Why privatize Comcare?

Sedgwick County’s Comcare is among only two county-operated community mental health centers in Kansas, and the new County Commission majority isn’t keen on government-run anything.

It follows that commissioners are looking at scenarios for privatizing mental health services in whole or in part. They should proceed slowly, though, and know where they’re going and why before giving up on a system that works as well as Comcare.

Though Comcare already contracts with the private sector for some services, the ideas floated during a commission meeting Tuesday included spinning off everything to a nonprofit organization and turning a scaled-down Comcare into a management agency overseeing private service contractors. There also was discussion of ways to raise private money to help support Comcare.

Currently, there are $2.7 million in local dollars within Comcare’s $30 million annual budget, which is mostly funded by state and federal money.

Of course, the local investment dovetails with other county priorities, as does Comcare’s work.

In recent years, for example, county leaders have become more aware of – and responsive to – the ways mental illness and addiction intersect with crime, homelessness, incarceration, and the lack of access to health insurance and care coordination. Excising mental health from the county’s obligations could prove both difficult and counterproductive.

The sweeping reforms being contemplated not only could leave hundreds of county employees jobless but also upend the treatment and stability of Comcare’s vulnerable clients, including many children with serious and persistent mental illnesses.

Just the reported talk of a privatization has stirred concern in the community, where Comcare employs 393 people and served 14,621 clients in 2014.

County commissioners no doubt would love to spare the county not only the local dollars currently spent on Comcare but also its ongoing and future liabilities.

But as the debate advances in coming weeks they should be guided less by some ideological playbook – and the imagined superiority and savings of some privatized alternative – than by the reality of how well Comcare provides services now.

“I don’t think the system’s broken,” Commissioner Tim Norton said during Tuesday’s “what if” discussion, emphasizing the need “to see a case for change.”

In the absence of that hard evidence, privatization of Comcare could put too much at risk, including lives.

For the editorial board, Rhonda Holman

This story was originally published April 16, 2015 at 7:07 PM with the headline "Why privatize Comcare?."