Questions raised about Medicaid reform plans 

Despite pleas from advocates and suggestions from a Senate committee member, it is unlikely that plans to shift all state Medicaid services to managed care will change, representatives of Gov. Sam Brownback's administration said.

The Senate Public Health and Welfare Committee wrapped up several days of testimony on the proposal Monday after hearing advocates for the developmentally disabled argue that the state should scrap its plan to put their clients under managed care, or in the very least, delay it.

At the end of the hearing, Sen. Dick Kelsey, R-Goddard, recommended the developmentally disabled be left out of the reforms for at least two years.

But Brownback's administration, led by Lt. Gov. Jeff Colyer, is already accepting bids to implement a plan to contract three managed care companies to supply all state Medicaid services by Jan. 1, 2013, The Topeka Capital-Journal reported (http://bit.ly/xnsPL3 ).

Currently, most of the state's developmentally disabled residents are served by a Medicaid waiver system for home and community-based care that advocates say works well except for long waiting lists.

Kelsey also recommended delaying the governor's plan entirely until July 1, 2013 in order to hold public hearings on the requirements for the managed care contracts. And he recommended splitting the state into three regions that would be served by one contract, rather than having three statewide contracts.

"He's just asking for the process to slow down," the Senate committee's chairwoman, Vicki Schmidt, said of Kelsey. "We've asked that in committee before and we've asked that of individuals who have come to testify and they've indicated that the train has left the station and there's no slowing it down now."

Schmidt, a Topeka Republican, said she was speaking specifically of Kansas Department of Health and Environment Secretary Robert Moser and Department on Aging Secretary Shawn Sullivan. Schmidt said hearing the testimony was valuable in informing the public and allowing concerns to be aired, but changes to the administration's plan "could prove very difficult at this stage."

During testimony Monday, Chad VonAhnen, of the Sedgwick County Developmental Disability Organizationm, agreed with others who think the state is moving too quickly.

"Where's the evidence this can work?" he said. "Why the rush? Why at all?"

"Families on the waiting list want to know what this (managed care) change means for them," VonAhnen testified. "Will their sons and daughters ever come off the waiting list when funding for their services is turned over to for-profit companies?"

The technical specifications for the three statewide managed care contracts are due at the end of the month and the cost estimates are due Feb. 22.

When asked how the Legislature could still influence the process, Kelsey said, "Ultimately, we control the budget."

"That is true," Schmidt said. "But controlling the budget (means) we would have to not fund Medicaid and I don't believe that is an option."

Still, Kelsey noted about 1,100 questions on the contracts had been submitted, which he said shows that "even the professionals don't understand what is being suggested, let alone the providers of Medicaid services and those receiving those services."

"They can't drive this Medicaid train so fast down the track without going off the track," he said after the hearing.

Brownback's office said the administration spent a year gathering input and crafting the contract request.

Rep. Jim Ward, D-Wichita, introduced a bill in the House last week that would keep the developmentally disabled from the managed care plan.

Brownback's office said the administration had spent a year gathering input and crafting the contract request.

"It would not be prudent at this juncture to revert from the schedule we've set," the governor's spokeswoman, Sherriene Jones-Sontag said in a statement. "It's been a transparent process, and the administration has welcomed the opportunity to respond to thoughtful questions and continue the dialogue. Based on all the discussions we've had and the information we received from Kansans, we feel the state is on the right path to improving outcomes and sustaining the Medicaid program. The care of all consumer groups will improve under KanCare; we are not in favor of providing these benefits to only some groups and not all."

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Information from: The Topeka Capital-Journal, http://www.cjonline.com

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