Proposed budget would cut $915,000 from Prairie View

Though potential state funding cuts to school budgets have received the most public attention, community mental-health centers are facing major challenges of their own.

Jessie Kaye, president of Prairie View Inc., which services Marion, McPherson and Harvey counties, with additional offices in Wichita and Hutchinson, could be facing losses in funding up to $915,000 next budget year.

?This is in addition to the nearly $1.5 million we have experienced in reductions in state funding over the past three years,? Kaye said. ?Our staff and organization can no longer absorb losses to absolve the state of its responsibility to care for its most vulnerable and indigent populations.?

Areas affected

The cuts being proposed would affect Prairie View?s crisis and emergency services, and the family centered systems of care in the three-county area.

?We now treat over 500 patients that do not have any insurance coverage,? Kaye said. ?Reductions in state funding make it incredibly challenging to continue providing services for individuals with no ability to pay for their care.?

Last year, these services cost Prairie View more than $365,000, even after subsidies from public dollars, according to Kay.

?In Marion County alone, more than 100 of our patients receive assistance from a public funding source such as the county or the state, in order to access services for their mental illness,? she said.

Prairie View?s Crisis Department responded to about 13,000 events in each of the last two years, Kaye said.

This included crisis calls, requests for interventions or assessments by individuals, law enforcement and hospitals.

?Of the 13,000 events, approximately 11,000 were crisis related telephone contacts and approximately 2,000 were face to face contacts at one of our sites or in the community,? Kaye said.

?These numbers do not represent the many thousands of calls that our admissions staff triaged first.?

State aid helps mental-health facilities like Prairie View care for individuals who have no ability to pay for needed treatment for their mental illness. It also covers the difference between Medicaid reimbursement rates and the actual cost of providing services.

?Our Medicaid losses last year totaled over $217,000,? Kaye said. ?These state-aid dollars help cover the cost of services for which there is no other reimbursement.?

Those services include assistance to law enforcement, courts, schools, hospitals and our communities in dealing with individuals with mental-health issues.

?Required consultations and assessments are not billable to any other entity, yet require clinical time and often transportation,? Kaye said. ?We have historically had crisis staff available 24/7, in order to intervene in matters of individual, family and community safety.?

Meanwhile, state dollars for family-centered systems of care dollars are used in the following ways, according to Kaye:

? to help cover expenses of therapist time in the schools;

? to operate a psycho-social program for school-aged youth during summer months;

? to provide staffing supervision for children in order for them to participate in community and school based activities;

? to assist families with learning about their child?s illness or condition;

? to provide services to help families remain intact and maintain community housing; provide treatment while a child is awaiting verification of eligibility for publicly funded benefits;

? to provide staff to support parents in dealing with their child?s special needs;

? to assist families with medical appointments and other necessary related services.

Local impact

Prairie View has provided service for Marion County for nearly 50 years. The local office is located in Hillsboro.

?In Hillsboro and Marion County, if the cuts occur as proposed in the governor?s budget, our ability to provide around-the-clock assistance will be limited,? Kaye said.

?Patients in need of treatment may have to wait longer to receive services and would probably receive a lower level of programming than is needed.

Kaye said because Prairie View is already staffed and operates at such an efficient level, additional reductions cannot be made ?without adversely affecting our patients and the compromising public safety.?

?We have already reduced administrative costs and have not been able to increase salaries for staff in quite some time.

?Short-sighted approach?

With the growth of the more Tea Party-oriented Republicans in the Kansas Legislature following the November elections, Kaye does not anticipate the Legislature will significantly improve Gov. Brownback?s proposed cuts for mental-health care.

?The current budget proposal is a short-sighted approach to funding mental-health services and will result in more unemployment among mental-health professionals and those citizens whose untreated illnesses impair their ability to work productively,? Kaye said.

?As a result of less community treatment and response to crises, we expect to see more institutionalization?state hospital and jails?of consumers no longer having these community resources.

?Our homeless population will also likely increase as a result,? she added. ?Law enforcement will experience increased activity and interaction with individuals suffering with mental illness and local emergency departments and health departments will see more persons in mental-health crises, for which they are ill equipped in terms of time, resources or specific expertise.?

As the licensed community mental health center for Marion, McPherson and Harvey counties, Prairie View is required by statute to provide certain interventions and services, regardless of citizens? ability to pay.

?This state mandate is the basis for much of our state funding,? Kaye said. ?As the level of funding continues to decrease, our ability to meet this demand is severely compromised.

?Mental health services in emergency and crisis situations is part of maintaining the public safety net?as essential as fire, law enforcement and ambulance services,? she added.

?Providing needed community-based treatment for those who suffer from chronic mental illnesses is a means of reducing their health-care expenses and avoiding the higher costs of more restrictive levels of care such as hospitalization, institutionalization or incarceration.

Short and long-term view

Kaye does see some hope down the road.

?As our system looks ahead to full implementation of the Affordable Care Act and mechanisms for payment reform, we are optimistic that a greater number of individuals will have access to the mental health and substance abuse services they so desperately need.

?This will ultimately result in an overall savings in physical-health expenses, reduced absenteeism and increased productivity in workplaces across the country. ?

But for the short-term, the picture looks bleak.

?The near future for mental health services in Kansas is quite frightening and will likely result in serious, if not tragic, consequences,? Kaye said.

?Representatives of our public mental system are working frantically to educate decision-makers in an effort to influence a safer and more realistic approach to solving out state?s budget dilemma.?

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