Education of issues important for DSNWK officials


Efforts to educate Kansas residents about potential concerns about applying a managed care model to long-term care for those with developmental disabilities has been a priority for Developmental Services of Northwest Kansas President Jerry Michaud.

One concern Michaud has is nationally no other state has implemented a program with the same parameters as KanCare.

"When you look at the experience of some of the other states who have gone into this, I think only four states in the union have adopted a managed care model that incorporated long-term care for developmentally disabled folks," he said. "And the models they operate are very different."

In addition, through multiple conversations with representatives of managed care companies, he has found they, themselves, question their organizations' abilities to handle services for the developmentally disabled.

Although he said he believes Gov. Sam Brownback's proposed changes are well-intentioned, he is unsure how they could be implemented without negatively affecting the clients of DSNWK, and how those changes could bring about a cost savings.

Under KanCare, DSNWK would contract with three different managed care companies, with a potential for three different sets of rules, policies and expectations. Therefore, in one group home setting of six individuals, Michaud said he can envision the possibility of three different sets of expectations and billing processes.

"How on earth could that work?" he said. "It just went to a level of complexity that took us to a crazy state, and why would we do that?"

In addition, the managed care companies work as for-profit businesses. Michaud estimated with a 3-percent profit margin and 7-percent administration fee, at least 10 percent of the state's resources will be reallocated away from services.

With a budget that has seen significant cuts during the last few years, which has led to closing a development center, closing group living settings and trimming staff, Michaud said his organization might be nearing the point of diminishing returns.

His concerns focus not just on the clients served, but those doing the serving.

"Our turnover rate is 50 percent," he said. "We try to do right by our staff, but a single parent raising a family, on our wages ... they're on the poverty line.

"It's a matter of justice and doing the right thing."