State delays integration of Medicaid services

Cabinet leaders say they want to gather more input on waiver consolidation plan

By Andy Marso, October 06, 2015

State officials announced Tuesday they will delay for six months a plan to consolidate Medicaid support services for Kansans with various disabilities.

The leaders of the Kansas Department of Health and Environment and Kansas Department for Aging and Disability Services said they want to use the time to gather more information from people who would be affected by the changes.

“After discussions with consumers, providers and other stakeholders, we have decided to take additional time to incorporate stakeholder feedback,” KDADS Secretary Kari Bruffett said.

Advocates for Kansans with disabilities had expressed concern about the pace of the potentially momentous change. They cheered the decision Tuesday.

“The question I think in everyone’s mind has been, ‘Why the aggressive timeline?’” said Matt Fletcher, associate executive director of InterHab. “So this is a highly encouraging sign.” Fletcher’s group represents people who provide support services to Kansans with developmental disabilities.

They’re one of the several groups of Kansans who are eligible to receive home and community-based support services they otherwise would receive in nursing homes through Medicaid waiver programs.

There also are waivers for Kansans with physical disabilities, traumatic brain injuries, autism and other types of disabilities — seven in all.

State officials months ago announced their intention to combine the seven waivers into two sets of services: one for children and one for adults. They said their intent is to streamline the process and not restrict people to certain services based on a disability label.

The details of the integration plan were expected to be released Sept. 30, with a public comment period to follow. If approved by the federal Centers for Medicare and Medicaid Services, the plan was to go into effect July 1, 2016.

But the state was not ready to unveil the draft plan last week and now doesn’t plan to implement it until Jan. 1, 2017.

“The purpose of waiver integration — which includes broadening the array of services available to truly personalize care plans — has not changed, but we have extended the time period for accomplishing it,” Bruffett said Tuesday.

Ami Hyten, assistant director of the Topeka Independent Living Center, said the Kansans with physical disabilities her organization serves wanted more specifics about what their services would look like after integration.

“There’s just ongoing concerns that folks are having with potential service restrictions and reductions,” Hyten said. “That’s kind of the overarching concern — that people don’t want to have fewer choice available to them or more complicated processes for accessing the services they need to remain living in their own homes.”

She said a more measured approach by the state is “really the best option for all people involved.”

Susan Mosier, KDHE secretary, said the state wants Kansans with disabilities to be at ease before changes are made.

“We want to ensure that we have the details of how waiver integration will work firmly in place before we move ahead,” Mosier said. “We want our consumers to be confident that their concerns have been addressed."

Fletcher said service providers stand ready to help the state accomplish that goal.

“There are a large number of providers with a great deal of expertise in their respective fields who would willingly come to the table and help the state craft improvements to how persons with disabilities receive supports,” Fletcher said.

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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