Gov. Sam Brownback agreed Wednesday to modify his plans for overhauling the Medicaid program in Kansas, following months of pressure from advocates for the developmentally disabled.


     Gov. Sam Brownback agreed Wednesday to modify his plans for overhauling the Medicaid program in Kansas, following months of pressure from advocates for the developmentally disabled.
     Brownback announced that his administration is endorsing a proposal for a one-year exclusion of long-term services for the developmentally disabled from contracts turning Medicaid's management over to three private, managed-care companies. The conservative Republican governor's administration expects to issue the contracts this summer, with the companies taking over Jan. 1, 2013.
     But Brownback and Lt. Gov. Jeff Colyer, a surgeon who led the team developing the overhaul plan, said concerns from the developmentally disabled, their families and their advocates led the administration to go along with waiting until 2014 to include their services in the contracts. The proposal allows the state to have pilot projects to test whether managed-care companies can deliver adequate services.
     House Majority Leader Arlen Siegfreid, a conservative Olathe Republican who's normally a Brownback ally, confirmed he's pursuing the proposal. Brownback announced his endorsement hours after hundreds of developmentally disabled Kansans and their advocates rallied at the Statehouse to urge the governor to alter his plans for the $2.9 billion-a-year Medicaid program, which covers health care for the poor, disabled and elderly.
     "We believe that allowing another year of discussion and input from the developmental disability community will make them comfortable with the program and allow us to craft solutions to the concerns they're expressing," Brownback said in a statement.
     Siegfreid said he'll offer his proposal this week as an amendment to the state budget.
Advocates for the disabled have been the most vocal critics of Brownback's plans. They worry that the overhaul will insert an extra layer of bureaucracy between developmentally disabled Kansans and service providers. Many don't trust assurances that private companies won't be allowed to cut services or payments to service providers.
     Some said Wednesday that Brownback's action was a positive step but didn't go far enough.
     Senate Minority Leader Anthony Hensley, a Topeka Democrat, said the entire overhaul should be delayed a year so the Legislature can provide adequate oversight. Sen. Dick Kelsey, a Goddard Republican, suggested a six-month delay for the whole program, "just to make it work more smoothly."
     InterHab, which represents service providers, still wants services for the developmentally disabled excluded from the contracts permanently.
     "Our question has always been, 'Why should community DD services be off-loaded to the managed care industry?' Not, 'When should it be done?'" said Tom Laing, its executive director.
     The administration has said repeatedly that the overhauled Medicaid program — to be called KanCare — will better coordinate care for participants, improving their long-term health. The administration also has said the overhaul will reduce the state's costs and savings are crucial because the federal government, facing its own budget problems, is likely to cut its Medicaid funding.
     Most of the 387,000 Kansans receiving state medical assistance are covered by managed care though private contractors, but the Medicaid overhaul represented the first time the state has tried to include relatively expensive, long-term care for the disabled and the elderly, including those in nursing homes.
     "We have heard the concerns expressed by family members of developmentally disabled individuals about the coming reforms and the pace of the change in particular," Colyer said in a statement.
     Participants in Wednesday's rally left personal items on the Statehouse's south steps in a temporary display to show their concerns.
     Critics of Brownback's plan argued that Kansas already has a good system for the developmentally disabled, in which 27 regional groups have contracts with the state to serve as its gatekeepers, determining who qualifies for services. Critics also note that developmentally disabled Kansans often receive services that don't resolve medical issues but help them live as independently as possible.
     Jerry Michaud, president and chief executive officer of Developmental Services of Northwest Kansas, one of the regional gatekeepers based in Hays, said Brownback's overhaul would add "an unnecessary level of complexity."
     Later, when told of Brownback's announcement, Michaud said having the administration acknowledge his and other advocates' concerns "at least is progress."