A federal decision that will force Kansas officials to revise, or perhaps reconsider, some of their plans for the KanCare program is good news for Kansans with intellectual and developmental disabilities and the families who care for them.
Medical care for the disabled already had been placed under KanCare, the state’s privatized Medicaid program, and long-term support services were scheduled to come under that program on Jan. 1. However, last week, the federal Centers for Medicare and Medicaid Services refused to approve a waiver to allow support services to be shifted to KanCare.
The plan to move residential programs, job training and living assistance services for the developmentally disabled under KanCare has never been a popular idea among Kansans who would be directly affected. Administration of those services is far different than for medical care, and other states that have tried a similar plan have run into considerable problems.
The overriding fear for those who advocate for people with disabilities is that services that clients depend on will be drastically reduced or eliminated. That fear is based on the stated goal of state officials to cut $1 billion in Medicaid spending over the next five years while also adding services. No real explanation has really been offered for how costs can be cut so much without services also being reduced.
There also is concern among both clients and providers about the state’s ability to reimburse providers in a timely manner. Medical providers already have reported problems in this area. For instance, officials at two Wichita hospitals have reported that their Medicaid accounts receivable that are more than 90 days past due have more than doubled since KanCare went into effect at the beginning of this year.
Federal officials want Kansas to provide more information about reimbursements as well as how KanCare will determine a person’s needs, provide the needed services and deal with appeals if requested services are denied.
Although state officials say the federal delay has nothing to do with the state’s readiness to move support services under KanCare, the fact that the Kansas Department for Aging and Disability Services still was taking public comment on the plan less than two weeks before it was scheduled to go into effect indicates that the state may need more time to refine its system. Another acceptable option would be to reconsider and perhaps scrap the plan to include support services for people with disabilities under KanCare.
State officials say they plan to move forward with their plans and bring support services under KanCare by Feb. 1. Federal officials wisely haven’t put a time frame on reconsidering the state’s Medicaid waiver. They should take their time and carefully consider all aspects of the Kansas plan and the affect it will have on some of the state’s most vulnerable residents.