By Dave Ranney
KHI News Service
TOPEKA, March 28
The Department of Social and Rehabilitation Services has released a copy of its contract with Kansas Health Solutions, the new managed care organization that”s scheduled to assume oversight of the state”s community mental health services on July 1.
The 155-page contract is available on
www.medicaidtraining.org
, a Web site SRS shares with Wichita State University. The contract is referred to as PAHP, a federal acronym for Pre-paid Ambulatory Health Plan.
SRS officials said the hope the contract will answer some of the questions raised by providers about the department”s switch to managed care.
“A lot of what people want to know is in the contract and the contract is right there on the Web site,” said Ray Dalton, Deputy Secretary of Health Policy at SRS.
Dalton and Kansas Health Solutions” interim CEO, Mike Hammond, responded to service providers” questions Wednesday during a Kansas Mental Health Coalition-sponsored forum at the Topeka and Shawnee County Public Library.
Hammond and Dalton also handed out their
answers to questions
submitted earlier by coalition members.
SRS entered a contract with Kansas Health Solutions earlier this year after a series of federal audits called for changes in how the state uses Medicaid to pay for mental-health and foster-care services.
Kansas Health Solutions is a nonprofit company started by
but separate from
the Association of Community Mental Health Centers of Kansas.
Dalton said the switch to managed care will allow people on Medicaid to receive services through private providers. Currently, these services are controlled by community mental health centers.
To see Medicaid patients, private providers will need to enter associate agreements with Kansas Health Solutions.
Under managed care, patients who happen to have had a bad experience at one mental health center could switch to another. Someone dissatisfied in Topeka, for example, could be seen at Lawrence”s Bert Nash Community Mental Health Center.
Patients also will have the option of dropping their local community mental health center in favor of a private provider as long as the private provider has entered an agreement with Kansas Health Solutions.
Community mental health centers still will be charged with providing support and case management services.
“People are going to have access to a wider array of providers,” Dalton said.
Other points of interest:
*
Peer-support services will be eligible for Medicaid funding.
*
Everyone on Medicaid will be sent a packet with information on how the new system will work. Kansas Health Solutions will have a Web site and toll-free number for answering questions.
*
Kansas Health Solutions will ensure round-the-clock access to services.
*
Depending on the severity of their diagnoses, some patients may find themselves with two case managers
one for coordinating services in the community, the other for coordinating clinical services. “This is a federal requirement, but let me see what we can do” Dalton said, responding to concerns that case-manager miscommunication is sure to cause problems.
*
Service providers” bills will no longer be paid by EDS, a private contractor under the current system. Instead, they will bill Kansas Health Solutions. “What”s going to happen when we don”t get paid for six or seven or eight months? That”s what always happens when there”s a change like this,” said Barb Andres, executive director at Breakthrough Club, a street-level program for the mentally ill in Wichita. “We don”t anticipate that happening,” Dalton said, causing the audience to chuckle in disbelief.
Hammond said Kansas Health Solution will begin testing its bill-paying software May 1.
In recent months, advocates for the mentally ill have openly questioned Kansas Health Solutions” ability to be up and running by July 1.
Hammond replied: “There will be hiccups, I”m certain.”
But Kansas Health Solutions” commitment to addressing the new system”s pitfalls, he said, is just as certain.
Dalton added: “There will be lots of opportunities to fix things as we go along.”
Hammond said Kansas Health Solutions is in the process of filling about 30 staff positions. The company, he said, has leased office space in Jayhawk Towers in downtown Topeka. It”s also interviewing CEO candidates.
Hammond said he”s anxious to get back to being executive director at the Association of Community Mental Health Centers of Kansas.
Hammond and Dalton”s assurances struck a chord with many of the providers in the room. “I”m hopeful
I”m cautious, but I”m hopeful,” said Shelly Duncan, executive director at United Methodist Youthville, a foster-care contractor for the state. “I like the idea that people will have more choice.”
Susan Crain Lewis, president and CEO of the Mental Health Association of the Heartland in Kansas City, Kan., called the initiative a “first step, a very small first step. There”s still a long way to go.”
-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
dranney@khi.org
or at 785-233-5443, ext. 128.