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Mental Health Contract Dispute Sparks Criticism Of Brownback Policies

Heartland Health Monitor/File photo

A contract dispute has ended a University of Kansas research center’s more than 30-year collaboration with the state’s community mental health centers--and that has several mental health providers lashing out at officials in the administration of Republican Gov. Sam Brownback. Heartland Health Monitor’s Jim McLean explains the history behind the growing controversy.

Back in the late 1980s, researchers at the KU Center for Mental Health Research and Innovation developed a new way of treating mental illness. They called it the “strengths model.” Since then the KU center has trained staff at many of the state’s community mental health centers. And it has developed something called a “fidelity scale” to document which of them are achieving the best outcomes.

The KU center’s Ally Mabry helped develop the grading system.

“This scale does not allow a center to just do this practice at a minimal or a moderate level," she says. "To meet fidelity you really need to be preforming at an extremely high level.”

The community mental health center in Johnson County is getting good results. Director Tim DeWeese says that’s because the focus is on helping clients identify their strengths and use them to reach specific goals.

"Are people achieving the goals that they want to achieve? Are they working? Are they living independently? Are they going to school? Are they in relationships? All of those kinds of things," he says. "And when you come from a strengths-based approach it’s much easier to help people move forward in their lives.”

DeWeese says he was “shocked” when he learned late last month that the KU center’s contract hadn’t been extended. He says it’s one of several policy and budget cutting decisions made by the Brownback administration that have weakened the Kansas mental health system.

“When you look over the course of the last six to eight years and you look at all of the policy decisions and cuts that have been made to the mental health system, all of those combined have clearly impacted our ability as community mental health centers to do their jobs," he says.

In fact, they’ve done the opposite of what Brownback said he wanted to do just three years ago. Responding to calls to devote more resources to mental health in the wake of the mass shooting at the Sandy Hook elementary school in Connecticut, Brownback launched an initiative to strengthen the Kansas system. He proposed a network of regional crisis centers and increasing payments to providers that could show they were using evidence-based treatment methods.

“I propose the creation of a new task force to the governor’s mental health planning council to evaluate our current mental health system and make recommendations for improvements," he said at the time.

The governor appointed Rick Goscha to chair the task force--the same Rick Goscha who heads the KU Center and today finds himself on the other end of a contract dispute with the Kansas Department for Aging and Disability Services.

Goscha says KDADS dropped the contract even though the center was working on priorities identified by the task force.

“If I go back to the governor’s mental health task force that I chaired, you know a report came out of that showed the need to invest in evidenced-based practices," he said. "Our center is aligned with helping the state meet those particular outcomes.”

A spokesperson for KDADS wouldn’t go on tape, but she says the agency wanted to make changes in the KU center contract to ensure that the Medicaid money that funded it was being spent appropriately. And she says Goscha rejected three “good faith” offers.

Goscha says all of the offers came at the last minute and included provisions that he had told agency officials the university could not accept.

With the contract deadline now passed, Goscha has laid off most of his staff and says he will soon have to close the center where he has worked since 1999.

“It’s, you can’t even imagine what this feels like," he says. "It’s absolutely crushing.”

In a letter to community mental health center directors, KDADS Secretary Tim Keck says the agency remains committed to using evidence-based practices and will find another way to continue the training and evaluation work once done by the KU center.