County joins health professionals in push back against Brownback’s Medicaid overhaul
by Dennis Sharkey
Jefferson County Commissioners joined health professionals on Monday in expressing concern for Gov. Sam Brownback’s overhaul of Medicaid.
Commissioners approved a resolution unanimously on Monday that strongly encourages the administration and lawmakers to leave the physically and developmentally disabled branch of care out of his plan known as KanCare.
The administration claims in the plan that the state and federal government will save more than $850 million over the next five years.
Brownback’s Chief Counsel Caleb Stegall spoke with a group of Jefferson County Republicans last month the day after the legislature adjourned into their current recess. Stegall told the group that the decision was made up front that services nor people would be cut from the system. He said they would find a different way to reform Medicaid.
Stegall said over the past 10 years the state’s budget has doubled in Medicaid spending from nine percent to 18 percent. Spending in the last three years has gone from $600 million to $1.1 billion.
“This is an exploding area of the state budget,” Stegall told the group.
Stegall told the group that despite the negative press about the plan people have to be patient.
“We believe this is a better way moving forward than just simply cutting people off the rolls or paying less for services,” he said. “We feel like it’s a solution that will work. We’re asking everyone to allow it to work.”
Many of those opposed have a hard time believing that turning over Medicaid services to private for-profit companies will result in services not being cut.
“We hope that it works and this KanCare is successful,” First District Commissioner Lynn Luck said. “It’s problematic when a for-profit company is going to provide services at the same level we have now.”
Sharon Spratt, chief executive officer for Cottonwood Inc. lobbied commissioners to pass the resolution. Her company provides physical and developmental disability care in Jefferson County.
Spratt told commissioners that there is a lot of data from other states that have switched to a private managed care system with negative results. She used the words “horror stories” when describing accounts of providers not getting paid.
“We are happy to work with the administration on the medical side,” Spratt told Commissioners. “We do not feel like it’s a good fit. “We’ve got a lot of evidence-based information.
“Plus they are going to need to make a profit for their shareholders,” Spratt added. “The places they talk about saving money are all on the medical side.”
Spratt said the companies involved have admitted they know little about that field of medical care.
Five private companies are bidding on providing the services to the state. Three will be chosen later this summer with the thought that two will survive after the initial three year contract according to Guidance Center Executive Director Keith Rickard. His organization provides mental health services for Leavenworth, Atchison and Jefferson Counties.
Currently mental health centers across the state deal with one management company that is not-for-profit called Kansas Health Solutions. The company was created by the centers to manage Medicaid. Rickard said mental centers will now have three companies to deal with instead of one. He doesn’t see how it will save costs and thinks the opposite.
“When you have one company those costs are a certain amount but when you have three companies you have to deal with your costs go up,” he said. “We probably won’t get much done other than managing.”
Rickard said the administration’s plan is based on controlling costs by controlling growth. However, he says controlling growth as the number of recipients that need services grows is not practical.
He said his organization has been controlling costs for more than 20 years. Contracts with vendors have been renegotiated. Positions have gone unfilled and employees have been asked to do more. Any further cuts means a cut to staff and services.
“We’re down to bare bones at this point,” Rickard said. “We balance our budget on the backs of our underpaid staff.”
Rickard said his 2012 budget was frozen at 2011 without being directed to do so. He said mental health centers did that as a gesture to show they are willing to work with the administration. However, he thinks cuts will be made.
“That will be determined after the fact,” he said. “Having managed care companies tell us what they think without true knowledge of what’s happening in the community is somewhat troubling.”
Rickard said the cheapest form of health care is preventative care. The most expensive is long term or treatment that requires inpatient care. He says his organization saves taxpayers money.
“If we didn’t exist there would be a need for bigger jails, bigger hospitals and need for more treatment facilities,” he said.
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