Kansas lawmakers temporarily limit a program that increases mental health services

Takeaways:

• Kansas lawmakers extended the limitation on which nonprofit medical providers can become CCBHCs until 2027
• The extension aims to manage the certification process and address concerns about workforce stability and fiscal impact
• There is broad agreement on the effectiveness of mental health centers, but advocates argue for expanding resources to meet increasing demand for mental health services

Targeted federal tax dollars turbocharged Sedgwick County’s COMCARE mental health clinic by helping it give patients more behavioral health treatment and add sorely needed staff.

COMCARE cut its staff vacancy rate from around 50% years ago down to 13%, thanks in part to a federal program.

Other community mental health centers have expanded their services to prison inmates and military members thanks to a federal model of mental health programming. The program certified nonprofit health centers and sent more money to increase programming.

But Kansas lawmakers decided to limit the types of psychiatric clinics, for now, that can tap into that money to improve services.

The federal government created the certified community behavioral health clinics (CCBHC) system in the late 2010s. Nonprofit medical providers could get certified as a CCBHC. To do so, clinics needed to offer nine core services, including crisis treatment, peer and family support counseling and psychiatric rehabilitation.

Any qualified nonprofit — which includes community mental health centers or addiction treatment programs — can get their money if it meets a range of standards.

Those centers must also offer those services to anyone regardless of ability to pay. Those locations got more money if they met the strict certification rules.

Kansas lawmakers passed a law in 2021 saying only community mental health centers can be certified under the program.

The law wasn’t controversial because other nonprofit medical providers were fine with putting community mental health centers first in line for certification.

This year lawmakers passed another law that only allows community mental health centers to become CCBHCs before 2027. The first law had a deadline in 2024.

“Now we’ve tacked on three more years,” said Stuart Little, lobbyist for the Behavioral Health Association of Kansas. “How many three-year extensions are we going to have on this?”

The new law comes as demand for mental health services continues to skyrocket.

Calls to the 988 suicide hotline increased 27% in its first six months. Mental Health America’s 2023 report ranked Kansas last in the nation for its mental health response. And more children report feeling depressed and contemplate suicide.

Little said the state should be expanding as many resources as possible because there’s plenty of work to go around.

Twenty-six mental health centers are pursuing certification in Kansas. Once those 26 finish, other providers can have their turn. Certification under the program, which was developed by the Substance Abuse and Mental Health Services Administration and Centers for Medicare and Medicaid Services, usually takes years.

Rep. Susan Ruiz, a Shawnee Democrat, said the state is not trying to stop anyone from becoming a CCBHC.

The original version of the bill did have a restriction that said only community mental health centers could get certified, but lawmakers weren’t comfortable with that permanent exclusion. So they create the multiyear provision instead.

“I have a problem with the word ‘limit’ because we’re not trying to exclude anybody from this,” Ruiz said.

Certification is also expensive. Ruiz said the full cost isn’t clear. She said allowing only certain places to become certified lets the state get a better understanding of the process.

Some centers are adding dozens of positions to get certified, and they worry a center in the same community also adding more positions would create workforce problems.

“This is not for the faint of heart,” said Joan Tammany, executive director of COMCARE in Sedgwick County, in a January committee meeting. “It’s taken us years to get to where we are. If we start expanding we’re going to destabilize what’s already being built.”

Sonja Bachus, CEO of the Community Care Network, represents 28 providers who could land CCBHC status after 2027. She told lawmakers in January that her network saw over 334,000 patients for 1 million visits in 2022. Of that, 10% of services provided were for behavioral health care.

She didn’t support the first version of the bill but is happy enough with the version that’s become law.

She told The Beacon over email that even though a multiyear sunset exists, the bill provides more clarity on who can apply in the future — something past legislation did not.

Bachus said members of her group are interested in becoming a CCBHC, but they need time before being able to apply.

“The Legislature took one more step that helps open the door to CCBHC status,” she said.