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Another behavioral health service gap in Kansas

Photo by Megan Hart/KHI News Service A safety net clinic that serves low-income and uninsured residents of Shawnee County has discontinued its behavioral health services, citing financial losses. The clinic's leader says patients are being referred to other providers.
Photo by Megan Hart/KHI News Service A safety net clinic that serves low-income and uninsured residents of Shawnee County has discontinued its behavioral health services, citing financial losses. The clinic’s leader says patients are being referred to other providers.

By Megan Hart

GraceMed has decided to drop behavioral health services in Shawnee County, at least for now.

The Wichita-based nonprofit took over operation of the Shawnee County Health Agency’s clinical arm in July. Dave Sanford, CEO of GraceMed, said the county set a goal of ending tax subsidies for health services within five years, and to do that, they had to cut an unprofitable service.

“Basically it was a loss leader,” Sanford said of behavioral health. “It was not producing the kind of revenue we needed to continue to offer it. We are having to make some hard decisions.”

GraceMed is referring patients to Valeo Behavioral Healthcare or Family Service and Guidance Center (FSGC), depending on whether they are adults or children, Sanford said. People who have insurance also could continue their care with a private provider, he said.

“We’re not just going to drop them,” he said. “We’re going to work with them to continue their care.”

Bill Persinger, CEO of Valeo, said the mental health center is preparing to absorb additional patients. It may be more difficult if a significant number of patients were prescribed psychotropic medications, because only higher-level providers such as psychiatrists can serve those patients, he said.

“We’re trying to gear up in anticipation of increased referrals,” he said.

Valeo and GraceMed were discussing possible partnerships before GraceMed decided to stop providing behavioral health care, Persinger said. They still are exploring possibilities, including having Valeo staff work out of the GraceMed building.

Pam Evans, director of marketing for FSGC, said they didn’t expect much effect from GraceMed’s decisions, because it was her understanding that most of Shawnee County Health Agency’s behavioral health patients were adults.

“Since we specialize in treating children, we aren’t expecting too much of an influx,” she said.

Shawnee County Health Agency employed two clinical social workers, who mostly offered 50-minute therapy sessions, Sanford said. Both did their jobs well, but didn’t see enough patients per day to generate needed revenue, he said, adding he is confident they won’t have trouble finding other jobs.

“An FQHC (federally qualified health center) is more prepared to do that mild-to-moderate counseling” than to see patients who need longer therapy sessions, he said. “We felt it would be best at this time to discontinue those services.”

GraceMed also ran into some delays getting the behavioral health providers’ credentials through the Kansas Department of Health and Environment, Sanford said. They couldn’t receive Medicaid reimbursements for services those two provided until KDHE informed the managed care organizations running KanCare that they were approved providers, he said.

Sanford said GraceMed could start offering behavioral health services in Shawnee County at some point in the future, but would focus on quicker counseling sessions. For example, a primary care doctor might call the behavioral health provider in for a 15- to 20-minute session if the patient reports stress or symptoms of depression during a check-up, he said.

The shorter sessions would make it feasible for a behavioral health provider to see eight to 12 patients per day, making the service financially viable, Sanford said.

“The whole goal is to go further upstream” and prevent mental health problems from getting worse, he said.

Megan Hart is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach her on Twitter @meganhartMC

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