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June 14th, 2021

ELLY GRIMM • Leader & Times

 

Access to mental health services is extremely important and recently, a bill signed by Kansas Gov. Laura Kelly will make some changes to that access throughout the state. 

Late last month, Gov. Kelly signed Senate Substitute for House Bill 2208, laying the groundwork for the most significant transformation of the Kansas community mental health system in decades. The bill establishes a new model for providing behavioral health services – the Certified Community Behavioral Health Clinic (CCBHC). The signing of this bill makes Kansas the first state to pass legislation identifying the CCBHC model as a solution to the mental health and substance use crisis.

“Access to mental health services are integral to building stronger communities, especially as we continue to recover from the pandemic,” Gov. Kelly noted in a release from the State of Kansas. “I’m proud we are the first state to establish this model as another step in the right direction toward addressing the mental health crisis we face. In 1990, the Kansas Mental Health Reform Act fundamentally changed the mental health system in Kansas with the goal of transitioning care from institutional services to community-based care in response to the needs at that time. That monumental legislation established Community Mental Health Centers (CMHCs) as the ‘safety net’ for Kansans with mental health needs, ensuring that behavioral health services are available in all 105 counties, 24 hours a day, seven days a week. HB 2208 reforms and modernizes the system to meet today’s needs. CMHCs across the state are facing challenges like increased demand for services, substantial reductions inpatient psychiatric hospital resources and workforce shortages.”

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With the recent signing of that law, Dr. Leslie Bissell with Southwest Guidance Center said she is happy with that direction. 

“We're definitely excited that, at a legislative level, the state is taking more interest in the mental health needs of Kansans,” Bissell said. “As a system, we have been underfunded for many years, so the new Certified Community Behavioral Health Clinic (CCBHC) model is going to help us as a system be able to recruit more qualified personnel and retain personnel and provide a wider range of services.”

The variety of integration that will be included, Bissell said, will be extremely beneficial. 

“One of the things about the CCBHC model is it's really focused on integrating a lot of different types of care under one umbrella, so it's looking at being aware of both mental health issues for our patients along with substance abuse issues and how both of those interact with our physical health,” Bissell said. “What this new model does is provide a framework for us to be able to better provide services and network more efficiently with other community partners doing that sort of work. That opportunity for partnerships is one of the most exciting parts of this expansion of our providing services.”

Specifically with SWGC, Bissell said she is excited to see everything roll out throughout Kansas. 

“What's going to be interesting for SWGC specifically, as one of 26 community mental health centers in Kansas, is because we have a more rural and frontier focus, how we're going to implement this model is going to be a challenge,” Bissell said. “The model was developed in more urban areas, so both the access to trained personnel who are able to do that label of work, as well as the logistics of travel time and those factors, are going to be a significant barrier for us to fully implement the model. The bill Gov. Kelly signed is definitely the first step toward that because without that level of support on the books that guarantees additional funding for our system to be able to offset some of the costs of our services, there's really no way we'd be able to think about expanding or doing some changes on how we provide services. Compared to some other centers, there are five or six that have already implemented this and are much deeper in the process of earning this specific certification, and those centers are more on the eastern side of Kansas. For SWGC, we'll probably come on later in the process to fully implement this, especially as our other rural partners are figuring out how they can meet all the requirements involved. It'll exciting to be part of this, we'll also be able to raise some salaries, and as a non-profit, we'll be able to provide salaries at a level our staff truly deserves.”

Such action at the legislative level, Bissell added, is extremely important. 

“One of the things the pandemic has taught us is how we provide our services can be done much more flexibly than what previous standards allowed us to do,” Bissell said. “Prior to COVID-19, there were a lot of restrictions on how we could do things like the telehealth appointments, and it also made it a bigger burden for the community to access those services – before, people might have had to drive a long distance to meet with us in person, but the pandemic allowed us to continue talking to patients through Zoom and other similar means. We also know, because of the pandemic, suicide rates are gradually increasing, and we know those feelings of isolation are continuing for some people even as restrictions are being lifted and people are able to be out and about more freely in some places. I would consider mental health the second wave of the pandemic – the first wave was dealing with the actual physical illness, and now it's the mental health response to all the stressors and strains that have been happening for the past year. As a center, we're poised to be able to offer a lot of support, and something like the CCBHC model infuses not only funding, but also practices, and we can learn from other centers what could work and what might not be needed as much here in Liberal. The more everything gets integrated, the more likely we are to catch mental health challenges earlier in our patients, and like any physical ailment, the sooner an issue is identified, the faster the response time can be, which equals less stress in the long term. If we can eliminate the barriers to people getting the support they need, the better it is for everyone.”

One of the major issues Bissell said she is excited to be tackling is substance abuse. 

“Bringing in more substance abuse services is going to be really key, especially for our area, because that's been a challenge for many, many years,” Bissell said. “With that, it's difficult to find providers, and it's hard to find providers who would want to provide that service in this area. For Southwest Kansas, being able to offer the substance abuse services is going to be a significant benefit. We'll also be able to integrate with primary care and have those conversations, and having that common language across the board will also be great. We have to think about how would having that infrastructure in place help make this area a more marketable place for someone to come, and what are some extra trainings our staff would have to get in order meet those needs for this model. There's a lot to consider there.”

For now, however, Bissell said SWGC will be in more of an observation stage. 

“Since SWGC is a smaller center compared to others, we're really going to be watching them for the next several months to see what they're learning and what's working well/not so well and how they get creative to fit the needs of their specific clientele,” Bissell said. “As the concept moves forward more, we'll be thinking about how we can morph it all to fit our needs and how they align/clash with the federal guidelines, which is always a challenge. Right now, we're in the investigation/observation stage of all of this and there is a lot we'll be looking at with the other centers.”

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