Mental Health Services in Kansas

State Hospitals and Institutions

Oversight

The Kansas Department for Aging and Disability Services (KDADS) is responsible for the administration of state-owned and -contracted facilities. The Kansas Department for Health and Environment (KDHE) licenses the facilities. Oversight and certification are provided by the federal Centers for Medicare and Medicaid Services (CMS).

State Mental Health Hospitals (SMHH)

Osawatomie State Hospital (OSH) was established in 1855. OSH provides services to adults diagnosed with psychiatric disorders, regardless of ability to pay or legal status.

Larned State Hospital (LSH) was established in 1914. LSH is the largest psychiatric facility in Kansas, serving the western two-thirds of the state. LSH provides services to adults with serious and persistent mental illnesses, most of whom have been deemed a danger to themselves or others. LSH also houses the Sexual Predator Treatment Program (SPTP), established in 1994. [See State Hospitals]

Since 2015, OSH and LSH have been the only SMHHs. OSH and LSH generally serve Kansans who require longer-term inpatient acute care. The Care and Treatment Act for Mentally Ill Persons (KSA 59-2945 et seq.) provides definitions and guidance for admission to the state hospitals.

Regional State Hospital Project

The 2022 Special Committee on Mental Health Beds recommended that $15 million from the State General Fund (SGF) be released to construct a facility for up to 50 inpatient beds in the Sedgwick County area. The State Finance Council released the $15 million to KDADS on December 21, 2022. Additionally, $25 million from the Strengthening People and Revitalizing Kansas (SPARK) fund was awarded to Sedgwick County for construction costs. The project is for 25 beds for forensic competency evaluations and restorations and 25 beds for acute inpatient psychiatric care, with consideration of expanding to 100 total beds. On August 28, 2023, Governor Kelly issued Executive Order 23-05, which created a 14-member panel to gather public input and make recommendations about the proposed hospital building.

The South Central Regional Psychiatric Hospital Advisory Panel is charged with gathering public input on needs and location of a regional state psychiatric hospital, including how a state hospital would fit with existing services in Sedgwick County, and researching existing resources, gaps in services, and barriers to care to improve access and delivery of services in south central Kansas.

State Institutional Alternative (SIA)

In 2020, a new provider classification, State Institutional Alternatives (SIAs), was developed by KDADS and KDHE in response to lifting the moratorium on admissions at OSH to expand regional capacity for adults and youth who meet the criteria for state hospital admissions.

SIAs are private psychiatric hospitals or community hospitals that agree to accept patients with mental illness who have been screened for admission to a state hospital. These SIA hospitals are paid a per diem rate for each patient day instead of the regular Medicaid rate. SIAs submit an application to the State to be able to enroll in Medicaid and be reimbursed on a per diem rate for any patients successfully screened for SMHH admission, and they receive state funds for the care of the uninsured.

SIAs provide regional hospital alternatives to LSH and OSH, allowing for care closer to home for patients and reducing demand on SMHHs, as well as reducing wait times for admissions. As of October 2023, there are ten contracted SIA facilities with seven facilities currently admitting a mix of geriatric, youth, and adult populations.¹

Residential Treatment, Training, and Care

The State of Kansas operates two residential treatment, training, and care facilities for individuals with intellectual disabilities. Primary funding for these facilities is from CMS.

Parsons State Hospital and Training Center (PSH&TC) was opened in 1903. PSH&TC serves adult and youth individuals with intellectual and developmental disabilities whose circumstances require specialized residential service provisions. Certification as a Hospital is from the Kansas Hospital Association as a Special Mental Hospital and by the State Department of Education as a Special Purpose School.

Kansas Neurological Institute (KNI) was established in 1959. KNI provides both a treatment center and residence for adults with intellectual and developmental disabilities who require a high level of ongoing support. Many residents require intensive physical and medical supports; about one-third are unable to eat by mouth and receive their nutrition through feeding tubes. Services from KNI, including outreach services, must be requested and approved through the Community Developmental Disability Organization (CDDO) for the county in which the person lives and must be services that cannot be provided or arranged through the community services system.

Community Inpatient and Structured Care

Community inpatient care and structured care environments are the two levels directly below the state hospitals on the adult continuum of care. Structured care environments include crisis stabilization services, nursing facilities for mental health, residential care facilities, sobering beds, and social detox beds. Community inpatient care includes crisis intervention, community inpatient psychiatric beds, medical detox beds, and substance use disorder treatment.

In 2017, the Kansas Legislature enacted the Crisis Intervention Act, which allows adults to stay involuntarily in crisis intervention centers for up to 72 hours for emergency evaluation and treatment. The Crisis Intervention Act also requires a center to file an affidavit with the district court within 48 hours of admission if the patient meets the criteria to be retained. Crisis intervention centers must discharge the patient if they no longer meet the criteria or if 72 hours has passed since admission. For more information on the Crisis Intervention Act and associated issues, see the article on Mental Health and the Criminal Justice System.

Kansas also has six established crisis stabilization centers located in Kansas City, Topeka, Wichita, Salina, Manhattan, and Hays. Crisis stabilization centers provide the highest level of care, and the beds are traditionally filled with individuals who pose an immediate risk to themselves or others and are receiving treatment voluntarily. These centers provide patients short-term mental health crisis care of less than 72 hours before they can transition to community-based care. Crisis stabilization is not traditionally provided in hospitals, but it can be an alternative to psychiatric hospitalization.

Community-Based Care

Community Mental Health Centers

In 1963, President John F. Kennedy signed the Community Mental Health Act, which led to the establishment of Community Mental Health Centers (CMHCs) across the nation. The Kansas Mental Health Reform Act of 1990 initiated the state’s transition from institutional to community-based mental health care. The Kansas Mental Health Reform Act deemed that Kansas residents in need of mental health services should receive the least restrictive treatment and the most appropriate community-based care through coordination between CMHCs and state hospitals.

Since 1990, CMHCs have served as the primary points of entry into the mental health system. CMHCs are mental health facilities that are statutorily identified to provide community-based public mental health services. CMHCs provide outpatient services to adults and children, as well as behavioral health screening for patients. CMHCs are subject to licensure and must also conform to CMS standards and audits. The 26 CMHCs in Kansas also serve as the gatekeepers for admission to state mental health hospitals. KDADS maintains a directory of CMHCs in their Directory of Mental Health Resources in Kansas. As more patients have used community-based services, the need for state hospital beds has declined.²

Kansas has 26 CMHCs that primarily serve adults with severe and persistent mental illness, children and adolescents with severe emotional disturbance, and other individuals at risk of requiring institutional care. Anyone experiencing a mental health crisis who lacks a mental illness diagnosis can seek treatment at a CMHC.³ According to KDADS, CMHCs offer “comprehensive mental health rehabilitation services, such as psychosocial rehabilitation, community psychiatric support and treatment, peer support, case management, and attendant care.”⁴

Certified Community Behavioral Health Clinics

Certified Community Behavioral Health Clinics (CCBHCs) are defined by the National Council for Mental Wellbeing as “a specially-designated clinic that provides a comprehensive range of mental health and substance use services.”⁵ CCBHCs are Medicaid provider clinics and are required to meet certain requirements in order to earn certification, which include providing evidence-based practices to their clients, as well as serving the “whole person.”

Generally, a CCBHC is required to provide a certain set of core services. These include, but are not limited to:

• Person-centered and family-centered care;
• Crisis services;
• Outpatient mental health and substance use services; and
• Screening, assessment, diagnosis, and risk assessment.

Currently, there are 20 CCBHCs certified in Kansas, with six more scheduled to be certified in state fiscal year (SFY) 2025. In July 2024, KDADS announced it had received a CCBHC Demonstration Grant. [Note: A CCBHC may also be a CMHC.]

Mental Health Intervention Team Grant

The Mental Health Intervention Team (MHIT) Grant is administered by the Kansas State Department of Education to help break down barriers in place for youth to receive mental health services. The MHIT focuses on K–12 students and their families by identifying students, helping families navigate mental health services, and linking them to the existing statewide behavioral health system and resources within the Mental Health Providers network. Additionally, the MHIT focuses additional resources on foster students in need of mental health services. The program consists of liaisons who “bridge” sharing educationally appropriate information with providers and classrooms, help families navigate waivers and paperwork, and schedule services. Communication between the mental health professional and school is permitted through both a memorandum of understanding (MOU) and, if the parent agrees, a release.

The MHIT Grant has been funded through a proviso bill beginning in 2018; 75 percent of funding goes to liaison salaries and benefits, and 25 percent of the total request flows through the school district to the CMHC. The MHIT began in 9 districts servicing 1,708 students in the 2018–2019 school year. In the 2022–2023 school year, the MHIT was in 66 districts, served 6,014 students including 552 foster students, and had 150 liaisons. For the 2023–2024 school year, 90 school districts applied, which included 24 new districts, and 182 liaisons are anticipated to participate.⁶

Suicide Prevention

Kansas Youth Suicide Prevention Coordinator

Among the provisions in 2019 HB 2290 was the creation of the position of Kansas Youth Suicide Prevention Coordinator within the Office of the Attorney General. The Office of the Attorney General, in partnership with The Jason Foundation, has developed the “Kansas – A Friend AsKS” app, which is a free smartphone app that provides information, tools, and resources to help an individual who may be struggling with thoughts of suicide.

Kansas Department of Health and Environment (KDHE)

In August 2020, KDHE was awarded a Zero Suicide in Health Care Systems grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). It is a five-year, $700,000-per-year grant, and it was the first of its kind for KDHE. The target audience for the grant is adults 25 years and older, and the activities of the grant are developed in accordance with the Zero Suicide Framework. KDHE publishes the Kansas Suicide-Related Data Dashboard on their website.

Kansas Department for Aging and Disability Services (KDADS)

988 Suicide Prevention and Mental Health Crisis Hotline

KSA 75-5964 through 75-5971 established the Living, Investing in Values and Ending Suicide (LIVES) Act, which laid the groundwork for implementation of 988 Suicide Prevention and Mental Health Crisis Hotline in Kansas. Kansas has a network of four 988 Contact Centers that provide coverage for Kansans, and a fifth is under development as of August 2023.

Suicide Prevention Coordinators

KDADS secured a five-year Garrett Lee Smith Youth Suicide Prevention Grant in 2023 that will help fund suicide prevention programs in Wyandotte and southeast Kansas counties. Additionally, the grant includes a federally funded full-time equivalent (FTE) position for a grant coordinator. KDADS also has a dedicated FTE for a State Suicide Prevention Coordinator that is state funded.

Kansas Suicide Prevention Plan

The Kansas Suicide Prevention Plan (2021–2025) outlines the activities and responsibilities necessary to accomplish suicide prevention goals and objectives across the lifespan. The primary purpose of this State Suicide Prevention Plan is to reduce death by suicide in Kansas. This plan will be renewed every five years, with reviews occurring at least annually, as needed, and based on any significant changes in data or resources.

Youth-Only Services

Youth have access to several mental health treatment options throughout the state. Options include psychiatric residential treatment facilities (PRTFs), the Medicaid Home and Community Based Services (HCBS) waiver for Serious Emotional Disturbance, and Professional Resource Family Care. Each option is detailed in more depth below.

Psychiatric Residential Treatment Facilities (PRTFs)

PRTFs provide out-of-home residential psychiatric treatment to children and adolescents whose mental health needs cannot be effectively and safely met in a community setting. These programs are intended to provide active treatment in a structured therapeutic environment for children and youth with significant functional impairments resulting from an identified mental health diagnoses, substance use diagnoses, sexual abuse disorders, or mental health diagnoses with co-occurring disorders (i.e., substance-related disorders, intellectual and developmental disabilities, head injury, sexual misuse disorders, or other disabilities that may require stabilization of mental health issues).

The residential treatment facility is expected to work actively with the family and other agencies to offer strengths-based, culturally competent, trauma-informed, medically appropriate treatment designed to meet the individual needs of the residents.

There are currently nine PRTFs in the State of Kansas, all overseen by KDADS. A list of current PRTFs is available on the KDADS website in their Directory of Mental Health Resources in Kansas.

Medicaid Home and Community Based Services (HCBS) Serious Emotional Disturbance Waiver

The Serious Emotional Disturbance (SED) waiver is for children 4 to 18 years of age who have a diagnosed mental health condition that substantially disrupts their ability to function socially, academically, or emotionally; are at risk of inpatient psychiatric treatment; meet medical assessment criteria; and are financially eligible for Medicaid. The application is completed through a local CMHC.

Services and supports under the SED waiver may include attendant care, independent living and skills building, short-term respite care, parent support and training, professional resource family care, and wraparound facilitation. As of October 13, 2023, KDADS reported there were 3,306 participants eligible to receive HCBS SED waiver services.⁷

Funding for Mental Health Services

CMHCs

Medicaid provides the largest source of state funding for community-based mental health services. CMHCs use certified Medicaid match funds to provide services for children with SED, children referred to CMHCs by children and family service contractors, and all other children and adults who are Medicaid eligible. Medicaid covers targeted case management, comprehensive medication services, personal care services, pre-admission screens, activity therapy, group and individual psychotherapy, training and educational services, crisis intervention, community transition, and respite care. [Note: The current KanCare Contract ends in December 2024. The procurement process for KanCare began October 2, 2023, with the issuance of a request for proposal, and the new KanCare Managed Care Organization contracts will begin January 1, 2025. It is unknown at this time how services will be impacted.]

Additional details on the CMHC and CCBHC changes are available in the KLRD memorandum on Differences between CMHCs and CCBHCs, which includes funding details.⁸

Crisis Stabilization Services

Crisis stabilization services are funded with 75 percent of revenue from Kansas Lottery vending machines. Additionally, COMCARE (Wichita), Valeo (Topeka), and RSI (Kansas City) receive funding independent of the Lottery vending machine revenue.

Family First Prevention Services Act

In 2018, President Trump signed into law the Family First Prevention Services Act, which encourages the maintenance of families to preempt a child’s entrance into the foster care system. The Act allows for federal reimbursement for mental health services, substance use treatment, and in-home parenting skills training.

Appropriations for SFY 2024

The annual KLRD publication Kansas Fiscal Facts includes a budget overview for Human Services as well as Session Highlights.

1. https://kdads.ks.gov/state-hospitals-and-institutions/state-institution-alternatives-(sias) ↩︎
2. 2018 Mental Health Task Force Report ↩︎
3. According to the National Alliance on Mental Illness, a “mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.” ↩︎
4. https://kdads.ks.gov/kdads-commissions/behavioral-health/community-mental-health-centers ↩︎
5. https://www.thenationalcouncil.org/program/ccbhc-success-center/ccbhc-overview/ ↩︎
6. Kansas State Department of Education testimony to the 2023 Special Committee on Mental Health ↩︎
7. https://kdads.ks.gov/kdads-commissions/long-term-services-supports/home-community-based-services-(hcbs)-programs (updated monthly) ↩︎
8. https://klrd.org/2023/11/30/community-mental-health-centers-and-certified-behavioral-health-clinics/ ↩︎

by Elizabeth Cohn
Senior Research Analyst
785-296-4382