Kansas Medicaid Infrastructure Grant

1. Kansas Medicaid Infrastructure Grant The Division of Health Care Finance shall develop and maintain a coordinated health policy agenda that combines the effective purchasing and administration of health care with promotion oriented public health strategies.

2. Working Healthy • Implemented July 1, 2002 • Eligibility: • 16-64 years of age • Income up to 300% of FPL, with disregards • Individual assets less than $15,000 • Meet the SSI or SSDI disability eligibility standard • Have verified earned income from competitive employment • Be a Kansas resident Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"

3. Additional Options • Medically Improved (2005): • individuals with a mental or physical health problem that has been stabilized by assistive technology, medication, treatment, monitoring by medical professionals, or a combination of all of these, and loss of medical services may result in a deterioration of the condition (current enrollment = 10) • WORK (2007) • a “cash and counseling” personal assistance program, along with other services, via a Benchmark Benefit, to the Medicaid State Plan, thus increasing the numbers of individuals with severe cognitive, developmental and physical disabilities enrolled in Working Healthy (current enrollment 237) Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"

4. Kansas Medicaid Infrastructure Grant (MIG) • Since 2003, have been addressing attitudinal barriers to ensure a workforce comprised of youth and adults with disabilities with a mindset that they are able and willing to work, and that supports available to promote and sustain competitive, integrated employment, including benefits planning and health care. • In 2004, acquired state funding for seven regional Benefits Specialists available to all Kansans with disabilities. • Since 2007, our program evaluators have been working across state agencies to develop a comprehensive, statewide, system-level and person-level data tracking system to collect, analyze, and disseminate data on employment and health that drives program decisions and design. • Since 2008, worked with other state partners to develop relationships with employers, and in 2009, funded and assisted in the development and implementation of a Business Leadership Network (BLN) in Greater Kansas City. • In 2010, developed and implemented Benefits Academies to develop the skills of local providers to offer accurate benefit information. Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"

5. KU Program Evaluation • Since the implementation of Working Healthy, our evaluation partners, the University of Kansas, have been extensively studying the program in order to: • understand factors that influence enrollment by comparing Working Healthy enrollees to eligible individuals who do not enroll • assess satisfaction with the program and its perceived strengths and weaknesses • use findings to help develop public policy on changes to Buy-Ins, Medicaid, federal assistance programs, and provider practices The Division of Health Care Finance shall develop and maintain a coordinated health policy agenda that combines the effective purchasing and administration of health care with promotion oriented public health strategies.

6. Data Sources Longitudinal surveys of enrollees and a comparison group of non-enrollees to monitor employment and quality of life over time • Annual satisfaction surveys, with modules related to time-sensitive policy issues such as Medicare Part D and SSDI policy changes. Includes: • Demographics/Self-reported disability type • Benefits lost as a result of participation • Quality of Life • Self-reported earnings and job type • Employment experiences • Worker surveys • Dis-enrollment surveys • Administrative data Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"

7. Working Healthy Enrollment by Month, 2002-2010 2003 2008 2009 2010 *Does not include retroactive enrollment months, therefore subject to increase. From: Kurth, Fall, Hall (in press). Working Healthy Data Chartbook,2nd Edition.

8. Improved Financial Status Since Enrolling in Working Healthy, Self-Reported Agreement Level by Year Kurth, Fall, Hall (in press). Working Healthy Data Chartbook,2nd Edition.

9. Improved Mental Health Since Enrolling in Working Healthy, Self-Reported Agreement Level by Year Kurth, Fall, Hall (in press). Working Healthy Data Chartbook,2nd Edition.

10. *Figures are adjusted to 2009 for medical inflation From: Kurth, Fall, Hall (2011, in press), University of Kansas CRL, DAS

11. *Figures are adjusted to 2009 for medical inflation From: Kurth, Fall, Hall (2011, in press), University of Kansas CRL, DAS

12. *Figures are adjusted to 2009 for medical inflation From: Kurth, Fall, Hall (2011, in press), University of Kansas CRL, DAS

13. Total Medicaid CostsHCBS v WORK (pmpm) Source: Kurth, Fall & Hall (2011). Working Healthy Data Chartbook, 2nd edition. Kansas Medicaid Buy-In Research and Evaluation. University of Kansas, CRL-DAS. Notes. All amounts are adjust to 2009 for medical inflation. All expenditures include inpatient, outpatient, prescription drugs, dental, HCBS/WORK costs and mental health managed care capitation amounts.

14. Total Medicaid CostsDD Waiver v. WORK (pmpm) Notes: DD sample n=364. WORK sample 2008 n=95, 2009 n=161 Data Source: Kansas Medicaid Management Information System (MMIS)

15. Mean Hourly Wage Earned by Working Healthy Enrollees, Self-Reported by Year Kurth, Fall, Hall (in press). Working Healthy Data Chartbook,2nd Edition.

16. Aggregate KS State income taxes Paid by Continuously Enrolled Working Healthy Participants, 2004-2009 From: Kurth, Fall, Hall (2011). Working Healthy Data Chartbook,2nd Edition.

17. Percentage of Working HealthyEnrollees Paying Monthly Premiums From: Kurth, Fall, Hall (2011). Working Healthy Data Chartbook,2nd Edition.

18. How are Working Healthy Enrollees Faring? • A majority of Working Healthy enrollees report: • Closer to achieving preferred lifestyle since enrolling (53.8%) • Improved financial status since enrolling (62.4.0%) • Increased level of independence since enrolling (57.7%) • WORK enrollees (83.2%) • Overall earnings are increasing, overall medical expenditures are decreasing • Data Source: 2009 Working Healthy Satisfaction Survey (n=410) The Division of Health Care Finance shall develop and maintain a coordinated health policy agenda that combines the effective purchasing and administration of health care with promotion oriented public health strategies.

19. Kansas Strategic Planto Promote Employment 2007 - 2011 • Currently there is no clear vision in Kansas for the employment of people with disabilities. • In order for a comprehensive employment initiative to be successful, it will be crucial for state programs to establish a shared vision for employment of people with disabilities, as well as coordination of efforts with the goal of eventually achieving that vision. • Ideally, to ensure participation and accountability, this initiative should be carried out under the auspices of the Governor and/or Kansas Legislature. Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"

20. Kansas Employment First Initiative Act On May 11th, 2011, Governor Brownback signed House Bill 2336, the Kansas Employment First Initiative Act, into law. • Requires state programs and services to promote the employment of youth and adults with disabilities by coordinating and collaborating to ensure that state programs, policies, procedures and funding support competitive, integrated employment • Authorizes state agencies to adopt rules and regulations to implement the act. • Defines the terms competitive and integrated. • Instructs state agencies to share data and information across systems, when feasible, to track progress • Establishes a five member commission that will issue an annual report to the governor and legislature tracking measureable goals and objectives to ensure implementation of the act. • Requires all state agencies to fully cooperate with, and provide data and information, to assist the commission in carrying out its duties. Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"

21. Contact Information To learn more about the Working Healthy program and view the Data Chart Book, visit our web site at: www.workinghealthy.org Mary Ellen O’Brien Wright (785) 296-5217 mwright@kdhekd.gov The Division of Health Care Finance shall develop and maintain a coordinated health policy agenda that combines the effective purchasing and administration of health care with promotion oriented public health strategies.