This past November, the Executive Branch of our Kansas
government announced plans to implement a new system for how Medicaid services
are delivered and reimbursed, called KanKare. This decision follows the trend
that most states have made in an attempt to improve care and reduce costs.
Three billion dollars will soon be managed by three private, for-profit,
out-of-state insurance companies.
Unlike most other states, however, the new KanKare system
includes the provision that long-term care services for people with
disabilities, including those with intellectual and developmental disabilities
and the elderly, will also be managed by these insurance companies. Most states
have excluded services for people with developmental disabilities from these
managed-care systems. (Or have “carved them out” after managed care systems
didn’t work). While insurance companies may do a fair job of managing medical
services, insurance company representatives admit that they have little to no
experience providing long-term care services for those with significant
developmental disabilities. Examples: a young man with autism who has severe,
challenging and life-threatening behaviors; a young adult woman who is severely
multiply disabled, has progressive health related issues and is in need of
residential services because her parents are ailing or an older adult with
intellectual disabilities and mental illness. These are not random examples.
These are three examples of Catholics and their families who live in the
Diocese of Wichita.
At a community meeting held recently in Wichita, Shawn
Sullivan, Secretary of the Department of Aging, spoke to people with
developmental disabilities, their families, caregivers, and representatives
from agencies which coordinate and provide services. With sincerity, he tried
to alleviate some of the fears that have been expressed regarding the upheaval
that this change may cause. Specifically, Secretary Sullivan, stated that
people with developmental disabilities could keep their current case manager if
they so choose, that services and reimbursement rates won’t be cut, and that
service agencies will be able apply to be a provider with one of the
managed-care companies. But many critical questions still need responses. To
name a few:
- How will cost savings be realized if many provisions of the current system are to remain the same?
- How will managed care affect the recruitment, training, and retention of direct care staff and, more importantly, the overall quality of care?
- How will the KanKare system impact the nearly 4,500 Kansans with developmental disabilities who are on a waiting list for services?
- Most significantly, how will managed care impact choice in services and supports that persons served and families have come to value as a meaningful testament to their dignity as a person regardless of the nature or severity of their disability?
Continue reading Tom Raucus' thoughts...
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