Your Monday Morning Update

October 8, 2013

Your Monday Morning Update:

On Sunday mornings, there’s nothing I enjoy more than sipping a steaming cup of coffee while reading the newspaper.  After reading last week’s headlines, my disposition was a bit discouraged, dampened and disheartened. Even high octane caffeine couldn’t raise my spirits.

Mid-morning, my little 14 year old pup crawled out from under my bed and let me know he needed to go outside.  I patiently sat on my front porch while he watered my lawn. Two neighborhood girls, ages five and eight, were walking two little replicas of my dog around the block.  

The eight year old looked at my pup, then at me and said “your dog is cute.” 

I said “your dogs are cute.”

She said “they aren’t ours.  They are Kathy’s.  We thought today was a good day to do some community service.”

Then it hit me. Sometimes you don’t have to look beyond your own front yard to find some good in the world.  So in honor of two beautiful little girls, today’s Monday Morning Update is going to contain some good news.

·        The waiting list dollars that had been promised by the State was finally released!  250 individuals from around the State are in the process of being awarded funding for much needed and long-awaited services.  Johnson County’s list consisted of 75 individuals.  The Community Developmental Disability Organization (CDDO) is preparing letters to go out to these individuals.  If you are waiting for services…good luck!  I wish it could be awarded to every one of you!

·        The Bob Bethell Joint Committee on Home and Community Based Services and KanCare Oversight Committee (whew- what an eyeful!) met Monday for a full-day update from providers and managed care organizations (MCO). This committee is basically responsible for keeping tabs on the implementation of KanCare.

Up first, the State gave an overview of what has been happening and shared figures related to savings, quality measurements, and issues and resolutions. Afterwards, individuals, providers, and organizations had the opportunity to provide testimony. Lastly, MCO’s shared what they have each been doing to improve the system.

Here’s a summary of the concerns I heard:

·        Providers are not paid in a timely manner.

·        Providers must plan on increased time or hire additional staff to handle the administrative part of Kancare.

·        Overpayments and underpayments are common.  Both take time to reconcile.

·        With the addition of three MCO’s, there is an additional layer of bureaucracy to work through.

·        Payments are not sequential.

·        Without timely reimbursements, cash flow is an issue. Many small providers struggle and fear they will go out of business.

·        Pre-authorizations pose an issue.

·        Some individuals have had a reduction in hours they receive and pose hardship on them or their family.

·        Pharmacy organizations testified that a change this large, presents difficulties, but feel that definite progress is being made.

·        Individuals questioned the role of the Ombudsman.  Since the position is under KDADS, many support an independent non-governmental Ombudsman that has the ability to act as a consumer advocate.

And because of two young girls, here’s what else I took away:

·        The Ombudsman is a very nice man and strives to resolve issues. He’s is doing exactly what he is told to do.

·        The State (KDADS, KDHE and the Governor’s office) are working very hard to make KanCare successful. I believe their intentions are honorable and they are determined to solve problems that folks encounter. Saving money is their charge, but they do care about those individuals that they are responsible for.

·        I believe that the State appreciates and understands the quality of IDD home and community-based services that Kansas has to offer.

·        The three MCO’s are continuing to change their processes to address issues related to reimbursement and administrative headaches for providers. They too are struggling to learn the KanCare model.

So call me Pollyanna–it’s OK with me. Whether it’s the front page of the newspaper, or a hearing on KanCare, there’s good news out there.  Sometimes we just need to look a little bit harder for it.  However, we still must remain vigilant in advocating for our loved ones and what we know to be right.  A little community service warmth only goes so far….