Agencies that had agreed to participate in a new Medicaid program have ample reason to be upset with the Kansas Department of Health and Environment.
Last week, less than 24 hours before the new program was supposed to launch, KDHE officials notified agencies — by email, no less — that they had decided to delay the program for at least six months, until Jan. 1, 2015. They apparently were unconcerned that many of the agencies, including Heartland Community Health Center in Lawrence, already had hired staff and taken other steps to implement the service, known as “health home.”
The new service is intended to provide a “health home” to help coordinate care for Kansans who have either severe mental illness or suffer from chronic medical conditions, such as diabetes, asthma or heart disease. The program is part of the Affordable Care Act, also known as Obamacare. Although many state leaders still adamantly oppose the implementation of that law, the state has decided to accept the health home program, which will be 90 percent funded by the federal government for the first two years.
The state had planned to start signing up participants for both programs on July 1. Agencies, like Bert Nash Community Mental Health Center, were able to move ahead on plans to provide health home services for people with mental illness. However, on June 30, the Heartland center and other agencies were informed the kickoff for health home services for people with chronic illnesses would be delayed because KDHE had been unable to sign up enough contractors to provide adequate services throughout the state.
KDHE had been working with the three private contractors that manage Medicaid services in the state, but apparently those contractors weren’t able to meet the federal requirement that the health home service not only be available statewide but that patients have a choice of providers. It’s disappointing the state couldn’t meet its own deadline, but the least it could have done is communicate adequately with agencies like Heartland, that were gearing up to provide the service. A KDHE representative said department officials waited until the last minute to notify those agencies because they continued to hope that they could meet the federal coverage requirement.
That isn’t a lot of help to Heartland, which already had hired two new employees and identified 300-500 patients that would qualify for the service. “We put a ton of time and energy into making this happen. … But this delay, it was incredibly disruptive,” said Heartland CEO Jon Stewart.
The last-minute delay is a real hardship for agencies that had worked hard to meet the state’s announced start date for this program. Stewart is enthusiastic about the program, which he sees as a way to provide better care to patients while also reducing the cost of providing that care. He told the Journal-World he remains hopeful the state will be able to meet its new Jan. 1 deadline to implement the plan.
The state and its Medicaid contractors should work hard — perhaps harder than they have up to now — not only to meet the federal coverage requirements but also to communicate adequately with agencies that have agreed to provide those services.