Topeka Opponents of putting long-term services for those with developmental disabilities under KanCare made a last-ditch plea to state officials on Tuesday.
"There is no good reason to dismantle the system," said Gayle Richardson, of Johnson County.
But state officials vowed that care would improve by expanding KanCare, which is the state's new Medicaid system.
Kansas Department for Aging and Disability Services Secretay Shawn Sullivan said KanCare will provide better health, employment and housing opportunities.
He said only 10 percent of those with developmental disabilities receiving assistance are employed while the national average is 20 percent and in some nearby states it is 50 percent.
Sullivan said the current system fares "poorly" in managing chronic conditions and there would be incentives for the private insurance companies operating KanCare to improve on that.
The divergent viewpoints came during the second and last public hearing on the state's proposal that will be submitted to the federal Centers for Medicare and Medicaid Services, or CMS.
Although approximately 100 people attended the hearing at the Ramada Inn, only a handful spoke.
Tom Laing, executive director of InterHab, which represents providers of services, said fears still exist that the drive for savings will trump adequate supports.
Richardson said the only way the insurance companies will make a profit is by reducing care. She described those receiving help as "fragile individuals."
"CMS is far away. The insurance companies are far away. We believe the best approach is local," she said.
Having fought the plan for two years, Sharon Spratt, chief executive officer of Cottonwood Inc. in Lawrence, said she is resigned that it will be implemented. "I guess we are going to have to live with it," she said.
Advocates for those with disabilities have long argued that the managed care companies in KanCare can handle medical needs but aren't prepared to handle long-term services, such as help with preparing meals, job coaching, money management, buying groceries and other assistance.
The state is accepting public comments on the plan until July 29. Those comments can be emailed to KanCare@kdheks.gov or mailed to ATTN: Rita Haverkamp, KDHE-DHCF, 900 SW Jackson, Room 900, Topeka KS 66612.