Butler County Times Gazette
  • Rep. David Crum: Committee’s approval of KanCare rejects ‘carve out’ for disabled

  • It is not right to turn over the provision of long-term services to a for-profit entity.
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  • On January 1st of this year the state of Kansas rolled out KanCare, our Medicaid reform program. After working very closely with the Center for Medicare and Medicaid Services (CMS) for many months our state was awarded the 1115 Medicaid Waiver, allowing this transition. The state has contracted with three Managed Care Organizations (MCO’S) to administer KanCare.
    Implementation for the Developmentally Disabled was delayed 1 year at the request of the Community Developmental Disability Organizations (CDDO’S), a network of 27 providers from around the state. A pilot program has been established to aid in the transition to KanCare.
    Some CDDO’S have resisted change from the beginning and have advocated for a “carve out” of Long Term Supports and Services. However, a study conducted in 2008 by the University of Kansas School of Medicine involving 4 CDDO’S and 955 developmentally disabled clients, revealed deficiencies in medical care for chronic disease management and appropriate cancer screening protocols. Experts, including Dr. Robert Moser, a primary care physician and Secretary of the Kansas Department of Health and Environment, have stated that better health outcomes will occur when health care, behavioral care and long term supports and services are incorporated under one umbrella of care with one entity, the MCO, accountable for appropriate health outcomes. They state that long term supports and services cannot be conducted in a vacuum.
    Some CDDO’s have raised inaccurate concerns by stating:
    Persons on the DD waiver will loose their long term case manager- This is inaccurate. The Disability Reform Act insures that persons with DD can keep their Targeted Case Manager under KanCare.
    Persons with DD will be forced to accept new service providers under KanCare- This is inaccurate. The terms of the 3 MCO contracts guarantee the DD client the ability to keep their same service provider.
    The MCO’s will be able to arbitrarily reduce the long-term services that are currently provided. This is inaccurate. The MCO’s will not have the authority to arbitrarily reduce long term services. Any changes in plans of care must be approved by the state.
    The MCO’s will make eligibility determinations for individuals receiving long-term services. This is an inaccurate statement- The current system of determining eligibility will remain the same by state law.
    It is not right to turn over the provision of long-term services to a for-profit entity. Many of the providers currently delivering services on the DD waiver are for-profit entities, demonstrating that it is possible to deliver quality services despite the fact that the entity makes a profit.
    The politically popular thing would be to support the “carve out” of Long Term Supports and Services. However, I have fought hard to avoid the “carve out” because I firmly believe that our developmentally disabled population in Kansas will receive improved health outcomes in a coordinated, managed care system. Earlier in this legislative session we passed a bill establishing the Joint Home and Community Based Services and KanCare Oversight Committee. This legislative committee will have every opportunity to correct deficiencies within the KanCare program.
    Page 2 of 2 - Our state has a track record of providing excellent support of our developmentally disabled. Kancare provides the opportunity to improve health outcomes while at the same time capturing savings that can be used to reduce the waiting list for services. Change is difficult but without innovation we cannot advance as a state.
    Rep. David Crum, Dist. 77, R-Augusta, can be reached at 785 296-6989, email:david.crum@house.ks.gov

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