The director of a University of Kansas research center that recently lost the contract for its main body of work is open to resuming negotiations with state officials.
Rick Goscha, director of the KU Center for Mental Health Research and Innovation, said he continues to receive emails and phone calls from mental health providers across the state who want to see the center and the Kansas Department for Aging and Disability Services work through their differences so that a longstanding training and evaluation program operated by the center can continue.
“Secretary (Tim) Keck continues to say he wants to support evidence-based practices in Kansas, and we are open to discussion how we can continue our work in this area,” Goscha said in an email. “Bottom line: the focus needs to remain on improving the lives of people with serious mental illness in Kansas.”
Last-minute attempts to negotiate terms of a new $2.4 million contract broke down June 30, the day before the start of the state’s new budget year and the deadline for an agreement to be in place. KDADS wanted to restructure the contract based on concerns that some of the methods the KU center used to match faculty to the project and some of the tasks in its work plan weren’t allowable expenditures under federal Medicaid rules. But Goscha said he couldn’t agree to a proposed no-cost extension to give the two sides time to overhaul the contract.
“Their last-minute offer was not a viable option,” Goscha said. “There is no way the university would have approved a contract that basically said ‘to be determined.’”
Shock waves
News that a project started in the late 1980s to foster the use of evidence-based treatment methods at community mental health centers in Kansas was coming to an end sent shock waves through the state’s mental health provider community.
Tim DeWeese, executive director of the Johnson County Mental Health Center, said he was “shocked and disappointed.”
“Without the KU center, I’m not sure how the state plans to ensure that we continue to maintain the quality of services,” DeWeese said.
The KU center has worked for years to help several community mental health centers implement the “strengths model” of treating people with severe and persistent mental illness. Developed by Charles Rapp, former director of the KU center, the model encourages therapists to help patients understand both their illness and the strengths they can utilize in overcoming it.
In addition to “strengths” training, the center evaluates and grades community mental health centers to ensure that the model is being used correctly.
Keck moved quickly to assure community mental health center directors that the state would find an alternative way to continue to training and evaluation work.
“The agency is not eliminating this element of its mental health funding, which is a critical part of our continued commitment to excellence,” Keck wrote in a letter to the directors. “This training will continue to be provided, but not necessarily under the same arrangement that the training has been provided in the past.”
KDADS explains concerns
Several mental health providers were openly critical of KDADS and the last-minute contract demands that led to a breakdown in negotiations.
Angela de Rocha, a KDADS spokesperson, said the agency had no concerns about the KU center’s work. But while declining to provide details, she said the agency had questions about how the university and the center had administered the federally funded contract.
Several days later Brad Ridley, the KDADS official charged with negotiating the contract, agreed to discuss the agency’s concerns. They boiled down to judgments about what are and aren’t allowable Medicaid expenditures, he said.
All of the money used to fund the project comes from the federal government. The university contributes facilities and faculty time of roughly equal value. The state’s job, Ridley said, is to oversee the contract to ensure that federal rules are being followed to the letter.
“Over the course of the last four years, we have made a lot of adjustments to the contracts we have,” Ridley said.
For one thing, he said, the Kansas Department of Health and Environment has been added as a party to several university research contracts because it is the state’s lead Medicaid agency.
“We’ve worked through these contracts to ensure that we and KDHE both are comfortable with the accountability of those Medicaid funds that are flowing through,” he said.
Differences in the way state agencies have interpreted Medicaid rules have sometimes been confusing for contractors, Ridley acknowledged. Before a recent reorganization of state agencies, the KU contract was overseen by the Department of Social and Rehabilitation Services. When SRS became the Department for Children and Families, responsibility for the KU contract was transferred to KDADS.
Old SRS rules allowed the KU center to use Medicaid funds to pay the tuition of graduate research assistants working on the project. But Ridley says KDADS and KDHE have questions about whether that’s an allowable expense.
“We didn’t say they couldn’t do it, but we added language to the contracts that says if it ends up being an unallowable cost that the university is liable,” Ridley said.
Keck, who also participated in the interview, hedged when asked whether the contract dispute and the publicity surrounding it had effectively ended the agency’s relationship with the KU center.
“Our plan is to move forward,” he said. “That may mean a lot of different things as it unfolds.”
The most pressing task KDADS faces is to find someone that can do trainings that already have been scheduled, Keck said.
“Once we get that figured out then we’ll move on to the mid-range things and then we’ll move to the long-term issues,” he said. “That may involve an RFP (request for proposals) at some point.”
When asked whether a proposal from the KU center would be considered, Keck said, “Sure.”
Jim McLean is executive editor of KHI News Service in Topeka, a partner in the Heartland Health Monitor team.
