April 2005 Newsletter
Volume 4, Number 4
Work Opportunities Reward Kansans (WORK)
By Mary Ellen O'Brien Wright, Working Healthy Program Director
Working Healthy and other Social and Rehabilitation Services (SRS) staff and
partners are continuing efforts to implement personal assistance services
for people enrolled in Working Healthy. In August 2004, an 1115 Independence
Plus demonstration application, titled WORK Opportunities Reward Kansans
(WORK), was submitted to the Centers for Medicare and Medicaid Services
(CMS). SRS has twice been asked to respond to “Requests for Additional
Information” (RAI). SRS responded in writing to the first RAI, which
consisted of 87 questions, in December 2004. The written response to the
second RAI was sent in March 2005.
Negotiations with CMS have focused on program clarification, the ability
of SRS to maintain required budget neutrality for WORK, the income and asset
limits for WORK enrollees, and the services to be offered through the new
waiver. In addition to responding to the questions in writing, negotiations
have involved several conference calls with CMS Central and Regional office
staff, as well as representatives from other Federal agencies, including
the General Accounting Office (GAO). SRS anticipates that CMS will request
a third
conference call in the early spring.
If approved, WORK will provide personal assistance services for Working Healthy
enrollees who require these services to live and work in their communities.
WORK will employ a “cash and counseling” model, allowing enrollees
to directly handle the money for their services, as well as the flexibility
to choose alternative methods for obtaining such services.
Medicaid/Title XIX is one of several programs in the broader Kansas Medical
Assistance Program (KMAP). KMAP also includes Medi-Kan, HealthWave and KAN-Be-Healthy.
The following information is provided for consumers or providers who want to
know more about these various medical programs available to Kansans.
An Unasked Question
By Kirk Maher, Liaison, Kansas Medical Assistance Progarm
I’m sure we have all heard “that the only stupid question is the
one
that goes unasked.” This is especially true when it comes to your health
insurance coverage. Understanding how our health insurance works is not only
important, but essential to fully participate in health care decisions. However,
some people are afraid to ask questions about their medical coverage...in case
it’s a “stupid” question.
The Kansas Medical Assistance Program (KMAP) wants beneficiaries to feel comfortable
seeking assistance getting answers to their questions, and encourages them to
contact KMAP resources whenever they have questions or concerns about their health
benefits. KMAP believes that the better educated beneficiaries are, the better
consumers they will be when seeking services.
KMAP wants beneficiaries to have a good understanding not only of their rights
when it comes to their medical coverage, but also their responsibilities. To
assist our beneficiaries in understanding their health benefits, the program
has provided a number of resources to help answer their questions. Some of these
resources are:
•
The Kansas Medical Assistance Program Medical Benefit Booklets. These printed
booklets are mailed to all KMAP beneficiaries yearly as a guide to their health
benefits, rights and responsibilities, types of coverage and other helpful information.
Booklets are also available upon request at the local SRS offices. In the future,
Newly eligible beneficiaries will be mailed this booklet upon becoming eligible.
•
The KMAP Website. The KMAP website provides information on health coverage and
medical policy for beneficiaries and providers. The KMAP website consists of
three main sections, Beneficiary, Provider and KAN Be Healthy. It is written
to meet the needs of those specific groups. The website address is: https://www.kmap-state-ks.us and each section is explained further below.
o The Beneficiary section allows access to information useful to beneficiaries.
This includes access to an on-line version of the benefit booklet mentioned earlier,
a provider directory search window where lists of KMAP providers can be accessed,
copies of beneficiary notices, a link to the FirstGuard website and information
on appeal rights.
o The Provider section of this website is divided into secured and non-secured
sides. The non- secured side provides access to provider manuals and bulletins,
plus a variety of other provider- focused information. The secured side of this
section is password protected and restricted for provider use only.
o The KAN-Be-Healthy section provides information geared to beneficiaries who
are under the age of 21, participating in the KAN-Be-Healthy Program.• Medical
Assistance Customer Service Center (MACSC). The MACSC phone line at 800-766-9012
is open from 7:30 am to 5:30 pm, Monday through Friday and is dedicated to answering
questions about medical benefits and assisting to resolve issues related to KMAP.
• KMAP Liaisons. Twelve Liaisons are strategically placed in the five designated SRS Management Regions across the state by EDS, the Fiscal Agent for the KMAP. The Liaisons serve as both resources on KMAP issues/questions and as facilitators for communication among EDS, Health Care Policy/Medical Policy, the Regional SRS Offices, providers and beneficiaries. KMAP Liaisons also provide support and training to local SRS staff and outreach education to the communities they serve. A map of individual liaison territories has been provided.
MAP INFORMATION:
TITLE – KS MEDICAL ASSISTANCE PROGRAM LIAISON TERRITORIAL MAP
Region 1 coverage area counties: Cheyenne, Sherman, Wallace, rawlings, Thomas,
Logan, Decatur, Sheridan, Gove, Norton, Graham, Trego, Phillips, Rooks, Ellis,
Rush, Pawnee, Smith, Osborne, Russell, and Barton.
Region 1 Liaison Contact Information: Gayle Hanson, Phone 785-628-1066 xtn
264, Email GXLH@srskansas.org
Region 2 coverage area counties: Greeley, Hamilton, Stanton, Morton, Wichita,
Kearney, Grant, Stevens, Scott, Finney, Haskell, Seward, Lane, Gray, Meade,
Ness, Hodgeman, Ford, Clark, Edwards, Kiowa, Commanche, Stafford, Pratt, and
Barber.
Region 2 Liaison Contact Information: Mary Calzonetti, Phone 620-272-5811,
Email MZC@srskansas.org
Region 3 coverage area counties: Rice, Reno, Kingman, Harper, McPherson, Harvey,
and Sumner.
Region 3 Liaison Contact Information: Cindy Proett Phone 620-663-5731 ext.
229, Email CXLP@srskansas.org
Region 4 coverage area counties: Jewell, Mitchell, Lincoln, Ellsworth, Republic,
Cloud, Ottawa, Saline, Washington, Clay, Dickinson, Marshall, Riley, Geary,
Nemaha, Pottawatomie, and Wabaunsee.
Region 4 Liaison Contact Information: Kayla Paige Phone 785-826-8000 ext. 302,
Email KJP@srskansas.org
Region 5 coverage area county: Sedgwick
Region 5 Liaisons’ Contact Information: Marc Madden Phone 316-337-6123,
Email WMXM@srskansas.or and Emily Gagnebin Phone 316-337-6350, Email EGG@srskansas.org
Region 6 coverage area county: Shawnee
Region 6 Liaison Contact Information: Kirk Maher Phone 785-296-0396, Email
WKM@srskansas.org
Region 7 coverage area counties: Jackson, Brown, Doniphan, Atchison, and Jefferson.
Region 7 Liaison Contact Information: Michelle Swain Phone 785-832-3885, Email
MIS@srskansas.org
Region 8 coverage area counties: Morris, Marion, Chase, Lyon, Bulter, Greenwood,
Elk, Cowley, and Chautauqua.
Region 8 Liaison Contact Information: Beth Gates Phone 316-321-4200 ext. 331,
Email EBEG@srskansas.org
Region 9 coverage area county: Wyandotte
Region 9 Liaison Contact Information: Monica Sipple Phone 913-279-7689, Email
MZZS@srskansas.org
Region 10 coverage area counties: Leavenworth, Johnson and Miami.
Region 10 Liaison Contact Information: Danny Hewett Phone 913-826-7577, Email
DLXH@srskansas.org
Region 11 coverage area counties: Anderson, Linn, Woodson,
Allen, Bourbon, Wilson, Neosho, Crawford, Montgomery, Labette, and Cherokee.
Region
11 Liaison Contact Information: Rita Stapleton Phone 620-421-4500,
Email RJXS@srskansas.org.
KMAP is fully committed to ensuring that our
beneficiaries receive the support necessary to fully participate in their
own health care
decisions. KMAP wants
to make sure beneficiaries have the resources available to them so
they never
have to feel they had a stupid question...because it was unasked.
Benefits Specialists' Corner
This issue features Working Healthy Benefits Specialist Judi Vargas from the
Manhattan SRS Office. When not at work, Judi like to learn new things and take
classes. She is currently finishing up her first year of graduate school with
one year left. During school breaks she tries to find time to travel to places
she has never been before, especially where there are beaches! Judi enjoys
cooking, working out, encouraging other people to exercise, dancing, and listening
to all kinds of music. On the flip side; she also likes to follow politics,
world events and business. Judi can be contacted by phone at (785) 776-4011
ext. 227 or by E-mail at MJXV@srskansas.org.
"Over the past two and a half years, I have seen many positive changes
with the Working Healthy program. With the knowledge consumers have gained
regarding
various work incentive programs, many more people are confident about going
to work. Not only do they hear about the positive outcomes, they see them.
Some outcomes that consumers have seen or experienced are: accumulation of
assets, staying employed longer, better health, increased self-esteem, increased
job skills and financial stability. Work incentive programs, including Working
Healthy, have made this possible for so many Kansans.
With so many programs available to consumers, part of our job as Benefits Specialists
is to inform all affected consumers of the resources they can access. As times
change, new information regarding programs can also change. However, asking
questions and accessing community resources will help individuals stay informed
of all the benefits available to them. As Benefit Specialists we, too, do all
of these things to stay informed.
We are also helping individuals who do not qualify for Social Security Administration
(SSA) benefits because of resources or income. Individuals who can work part-time
may still be able to qualify for Working Healthy coverage even if they get
turned down by SSA because of income and/or resources. The “medically
improved” category has also allowed individuals to continue Medicaid
coverage through Working Healthy, when they would otherwise not qualify for
any Medicaid benefits. These components of our program make Working Healthy
unique, because we offer Medicaid coverage that wouldn’t otherwise be
available to working Kansans with disabilities. It has been exciting to see
how positive changes to our program have helped individuals in these situations
and how continued expansion of our program has the potential to help many more."
-Judi Vargas, Working Healthy Benefits Specialist
.
This newsletter and other Working Healthy information can be found online at:
http://das.kucrl.org/medicaid.html
Working Healthy is published quarterly by the University of Kansas CRL, Division
of Adult Studies and in cooperation with the Kansas Department of Social and
Rehabilitation Services. Additional copies and copies in alternate formats
are available upon request by writing the University of Kansas Division of
Adult Studies, Attn: Noelle, 1122 West Campus Rd.. JRP Hall Rm. 517, Lawrence,
KS 66045, by phone (785) 864-7085, by email: pixie@ku.edu
KU Research Team:
Jean Hall, Principal Investigator
Noelle Kurth, Project Coordinator and Editor
Dan Cox, Graduate Research Assistant
SRS, Division of Health Care Policy:
Mary Ellen O'Brien Wright, Program Director
Nancy Scott, Benefits Specialist Team Leader