State officials have decided to postpone the launch of Medicaid-funded health homes for the seriously mentally ill.

Initially, the initiative was supposed to be up and running Jan. 1, 2014, but the Kansas Department of Health and Environment announced that the start-up date had been pushed back to July 1, 2014.

“There are a number of reasons, but essentially we want to make sure everything is ready operationally,” said Becky Ross, Medicaid benefits coordinator at the KDHE Division of Health Care Finance. “It had become clear that we needed to provide some more assistance to both the managed care companies and the potential home health partners, particularly around HIT (health information technology).”

Other factors in the postponement, Ross said, included the department needing to finalize its rate calculations, wanting to maximize its use of federal planning money, and hoping to avoid the confusion of health homes being introduced at the same time participants re-enroll in KanCare health plans.

“A lot of things are going to be happening on Jan. 1, and we were concerned that it would be confusing for consumer/members to get a welcome-to-health-homes letter at the same they’re being told it’s time to choose their MCO (managed care organization) again,” she said. “Medicare open enrollment will be going on at the same time as well. It just seemed to make sense to move this back to July.”

Ric Dalke, president of the Association of Community Mental Health Center of Kansas board of directors, said he welcomed the delay.

“The sentiment, I think, is ‘Let’s make sure everybody has their ducks in a row before we get into this,’” he said. “That’s what KDHE is saying and that’s pretty much our position as well.”

Dalke said he expected most of the state’s community mental health centers would take part in the initiative once it is launched.

“We’re excited about moving into this service delivery model,” he said. “We’re looking forward to doing things better.”

In the health home model, the state’s mental health centers and safety-net clinics providers will be reimbursed for coordinating care for mentally ill patients in ways designed to prevent hospitalizations, emergency room visits and other costly crises responses.

Ross said KDHE expects to have about 36,000 people enrolled in health homes next year.

Together, she said, the clinics and the mental health centers will take responsibility for making sure their patients have access to six services:

Comprehensive care management
Individual and family supports
Referral to social and community services
Care coordination
Comprehensive transitional care
Health promotion
The state’s managed care contractors, Ross said, will oversee the process and use their payment data to determine which patients require the most care coordination.

Ross said she hoped to release a “draft” of the initiative’s payment structure in November.

“We’re working with the actuaries now,” she said. “We’re really wanting to build a rate that’s sustainable and gets us to quality outcomes.”

After health homes for the mentally ill are in place, Ross said, the initiative will be expanded to include patients with other chronic conditions, primarily diabetes, asthma, heart disease, obesity and substance abuse.

Many of the enrollees are expected to be people with physical or developmental disabilities.

“I’m guessing that about 10 to 20 percent of the 8,500 Medicaid-waiver people that we serve will be auto-enrolled in a health home,” said Tom Laing, executive director of Interhab, an association that represents most of the state’s community based programs for the developmentally disabled.

Laing said Interhab members are “generally favorable toward” health homes but welcome the delay in implementation.

“What this highlights, I think, is how complex all this is,” he said, “and how the original implementation calendar might have been overly ambitious.”