“This is a major, important issue,” Brownback said during an afternoon press conference at the Statehouse.
Most of new money - $7 million – will come from the state’s federally funded Temporary Assistance for Needy Families block grant.
The remainder will come from other sources including:
• $2 million from a fund tied to the dissolution of Kansas Health Solutions, a managed care company that was phased out after the launching of KanCare;
• $500,000 from a Governor’s Budget Amendment tied to savings from the KanCare program.
Brownback said the increase in spending was in response to a long list of recommendations he received from a task force that he appointed in 2013 in the wake of the elementary school shootings in Newtown, Conn. The 16-member task force filed its report last month.
“These initiatives … will help improve mental health services across the state of Kansas,” he said.
Kansas Department for Children and Families Secretary Phyllis Gilmore said her agency plans to use most of its $7 million to expand services for at-risk families.The governor’s plan includes spending $350,000 to launch a comprehensive review of the state’s mental health spending, $500,000 on grants for programs aimed at keeping the mentally ill out of jail, $500,000 on 81 additional beds in drug treatment programs and $1 million on reducing community mental health centers’ costs of caring for the uninsured.
Many of the families, she said, include parents who are mentally ill, abuse drugs or alcohol, or both; their children oftentimes are in foster care.
“The children bear the brunt of their parents’ problems,” Gilmore said. “In the current fiscal year – since July 2013 – more than 3,000 children have been removed from home for a wide variety of reasons, including behavioral problems, neglect and physical abuse. Mental health issues are often at the root of the problems in the home.”
A portion of the money, she said, would be spent on vocational programs aimed at helping the mentally ill find and keep work.
Gilmore said DCF officials hadn't decided exactly how the additional money would be spent. But parts of the initiative would focus on reducing needy parents’ dependency on government benefits, reducing out-of-wedlock pregnancies and promoting two-parent families.
Brownback said his plan did not call for expanding the state’s Medicaid program to include low-income, childless adults, many of whom are thought to be mentally ill.
Instead, the governor said his administration is focusing most of its efforts on eliminating waiting lists for community-based services for the physically and developmentally disabled, and on coping with the ever-increasing numbers of people – children, pregnant women and frail elders, mostly – who are eligible for Medicaid.
In its report, the governor’s task force stopped short of urging expansion of Medicaid eligibility. But it noted that consumers’ access to “the correct service at the time that it is needed” often depends on whether they are insured. Those with insurance are more likely to be treated than those without insurance.
Medicaid, or KanCare as it is known in Kansas, offers health coverage to the poor who are elderly or disabled and pregnant women.
According to the report, “A significant number of Kansans who lack health insurance are currently ineligible for Medicaid (most of these are working poor)."
A National Alliance on Mental Illness analysis last year found that more than 21,000 Kansans known to be mentally ill and uninsured would be eligible for Medicaid if lawmakers agreed to expand the program.
“I think it’s pretty clear the (Brownback) administration is not interested in that right now,” said NAMI Kansas Executive Director Rick Cagan. “But NAMI is still committed to an expanded Medicaid program because there’s a whole segment of the population that simply will not have access to quality mental health services without some type of insurance coverage.”
The task force also encouraged the governor to increase state aid that community mental health centers use to offset their costs of caring for the uninsured.
This state-funded support was cut from $31 million in fiscal year 2007 to $10 million in fiscal 2014. The governor’s plan will set aside an additional $1 million in fiscal 2015.
Cagan called the additional $1 million “inadequate,” noting that 60 percent of adults known to have a serious mental illness in Kansas currently are not receiving services.
“You would have to perhaps double the size of the mental health centers’ budgets just as a starting point for being able to get all those people into treatment,” he said. “Expanding Medicaid is the way to close that gap.”
Ric Dalke, executive director at the Area Mental Health Center in Garden City and a member of the governor’s task force, said the additional funding was a welcome development.
“This’ll be a great first stab at where it is that we need to be going,” Dalke said.
David Ranney is senior writer/editor with KHI News Service, an editorially independent reporting program of the Kansas Health Institute.