Volume 6, Number 1


July, 2006

Comprehensive Employment Opprotunities (CEO) Proposal Submitted

Kansas Working Healthy staff recently submitted an application for a CEO grant from the Centers for Medicare and Medicaid Services. The vision of the Kansas proposal is that “Increased employment and entrepreneurial opportunities for people with disabilities will result in equal participation and competitive employment.” The proposal outlines six goals:



1. Develop a strategic plan to address increasing the competitive employment of individuals with disabilities;



2. Create a cross-government vision that compels coordination across and within agencies to expand the competitive employment of Kansans with disabilities;



3. Fully engage employers as partners in the employment of Kansans with disabilities;



4. Empower individuals with disabilities and their families, through choice, to become independent and self-sufficient economic agents;



5. Create a comprehensive, statewide system- and person-level data tracking system to collect, analyze, and disseminate data on the employment of Kansans with disabilities; and



6. Maintain and strengthen the Kansas Medicaid Buy-In program, Working Healthy.



In order to achieve these goals, the project will employ novel approaches such as pilot projects with businesses, life planning and peer mentoring programs for youth with disabilities, professional development modules for service providers, and creation of a “virtual data warehouse.” Employers and people with disabilities will be involved in all project activities. If funded, the new grant activities will begin in January 2007.

Kansas Young Adult Survey

In partnership with the Kansas Youth Empowerment Academy, and with funding through the Sunflower Foundation and the Working Healthy program, KU staff recently completed a survey and focus groups with alumni from the Kansas Youth Leadership Forum (KYLF) to gain an understanding of their concerns related to health care, employment, education, and community participation. The 30 participants in the study had a range of disabilities, represented both rural and urban areas of the state, and ranged in age from 18 to 24. Among the findings were that:



• Participants experience several barriers to accessing health care, including lack of transportation, expense, attitudes of providers, difficulty finding doctors who accept Medicaid, and difficulty getting referrals to specialists;



• Although 77% of participants plan to work, only 53% had received vocational or career training to help prepare them for a job;



• Twenty percent feared losing health insurance or disability benefits if they work too much;



• When asked to rank topics about which they would like more information, “becoming more physically active,” “how to find a support group,” and “how to participate in recreational activities” were among the top ten responses.



Hopefully, these and other needs of young adults with disabilities will be addressed through various activities of the Kansas CEO grant. A copy of the full report from the KYLF study will be posted soon at the KS Youth Empowerment Academy Website.

Benefits Specialist Corner

This issue features Working Healthy Benefits Specialist Stefania Haessig from the Wichita Service Center. Stefania has been a Benefits Specialist for a little over a year. Her coverage area includes the counties of Harper, Kingman, Reno, Sedgwick and Sumner. Stefania can be reached by phone at 316-337-6427 or by E-mail at WSZH@srskansas.org



"Working Healthy is an exciting program. Over the years enrollment has grown and challenges have been faced along the way. I have been a Benefits Specialist for a year now and during this time I have experienced how much this program benefits its enrollees. With the elimination of spenddown, the payment of Medicare Part B and Part D premiums, and the ability of enrollees to accumulate assets and earn more without losing medical coverage, Working Healthy has been a tremendously successful program. In addition, I believe that Working Healthy gives people the opportunity to increase their standard of living. When a person is working, it is not simply an accumulation of money. Work gives people the ability to be self-sufficient and increases confidence and creativity. Moreover, it puts the person in a new role as an employee, where he or she enters a different environment with socialization, team work and responsibility. 



In order to better serve our consumers, we, the Benefits Specialists are willing to take on new tasks and to face new challenges. We learn to change our approaches and to adapt in new situations. We have added new roles to our job descriptions, such as providing assistance with Medicare Part D. We believe that when major changes that impact the lives of our consumers take place, we should also change our role and priorities so that we can respond accordingly to the situation. Through personal research, frequent training, conferences and tele-meetings, we are able to expand our knowledge so that we can provide solutions to any problem. 



Two other Benefits Specialists and I will be attending the Association for Persons in Supported Employment (APSE) Conference in Boston. At this conference, issues such as job development, program management, placement support, school to career transition, and family and consumer issues will be discussed. 



Finally, I would like to add that I truly believe in the potential of Working Healthy. I have seen how it influences people’s lives and I am very proud to be promoting a program with such a positive influence. I would like to personally thank all the Benefits Specialists who assisted me throughout the year. When I first started in this position, I had a lot to learn and I would like to let them know how much I appreciate their patience, time and willingness to help me overcome difficulties. We have a great team that is working closely together targeting a better future." -Stefania Markou Haessig, Working Healthy Benefits Specialist



Working Healthy Enrollment & Premium Statistics

By Noelle Kurth, KU Evaluation Team

As of July 1st Working Healthy celebrates its fourth year. From that first month in 2001, staff have been continually surprised by its growth and success. First year enrollment was more than double the projected figure of 100 people in just the first month (see Figure 1). Since then, because of the hard work of program staff and the continued feedback and support of stakeholders across the state, Working Healthy enrollment has not only grown, but the program itself has matured. For example, in October 2004 the “Medically Improved” category of coverage under Working Healthy was added, allowing individuals with that Social Security designation to continue participation in Working Healthy as long as their disability or condition is documented by a doctor, nurse practitioner or psychologist. Having eight individuals currently enrolled under this category of Working Healthy is significant and unique to Kansas.



Another programmatic and enrollee achievement over the past four years is the increase in the number of individuals paying premiums. Currently, 67% of Working Healthy enrollees pay premiums for their coverage (see Figure 1). This indicates that a significant number are either earning more than they were before they began the program - i.e. with Working Healthy they are able to earn more and keep their Medicaid coverage so they are not consciously keeping their earnings low - or people with disabilities who previously did not have Medicaid coverage at all due to the level of their earnings now are able to obtain Medicaid coverage because of Working Healthy. 



Recently, Working Healthy enrollment has declined slightly. Until January of 2006, enrollment had steadily grown. A concrete reason for this decline has yet to be determined, but one possible explanation is the start of Medicare Part D prescription drug coverage on January 1, 2006. Many consumers believe or have been led to believe that because Medicare now pays for their prescription drugs, keeping Working Healthy is not necessary. Because Working Healthy was previously paying for their medications, they no longer see a reason to keep paying Working Healthy premiums in addition to having Medicare Part D. In some cases, this may be true; however, in many cases it is still beneficial for dual-eligibles to keep Working Healthy coverage. We encourage all enrollees to talk to their Benefits Specialist before dropping their coverage. Interruptions in Working Healthy could prove costly if a person finds they should not have dis-enrolled and need to pay premiums for retroactive enrollment months. We are surveying and speaking with consumers to determine other possible reasons for this first decline in enrollment in four years.



FIGURE ONE INFORMATION: 

Title: Kansas Working Healthy Total Enrollment

July 2002: Total enrollment = 248, 20% of which paid a premium

January 2003: Total enrollment=531, 53% of which paid a premium

June 2003: Total enrollment = 614, 59% of which paid a premium

January 2004: Total enrollment = 694, 61% of which paid a premium

June 2004: Total enrollment = 764, 60% of which paid a premium

January 2005: Total enrollment = 844, 62% of which paid a premium

June 2005: Total enrollment = 933, 63% of which paid a premium 

December 2005+: Total enrollment = 1008, 63% of which paid a premium

June 2006*: Total enrollment = 968, 67% of which paid a premium

+Note: December 2005 data is provided due to enrollment at its highest point to date in this month.

*Note: Because of the 3-month window for retroactive enrollment, the June 2006 figure is subject to increase.

Source: Kansas InterChange Medicaid Management System (KiCMMIS)

Working Healthy is published quarterly by the University of Kansas CRL, Division of Adult Studies and in cooperation with the Kansas Health Policy Authority. 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

Michelle Crick, Graduate Research Assistant

Kansas Health Policy Authority:

Mary Ellen O'Brien Wright, Program Director

Nancy Scott, Benefits Specialist Team Leader