As the Kansas legislative session draws to a close, local advocates for the developmentally disabled are anxiously awaiting the final outcome of the budget debate.

As the Kansas legislative session draws to a close, local advocates for the developmentally disabled are anxiously awaiting the final outcome of the budget debate.

Home-based services are scheduled to be moved to the new managed-care system called KanCare at the beginning of the 2014.

However, local advocates for the disabled are hoping a proviso will be added to the final budget bill to carve the services out for at least another year.

As of Jan. 1 of this year, all medical services provided by Medicaid came under the auspice of KanCare.

Gov. Sam Brownback pushed for the change, promising placing the Medicaid under the control of three private managed-care insurance companies would result in increased efficiencies and decreased cost to the state. He also assured the public this could be achieved without cutting services to the poor and disabled.

Local disabled advocates argue there is no way for-profit insurance companies can make money operating the KanCare system, reduce costs to the state and preserve services for the most vulnerable Kansans.

“I was no math major,” said Jon Zehnder, director of operations for Disability Supports in McPherson, “but that does not add up.”

Current KanCare issues

Residential services that are paid for under the Medicaid Intermediate Care Facility program already have come under the KanCare system.

Doug Wisby, president of the developmentally disabled service provider MCDS of McPherson, said MCDS’ residential services has received late and partial payments from the state. In terms of medical coverage under KanCare, families are finding it difficult to remain with their current providers under the new system. For example, there is no KanCare-affiliated dentist in the city of McPherson, he said.

Many of the MCDS’ clients have complex medical issues, and Wisby said parents and guardians believe keeping doctor’s their loved ones have had for years is important. Wisby said families also have had difficulties getting medical cards for their loved ones under the new system.

‘The grand experiment’

These issues with the current KanCare system has providers and families concerned about what moving home-based services to the system will mean.

Zehnder said these insurance companies have no experience handling services such as day services, employment programs and transportation.

“None of theses organizations — that is these three for-profit insurance companies — have experience with long-term care of people with developmental disabilities. That is what makes this a fairly grand experiment with people who are pretty vulnerable,” he said.

Home-based services are covered by state and federal funding. The 1995 Developmental Disability Reform Act moved most developmental or intellectually disabled Kansans out of institutions into community settings.

To provide services for these individuals, local service providers contracted through local organizations called Community Developmental Disability Organizations for funding.


The KanCare system adds a new layer of bureaucracy to the system, Zehnder said. Instead of having one contract with the CDDO, the providers have to have three. This will mean  more paperwork for providers and additional staff hours. Some small providers have chosen to close, Zehnder said.

“If there are additional expenses without additional funding coming through, there could be a reduction in services,” Zehnder said. “We do not plan to do that, but there is only so much money to be paid out for services.”

Because of late and partial payments from the KanCare system, one provider Zehnder said he was acquainted with in the state had to borrow several hundred thousand dollars to make payroll.

The state was supposed to launch a pilot program to see how well administering community-based services under the KanCare system would work. The pilot has yet to get off the ground.

“We are half way through the year without any good indication of how it would go,” Zehnder said.

Family concern

Bob Harper, chairman of the board for Disability Supports, feels the frustration of the debates in Topeka first hand. His 33-year-old daughter has a developmental disability. She has the intellectual capacity of a 2- or 3-year-old and will never be self sufficient. She receives day and residential services.

“My daughter has been with Disability Supports since about 2000, and now an out-of-state company wants to come in and say she doesn’t need those services any more. Her condition hasn’t changed. I want to know how they will make that determination,” Harper said.

Harper said he fears Brownback’s efforts are just the beginning of loss services and rights for the disabled.

“I can’t fault Brownback for trying to save money, but he is doing it at the expense of the most vulnerable members of society. It just isn’t right.”

Down to the wire

All the advocates the Sentinel spoke to said they were still hopeful for the approval of the budget proviso.

Wisby said with the majority of the debate focused on sales taxes, he hoped the proviso is not forgotten.

“We are ever hopeful,” Wisby said. “We have been down to the statehouse, and our local legislators have been supportive. We hope we get the proviso. We just don’t think (KanCare) is a good fit for long-term support (of the developmentally disabled).”

The Legislature’s annual session was in its 98th day as of Friday. The state constitution specifies 90-day sessions, but Republican leaders had promised lawmakers would meet just 80 days.