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I am sometimes stunned by the lack of concern our governor seems to show toward the residents and businesses.

Last week, less than 24 hours before the new program was supposed to launch, KDHE officials notified agencies — by email, no less — that they had decided to delay the program for at least six months, until Jan. 1, 2015. They apparently were unconcerned that many of the agencies, including Heartland Community Health Center in Lawrence, already had hired staff and taken other steps to implement the service, known as “health home.”
But what really happened here?    What is Health Home, and what is the real impact toward Kansas?  

Also, why was there a last minute delay?   Why an email shot out with a days notice to let people know that this wouldn't be moving ahead?

The new service is intended to provide a “health home” to help coordinate care for Kansans who have either severe mental illness or suffer from chronic medical conditions, such as diabetes, asthma or heart disease. The program is part of the Affordable Care Act, also known as Obamacare. Although many state leaders still adamantly oppose the implementation of that law, the state has decided to accept the health home program, which will be 90 percent funded by the federal government for the first two years.

The state had planned to start signing up participants for both programs on July 1. Agencies, like Bert Nash Community Mental Health Center, were able to move ahead on plans to provide health home services for people with mental illness. However, on June 30, the Heartland center and other agencies were informed the kickoff for health home services for people with chronic illnesses would be delayed because KDHE had been unable to sign up enough contractors to provide adequate services throughout the state.

What happened was that the state was unable to provide for enough independent contractors through it's three private contracted services (Amerigroup, United Health, Kancare direct)   which are all under the KanCare implementation in our state.

While Kansas has issues with the number of health professionals and others available for this task, the ramp up of Home Health was originally seen as a program designed to encourage individuals to enter the health professionals field and to attract new candidates.    Ongoing problems with KanCare, however, seem to be influencing independent contractors to be wary of their level of interest.

Delayed and denied payments from KanCare’s private insurance companies have gotten so bad that some service providers aren’t accepting Medicaid patients from certain companies.

Is this how privatization saves the state money? Is this what the providers of long-term care to Kansans with intellectual and developmental disabilities have to look forward to, now that the state has received federal approval to include these services in KanCare?

Deb Voth, president of Rainbows United in Wichita, told The Eagle editorial board that 90 percent of her agency’s billings to one of the managed-care organizations has not been paid. As a result, it is not accepting any more patients through that MCO.

Overall, nearly 50 percent of Rainbows’ billings to the three MCOs is in arrears, Voth said – and that is after Rainbows had an attorney shake some payments from the companies.

The Hutchinson Clinic sent a letter to its Medicaid patients last month telling them it might drop its contracts with two of the MCOs because of payments problems. Michael Harms, the clinic’s chief financial officer, told the Kansas Health Institute News Service that the clinic has had problems with “thousands of claims” and is behind “hundreds of thousands” of dollars in payments.

Kansas, in effect, has created a system where private contractors are unsure of payment from the insurance agencies and may not wish to be involved.   So, when Kansas decides to move ahead with a program that has 90% federal funding, contractors are still not so eager to sign up, and the companies who have been handling the processing are telling Kansas they have been unable to recruit enough to meet the federal guidelines.

This is the Catch-22.   Save money by not paying, and eventually people don't want to work, and now when you have more money to offer work, they really don't want to work for you because the past track record tells them they may not get paid.   Who, as a result, suffers from this drain circle of responses?   Of course, the mentally and chronically ill, who need assistance through the Home Health program, and who were promised to get it..

Up until an email went out with 24 hours to go.

Now, many agencies find themselves burned again.. they hired on staff and now they will not receive funds (sound familiar?), and those who needed and were promised the help will not receive it.

There may have been many issues that caused a necessary delay, and the lack of finding contractors is a good one.   A hands on government, however, would have known that the wouldn't make the deadline well in advance of 24 hours of the kickoff.   Had the Brownback administration paid attention, agencies and others could have been better prepared and planned accordingly.

Instead, this week will be filled with apologies, broken promises, and probably some lost jobs by people who thought they were moving into a new position.    

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