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Prairie Village family falls through Medicaid gap during KanCare transition
The state’s transition to KanCare, combined with previous Medicaid difficulties, left one Prairie Village family without desperately needed services last week as the new system took effect.
Finn Bullers, who has muscular dystrophy, type-1 diabetes, and is dependent on a ventilator to breathe, lost his home nursing care when he was dropped from his healthcare service at midnight on December 31. “If this tube drops off (the ventilator), in three minutes it’s lights out,” he says emphasizing how critical it is to have nursing care.
KanCare, which required Medicaid members to enroll with one of three private managed care organizations for their health coverage, took over the Medicaid program on Jan. 1 with promises of saving the state up to $1 billion over the course of five years.
But Bullers, who is able to stay at home with both personal a skilled nursing care, was left without a Medicaid provider or nursing care at the start of the year. While it was at the point of the changeover to KanCare that he lost services, required virtually around the clock, the problems started in the run-up to the handoff. That’s when his case manager left to join a managed care company and a series of other managers did not solve a problem with Medicaid paperwork.
“The transition has been less than ideal,” he says. “People living minute-to-minute can’t wait for this to sort out.” Bullers’ wife, Anne, and children, who are 12 and 8, became responsible for his complex medical and care needs when there was no notification from a new managed care provider. That prompted an early morning e-mail to Gov. Brownback on Jan. 2. State Rep. Barbara Bollier became aware of the situation and got involved with the KanCare ombudsman who worked to restore service. By late Jan. 3 Bullers had been contacted by case manager from his new provider and had a caregiver visit, but still has not had skilled nursing assigned and won’t have an assessment until later this week. “We are not out of the woods, yet,” Bullers says, but it is looking better.
Bollier was pleased with how quickly the ombudsman responded and resolved the coverage problem. “The most important thing in all of this (transition) is that it needs to be safe,” she said. This was the only constituent contact about a transition problem she received, although the program was “rushed,” she said.
Bullers, a former Kansas City Star reporter, continues to volunteer at Corinth Elementary with the student newspaper, despite his disabilities. The medical complications have had a significant financial impact on the family. A former journalism student of Anne’s has started a fundraising site to help with medical expenses. KMBC has run an interview with Bullers that can be seen here.
UPDATED: The Kansas Department for Aging and Disability Services sent a response to the story after it ran this morning. See it after the jump.
Good morning. I am writing in regard to your article about Mr. Bullers:
1. We solved the problem the same day it was brought to our attention by the consumer. We wish we would have been given a chance to tell the Prairie Village Post this story because Mr. Bullers’ issue with his services was unrelated to the KanCare switch, but rather it was related to an eligibility issue that he would have faced even if KanCare had not been implemented. I attempted to call you Friday afternoon but was unable to make contact. Would appreciate a follow-up story clarifying these matters.
2. This consumer was able to use our ombudsman services. The ombudsman position held by Mr. James Bart is working very well. Mr. Bart has immediate access to all the staff he needed to contact in order to investigate and resolve this consumer’s issues.
3. KanCare consumer concerns are closely monitored and responded to quickly. We have a response plan in place and it worked the way it was designed to work in this case. We have built accountability into the system and, during this period of transition, speedy resolution of problems is our highest priority goal. This is why we have our daily Rapid Response Calls each day, M-F, at 9 a.m. Anyone with a questions about KanCare implementation can join this conference call. Additionally, the consumer assistance line is available throughout each business day, that number is:
Angela de Rocha
Director of Communications
Kansas Department for Children and Families
PVPost.com contacted the state’s ombudsman Friday seeking comment and left a detailed message including all of our contact information. We did not receive a return call.
We believe we address all of the points Ms. de Rocha mentions in her note in the story itself.
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