Archive for Saturday, December 24, 2011

Governor’s plan for managed care raising concerns

December 24, 2011


Gov. Sam Brownback, pictured in January 2012, speaking to reporters and editors at the Lawrence Journal-World.

Gov. Sam Brownback, pictured in January 2012, speaking to reporters and editors at the Lawrence Journal-World.

— Gov. Sam Brownback’s plan to have managed care companies provide services for those with developmental disabilities is raising concerns.

Gene Kean, a Lawrence resident whose sister is cared for at Lakemary Center, said he believes the quality of her care would be sacrificed by the proposed changes.

“If the state gets away with this, it appears some very important functions of local care decision-making would be taken away from those who have the daily intimate knowledge of what is best for their clients,” Kean said.

Brownback and Lt. Gov. Jeff Colyer want to overhaul Medicaid, which is the state and federally funded health program for those with disabilities, the elderly and low-income residents.

It’s one of the largest expenses in state government, accounting for nearly $2.8 billion in spending. About 350,000 Kansas residents are covered by Medicaid.

Brownback wants to contract with private managed care companies to handle the program and call it KanCare.

The Brownback administration has promised that KanCare “will improve coordination of care and services to achieve better outcomes and long-term savings without reducing benefits or eligibility, while safeguarding reimbursements for providers.”

The administration says that the proposal will reduce growth in Kansas Medicaid spending by 8 percent to 10 percent.

But organizations that care for those with severe disabilities say that managed care companies aren’t familiar with the long-term needs of their clients, some of whom require round-the-clock attention.

Under the proposal, those with developmental disabilities may be forced to change the support staff that they have depended on for years, they say. Most states that have gone the managed care route for Medicaid have excluded the developmentally disabled from those changes.

Bill Craig, president and chief executive officer of Lakemary Center, said, “We have severe doubts that it is workable.” Lakemary Center serves more than 500 adults and children in northeast Kansas.

Craig says he has no problem turning to managed care for health care expenses, but he said the long-term supports needed by those with developmental disabilities should be “carved out” of Brownback’s plan. People are starting to make their wishes known in this area. Last week, a meeting on the issue in Lenexa drew about 300 people.

Craig said his position had nothing to do with “preserving our organizations.” He said, “Many of us are parents. My 32-year-old son, with severe disabilities, I want to know that after I’m gone that he will not be downgraded to lower quality services than he already has.”

Kean said he thought that over the years Kansas had been a model in providing services for those with disabilities. “Why do we have to go backwards?” he said.


Gandalf 6 years, 5 months ago

Of course care will be worse. The "managers" will suck up far more than they save in "administrative" fee's. Patient care will get worse and Dr's fee's will go down.

Backwards again with EviL sam.

Mike1949 6 years, 5 months ago

Let me see, managed care, in other words institutionalized for profit companies. Wasn't there a group of people in Arizona, New Mexico or somewhere that they did that with the states prison system? Inmates were fed bread & water, slept with no blankets, were over crowded in their cells just so the commissioners and people involved could make millions off the state? This was in the news a few years ago.

It sure sounds like our (not very nice word) Governor wants to do the same here in Kansas with the defenseless disabled! Why hasn't people here in Kansas with any kind of intelligence clamored for recall or something to stop this Governor from doing so much damage to Kansans!

kochmoney 6 years, 5 months ago

“will improve coordination of care and services to achieve better outcomes and long-term savings without reducing benefits or eligibility, while safeguarding reimbursements for providers.”

No they won't. They'll grab a larger slice of the pie and achieve savings on the backs of the people they're supposedly there to help and the providers who care for them.

Lawrence Morgan 6 years, 5 months ago

This is the totally wrong direction to go.

David Reynolds 6 years, 5 months ago

Of course there are concerns. Is there anything that someone does or doesn't do that doesn't raise a concern? Let's give it a rest.

just_another_bozo_on_this_bus 6 years, 5 months ago

Just more of the same corporate welfare that's become central to the Republican agenda. This would do nothing to decrease costs-- to the contrary, it'd increase costs by putting unnecessary middle men into the process whose only purpose is to skim a generous share off the top for themselves.

mloburgio 6 years, 5 months ago

In Kansas, Gov. Sam Brownback puts tea party tenets into action with sharp cuts

A new “Office of the Repealer” has been created to reduce the number of laws and regulations, and the Repealer is canvassing the state for more cut suggestions.

In the upcoming legislative session, Gov. Sam Brownback (R) plans to roll out proposals to change the way schools are funded, taxes are levied and state pensions are administered.

A year after voters vaulted hundreds of tea party candidates to power in Washington and in state capitals, the movement’s goals are being pursued aggressively in states such as Wisconsin, Ohio and Texas.

But in Kansas, as nowhere else in the country, tea party fervor is reshaping government. The same political forces of the Republican Party driving the confrontation over taxes and spending in Washington are now completely in charge in Kansas.

always remember if you want a republican to care about you, remain a fetus!

frankwiles 6 years, 5 months ago

Is this what a good Christian would do? Apparently the 11th commandment is profit related...

Richard Heckler 6 years, 5 months ago

Gov Brownback is not about Christianity or God let's be real. Those are words he uses as a tool to manipulate the public. Gov Brownback and his RINO party are frauds.

Gov Brownback is about corporate america,big profits and special interest campaign money.

Gov Brownback and his RINO party have the above as their agenda. It's been working for 31 years.

Corporate privatization is the primary agenda! Too many buy into this nonsense that government is bad bad bad. In reality corporate privatization has never been substantiated as a fiscally responsible means to accomplish anything.

Corporate privatization represents taxpayer bailouts,tax dollar handouts,fraud and takeover of our political system. Gov Brownback and his RINO party represent the same damn philosophy.

Too many buy into this nonsense that government is bad bad bad. Yet we have career politicians that never leave that bad bad bad government so how bad is it?

They use bad bad bad government to increase their wealth and campaign contributions. In over 30 years Gov Brownback and his RINO party made bad bad bad government to their liking while taking more from our wallets.

Fossick 6 years, 5 months ago

At least it was original. I'll take it.

JackMcKee 6 years, 5 months ago

It would be easier if the LJW would just make the headline "Brownbacks plan for __ causing concern".

Jan Rolls 6 years, 5 months ago

This jerk wants to change everything just to be doing it so he can say he left his mark on kansas. Please read the K.C.Star editorial on December 22nd. In that editorial this jerk admits that his arts plan did not work. He also admits in that editorial that his recently departed srs secretary didn't know what he was doing. When will this jerk learn that you don't just change things because he wants to. He brought all of these incompent people in because they were republicans instead of hiring qualified democrats with years of experience. This is the sign of a person that thinks he was elected dictator and it is obvious that he has no concern for the people of kansas.

Dick Sengpiehl 6 years, 5 months ago

Gov Brownback's religion and idealism get in the way of good governing. GOPers I know are surprised how quickly King Sam has moved to put his plans into action. All they would have had to do was to check his Senate record. Christopher Reeve in his book "Still Me" chronicles Senator Brownback's efforts to defund the NIH because of his opposition to stem cell research. A disgusting Senator, a disgusting Governor.

Cait McKnelly 6 years, 5 months ago

Nancy Reagan, at one point, begged the GOP to stop getting in the way of stem cell research because of the impact it was having on Alzheimer's research. In many ways, the Republican Party turned it's back on it's own demi-god. But you must understand that the GOP of even thrity years ago was far different than it is now. Many former (may I stress the "former"?) Republicans in this state mourn the loss of Robert Dole and Nancy Kassebaum to this day. I grew up in a radical Republican household and believe me, my own father would reject today's GOP. That's saying a lot!

Fossick 6 years, 5 months ago

Woo hoo! We have a right-wing Godwin. It's a nice change from the wholly unimaginative Brownback/brownshirt comments one usually get in these threads. Variety is the spice of life, after all.

tbaker 6 years, 5 months ago

So government sets up innocent, decent people to be dependents. They get them used to receiving a service at no cost to them. Promises are made. Lives are planned around this service being provided to them. But the service isn’t really free, working people have to pay for it. Then the economy tanks and the tax revenue goes with it when the working people are no longer working. Now government has to break those promises. People’s lives are ruined, many at the moment in life when they are absolutely least able to cope with it. This is immoral, sickening, and stupid. No one takes care of me quite like me. Why isn’t government in the business of empowering individuals to take of themselves instead of handing out money taken from everyone else? What if government allowed us to put away as much money as we wanted, tax free, in an investment vehicle designed to pay for managed care in our old age? Maybe buy an insurance product designed to cover this expense? How about individual people being allowed to deduct all of their healthcare expenses from their taxes, just like business gets to now? As long as the system is based on the government delivering this service instead of people being freed and empowered to care for themselves, these sad stories will persist. This is yet another example of the government operating well outside its original scope and failing miserably at providing something that should be left to the people and the private marketplace. It’s not about taking care of the seniors; it’s about power and politics and it disgusts me. Gov. Brownback is just the latest in a long line of examples. He’ll play the hand he was dealt, as will his successor, instead of implementing the fundamental changes that are required, like ending the government’s role in providing this service.

jafs 6 years, 5 months ago

That's fascinating.

Did you miss the population discussed in the article, ie. developmentally disabled folks?

Or do you expect that they, even with significant organic impairment, should just take care of themselves?

tbaker 6 years, 5 months ago

Check your fallacies Jafs. What I think is the private sector could do a far better job of enabling their families to care for them. In the event they're indigent, then the government has to step in. That should be a last resort, not the model.

jafs 6 years, 5 months ago

"Why isn't the government in the business of empowering people to take care of themselves"?

"No one takes care of me quite like me"

Your entire post is in that vein.

On a story about people with significant organic impairment.

Did you even read the story?

jafs 6 years, 5 months ago

By the way, we'll see if these private sector managed care companies provide a better model or not.

My wife, who has worked with the dd population for over 25 years, is pretty sure they won't.

hedshrinker 6 years, 5 months ago

tbaker, did you miss that the client population under discussion are people with lifelong ORGANIC brain impairments? Most of these people to live in the community require every day services . The way this is going in other states is that the managed care folks deny home services like an attendant/housekeeper, bath aid/ transportation/med aid, etc and then the person's only alternative is to be institutionalized in some long term care facility...which of course costs significantly more $$$$$. Penny wise and pound foolish, focus on short term gain and totally oblivious to long term damage....of course the Gov will be long gone fr KS by then, off on his mission of destruction while Kansans are left to pick up the pieces of lives destroyed. .Managed care didn't work in the mental health field and I can't imagine adding yet another layer of bureaucracy (typically staffed by non-clinical people with an incentive to deny services) is going to improve delivery of quality services.This will further disincentivize providers as they will be reimbursed at an even lower rate...many providers limit Medicaid and Medicare clients or don't accept them at all b/c reimbursement rates are so low.

William Weissbeck 6 years, 5 months ago

The math is so simple that even the GOP can do it - and that's the problem. Private businesses do something because they can make a profit. Where is the profit here if the goal is to reduce costs? You cut services. And because the decisions are being made outside the public realm, they often are outside public debate. And does anyone think that an executive at a private management company is going to accept less in pay and benefits than the previous state director?

oldbaldguy 6 years, 5 months ago

Unless you are really well off, good luck taking care of your child or relative who is at Lake Mary or goes to Cottonwood or any other program/facility across the state. I cannot get insurance for my son, never could. CP from birth. He relies on Medicaid. The private side will not not provide help for kids like him. Government does through Medicaid, HCBS waiver and other programs. You folks who say the private sector can do this are just wrong.

What did we do years ago? They died young or were put in to mental institutions. Few states include the developmentally delayed in managed care because it does not work.

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