LITTLE ROCK — Advocates for the developmentally disabled expressed concerns to legislators Wednesday that an overhaul of the state’s Medicaid system could hurt some mentally disabled Arkansans.
Katy Carver, executive director of the Arkansas Waiver Association, told the Hospital and Medicaid Study Subcommittee of the Arkansas Legislative Council that a proposed model for creating developmentally disabled centers across the state could lead to cuts in services and the creation of a new level of bureaucracy between patients and the care they need.
Charlie Green, director of the state Division of Developmental Disabilities, told the panel that those concerns are groundless.
Gov. Mike Beebe has received a go-ahead from the U.S. Department of Health and Human Services to develop a proposal for overhauling the way health care providers in the state are reimbursed for their services. Beebe has said he wants to switch from a system in which providers are paid for each service to a system in which providers are paid for bundled episodes of care.
The governor is seeking to lessen the impact of a projected shortfall in the state’s Medicaid budget of at least $60 million by next July.
Independent reporting for Pine Bluff & Jefferson County since 1879.
Work groups have been formed to address nine different areas of health care. Carver testified Wednesday that the work group on care of the developmentally disabled is looking at the idea of creating service centers across the state that would serve as one-stop centers for providing, through employees and contractors, home- and community-based care to all developmentally disabled patients in the local community, county or area.
Carver also said the work group is looking for a universal assessment tool for determining individuals’ needs.
“I think we all know what that means. We are going to cut services for some people,” she said.
State Rep. Debra Hobbs, R-Rogers, said it sounded as if the centers would “put in a new layer of bureaucracy to determine what services the disabled need.”
“You’re exactly right,” Carver said.
Keith Vire, vice president of the Arkansas Waiver Association’s board of directors and CEO of the Arkansas Support Network, said he was concerned about the possibility of “ending up with some mega-providers, and not very many in those smaller communities.”
He also said he would rather see pilot programs created in some communities rather than statewide implementation by July 2012, the deadline set by the governor.
“We think that this is just too darn quick,” Vire said.
Green testified that the model the work group is considering is just a way “to get people started talking.” He said the centers would not create a new level of bureaucracy, would not cut services and would not reduce care options in small communities.
“What I want to do is push decision-making down closer to the service,” he said.
He also said the changes state officials want to make cannot all be implemented by July, but the state needs to do as much as it can now.
“That $60 million projected deficit is coming next fiscal year, and then over $200 million the one after that, so we can’t wait around. We’ve got to start moving,” Green said.
One question that will have to be addressed is how to define the term “episode of care” as it applies to the developmentally disabled, he told the panel.
“For our guys an episode is for the rest of their life, but we’re going to break it down into annual episodes, we think, if that’s how it comes out in the process,” he said.
Sen. Percy Malone, D-Arkadelphia, a pharmacist, said he had doubts about the concept.
“I don’t believe the quality of care will be the same,” he said. “We’re going to dumb down the care.”
Also Wednesday, Andy Allison, who was hired last month to head the state’s Medicaid program, told the panel he is “really excited” to be a part of the overhaul effort, which he said will seek not only to reduce costs but to improve patient care.
John Selig, director of the state Department of Human Services, testified that in the next couple of weeks the state will have the opportunity to apply for federal grant money to help implement the overhaul.