By Dave Ranney
KHI News Service
TOPEKA, May 25
State and federal officials have come up with new criteria for deciding which services for mentally ill children and adults will be eligible for Medicaid reimbursements.
“The standards are out and ready to go,” said Abbie Hodgson, a spokeswoman for the Kansas Department of Social and Rehabilitation Services. “They”re all on the Web site:
medicaidtraining.org
.”
The Web site, she said, also includes answers to questions posed by programs affected by the changes.
“We”re working with all the facilities to make sure they are informed and aware of the standards and how they will be implemented,” Hodgson said.
The new rules take effect July 1.
SRS on Thursday in Lawrence hosted a statewide training-the-trainers session on the new provider manual.
But several program directors say they are a long way from understanding how the changes will affect their services.
“Whenever you go through change, there”s a tension and you”ve got to take time to get things figured out,” said Barb Andres, executive director at Breakthrough Club, a street-level program for the mentally ill in Wichita.
“But a lot of us are nervous now
really nervous
because the changes we”re talking about are huge and there”s not a lot of time to figure out how to deal with them,” she said during a Tuesday meeting in Topeka of the Mental Health Coalition of Kansas.
The changes are driven by a series of federal audits and reviews that challenged how the state used Medicaid to underwrite its community mental health centers and residential programs for children in foster care.
According to the reviews, not all of the Medicaid-funded services were considered “medically necessary,” and the state”s community mental health system had not done enough to encourage competition between public and private providers.
State and federal officials have spent several months negotiating the proposed changes, but they”ve yet to agree on standards for defining and assessing medical necessity.
Without these standards, program directors say they”re left to wonder which of their services will be covered and how they”ll be paid.
“This is a minefield we”re dealing with,” said Karen Wakefield, chief executive officer at Florence Crittenton Services, a Topeka-based program for teenage girls.
Florence Crittenton Services will host an informational meeting from 11:30 a.m. to 1 p.m. June 7 at the Topeka Community Foundation Conference Room, 1315 SW Arrowhead.
“We”re hoping to bring together all the players we can get to talk about what might be areas of vulnerability,” Wakefield said. “We”re hoping that when we talk about these things out loud we”ll get to the point of coming up with a plan for what to do when we get in a bind.”
The meeting is open to the public, though seating will be limited.
Andres said her nervousness should not be seen as resistance.
“I”m not afraid of change; change is good,” Andres said. “We”ve already made changes in anticipation of what”s going to happen July 1. Some of it”s been negative, but I have to say a lot of it”s been positive.”
“Change is stressful and it”s true, we don”t know all the answers to all the questions, but I can see that we”re all going to go through the same training so that we”ll be doing things the same way,” said Sandy Shire, director of special populations at Four County Mental Health Center in Independence.
“I think that”s wonderful
no more “Well, this center does it this way, and that center does it that.” We should all be on the same page,” said said.
Under the new standards, community mental health centers may use Medicaid to pay for peer-support services.
“That is a huge step in the right direction,” Shire said.
At SRS, four program managers are taking calls from providers and consumers:
Mental health: Kathy Mosher, 785-296-7272.
Substance abuse: Kim Brown, 785-291-3326.
Foster care: Sandra Hashman, 785-296-7272, Sandra Hazlett, 296-4653.
-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.