KHI News Service

Brownback says now not the time to expand Medicaid

Cites waiting lists for the disabled seeking HCBS Medicaid services

By Dave Ranney | March 13, 2014

Minutes after calling attention to his administration’s efforts to reform the state’s mental health system, Gov. Sam Brownback reiterated his resistance to expanding the state’s Medicaid program.

It would be short-sighted, he said today at an event organized by mental health advocates, to broaden the program’s reach to include able-bodied, childless adults at a time when the state still has thousands of people with physical and developmental disabilities on waiting lists for services.

“I want us (first) to take care of the people who are on the waiting lists now,” Brownback said during a conversation with Finn Bullers, an advocate for the disabled.

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Gov. Sam Brownback talks with Finn Bullers, an advocate for the disabled during Mental Health Advocacy Day.

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The governor in a speech to the advocates had pledged his support for mental health programs and Bullers wanted to know why he wouldn't support a Medicaid expansion that could help many mentally ill people gain health coverage.

“He makes a wonderful speech,” Bullers said. “But when the rubber meets the road, the money isn’t there now. And when the money isn’t there, the services don’t get provided. If he expanded Medicaid, there would be more money than there is now and more people –people with disabilities, people with mental illnesses - would be getting services.”

But Brownback disagreed, telling Bullers a better approach would be to improve the current system.

“We have a lot of mental health (care) being done in our correctional system,” Brownback said. “Our systems aren’t integrated. In fact we’re probably exacerbating the problem.”

Brownback said that 68 percent of the state’s prison population is known to be mentally ill, addicted to drugs or alcohol, or both. But the state’s mental health and addiction treatment programs, he said, tend to have little interaction with one another.

“We’ve got to do a better job,” he said.

Sean Gatewood, a spokesman for the Kansas Medicaid Access Coalition, which is pushing for Medicaid expansion, also questioned Brownback’s reasons for not broadening access to the program.

“He seems to be overlooking the data that says 70 percent of the people being treated at one of the community mental health centers are making less than $20,000 a year,” Gatewood said. “And 53 percent are uninsured, which means they’re poor but they’re not poor enough to be on Medicaid (under the state's current eligibility requirements). These are the people that, clearly, Medicaid expansion would benefit.”

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Charlie Ross, a mental health advocate from Lawrence, suggested that Gov. Sam Brownback spend a night at Osawatomie State Hospital after Brownback told the crowd he had spent the night at prisons and homeless shelters to get better understanding of the conditions.

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Earlier, Brownback called attention to an initiative he launched earlier this year aimed at increasing service coordination between the state’s 27 community mental health centers. He also noted his administration's move to reconfigure and privatize operations at the Rainbow Mental Health Facility in Kansas City.

Both initiatives are being done without increases in state spending.

A Brownback-appointed task force is expected to propose a long list of proposed mental health system improvements within the next two to three weeks.

“It’s my understanding there may be as many as 90 different recommendations,” Brownback said.

About 350 people – a mix of mental health consumers, advocates, and service providers – attended the morning rally at the Maner Conference Center.

The governor assured the group that he shared many of their concerns, especially those tied to overcoming the stigma of mental illness and promoting peer support.

“The hallmark of a compassionate society,” he said, “is to help people who need help.”

Brownback said he had spent nights in prisons and homeless shelters in order get an up-close look at the issues facing society’s disenfranchised. In both instances, he said, he found that almost everyone suffered from “broken relationships” and severed family ties.

“We need to surround them with love,” he said.

After his speech, the governor was approached by Charlie Ross, a mental health consumer and advocate who lives in Lawrence. He encouraged Brownback to also spend a night at Osawatomie State Hospital.

“That’s a good idea,” Brownback said. “I hadn’t thought of that.”

Ross was a patient at Osawatomie for eight days in 2005.

“I’ve come to the conclusion that everything is underfunded,” Ross said. “And the only way we can turn that around is to educate the public, get them past the stigma, and get them to understand what mental illness is all about. Once that happens, I think they’ll be willing to put money into programs. That would be a sea change that would raise all boats.”

Kansas Department for Aging and Disability Services Secretary Shawn Sullivan said the agency is about two months away from announcing plans for convening a statewide discussion on mental health issues.

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Cherie Bledsoe, a Kansas City, Kan. woman who suffers mental illness, said peer support was important for those coping with the problem.

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He said it would be aimed at both children and adults.

Cherie Bledsoe, who runs SIDE, a Kansas City-based support group for consumers, said she would welcome that.

“People need to know that having a mental illness isn’t like what they see in the media,” she said. “It’s true that some people with mental illness do bad things, but people who aren’t mentally ill do bad things, too. It’s just you don’t hear about them so much.

“No one wants to be mentally ill,” Bledsoe said. “We just want to be part of the community, and for that to happen we need support. We need understanding.”

Blesoe, Ross and others then spent much of the afternoon talking with legislators at the Statehouse.

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