Reducing staff, eliminating residential care beds, and consolidating services. It's the growing trend in the state's mental healthcare system. And we could see more changes come Tuesday. That's when Governor Sam Brownback is expected to announce his Medicaid reform proposal.
About two decades ago, Gerry Lichti and his wife put their son in the state's care, because of his sometimes violent mental disorder.
"We could not possibly take care of him at home,” Lichti said.
Still, Lichti won't say the state's mental healthcare services are any better today than they were decades ago when his son was in the system.
"I'm not sure I would be willing to say that any longer because of some of the severity of the cuts that have occurred in the last couple of years,” Lichti said.
Lichti is the president of the Wichita chapter of the National Alliance on Mental Illness. He's referring to millions of dollars in Medicaid cuts to mental healthcare services. The Association of Community Mental Health Centers of Kansas says over the last three fiscal years, there have been 33.4 million dollars in cuts.
"So, we could lose close to half a million dollars this year as a result of Medicaid reductions,” Prairie View President Jessie Kaye said.
Kaye says her facility has cut, or not filled, 19 positions. One of the areas hit by the Medicaid cuts is its residential program for adolescents. That program was cut in half. It went from 28 beds, down to 14.
"That's a lot of change in a short period of time,” Kaye said.
This spring, both Prairie View and Youthville noticed fewer referrals to their residential programs. That's when the state started limits on Medicaid services.
"All providers are being strongly encouraged to rely on the less expensive community-based care,” Kaye said.
That means more "less intensive" out-patient services for children, like counseling. So, there's less of a need for residential programs and staff.
"Outpatient services don't work for everyone,” Kaye said.
Kaye says her facility is seeing more people who qualify for Medicaid.
"But the level of treatment, the intensity of service, or the number of units of treatment that we can deliver have been limited due to the reduction in Medicaid funding,” Kaye said.
That's the path Lichti doesn't want to go down.
"What's going to happen without the treatment is we're going to have kids and adults who are simply not getting the care they need and then it's going to create all kinds of complications for society,” Lichti said.
Critics of how mental healthcare was funded in the past argue it was too inflated. They called it "over-bedded." But Kaye says now, the state has over-corrected in the wrong direction.
Other residential programs have been impacted as well. Saint Francis community services consolidated its Ellsworth program with its Saline County facility. And New Hope in Norwich closed its facility in August.