A proposal to except developmental disability care from the governor’s Medicaid reform effort led to a tense exchange — and an admonition from the speaker of the House — for two of Wichita’s most prominent lawmakers.
The exchange came after Rep. Jim Ward, D-Wichita, and Brenda Landwehr, R-Wichita, tangled over an attempt by Ward to amend a bill to take developmental disabilities out of Gov. Sam Brownback’s plan to cap the costs of the state’s Medicaid services programs.
Brownback is in the process of implementing a plan to shift services to managed-care plans administered by for-profit insurance companies, to be called KanCare.
Ward strongly criticized Landwehr, the chairwoman of the Health and Human Services Committee, for delaying consideration of the exception. At one point, he urged the House to “keep your big-boy pants on, today’s the day.”
But as it turned out, it wasn’t the day.
Landwehr and her allies succeeded in keeping Ward’s amendment from coming to a floor vote by getting the underlying bill sent back to committee on a 69-54 vote.
“I would be happy to have two or three weeks of hearings on this (disabilities) issue because it’s major,” Landwehr said. “I understand these budgets, I actually know some of these kids as friends and family and neighbors that are receiving these services. I talk to the parents. To make a policy change like this on the floor is not doing a service to them.”
Ward said after the meeting that the bill was sent to the Appropriations Committee to kill it, but he plans to bring it up again when the Legislature reconvenes for its wrap-up session late next month.
Providers, parents and others in the developmental disabilities community have been lobbying for an exemption from KanCare, out of concern that the change would be too disruptive to mentally fragile individuals receiving home- and community-based services.
Care for the developmentally disabled represents about $320 million of the $2.9 billion to be contracted out under KanCare, officials said.
Ward attempted to get developmentally disabled people out of KanCare by attaching it to a bill — being carried by Landwehr — to establish a committee to oversee the operation of KanCare.
The amendment had bipartisan support, with several Republicans going to the well to speak in favor of it.
“I’m sure all of us have heard from our constituents who are parents of the disabled, that they do not want insurance companies who are unfamiliar with the care of the (developmentally disabled) population managing their care,” said Rep. Pat Colloton, R-Leawood.
She said in medical matters, KanCare is a good idea and can bring about savings for the government. But she said handling services for the developmentally disabled is a different challenge, one that traditional health insurers are poorly equipped for.
“The typical day of a developmentally disabled person requires help, perhaps with feeding, providing food for them, help with dressing, help with even going to the bathroom, many of them have a variety of physical ailments,” she said. “In that case, you can’t simply say, ‘Oh, take a little bit more blood pressure medicine’ or ‘Oh, by the way, now why don’t you just manage yourself and hurry out to look for a job.’”
Rep. Bill Otto, R-LeRoy, linked it to pro-life politics and said “I support those people who are born less than perfect and those who become less than perfect through their lives.”
With momentum seemingly building for Ward’s amendment, Rep. Dave Crum, R-Augusta, proposed sending the underlying bill back to the Appropriations Committee for further study.
That drew an immediate and passionate response from Ward.
“Incredible,” Ward said. “This bill was introduced in January. I spent 60 days cajoling, arguing, persuading, begging the chairman of Health and Human Services (Landwehr) to have a hearing on the bill and was told, ‘Maybe, maybe, we’ll see.’
“So then at the end, the very end, she sticks three bills before the committee in a two-hour period and restricts the confreres to two minutes. People who had traveled across the state to bring their message to Topeka; two minutes; ‘we don’t have time to listen to you more than two minutes.’”
Ward said after that hearing, he asked Landwehr to put the bill to a committee vote and she answered “Well I don’t know, that hasn’t been decided yet.”
“And now they come and say, ‘Oh my gosh, we need to send it back to committee,’” Ward said.
Moments later, Landwehr replied: “You may not like my policies, you may not care how I handle my policies, but one thing that legislators who have worked with me for 18 years know, I do not lie.
“The delay in the hearings was to wait until we knew who the (KanCare) bidders would be,” she said. “The delay in the hearings was so that we could have the opportunity to give the questions to KDHE to answer and respond, because these people deserved an answer.”
Landwehr said she had scheduled three days of hearings, but House members were held up on the floor, forcing cancellation of the first day and cutting 45 minutes off the second day. She said she didn’t like limiting speakers on the third day, but had to, in order to hear from all the people who had traveled to attend.
“The carrier of the amendment (Ward) wasn’t there for the hearing,” Landwehr said.
At the time of the hearing, Ward was appearing before a special ethics committee to fend off a complaint — filed by Landwehr, among other Republicans — questioning Ward’s explanation of a floor amendment he’d attempted to try to reduce property taxes.
House Speaker Mike O’Neal, R-Hutchinson, rebuked the lawmakers after the argument over disability services.
O’Neal cautioned them not to engage in personal attacks and not to “impugn the motives of members.”