By CRISTINA JANNEY
Hays Post
Board members at High Plains Mental Health advocated for Medicaid expansion in Kansas during a discussion with state legislators and legislative candidates Thursday.
Rep, Troy Waymaster, R-Bunker Hill, who has been chairman of the House Appropriations Committee, said finding the estimated $31 million to $40 million to match the federal dollars to the state would be difficult.
About 52 percent of the state budget goes to K-12 education, and the state is facing a Kansas Supreme Court decision that will require additional funds. Once higher education is added to the equation, education accounts for 65 percent of the state budget.
Richard Miller, HPMH board member and former CEO of the Norton County Hospital, expressed his frustration the Legislature had not yet passed Medicaid expansion.
“To those of us who have been in health care and community mental health services, the $31 million I know, Troy, is tough to come up with, but look what it is costing the hospitals and mental health centers and putting it on the backs of the county commission and they [also] have their local hospitals to support. …
“It would just make a lot of sense, and if it is not a priority, get it up there as a priority because it would benefit so many people and so many health care facilities and mental health centers just by taking the 90 percent from Washington. To me, it becomes a red and a blue thing. In my opinion, had that been a proposal that had come from Republicans at the national level, it might get a different consideration here.”
Rep. Eber Phelps, D-Hays, pointed out Medicaid expansion passed both houses, but was vetoed by Gov. Sam Brownback. There were not enough votes for a veto override. Gov. Jeff Colyer was the architect of the privatization of Medicaid, so the Legislature did not think expansion would receive the governor’s signature in 2018, Phelps said.
The state has lost about $2.9 billion in federal funding by not expanding Medicaid in the state, Phelps said.
Phelps said he was hopeful some of the funds that were cut from mental health services after tax cuts were implemented in 2012 could be restored during the next session.
“One thing that has really struck me about the whole issue of mental health besides the growing number of suicides in rural Kansas and the number of suicides among young people, not just in western Kansas, but all over,” Phelps said. “Apparently, as a country, we have lost our focus a little bit on mental health after making a lot of strides in years back.”
Phelps raised concern about the number of people who have mental health issues that are ending up in jail instead of in treatment. He cited a report by NPR on the Cook County Jail, where out of 2,500 inmates about 50 percent suffer from mental health issues.
In that report, inmates said they were intentionally getting arrested because that was the only way they could receive psychiatric treatment.
He said he thought those percentages could be extrapolated to our Kansas jails.
“What we have gotten ourselves into as a country and a state is a model that is totally wrong,” Phelps said, “because we are incarcerating people who shouldn’t really be there. They are sick. …
“I think most legislators if they are paying attention in their districts and visiting with their county sheriffs, they are realizing they are taking on a burden, as I mention with Cook County. The No. 1 mental health provider in the nation is the Cook County prison. We have got to get away from that model and get back to looking at preventive and maintenance and taking care of these people who need our help.”
Board member Jan Badsky commended Phelps on highlighting the need for prevention. However, she noted with all the bureaucracy and funding challenges, it can be easy for people to fall through the cracks. Then that person ends up in a state hospital, such as Larned.
Rep. Leonard Mastroni, R-La Crosse, and a former HPMH board member, expressed his frustration with the Kansas Department of Administration’s hiring practices, which he said makes it difficult for even entry-level personnel to qualify for positions at state hospitals. This has left many positions open. For example, a person can’t qualify for a state hospital job if they owe state back taxes.
In terms of funding, Rep. Ken Rahjes, R-Agra, said mental health is battling with many other issues and government agencies for funding and attention. In dealing with his constituents and farmers, mental health is only coming in at No. 13 or 14 on a long list of priorities.
Rahjes encouraged outside-of-the-box thinking, cooperation with other agencies and development of grant funding as means to expand services.
Walter Hill, HPMH executive director, said High Plains is trying to maximize its resources to reach as many people as possible by using programs such as telemedicine. The mental health center is also sending clinicians to the Ellis County Health Department, HaysMed and the Phillips County Hospital to try reach more people.
The board members also expressed concerns about dealing with the administrative arms of state government.
Rahjes said he too had struggled with the Kansas Department of Aging and Disability and had to call the agency on behalf of constituents.
Waymaster said his constituents were regularly calling him with difficulty working with the private companies that have been contracted to handle Medicaid claims under KanCare. He described a case in which a family was waiting for Medicaid approval for their father who was in nursing care. The man died before his application was approved, and the family was sent a bill for $18,000.
Waymaster made a call, and the application was “miraculously” approved after a six-month wait.
He acknowledged families should not have to go through this, but the Legislature does not hire and fire individuals in the administrative branches of government. They just approve funding.
Kim Thomas, former Stockton mayor and candidate for the 110th District seat, and Jerry Hill, candidate for the 120th District seat, also attended the meeting.