Changes under way for determining in-home Medicaid services

Mary Barker, a case manager with the Jayhawk Area Agency on Aging, reassesses the needs of Vivian Glessner, a 91-year-old resident at Briarcliff Care Center in Topeka. Barker meets with Glessner every 11 months to make sure she’s receiving the appropriate level of Medicaid-funded services. An association representing the state’s area agencies on aging has bid on a contract that would have case managers for the frail elderly also assess the needs of people who are physically disabled or have traumatic brain injuries.

Mary Barker, a case manager with the Jayhawk Area Agency on Aging, reassesses the needs of Vivian Glessner, a 91-year-old resident at Briarcliff Care Center in Topeka. Barker meets with Glessner every 11 months to make sure she’s receiving the appropriate level of Medicaid-funded services. An association representing the state’s area agencies on aging has bid on a contract that would have case managers for the frail elderly also assess the needs of people who are physically disabled or have traumatic brain injuries. by Phil Cauthon

State officials are changing the way they determine which in-home Medicaid services are provided to the frail elderly and people who are physically disabled.

The new system will rely on a single agency or organization with a presence in each of the state’s 105 counties to assess what services a person will receive. Currently, there are more than 30 organizations involved with the process. Some assess only the elderly. Others focus solely on the physically disabled.

State officials said their aim is to create a “one-stop shop,” so that services will be determined in the same place regardless of a person’s condition.

'Mishmash'

“The system we have now is a real mishmash,” said Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services. “We’ll be going to one that takes more of a no-wrong-door, single-entry approach and implements a conflict-free provision of services.”

About 12,000 Kansans currently rely on the services provided by the system, at an annual cost to taxpayers of about $200 million.

A solicitation to potential contractors interested in managing the new system was put out in February. Bids were due April 3.

Sullivan said he hoped to have the contract awarded sometime next month so that a single, statewide Aging and Disability Resource Center (ADRC) will be up and running by Jan. 1, which also is the scheduled start of KanCare, Gov. Sam Brownback’s plan for letting managed care companies administer the state’s $2.9 billion Medicaid program. KanCare remains contingent upon federal approvals.

The resource center, according to Sullivan, would be in charge of measuring the needs of an elderly, physically disabled or brain-injured person. It also would do preliminary screening for Medicaid eligibility and help the person choose the managed care company best suited to meet the person’s needs.

Today, the assessments are handled by 11 area agencies on aging, 10 centers for independent living and about a dozen home health agencies that specialize in caring for the brain-injured.

“When you have this many systems in place, it can be confusing as to who to turn to for assistance,” Sullivan said. “With the ADRC, we’ll be going to one database, one information source and one hotline for people to call.”

Federal initiative

The change, he said, was driven by a federal initiative aimed at increasing efforts to help Medicaid beneficiaries live in community settings rather than nursing homes and a concern among state officials that not enough was being done to prevent the centers for independent living from inflating their assessments in ways that generated more work — and therefore more revenue —- for their case management and home-health programs.

Continue reading at khi.org.

Tagged: medicaid, resource, sullivan, home, brownback, in-home, disability, nursing, kancare, adrc, aging, services, center, kansas

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