By Gabriella Dunn, August 05, 2016
Disabled Kansans, their family members and health care providers have been complaining about disability services since Kansas privatized the Medicaid system in 2013. Medicaid, called KanCare in Kansas, is the health insurance program for people with low incomes or who are disabled.
On Friday, lawmakers offered blistering questions and comments to officials from the two state agencies in charge of the Medicaid disability system.
“Do you hear what these people are saying? Do you have any empathy?” Sen. Laura Kelly, D-Topeka, asked officials from the Kansas Department of Health and Environment and Kansas Department for Aging and Disability Services.
Her comments encapsulated growing frustration among lawmakers on the state’s KanCare Oversight Committee. Bi-partisan discontent with the state’s Medicaid system culminated in a two-day meeting Thursday and Friday that included a tour of the state’s Medicaid clearinghouse, where thousands of applications for health insurance have been backlogged over the past year.
Much of Friday’s contention between the committee and state officials centered on the agencies’ efforts to overhaul the way Kansans with disabilities receive state services.
"“Being a person who has seen what has happened in the communities that cannot protect themselves, it’s up to us to do that," said Rep. Willie Dove, R-Bonner Springs. "I’m very upset with what’s going on. We will fight that tooth and nail, because it doesn’t appear to be something that’s going to help our constituents."
Rep. Dan Hawkins, R-Wichita, chairman of the KanCare Oversight Committee, said the people who would be affected by this change are "fearful."
"People are scared that implementation will just be botched," Hawkins said. "People become very cynical of our system and what the government is doing with our health care system. Naturally you’re going to see a pretty good amount of push-back."
"It wouldn’t surprise me if you see something from the Legislature saying don’t go forward," he told the two agencies.
The proposed changes would affect thousands of people who are developmentally or intellectually disabled, are elderly and frail, have a traumatic brain injury, are physically disabled, have a serious emotional disturbance or who need long-term medical care.
People who would qualify to live in an institution instead receive home- and community-based care through what’s called a Medicaid waiver. The waiver provides additional services usually not allowed by Medicaid, a state and federal health care program for people with low income or who have a disability.
The waivers cover services such as 24-hour intensive care, help with daily living, educational assistance, work assistance and medical care.
The state agencies say they want to change the way services are offered and waivers are granted, and that the change will allow it to serve more people without spending any more money.
But some disability advocates question whether that’s possible. And some suspect this is a way for the state to cut corners on cost and lessen the number of services people receive.
The Medicaid system has been riddled with problems recently. More than 3,000 disabled Kansans are on waiting lists for services, and the state says a seven-year wait is typical.
The state also has a backlog of applications for Medicaid that started mounting a year ago when the state switched the computer system used to process the applications. The committee was told on Thursday that nearly 4,000 Kansans have been waiting more than 45 days for their applications to be processed. In mid-May that number was above 10,000.
Given the backlog on Medicaid applications, some legislators don’t want the agencies to change the disability waiver system.
"You should not be expending resources on this and putting people through another change," Kelly said.
"The sin that’s being committed here is you are ignoring, or certainly distracting, resources from solving problems in the system you’re responsible for, so you can go forward with something you want to do – something we don’t want you to do," she continued.
Rep. Jim Ward, D-Wichita, emphasized that there was widespread consensus among lawmakers on the oversight committee to halt the changes.
"You don’t care what we say, you’re going to do what you’re going to do, and the Legislature be damned," Ward told agency officials.
The conversation arose after a morning of testimonies from disgruntled KanCare recipients and providers.
"We’ve been listening this morning for two hours to significant problems in KanCare," Ward said. "We’ve been getting emails about significant problems. The backlog is simply unacceptable."
"That’s the frustration you’re hearing in all of our voices today."
Michael Randol, director of the Kansas Division of Health Care Finance for the state health department, said he and the agency plans to present a plan for the change to the disability waivers to the Legislature in the upcoming session.
"I still think it’s the right thing to do," he said.
The Legislature passed in the previous session attempting to halt the agency’s work on the issue.
"It was already a done deal," Kelly said. "There wasn’t any real listening going on."
"You guys have already decided what you’re going to do with this."