Health Forward Foundation

KanCare Preparations Impact Healthcare Workforce

OLATHE, Kan. – Workforce shortages prompted by the overhaul of the Kansas Medicaid program are hampering operations at agencies in Johnson County and around the region, according to executives at the organizations.

Human Services Director Debbie Collins said since September, her Johnson County agency had lost three of its nine case managers that assist frail elderly Medicaid clients through the Area Agency on Aging.

Collins said the workers all left for similar positions at UnitedHealthcare, one of the three insurance companies hired by the state as part of the new Medicaid program, which the state has dubbed KanCare. Virtually all the state’s 380,000 Medicaid recipients are scheduled transfer into the KanCare managed care plans effective Jan. 1.

The other two KanCare contractors are Amerigroup and Sunflower State Health Plan, a subsidiary of Centene. All three companies have been busy hiring workers for the past few months.

Collins and other agency administrators interviewed for this article said the bright side of losing the workers was knowing that the KanCare companies had hired qualified staff.

They said they didn’t blame their workers for taking the jobs because the employees told them they would get substantially higher pay at the managed care companies.

But the agency leaders said they weren’t sure how KanCare could save the state money, if the contractors will have significantly higher personnel costs.

“We are all befuddled about that,” Collins said.

Savings will come through a focus on patient education, preventive care, and by “ensuring members have access to the right care, at the right place and at the right time,” said Monica Stoneking, a spokeswoman for Sunflower State Health Plan.

Sunflower, she said, was paying “competitive wages in accordance with industry standards.”
Amerigroup spokesperson Maureen McDonnell declined to comment.

Alice Ferreira, a spokesperson for United Healthcare said the company was giving its new hires flexibility so that their former employers wouldn’t be left in the lurch.

“UnitedHealthcare has been working collaboratively with the agencies to provide case managers the work flexibility to ensure they are able to continue to work with the members as appropriate,” she said in an email. “We are committed to ensure members receive the care they need, and anticipate that this partnership will result in a smooth transition.”

She the company also was dedicated to “creating new jobs in Kansas.”

Officials at each of the KanCare contractors have said they would hire as many as 300 people as they prepare for the new program. Each company also has a Kansas headquarters office.

Officials in the administration of Gov. Sam Brownback estimate KanCare will save the state and federal governments $1 billion over the next five years.

Among the various social service and state agencies that have lost workers to the KanCare companies are the state’s Area Agencies on Aging, which, in any event, are seeing their roles change under KanCare.

Though the agencies are handing off case management for the frail elderly to the KanCare companies, they are expected to take on expanded roles in serving individuals with physical disabilities and traumatic brain injuries by assessing their needs for assistance and helping them choose the right KanCare plan, in the event the persons are not content with their state-assigned plans.

Collins said the changes have left her uncertain about what her staffing needs will be after the first of the year.

“We may very well have to expand,” she said. “We really don’t know what the workload will be.”
Other organizations experiencing KanCare-related personnel pinches include the Johnson County Mental Health Center and the Southeast Kansas Area Agency on Aging in Chanute.

Johnson County Mental Health has had 15 staff members take positions with the KanCare companies, according to agency officials, including a senior administrator and a number of clinicians and case managers.

In response, the center has pressed supervisors and everyone else with proper certification and training into service to coordinate care for clients, said Executive Director Maureen Womack.

The main problem, she said, was that clients had lost their connections to workers with whom they felt comfortable dealing.

“What is falling through the cracks,” she said, “is the therapeutic relationship.”

At the Southeast Kansas Area Agency on Aging, Executive Director John Green said 10 of his 12 case managers had left for the managed care companies. The KanCare firms were allowing those employees to continue their work with his agency on nights and weekends, he said.

“We are pretty thinly spread,” Green said, “but we are doing our best to make sure it works.”

In Johnson County, the transition to KanCare was hitting home with Patti Rogers. A resident of an Olathe apartment building, Rogers’ 81st birthday is next week.

For the last seven years, Monica Anderson has worked with Rogers as a geriatric case manager through the aging agency.

Rogers said she had relied on Anderson for everything from help understanding the complexities of Medicare and Social Security to coordinating meal deliveries when Rogers was too ill to cook.

“Everything was smooth as glass,” Rogers said.

But now, she anticipates she’ll have a different case manager through Sunflower. Anderson will continue working at the aging agency, but the agency no longer will do the case management.

On Tuesday, Anderson paid her final visit to Rogers. They hugged after completing their business.

“I love you, Monica,” Rogers said. “I always will.”

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