Kansas Mental
Health Coalition

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  • January 28, 2015 7:51 PM | Amy Campbell (Administrator)

    The Kansas Department on Aging and Disability Services has announced proposed changes to three HCBS waiver programs and has opened a public comment period from 1/26/15 through 2/25/15. The final proposal is summarized in the linked document: HCBS Transition Plan and Proposed HCBS Program Changes and Request for Public Comments. 

    The final summary of the proposed changes in the HCBS renewals effects the following programs:  Autism   Technology Assisted (TA)  Severe Emotional Disturbance (SED).

    Public comment opportunities include meetings February 4th and 5th from 10-12 and 2-4 in Wichita and Topeka, teleconferencing, email, mail, and fax.  See the document above.

    SED Waiver changes includes: parents signature indicates their preferences were reflected in the Plan of Care, adding consumer's preferred outcomes to the Plan of Care, identifying less intrusive methods that were tried but not successful, adding a provision that - if there is a waiting list - eligible military families may bypass the waiting list, and significant added layers to the SED eligibility process. 

    The current process is that the Community Mental Health Center (CMHC) completes the functional assessment and determines if a consumer is clinically eligible for the SED waiver. In the proposed process the CMHC will complete the functional assessment and send the information to KDADS for the clinical determination. Once a consumer is found to be clinically eligible for the waiver the Department of Children and Family will assess if that consumer if financially eligible to be on the waiver. Once a consumer is found to be both clinically and financially eligible for the waiver the CMHC will develop the Plan of Care and submit it to the Managed Care Organization (MCO) for review and approval. After the Plan of Care is approved by the MCO the CMHC will provide the waiver services to the consumer.

  • January 26, 2015 8:58 PM | Amy Campbell (Administrator)

    By

    Hospital officials gave their backing Monday to a Kansas House committee's effort to expand the state Medicaid program to capture additional dollars under the federal health care overhaul, despite opposition to the plan from Republican leaders.

    The Vision 2020 Committee heard supportive testimony from Tom Bell, president and CEO of the Kansas Hospital Association, and two top executives with Via Christi, the state's largest health system. They said expanding Medicaid as contemplated by the 2010 federal health care law would provide coverage to another 169,000 Kansas residents, including 100,000 with jobs.

    Committee Chairman Tom Sloan, a Lawrence Republican, is pursuing the Medicaid expansion plan despite strong opposition from top Republicans in the GOP-dominated Legislature. Sloan is more liberal than most other GOP lawmakers, and his committee — set up to study long-term problems — is unusual in not being controlled by conservatives.

    The state's $3 billion-a-year Medicaid program provides health coverage to 368,000 needy and disabled Kansans, but it doesn't cover able-bodied adults without children, and many parents aren't covered unless their incomes fall well below the federal poverty level. Meanwhile, the federal health care law provides insurance subsidies for families but only at or above the poverty level, or $23,850 for a family of four.

    Bell said the Hospital Association is working on legislation to authorize Republican Gov. Sam Brownback — a strong opponent of the federal health care law — to negotiate the terms of an expansion with the federal government. Sloan said his committee's bill will be more specific and include provisions for raising any state dollars needed to match federal funds. State law currently prohibits a Medicaid expansion.

    "I think the point is, let's have a serious discussion about this," Bell told the committee.

    Rep. Jim Ward, a Wichita Democrat, introduced a bill last week to expand the Medicaid program as contemplated by the federal law.  

    But most Kansas Republicans view that law, championed by Democratic President Barack Obama, as expanding the federal government and creating new burdens for businesses — and don't want any state involvement.

    The federal government promises to pay the full cost of a state's Medicaid expansion through 2016 and at least 90 percent after that. But top Kansas Republican legislators are skeptical that the promise will be kept.

    "Can you tell me — anybody tell me — it's going to be there forever?" said House Speaker Ray Merrick, a Stilwell Republican. "No."

    Senate Majority Leader Terry Bruce, a Nickerson Republican, said GOP lawmakers are reluctant to extend social services benefits to able-bodied adults. He also doubted the state can provide matching funds.

    The state faces budget shortfalls totaling more than $710 million in its current budget and the one for the fiscal year beginning July 1. The gaps arose after lawmakers aggressively cut personal income taxes in 2012 and 2013 at Brownback's urging to stimulate the economy.

    Bell said hospitals are even willing to consider a special tax to raise the state's matching funds, believing it's worth it to get the additional federal dollars. Also, the group contends expanded coverage will decrease other costs, such as those hospitals incur when indigent patients use emergency rooms for their primary medical care. 

    Online:

    Kansas Hospital Association: http://www.kha-net.org/

    Kansas Legislature: http://www.kslegislature.org

    ___

    Follow John Hanna on Twitter at https://twitter.com/apjdhanna .

  • January 26, 2015 5:25 AM | Amy Campbell (Administrator)

    Patient Information   http://www.ksdentalfoundation.org/patients/ 

    2015 Salina KMOM Clinic Location

    Salina Bicentennial Center
    800 The Midway
    Salina, KS

    KMOM-Salina, February 13-14, 2015

    Answers to Patient Questions:

    • Continue taking any prescription medication as directed so bring it along so a dose is not missed should the patient have to wait a good portion of the day.
    • The patient will need to fill out a brief health history so bring a list of allergies, prescriptions, etc. to have this information available.
    • Patients do not need to bring dental records or proof of income.
    • Services are first come, first served and ALL patients must be able to wait in line – no appointments.
    • The clinic opens at 4:30 am on both Friday and Saturday (February 13-14) and waiting in line or determining how early to get in line, is up to the patient.
    • We only let in as many patients as we will be able to treat that day (approximately 1,000) and we will then close the doors. Standing in line on Friday and not getting in does not give the patient priority the next day. It is the same process on Saturday, first come, first served.
    • Be prepared to wait and potentially be there all day. We let approximately 1,000 patients in the clinic so it may be mid-afternoon before a patient is treated.
    • We will provide breakfast and lunch for the patients at no cost to them.
    • After a medical screening, the patient will be examined by a dentist at KMOM and the patient’s greatest need will be treated. For example, if a patient needs extractions and fillings, the greatest need (probably the extractions) will be treated at KMOM. The patient does have the option to come back the next day to get the fillings but they must wait in line again like everybody else. No line priority is given.
    • Services provided include cleanings, fillings, and extractions. No dentures will be provided at KMOM.
    • Full mouth extractions will be done if determined necessary by the examining dentist. The patient will be able to discuss treatment/procedure options with the dentist prior to care.
    • We typically have as many volunteers as we need registered prior to KMOM. Therefore, volunteering will not give priority or access to treatment. Registered volunteers who wish to be treated need to manage their schedule so they can wait in line for treatment.


  • January 17, 2015 8:47 AM | Amy Campbell (Administrator)

    Budget director says adjustments necessary to structurally balance budget

    By Andy Marso | January 16, 2015   Read KHI Article

    Gov. Sam Brownback’s administration outlined a sweeping budget plan Friday that includes changes to Medicaid and increases in the state’s tobacco and alcohol taxes.

    Budget Director Shawn Sullivan said closing a $650 million budget gap will require new tax revenue and slowed expenses in the state’s “three major cost drivers”: public schools, public employee pensions and Medicaid.

    “It is time to make additional changes to both better the care coordination of 400,000-plus members in Medicaid and, second, to further bend down the cost curve in Medicaid,” Sullivan said.

    Two years ago the state moved all Medicaid services to managed care under the administration of three private insurance companies — a program called KanCare.

    The budget proposed Friday aims to save about $50 million through a series of “policy and contractual changes.”

    One is to increase the “privilege fee” levied on the three KanCare companies —known as managed care organizations, or MCOs — from 1 percent to 5.5 percent. Sullivan said that should bring about $8 million to the state general fund. It also will allow the state to draw down federal matching funds and increase the per-member reimbursement for MCOs so they are “held harmless.”

    Brownback also will use his executive authority to shift responsibility for determining Medicaid eligibility from the Kansas Department for Children and Families to the Kansas Department of Health and Environment.

    Sullivan said that’s an attempt to reduce incorrect eligibility approvals.

    “Right now our error rate on eligibility is over 12 percent, according to an audit that was done two years ago,” he said. “If we lower that error rate to just 2 percent, then it saves $26 million. The national average is 3.3 percent.”

    Other changes to Medicaid focus largely on altering prescription drug reimbursement procedures. Sullivan said that includes adjusting the pharmacy dispensing fee, changing the formula for the pricing of drugs and changing billing requirements for drug testing codes.

    Medicaid is funded jointly by the federal and state governments, but Sullivan said none of the Medicaid changes would require federal approval. Some will require legislative approval, however, including the establishment of a behavioral health drug formulary.

    The formulary would allow the state or MCOs to regulate mental health drugs like they do other types of prescriptions, through tools like prior authorization and preferred drug lists.

    Advocates have said for years that such a plan would foster safer, more appropriate use of anti-psychotic medications, but the mental health community has resisted, saying that delays in the dispensing of mental health medications can be deadly.

    State law currently bans applying regulatory tools like prior authorization to mental health drugs. Amy Campbell, a lobbyist for the Kansas Mental Health Coalition, said her organization remains open to changes that discourage unsafe prescribing patterns but opposes repealing the ban on a behavioral health drug formulary.

    “Unfortunately we’ve been having a really hard time getting anyone to talk to us about what specific language might help with these safety situations that they’re concerned about,” she said. “We think there is so much room for cooperating on smart prescribing policy. We’re a little perplexed at this drive toward revoking the statute.”

    The Medicaid changes are intended to slow costs that Sullivan said have climbed by $182 million on the state side alone in the last three years.

    Sen. Jim Denning, a Republican from Overland Park, laid blame for the cost increases at the feet of the federal government. The federal Affordable Care Act levied a provider tax on the state for each of the three MCOs.

    “When you look at these documents, you think Medicaid is out of control again,” said Denning, an administrator at Discover Vision. “It probably is, but it’s not from medical or surgical (costs) or new (members) getting on. It’s federal taxes that are driving it now.”

    Sullivan said during his budget presentation that the state is also using extra Medicaid drug rebate money to close the current budget gap. He noted that some of that excess came from the ACA’s expansion of the drug rebate program but “a larger part” is from “improved utilization” of the rebate program by the MCOs.

    Prior to the ACA, managed care companies were not permitted to participate in the drug rebate program.

    Other new revenue streams for the general fund proposed Friday include tying future income tax cuts to economic growth rather than making them automatic and approving sizable increases in the state’s tobacco and alcohol taxes.

    Under Brownback’s plan, the tobacco tax would almost triple, from 79 cents to $2.29 per pack, and the alcohol enforcement tax would increase from 8 percent to 12 percent. The increases are expected to bring in about $110 million annually.

    Sullivan said it had been more than a decade since either tax had been raised. He also said the increases were consistent with the governor’s philosophy of taxing consumption rather than income.

    Sen. Jeff Melcher, a Republican from Leawood, said he would prefer to see the budget office seek more revenue by ending sales and property tax exemptions, including the state’s deep discount on farmland property tax.

    “I don’t know why we didn’t have a proposal to correct some of the people not paying into the system now rather than going into two areas that are already heavily taxed,” Melcher said.

    Melcher said many of his constituents already travel to lower-tax Missouri for their alcohol and cigarettes.

    Sen. Laura Kelly, a Democrat from Topeka, said she could sympathize with border counties likely to lose more business. But she said the tobacco tax makes sense from a public health standpoint.

    “I’m anti-smoking, and I know that the higher the cost of cigarettes, the less likely young folks are to pick it up,” Kelly said. “If you don’t start smoking when you’re young, generally you don’t start smoking.”

    In the broader budget picture, Kelly said the cigarette and alcohol taxes won’t be a sufficient long-term fix. The income tax plan needs to be further explored, she said.

    Kelly said the changes proposed Friday are complex, and require more time to evaluate.

    “I’ve got a lot of reading to do this weekend,” she said.

    - See more at: http://www.khi.org/news/article/brownback-budget-includes-medicaid-changes-tobacco-tax-increase#sthash.1Lbu4vEY.dpuf 

  • January 15, 2015 5:35 AM | Amy Campbell (Administrator)

    By Peter Hancock

    January 14, 2015, 5:36 p.m. Updated January 14, 2015, 10:12 p.m.

    http://www2.ljworld.com/news/2015/jan/14/rural-hospitals-plead-medicaid-expansion/

     — Kansas hospital officials told a legislative committee Wednesday that they face tremendous economic challenges if the state does not expand Medicaid as allowed under the Affordable Care Act.

    "We’re in the roughest time we’ve ever been in," said Dennis Franks, CEO of Neosho Memorial Regional Medical Center in Chanute.

    Franks was among several people who testified Wednesday before the House Vision 2020 Committee, which is chaired by Rep. Tom Sloan, R-Lawrence. That committee is generally charged with conducting long-term studies of issues that normally don't get the attention they need in a regular 90-day session, Sloan said.

    Sloan said he hopes to develop a "Kansas solution" for expanding Medicaid that will pass the conservative-dominated Legislature.

    But the hearings began barely two months after a general election, when many Republicans campaigned on their opposition to the Affordable Care Act, also known as ObamaCare. And as soon as the hearings began GOP House leaders quickly started pushing back.

    "That's not a health committee," said House Speaker Ray Merrick, R-Stilwell, when asked whether he would allow a Medicaid expansion bill to be debated on the floor of the House. "We have committees where that stuff goes through."

    But Sloan appeared to be trying to win over support from conservative lawmakers by focusing the first hearing on the impact that not expanding Medicaid has on rural hospitals.

    Franks said his hospital serves about 42,000 people in a four-county area in southeast Kansas where 12.5 percent of the population is uninsured and 32 percent of all children live in poverty. He said the cost of providing charity and uncompensated care at Neosho runs about $1.4 million a year.

    “It is a battle out there," Franks said. "We are under siege from the federal government, and from state government.”

    The problem for Neosho hospital, and for many rural hospitals, officials said, is that the Affordable Care Act is financed in part with a reduction in hospital payments from Medicare, the federal health insurance program for the elderly.

    That was supposed to be offset by increasing the number of people with insurance, through expanded Medicaid and subsidized private insurance sold through exchange markets, thus lowering the amount of money hospitals lose through uncompensated or charity care.

    Under the law, the federal government pays almost all of the cost of covering those who become eligible for Medicaid due to the expansion.

    The Kansas Hospital Association has estimated that Kansas will forgo $380 million in federal funding this year by not expanding Medicaid.

    The law originally required states to expand Medicaid — the joint state and federal insurance program for the poor — to cover everyone in households with incomes up to 138 percent of the poverty level. But the U.S. Supreme Court overturned that provision and said that Congress could only make Medicaid expansion optional for states.

    Kansas is one of 22 states that so far have declined to expand their Medicaid programs.

    Mike Larkin, executive director of the Kansas Pharmacists Association, said the ruling has divided the country into what he called the "have states" and "have-not states." In the have-not states like Kansas, he said, hospitals are seeing the reduced Medicare reimbursements, but they are not seeing an increase in patients who have health insurance.

    Chad Austin, a lobbyist for the Kansas Hospital Association, said rural hospitals are hit especially hard by that because a larger share of their patients are covered by Medicare.

    "We have an older population, more elderly population, that has some different challenges associated with that," Austin said.

    Rep. Barbara Bollier, a moderate Republican from Mission Hills and a physician, said she thinks a Medicaid expansion bill could pass this year if it's presented in a way that conservatives might accept.

    "We have a budget crisis. Expanding Medicaid would actually help that. So in the end, I think this will have to be part of the discussion.

    Freshman Rep. Shannon Francis, R-Liberal, said expanding Medicaid might be good for the hospitals in his district, but he's not sure whether voters in that conservative part of southwest Kansas are ready to accept it.

    "I'm not sure there's a consensus yet in my community," Francis said.

  • December 05, 2014 5:21 AM | Amy Campbell (Administrator)

    By Bryan Thompson | December 05, 2014,   KHI News Service

    Premiums in the federal health insurance marketplace are slightly higher, on average, for 2015 than last year — but not for the "benchmark" plan in Kansas.

    A new report from the U.S. Department of Health and Human Services says the cost of the so-called “benchmark” silver plan is up an average of 2 percent in 35 states across the nation. But in Kansas, the benchmark plan cost is actually an average of 5 percent lower for 2015.

    Document

    Health Plan Choice and Premiums in the 2015 Health Insurance Marketplace

    Download .PDF

    Kansas Insurance Department spokesman Bob Hanson said that’s because Blue Cross Blue Shield of Kansas has added a HMO marketplace plan with premiums lower than last year’s benchmark plan.

    “Last year’s lowest benchmark silver plan is now the second lowest in premium for this year,” he said. “Coverages are the same, however.”

    Document

    Issue Brief: Kansas Marketplace Opens for Year Two

    Download .PDF

    These figures don’t include tax credits that almost eight in 10 Kansas customers qualified for last year. HHS officials said that with those tax credits, most customers can find coverage for $100 a month or less, out-of-pocket, if they shop around.

    Five companies are selling plans in Kansas this year, compared to four last year. With 25 percent more issuers participating in the marketplace in 2015, based on analysis of 35 states, more than 90 percent of consumers nationwide will be able to choose from three or more issuers — up from 74 percent in 2014.

    Open enrollment in the marketplace continues through Feb. 15, 2015. But consumers, including those who currently have coverage through the marketplace, need to enroll or re-enroll by Dec. 15 in order to have coverage effective on Jan. 1, 2015.

    - See more at: http://www.khi.org/news/article/kansas-average-benchmark-plan-cost-lower-2015#sthash.JVlw86N3.dpuf 


  • November 04, 2014 8:33 AM | Amy Campbell (Administrator)

    GET OUT AND VOTE TODAY!

    Hopefully, you have already been involved in local campaigns, showed up to your candidate’s fundraiser and thanked him or her for caring about mental health issues.  This morning, you got up a little early, walked out the door past the campaign signs posted in your yard, and dropped by your local polling place on the way to work.  The “I Voted” sticker on your lapel shows that you are way ahead of the game.

    No?  Well, it is not too late to support the policymakers who have supported you.  MAKE IT COUNT!  With the polls running very close in a number of races, your vote matters.

    Here are a few hints to help you cast your vote.  Remember, the choices of our elected officials WILL impact your life.  And, as always, if you have any questions at all, about voting or about your local candidates - please do not hesitate to call me at 785-969-1617.

    The Kansas polling places opened at 7:00 a.m. and will close at 7:00 p.m.

    Click this link https://myvoteinfo.voteks.org/VoterView/RegistrantSearch.do   for important information from the Secretary of State’s office – everything you need to know about your ballot!

    Simply enter your county, name and birthdate to see the address of your polling place, the districts you live in, and your voting history.  Under Sample Ballots, click on the underlined color letters of your precinct ballot.  You can see all of the choices you will make in the voting booth. 

    Now that you have all the information you need – GO VOTE!  And, by the way, it isn’t too late to call your local candidate and tell them you are supporting them.  They’ve been working very hard and a good word is always appreciated.  See the House of Representatives candidates list attached.

    BRING YOUR PHOTO ID:  Info from the KS Secretary of State's website.

    Starting January 1, 2012, Kansas voters must show photographic identification when casting a vote in person. If the photo ID has an expiration date on it, the ID must not have expired at the time of voting. An acceptable photo ID does not have to have an expiration date on the document in order to be valid. Persons age 65 or older may use expired photo ID documents. Acceptable forms of photo ID are:

    ·         A driver's license or nondriver's identification card issued by Kansas or by another state or district of the United States

    ·         A concealed carry of handgun license issued by Kansas or a concealed carry of handgun or weapon license issued by another state or district of the United States

    ·         A United States passport

    ·         An employee badge or identification document issued by a municipal, county, state, or federal government office

    ·         A military identification document issued by the United States

    ·         A student identification card issued by an accredited postsecondary institution of education in the state of Kansas

    ·         A public assistance identification card issued by a municipal, county, state or federal government office

    ·         An identification card issued by an Indian tribe

    More information about Photo ID and how to obtain free photo ID or voter ID – go to : http://www.gotvoterid.com/valid-photo-ids.html#idlist   This won’t help you get an ID today, but you can cast a provisional ballot today and provide an ID to the election clerk before the county canvass.       

    ____________________________________________

    CONSTITUTIONAL AMENDMENT FOR CHARITABLE RAFFLES

    One more note – there is a constitutional amendment on the ballot regarding charitable raffles.  Currently, raffles of any kind are illegal in Kansas unless they are crafted in a way that gets around the letter of the law (i.e. doesn’t require purchase of an entry, or is somehow based on skill).  These loopholes are a convoluted way to get around our constitutional prohibition against lotteries (state lottery exempted of course).  KMHC has no official position on the issue.

    Click here for information from the Department of Revenue about the ballot question    


  • September 16, 2014 11:38 AM | Amy Campbell (Administrator)


    9-16-14 (TOPEKA) – Kansas Department for Aging and Disability Services (KDADS) Secretary Kari Bruffett announced today the funding of several projects to expand the number of Kansas law enforcement officers and those in related fields that are trained to deal appropriately with individuals experiencing mental health crises.

    “Some of the most significant recommendations made by the Governor’s Mental Health Task Force address the way law enforcement officers interact with the mentally ill,” Secretary Bruffett said. “The task force emphasized the need for front-line responders to receive instruction in the most effective ways to interact with individuals who suffer from mental illness. In the communities that this training has already occurred, law enforcement and corrections personnel report that it makes a huge difference in way these situations are resolved. ”

    The projects were developed as a response to recommendations made by the Kansas Governor’s Mental Health Task Force and with the guidance of the Kansas Governor’s Law Enforcement Behavioral Health Advisory Council.
    In May, Governor Sam Brownback outlined his administration’s plans for strengthening the delivery of behavioral health services in Kansas. One of the initiatives he announced was the creation of the Law Enforcement Behavioral Health Advisory Council, consisting of Attorney General Derek Schmidt, Secretary Ray Roberts, Sedgwick County Sheriff Jeff Easter, and Topeka Police Department Captain Bill Cochran. The council serves in an advisory capacity to review future community grants aimed at helping to keep individuals in the community and out of jails, prisons, and state hospitals. Crisis Intervention Training (CIT) and Mental Health First Aid training is a part of that effort aimed at education for front-line responders.

    Read the press release.


  • September 02, 2014 11:13 PM | Amy Campbell (Administrator)
    Procedure to consider changes to the Consensus Recommendations - KMHC will consider amendments proposed by Coalition members at the October, November and December meetings.  Please review the current Recommendations here.  Please review the current Issue Papers here.  If your proposed amendment is a simple update to current language, please draft the amendment as it would be inserted into the current document.  If it is a new topic or action item, please draft an Issue Proposal Paper - see format here - and submit to KMHC at this link by the Friday before the meeting.


  • August 31, 2014 12:31 PM | Amy Campbell (Administrator)


    Governor Brownback has issued a proclamation declaring September 7-13, 2014, Suicide Prevention Week.



(c) Kansas Mental Health Coalition, P.O. Box 4103, Topeka, KS  66604-0103         785-969-1617

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