The head of an advocacy group for Kansas providers of disability support services said this week that the Brownback administration is trying to combine Medicaid waivers through a state contract after the Legislature blocked the administration from doing it by statute.
Tim Wood, executive director of Topeka-based Interhab, said the request for bids released Feb. 22 would lead to a major change for Kansans with disabilities and was done quietly without their input.
“I think everybody’s on board to improve the (disability waiver) system … but this is no way to develop good public policy,” Wood said.
Angela de Rocha, a spokeswoman for the Kansas Department for Aging and Disability Services, said the contract the state is looking to sign does not amount to waiver integration.
The waivers in question are for daily living support services that people with disabilities can receive through Medicaid in addition to medical care. The idea is to allow people with disabilities to get any services they would get in an institution — like bathing, cooking and dressing — in their homes or communities instead so they can live more independently.
Kansas has seven waivers split by type of disability: childhood autism, frail/elderly, intellectual and developmental disability (I/DD), physical disability, serious emotional disturbance (SED), technology assisted (TA) and traumatic brain injury (TBI).
The Brownback administration proposed combining them in 2015, with officials saying it would make the process of evaluating people for services more efficient and easier to navigate. But the administration suspended the initiative amid opposition from disability groups, and legislators passed a budget proviso barring any spending on it.
Kansans with disabilities in each waiver group currently have different points of contact that assess their eligibility and coordinate services locally:
- The 11 Aging and Disability Resource Centers scattered throughout the state run the frail/elderly, TBI and physical disability waivers.
- The 26 community mental health centers handle the emotional disturbance waiver.
- The 27 community developmental disability organizations handle the I/DD waiver.
- Medical diagnosis determines eligibility for the autism and technology-assisted waivers, which have fewer participants.
In the request for bids, the state said it is looking for a bidder who can do the work of the current Aging and Disability Resource Centers, or ADRCs, but will give preference to contractors that can “demonstrate an ability to expand the service population and provide outreach for IDD Program, SED Program, Autism Program, and TA Program.”
De Rocha said that did not mean waiver integration.
“It extends the current contract we have until we can get the new contract in place, and we’re going to be contracting with the ADRCs to do more of the assessments,” de Rocha said.
The request for bids also calls for the 11 Aging and Disability Resource Centers to be combined into four large “catchment areas” — but with multiple locations within each one.
“ADRCs must have a physical location within the region and provide comprehensive call and walk-in centers capable of covering the entire regional area and must be accessible to all individuals to complete all functions of the ADRC,” the contract states. “The location may include a main location, any branch, or satellite locations that are clearly identifiable, and are required to be available by public transportation, provide adequate parking, and possess the capacity to serve individuals with disabilities.”
The changes wouldn’t go into effect until March 31, 2018, under an amendment the state filed March 1.
But Wood said he believes the contract may violate the budget proviso barring spending on waiver integration and could be a “major disruption” for disabled Kansans.
He said he has shared his concerns with state officials, including KDADS Secretary Tim Keck, but has not liked the response.
“There doesn’t seem to be any intention of slowing this down,” Wood said.
Wood said Interhab’s next step is to send letters to all 165 legislators, asking them to intervene.
Andy Marso is a reporter for the Kansas News Service, a collaboration of KCUR, Kansas Public Radio and KMUW covering health, education and politics in Kansas. You can reach him on Twitter @andymarso. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to kcur.org.