Kansas social worker uneasy with KanCare's handling of brain cases

Social worker Gayle Taylor is part of a care provider network for a Kansas man who suffered a traumatic brain injury and compounds his predicament by engaging in substance abuse.

In mid-January, Taylor said she arrived at the Medicaid client's home to find him bleeding from an arm wound. He apparently didn't grasp how or where to get help and languished for five days without treatment.

Gov. Sam Brownback had turned over the state's $3.2 billion Medicaid program two weeks earlier to United HealthCare, Sunflower State Health Plan and Amerigroup companies to operate a managed-care system designed to improve care for 380,000 Kansans and save the state an estimated $1 billion over five years.

Taylor, who owns Burlington-based Therapy Services, related snippets of her client's situation during a Statehouse rally and a subsequent interview.

"What I'm so afraid of is, without proper care, people are either going to end up dead, homeless, in jail or in a nursing home. They will lose their independence,"she said.

Kari Bruffett, director of the division of health care finance at the Kansas Department of Health and Environment, looked into the situation during the past week and concluded Taylor's client was receiving all services he was entitled. Bruffett was bound by confidentiality regulations, but said the case illustrated the complex medical and behavioral puzzles woven into lives of Medicaid program recipients.

"What we're able to confirm is he is receiving care coordination and is getting the services he needs," she said. "There are challenges for him."

However, Taylor said she remained uneasy about implications of KanCare as it related to people with brain injuries.

"I'm a skeptic about this particular population of people, she said. It's going well with other populations."

Lt. Gov. Jeff Colyer, a surgeon who is taking a leadership role in Medicaid reform in the Brownback administration, said the introduction of private insurance companies to the mix would subject the state to growing pains. The strategy is to moderate costs with establishment of three competitive long-term managed care plans while maintaining comparable service levels to clients and payment rates to providers. He said during a Senate committee hearing KanCare had already saved the state $18 million.

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Kansas social worker uneasy with KanCare's handling of brain cases