COMMENTARY

Challenges come fast for Johnson County mental health system

Updated: 2012-12-14T13:42:35Z

By MARY SANCHEZ

The Kansas City Star

— The colorful flier lies.

“Change can be easy” is the leading quote in a flow chart to help guide people through Kansas’ shift to managed care for those covered by Medicaid.

But change is never easy. Not for humans.

And this is a massive undertaking, set to begin next month.

A slice of it, the impact on the approximately 10,000 Johnson Countians who seek county mental health services, was addressed in a forum Tuesday evening.

Under the new KanCare system, people have been randomly assigned to either UnitedHealthcare, Amerigroup or Sunflower.

Tim DeWeese, director of clinical services for Johnson County Mental Health, talked of his own reservations, the challenges, and yet still came across infectiously optimistic.

“If I didn’t think this was possible, I wouldn’t be standing here,” he said. “We’ll make it work.”

A few people thanked him for staying put, for not following other employees and joining the managed care companies.

Never mind that he has far fewer case managers and clinicians than a year ago. Nor that the budget has been cut about 60 percent since 2008. And he is fully expecting it to be cut by 30 percent in the coming year.

“I don’t know any business that can stay in business with a 90 percent cut in a four- to five-year time period,” he acknowledged.

Yet issues endemic to mental health care services can be addressed during the switch, DeWeese stressed.

Too often, mental health systems worked to help people become dependent on them, not independent, he said. There is the huge need to convert to integrated care. People with mental illness die about 20 years earlier than people without. But the reason isn’t necessarily the mental issue. It’s because they tend to not receive other primary care as well.

DeWeese mentions the case of a person who had schizophrenia under control, and then died of a heart attack.

“I’m tired of going to funerals of the people we serve,” he said. “They die far too young.”

So by the end of next year in Johnson County, primary care needs will be met at the same location where people can receive their mental health care.

Entry systems to care will be overhauled, he said, eliminating weeks of waiting for a first appointment.

He wants the pediatric services to be geared more toward prevention of mental illness, to keep young people from needing help for serious issues later in life.

The umbrella shift that encompasses everything is moving from a system designed around fee-for-service to focusing on outcomes.

And the meeting was just a start. DeWeese plans to hold such open sessions for the public quarterly.

To reach Mary Sanchez, call 816-234-4752 or send email to msanchez@kcstar.com.

Deal Saver Subscribe today!