Sedgwick County commissioners discuss privatizing county’s mental health services

Sedgwick County commissioners are considering shutting down their Comcare mental health department and shifting its service responsibilities to a private nonprofit group.

At their staff meeting Tuesday, commissioners heard various scenarios for transferring the department to an existing nonprofit, or creating a new one to take over.

The proposed switch to private management could displace as many as 393 county employees. Some scenarios would have them all transferring to the nonprofit group, while others would result in as many as 344 layoffs.

With 14,621 unduplicated clients in 2014, Comcare is the largest community mental health organization in the state. Johnson County Mental Health Center, with 8,741 clients, is the only other one in Kansas directly run by a county government.

Local tax dollars pay about $2.7 million of Comcare’s $30 million mental health budget, with the bulk of funding coming from state and federal sources.

Comcare’s county employees directly handle about half the services the agency provides to the public. The other half comes through contracting with private-sector service providers, said Chris Chronis, Sedgwick County’s chief financial officer.

In addition to the option of leaving Comcare the way it is, Chronis presented three scenarios for moving the agency more toward the private sector:

▪ Full privatization: The county would turn all employees, funding, assets and responsibilities over to a designated nonprofit. The County Commission would step aside and exercise no further control over mental health services.

How much to spend and how to spend it would be up to the nonprofit, which would retain any surpluses or pay any shortfalls. The 393 current county employees would transfer en masse to the nonprofit. County Manager William Buchanan said their jobs would be guaranteed for a negotiated period of time, possibly a year, after which it would be up to the nonprofit to determine whether to keep them.

▪ Comcare contracting: Comcare would continue to exist as a county department but would be pared down to management only and contract out all direct services to clients. Commissioners would remain in control.

This scenario would result in layoffs for 344 service-providing employees, at an estimated cost of about $3.3 million for severance pay and accumulated vacation payouts.

▪ Nonprofit contracting: The county would turn full responsibility for mental health services over to a private nonprofit, which would then contract out all direct-care services to other entities.

About 48 Comcare administrative employees would transfer to the nonprofit, while 344 direct-care workers would be laid off, again, resulting in $3.3 million of severance and vacation payout costs. The commission would have no further role in directing services and any shortfalls or income would go to the nonprofit.

Commissioner Tim Norton questioned the entire concept and said commissioners would abandon responsibility for their constituents’ services if they offload Comcare.

“I know we’re having this conversation, but I’m not sure why,” Norton said. “I don’t think the system’s broken; I think it’s been effective for many years.

“What are those things we’re looking for? Is it dollar savings? Is it divesting ourselves from providing services? Is it that we think we are not very good at it? Whatever that is, I’d like to see a case for change.”

Commissioner Jim Howell said he would like more information, particularly from the point of view of people receiving services, and how those services can possibly be provided more efficiently.

“I’d think the goal for government ought to be we would provide good services at the least cost to the taxpayers,” Howell said. “I think it’s healthy to review what we’re doing periodically.

“Just to say we’re comfortable and things are working well is not the question. Is there anything we can do better?”

Commission Chairman Richard Ranzau said he thinks privatizing Comcare would open up more opportunities to raise charitable donations to help pay for a new building for mental health services, and Commissioner Karl Peterjohn said he thinks there are grants available to nonprofits that aren’t available to government agencies.

Buchanan said the county could start its own tax-exempt charity to raise money and go for private grants to help support Comcare. He said he would research those options and report back to the commission in an upcoming meeting.

This story was originally published April 14, 2015 at 1:00 PM with the headline "Sedgwick County commissioners discuss privatizing county’s mental health services."