Most vulnerable in Kansas at risk of losing quality care

JOHNSON COUNTY, Kan. - The deadline is quickly approaching to move the most vulnerable people in Kansas under KanCare, the state managed Medicaid program. On Jan.1, 2014, 8,600 people with intellectual and developmental disabilities will receive long term service under KanCare.

However, mom and pop service providers currently providing care for people with intellectual and developmental disabilities say KanCare is not ready to handle 8,600 more people in the system. They claim there are mounting billing issues with KanCare that compromise their ability to provide quality care to the people who need it the most.

Marilyn Kubler and her husband run Jenian, Inc., a case management company that manages 130 people in Johnson County who need help taking care of themselves, including her 34-year-old daughter Jenny who has Down syndrome.

"I have a passion for people that have disabilities and I know I have the ability to find services to help them but if we can't get paid for those services, I can't afford to continue to help people," Kubler said.

The State of Kansas has always paid service providers to help people like Jenny live independently.  Now, under KanCare, Kubler and other service providers are experiencing major cash-flow issues. Kubler said they are not getting reimbursed for their claims in a timely manner.

"What frightens us is come January when the rest of our 130 people go into KanCare, we're not going to get paid for our services," she said. 

Dynel Wood, another service provider in Johnson County who runs Options Services in Olathe, Kan., mentioned similar issues.

"Before, the system was great. We billed the state, two weeks later we received our payment. It was very smooth," Wood said.

Now, Wood said it takes months to get paid back. She said at one point she was short nearly $40,000 waiting for her claims to be approved.

For small service providers with small budgets, there could be painful consequences.

"Nobody has addressed the fact that come January, and the payments aren't coming in, how many people are going to stay in business and how many people are going to keep their staff," Kubler said.

"If we can't pay our employees, they're not going to come back and work for free. They may for a little while but they're going to move on," Wood said. 

Both Wood and Kubler said there is also a steep learning curve with the new system and small service providers haven't been brought up to speed with KanCare terminology and processes.

"I know everybody wants to make this work but it's moving way too fast. They need to slow it down. They need to give us time to work collaboratively to make sure the transition is successful," Wood said.

Angela de Rocha, a spokesperson for the Kansas State Department of Health said the state has responded to providers who have experience problems with billing.

"This is an ongoing effort. Our staff and the MCOs have been working very hard to ensure the system works for both the consumers who receive the care, and their providers," she wrote in a statement.

Meanwhile, the National Council on Disability said this is one of the reasons KanCare isn't ready to expand. In a letter to the state on Dec. 13, 2013, the agency said the state needs a year to try to work out the kinks.

The State of Kansas disagreed with the agency's evaluation saying it needed more time in recent state hearings to provide their assessment of the implementation of KanCare.

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