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On January 1, 2017, the KHI News Service became part of KCUR public radio’s new initiative, the Kansas News Service. The Kansas News Service will continue to cover health policy news and broaden its scope to include education and politics. All stories produced by the former KHI News Service are archived here. Stories and photos may be republished at no cost with proper attribution and a link back to KHI.org.

Medicaid expansion advocates focus on mental health, public safety as election nears

By | November 07, 2016

Advocates for Medicaid expansion in Kansas are focusing on a new issue in their final push before Tuesday’s election.

They’re selling expansion as a way to address the state’s mental health crisis and the public safety concerns it’s raising among local officials.

Photo by KHI News Service Rick Cagan, director of the Kansas chapter of the National Alliance on Mental Illness, and other mental health advocates are promoting Medicaid expansion as a way to address the state’s mental health crisis and the public safety concerns it’s raising among local officials.

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With state mental health hospitals operating at capacity and community mental health centers curtailing services because of state budget cuts, people with mental illness have fewer treatment options. As a consequence, more are running afoul of the criminal justice system, said Rick Cagan, director of the Kansas chapter of the National Alliance on Mental Illness.

“If you don’t get treatment where you need to get it, you’re going to end up somewhere else,” Cagan said. “And oftentimes that’s homeless, that’s jail, that’s in the ER or possibly in prison.”

Nearly 40 percent of inmates in the Kansas prison system have some sort of mental illness. The same goes for about 20 percent of those serving time in county jails.

Usha Reddi, the mayor of Manhattan, is one of several local leaders calling on Gov. Sam Brownback and state officials to address the issue.

“We can’t have our jails become the mental health facilities or the new place to go if you don’t have insurance because we’re going to be paying for it,” Reddi said. “We are all going to be paying for this in the long run.”

Wichita Police Chief Gordon Ramsay is one of several Kansas law enforcement officials calling for a state response. He said his officers are encountering more people who need mental health treatment — not arrest and jail.  

“All you have to do is drive around certain streets in the city and you can see that mental illness is a major problem here,” Ramsay said. “This is something, whether it’s an administrative issue or a policy issue, it needs to be addressed because it’s placing a substantial burden on our policing efforts.”

Hospital administrators also are sounding the alarm.

Bob Copple, who runs Via Christi Hospital in Manhattan, said increasing numbers of people with mental illness are showing up in the emergency room often because they have nowhere else to go.

“We recently had a patient here in our facility in Manhattan who had to have law enforcement with them 24/7 for over a week until there was a space they could go to for inpatient behavioral health in our state,” Copple said.

Copple, Ramsay and Reddi all spoke at events staged by Medicaid expansion advocates in recent weeks aimed at raising awareness before the election.

“All you have to do is drive around certain streets in the city and you can see that mental illness is a major problem here. This is something, whether it’s an administrative issue or a policy issue, it needs to be addressed because it’s placing a substantial burden on our policing efforts.”

- Wichita Police Chief Gordon Ramsay

Cagan hopes that voters are paying attention. He said expanding coverage to uninsured Kansans with mental illness will trigger more federal funding for stressed hospitals and community treatment centers.

“Medicaid expansion would be the single biggest boon to the mental health system,” he said. “You know, 50 percent of individuals — adults and kids — with serious mental health conditions are not in treatment, and certainly lack of insurance is one of the reasons why.”

Today, only the poorest families qualify for KanCare, the state’s privatized Medicaid program. Non-disabled adults without children aren’t eligible no matter how poor they are.

Expanding KanCare would provide medical and mental health coverage to an estimated 150,000 of those adults, many of whom are uninsured.

Brownback and Republican legislative leaders have blocked debate on expansion over concerns that the federal government won’t meet its obligation to pay 90 percent of the cost.

Brownback also objects to extending coverage to non-disabled adults until Kansans with developmental disabilities — who are now on waiting lists — get the support services to which they’re entitled.

“We’ve got to meet these conditions, because you have people who are not able-bodied who do have dependents who are not getting the full set of services,” he said.

Expansion supporters say even though Brownback has raised objections, they’re not sure he would veto an expansion bill if they can get one passed in the 2017 legislative session.

“Just because the governor has not changed his position doesn’t mean that we shouldn’t move forward as aggressively and positively as we can,” said Tom Bell, president and CEO of the Kansas Hospital Association. “Put something in front of the governor and see what he does. I don’t think we have any other choice.”