Kansas has money to help mental health centers offset their losses from treating uninsured patients. But those funds are failing to meet the demand as more uninsured Kansans seek help.

The mental health care business is already not very profitable. But it is even harder for centers like the Wyandot Behavioral Health Network in Kansas City, Kansas, to sustain its programs because 40% of its patients have no insurance.

The health network can’t turn people away for inability to pay. So when someone without insurance needs a psychiatrist, a specialized and expensive staff position, Wyandot offers that care even though Medicaid reimbursement rates don’t pay them enough for the visit. 

“It’s just a money loser,” said Randy Callstrom, executive director of the Wyandot Behavioral Health Network. 

Mental health centers in Kansas say the number of patients who don’t have insurance to cover the cost of their visits is rising. That’s hurting their bottom lines and forcing these community centers to pull money from other parts of the budget to cover basic costs. The state does reimburse centers for these costs, but providers say that funding is stagnant. 

“Our cost is continuing to go up considerably every year,” Callstrom said. “So those grant dollars that we received are not really covering the level of care that they once did.”

Kansas lawmakers are trying to fix that, though. The budget, which has passed the House, includes a $6 million funding increase to help centers treat uninsured Kansans. That money would help centers like Wyandot.

The Senate could still change that, but the request for additional funding has already passed the House when plenty of other proposed funding increases have been shot down. 

Patrick Schmitz, president and CEO of the Lawrence mental health center Bert Nash, said this is a perfect storm. Mental health needs are increasing and coverage is being reduced.   

There’s an increase in mental health issues across the country.

Centers for Disease Control and Prevention data from 2023 found that 40% of high school students persistently felt sad or hopeless and 20% have seriously considered suicide. In 2011, only 28% felt hopeless and 16% considered suicide. 

The Kaiser Family Foundation reported that 23% of adults were getting mental health care in 2022, an increase from the 19% of adults getting help in 2019.

Schmitz said he’s seeing more private therapists not taking insurance. Some patients may have insurance, but won’t hit their deductible by going through therapy, so they are paying out of pocket. 

“We have to provide care,” he said. “So we put them on a sliding fee schedule, or find some other ways for them to be covered so they can get the care they need.”

And pandemic-era programs that expanded Medicaid coverage ended. 

At Bert Nash in Lawrence, a failure to expand state support would threaten future raises for staff. It would mean equipment would be replaced less often and services won’t expand. The Wyandot center said building repairs — like a leaky roof — could get put off in addition to stagnant wages. 

Centers have dealt with similar situations before.

Callstrom remembers when reimbursement rates were stagnant. That meant there was a decade-long period where staff rarely got raises. Those reimbursement rates were changed and the center could afford to give some staff raises of up to 40%. 

Schmitz said he knows there are times where clinics lose money in the mental health care business. But serving more people who are unable to pay for services through insurance isn’t sustainable, unless the legislature acts. 

“The dream that we have in terms of expanding behavioral health care in Kansas will be halted,” he said.