In a remarkably bold letter, top Johnson County officials this week strongly objected to failures in the KanCare program that’s supposed to help thousands of people with disabilities, mental health problems and other troubles.
Bravo for Johnson County Commission Chairman Ed Eilert and others. This is a needed step toward demanding improvements in KanCare. It must be radically reformed or blown up in 2017 to provide better care for Kansans.
The letter signaled that the largest county in Kansas has run out of patience with Gov. Sam Brownback and Lt. Gov. Jeff Colyer, who have claimed for years that KanCare is a great way to spend Medicaid dollars in the state. Meanwhile, Brownback and the GOP-dominated Legislature have refused to expand Medicaid, preventing tens of thousands of people from getting better health care.
The letter came in direct response to a glowing opinion piece written by Kansas Department for Aging and Disability Services Secretary Tim Keck in The Wichita Eagle. His laughable lead paragraph: “Kansas’ safety net for the disabled is strong and improving every day.”
Johnson County officials strongly disputed that contention, writing, “In reality, the state’s safety net has eroded so much that in Johnson County, local taxpayers have had to step in to that role. Some of our most vulnerable citizens … people with disabilities, a mental health diagnosis, or both … are quite simply ‘slipping through the cracks.’
“The lack of support by the state for our vulnerable citizens has forced the taxpayers of Johnson County into the position of paying for services that are the responsibility of the state. At the end of Secretary Keck’s editorial, he praised Kansas for ‘achieving remarkable success in caring for disabled citizens.’ We have not seen the remarkable success that is described and are holding our breath that no other crisis or cut is forthcoming.”
The letter was signed by Eilert on behalf of the entire commission; B. Scott Tschudy, chairperson of the advisory board for the Johnson County Mental Health Center; and Gayle Richardson, chairperson of the governing board of Johnson County Developmental Supports.
Keck had written his comments after a former state representative wrote in The Eagle that he hoped the Centers for Medicare and Medicaid Services — which reportedly visited Kansas this week — would reject the request by the Brownback administration “to renew the federal government’s approval of KanCare and its administration of the state’s Medicaid program.”
Keep this in mind: Johnson County is the largest county in the state and among the most affluent. It’s able to handle the extra financial burden of paying for this care. Things are likely much worse in many other counties in the Sunflower State.
The Johnson County officials’ letter pointed out that KanCare proponents had promised no reduction in Medicaid eligibility, no Medicaid rate reductions, no cuts in benefits or services, more administrative efficiency and improved health outcomes, plus more.
“Nearly four years in, Kansas is not seeing these promises fulfilled. What we have seen is an underfunded system that is continuously being whittled away. There is no Inspector General to serve as a watchdog over the program. Instead of increased administrative efficiency, clients and providers have to deal with three private Managed Care Organizations (MCO) who all do things a bit differently. Increased resources through KanCare for community employment and behavioral care have not yet materialized. Improved health and wellness outcomes have not been measured. And in 2016, the hits just kept on coming.”
Johnson County officials noted that Brownback sliced KanCare funding by $56 million earlier this year. He did that to help balance the state budget, which is badly underfunded because of his reckless 2012 income tax cuts that have reduced state revenues more than $650 million every year.
The recent cuts plus other failures in KanCare are having a damaging effect on services, the Johnson County officials wrote.
“When layered over the fact that Medicaid rates have been stagnant since 2008, virtually no Johnson County service provider will take on new residential clients. Some have stopped providing residential service. Some are closing their doors completely.”
Real people are being affected by these decisions, the letter noted.
“One provider closing its doors this week is Cornerstone Supports. Sixteen clients served by Cornerstone suddenly needed to find other providers to support them. Where is the safety net in this situation? It’s not the state, and it’s not the MCOs. The governing board of Johnson County Developmental Supports voted to ask the Johnson County Board of County Commissioners, who oversee the Johnson County Developmental Supports budget, to create staff positions to support individuals from Cornerstone left without a provider. These people’s lives have been disrupted and services put in jeopardy due to state policy changes and the Governor’s budget cuts.”
Real reforms of KanCare are needed, and the feds should demand that. The letter from Johnson County officials is a great example of local leadership that could spur changes in KanCare.