Turning community mental health operations over to a non-profit agency would make Sedgwick County a smaller government, but the change would be complex and could create unnecessary anxiety among staff and clients, according to an analysis shared with commissioners Tuesday.
Comcare, the county’s mental health center, serves about 16,000 people who struggle with mental illness and alcohol and drug addiction.
Commissioner Richard Ranzau asked county staff to study the pros and cons of moving it to the private sector.
The idea first emerged a couple of years ago when a committee began looking at ways to trim the county’s budget and make it more efficient. Twenty-five of 27 community health centers across the state are under a non-profit. Those run by government are in Sedgwick and Johnson counties.
“I think it would alleviate some of the bureaucracy that Marilyn (Cook, the executive director of Comcare) and others have to deal with and allow for increased efficiencies,” Ranzau said after the meeting. “If we did it right, I think it’d help us control costs over time.”
County Manager William Buchanan disagrees and recommends that Comcare continue under the county.
“This issue came up a couple years ago. I didn’t think it was a good idea then, and I don’t think it’s a good idea now,” he said.
He pointed to two major reasons he’s against moving Comcare out of the county’s purview.
“Having elected officials in charge instead of a private board of directors, it’s direct democracy. Otherwise it’s diffused,” Buchanan said. “No. 2, we provide superb service, so what’s the need for change?”
Cook “has been an advocate for a long time for more flexibility” and had supported the idea a couple of years ago, he said.
On Tuesday, she told commissioners that “I think we missed our opportunity having not done it a couple of years ago. I think it made more sense a couple of years ago.”
That’s because Comcare has made changes since the idea first emerged.
Efforts to reach Cook for additional comment were unsuccessful. The Eagle asked the county’s communications team to have Cook call the newspaper. Amanda Matthews, a spokeswoman, responded by saying that Buchanan would call The Eagle. The Eagle also called Cook directly but was unable to reach her.
The staff report said advantages of making Comcare a non-profit would include the county having fewer employees. The agency has a staff of about 400 people with a budget of about $46million. There also would be less demand on other departments that serve Comcare, such as legal, finance and technology.
Listed as “unknowns” were the impact of any changes on Comcare clients and the effect of the federal Affordable Care Act on a new, smaller organization. Smaller group and health insurance costs also would be a factor.
Disadvantages would be the need for changes to state law that allows commissioners to serve as the governing board over Comcare. The county also would have a “reduced influence over a significant component of the public health/public safety continuum,” the report said.
Cutting ties financially would be complex. For example, the county could have to pay out about $580,000 for unused vacation time for employees.
Billing and technology changes also could be a hassle, the analysis said.
Buchanan said he couldn’t think of an existing non-profit agency equipped to take over an operation as big as Comcare.
“I think you’d have to create one,” he said.
Comcare receives $6.79 per capita from property taxes. That ranks it as 40th among 105 counties in terms of funding and below the mean of $7.04. Its per capita funding ranks fourth among metropolitan counties behind Johnson, Shawnee and Douglas counties and ahead of Wyandotte County.
Cook said during the meeting that if she were to continue to head Comcare under a non-profit, she’d ask for more money.
Commission Chairman Jim Skelton said after the meeting that he was undecided about whether to move forward with more discussion about the idea.
“I think it’s reasonable to keep it on the table right now,” he said. “I still have yet to sit down with staff and talk about the details. I’m interested in learning more at this point.”
Commissioner Dave Unruh said he was “not convinced that we need to make a change. I’m interested in doing what makes sense. My primary concern is that the client continue to receive responsible and high-quality attention from our service providers. We have worked very hard at making our organization efficient and cost-effective.”
Unruh also doubted whether the county could find a non-profit agency willing in this economic environment to take on something as big as Comcare.
The Breakthrough Club, a program offered through Episcopal Social Services that works to support people with mental illnesses, did not return a phone call. Neither did the Wichita chapter of the National Alliance on Mental Illness.