Kansas Gubernatorial Candidate Says He Would Revamp Parts Of Medicaid
Democratic gubernatorial candidate Paul Davis says if elected he will reverse Gov. Sam Brownback’s controversial decision to put the private companies managing the state’s Medicaid program in charge of delivering support services to Kansans with developmental disabilities.
Brownback, a conservative Republican seeking a second term, privatized the state’s $3 billion Medicaid program in 2013 and renamed it KanCare to achieve two – and some say conflicting – goals of improving care and reducing costs. But pushback from families and service providers forced the governor to delay the full inclusion of approximately 8,500 developmentally disabled Kansans in the privatized program. The managed care organizations have provided their medical care since KanCare’s launch, but not the support services they receive to help them live independently.
Davis, the Democratic candidate for Kansas governor, said last week that support services for developmentally disabled Kansans should not be part of KanCare.
That changed in February of this year when, despite continuing objections from families, the MCOs became responsible for providing all services.
“The result has been a disaster,” Davis said at a Statehouse news conference. “Governor Brownback was wrong to do this and as governor I will fix his mistake.”
Davis said “folks all across the state” are seeking him out to tell him about problems they’re having with the MCOs. He said the problems include cuts in services, lack of communication and increased administrative hurdles.
“KanCare has made these folks’ lives and the lives of their loved ones much more challenging,” he said.
Kari Bruffett, secretary of the Kansas Department of Aging and Disability Services and one of the architects of KanCare, sat in on Davis’ news conference and met with reporters afterward to rebut his charges.
“The idea that services are being roundly cut doesn’t make sense and it doesn’t align with the reality of how the program is administered,” Bruffett said.
Since the February transition, case managers representing individuals in the program have been working with representatives of the managed care companies to review each recipient’s care plan. The MCOs have been free to seek approval from KDADS to reduce services on a case-by-case basis since August. But Angela de Rocha, a spokesperson for the agency, said, “So far, we have received no requests to reduce services.”
When the care plans of Kansans with physical disabilities were reviewed during the first year of KanCare, most of the changes made were done to increase services, de Rocha said. In addition, she said, more services are being provided to approximately 800 developmentally disabled Kansans who had received only partial services prior to KanCare.
Still, Davis - who stumbled when attempting to answer some basic questions at the news conference about KanCare, such as how many developmentally disabled Kansans were enrolled - said privatizing the program that provides health care and support services to about 400,000 low-income, elderly and disabled Kansans had been a big mistake.
“It has become very clear that this program is in trouble,” he said, noting that almost two years after KanCare’s launch hospitals, doctors and other providers continue to complain about increased red tape and persistent problems obtaining timely payments from the MCOs.
Davis, who said he will conduct a top-to-bottom review of KanCare if elected, said he doesn’t object to the concept of managing the medical care provided to Medicaid recipients. But he said private companies with incentives to increase profits and reduce costs should not be in charge of determining how much support to provide disabled Kansans who want to remain in their homes.
Nonprofit service providers should once again be allowed to make determinations about those “very unique services,” Davis said.
Les Letulle, a retired social worker who once served on the board of a service provider, TARC of Topeka, said the transition to KanCare hasn’t interrupted the services that his developmentally disabled adult daughter receives. But he said he and other parents remain concerned that could change as pressure increases on the MCOs to make profits and reduce costs.
“Though everybody insists that won’t happen, when push comes to shove things start to happen,” Letulle said.
Letulle said he doesn’t see how the MCOs, which he views as an extra layer of bureaucracy, can improve care and reduce costs at the same time.
“It’s a hypothetical concept that people can say something about but which doesn’t have any real evidence behind it,” he said.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute.
