By Dave Ranney
KHI News Service
TOPEKA, Nov. 29
Florence Crittenton Services doesn”t have a ton of money.
“We have about $200,000 in the bank,” said Karen Wakefield, who runs the Topeka-based residential program for 24 teenage girls who are either in foster care or crosswise with the law.
That”s not enough to keep the place going for three months.
So when Wakefield learned that changes in the way Medicaid pays for Crittenton”s services won”t kick in until April instead of the anticipated Jan.1
she knew she was in trouble.
“That”s going to mean some serious cash-flow problems for us,” Wakefield said.
Earlier this month, Crittenton hired the nurses and administrative staff it needed to be in compliance with the new certification standards.
“For us, that”s $80,000 in additional (annual) cost,” Wakefield said.
Earlier, Kansas Department of Social and Rehabilitation Services officials told Wakefield to expect Medicaid to begin picking up the additional costs on Jan. 1.
But Nov. 8, SRS and the Kansas Health Policy Authority announced that payments wouldn”t start for three more months.
“That means we”re going to be spending money that isn”t in our budget,” Wakefield said. “That”s a very big concern, we”re not a big program.”
It”s a concern, too, at Lakemary Center in Paola.
“We did the same thing they did,” said Bill Craig, the center”s president and CEO.
“It”s created a cash-flow issue for us,” he said. “It would for anybody.”
Founded in 1969, Lakemary Center is a 64-bed treatment facility for children with developmental disability, some of whom, Craig said, “also suffer from psychiatric issues.”
SRS officials promised to find a way to offset the programs” costs.
“It”s not a question of whether we will, it”s a question of how we go about it?” said SRS Secretary Gary Daniels. “The issue is one of methodology.”
Kyle Kessler, deputy secretary for public and governmental services at SRS, said the department is prepared to pick up some or all of the three-month tab, if necessary.
“We”ll be handling it on a provider-by-provider basis,” Kessler said.
After April 1, the programs will be paid by Medicaid, a 60:40 mix of federal and state funds.
It”s not yet known how much the delay will end up costing SRS, Kessler said.
“We”re just starting to have those conversations,” he said.
Many of the children whose stays are affected by the policy changes are state custody through either the foster care or juvenile justice systems.
“We”re working with JJA (Juvenile Justice Authority) on this,” Kessler said.
Wakefield and Craig said they”re hoping SRS proves trustworthy.
“Gary Daniels is an honorable man,” Craig said. “I believe him, though I”m still not clear on how this is going to work.”
“We”ll see at the end of the day,” Wakefield said.
To survive the cash-flow crunch, Crittenton may pursue grants or United Way funding, Wakefield said.
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.