KHI News Service

Mental health center braces for spending cuts

By Dave Ranney | December 07, 2012

The head of a community mental health center that serves 20 counties in northwest Kansas said today that his agency will need to significantly cut its budget for children’s services because of the anticipated decrease in state tobacco settlement dollars it receives.

Hill, executive director of High Plains Mental Health Center in Hays, said he cannot responsibly ask his board to spend money he doesn’t expect it to receive.

“We have $180,000 in the budget now,” for the programs, he said. “I’ll be recommending $90,000. I’ll be presenting this to my board next Thursday.

Hill said the agency's planned spending cuts were driven by a Kansas Children’s Cabinet decision Monday to include programs for mentally ill children and their families on a list of services that Gov. Sam Brownback could consider defunding in anticipation of a major reduction in the state’s tobacco-settlement revenues.

KHI News Service

Walt Hill, executive director of High Plains Mental Health Center in Hays.

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The Cabinet’s recommendation called for reducing the $56 million in tobacco money now being spent on children’s services to $37 million in the fiscal year that begins July 1, 2013.

Hill said he and other mental health center directors expect Brownback to embrace the Cabinet’s recommendation.

The governor’s spending plan for the coming fiscal year won't not be officially public until it’s presented to legislators in early January.

Earlier this fall when presenting their recommendations to the state budget division, the Kansas Department for Aging and Disability Services foretold the Cabinet’s recommendation by including the Family Centered Systems of Care program ($4.76 million) and Children’s Mental Health Initiative ($3.8 million) in its list of programs that could be eliminated, if funding was tight.

Hill said the two programs provide case management and in-home services for about 400 children in northwest Kansas.

“It appears that we won’t be able to provide these services for children who aren’t on the SED (Severe Emotional Disturbance) waiver and eligible for Medicaid,” Hill said. “That’s about 200 kids.”

He said he would look for alternate sources of funding, but wasn't optimistic about finding them.

“The only thing I know to do is find ways to get Medicaid to pay us for services they aren’t paying us for now,” he said. “We’re not going to get more from the state, and the counties have made it clear that they’re really not in a position to do more, either.

“The only thing left is Medicaid,” Hill said. “These are services that insurance doesn’t cover and that most of these families can’t afford.”

Hill discussed the problem during a Friday meeting of the Governor's Mental Health Services Planning Council.

Sheli Sweeney, advocacy and member services coordinator with the Association of Community Mental Health Centers of Kansas, said other centers were “sure” to follow High Plains' lead.

“What we’re trying to get people to understand is that the $3.8 million that’s in the Children’s Mental Health Initiative Fund is used to bring in matching Medicaid dollars,” she said. “So we’re not just talking about $3.8 million, it’s actually closer to $10 million.”

The Family Centered Systems of Care program, she said, was wholly state funded and not subject to a federal Medicaid match.

“These are not expensive programs,” Sweeney said. “They serve more than 6,000 children across the state. They keep families together, they keep children in school, out of PRTFs (Psychiatric Residential Treatments Facilities), out of foster care and out of the juvenile justice system.”

The Cabinet’s recommendation was driven by concerns that an ongoing legal dispute involving 32 states, including Kansas, and the nation’s major cigarette companies could result in the companies being allowed to withhold tens of millions of dollars in payments.

Earlier this year, Brownback proposed cutting the Children’s Initiative Fund expenditures by $16 million, arguing that tobacco payments had fallen short of projections in 2010 and 2011. Both times, the shortfalls — $1.2 million in 2010 and $6.7 million in 2011 — were offset by transfers from the State General Fund.

Legislators restored most of the funding after the tobacco money receipts exceeded the governor's expectation.

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