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Working Group Looks For Behavioral Health Solutions For Rural Kansas

Bryan Thompson
Heartland Health Monitor
The Rural Health Working Group meets at Pawnee Valley Community Hospital, in Larned.

A panel tasked with finding “Kansas solutions” for health care delivery problems in rural Kansas turned its attention to behavioral health Tuesday.

At a meeting in Larned, Eric Van Allen told the Rural Health Working Group that Kansas spends about $400 million annually on behavioral health — including roughly $175 million through the Medicaid program.

Van Allen, who represents the Boston-based behavioral health management company Beacon Health Options, suggested Kansas might try shifting some of those costs onto the federal government.

He said it might be possible to implement a limited form of Medicaid expansion covering only behavioral health needs, although that has not been done in other states.

But Lt. Gov. Jeff Colyer, who leads the working group, didn’t seem eager to try that.

“The specific program that he was talking about has not been available to do that now. I think that’s speculation,” he said.

Kansas is one of 19 states that have not expanded eligibility for Medicaid under the Affordable Care Act, which President-elect Donald Trump has promised to repeal or at least reform. What’s more, U.S. House Speaker Paul Ryan has floated the idea of replacing the Medicaid program with block grants to the states

“I don’t know what they’re going to do on that,” Colyer said. “I think we really need to wait and see. This is not just the [Trump] administration, but the Congress is going to weigh in on that, and we’ll hear a pretty vigorous discussion over the next few weeks.”

Deborah Stern, senior vice president of clinical services and general counsel for the Kansas Hospital Association, traced the stresses on the state’s mental health system back to the 1990s. That’s when Kansas lawmakers began closing state psychiatric hospitals in an effort to treat people with mental illness in their communities instead.

The problem, Stern said, was that lawmakers diverted the savings from state hospital closings to other purposes rather than investing them in community mental health programs.

Stern also pointed to expanded Medicaid eligibility as a way to pump funding into the system. She said at least 25 percent of behavioral health patients lack insurance. Getting them onto KanCare, the Kansas Medicaid program, would give them a way to pay for the care they need.

Her recommendations also included training more licensed mental health technicians and increasing use of interactive video to deliver behavioral health care remotely.

Van Allen, of Beacon Health Options, agrees that telepsychiatry can be valuable. But for it to really take hold, he said two things need to happen: reducing restrictions that prevent providers in other states from interacting by video with patients in Kansas and developing systems so that telehealth providers can be paid for their services.

Colyer anticipates the working group will make some recommendations along those lines.

“Telehealth is an important piece,” Colyer said. “There are some structural things that we can do that can help move that forward. A lot of it comes from the federal government. They’re regulating what some of these things are, and we will take advantage of things to get the best care for Kansans.”

The working group meets again in December and plans to have its recommendations ready for lawmakers by the start of the 2017 legislative session.