A special task force is correct that the state is providing insufficient care and support for Kansans with mental illnesses. But its call for increased resources – including expanding Medicaid – is not what Gov. Sam Brownback and the Legislature want to hear.
The Adult Continuum of Care Committee wrote in a recent report that the state’s continuum of behavioral care services was “insufficient to serve the needs of the population.” It also concluded that an inadequate safety net for people with severe, complex mental illnesses “jeopardizes the well-being of those individuals, puts communities at risk and places an undue burden on local resources, including law enforcement.”
The behavioral health system in Kansas has long been strained. But the problem became more acute this year after the state was forced to cap admissions to the Osawatomie hospital because of overcrowding. It then had to limit admissions even more and eventually institute a moratorium after it closed part of the hospital to complete federally mandated renovations.
The task force report emphasized that the state needs to complete the renovations as soon as possible so that hospital admissions can increase. It called for more regional and local services that can help reduce the strain on the state hospitals, including residential care facilities and crisis stabilization and diversion programs. It also recommended increasing the reimbursement rate for beds to support smaller community hospitals in expanding psychiatric units.
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But coming up with additional resources will be difficult, because of state budget problems and ideological objections.
The biggest opportunity to expand and improve the mental health system is to allow a federal expansion of Medicaid. According to the Kansas Mental Health Coalition, 53 percent of the people treated at community mental health centers in Kansas are uninsured, and 70 percent of them have incomes of less than $20,000. Expanding Medicaid would qualify thousands of Kansans to receive federally funded mental health services, helping them live healthier and more productive lives.
An official with the Kansas Department for Aging and Disability Services discouraged the task force from recommending Medicaid expansion, which Brownback and a majority of state lawmakers oppose. But the report recommended it anyway, saying the state should explore one or more expansion models.
The state also recently passed up another opportunity for expanded federal funding. KDADS decided not to apply for a federal Excellence in Mental Health grant that could have generated millions of dollars for behavioral health programs throughout the state, the Kansas Health Institute News Service reported.
A KDADS spokeswoman said the grant was too limited in its approach. But Kyle Kessler, executive director of the Association of Community Mental Health Centers of Kansas, said the grant could have “increased access to services and covered the costs of those services.”
The Brownback administration has put a lot of effort in trying to reform and reorganize the behavioral health system so that it can “provide the right care at the right time in the right place.” But the system also needs more resources.
For the editorial board, Phillip Brownlee