keep the developmentally disabled in the state Medicaid program for a year to give them more time to increase their comfort level.

“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,” Colyer said in a statement. “We believe this staggered implementation will allow for more conversations, more public input, and a more effective implementation.”

Brownback’s announcement came only hours after hundreds rallied to keep the developmentally disabled from being moved into a managed-care plan as part of the governor’s proposed overhaul of the state’s $2.9 billion Medicaid program, called KanCare.

The plan could potentially affect 7,862 developmentally disabled people who currently receive services, including 1,176 who are on a waiting list for additional help. State officials said there are another 2,640 who don’t get services at all and are on a waiting list.

As the program changes, many are worried about how insurance companies might serve the developmentally disabled, who include those who suffer from autism or Down syndrome and need help with housing, employment or other daily living needs.

“They have no experience in doing this. They don’t know how to do it,” said Maury Thompson, executive director of Johnson County Developmental Supports.

Among those at the rally was Mike Everett of Leawood. Everett worried about what would happen to his 33-year-old autistic daughter, Alyne, in a managed-care program. He also questioned what would happen to Alyne’s caseworker, whom she’s grown accustomed to over the years.

“The possibility’s there that we’ll lose that caseworker because these insurance companies will take that over. So now we’re talking to somebody on a toll-free number who doesn’t know us, doesn’t know Alyne and we don’t know them. Customer-service wise, we’re really concerned,” he said.

Brownback’s Medicaid overhaul also has prodded several local governments, including Johnson County, to voice concerns. Last week, Johnson County commissioners passed a resolution asking the state to exempt long-term care for the intellectually and developmentally disabled from the managed-care plan.

Johnson County Commission Chairman Ed Eilert called Brownback’s announcement a good first step. But he said he wants some measure that would stop the developmentally disabled community from being automatically enrolled in KanCare after a year.

During this year’s legislative session, there have been a number of proposals aimed at slowing down KanCare, scheduled to begin in 2013. The state is trying to decide which insurance companies will get the managed-care contracts, and it still needs federal approval to move ahead with the plan.

Before Brownback’s announcement, House Majority Leader Arlen Siegfreid had said he would attach language to the budget bill that would exempt long-term care for the developmentally disabled from managed care for one year.

Siegfreid, an Olathe Republican, said he is proposing a pilot program in that first year for any providers that would choose to participate in the managed-care program. Siegfreid said he hoped a one-year delay would help allay any misunderstanding that created fears about the program.

“I think managed care has a sound basis. I think the governor and the lieutenant governor are trying to do something that’s good for Kansas,” Siegfreid said.

Siegfreid’s proposal would not apply to medical care if the developmentally disabled become sick or injured.

“The rally is a reflection, I think, of a misunderstanding. That’s why there needs to be a year for the actual facts — not what if this happens, what if that happens,” he said.