Special to the Kansas City Star, October 14, 2014
By Susan Jarsulic
It really isn’t a very good time to live in Kansas if you have an intellectual/developmental disability.
Over the strong objections of persons with these disabilities, their families and advocates, Kansas moved people like my daughter into KanCare for her long-term care needs. While the Kansas Department of Aging and Disability Services and Kansas Department of Health and Environment continue to amaze us with how wonderfully things are going, families and providers of services to disabled persons face a much different reality.
One of the biggest claims made by former Kansas Department of Aging and Disability Services Secretary Shawn Sullivan and members of the Kansas Legislature was that we would not lose our targeted case manager. In our case, our case manager has been with us more than 18 years and knows my daughter and her needs. The Kansas department and the three insurance companies running Medicaid now have instituted “Health Homes” and are automatically assigning people to health homes without any advanced communication. If a person fails to opt out of a health home assignment, they no longer have their targeted case manager. This appears to be a backdoor method of removing case managers.
The Department of Labor has made changes to the Fair Labor Standards Act, effective Jan. 1, 2015, which states that in-home caregivers must be paid at least the minimum wage and overtime for hours over 40 in a week. In a public meeting in Wichita several weeks ago attended by Governor Sam Brownback, he asked the attendees to contact the Department of Labor and ask that Kansas be exempted from paying a fair wage.
At these same meetings held in various cities in Kansas, families and providers were advised that Kansas will not be paying overtime and that any caregiver is limited to 40 hours per week. In some parts of the state it is difficult, if not impossible, to find caregivers who will work for $9.35 per hour. By the way, the payment rates haven’t changed in years.
Persons who need assistance during the night and have sleep cycle support may lose that support because of its cost. Currently, a caregiver makes $25 for the entire night, which comes out to $3.13 per hour for an eight-hour shift. The new labor rules say that service should be paid at an hourly rate equal to or better than minimum wage. The Kansas approach is to first attempt to get an exemption from the federal government or secondly, advise their residents that they will no longer have overnight support and that their only option may be nursing home care.
I really don’t think my 36-year-old daughter would want to move to a nursing home. My 77-year-old mother did not want to go to a nursing home even for a short rehabilitation after a shoulder injury.
I am also the president of an adult day program attended by my daughter and 10 other individuals with intellectual and developmental disabilities. Sunflower State Health Plan (one of the managed care organizations) has sent emails three times recently that they are delaying payments by one or two days. I don’t have the option to delay payments or payroll for my business. Why does the state of Kansas allow an insurance company to delay payments for services we have provided?
Kansas took a system that was working fine and has managed to create chaos.
Susan Jarsulic lives in Shawnee.