Vietnam Veterans of America Chapter 939 will host a town hall meeting concerning Agent Orange and its long-term effects.
The meeting will at 6:30 p.m. Friday at Fort Hays State University in the Stouffer Lounge, second floor.
According to a new release, specialists from national VVA headquarters will present new information and study results during the first part of the meeting and then have a question-and-answer session.
They also will be compiling data concerning birth defects and diseases in children and grandchildren of Vietnam veterans.
Agent Orange is the name given to the defoliants sprayed throughout Vietnam and on some air bases in Thailand. It also was used on the Korean DMZ in 1968 and 1969.
Any veteran who served in those areas are presumed to have been exposed and should be registered on the Agent Orange Registry. Diabetes, Parkinson’s, ALS, Ischemic heart disease, prostate cancer, many other forms of cancer, and leukemia are just some of the conditions for which a veteran can be compensated.
Widows of Vietnam veterans who died as a result of one of the conditions could have the ability to file a back-dated claim for the cause of death. A representative from Kansas Commission on Veteran Affairs will be at the meeting to answer questions concerning possible claims for veterans and surviving spouses.
TOPEKA — A bill aimed at speeding payments from the state’s KanCare contractors to Medicaid service providers was endorsed today by the House Health and Human Services Committee.
House Bill 2552, a so-called “prompt pay” bill, had the backing of most of the state’s Medicaid provider groups and faced no opposition.
The measure essentially would write into law some of the payment requirements already included in the state’s contracts with the three insurance companies that have run day-to-day operations of the Kansas Medicaid program since Jan. 1, 2013, when the administration of Gov. Sam Brownback moved virtually all the state’s Medicaid enrollees into health plans run by three managed care companies.
The bill also would let doctors, hospitals and other Medicaid service providers collect 12 percent interest on late payments from the KanCare companies. The three current contractors are Amerigroup, UnitedHealthcare and Sunflower State Health Plan, a subsidiary of Centene.
A similar measure, Senate Bill 317, was introduced in the Senate and heard last week by the chamber’s Public Health and Welfare Committee. But no action has yet been taken on it.
The state’s contracts with the insurance companies include provisions that require they make timely payment for so-called “clean claims” submitted by Medicaid providers. The insurance companies have reported to state officials that they are meeting the contract standards well enough to qualify for the contract dollars the state has held back as an incentive for prompt payments.
A clean claim is one deemed by the managed care company to have been properly submitted in accordance with its billing procedures.
Providers have complained that the state’s contractual requirements for prompt payment have failed to account for the time it can take for a claim to be deemed “clean.”
Interhab, the group that represents most of the state’s Community Developmental Disability Organizations, pushed to have the 12 percent interest penalty in the bill raised to 18 percent. An amendment that would have done that was offered by Rep. Jim Ward, a Wichita Democrat. But his amendment failed on a voice vote.
Working to beat looming procedural deadlines, the committee also voted on several other proposed bills but tabled a controversial measure that would have required municipal water utilities to issue warnings about the reputed hazards of fluoridation.
Public health officials argued the warnings are baseless and that fluoridated water helps prevent cavities, especially in children.
By voting to table HB 2372, the committee probably killed it for this session. The vote was 10-2. The two committee members who voted against tabling the bill were Reps. Patricia Sloop, a Wichita Democrat, and Kevin Jones, a Wellsville Republican.
The bill would have required municipalities to warn their water customers that the “latest science confirms that ingested fluoride lowers the IQ in children.”
The bill was pushed by an anti-fluoride group that in 2012 helped orchestrate the defeat of a fluoride ballot initiative in Wichita, one of the largest cities in the nation that doesn’t add fluoride to its drinking water.
Rep. Barbara Bollier, a Mission Republican and physician, voted to table the proposal. She said the vast majority of studies have shown that fluoridation is safe and effective.
“The studies that I have read are not consistent with the information that they (the bill’s supporters) brought forward,” Bollier said.
Also today:
The committee endorsed HB 2611. Supporters, including the Kansas Dental Association, said the bill would lift current restrictions that effectively limit dentists from having more than three practice locations and could improve access to oral health care in underserved parts of the state.
Approved HB 2673, which would update state law dealing with the regulation and supervision of physician assistants.
Recommended passage of HB 2701, which would add drugs containing lorcaserin to the state’s list of controlled substances. Lorcaserin is most commonly prescribed for weight loss. It already is listed by the U.S. Drug Enforcement Agency as a Schedule IV drug.
The committee also voted to approve House Resolution 6049, urging creation of a state plan for treating chronic obstructive pulmonary disease.
WICHITA — State officials say they’re close to launching a website for helping Kansans figure out which nursing home offers the highest quality care in their communities.
Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services
“It should be up sometime in April,” said Kansas Department for Aging and Disability Services Secretary Shawn Sullivan, at a meeting of the House Committee on Children and Seniors earlier this week. “The idea is for this to become a resource for people to use when they’re having to choose a nursing facility for themselves or for a loved one. It shouldn’t be the only factor in the decision-making process, but it’s a resource that we feel should be made available.”
The new program, called Kansas Nursing Home Report Card, will assign each of the state’s 330 nursing homes a series of one-to-five ratings based on licensure inspections, quality indicators, staffing data, and resident satisfaction surveys.
The KDADS report card, Sullivan said, would be similar to but better than the Centers for Medicare and Medicaid’s Five-Star Quality Rating System, which has been in place since 2008.
KDADS, he said, has contracted with a national company, My InnerView, to conduct in-person interviews with roughly 7,000 of the state’s 18,000 nursing home residents.
Sullivan said that survey should be completed this week. The survey questions, he said, were designed to measure residents “overall satisfaction” and whether they would recommend their facility to others.
The report card’s quality indicators, he said, would be “risk adjusted” so that facilities that care for “higher acuity” residents are not penalized for admitting especially frail residents.
Quality indicators include the prevalence of pressure sores, use of restraints, undue weight loss, and reliance on catheters.
The federal rating system’s data, Sullivan said, are not risk adjusted and do not measure resident satisfaction.
The KDADS report card, he said, would allow users to find out which issues were of the most concern to residents in a particular nursing home.
Most of the website has been developed in-house by KDADS staff. The department’s contract with My Innerview is for $295,000 for two years, agency officials said.
Rep. Melissa Rooker, a Fairway Republican, said the initiative seemed like a good idea.
“Anytime a family is put in a position of having to contemplate putting a loved one in a nursing, it’s a highly emotional issue,” she said. “So anything we can do to help families not make those decisions blindly is a step in the right direction.
“I fully understand how confusing and frightening and unnerving it is for families to have to make these decisions,” Rooker said. “It’s a constant challenge.”
Debra Zehr, chief executive of LeadingAge Kansas, which represents non-profit nursing homes, agreed with Sullivan’s critique of the federal rating system.
“It has a lot of problems,” she said. “I’m confident that the one KDADS is putting together will be better.”
Zehr said her members “conceptually” support the report card but would encourage family members not to limit their decisions to information pulled from inspection reports.
“I tell people to visit the facility, drop by unannounced, talk to staff – don’t just take the tour,” Zehr said. “Go there afterhours or on a weekend. Talk to other residents’ family members. Call the (Kansas Long-term Care) Ombudsman’s Office, ask them what they’ve heard.”
Mitzi McFatrich, executive director of Kansas Advocates for Better Care, said she hoped KDADS would expand the report card to include the state’s assisted living and residential health care facilities.
Currently, she said, “there really is no national or state government data on these facilities that the public can access.”
Angela de Rocha, a spokesperson for KDADS, said the agency would explore expanding the report card after it’s had time to measure the initiative’s effectiveness.
To contact the ombudsman’s office, call (877) 662-8362 (toll-free) or email [email protected].
TOPEKA — University of Kansas Chancellor Bernadette Gray-Little is scheduled to appear before a legislative committee Thursday to renew a request for state help in financing a state-of-the-art classroom building at its medical school.
KU Chancellor Bernadette Gray-Little
In testimony to the Joint Committee on State Building Construction, Gray-Little is expected to say that the $75 million building is urgently needed to meet accreditation standards and to accommodate new ways of teaching that emphasize active learning in small-group settings over note taking in large lecture halls.
“We want to make sure that we have a facility that is adequate to (meet) those standards and that provides us with an opportunity to educate our medical students the way that medical students are educated now rather than the way they were educated 50 years ago,” Gray-Little said in a recent interview.
The proposed structure would replace one built on the school’s Kansas City, Kan. Campus in 1976 that university officials say is outdated and needs $5.3 million of repairs.
The new building also would allow the university to do more address the growing shortage of physicians across the state, Gray-Little said.
“Part of the reason for the health education building is to allow us to expand the size of our classes,” she said. “We are 39th in terms of the number of physicians for the population. We need to replace physicians at a much higher rate that we’re (now) able to do.”
The university’s plan is to increase students on its Kansas City campus to 200 per class year instead of the current 175.
The university has authority to issue $75 million in bonds to finance construction of the building, but Gray-Little said it can’t afford to move forward with the project unless lawmakers and Gov. Sam Brownback agree to cover $40 million of the cost.
“This would be a partnership between the state, the university and private donors to make this possible,” she said.
At the start of the session, the governor proposed restoring some of the $33 million in higher-education cuts approved last year. But his budget proposals didn’t include any money for the health education building.
The university is requesting that the state provide $15 million over several years to help it pay off the bonds. In addition, the university wants to use $25 million recently returned to the state to compensate it for Social Security contributions made on behalf of medical school residents that were subsequently deemed unnecessary.
An attempt last week by Sen. Laura Kelly, a Topeka Democrat, to add $1.5 million to the fiscal 2015 budget to cover the first debt-service payment failed on a tie vote. She said she is hoping that the chancellor will make a strong enough case to switch a vote or two.
“Some members have expressed an interest in knowing more,” Kelly said. “So, that’s why we asked the chancellor and officials from the Med Center to come over here and educate the committee.”
The committee is scheduled to meet at noon Thursday in room 159-South at the Statehouse.
GARDEN CITY — Until recently, 50-year-old Tammy Ryan had never had health insurance.
“I kept hearing about how everybody was going to have to have insurance,” she said, referring to the onset of the Affordable Care Act, also known as Obamacare. “So I quit my waitressing job, which didn’t have insurance that I could afford, and took a job with the school district. I’m making less money now, but I have insurance.”
Ryan said she isn’t sure what her new policy will cover.
“I have a doctor’s appointment in a couple weeks, I’ll find out then,” she said. “There’s a lot I don’t know because up until now, I’ve never gone to see a doctor unless I was really, really sick.”
Ryan is a single mother who reared three children and now cares for three grandchildren. She said she’s been told she has heart disease. She may have diabetes, too.
“My mother, my youngest daughter, my brother and my sister all have diabetes,” she said. “I might have it, I don’t know. I feel alright now.”
Though she’s in relatively good health, Ryan said she has more than $10,000 in medical bills.
“I don’t have that kind of money, so I just kind of ignore them,” she said. “I know they’re there, but I don’t know what else to do. I’m barely making it as it is.”
Ryan said she expects to earn between $9,000 and $10,000 annually at her new job, which involves preparing and transporting school lunches. She works 35 hours a week.
“When I had my taxes done last year I got a note that said I should apply for Medicaid because I was probably eligible,” she said. “I went ahead and applied, but they said I made too much money.”
Ryan said the grandchildren, ages 5, 7 and 8, have lived with her “since they was babies.”
Ryan said she tries not to think too much about her family’s health care.
“I just hope and pray that things work out. I take everything day by day,” she said. “But when I do think about it I get angry. I’ve been a single mom most of my life. I raised my kids all by myself, and now I’m raising my grandkids. And then I see people who have more kids than I do and who aren’t working, and they’re on Medicaid and they’re getting food stamps. It doesn’t seem fair to me. It angers me.”
TOPEKA — Kansas will get $10.8 million in additional Medicaid money from the federal government as a bonus for enrolling more children from low-income homes in state-federal health insurance programs.
The award was announced today by officials at the federal Centers for Medicare and Medicaid services. It is part of more than $307 million in bonuses to be paid out to 23 states.
State officials said they had not yet received the money but had been informed by CMS of the award.
“This bonus is a result of Kansas’ ongoing and strong efforts to identify and enroll eligible children in Medicaid and CHIP (Children’s Health Insurance Program) health coverage,” said Miranda Steele, a spokesperson for the Kansas Department of Health and Environment, the state’s lead Medicaid agency. “This would not be possible without the diligence and commitment from the state and many other organizations across Kansas who work directly with families to make sure they’re aware of our services.”
Steele said Kansas received the bonus because its enrollment of children exceeded a baseline number determined by the federal government in 2007. The state has qualified for a bonus in each of the past five years with sums ranging from about $1.2 million for fiscal 2009 to more than $12 million in fiscal 2012, according to federal reports.
About 200,000 children currently are covered by the state’s Medicaid and CHIP programs.
TOPEKA – The Kansas Department of Health and Environment has issued a boil advisory for the public water supply located in the city of Thayer in Neosho County.
The city water supply experienced a loss of pressure in the water system due to an operational malfunction. When such a loss of pressure occurs, it is possible for contaminants to enter the system. Chlorine residuals may also drop to levels that are inadequate to protect against bacterial contamination.
Effective immediately, customers should observe the following precautions until further notice:
• Boil water for one minute prior to drinking or food preparation, or use bottled water.
• Dispose of ice cubes and do not use ice from a household automatic icemaker.
• Disinfect dishes and other food contact surfaces by immersion for at least one minute in clean tap water that contains one teaspoon of unscented household bleach per gallon of water.
• Water used for bathing does not generally need to be boiled. Supervision of children is necessary while bathing so that water is not ingested. Persons with cuts or severe rashes may wish to consult their physicians.
• If your tap water appears dirty, flush the water lines by letting the water run until it clears.
Officials will send notifications when the boil advisory has been rescinded.
TOPEKA — Kansas will not be able to move forward Jan. 1 as planned with its KanCare expansion intended to include long-term supports for the developmentally disabled.
Officials said the lack of a CMS sign-off for the Jan. 1 start more likely would result in a delayed approval after various changes are made to the plan as opposed to outright rejection of what has been one of the more controversial components of Gov. Sam Brownback’s ongoing Medicaid program makeover.
“They have told the state that they will not approve the 1115 waiver that carves in the DD folks on Jan. 1,” said Sen. Laura Kelly, a Topeka Democrat who has been in contact with CMS officials. “My sense is that this will just delay the decision.”
Kelly said there were four main areas of concern with the administration’s plan as outlined by federal officials and others:
• The number of disabled people on the state’s so-called “underserved list.”
• Concerns about whether the state can guarantee prompt payments for services by the state managed care companies to DD service providers.
• The state’s organizational structure for its KanCare ombudsman. Critics say the ombudsman should not be directly employed by a state Medicaid agency in order to assure greater independence.
• Concerns about “notices in the state’s 1915C waiver and proposed 1115C waiver amendment.”
Brownback officials subsequently issued a statement saying they would continue talks with CMS through Feb. 1 — a date not mentioned in the letter from CMS — in an effort to resolve or respond to the concerns that have been raised and, during that interval, develop a new implementation timeline for the KanCare expansion, to which they said they remain fully committed.
“Going forward, this administration aims to keep Kansans off the underserved list and reduce the (physical disability/developmental disability) waiting lists, and KanCare’s integrated care coordination is key to solving that longstanding issue,” Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, said in the prepared statement.
Administration officials said they would mail letters to DD consumers and providers to notify them “of this temporary postponement” of the state’s expansion plan.
State officials said the delay also would allow adequate time for them and federal officials to review the latest public comments on the planned expansion.
Interhab, the association that represents most of the state’s Community Developmental Disability Organizations, filed comments earlier this week with CMS, newly outlining that group’s ongoing trepidations with the proposed carve-in of DD services.
The public comment period on the state’s so-called 1115C waiver amendment proposal did not officially close until Dec. 24 after being extended because of an earlier glitch on the CMS public comment website.
Interhab also sent a memo dated Dec. 23 to Sullivan at KDADS, urging the state to delay or cancel its plan to include DD long-term supports in KanCare due to — among other things — “too much detail work left undone.”
Earlier this month, the National Council on Disability, a federal advisory panel, urged CMS officials to delay for one year the state’s request to include long-term DD supports and services in the state’s sweeping managed care plan. Medical services for the developmentally disabled were included in KanCare on Jan. 1, 2013, when virtually all the state’s 380,000 Medicaid beneficiaries were moved into managed care plans run by three major, for-profit insurance companies.
Advocates for the disabled said they were pleased that CMS had withheld approval.
“We are extremely pleased that CMS has listened to Kansas stakeholders about the serious problems with KanCare, including but not limited to wrongly forcing over 1,700 people on the so-called underserved waiting list and the lack of proper notice regarding service reductions and appeal rights,” said Rocky Nichols, executive director of the Disability Rights Center of Kansas.
“KanCare simply isn’t ready to take on the DD Waiver, and thankfully the federal government is getting that message loud and clear,” he said.
Interhab Executive Director Tom Laing said the delay would allow the group to continue its appeals to the Kansas Legislature, which convenes again in January, to block the administration plans to carve in DD services.
“I think legislators — many of whom who were being assured by the administration that everything was fine — will now want to ask new questions,” Laing said. “This wasn’t ever a partisan issue. We had Republicans and Democrats and moderates and conservatives who had concerns about this. It’s not a matter of adjusting a few nuts and bolts. However much the state might want to say otherwise, there are fundamental problems” with the expansion plan.
Interhab has long argued that long-term supports for the developmentally disabled should be left alone, saying they don’t lend themselves to the commercial, medical models used by shareholder-owned insurance companies.
BUNKER HILL — Smoky Hills Public Television premieres a new season of “Doctors on Call” at 7 p.m. Jan. 7. The live call-in program features a new medical topic each Tuesday night through April.
SHPTV can be seen on Eagle cable channels 9 or 609.
Doctors from throughout the state travel to Bunker Hill to provide information and answer questions from the viewing audience. Questions can be called in during the show or emailed prior to the broadcast. The doctors selected each week have expertise in the topic chosen for that program.
Some of this season’s topics include women’s health, pain management, digestive disorders, hospice care, cancer, men’s health, orthopedics, heart disease and common illnesses.
To submit questions electronically on a specific topic, viewers can send an email to [email protected] or message through Twitter with the hashtag #DOCCall. Questions submitted through either email or Twitter must be received by noon on the day of the show. During the program, viewers can call (800) 337-4788.
TOPEKA (AP) — Kansas officials are launching a campaign to get residents to test their homes for radon gas.
Gov. Sam Brownback signed a proclamation Friday designating January as Kansas Radon Action Month.
Throughout the month, the Kansas Department of Health and Environment will provide free test kits at more than 80 locations throughout the state.
KDHE Secretary Robert Moser says the agency is trying to gather data about radon levels around the state, especially in homes. He says as many as one in four homes may have high levels of the odorless, colorless gas.
Radon can cause health problems for humans, including lung cancer. Moser says knowing levels of the naturally occurring gas will help set health policies.
TOPEKA (AP) — A federal panel says the KanCare takeover of long-term services for the developmentally disabled should be delayed.
KanCare, the state’s privatized program for the poor and disabled, is scheduled to begin providing those services Jan. 1. However, it needs a waiver from the Center for Medicare and Medicaid Services by Jan. 1.
The National Council on Disability is recommending that Medicaid delay the waiver for one year. The panel said the state has not adequately considered concerns raised by clients, guardians and service providers about the expansion.
The Wichita Eagle reported the state Department for Aging and Disability Services officials disagreed with the panel’s recommendations. They say the panel didn’t spend enough time in Kansas to understand the safeguards KanCare has to protect the rights of the disabled.
Many chances to give during National Blood Donor Month
WICHITA — January is National Blood Donor Month, and the American Red Cross invites those who are eligible to join millions of blood donors across the country in helping ensure a stable blood supply for patients in need.
January can be a difficult month to collect donations due to inclement weather and seasonal illnesses. The Red Cross encourages eligible donors to make an appointment to give during National Blood Donor Month by visiting redcrossblood.org or calling (800) RED CROSS.
Upcoming blood donation opportunities: Ellis County
Jan. 2 from 11 a.m. to 6 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 3 from 9 a.m. to 4 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 4 from 9 a.m. to 1 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 7 from 11 a.m. to 6 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 8 from 11 a.m. to 6 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 9 from 11 a.m. to 6 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 10 from 9 a.m. to 4 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 14 from 11 a.m. to 6 p.m. at American Red Cross, 208 E. Eighth St.
Jan. 15 from 1 to 6 p.m. at Knights of Columbus, 1013 Washington, Ellis
Jan. 15 from 11 a.m. to 6 p.m. at American Red Cross, 208 E. Eighth St.
Norton County
Jan. 9 from noon to 6 p.m. at Norton County 4-H Building, 126 E. Park St., Norton
Thomas County
Jan. 7 from noon to 6 p.m. at Colby Community Building, 285 E. Fifth, Colby
Jan. 8 from 7:45 a.m. to 1:30 p.m. at Colby Community Building, 285 E. Fifth, Colb
Jan. 14 from noon to 6 p.m. at United Methodist Church, 500 Summit Ave., Wakeeney
WASHINGTON — The National Council on Disability today sent a letter to federal health officials urging them to postpone for a year consideration of a request by the administration of Gov. Sam Brownback to include long-term services for the developmentally disabled in KanCare.
The council, which held two days of hearings last week in Topeka as part of its ongoing study of the ramifications of Medicaid managed care, said Kansas officials need to collaborate more with developmentally disabled (DD) service providers and families before moving forward with their plans.
The council also cited concerns over delayed payments and other problems reported with KanCare and said the state should be obliged to eliminate its existing waiting list for services before being allowed to expand its relatively new managed care initiative.
“We think that concerns of the stakeholders and affected individuals and families are so significant that there should be a sufficient time period to review all the concerns that have been articulated,” said council member Gary Blumenthal, a former Kansas legislator now living in Massachusetts. “We recommend a 12-month evaluation.”
Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services. Photo by PHIL CAUTHON, KHI
The council is a federal agency that advises executive branch agencies and Congress on disability policies. But the agencies are not bound by the council’s recommendations.
Eyes on Kansas
It is somewhat unusual for the panel, which generally makes broad or more general policy recommendations, to issue recommendations specific to a state Medicaid plan, but council officials said the national significance of what is happening in Kansas warranted the letter because the Kansas plan could be taken as a model by other states and needs to be done correctly, if at all.
“In a lot of ways, policymakers throughout the rest of the country are looking at Kansas and seeing what happens in Kansas as a potential model,” said council member Ari Ne’eman of Silver Springs, Md. “So, we focused on Kansas but we did so because we want to make sure that if managed care is done, it’s done properly and if it’s not being done properly then it’s not done.
“We were very specific in our concerns and in our recommendations and that speaks to the fact that program design is really the key to everything when it comes to the difference between a managed care framework that leads to improved outcome or one that produces potential harm. That was why we felt the need to focus on Kansas.”
Ne’eman said other states have used managed care for disabled populations but that the Kansas plan was distinct because of its scope and because KanCare was being run by “commercial insurance companies” as opposed to non-profit agencies.
Ne’eman said one of the council’s chief concerns with the Kansas plan was that it extended managed care to disabled persons in home- or community-based settings but exempted those in the state institutions.
He said that might create incentives for the managed care companies to send people with more costly or serious disabilities to the state institutions to get them off their ledgers. A longstanding goal of the council has been to end reliance on institutions such as the state hospitals.
‘Distorted’
A ranking Kansas official said the council’s letter merely repeated “distorted” reports the council heard when it was in Kansas last week without hearing all the information the Brownback administration could have provided about its planning and implementation of the program.
“Secretary Sullivan does not believe that that (the council) received an accurate picture of the managed care expansion in Kansas during the part of one day it spent hearing from the stakeholders,” said Angela de Rocha, a KDADS spokesperson. “The proceedings were set up in such a way as to paint a distorted picture of the detailed planning and consultation that has gone into including LTSS (long-term support services) for individuals in KanCare with I/DD (intellectual or developmental disabilities). This letter (sent to CMS) presents the same sorts of distortions.
“During the first (council) panel discussion, Dr. Susan Mosier and Secretary Sullivan were given no more than 10 minutes to provide an overview of KanCare and of the inclusion of LTSS into KanCare,” de Rocha said. “This was not sufficient time for the state to describe the process it has used for design, planning, implementation and evaluation of KanCare over the last three years.”
But council officials said they have been collecting information on KanCare for more than a year and that the agency’s review of KanCare and subsequent letter to CMS followed managed care guidelines first published by the council in March.
“We don’t in any way mean to take lightly Secretary Sullivan,” said council member Blumenthal. “We think he’s done an admirable job trying to pull together something that would be challenging to anyone. But this has national significance and given its size and scope we believe it is something that does really merit a cautious review.”
The council has been collecting information about Medicaid managed care nationwide and has similar hearings planned for Chicago, New York City, Tallahassee, Fla. and San Francisco.
Council members said they see potential benefits in managed care for the disabled but that it would be best done adhering to the guidelines it published in March.
The Brownback administration has been planning for at least two years to include long-term DD services in KanCare beginning Jan. 1, 2014. But officials at the federal Centers for Medicare and Medicaid Services have not yet signaled their approval of the state’s plan, which is needed if it is to move forward.
Medical services for the developmentally disabled on Medicaid already are part of KanCare. The administration’s requested expansion of the program would fold in residential and other day-to-day living supports financed by Medicaid.
Decision coming ‘soon’
The state submitted its expansion request in the form of an amendment to the so-called Section 1115 waiver that authorized the state to launch the first phase of KanCare on Jan. 1 this year. Approval of that application by CMS didn’t come until Dec. 27, 2012, only days before Kansas undertook the major remake of it Medicaid program by shifting virtually all the state’s 380,000 program enrollees into health plans run by three private insurance companies: Amerigroup, UnitedHealthcare and Sunflower State Health Plan, a subsidiary of Centene.
Federal officials recently extended the public comment period on the state’s amendment request until midnight, Dec. 24 after learning that a website used to collect comments on the proposal was malfunctioning. The site since has been fixed. CMS officials said they are not obliged by policy or law to wait 15 days after the close of public comments to render a decision as was the case for the state’s initial 1115 waiver application. The wait period does not apply for application amendments, according to CMS spokesperson Emma Sandoe.
The agency did not immediately respond to a request for comment about the council’s letter it received.
Sandoe said the agency would decide “soon” on Kansas’ application but did not provide more specific detail.
Tom Laing, executive director of Interhab, an association that represents most of the state’s Community Developmental Disability Organizations, said he thought the council’s letter and hearings that preceded it were well done and that he agreed with most of the conclusions. Interhab has been at the forefront of efforts to bar or delay the Brownback administration’s efforts to include long-term DD services in KanCare.
“I would give satisfactory marks without hesitation to the state for their work over the last several months with our members,” Laing said.
“I think the horns of the dilemma is that the decision to do this was done far in advance of having these conversations. I think there was a decision early to throw the whole Medicaid ball of wax into KanCare and that this would somehow work out and that they (administration officials) had only slight understanding of some of the complications that might arise. I don’t fault them for the work they’ve done in the last several months but there’s a lot more work to do and they might have had a different decision, if they had engaged (stakeholders) more in the planning stages. I think there was an utter lack of dialogue then and now, in the implementation stages, there’s a lot of dialogue,” Laing said.
