By Megan Hart, August 05, 2016
For the first time in years, Kansas doesn’t have anyone with physical disabilities on the waiting list to receive home-based Medicaid services, state officials said.
The Kansas Department for Aging and Disability Services reported Friday that the 438 people on the physical disability waiver list had been cleared to receive home and community-based services.
The waivers provide Medicaid coverage for home and community-based support services that allow Kansans with disabilities to remain at home rather than in institutions. The services are split into seven groups based on type of disability: developmental, physical, frail elderly, autism, traumatic brain injury, technology assisted and serious emotional disturbance.
Waiting lists for services for Kansans with physical disabilities and developmental disabilities have existed for years.
During this week’s meeting of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare, KDADS Acting Secretary Tim Keck told legislators that the agency had extended offers to everyone who was on the physical disabilities waiting list in late July. Not all of them may have received services yet.
“That is not to say that more people will not go on the waiting list in coming days. Individuals apply every week,” he said. “But we have now provided an offer of services to all the individuals who qualified.”
As of mid-December 2015, 1,319 people with physical disabilities and 3,455 people with developmental disabilities still were on the waiting list for home and community-based services.
It wasn’t how many of the 881 people removed from the physical disabilities list between the end of 2015 and mid-July received services or were dropped for other reasons. Angela de Rocha, KDADS spokeswoman, said she wasn’t sure how many of those people were receiving services but said everyone would have been offered them.
The waiting list for people with developmental disabilities had 3,837 on it as of mid-July.
Advocates for Kansans with disabilities have expressed concerns as the number of people enrolled in Medicaid and receiving services dropped in recent years.
Mike Randol with the Kansas Department of Health and Environment
(Photo by Stephen Koranda/Kansas Public Radio)
The committee also heard that two of the three managed care organizations that operate KanCare, the state’s privatized Medicaid program, made a profit in 2015.
According to a report presented Friday, UnitedHealthcare made $44 million, Amerigroup made $31 million and Sunflower Health Plan lost $16 million last year.
The three managed care organizations, or MCOs, all reported losses in 2013, the first year of KanCare. Reports didn’t specify how much each lost, but pegged the total at $110 million. They also reported losses in 2014.
Rep. Jim Ward, a Wichita Democrat, questioned whether the MCO profits had come at the cost of services and a backlog of Medicaid applications.
“You’ve heard for two days the problems that are going on within the system, all dealing with not getting services, not becoming eligible, all of which affects the bottom line,” Ward said.
Mike Randol of the Kansas Department of Health and Environment said there was no connection between the Medicaid application backlog and the MCO profits
“They were making money prior to that,” he said. “There’s no sinister attempt by anyone at any agency that I’m aware of.”
Tim Spilker, CEO of UnitedHealthcare Community Plan, said the company was providing all required services and paying for some that weren’t required but would help clients gain independence.
“We’ve paid for first month’s rent, security deposits,” he said.
A representative from Sunflower pointed to its efforts to connect young people who have developmental disabilities with employment opportunities and to improve care coordination. Amerigroup introduced Elizabeth Flora-Swick, a graduate student who received help from the company to continue receiving support services when she went to college out of state.
“As a young person navigating through college, I’m just incredibly thankful that Amerigroup stepped in when they did,” she said.
Others told a different story about the KanCare system.
Rachel Monger, director of government affairs for LeadingAge Kansas, told the committee that four nursing homes her group represents had closed due to Medicaid rate cuts and other issues. Two others sold their facilities to for-profit nursing home chains.
“Nursing homes are faltering, especially in rural areas where their services are most needed,” she said.
Jane Kelly, executive director of the Kansas Home Care Association, said some of her group’s members have noted continuing difficulties with getting authorization for services and receiving payments after providing services. She said members are frustrated, and the problems have led some hospitals and health departments to stop offering home-based services.
“Many of our members have given up complaining to us,” she said. — Stephen Koranda of Kansas Public Radio contributed to this story.
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