Douglas County Commission to consider funding increase that would expand mobile crisis services

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The Douglas County Commission on Wednesday will consider providing additional funding that would enable the county’s mobile response team to increase its crisis response services to 18 hours a day, and 24/7 coverage by May.

Bert Nash Community Mental Health Center’s recent transition to the Certified Community Behavioral Health Clinic (CCBHC) model has allowed the center to leverage new funding related to the change, according to the meeting’s agenda packet

In order to leverage that money, additional costs would first need to be paid with alternate funding. Were the county to delay expansion of the mobile crisis response team, it would risk having to pay back funds to the State of Kansas and a future reduction to its per-client rate, an agenda report stated.

The county’s new mobile crisis response team launched Sept. 11 in coordination with Kansas Suicide Prevention HQ (KSPHQ) and the 988 Suicide and Crisis Lifeline. Current staffing provides coverage from 8 a.m. to 10 p.m. seven days a week.

Staff at Bert Nash recommend the commission approve up to $70,000 in additional funding for 2022 and up to $220,000 in 2023, according to a memo to commissioners from Bob Tryanski, director of behavioral health projects for Douglas County. 

$50,000 of this year’s request would make up for a funding difference to support the existing team, and $20,000 would be used to expand services from 14 to 18 hours daily in December. By 2023, the unit’s 10 full-time equivalent staffing rate would increase to 20 with a goal of providing 24/7 service by May, resulting in an increased need for funding.

Another option the packet presents is to add fewer new team members — two therapists and two full-time equivalent certified peer support specialists — while still expanding coverage from 8 a.m. to 2 a.m. daily.

The mobile response team will utilize several actual and potential funding sources, and the CCBHC model of funding will pay for 100% of the costs of serving the Medicaid population, the report said. The center estimates 56% of its clients’ visits in 2022-23 will qualify for Medicaid funding.

Bert Nash’s meeting presentation Wednesday also will provide a staffing overview and several funding scenarios for sustained funding in 2024.

In September, we asked Bert Nash spokesperson Jeff Burkhead if the center’s new performance requirements for CCBHC certification would affect whether Medicaid could eventually recoup benefits it would pay on behalf of the center’s clients.

Burkhead explained in an email the center’s first cost report as a CCBHC would run July 1, 2022 through Dec. 31, 2023. From the report, the total approved expenses would be divided by the total number of client visits. That number forms the Prospective Payment System, or PPS rate, which is essentially a per-client funding allowance. The agenda report for Wednesday lists that rate at $329 with an inflation index rate of $355.

During a process known as rebase, the state will examine Bert Nash’s total expenses and visits during the rate period.

“If there is a material difference in either of those numbers from our approved cost report, our understanding is we could be asked to ‘reconcile’ or pay back some of the revenue generated by the PPS-1,” Burkhead wrote.

Burkhead said he was not aware of any repayment requirements solely based on quality or service criteria apart from the prospective payment rate.

“However, we would certainly expect the State of Kansas to work with the Bert Nash Center through a performance improvement plan if we were not meeting the quality and service criteria,” Burkhead said.

How the mobile crisis response team works

People in crisis who reach out to KSPHQ via 988, 785-841-2345, or through the Lawrence Police Department’s dedicated line are asked if they want the mobile response team to respond in person. About 80% of calls are resolved on the phone, according to a slideshow included in the agenda packet.

When a team is deployed, two team members respond and assess the situation. The goal is to avoid hospitalization and incarceration whenever possible. About 70% of on-site mobile crisis calls are resolved by keeping the client in the community. If that’s not feasible, the mobile response team will transport the client to a higher level of care, be it LMH Health or eventually the new Treatment and Recovery Center of Douglas County, which has yet to open its doors.

The Douglas County Commission meeting will start at 5:30 p.m. Wednesday, Oct. 19, at the Douglas County Courthouse, 1100 Massachusetts St. Access meeting materials at this link. Find information to join the meeting via Zoom at this link.

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Tricia Masenthin (she/her), equity reporter, can be reached at tmasenthin (at) lawrencekstimes (dot) com. Read more of her work for the Times here. Check out her staff bio here.

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