photo by: Josie Heimsoth/Journal-World

Douglas County commissioners met on Wednesday, February 26, 2025.

When Bert Nash became a Certified Community Behavioral Health Clinic in 2022, that brought in more funding for the mental health center, but also required it to significantly expand its services.

Now, as Bert Nash stares down a seven-figure budget shortfall, it wants to start the conversation early about the costs of providing those services — including to people who are unable to pay — and how much of the burden Douglas County’s government should shoulder.

At the Douglas County Commission’s meeting on Wednesday, leaders from Bert Nash shared an overview of the center’s financial challenges and how they plan to address the anticipated shortfalls for the year ahead. In 2024, Bert Nash reported $41.11 million in expenses and $40.61 million in revenue, resulting in a $500,000 deficit. But the mental health center is projecting an even bigger $1.5 million shortfall for 2025, with $43.7 million in expenses and $42.2 million in revenue.

“Our challenge as we move into 2025 is how do we match up what we have been delivering versus what we get paid?” said Bert Nash CEO Patrick Schmitz. He said that while it’s expected that revenue will increase from last year, it still isn’t where it needs to be.

As the Journal-World has reported, Bert Nash says it’s actually been exceeding its projections for numbers of patients and visits, but it’s also serving more patients who are uninsured and underinsured than in the past.

Schmitz and Bob Tryanski, Douglas County’s director of behavioral health projects, elaborated a bit more on Wednesday about those services to patients who aren’t able to pay. Schmitz said a big part of the organization’s philosophy is providing care for everyone, but there are also obligations that come with the center’s status as a Certified Community Behavioral Health Clinic, or CCBHC.

A CCBHC is a safety net clinic that provides mental health and substance use services to anyone who needs them, and CCBHCs are sometimes required to offer services to people who are unable to pay. Tryanski said that as a CCBHC, there are certain community treatments that Bert Nash is mandated by the federal government and by the state to provide.

Tryanski said that “part of the conversation, I think is how much of that required mandate for the CCBHC should be carried with local dollar costs.”

Douglas County is responsible for a significant portion of Bert Nash’s funding — in 2025, the presentation from Bert Nash on Wednesday showed, the county’s contribution accounts for 17% of Bert Nash’s budget. And while Bert Nash is considering cost-saving measures, like selling the Bridges group home facility or not filling some currently vacant jobs, it also expects to ask for more help from the county.

Commissioner Karen Willey said she appreciated Bert Nash starting these conversations well ahead of the county’s budget hearings for 2026. And Schmitz reiterated that the county was one of the center’s most essential partners, and said it would be important to come up with solutions together.

“We’ve been talking about these things for some time and being well aware and needing to come together because we are your community health center, and you are our most significant partner, without question,” Schmitz said. “We exist because of you and so many solutions require us to be collaborating moving forward.”

As the Journal-World reported, Bert Nash has identified several parts of its operations that will potentially be operating on a funding deficit for 2025, including its Mobile Response Team, the Treatment & Recovery Center, Transitional Housing, Assertive Community Treatment and outpatient services for uninsured and underinsured individuals.

The discussion about Bert Nash took place as part of a work session on Wednesday, meaning the commission did not take any action afterward.

In other business, the commission:

• Heard an update on a partnership designed to support local entrepreneurs, which has provided more than $2.2 million in loans to businesses in the area since its work began over a decade ago.

For more than 14 years, Douglas County has been designated as an Entrepreneurship Community, or an e-community, by Network Kansas. It’s one of 75 Kansas communities that partner with the organization, which Network Kansas President and CEO Eric Peterson said connects entrepreneurs and small business owners with tools and resources.

The presentation to commissioners on Wednesday highlighted that between Douglas County and Lawrence — which is itself an e-community — $2,136,680 in loans have been funded: 40 through Douglas County and 18 through Lawrence. Additionally, in 2024, Diversify Douglas County — a program aiming to provide loans to minority-owned startup companies — awarded $68,500 in loans to five entrepreneurs.

Commissioner Patrick Kelly said it was important to find ways to quantify what the county was doing to grow its tax base, and that it was clear entrepreneurship efforts played a key role.

“Part of my job, I feel like, is to keep pressing for more, especially on the economic development side, when we hear so often that we need to increase our tax base,” Kelly said. “And my big belief is that entrepreneurship is a strong way to do that work.”

Entrepreneur Nicole Rials, who has her own private practice at K. N. Rials Therapy and Consulting, also addressed the commission on Wednesday and said that the way out of poverty is through entrepreneurship.

“We are doing generational work right now,” Rials said. She said she’d spoken with “… families who were trying to build their businesses for their kids, so it’s work that pays off now, but more importantly, it’s generational work and it’s really important in the climate that we’re living in.”

• Reallocated $46,000 from the Assertive Community Treatment program, which is an integrated service to help those diagnosed with serious mental illness, to fund a position on the City of Lawrence Homeless Response Team.

The approved fiscal year 2024 and 2025 budget for Bert Nash included $200,000 of support for the Assertive Community Treatment program. The county administration is allocating the funding from the program to fill a projected budget shortfall that could result in the elimination of a Bert Nash staff member who serves on the City of Lawrence Homelessness Response Team.

The staff member is partially funded by a $27,000 Emergency Solutions Grant from the Kansas Housing Resource Corporation, covering part of the $73,000 cost for the position from July 1, 2024, to June 30, 2025. The City of Lawrence plans to apply for the Emergency Solutions Grant and, if awarded, provide part of the funding in July 2025. In 2026, the city will fully fund the staff position, regardless of the grant.

• Adopted a resolution to initiate the process of using bonds for a portion of the roughly $80 million Judicial and Law Enforcement Center and Public Safety Building project. The county has not yet determined the total amount it will request for the project funding from the bonds. County commissioners will review another resolution on April 9 to approve the bond sale.

• Adopted a redesignation agreement for the Lawrence-Douglas County Metropolitan Planning Organization. The agreement was revised to account for changes to the “organizational structure within the City of Lawrence and to align with KDOT’s updated designation language.” According to a memo in the agenda, no substantive changes were made to the agreement, but information and technical language related to KDOT’s recommended language were added.

• Heard a presentation from Little Government Relations about the Kansas Legislature’s session so far.