KHI News Service

Governor proposes deeper cuts in mental-health spending

By Dave Ranney | March 18, 2011

Gov. Sam Brownback has proposed cutting the budget for community mental health centers by an additional $17 million.

“This is absolutely devastating,” said Mike Hammond, executive director at the Association of Community Mental Health Centers of Kansas.

In a budget memo late Wednesday afternoon, Brownback noted that his proposed reduction in Medicaid funding for the centers, “reflected a new, lower estimate for expenditures in the Prepaid Ambulatory Health Plan.”

That plan is a managed care program run by Kansas Health Solutions, which is governed by a 15-member board, eight of whom have ties to the state’s 27 mental health centers.

The $17-million reduction would include $7.2 million from the State General Fund. The balance in cuts would be lost federal aid dollars.

The state's total spending on the community mental health centers for the current fiscal year is expected to be $221.5 million. The governor's latest proposal would reduce that total spending to about $196.3 million in fiscal 2012.

Hammond acknowledged that Kansas Health Solutions had generated the Medicaid savings cited by the governor, but he said those were going to be used by the centers to offset other proposed reductions in a pair of state-funded grant programs.

“He’s using the same money to cut us twice,” Hammond said. “If what the governor has proposed were to pass, we’d have a system that would send people in crisis situations to emergency rooms or to one of the state hospitals. If you’re a person without resources, the publicly funded community mental health would no longer be there for you.”

Kansas operates three state-run hospitals for the mentally ill.

“Let me remind you that all three hospitals are full,” Hammond said, “and we just took 14 beds offline at Rainbow (Mental Health Facility, Kansas City) because the feds came in and said it was understaffed.”

According to a Division of Budget document, community mental health centers are expected to receive an additional $16.6 million in Medicaid funding in the current fiscal year, about a 9 percent increase, while caseloads rose 4.5 percent. But the centers would see state-funded grants that help covers services for the uninsured reduced $15.2 million in the coming fiscal year, which starts July 1.

Hammond said the increase in Medicaid dollars this year wouldn't offset the cuts in the coming year for programs that help the center's pay for services to the uninsured.

"What people need to realize is that with Medicaid, there are no excess revenues that can somehow be used to offset the needs of the uninsured."

The House and Senate budget committees on Friday declined to go along with the proposed reduction.

"Mental health has been a priority in the senate for many years," said Senate Ways and Means Committee Chairwoman Carolyn McGinn, R-Sedgwick. "If you go back in the budget you can see that mental health has taken huge hits over the years, and so the Senate has just tried to restore some of those funding dollars."

In January, Brownback proposed eliminating a $10.2 million state grant that mental health centers used to cover the costs of caring for the uninsured.

According to a report from the Legislative Research Department, that cut would result in more than 2,300 individuals being denied services.

Brownback also proposed dropping Family Centered System of Care, a $5 million grant that centers used pay for services for families with mentally ill children.

The Senate budget committee has voted to restore most of the funding for each of those two programs.

The House Appropriations Committee has voted to restore most of the grant funding for the uninsured but none for the Family Centered System of Care grant.

Over the last three years, the grant program for the uninsured has been cut 65 percent.