Topeka — Members of the joint Legislative Post Audit Committee on Tuesday voted, 5-4, to order an audit of the state's Community Developmental Disability Organizations, or CDDOs.
In Kansas, there are 27 CDDOs that provide needs assessments and help coordinate care for Medicaid beneficiaries who have developmental disabilities; some of those CDDOs also provide the services.
The audit — requested by Senate Majority Leader Terry Bruce, a Hutchinson Republican — will be aimed at answering three questions:
1. Do substantial conflicts of interest remain for CDDOs that both provide and contract for services, and how could those conflicts be resolved?
2. How could the community services system be changed to maximize funding available for services for the disabled?
3. What would be the consequences for the community service system if Senate Substitute for House Bill 2155 was implemented?
Auditors said the report could be completed by Jan. 15, using three full-time researchers and by delaying a current audit. Committee members voted to delay an audit of the Kansas Sex Predator treatment program.
Sen. Anthony Hensley, a Topeka Democrat, said he didn't think the CDDO audit was necessary.
"In fact, I think it's premature based on the peer-review study that's been going on — and that was agreed to by the providers and by the state several years ago after the most recent audit in 2003," Hensley said.
The peer review he referred to involves out-of-state reviewers called in to investigate potential conflicts of interest when a CDDO is a provider of service for a client for whom it also does the needs assessment. A report has yet to be issued by the out-of-state reviewers, officials said.
Sen. Laura Kelly, a Topeka Democrat, asked auditors what they knew about the reviewers' work.
"It might be good if we knew something about what that system has done and the outcome of that system before we decide we're going to spend six months and three staff to determine whether or not there are any conflicts of interest," Kelly said.
The auditors said they would have to follow up later with an answer to Kelly's question.
Sen. Michael O'Donnell, a Wichita Republican, moved to expedite the CDDO audit.
Sen. Julia Lynn, an Olathe Republican, also spoke in favor of the audit.
"If there has been something put in place to address the concerns, I certainly don't know about it. And I think doing an audit now would give us some very valuable information as we go into implementation of KanCare," Lynn said, referring to Gov. Sam Brownback's initiative to move all Medicaid beneficiaries into managed care plans run by three insurance companies.
"Given what's occurring with KanCare, I'd be very interested in moving this audit forward and I think it's very timely," she said.
After the committee meeting, Tom Laing — executive director of Interhab, an association that represents most of the state's CDDOs — told KHI News Service that he thought the audit was "political payback" for his organization's opposition to incorporating long-term services for the developmentally disabled in KanCare.
"We'll go through the process. We don't have any problems with it. It's just hoop jumping," Laing said. "The CDDO system scores extremely high in terms of mitigating against outcomes that could be caused by conflicts of interest."
"The bigger irony is this: they just agreed to turn over $9 billion over the next three years to three out-of-state insurance companies," via KanCare, Laing said. "And that question never comes up, as to whether or not any conflicts will arise in that process. The lens of scrutiny is variable, I guess."
The four Democrats on the committee voted against the audit: Hensley, Kelly, and Reps. Tom Burroughs of Kansas City, Kan., and Ed Trimmer of Winfield.
The five Republicans present voted for it: O'Donnell, Lynn, Sen. Jeff Longbine of Emporia, and Reps. Virgil Peck of Tyro and John Barker of Abilene.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice.