Jul 17, 2023

Opinion: Kan. is on the precipice of change in the mental health arena

Posted Jul 17, 2023 10:00 PM
Robbin Cole is CEO Pawnee Mental Health Services-courtesy photo
Robbin Cole is CEO Pawnee Mental Health Services-courtesy photo

By Robbin Cole, CEO Pawnee Mental Health Services

Earlier this year, Mental Health America placed Kansas 51st in the nation (including DC) in terms of overall mental health. The report ranked the states in 15 different measures. The measures that had the largest impact on the overall ranking for Kansas were youth with substance use disorder, adults with any mental illness and adults with serious thoughts of suicide.  

Hope is not lost. It never is, by the way. Kansas is on the precipice of change in the mental health arena.  In 2021 the Kansas Legislature passed the CCBHC model into law. CCBHCs (Certified Community Behavioral Health Clinics) are a federal Medicaid model that relies on intensive care management to integrate physical and mental health care. Kansas is the first state in the nation to pass CCBHC legislation. Pawnee was provisionally certified as a CCBHC on July 1 and will work towards full certification by January 1, 2025. All Community Mental Health Centers in Kansas are moving towards certification as CCBHCs by the end of the year. This is one of many things happening in Kansas which should improve upon Kansas’s last place ranking.

CCBHCs are required to provide nine core services:

  1. Screening, assessment, and diagnosis
  2. Primary care screening and monitoring
  3. Crisis care mental health services
  4. Patient-centered treatment planning
  5. Outpatient mental health and substance use services
  6. Targeted case management
  7. Psychiatric rehabilitation services
  8. Peer support, counseling, and family support services
  9. Veterans Services

The goals of the CCBHC program in Kansas are to:

  1. Increase access to community-based mental health and substance use disorder services (particularly to under-served communities)
  2. Advance integration of behavioral health with physical health care
  3. Improve utilization of evidence-based practices on a more consistent basis

The Medicaid CCBHC model will pay Kansas Community Mental Health Centers on a cost basis, that is, what it costs to provide services to meet the needs of the community, rather than based on Kansas Medicaid rates which have remained virtually unchanged (with some exceptions) for twenty years. This will better position Kansas Community Mental Health Centers to recruit and retain staff for the important work we do. Mental Health America’s ranking of Kansas as 51st in the nation will soon be in our rear-view mirror.

Another thing happening in Kansas which should improve upon Kansas’ last place ranking was the recent allocation of SPARKS funds (federally funded, state administered, pandemic related dollars) to open a new state mental health hospital in south central Kansas. This hospital will create 50 adult inpatient psychiatric beds. The state also has allocated $12.7 million to KVC Health Systems to open a new psychiatric hospital in Olathe which will create 48 youth and 24 adult psychiatric beds. Mental Health workforce issues complicate the issue but that’s another matter.

While Kansas’s 51st ranking isn’t about Medicaid expansion, it’s about Medicaid expansion.  Kansas is one of only 10 states in the nation that has not expanded Medicaid. The federal taxes we pay help support Medicaid expansion in the 41 states (including DC) that accept Medicaid’s ongoing cash infusion, including the four states bordering Kansas on all sides.

Our state legislative leaders won’t even allow the issue to come to the floor for debate. Polls show that a majority of Kansas voters would support Medicaid expansion if given the opportunity. The federal government covers 90% of the cost of expansion. The University of Kansas Institute for Policy and Social Research estimates that Kansas lost out on an estimated $4.9 billion in federal Medicaid funding between 2014 and 2021 as well as $6.62 billion in related economic activity for failure to expand. The money is there. Let’s take our fair share.

More than 150,000 Kansans with household incomes under 138% of the federal poverty guidelines 

would qualify for health insurance benefits under an expanded Medicaid program. For a family of three, the threshold is about $32,000 annually. Imagine the social and economic impact on Kansas if all Kansas children and families had access to affordable health care. Imagine the impact on Kansas hospitals and other health care providers, especially those in rural areas, if they could get paid for the services, they provide to the people under 138% of the federal poverty guidelines who they serve. 

No state wants to be 51st in the nation in anything. We certainly don’t want to be 51st in the nation in mental health. Let’s urge the State of Kansas to do what it must to improve upon Kansas’ last place mental health ranking. 

For more information on CCBHC in Kansas, go to https://kdads.ks.gov/kdads-commissions/behavioral-health/certified-community-behavioral-health-centers. For more information on the 2023 State Mental Health Rankings go to https://mhanational.org/issues/2023/ranking-states.

Robbin Cole, CEO Pawnee Mental Health Services