Brownback Official Lays Groundwork for Massive TCM Disruption

New Light on the State’s Intent Regarding TCM Services

by Marla Flentje

Last week, an employee from the Kansas Department of Aging and Disability Services (KDADS), made clear that the Governor’s promise that families can keep their case managers is about to be abandoned.

At the annual Interhab Conference, KDADS representative Susan Fout led a workshop titled “Conflict-Free Case Management.”  Based on the report of an agency attendee and Fout’s handouts and slides (which are available), the content of the session focused on how the Kansas TCM model is riddled with conflicts of interests and works against the interests of persons served.  In other words, community agencies providing services such as residential or employment support cannot also effectively provide case management.  The workshop materials suggest that these agencies have a built-in bias in favor of their bottom line and against the person served.

Strangely, this informal “announcement” making the case for a wholesale change in the I/DD case management system was not made by top state officials.  What is that about?

Because choice in the Kansas I/DD system is available, self-advocates and families can make the determination as to whether a TCM conflict of interest exists and initiate a change if they wish.  State limitations on the consumer’s choice of case managers is contrary to the free market ideology of the Governor and legislative leaders.

Make no mistake — a state regulation that I/DD direct service providers can no longer offer TCM services would massively destabilize the system and require thousands of families to find a new case manager.  In the ensuing chaotic vacuum, families likely would be left at the mercy of the MCOs’ care coordinators — some of whom may be qualified, but some definitely not.  And clearly, none of the MCOs’ case coordinators can provide conflict-free case management services.

Families and other I/DD advocates:  It’s time to sound the alarm bell.  This ominous TCM message, combined with the MCOs’ enormous  financial losses and a growing state budget shortfall, foreshadow dramatic reductions in the services needed by our loves ones.

On November 4, you have the opportunity to express your approval or disapproval of the direction Governor Brownback is taking with I/DD services.  BE SURE TO VOTE!



3 thoughts on “Brownback Official Lays Groundwork for Massive TCM Disruption

  1. e. remington

    This can cause immediate and profound harm (another word for standing)! What part of “waiver” does the State choose to understand? The largest built in conflict-of-interest will exist when a for profit company is in charge of TCM.

  2. David P. Rundle

    It’s very sad we cannot trust this regime.

    It’s sadder it is a regime and not an administration. Every other governor in my entire adulthood has sought to run the government of Kansas for better or worse. Brownback has tried not to run it but to reshape it to fit his ideology.

    He makes promises but breaks them. He ignores informed opinions and the desires of consumers, advocates and parents.

    Our governor came to power to experiment. Experimenting is not governing and experimenting with people’s lives is simply wrong.

    Experimenting is not governing. Experimenting

  3. Cathy Pechin

    My son’s TCM brought this up yesterday. Having had 8 TCMs, none have ever showed a bias toward the program that they worked under because they follow the rules unlike Sunflower. But, again, who would be surprised by this. “For-profit” and the TCMs are in the way so……….. I don’t see how the MCOs can take on any other responsibilities because they can’t handle what they have now: Grievance filed over 10 weeks ago and still no letter.

    Be forewarned that my son’s Personal Care Assistant hours, additional ones, were denied because they were for “supervision” in their mind, I sit and around and watch TV with him and shouldn’t be paid for that time. Obviously, they haven’t spent much time with an adult that functions at the pre-school level. What concerns me is if they start hacking away hours that they claim are “supervision”, how many hours will they eliminate? If I have to supervise his bathing for his safety after I do some set-up and other assistance, is the remaining time just supervision and counts for nothing. They could make a lot of PCA hours disappear. I know a lot of people hire someone outside the home and you won’t find many people that want to hang around and supervise for free between periods of hands on assistance. This is why I won’t let this go. This could be next and would result in working toward making that profit. Looks like the house will not sell this year but Sunflower thought we moved anyway – another long story. Maybe they just hoped?

    When you look at the numbers, they are going to have to make a lot of cuts and they are working on it. They don’t understand the needs of this population.

    Health homes is something that I am trying to understand also but the elimination of TCMs seem to be a necessary element for that idea too. It is not a “home” but a group that will make life or death decisions about people that they don’t know.

    Where will it end?


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