Heartland Health Monitor
9:48 am
Mon April 28, 2014

Brownback Makes Move To Deliver On Promise To Reduce Disability Waiting Lists

Nancy Swogar is one of about 230 people served by Johnson County Developmental Supports.
Nancy Swogar is one of about 230 people served by Johnson County Developmental Supports.
Credit Mike Shields / Kansas Health News

Gov. Sam Brownback said Friday he will ask the Kansas Legislature to approve spending an additional $2.6 million in state funds to help reduce the waiting lists for in-home, Medicaid services for the disabled.

If approved, an estimated 209 additional people would receive the services.

There are about 5,000 people on the waiting lists; more than 3,100 are developmentally disabled. About 1,800 physically disabled people also await services, though administration officials said they were still in the process of verifying the accuracy of that number.

If the governor’s funding request is approved by lawmakers, 77 of the 209 beneficiaries would come off the developmental disability waiting list and 132 from the physical disability list, according to Brownback officials.

The Kansas Department for Aging and Disability Services reported there were 8,759 developmentally disabled Kansans and 5,467 physically disabled people receiving in-home services as of April 15.

“Reducing the disability waiting lists has been a priority of this administration for the past three years,” Brownback said during a press conference at Johnson County Developmental Supports to announce his budget amendment. Johnson County Developmental Supports is a county agency that assists the developmentally disabled with job support and other services.

The reaction to Brownback's announcement from advocates for the disabled was mixed.

“For the 77 (developmental disability) families, it’s very good news, absolutely,” said Tom Laing, executive director of Interhab, the association that represents most of the state’s Community Developmental Disability Organizations or CDDOs. “But as regards the system as a whole, it’s really nothing more than a baby step when you compare 77 people to a 3,000-person waiting list and then look beyond that to the system needs.

“They (the Brownback administration) haven’t put a single penny in the (Medicaid) reimbursement rate to adjust to the new costs during his tenure,” Laing said.

The CDDOs are experiencing new administrative complexities and costs since long-term services for the developmentally disabled were included in KanCare earlier this year, he said.

But Brownback officials said they were fulfilling their promise to put a portion of savings from KanCare into reducing the waiting lists.

KDADS Secretary Shawn Sullivan chats with Finn Bullers, right, a persistent critic of Brownback administration policies and KanCare in particular.
KDADS Secretary Shawn Sullivan chats with Finn Bullers, right, a persistent critic of Brownback administration policies and KanCare in particular.
Credit Mike Shields / Kansas Health News

They said counting federal matching funds, the administration has already put $43.4 million into reducing the wait lists since fiscal 2013. The state portion of that spending was $18.7 million.

And Brownback officials said they are seeing early benefits from KanCare, which was launched Jan. 1, 2013, citing reduced emergency room visits by Medicaid beneficiaries who receive so-called Home and Community-Based Services, or HCBS.

Lt. Gov. Jeff Colyer displayed a poster-size chart showing that emergency room visits among HCBS recipients had dropped more than 27 percent in the first year of KanCare. The most significant drop was among those with physical disabilities, according to the chart.

“The good news is that there are dividends from KanCare,” Colyer said. “We inherited a multi-year list and we’re eliminating one of the waiting lists and we’ve made significant reductions (in the others) in the past 18 months.”

The administration announced earlier this year that it was ending the so-called “underserved list” of developmentally disabled people who were receiving some but not all the services they were determined to need. Federal officials made elimination of that list through full provision of services a requirement before approving Kansas’ request to include long-term DD services in KanCare, the Brownback initiative that moved virtually all the state's Medicaid enrollees into health plans run by three for-profit insurance companies.

There were about 1,700 developmentally disabled Kansans on the “underserved” list, which is in the process of being whittled away as individuals are being reassessed to determine what services they still need and want.

“Generally speaking, this is a good development. More people off the waiting list,” said Tim Wood, manager of the End the Wait Campaign at the Kansas Disability Rights Center, reacting to the governor's announcement. “It’s good news. Obviously, we’d like to see more. One thing that doesn’t get talked about: There’s no long-term strategic plan. What are we going to do long term to be sure we can deal with the shifting demographics and growing needs of these folks?”

The governor said he also will ask the Legislature for $500,000 to "beef up" substance use disorder treatment for the uninsured. If approved, officials said that would fund 81 inpatient beds. He also will ask for $500,000 to expand state hospital and corrections system mental health diversion programs to strengthen crisis services, law enforcement training and prevention programs.

Mike Shields is a reporter with KHI News Service, an editorially independent reporting program of the Kansas Health Institute.