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Jan. 10, 2013
KANSAS CITY, Kan. Gov. Sam Brownback today described the broad outline of a new mental health initiative that he said would focus on the development of regional hubs to target services toward mentally ill persons who resist treatment until a crisis forces them into a mental hospital or prison.
He and other administration officials acknowledged the plan was prompted in part by the Newtown, Conn. school shooting last month that left 20 children and six adults dead after an apparently deranged and heavily armed man attacked Sandy Hook Elementary.
"What I've decided to focus on here is an area we know we can improve upon and can move forward on," Brownback said. "It's not a complete and full answer to the question. But we're focusing on an area where we as Kansans can move forward together."
"These events (the shootings) have dialed up interest in mental health services and we need to take advantage of that," said Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, the agency that oversees the state's mental health system.
Administration officials said details of the new initiative remain to be worked out over the next two months with the help of a new task force formed under auspices of the state mental health planning council and after likely consultation with legislative committees.
But the broad goals of the plan were described during a press conference called by the governor at Wyandot, Inc., the community mental health center in Kansas City, Kan.
Sullivan described the initiative as "Mental Health Reform 2.0," noting that the last major reforms to the system were about 15 years ago when the state closed Topeka State Hospital as part of the move to shift treatment to community settings instead of institutions. Some critics say an unintended consequence of those earlier reforms was that the state's jails and prisons have became de facto mental institutions because that's where many unstable persons end up.
Whether the new reform will prove as consequential or long lasting as those of the 1990s remains to be seen. For one thing, the governor's plan proposes no additional spending on mental health. Instead, it would redirect about $10 million already spent on services to the new program, which Sullivan said would build on a successful pilot project launched last year in four northeast Kansas counties.
The pilot, he said, focused on providing "intensive case management" to people with substance abuse and mental health problems. He said it had been "extremely successful" preventing readmissions to the state mental hospitals.
"We're going to look at replicating that model throughout the system," he said.
Sullivan said the plan would include development of between five and seven regional service hubs to be called Regional Recovery Support Centers.
In addition to intensive case management for those most resistant to treatment, the centers would provide regional collaboration among providers, peer support for families and some sort of "intermediate" facilities where mentally ill persons could spend two or three days becoming "stabilized" before returning to "wrap-around" services in their communities.
Sullivan said officials knew there were many people in the state hospitals who probably could be better served in community settings and that the system evaluation by the new task force would seek to identify how to make that happen.
He said the administration still had not identified locations for the regional hubs or which facilities might be used for the short-stay stabilization of patients.
Also joining the governor at the event and making brief remarks were Lt. Gov. Jeff Colyer, Corrections Secretary Ray Roberts and Mike Hammond, executive director of the Association of Community Mental Health Centers of Kansas. Also with the governor were Wes Cole, chair of the mental health planning council, and Ric Dalke, executive director of the Area Mental Health Center in Garden City. Dalke is current chair of the board of directors of the community mental health center association.
Hammond said the state's 27 community mental health centers welcomed the initiative because it could preserve $10 million in funding they need to help treat uninsured or underinsured patients.
He said the centers also welcomed the opportunity to take part in evaluating and making recommendations for improving the mental health system.
The state currently spends about $433 million a year on mental health services. That total includes federal Medicaid dollars and the costs of the state mental hospitals and other residential facilities.
State grant dollars to the community mental health centers, which are required by state law to serve all comers regardless of their ability to pay, has been cut by about half since 2008.
Mental health center officials say the $16 million in grants they get now help cover their costs of serving uninsured patients. They say the Medicaid reimbursements they get for treating people covered by that program fail to cover the true costs.
The governor did not rule out the possibility he would propose additional mental health spending in the future, depending upon the recommendations of the task force. But neither did he signal eagerness to loosen state purse strings.
"Let's see if they ask for it and in what areas," he said in response to reporter questions, "$433 million is a pretty good amount of money."
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