Editorial: Ongoing concern

Concerns about including all services for people with developmental disabilities in the new KanCare program remain to be addressed.

Leaders of organizations that advocate for people who have developmental disabilities may have won the battle in the Kansas Senate this session, but it’s certain that the war is not over.

Senate Majority Leader Terry Bruce, R-Hutchinson, stressed as much when he said he has no plans for the Senate to take up the Senate substitute for House Bill 2155 that would limit services a Community Developmental Disability Organization (CDDO) could provide. The issues the bill was attempting to address still need to be faced, he warned.

Yes indeed. And the assistance provided to thousands of Kansans remains to be determined.

The heart of the matter lies in the implementation of KanCare, the overhaul of the Medicaid system that is taking effect in Kansas, turning the state’s 350,000 Medicaid clients over to managed care plans (MCOs) run by three for-profit insurance companies.

Advocates for the intellectually and developmentally disabled (I/DD) community have said those persons should not be brought under KanCare for anything except medical situations — most certainly not for the management of their long-term, lifetime support services.

These advocates are concerned that in KanCare, the MCOs would conduct assessments of individuals, complete the plan of care for them and then have a financial incentive to influence the outcome of that care. Currently, in a CDDO such as Cottonwood, for example, one person conducts the assessment, another develops the care plan, and then the state approves it. It’s working well, does not involve a conflict, and “if it ain’t broke, don’t fix it,” they say.

As of right now, the intellectually and developmentally disabled are scheduled to be included in KanCare effective Jan. 1, 2014. Their advocates want them permanently excluded. Many cite the situation in Texas, where a three-year pilot program was proposed before such a major redesign of services to the I/DD community was implemented. Colorado is planning a similar three-year pilot.

InterHab, an organization advocating for I/DD persons, submitted a major study criticizing the KanCare plan and its related timeline in Kansas. It recommended instead a longer and more comprehensive pilot program with evaluation steps for the three MCOs selected for KanCare.

The Legislature may want to give that serious thought. Because, as Senator Bruce said, the issues are not going away.