House GOP leaders pen letter backing DD supports in KanCare

The top three House GOP leaders have penned a memo to fellow members of the chamber saying the trio supports including long-term supports for the developmentally disabled in KanCare.

Most providers of the DD services oppose the KanCare expansion and the House leaders rebuked them in the letter for “making every effort to undermine the state’s ability to improve services to our DD population and address the waiting list for DD services.”

The memo, signed by House Speaker Ray Merrick of Stilwell, Majority Leader Jene Vickrey of Louisburg and Speaker Pro Tem Peggy Mast of Emporia, was distributed to House members on Thursday, the day after Rep. John Rubin, a Shawnee Republican, announced during a House GOP caucus meeting that he was collecting signatures in support of extending the “carve-out” of the DD services from KanCare until Jan. 1, 2015.

Rubin said he collected 20 signatures from Republican members within a few minutes and that he expected most or all the chamber’s Democrat also would sign on. Rubin wasn’t immediately available for comment on Friday morning.

“Clearly, not everyone in the caucus agrees,” with the House leaders’ position, “and that is their prerogative,” said Rachel Whitten, a Merrick spokesperson. “However, leadership feels very strongly that the DD inclusion in KanCare will provide the best possible services for that community.”

Long-term supports for the developmentally disabled currently are scheduled to be rolled into KanCare beginning Jan. 1, 2014, ending a one-year moratorium on the inclusion written into the state budget by last year’s Legislature. Medical services for the developmentally disabled have been part of KanCare since the initiative was launched Jan. 1 this year by the administration of Gov. Sam Brownback.

“I thought the whole thing was an effort to stem the tide,” said Tom Laing, executive director of Interhab, commenting on the leaders’ memo. Interhab is the association that represents most of the state’s Community Developmental Disability Organizations.

Laing said the memo contained some inaccuracies. He disputed the assertion by the GOP leaders that DD providers had tried to stall a transition or “pilot” program preparing DD providers and the KanCare contractors for the inclusion of long-term supports.

“The Speaker was completely misinformed by somebody,” Laing said. “He wouldn’t have written that if he knew the facts. Our members have helped with the pilot and have worked on it for months.”

The memo also said the DD providers had opposed the 1995 law that shifted reliance on state institutions to community-based services. Laing said the reform law was passed with overwhelming support in the House and Senate with strong backing of advocates for community services.

The governor in a recent budget amendment proposed additional state spending to reduce the number of people on the waiting list for DD services. Members of the House Appropriations Committee subsequently endorsed the governor’s request but made it conditional on long-term DD supports being included in KanCare.

The House leaders in their memo cited Dr. Robert Moser, a physician and secretary of the Kansas Department of Health and Environment.

“Secretary Moser, MD of the Department of Health and environment has provided care to many DD clients through the years in his private medical practice. He feels strongly that long term supports cannot be provided outside of a system that makes one entity accountable for medical care, behavioral care and long term care. Inclusion is the most effective way to improve health outcomes and reduce hospitalization. There must be accountability throughout all facets of care,” the memo stated.

Rep. Arlen Siegfreid, an Olathe Republican, said he supported extending the carve-out but didn’t believe there would be enough votes in the House to do that. He said he was preparing an alternative budget proviso.

“I’m working on my own proviso for Appropriations and Ways and Means,” he said, “to make certain that the promises that have been made to these folks (the DD community) are kept. It would promise them that they get to keep their caregivers. It would promise them that they get to keep their case workers and it would promise them that they (the KanCare managed care companies) could not arbitrarily cut the amount of spending on their services.”

Brownback officials have offered those same assurances for months, saying the protections are written into the KanCare contracts and current state law. But they have not succeeded convincing critics of the initiative.