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Kan. gov.'s Medicaid overhaul still contested

Published on -4/25/2012, 4:54 PM

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TOPEKA, Kan. (AP) -- A Republican leader and frequent ally Gov. Sam Brownback said Wednesday that he'll try to delay part of the GOP governor's plan to overhaul the state's Medicaid program, and several hundred people rallied at the Statehouse to protest changes for the developmentally disabled.

House Majority Leader Arlen Siegfreid confirmed he is drafting a proposal to exclude long-term services for the developmentally disabled for a year from Medicaid contracts Brownback's administration plans to issue this summer. The contracts will turn the $2.9 billion-a-year program over to three private, managed-care companies, starting Jan. 1, 2013.

Siegfreid, an Olathe Republican, said he'll offer his proposal this week as an amendment to the state budget. It will allow pilot projects to test whether a managed-care program can deliver long-term services to the developmentally disabled. Advocates for the disabled have been the most vocal critics of Brownback's efforts to overhaul Medicaid, which covers medical services to the poor, needy and disabled.

Most of the 387,000 Kansans receiving state medical assistance are covered by managed care though private contractors, but the Medicaid overhaul is the first time the state has tried to include relatively expensive, long-term care for the disabled and the elderly, including those in nursing homes. Under Siegfreid's plan, the state would "carve out" long-term services for the developmentally disabled until 2014.

"It will give us another year to look at it, to see if it works," Siegfreid said.

Brownback's office did not immediately respond to Siegfreid's proposal, but it has said the overhauled Medicaid program -- to be called KanCare -- will better coordinate care for participants, improving their long-term health. The administration also has said the overhaul will reduce the state's costs and savings are crucial because the federal government, facing its own budget problems, is likely to cut its Medicaid funding.

Some members of the Republican-controlled Legislature agree, particularly Brownback's fellow GOP conservatives, and they've blocked efforts to tinker with the overhaul.

Participants in Wednesday's rally left personal items on the Statehouse's south steps in a temporary display to urge Brownback to change his plans and persuade legislators to intervene.

The administration has said repeatedly that the Medicaid contracts will require the companies to work through existing providers of services for the developmentally disabled and won't allow the contractors to cut payments to those service providers.

But critics worry such assurances won't hold in the future. They also argue that Kansas already has a good system for the developmentally disabled, in which 27 regional groups have contracts with the state to serve as its gatekeepers, determining who qualifies for services. They also note that developmentally disabled Kansans often receive services that don't resolve medical issues but help them live as independently as possible.

Jerry Michaud, president and chief executive officer of Developmental Services of Northwest Kansas, one of the regional gatekeepers based in Hays, said Brownback's overhaul would add "an unnecessary level of complexity."

"This is not a forte for managed-care companies," he said. "I can understand the administration's desire to have everything in one pot, but it is different."

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Online:

Kansas Legislature: http://www.kslegislature.org

Kansas governor: https://governor.ks.gov/

John Hanna can be reached at www.twitter.com/apjdhanna

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