Raising kids, eating right, spending smart, living well—that’s the theme of national Living Well Month being promoted in March by the Extension Association of Family and Consumer Sciences (FCS), both at the national level and here in Kansas. The goal of Living Well Month is to help people understand the education and information provided by Extension FCS agents to help them “live well.”

The Kansas Extension Association of Family and Consumer Sciences works through K-State Research and Extension to offer all kinds of information that will help families achieve a positive, healthy lifestyle. Whether you are trying to manage your diabetes through meal planning and exercise, make decisions about health care and insurance, or get tips on effective parenting techniques, Extension probably has a research-based answer.

To make every month a “Living Well Month,” consider these tips from the Cottonwood Extension District FCS agents in Hays and Great Bend:

1. Engage children in at least 60 minutes of physical activity on most, preferably all, days of the week. Adults need at least 30 minutes of physical activity most days. Besides participating in sporting activities, turn on some music and dance. Be creative by assembling an obstacle course or using hula-hoops. Start planning a garden. Take a walk or bike ride in your neighborhood. Registration is still open for Walk Kansas which begins March 18 through May 12, so form a team of six people to take advantage of this signature health and fitness program from K-State Research and Extension.

2. Eat a variety of healthful foods. Be sure to have plenty of colorful fruits and vegetables every day. Most people need at least 4 ½ cups to meet the daily recommendation. Have a glass of 100 percent juice or sliced banana on cereal for breakfast, enjoy raw vegetables with dip to accompany a sandwich at lunch and have a sliced apple for dessert. At dinner, steam some vegetables and prepare a fruit parfait with yogurt for dessert. Join us in Hays at noon on April 3 for a free demonstration of “Healthy Cooking Styles” for new ideas to enhance healthy meals.

3. Read, read, read. Go to the library and check out books. Keep the mental stimulation flowing regardless of your age for optimum brain health. Extension agents across Kansas are providing research-based programming from “Better Brains for Babies” through “Keys to Embracing Aging” which focus on aspects of brain health and intellectual development. Join us on April 18th at the Hays Public Library, 1:30-2:30 pm, for the free program “Emergent Literacy: Helping Children’s Development Through Reading” presented by Dr Bradford Wiles, Extension child development specialist.

4. Maintain a healthy home. Be sure your smoke and carbon monoxide detectors are working correctly and test your home for the presence of radon (Extension offices offer a do-it-yourself radon test kit at a low cost.) Help manage allergies and/or asthma by cleaning and vacuuming regularly to reduce allergy triggers in the home. Fix leaks and moisture problems to prevent mold growth. Avoid accidental poisonings by keeping medications locked up, and cleaning agents and other poisons out of reach of children.

5. Keep your family finances in check. Track your expenses and update your budget regularly. Extension FCS agents can help with programs on basic budgeting, saving, estate planning, discovering your money personality, smart food shopping and tips for healthful low-cost meals at home. Save the date for another “Healthy Meals Under Pressure” demonstration of cooking with electric pressure cookers on April 26th in Hays.

6. Use safe food handling practices to avoid foodborne illness and keep your family and guests healthy. Extension FCS agents offer programs for youth and adults on food safety, proper hand washing and safe home food preservation. We also offer food safety training for restaurant, non-commercial and volunteer food handlers so you can be safe when eating away from home. Extension FCS agents will host a regional Servsafe Manager Certification course in Russell on April 11 and a basic food handler class for food service employees and volunteers on May 17th in Hays.

7. Check out all the information and classes provided by your local Extension office. Cottonwood Extension FCS agents Linda Beech and Donna Krug are a wealth of information and training for living well. Get information emailed directly to you in the quarterly Cottonwood District newsletter– contact the Extension Offices in Hays or Great Bend to join the mail list. Also see our website at www.cottonwood.ksu.edu, follow us on Facebook at “K-State Research and Extension- Cottonwood District,” read our columns, listen to us on the radio and call when you have individual questions. Extension FCS agents are here to help you learn more about “living well.”

Linda K. Beech is Cottonwood District Extension Agent for Family and Consumer Sciences.

In early March, I wrote an article about changes in the State of Kansas that increased the complexity of obtaining Medicaid benefits.  My article was prompted by several investigative articles appearing in The Kansas City Star, finding multiple problems with the Kansas system.  (The Kansas City Star, “KanCare Changes Leave Seniors Struggling to Keep Medicaid Coverage,” by Andy Marso, February 22, 2018.  That article was a follow-up to another article by Mr. Marso, “What’s the Matter with KanCare? Challenges on Four Fronts,” The Kansas City Star, February 22, 2017.)

The Director of Communications (Angela de Rocha) of the Kansas Department for Aging and Disability Services responded to my article by way of a letter to the Editor.  She stated that my article was “wrong, inaccurate and misleading.”  The truth is, her response was “wrong, inaccurate and misleading.” 

Before I get into some of the specifics, it is important to point out that though the system is flawed, it has many good people within it trying to make it work and trying to help consumers.  On the legal side, Brian Vazquez and Loren Snell are bright, reasonable, and “see the big picture.”  Breanna Dorman is a go-to person to get things done through the KanCare system.  Frankly, I do not know what we would do without these individuals.

Now, to Ms. de Rocha’s letter.

1. “Medicaid… has nothing to do with federal deficit reduction legislation.”  This is a most surprising statement.  In February of 2006, the Deficit Reduction Act was passed (known as the DRA of 2005; Senate Bill 1932 of the 109^th Congress).  It is considered by those working with the elderly and Medicaid as one of the most landmark changes to Medicaid law and state programs.  States were required to adopt its provisions.  It changed Medicaid eligibility rules, including the look-back period (from 36 months to 60 months) and the “uncompensated transfer” definition.  It changed the start date of Medicaid eligibility, restricted home exemption rules, changed Home and Community-Based Services Medicaid rules, restricted the use of annuities and promissory notes, and so on.  Frankly, there is no way to understand Medicaid without understanding the rules modified or created by the DRA.  Clearly, Medicaid has and always will have a lot to do with federal deficit reduction legislation.

2. “Kansas has never provided health care in ‘local Medicaid offices’.”  First, that was not the statement in my article.  The article did say that Medicaid offices were closed and replaced with a system centralized in Topeka.  That is absolutely correct.  Previously, there were local offices staffed with local experts who determined Medicaid eligibility. 

These offices were operated by the Kansas Department of Social and Rehabilitation Services (SRS), which was the predecessor to the Kansas Department for Children and Families (DCF).

3. “Kansas has not ‘turned over management of Medicaid’ to a company called Maximus.”   Medicaid applications used to be handled in local communities.  Now, through the KanCare Clearinghouse, Medicaid application processing is mostly staffed by a private contractor, Maximus.  Under Maximus’ agreement with the State, it oversees most aspects of Medicaid, including application determinations and redeterminations, though the final determination is supposed to be made by a State employee.  (Kansas Department of Health and Environment, Policy Clarification 2017-07-01).  Maximus is not doing its job.  In fact, the State has now threatened to fine Maximus $250,000 a day for its failure to properly operate the Clearinghouse (The Kansas City Star, “Kansas tells Medicaid contractor: Shape up, or face millions in fines,” by Jonathan Shorman, February 16, 2018).

4. “Health outcomes for Medicaid beneficiaries…are significantly better under KanCare than they were under the old system.”  I am speechless about this comment by de Rocha.  It is just so incorrect.  Last year, the federal government, through the Centers for Medicare and Medicaid Services (CMS), investigated the KanCare program.  It found the KanCare program in “non-compliance…with federal Medicaid statutes and regulations.  This non-compliance… places the health, welfare, and safety of KanCare beneficiaries at risk and requires immediate action.” (Letter to Susan Mosier, Secretary and State health Officer, from James G. Scott, Associate Regional Administrator for Medicaid and Children’s Health Operations, dated January 13, 2017.)

The fiasco of the KanCare system has been discussed in news articles across the State.  The problems persist.  It grows tiresome when State officials say the system is delivering better services when the opposite is true.  Someone needs to speak out.

My original article suggested that as a starting point to fix the system we return the processing of applications to local offices where consumers could meet face to face with real people.  A worker would be assigned to a case to help the applicant through the process.  House Minority Leader Jim Ward said it well.  “This idea that we can consolidate all this out into a building (in Topeka) when we had an infrastructure of local agencies, local groups, local persons that was working fine.  We created the most inefficient system.”  (See The Kansas City Star article, “Kansas tells Medicaid contractor: Shape up, or face millions in fines,” by Jonathan Shorman, February 16, 2018.)

It is going to take all of us to raise Cain with our elected officials.  The KanCare system must be fixed or replaced.

Randy Clinkscales of Clinkscales Elder Law Practice, PA, Hays, Kansas, is an elder care attorney, practicing in western Kansas. To contact him, please send an email to [email protected]. Disclaimer: The information in the column is for general information purposes and does not constitute legal advice. Each case is different and outcomes depend on the fact of each case and the then applicable law. For specific questions, you should contact a qualified attorney.