Sedgwick County unveils draft request to privatize mental health care

Sept. 09--The county could soon ask nonprofits to take over Comcare, the state's largest community mental health center.

Sedgwick County released a draft proposal to potentially privatize mental health care services offered by Comcare, which is now run by the county.

Some or all of Comcare could be privatized if a nonprofit can meet the county's requirements in its request for proposal. County health and human services director Tim Kaufman presented the draft of the request to county commissioners Tuesday.

"We've written this so that responses could come in a variety of different ways," Kaufman said.

Commissioners are split on whether issuing the request for proposal is a good idea.

The majority of commissioners favor exploring options with nonprofits that could make mental health care better and more efficient.

"I think the idea of examining what we're doing and taking a look at it is helpful," commissioner Karl Peterjohn said.

Two commissioners, with an 'if it ain't broke, don't fix it' approach, say Comcare is already an efficient organization with deep ties to the community and law enforcement agencies.

"We need to be very smart before we just throw this out on the street and not really understand all the implications of us not taking full responsibility for mental health in our community," commissioner Tim Norton said.

The proposal

Comcare provides a variety of mental crisis services, such as case management, therapy and support. It also operates a suicide prevention hotline, a mobile unit for responding to mental crises and a community crisis center that can provide supervised care to people with substance abuse or mental health issues.

The new organization must provide the same level of services or better than what Comcare currently provides, according to the draft. It also cannot be a for-profit entity, Kaufman said.

"To be licensed by the state, a (community mental health center) has to be a nonprofit," Kaufman said.

Comcare is one of 26 community mental health centers licensed in the state. Almost all public mental health care in Kansas goes through these centers.

Comcare is the largest such center in Kansas, with about 470 full-time employees and a $41.6 million budget that is about 10 percent of county spending. It serves Sedgwick County, but also provides mental health crisis services for Butler and Sumner counties.

Acting county manager Ron Holt said responses from nonprofits will let the county "review from an outside point of view how well we're doing."

Kaufman said Comcare data, similar requests in other jurisdictions, and community mental health center contracts were used to create the draft.

Law enforcement agencies previously expressed concern about the potential effects of privatizing mental health care.

Holt said agencies that would be affected were involved in the drafting process.

Comcare has extensive ties to the criminal justice system, staff say. It evaluates people referred by law enforcement, performs mental competency evaluations for the courts and provides treatment for jail inmates with mental health issues. It also is the gatekeeper for the county's admissions to Osawatomie State Hospital in eastern Kansas.

Kaufman said the transition from Comcare to a nonprofit would take about a year "after a decision or a selection is made."

The county would need permission from Topeka as well.

"The transition would have to be approved by the secretary for the Kansas Department for Aging and Disability Services," according to the draft.

A split commission

A work group of county staff drafted the request for proposal after a majority of commissioners expressed interest in the idea in June, Kaufman said.

Some commissioners said Tuesday they're still interested in hearing if nonprofits could take over some Comcare services.

"It's useful to take a look at this," Peterjohn said. "I think that has value in and of itself."

Commissioner Jim Howell said the request is an opportunity for the county to look critically at the way it provides mental health care.

"We should question ourselves once in a while to validate those aspects of what we do," Howell said.

Commissioner Dave Unruh said he did not support privatizing Comcare.

"I think we need to keep this particular service in-house in our current structure," Unruh said.

Norton said the county has a long history of providing mental health care.

"If we start breaking it up and fragmenting it, we may do a disservice," Norton said.

Norton suggested a conference or symposium that would involve law enforcement, hospitals, nonprofits, businesses, health care providers and others in the discussion about privatizing county mental health care.

"We should have a community conversation because mental health is our charge and our responsibility," Norton said. "Before we go down this path, we might want to have that large-base community dialogue about the system because it affects so many things."

Reach Daniel Salazar at 316-269-6791 or dsalazar@wichitaeagle.com. Follow him on Twitter: @imdanielsalazar.

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