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Contract negotiations create uncertainty for community mental health centers

By Meg Wingerter | September 23, 2016

Contract negotiations create uncertainty for community mental health centers
Photo by KHI News Service File Tim DeWeese, executive director of the Johnson County Mental Health Center, says contract impasses between the state and training providers could force community mental health centers to find their own training. And he says that change could lead to lower-quality care.

Contract impasses between the state and training providers could force community mental health centers to find their own training — which one mental health center leader said would reduce the quality of care.

The Kansas Department for Aging and Disability Services contract with the Training and Technology Team, or T3, at Wichita State University expires in October. T3 does online and event training, mostly geared toward providers of children’s mental health services. It also provides technical support for community mental health centers in Kansas. 

Some other contracts are pending almost three months into the fiscal year. Those still negotiating with KDADS include Wichita State’s Community Engagement Institute, which offers peer support specialist training, and the community mental health centers themselves, which are operating under an extension through December.

Tim DeWeese, executive director of Johnson County Mental Health Center, said the ongoing uncertainty could create problems for employees like peer support specialists, who require certification. Medicaid will only reimburse community mental health centers for services provided by employees who have completed their training within six months of being hired.

“It’s a pretty big deal, given that peer supporters are supposed to be specifically certified,” he said. “I think, again, it’s just one more example of the state dismantling the mental health system.”

The current contractors had offered the training for a long time, DeWeese said, and it isn’t clear who else could provide the same services. He also wasn’t sure what it might cost for Johnson County Mental Health Center to do its own training.

“It essentially places the burden on us,” he said. “It’s another unfunded mandate.”

It also isn’t clear how the state would ensure that community mental health center employees receive proper training, DeWeese said.

“It really minimizes the importance of evidence-based practices in the state,” he said.

Brad Ridley, KDADS commissioner for finance and information services, said the state already has some training on a website, KS Train, and is in the process of switching its other online training programs to the same site.

“It was being more consistent and efficient from a statewide IT perspective,” he said.

State budgets have been tight for more than a year, following large income tax cuts approved in 2012.

Similar contract concerns

The contract for T3, the Wichita State team that provides training with children’s issues, will end in October after 18 years, said Yasir Muneer, executive director of T3. The system allowed community mental health centers to track how much of the required training their employees had completed and provided information to KDADS and community mental health centers, he said.

Stacy Rucker, state training coordinator for T3, said KDADS officials told her that using Medicaid for training wasn’t allowable under federal rules.

Similar concerns came up in the state’s negotiations with the University of Kansas this year. The KU Center for Mental Health Research lost its contract to ensure the state’s community mental health centers are implementing evidence-based practices for treating mental health problems correctly. Contract talks later restarted

That disagreement centered on whether KU could use Medicaid funds to pay graduate research assistants’ tuition. The center’s director said KDADS made a last-minute offer for an extension that would have required him to lay off half his staff. 

Federal rules do allow Medicaid administrative funds to be used for certain types of training, but the Centers for Medicare and Medicaid Services didn’t respond to a request to clarify if the Kansas programs were acceptable uses.

Some training delayed

Training sessions for people recovering from mental illnesses who want to help their peers have been pushed back while the state hammers out contract questions with the Community Engagement Institute at Wichita State.

Peer support specialists are people who are recovering from their own mental illnesses and have received certification to help others begin recovery, said Randy Johnson, director of the institute’s Center for Behavioral Health Initiatives. They typically work for community mental health centers or consumer-run organizations and can bill Medicaid for specific services

The institute and KDADS didn’t finish negotiations before the new fiscal year started in July, so they agreed to an extension through Aug. 31, said Scott Wituk, the institute’s executive director. That extension has ended, but he said they still are working on negotiations.

“We want to be responsive to the needs of KDADS and its partners,” he said.

It isn’t unusual for negotiations to run over, Wituk said, but the Center for Behavioral Health Initiatives has canceled or postponed some training sessions until a new contract is finished.

Peer specialists learn how to use their own experiences to connect with clients with mental illnesses, Johnson said. While they aren’t meant to replace mental health providers, clients can benefit from seeing both, he said.

“Working together is where we see the most forward movement” in people’s conditions, he said. “People respond differently to different things.”