photo by: Josie Heimsoth/Journal-World

Bert Nash Community Mental Health Center is pictured Tuesday, February 25, 2025.

Bert Nash Community Mental Health Center says it’s facing a roughly $1.5 million budget shortfall for 2025, and it may have to adjust its fees, seek more support from Douglas County and leave many of its currently vacant jobs unfilled to make up the gap.

In a memo shared with Douglas County commissioners, Bert Nash reported $41.11 million in expenses in 2024 and $40.61 million in revenue, for an almost $500,000 deficit, and the mental health center is expecting an even larger deficit in 2025. On Wednesday, leaders from Bert Nash will meet with county commissioners to brief them on the problem and discuss how they intend to mitigate it.

Specifically, the center projects $43.7 million in expenses for 2025, but only $42.2 million in revenue, for a $1.5 million shortfall. CEO Patrick Schmitz told the Journal-World via email that expenses are rising for salaries and benefits, program costs and rent and utilities for Bert Nash’s buildings. Additionally, there are revenue gaps in key programs such as the Mobile Response Team and the Treatment & Recovery Center, Schmitz said.

“(Approximately) 80% of expenses at the Bert Nash Center are associated with staff salaries and benefits,” Schmitz said, noting that Bert Nash currently employs more than 420 people.

Schmitz said the budget doesn’t currently include any layoffs. But the center is proposing to leave 65% of its currently open positions unfilled, and to reduce the number of new positions it adds by 90%. The departments that would be affected by this include administrative support, clinical services and community outreach, Schmitz said.

“The organization is closely monitoring its financial situation and may need to engage in strategic restructuring and a refocus of responsibilities if the situation persists,” Schmitz said via email.

In addition to cutting the vacant and new positions, the center is considering selling the transitional group home facility known as Bridges to “address an ongoing funding gap created by managing expenses on an older, costly building that has been of limited use for the last several years,” the memo said.

Schmitz had a list of other options that Bert Nash was looking into, as well: “legislative requests for increases to the Mental Health Reform grants and Crisis Intervention Center revenues, raising prices, adjusting sliding scale fees, negotiating commercial contracts, seeking county support, fundraising, and capital grants.”

The memo says that the shortfalls aren’t a result of lack of demand for services — in fact, it says, Bert Nash “has exceeded projections for the number of community members served, the number of services provided, and the overall number of visits.” Rather, a major problem is that many more of these patients are uninsured and underinsured than in years past.

In particular, there was a gap of several thousand between the actual number of visits by patients covered by Medicaid and the number that the center projected. The projection was for 49,170 such visits in 2024, but the actual number was only 45,786, a difference of 3,384 visits.

According to the memo, Bert Nash has been significantly affected by policy shifts that occurred after the COVID-19 pandemic. As Kansas Reflector reported, during the pandemic, Medicaid programs were required to keep most of the people on their rolls continuously enrolled, and Medicaid enrollment in Kansas rose from 410,000 to 540,000 people during that time. But when the requirement ended, more than 100,000 Kansans were dropped from the rolls; Kansas Reflector reported in August 2024, that since April of 2023, 114,000 Kansans lost Medicaid coverage.

For 2025, Schmitz said, the center has identified several parts of its operations that will potentially be operating on a funding deficit: the Mobile Response Team, the Treatment & Recovery Center, Transitional Housing, Assertive Community Treatment and outpatient services for uninsured and underinsured individuals. Those programs’ deficits could total $3.26 million, he said.

“The gaps you are seeing reflected, which were just some examples, are the reality of providing care in a state that lacks Medicaid expansion and where commercial insurance companies increasingly do not cover the costs of care,” Schmitz said via email.

Schmitz said via email that in addition to the funding request to the county commissioners on Wednesday, Bert Nash plans to ask the state of Kansas for additional funding as well. He added that Bert Nash ideally needs to create a budget that includes a minimum of a $2 million surplus to restore cash reserves and deferred revenue.

He said that if community members want to help Bert Nash, they can advocate for increased mental health funding at local, state and federal levels, take part in community meetings and forums to discuss mental health needs, and support initiatives that benefit health care safety net providers.

“Fundamentally, health care financing in America is broken and particularly so for the safety-net providers who serve the uninsured and underinsured along with those most severely impacted with behavioral health conditions,” Schmitz said in an email. ” … This is in part why we wished to speak to the Board of County Commissioners and elevate this conversation in our community.”

The County Commission will discuss Bert Nash’s financial situation during a work session before its meeting on Wednesday. That session will begin at 4 p.m. at the county courthouse, 1100 Massachusetts St.

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On Wednesday, county commissioners will also consider reallocating $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.

According to a memo in the agenda, 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 an Emergency Solutions Grant totaling $27,000 that is administered by the Kansas Housing Resource Corporation. This is only partial funding to support the full $73,000 cost for this position from July 1, 2024, through June 30, 2025.

The memo states that Bert Nash notified the Homeless Response Team that it would not be able to provide the necessary funding to support the position from January 2025 through June 2025. Bert Nash has also indicated that it does not intend to reapply for the Emergency Solutions Grant funding in the upcoming grant cycle. Without additional funding for the position, the memo says that this position will need to be eliminated.

“This position on the HRT is a valuable, long-standing member of the team with a trusted rapport with community members that has resulted in countless individuals seeking shelter and services that end their homelessness,” a memo to commissioners says.

The City of Lawrence has indicated that it will apply for the Emergency Solutions Grant funding, and if it is awarded, would offer a portion of the necessary funding in July 2025. In 2026, the city would assume full financial responsibility for this staff position, with or without the grant funding.