Incomplete data renders audit of Kansas mental health and substance abuse programs inconclusive

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TOPEKA — State legislative auditors say data gaps and broad definitions limited the conclusions and recommendations they could provide in a recent review of Kansas’ most common mental health and substance abuse programs.

The audit focused on 23 providers of about 200 total statewide. They receive funding through Medicaid or a criminal justice intervention law, or are a community mental health center. While the report includes general findings, the lack of data prevented auditors from providing suggestions on how to bolster programs at state providers.

Still, Sen. Caryn Tyson, R-Parker, was adamant about ensuring this information came before pertinent legislative committees next session. 

“I think there’s a lot of good information in here. I’d hate to see it lost in the shuffle,” Tyson said Thursday during a meeting of the Legislative Post Audit Committee. 

In recent years, the focus on mental health and substance outcomes to address prison overpopulation, as well as educational, personal and professional outcomes, has grown in Kansas. Increased mental health and substance issues amid the pandemic was among the reasons the legislative committee listed when it requested the audit in September. 

More than $1.1 billion in federal pandemic aid for Kansas schools is targeting mental health, according to the Associated Press, with many districts hiring additional counselors and social workers.

Andrew Brown, the commissioner of behavioral health services for KDADS, said the agency is replacing systems used for the last 30 years to collect and report data on behavioral health services. He said this transition likely contributed to the difficulty in getting complete data for review.

“In a few years, KDADS will have statewide electronic health record systems fully implemented and be able to establish (software) connections with providers to collect and exchange data on patient outcomes and help with tracking patients across multiple providers and hospitalizations,” Brown said in response to the report.

General findings from the audit show that of the 11 most commonly reported programs from providers interviewed, one had strong support for effectiveness, seven had moderate support, two had weak evidence and one was inconclusive. 

Cognitive-behavioral therapy showed strong evidence, while assertive community treatment, dialectical behavior therapy and the matrix model were among those with moderate backing. Integrated dual disorder treatment and peer support had little evidence to support them.

While these programs show effectiveness, many providers reported a lack of funding, and staff shortages hampered efforts to provide these services, said audit supervisor Heidi Zimmerman. 

“Specifically, providers noted that Medicaid rates have not been increased since the early 2000s,” Zimmerman said. “Many providers also reported difficulties in finding enough qualified staff and some said that licensed clinicians were especially difficult to find.

Auditors compared Kansas with Idaho, Iowa, Nebraska, Nevada and South Dakota — five states with a similar population, median household income and illicit drug use per capita. Data from the Substance Abuse and Mental Health Services Administration suggests Kansas is generally in line with other states, with some exceptions.

“Kansas has fewer substance abuse providers that offer hospital inpatient services,” Zimmerman said. “On the other hand, though, Kansas had more mental health providers that offered services such as telemedicine or emergency psychiatric services.”

Kansas Reflector is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Kansas Reflector maintains editorial independence. Contact Editor Sherman Smith for questions: Follow Kansas Reflector on Facebook and Twitter.

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