State integration concepts and frameworks

¶ … integration of human services is critical to the efforts of the state of Kansas in its ongoing attempts to integrate services for elderly people needing long-term care. What we will show in this short study is that careful oversight in managed health care, including of contractors that programs are outsourced to as well as the integration of services produces the results necessary for more efficient yet better social services.

In the opinion of this author, practically all of the Kansas Department on Aging should and can be subsumed under the Rehabilitation Services and the Mental Health Services departments of the Kansas Department of Social and Rehabilitation Services which is under the Kansas Health Policy Authority. This agency works to fully optimize the promotion and protection of the health of Kansas citizens through the efficient and effective public health programs as well as services and through the preservation, protection and also the remediation of natural resources of the environment. It also protects the state's children, promotes adult self-sufficiency and also provides support and services to improve lives in the state. The bridge of integration between the Departments of Social and Rehabilitation Services and the Department of Aging is represented in the Rehabilitation section ("Kansas department of," 2011 and "Kansas department on," ) . This is primarily through the agency of managed care in community-based programs in the opinion of this author; this would be superior to creating a new agency such as the Office of Integrated Community Services. This author favors the second option given to Governor Brownback which for the reform of the integration of human services in Kansas which would involve an agency modification instead ("Remaking kansas medicaid," 2011).

Currently, the subsections of these departments are integrated via managed care services due to "outpatient" and out of institutional services. Much of this would be done by restructuring and outsourcing of government services to private sector agencies that hopefully will do things more efficiently as well as providing better service ("Remaking kansas medicaid," 2011).

While outsourcing and saving money all looks good on paper, the question is very much about how this outsourcing has fared historically. A 2010 report for the state legislature traces the progress of state outsourcing and finds that the stat has achieved moderate to high levels of accountability effectiveness. However, accountability is undermined by the use of risk shifting, reliance upon a system of multiple providers and adopting new information technologies. This data does not necessarily supplement the conventional wisdom about outsourcing to contractors as being the best way to go. Confusion, the duplication of services and other problems have been However, in the age of recession, innovation has become the norm and in between the extremes of left and right there is a middle ground that dictates that accountability to and oversight of contractors provides the environment necessary for the reforms to take effect and for the positive results of the outsourcing to take hold. Such oversight provides the coordinated and integrated coverage that the taxpayers expect and deserve ("Kansas health policy," 2010).

This is especially the case in managing and coordinating care for the aged and disabled population in the state of Kansas. This is now that is as follows, which now includes these components:

Additional managed care options for Kansans in the disabled and aged populations could be put in place but would require policy and RFP development. This would most likely entail new and up-front funding to implement.

Waiver consolidation that would require more stakeholder input, design, CMS review and approval.

Apart from program reductions, this option appears reformers to offer the greatest potential for long-term savings in Medicaid medical costs, such as more comprehensive programs linking medical care with behavioral health and/or long-term care would merit a more comprehensive review (ibid, pp. 49-50).

With regard to the feasible Short-Term Options which will be implemented within one year, the following options are the most likely to generate increased financial savings in the short-term. This is based upon the ease of implementation. Also key is the initial investment of funds that are required. The report concluded that the speed with which savings can be achieved. These options do not constitute recommendations by KHPA. Implications for each option are describe above and are not repeated in this summary list (ibid, p. 50).