Topeka mental health leaders: Medicaid cuts would jeopardize care

Leaders of two Topeka community mental health organizations spoke out against the state’s proposed 4 percent cuts to Medicaid, a move they said will cost the two centers about $1.1 million and will jeopardize mental health services in Shawnee County.

Brenda Mills, CEO of Family Service Guidance Center of Topeka, and Bill Persinger, CEO of Valeo Behavioral Health Care, sent a joint news release on Friday to express their concerns about the Medicaid cuts, proposed as part of the state’s plan to handle budget shortfalls.

“There have been about 10 or so events or public policy decisions, revenue decisions, whatever you want to call ’em, since about 2009 or so that have really shaken the foundation of community mental health center funding,” Persinger said, adding that the announcement of a 4 percent Medicaid cut just layered on top of other cuts to make the situation untenable.

“Each one in and of themselves has had a negative effect on public mental health, but when you add them all together, and you look at the impact of the most recent two or three of these events or decisions, we’re looking at a serious problem,” he said. “We’re going to have to change the way we practice, but it’s our job to be there (to help).”

Persinger said the 4 percent Medicaid cut for Valeo would mean about $537,000 less annually, while Mills said the cut would be about $500,000 for FSGC.

Those cuts come on top of $1 million each organization lost after the state cut a “health homes” program that offered services for severely mentally ill individuals, Mills said. The end of that program, which was shut down completely statewide, translated to a loss of 22 positions at FSGC, she added. No staff members were laid off, and the positions were eliminated through attrition.

Persinger said Valeo also has used attrition to eliminate positions to save money and so far, hasn’t had to lay anyone off.

Both mental health leaders said they were unsure what programs or services will be cut as a result of the loss of Medicaid funding, and both organizations are assessing the situation.

“I am not at liberty to even lay that out yet,” Mills said. “We are putting a plan together and reviewing it with board. We’ve already gotten rid of all the extras, that’s the thing. The next place we have to look is services, where we’re losing money.”

As community mental health centers, Valeo and FSGC are mandated to provide services to the uninsured, but Persinger said Valeo may have to consider how in-depth those services will go.

“We do have some latitude in terms of the depth and the scope of services that are offered,” he said. “We do have some discretion there, and we are in the process of trying to figure that out right now, more specifically than we’ve had to in the past. We’re pretty carefully going to have to try to figure out what amount of charitable capacity we do have.”

Sen. Laura Kelly, D-Topeka, serves on the Joint Committee on Home and Community Based Services and KanCare Oversight. She said the proposed Medicaid cuts will be “devastating to the entire world of mental health.”

“They provide services on an as-needed basis, regardless of the ability to reimburse,” she said. “They’re already seeing a number of patients who have no insurance coverage, and they’ve been subsidizing that, obviously, with those that do.

“If you reimburse less for those with Medicaid, that gives them even less money and less flexibility to provide services for those who have no coverage. This is on top of a series of cuts for mental health. It’s pretty devastating.”

With Kansas revenue shortfalls announced this week, Kelly said more Medicaid cuts are “always a possibility,” but thought they might not occur because it is an election year and the primaries are drawing close.

“More Medicaid cuts would be devastating, honestly,” Mills said of additional revenue challenges the state may face.

The solution, Kelly said, is the same one she backed in 2012.

“We need to restore a sustainable, reasonable tax structure in the state of Kansas so that we can pay our bills,” she said.

Credit: Morgan Chilson morgan.chilson@cjonline.com

Copyright Topeka Capital Journal Jun 4, 2016, source Newspapers