Kansas legislature

Kansas Legislature

Advocates for people with developmental disabilities say they want to stay out of KanCare

March 20, 2013


— Advocates on Wednesday told lawmakers that Kansans with developmental disabilities shouldn't have their long-term care administered by for-profit companies as part of the new KanCare program.

And the head of the Lakemary Center in Paola, which is a psychiatric treatment center specializing in children with developmentally disabilities, described serious problems with private managed-care companies running KanCare.

Bill Craig, chief executive officer of Lakemary, said some of the decisions from the managed-care companies have been "incredibly cruel and irreversible."

He said children are being released before they are ready and sent to community settings "where they are likely to fail."

Craig also said the companies delayed payments for so long that his facility was forced to take out a $500,000 line of credit to meet payroll obligations.

KanCare, which took effect Jan. 1, is Gov. Sam Brownback's overhaul of the Medicaid program that moved about 350,000 Kansans into health plans managed by three managed-care companies.

Brownback had sought to place long-term services for about 10,000 people with developmental disabilities in KanCare but advocates persuaded legislators to postpone that for one year.

Advocates now are fighting to keep those services out of KanCare permanently. They argue that long-term services, which sometimes require round-the-clock assistance, is not the same as covering someone who may go to a doctor's office several times a year.

Aldona Carney of Wichita, whose 18-year-old son, Neil, requires constant care and who becomes violent without proper medication, said, "Long-term care for people with developmental disabilities should be carved out of KanCare." She said the case manager for her son "must remain conflict-free."

Barbara Ladon, a national health care consultant with Newpoint Healthcare Advisors, said the state should delay consideration of putting long-term support services under KanCare until a comprehensive pilot project is implemented that has sound measurements. She said that currently KanCare has a 10-month pilot project but there doesn't appear to be an evaluation or course correction period built in.

Ladon said Texas and Colorado have planned pilot projects, but they have set aside three years to review the issue.

The Brownback administration said, however, it plans to place the long-term care services for developmentally disabled Kansans under KanCare on Jan. 1.

"We think we are going to provide a better quality of life and better health outcomes," said Angela de Rocha, communications director for the Kansas Department for Aging and Disability Services.

De Rocha said healthcare, behavioral services and long-term care will be better coordinated under KanCare.

Concerning payment delays cited by Craig, De Rocha said KanCare did have some delays in payments when it started in January but many of those problems have been ironed out. And De Rocha disagreed that Kansas' pilot project had no evaluation component.


roosmom 1 year ago

As of today the issue is Sentate Substitute House Bill 2155 which cannot be read online until Monday. This bill would give the insurance companies almost complete power or at least lay the ground work for that. I am an independent case manager and have been for years. Giving an advocacy role to the company that is supposed to make a profit and cut costs -logically WILL NOT do their best to advocate on behalf of the person. I know the people I work for do not want an insurance employee doing their assessments, plans of care and quality oversight for services. This will be the largest conflict of interest. I hope that the LJW will talk to those that will be impacted by this. Chipping away that is what 2155 will do.


elliottaw 1 year ago

At what point can Brownback just be impeached or thrown in jail? Where's that power hungry judge we might need him on this.


MarcoPogo 1 year ago

The most obvious response to this article has probably been posted and pulled down at least three times.


BigDog 1 year ago

She said the case manager for her son "must remain conflict-free."

Explain how the case managers are conflict free now .... most case managers work for organizations who are also providing the individuals day-to-day care.


IKU57 1 year ago

United States

The United States has experienced two waves of deinstitutionalization. Wave one began in the 1950s and targeted people with mental illness.[43] The second wave began roughly fifteen years after and focused on individuals who had been diagnosed with a developmental disability (e.g. mentally impaired).[43] Although these waves began over fifty years ago, deinstitutionalization continues today; however, these waves are growing smaller as fewer people are sent to institutions.

A process of indirect cost-shifting may have led to a form of "re-institutionalization" through the increased use of jail detention for those with mental disorders deemed unmanageable and noncompliant.[44] In Summer 2009, author and columnist Heather Mac Donald stated in City Journal, "jails have become society’s primary mental institutions, though few have the funding or expertise to carry out that role properly... at Rikers, 28 percent of the inmates require mental health services, a number that rises each year."[45]


autie 1 year ago

They cannot and will not answer the first simple question. How can this work when one inserts a for profit entity in the mix that must siphon out their cut and not diminish the scope of services? They claim it will be through efficiencies. They apparently know nothing of what they speak.


JM Andy 1 year ago

The ID/DD/MR folks have a strong lobby and a complex service system. I'm afraid that's the only thing that's kept the Koch/Brownback/CStreet train from barreling through their lives thus far. But it's coming. And it's going to be ugly.


UneasyRider 1 year ago

Koch's told Brownback what they wanted, Brownback told his Legislative flunkies to do it. So it will done. Profits for private businesses are what matters to this Republican governor and legislators.


Jackie Jackasserson 1 year ago

The evaluator just started a couple of months ago. However, the program will be implemented regardless of findings because that's what the gov wants. Don't expect findings to be posted anywhere.


just_another_bozo_on_this_bus 1 year, 1 month ago

They're speaking to deaf ears. For this legislature and the gov's administration, it's all about ideology. Doing the right thing has no place in their decision making.


JohnSickels 1 year, 1 month ago

Anyone who thinks kids with developmental disabilities should be placed at the mercy of the free market is a fool, and ideologue, or cruel.


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