Gov. Sam Brownback moves on mental health promise, but he should expand Medicaid in Kansas

05/28/2014 6:07 PM

06/03/2014 10:17 AM

Though constrained by self-inflicted limits, Kansas Gov. Sam Brownback is making a good-faith effort to improve services for people with mental illnesses.

Brownback said this week he had found nearly $10 million to improve and expand resources for mentally ill Kansans. And he announced the creation of a “behavioral health subcabinet” to bring officials with expertise in corrections, education, health and family welfare together on a regular basis.

Those moves reflect a commitment to follow up on the recommendations of a task force the governor appointed after the murders of schoolchildren in Newtown, Conn., in 2012. The group filed an extensive report last month.

But Kansas’ mental health network, including 27 community centers around the state, is receiving about $15 million less than in 2008. So the additional money is more of a way out of a deep hole than a serious expansion of services.

And Brownback continues to resist expanding Medicaid eligibility as called for by the Affordable Care Act. Most of the people who seek help at Kansas’ overloaded community mental health centers are poor and uninsured. Many others never even attempt to find treatment, figuring they can’t afford it.

The National Alliance on Mental Illness has estimated that more than 21,000 uninsured Kansans who struggle with some form of mental illness would qualify for Medicaid if Kansas would expand its limits to 138 percent of the federal poverty level, as more than half of the states have agreed to do. That single step — which Brownback ignores — would be the best way to get people into reliable, long-term treatment.

Brownback’s plans for expanding services remain somewhat vague.

He intends to spend $7 million in funds the state receives from the federal Temporary Aid to Needy Families program to help combat mental illness. Phyllis Gilmore, secretary of the Department of Children and Families, told reporters that investments in “family-strengthening” programs could include drug and alcohol treatment, job training and promoting two-parent families.

An additional $1 million will be spent on a one-time basis to help community mental health centers care for the uninsured. That’s good news, but the one-time nature could prove difficult. The same goes for a one-time payment of $500,000 to add 81 substance abuse beds to the state’s network.

A promising initiative is Brownback’s decision to commit $500,000 to projects intended to keep persons with mental illnesses out of jails and state hospitals. Examples could be crisis intervention training for law enforcement officers or mental health courts.

Brownback has shown a thoughtful approach to combating mental illness. But without expanding Medicaid eligibility and/or reversing the income tax cuts that have crippled the state’s finances, he is limited in what he can do.

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