The state’s community mental health centers are drafting plans for limiting their services for the uninsured.
“We cannot keep continuing to be everything to everyone, while, at same time, see our funding for services for the uninsured continue to be reduced,” said Mike Hammond, executive director at the Association of Community Mental Health Centers of Kansas.
The planned limits, Hammond said, are necessitated by deep cuts in the state-funded grants the centers use to cover the costs of serving the uninsured.
Three years ago, the grants administered by the Department of Social and Rehabilitation Services totaled $31 million. Starting July 1, they drop to $14.8 million.
“You can’t take that much money out of the system and not have it impact services,” Hammond said.
Addressing a Wednesday meeting of the Kansas Mental Health Coalition, Hammond said the centers are developing plans for a three-tier system that will differentiate between patients with insurance, those on Medicaid and the uninsured.
“Every center is currently looking at how to design a benefit plan for individuals who don’t have a payer source,” Hammond said.
The reduced SRS grants, he said, will be used to pay for services for uninsured adults with serious and persistent mental illnesses and for uninsured children with severe emotional disturbances.
But someone with a less-serious condition — mild to moderate depression, for example — will likely have access to fewer office visits.
“The goal is still to respond to every crisis,” Hammond said, “but for those not in crisis, it’s likely there will be some triaging.”
The packages, he said, “are being put together now, they’ll be presented to the centers’ governing boards this summer, and I suspect they’ll be rolled out sometime this fall.”
Whether the limits comply with state laws requiring centers to serve all patients regardless of their ability to pay remains to be seen.
Hammond warned that if centers do not find ways to limit their losses, some could be forced to close their doors.
“I’m looking at $300,000 to $500,000 deficit for next year — that’s on an $8 million budget,” High Plains Mental Health Center Executive Director Walt Hill told KHI News Service.
The cuts in state funding, Hill said, are expected to affect some centers more than others.
“Those with a high percentage of Medicaid will fare better than those with a higher percentage of uninsured,” he said.
Based in Hays, High Plains Mental Health Center’s catchment area covers 20 counties in Northwest Kansas.
“Our experience has been that out in Western Kansas, we tend to have more uninsured and fewer Medicaid,” Hill said. “The vast majority — I’d say 80 percent — of the people we’re talking about here are neighbors, family and friends living on less than $25,000 a year.”
SRS Secretary Don Jordan said the agency will do what it can to help the centers manage the cuts.
“It is not in our best interest to drive a community mental health center out of business,” Jordan said.
Several coalition members complained the legislators have been slow in comprehending the impact of the cuts.
“I’m frustrated by the lack of effectiveness that we’ve had with the you-can-pay-now-or-pay-more-later argument,” said Rick Cagan, executive director at National Alliance on Mental Illness-Kansas. “My office gets calls every day from people who can’t get the services they need…and it’s going to get worse.”
Jordan complimented the advocates on their lobbying efforts this year, but asked the group to realize that legislators were inundated with e-mails from constituents opposed to raising taxes.
He warned that next year’s cuts are likely to be worse than this year’s.
“I didn’t come here with the message that this is pretty,” Jordan said.
— Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at dranney@khi.org or at 785-233-5443, ext. 128.