KanCare will address needs

A recently published letter (Feb. 18) titled "KanCare proposal raises concerns" was submitted by a local service provider with questions about the inclusion of Kansans with intellectual and developmental disabilities (I/DD) into KanCare the state's Medicaid reform plan. Kansans need to understand the challenges the state faces under the current system, why the governor tasked the lieutenant governor and our sub-cabinet working group to transform it and how the reform will improve the lives of thousands.

In Kansas, Medicaid serves as a safety net for 383,000 elderly, disabled and low-income families and children. Since 2000, the growth in spending for the Kansas Medicaid program has averaged 7.4 percent annually. If this spending growth is allowed to continue, Kansas will be forced to either cut spending on other state responsibilities like education and public safety or follow the lead of other states by cutting provider rates, restricting eligibility and reducing services. None of those are options for Gov. Brownback. When we set out to transform Medicaid, our vision was to serve Kansans with a transformed, fiscally sustainable program and provide high-quality, holistic care that promotes personal responsibility.

There are great opportunities for improvement with the physical health outcomes and mental health coordination for intellectually and developmentally disabled Kansans. Under KanCare, persons with I/DD will be able to access the system through their current providers and case managers, without cuts in services. The Feb. 18 letter questioned whether the long-term services and supports we have protected within KanCare will continue past the contract term or be just short-term. Many of the assurances within the KanCare system that protect the use of a person's case manager and provider are a result of the Developmentally Disabled Reform Act of 1995. We know of no intent within the Legislature to overturn this act, so these assurances should continue past the life of the KanCare contract term.

There was also a question about the timeline for implementation of KanCare. More than two-thirds of the 383,000 Kansans on Medicaid are already within a managed care system. As the remaining one-third are moved into a KanCare plan, there will be the phased-in implementation of enhanced care coordination through patient-centered health homes within the first two years of the system.

The letter questioned whether "it is a proper delegation of legislative and executive oversight that the I/DD community network, its families and individuals served be placed at a distant arm's length from both the administration and the Legislature, separated by an administrative wall of three separately empowered national for-profit companies?" We believe with state oversight, contractual protections and private-sector resources, all persons with I/DD will benefit from KanCare. There will be savings without sacrificing what works in the system today. The goal of KanCare is to reduce costs by improving quality of care and outcomes. KanCare reflects a commitment to members that they will not lose the services they need and will benefit through improved physical and mental health outcomes, enhanced coordination and care of the whole person.

ROBERT MOSER, M.D. and SHAWN SULLIVAN,

Topeka

Moser is Secretary of the Kansas Department of Health and Environment; Sullivan is Secretary of the Kansas Department on Aging.