See below for an article by Dave Ranney that provides insight into progress on Aging and Disability Resource Center roles and responsibilities:
KHI News Service
August 13, 2012
Changes underway for determining in-home Medicaid services:
New assessment system expected to start in January along with KanCare
"State officials are changing the way they determine which in-home Medicaid services are provided to the frail elderly and people who are physically disabled.
The new system will rely on a single agency or organization with a presence in each of the state’s 105 counties to assess what services a person will receive. Currently, there are more than 30 organizations involved with the process. Some assess only the elderly. Others focus solely on the physically disabled.
State officials said their aim is to create a “one-stop shop,” so that services will be determined in the same place regardless of a person’s condition.
'Mishmash'
“The system we have now is a real mishmash,” said Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services. “We’ll be going to one that takes more of a no-wrong-door, single-entry approach and implements a conflict-free provision of services.”
About 12,000 Kansans currently rely on the services provided by the system, at an annual cost to taxpayers of about $200 million.
A solicitation to potential contractors interested in managing the new system was put out in February. Bids were due April 3.
Sullivan said he hoped to have the contract awarded sometime next month so that a single, statewide Aging and Disability Resource Center (ADRC) will be up and running by Jan. 1, which also is the scheduled start of KanCare, Gov. Sam Brownback’s plan for letting managed care companies administer the state’s $2.9 billion Medicaid program. KanCare remains contingent upon federal approvals.
The resource center, according to Sullivan, would be in charge of measuring the needs of an elderly, physically disabled or brain-injured person. It also would do preliminary screening for Medicaid eligibility and help the person choose the managed care company best suited to meet the person’s needs.
Today, the assessments are handled by 11 area agencies on aging, 10 centers for independent living and about a dozen home health agencies that specialize in caring for the brain-injured.
“When you have this many systems in place, it can be confusing as to who to turn to for assistance,” Sullivan said. “With the ADRC, we’ll be going to one database, one information source and one hotline for people to call.”
Federal initiative
The change, he said, was driven by a federal initiative aimed at increasing efforts to help Medicaid beneficiaries live in community settings rather than nursing homes and a concern among state officials that not enough was being done to prevent the centers for independent living from inflating their assessments in ways that generated more work — and therefore more revenue — for their case management and home-health programs.
Currently, the centers are allowed to assess a physically disabled person’s needs, serve as the case manager and provide the services.
“When we did our KanCare public forums last year, we had a lot of (Medicaid) providers say we should look at separating the services — that it might be OK for someone to do the assessment and the case management, but it wasn’t OK to have someone doing case management and direct care,” Sullivan said. “Part of the ADRC is in response to that.”
The concern about potential conficts of interest has centered on the centers for independent living.
The area aging agencies assess the needs of the frail elderly and often serve as case managers, but unlike the centers for independent living, none of them provide in-home care. Instead, the frail elderly receive services from individuals hired by the seniors or employed by home health agencies.
“Objectivity has always been one of our core values,” said Julie Govert Walter, who runs the 18-county North Central-Flint Hills Area Agency on Aging in Manhattan. “We’re not getting paid to provide a service in somebody’s home, so there’s no incentive to say they need a whole bunch of services they may not really need.”
In Kansas, Medicaid provides home and community-based services for about 5,400 frail elders, 6,100 people with physical disabilities and 400 people with brain injuries. The new system will not apply to people with developmental disabilities who receive in-home Medicaid services. Their needs will continue to be assessed by one of the state’s 28 Community Developmental Disability Organizations.
Case management
Sullivan said that after Jan. 1, the ADRC assessments would be forwarded to the managed care companies, which then would take on the case management responsibilities.
The companies, he said, would have the option of subcontracting with other case management organizations. For example, the companies could subcontract with a center for independent living for case management or direct-care services.
Some details still are being worked out.
“We’re in the process — over the next couple weeks — of finalizing the details for the managed care plans,” Sullivan said. “That’s not been decided yet.”
But it’s clear, he said, that a subcontractor won’t be allowed"...(read more)
Another related article from KHI on ADRCs:
Kansas looks to Wisconsin for ADRC model
System there has helped reduce waiting lists for services, officials say
Monday, August 13, 2012
Monday, August 6, 2012
A look at the Kansas political landscape...
The New York Times published an article yesterday examining the changing political landscape in Kansas and showcasing the viewpoints between conservatives and republicans:
The New York Times
By John Eligon
Published August 5, 2012
"TOPEKA, Kan. — In eight years in the Kansas Legislature, State Senator Dick Kelsey said, he never voted for a tax increase and frequently supported spending cuts. As an evangelical pastor, a staunch opponent of abortion and an acknowledged leader in the fight to elect conservative lawmakers, he has been endorsed by Kansans for Life and the National Rifle Association.
Yard signs for state candidates at a Republican forum in Topeka. Conservatives say some party members are too moderate.
But after publicly criticizing elements of Gov. Sam Brownback’s tax plan this year, Mr. Kelsey found himself among a cluster of conservative Republican state senators that a more conservative coalition here is working to defeat in Tuesday’s primary elections.
Kansas politics have been tilting more to the right for at least the last two decades. And now that shift is prompting a bitter clash within the state’s Republican Party. Conservatives are feverishly working to win the Senate and drive out the last remnants of what they see as moderate Republicanism in a state with a deep-rooted history of centrist Republicans in the mold of Bob Dole, Dwight D. Eisenhower and Nancy Kassebaum.
The divisive primary campaign reflects the ambivalence gripping Republicans across the country, yet the situation here is more complicated than the typical conservative-versus-establishment disputes.
What sets the battle in Kansas apart is the distance between the factions. Conservative and moderate Republicans essentially operate as separate parties, and so far, no one — including Mr. Brownback — has stepped forward to try to bridge that gap in the popular tradition of moderation. Instead, each side claims to represent the soul of the party.
“We don’t even know what it means to be a Republican in the state of Kansas,” said Casey W. Moore, a conservative Senate candidate from the Topeka area.
Nationally, conservatives have been defining the party in their image. Last week, they scored a big victory in Texas when a Tea Party favorite defeated Gov. Rick Perry’s favored candidate in the primary for an open United States Senate seat. That outcome followed conservative victories this year over established Republicans in Senate primary races in Indiana and Nebraska.
Kansas conservatives are optimistic that they can do the same on the state level and upend long-held assumptions that the people of their state prefer moderate lawmakers.
Two years ago, conservative Republicans here captured a majority in the Kansas House of Representatives — around 70 of 125 seats — for the first time in about four decades"...(read more)
The New York Times
By John Eligon
Published August 5, 2012
"TOPEKA, Kan. — In eight years in the Kansas Legislature, State Senator Dick Kelsey said, he never voted for a tax increase and frequently supported spending cuts. As an evangelical pastor, a staunch opponent of abortion and an acknowledged leader in the fight to elect conservative lawmakers, he has been endorsed by Kansans for Life and the National Rifle Association.
Yard signs for state candidates at a Republican forum in Topeka. Conservatives say some party members are too moderate.
But after publicly criticizing elements of Gov. Sam Brownback’s tax plan this year, Mr. Kelsey found himself among a cluster of conservative Republican state senators that a more conservative coalition here is working to defeat in Tuesday’s primary elections.
Kansas politics have been tilting more to the right for at least the last two decades. And now that shift is prompting a bitter clash within the state’s Republican Party. Conservatives are feverishly working to win the Senate and drive out the last remnants of what they see as moderate Republicanism in a state with a deep-rooted history of centrist Republicans in the mold of Bob Dole, Dwight D. Eisenhower and Nancy Kassebaum.
The divisive primary campaign reflects the ambivalence gripping Republicans across the country, yet the situation here is more complicated than the typical conservative-versus-establishment disputes.
What sets the battle in Kansas apart is the distance between the factions. Conservative and moderate Republicans essentially operate as separate parties, and so far, no one — including Mr. Brownback — has stepped forward to try to bridge that gap in the popular tradition of moderation. Instead, each side claims to represent the soul of the party.
“We don’t even know what it means to be a Republican in the state of Kansas,” said Casey W. Moore, a conservative Senate candidate from the Topeka area.
Nationally, conservatives have been defining the party in their image. Last week, they scored a big victory in Texas when a Tea Party favorite defeated Gov. Rick Perry’s favored candidate in the primary for an open United States Senate seat. That outcome followed conservative victories this year over established Republicans in Senate primary races in Indiana and Nebraska.
Kansas conservatives are optimistic that they can do the same on the state level and upend long-held assumptions that the people of their state prefer moderate lawmakers.
Two years ago, conservative Republicans here captured a majority in the Kansas House of Representatives — around 70 of 125 seats — for the first time in about four decades"...(read more)
Friday, August 3, 2012
Wichita Eagle Editorial: Waiting lists loom
DRC's "End the Wait" Campaign inspired a great editorial from Rhonda Holman of the Wichita Eagle Editorial Board:
Published Friday, August 3, 2012:
"As the Brownback administration takes pride in fiscal-year-ending reserves, another number looms large and shamefully – the more than 7,000 Kansans with physical or developmental disabilities who are awaiting home- and community-based services.
With such services, individuals can live independently or in homelike residential settings. Without them, they may be forced to move into nursing homes – not only sacrificing quality of life but costing taxpayers far more.
Neither Gov. Sam Brownback nor the Legislature has demonstrated much urgency to better fund disability services and whittle down these lists, although the budget surplus would have made that possible.
The Brownback administration has argued that it inherited the waiting lists from former Gov. Kathleen Sebelius, now U.S. secretary of health and human services, and “that merely increasing funding for such services will not solve the problem,” as Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, wrote in a May commentary.
Officials also point to reforms coming with the reinvention of Medicaid as KanCare in January 2013, and with the addition to KanCare of the management of long-term care services for the developmentally disabled a year later.
But state leaders soon may be unable to set their own timetable for addressing the lists.
That’s because the U.S. Justice Department has been conducting an investigation into whether the waiting list for individuals with physical disabilities violates the Americans With Disabilities Act and court decisions including the U.S. Supreme Court’s 1999 Olmstead case, which ruled that a disabled person has a right to live in the “least restrictive environment.”
That investigation could lead to a lawsuit, and eventually a costly remedy being forced on Kansas. Georgia has had to spend $100 million on disability services since 2009 as part of a settlement agreement with the federal government.
“Wisdom would tell you we should handle this waiting-list issue on our own terms, proactively,” Tim Wood, manager of the Topeka-based Disability Rights Center of Kansas’ “End the Wait” campaign, told The Eagle editorial board.
Wood and other advocates plan to ramp up their campaign in time for the 2013 legislative session, looking to a long-neglected legislative blueprint for guidance on how to not only reduce waiting lists but expand and strengthen the home- and community-based services system. Another meeting is planned in Sedgwick County for Aug. 14 or 16 (for more information, call 785-273-9661).
The campaign aims to reduce the waiting list for services for the developmentally disabled, which includes more than 3,200 people without services and another nearly 1,700 awaiting additional services.
The wait averages 30 months but can stretch on for years.
Looking the other way won’t make these lists disappear, nor do anything to help the people languishing on them."
Published Friday, August 3, 2012:
"As the Brownback administration takes pride in fiscal-year-ending reserves, another number looms large and shamefully – the more than 7,000 Kansans with physical or developmental disabilities who are awaiting home- and community-based services.
With such services, individuals can live independently or in homelike residential settings. Without them, they may be forced to move into nursing homes – not only sacrificing quality of life but costing taxpayers far more.
Neither Gov. Sam Brownback nor the Legislature has demonstrated much urgency to better fund disability services and whittle down these lists, although the budget surplus would have made that possible.
The Brownback administration has argued that it inherited the waiting lists from former Gov. Kathleen Sebelius, now U.S. secretary of health and human services, and “that merely increasing funding for such services will not solve the problem,” as Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, wrote in a May commentary.
Officials also point to reforms coming with the reinvention of Medicaid as KanCare in January 2013, and with the addition to KanCare of the management of long-term care services for the developmentally disabled a year later.
But state leaders soon may be unable to set their own timetable for addressing the lists.
That’s because the U.S. Justice Department has been conducting an investigation into whether the waiting list for individuals with physical disabilities violates the Americans With Disabilities Act and court decisions including the U.S. Supreme Court’s 1999 Olmstead case, which ruled that a disabled person has a right to live in the “least restrictive environment.”
That investigation could lead to a lawsuit, and eventually a costly remedy being forced on Kansas. Georgia has had to spend $100 million on disability services since 2009 as part of a settlement agreement with the federal government.
“Wisdom would tell you we should handle this waiting-list issue on our own terms, proactively,” Tim Wood, manager of the Topeka-based Disability Rights Center of Kansas’ “End the Wait” campaign, told The Eagle editorial board.
Wood and other advocates plan to ramp up their campaign in time for the 2013 legislative session, looking to a long-neglected legislative blueprint for guidance on how to not only reduce waiting lists but expand and strengthen the home- and community-based services system. Another meeting is planned in Sedgwick County for Aug. 14 or 16 (for more information, call 785-273-9661).
The campaign aims to reduce the waiting list for services for the developmentally disabled, which includes more than 3,200 people without services and another nearly 1,700 awaiting additional services.
The wait averages 30 months but can stretch on for years.
Looking the other way won’t make these lists disappear, nor do anything to help the people languishing on them."
Thursday, July 26, 2012
KanCare Educational Tour
The State of Kansas will host a series of informational meetings on KanCare beginning on July 30th. Informational meetings for Medicaid providers will be held during afternoons on each of the scheduled dates, while information for Medicaid beneficiaries and their families will be held in the evenings. Below is a brief overview of the schedule. Please download the attached forms for details on meeting locations and registration.
Note: Providers must pre-register to attend!
Monday, July 30th
Garden City & Topeka
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Tuesday, July 31st
Wichita & Leavenworth
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Wednesday August 1st
Salina & Fort Scott
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Thursday August 2nd
Hays & Overland Park
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Medicaid Providers: Location Details & Registration
Medicaid Beneficiaries/Families: Location Details & Information
Note: Providers must pre-register to attend!
Monday, July 30th
Garden City & Topeka
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Tuesday, July 31st
Wichita & Leavenworth
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Wednesday August 1st
Salina & Fort Scott
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Thursday August 2nd
Hays & Overland Park
Medicaid Providers: 1pm - 4pm
Medicaid Beneficiaries/Families: 6pm - 8pm
Medicaid Providers: Location Details & Registration
Medicaid Beneficiaries/Families: Location Details & Information
Thursday, July 12, 2012
There's Still Time: Submit comments on KanCare
You may recall that Administrative officials held public forums in Topeka and Wichita last month on the subject of their 1115 waiver to be submitted to the Centers for Medicaid Services (CMS). This submission to CMS will in fact be a re-submission as the Administration withdrew their original application for the waiver to meet state policies requiring consultation with tribal health organizations.
The public forums were well attended and many participated via teleconference at the Topeka forum. However if you were unable to participate - or you were there but still have additional concerns or thoughts you would like to share with the Administration on the 1115 waiver there is still time to do so.
You may submit written comments via email to KanCare@kdheks.gov
The deadline to submit is July 14th. Seeing as that deadline falls on a Saturday, administration officials are encouraging comments to be submitted by this Friday.
Once the State re-submits the 1115 waiver to CMS there will be a second public comment period - this comment period will be hosted by CMS on their website. Stay tuned to The InterHab Insider, we'll be sure to notify you when the State re-submits and when CMS begins the public comment period.
The public forums were well attended and many participated via teleconference at the Topeka forum. However if you were unable to participate - or you were there but still have additional concerns or thoughts you would like to share with the Administration on the 1115 waiver there is still time to do so.
You may submit written comments via email to KanCare@kdheks.gov
The deadline to submit is July 14th. Seeing as that deadline falls on a Saturday, administration officials are encouraging comments to be submitted by this Friday.
Once the State re-submits the 1115 waiver to CMS there will be a second public comment period - this comment period will be hosted by CMS on their website. Stay tuned to The InterHab Insider, we'll be sure to notify you when the State re-submits and when CMS begins the public comment period.
Monday, July 9, 2012
"KanCare is looking like another DMV disaster-to-be"
Kansas City Star columnist Steve Rose weighs in with concerns about the hurried implementation of KanCare and the unwise decision to include long-term supports for Kansans with developmental disabilities:
"KanCare is looking like another DMV disaster-to-be"
July 5, 2012
Steve Rose
The Kansas Health Institute has nailed it.
KanCare - to paraphrase - is likely to be a mess when it is implemented on Jan. 1.
On that date 380,000 poor and disabled Kansans, who now receive services through Medicaid, will be shifted to private, managed care in an attempt to save money. The new program is called KanCare.
The KHI researched what has happened in Kentucky, which recently has implemented what we are about to implement. And, so far, it has had lots of hiccups.
And Kentucky did not even include three categories that are included in the Kansas plan: long-term services for the elderly, physically disabled and, eventually, the developmentally disabled.
Personally, I am not opposed to the overall concept. Clearly, Medicaid costs are out of control, and the best hope for efficiencies is through some sort of fixed-rate managed care, although — as I have written before — the developmentally disabled should never go to managed care.
But this must be done very, very carefully. And the way it looks, Kansas will not be prepared by Jan.1 to make a smooth transition.
According to KHI news service, the state auditor from Kentucky said...(read more)
"KanCare is looking like another DMV disaster-to-be"
July 5, 2012
Steve Rose
The Kansas Health Institute has nailed it.
KanCare - to paraphrase - is likely to be a mess when it is implemented on Jan. 1.
On that date 380,000 poor and disabled Kansans, who now receive services through Medicaid, will be shifted to private, managed care in an attempt to save money. The new program is called KanCare.
The KHI researched what has happened in Kentucky, which recently has implemented what we are about to implement. And, so far, it has had lots of hiccups.
And Kentucky did not even include three categories that are included in the Kansas plan: long-term services for the elderly, physically disabled and, eventually, the developmentally disabled.
Personally, I am not opposed to the overall concept. Clearly, Medicaid costs are out of control, and the best hope for efficiencies is through some sort of fixed-rate managed care, although — as I have written before — the developmentally disabled should never go to managed care.
But this must be done very, very carefully. And the way it looks, Kansas will not be prepared by Jan.1 to make a smooth transition.
According to KHI news service, the state auditor from Kentucky said...(read more)
Thursday, July 5, 2012
KDADS is Official
As of July 1, 2012 the Kansas Department on Aging and Disability Services (KDADS) will be the state's official charge for administering the following services:
- Aging services
- Mental Health Programs
- Addiction and Prevention Programs
- State Hospitals and Institutions
- Home and Community-based Waiver Programs
KDADS has formed as the result of an executive reorganization order issued by Governor Sam Brownback during the 2012 legislative session. It is a merging of the following departments: The Kansas Department on Aging, the Disability and Behavioral Health Services Division at SRS and parts of the Health Occupations Credentialing Division at KDHE.
See below for an introductory letter, organizational chart and FAQs provided by Sean Sullivan, Secretary of KDADS:
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