The Providers Advocacy Coalition of Kansas (PACK) wants parents and family members of persons with I/DD to share their experiences with KanCare. You are invited to attend a meeting for this purpose on October 14 at 6:30 pm at the Overland Park Christian Church. Here is a letter detailing some of the problems families and advocates in the Kansas City area have experienced with KanCare:
October 6, 2014
When intellectual and developmental disability (IDD) long-term services and supports were woven into KanCare, what we were afraid would happen, promised wouldn’t happen, is indeed happening!
Targeted Case Management is Under Fire.
During the KanCare explosion, families and advocates fought to keep their targeted case managers (TCM). The relationships and services that TCM provides are unlike those of any other HCBS waiver. The Governor and his administration time and time again promised “you will be able to keep your case manager”. We wanted to believe them. As time has passed, little by little, minute by minute, this service is now at risk. How is this happening?
Effect on Our Family Members
TCMs know our family members personally, and know what they need. TCMs are losing their ability to advocate for our families and be our voice.
TCMs know where to find resources and reliable information. Families depend on them for assistance.
Many individuals don’t get important correspondence because the State maintains incorrect addresses. TCMs make sure necessary information is shared.
In the future, TCMs will have to restructure how they perform their work. Some of the duties they currently perform, will either not be done or someone else will have to do it.
Without TCMs, there may be a potential lapse in Medicaid eligibility resulting from a lack of information from MCOs or KDADS.
Crisis situations that are dealt with quickly by TCMs may be delayed or overlooked.
Health Home Confusion
The Health Home (HH) rate is not adequate for individuals with severe mental illness. Our family members with mental illness require additional support.
It appears that HH partners are no longer required to subcontract with TCMs, just “encouraged”.
The State says that folks in the HH don’t have to have a TCM. Since many of duties performed by the TCM are required, who will do them?
Change in definition and expectations of what TCMs can bill for
The definition as to what is now considered a billable activity has changed, resulting in TCM providing support but not being reimbursed.
The State and MCOs are now requiring new and additional meetings and documents, many of which TCMs are unable to bill for.
A reimbursement rate workgroup with the State was formed, but suggestions from that group have not been implemented.
Slow or incorrect payment for services
MCOs are slow in paying for certain services or individuals, with no explanation as to the reason.
TCMs spend their valuable time having to follow up on these slow or incorrect payments.
New and Ineffective Processes
The crisis process now goes through additional layers, resulting in delayed responses.
Not all MCOs approve requests when additional hours are needed to perform vital services.
Lack of Leadership from the State
Inconsistent and vague answers from KDADS and MCOs cause general confusion.
All three MCOs have different processes and procedures causing confusion.
KDADS employees are no longer accessible and questions remain unanswered.
MCOs are unable to answer many questions and will refer to KDADS or the CDDO, who in turn are unable to answer the questions.
Points for Us to Consider
At what point does providing TCM support becomes a money-losing service that agencies can’t afford to provide?
Many agencies have lost revenue sources over the past couple of years and no longer have the monies to subsidize these TCM services.
TCMs are dedicated to the individuals they serve however, can’t continue to do more for less.
If the content of this letter concerns you at all, please check out the attached flier and plan to attend a Family Forum to discuss this important issue.
We encourage you and other families to join us!
Concerned individuals and families:
Rev. & Mrs. Eugene Stohs ,Doug & Marianne Geck, Colin Olenick
Jim & Pat Moore, Tim & Daphne Tacket, Diana Bright
Elizabeth Bartow, Dr. & Mrs. Mahmoud Wahba, Gloria Lefman,
Susan Divine, Rosemary & Tiffany Maxwell, Lisa Buckle,
Phil & Marilyn Kubler, Don & Susan Jarsulic, Kathy Crockett
Ron & Betsy Nelson, Gordon & Susan Docking, Karen Lemons,
Gregory & JoEllen Billiard, Donna Janes-Wallis