Disability advocates seek another delay on Medicaid waiver integration

By Andy Marso, March 02, 2016

Kerry Cosgrove, flanked by a roomful of disability advocactes, gives testimony ot the subcommittee meeting.

Kerry Cosgrove was one of several advocates who spoke during a
Wednesday hearing at the Statehouse on a Medicaid waiver
integration proposal. Cosgrove and others who represent
disability advocacy groups say the state should slow the process
and provide more information about the plan.
(Photo by Andy Marso/KHI News Service)

A dozen disability advocacy groups lined up Wednesday to voice their concerns about a Medicaid waiver integration proposal during a two-hour hearing before a special legislative subcommittee.

Four members of the House Health and Human Services Committee heard from people representing Kansans with an array of disabilities, all of whom want the state to slow the integration process and provide more information about the plan.

“It’s just ridiculous that we have no details and they’re expecting this to be implemented Jan. 1,” said Kerry Cosgrove, a case manager and mother of an adult who receives developmental disability services.

The waivers allow Kansans with disabilities to receive support services in their homes and communities rather than institutions.

Kansas currently has specialized waivers for categories including physical disability, developmental disability, frail/elderly, autism and traumatic brain injury. State officials have proposed reducing that to two age-based categories.

The plan was first postponed in October to seek more input from the disability community. But Tim Keck, interim secretary of the Kansas Department for Aging and Disability Services, has said the state plans to follow through on it.

A bill promoted by Rep. Jim Ward, a Democrat from Wichita, would require the Legislature to approve waiver integration plans before they could be implemented.

Wednesday’s subcommittee hearing did not deal with that bill specifically but provided an open forum for groups to air their integration concerns. State officials will have the chance to rebut those concerns next week.

Most who spoke Wednesday said they thought the state had been stingy with details — even to those on designated workgroups — about how the integrated waivers would work.

Janis DeBoer, executive director of the Kansas Area Agencies on Aging Association, said the current waiver for frail and elderly Kansans works well for that population and she saw no benefit for older Kansans in waiver integration.

Her organization worries that combining the waiver with others that have long waiting lists may create more delays for seniors seeking services to help them return home, rather than go to a nursing facility, after an injury.

“We can’t figure out how seniors are not going to get lost in the shuffle,” DeBoer said.

Mike Oxford, director of a Topeka nonprofit that helps Kansans with physical disabilities live independently, said he could see the possible benefits of integration.

Oxford said he’s long questioned the wisdom of separating Kansans by disability labels rather than actual need.

“Based on that, I support this,” he said. “But it’s going way too fast.”

Oxford said his organization’s clients are still adjusting to the state’s switch to managed care Medicaid, called KanCare, and changes to federal labor law that affected caregivers.

“I think a lot of us have change fatigue,” he said.

Ward is on the subcommittee with three Republicans: Rep. Jim Kelly, Rep. Les Osterman and the chairman, Rep. Willie Dove.

Kelly asked several speakers how much more time the state should provide before implementing waiver integration.

Some of them suggested the implementation date be moved to July 1, 2017. Tom Laing, executive director of a Topeka organization that represents developmental disability service providers, said no arbitrary deadline should be set.

Instead, Laing argued, the waivers should not be integrated until a detailed plan has been developed and scrutinized and Kansans with disabilities are comfortable with it.

“It’s a theoretical discussion to us,” he said. “But if we’re receiving services, it’s our life. It’s our daily life.”

The nonprofit KHI News Service is an editorially independent initiative of the Kansas Health Institute and a partner in the Heartland Health Monitor reporting collaboration. All stories and photos may be republished at no cost with proper attribution and a link back to KHI.org when a story is reposted online.

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