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Archive for Sunday, November 5, 2000

Bert Nash slows spending

State refinancing initiative questioned

November 5, 2000

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Not so fast.

Some Kansas mental health centers have hit the brakes on a statewide refinancing plan, causing the Bert Nash Community Mental Health Center to delay improving services and halt deficit spending.

"We are running a deficit, and we are having to replenish our funds from our reserves," said Sandra Shaw, Bert Nash executive director.

End of the year costs are expected to exceed income at Bert Nash by about $500,000, primarily because of under earnings, Shaw said.

That problem was expected to be remedied through the new refinancing plan, known as Mental Health Initiative 2000. Originally it was to be phased in starting next year. The initiative would reduce the amount of federal grant money mental health centers receive annually in return for higher Medicaid reimbursement rates.

Currently, grant funding has not made up the difference in costs and earnings, Bert Nash officials have said. Neither have Medicaid reimbursements.

Under the new initiative, Bert Nash and other mental health centers would be able to receive full reimbursements through Medicaid. That's because they would give up about $16 million in grant money, which would be redistributed through Medicaid.

Some mental health centers are wary of the plan, including four in Western Kansas because they think they may benefit more from the grant money, Shaw said.

The Association of Community Mental Health Centers Inc., Topeka, is discussing the issue with Kansas Department of Social and Rehabilitation Services, said Ellen Piekalkiewicz, policy and planning director. She said there are about 10 mental health centers throughout the state that are unsure of the plan. There are 29 mental health centers in the association.

The concerns center on an expected tight budget year in government, which could also affect grant funding, Piekalkiewicz said. A compromise may have to be reached concerning the amount of the grant money that would be redistributed through Medicaid, she said.

It may have to be less than $16 million, and Medicaid reimbursement may have to be less than the 100 percent initially hoped for, she said.

"We want to make sure when we make the transition we don't throw the baby out with the bath water," Piekalkiewicz said. "It's very complex."

SRS has been working with mental health centers on the refinancing plan. SRS Secretary Janet Schalansky must approve it, and recommendations are expected to be presented to her in about a week, said Laura Howard, SRS assistant secretary for health care policy.

"It's just the process," Howard said. "There hadn't really been an actual planning document and it is being prepared. I think we will have something that everyone will approve of."

SRS expects to have something worked out concerning grant fund distribution, but not necessarily the setting of Medicaid rates, Howard said. She declined to speculate when the entire refinancing package might be ready for implementation.

A delay in implementation is playing havoc with Bert Nash's budget process for 2001.

"It just makes things more complicated," Shaw said. "We'll have to phase in some initiatives and expansion of services. We really need to expand our staff."

The staff expansion is needed because of a growing caseload, Shaw said. Bert Nash also had planned to expand its crisis and emergency team, but that, too, will be placed on hold.

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