SESSION OF 2021
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2160
As Amended by House Committee on Health
and Human Services

Brief*
HB 2160, as amended, would establish certification and
funding processes for certified community behavioral health
clinics (CCBHCs) and prescribe the powers, duties, and
functions of the Kansas Department for Aging and Disability
Services (KDADS) and the Kansas Department of Health and
Environment (KDHE) with regard to CCBHCs.
The bill would be in effect upon publication in the
Kansas Register.

KDADS Responsibilities
The bill would require KDADS to establish a process to
certify and fund CCBHCs.
The bill would require KDADS to certify as a CCBHC
any community mental health center (CMHC) licensed by
KDADS that provides the following services: crisis services;
screening, assessment, and diagnosis, including risk
assessment; person-centered treatment planning; outpatient
mental health and substance use services; primary care
screening and monitoring of key indicators of health risks;
targeted case management; psychiatric rehabilitation
services; peer support and family supports; medication-
assisted treatment; assertive community treatment; and
community-based mental health care for military service
members and veterans.
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org
KDHE Responsibilities
The bill would require KDHE to establish a prospective
payment system (PPS) under the Kansas Medical Assistance
Program to fund CCBHCs. Daily or monthly rate payments
would be allowed in the PPS.
The bill would require KDHE to submit to the Centers for
Medicare and Medicaid Services (CMS) any approval request
necessary to implement the PPS for CCBHCs.

Rules and Regulation Authority
The bill would authorize KDADS and KDHE to adopt
rules and regulations as necessary to implement and
administer CCBHCs.

Date of Implementation
The bill would require KDADS and KDHE to implement
the CCBHC certification and funding processes and the PPS
by May 1, 2022.

Background
The bill was introduced by the House Committee on
Health and Human Services at the request of Representative
Lynn. The bill was one of the recommendations made by the
2020 Special Committee on Mental Health Modernization and
Reform.
[Note: A companion bill, SB 138, has been introduced in
the Senate.]


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House Committee on Health and Human Services
In the House Committee hearing, proponent testimony
was provided by representatives of the Association of
Community Mental Health Centers of Kansas, Inc.;
COMCARE of Sedgwick County; Four County Mental Health
Center, Inc.; High Plains Mental Health Center; Johnson
County Mental Health Center; Kansas Mental Health
Coalition; and Wyandot Behavioral Health Network. The
proponents generally stated the CCBHC model would provide
a comprehensive range of mental health and substance use
disorder 24-hour crisis care services and receive an
enhanced Medicaid reimbursement rate based on the
anticipated costs of expanding services to meet the needs of
these complex populations. The proponents noted the state’s
shortage of mental health professionals, which is further
challenged by being surrounded on all four borders by states
that have either expanded Medicaid, implemented the
CCBHC model, or both; providing those states with additional
resources and the ability to recruit away already scarce
Kansas behavioral health professionals. The proponents also
noted an increased demand for services and stagnant
reimbursement rates and stated the CCBHC model would
provide an integrated and sustainably financed model for care
delivery. The Four County Mental Health Center
representative testified to the success of its CCBHC “look
alike” program funded through a CCBHC-expansion grant
from the Substance Abuse and Mental Health Services
Administration and its goal to become a CCBHC by the end
of the two-year grant cycle. Written-only proponent
testimony was provided by the KanCare Advocates Network
and the Kansas Association of Addiction Professionals.
Neutral testimony was provided by a representative of
KDHE. The KDHE representative stated concerns with
implementing the CCBHC model by July 1, 2021, and
indicated, ideally, 18 months would be needed for
implementation. The representative stated the CCBHC model
was discussed at a high level during the 2020 Special
Committee on Mental Health Modernization and Reform, but
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establishing the program would be more complex. The
representative stated CMS had requested 18 months to
review and approve any 1115 waiver amendments or
substantial state plan amendments. The PPS planning and
rate setting process would involve the completion of multiple
steps, including assessing the impact of the CCBHC model
on 1115 waiver budget neutrality and addressing any budget
neutrality concerns and developing a unique PPS rate would
need to be developed for each CCBHC based on each
facility’s cost. Written-only neutral testimony was provided by
KDADS.
No opponent testimony was provided.
The House Committee amended the bill to change the
implementation date from July 1, 2021, to May 1, 2022.

Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill as introduced, although the bill would
require a start date of no later than July 1, 2021, CMS
recommends at least 18 months to allow for the drafting of a
Medicaid state plan amendment or 1115 waiver amendment
and an impact assessment of the CCBHC program on the
State’s 1115 waiver budget neutrality. This recommendation
would make a fiscal year (FY) 2022 implementation date
highly challenging. However, the fiscal effect is calculated
assuming the July 2021 date. KDHE and KDADS estimate
the combined cost for the agencies would range from $43.0
million to $74.2 million from all funding sources, including
$17.4 million to $29.9 million from the State General Fund
(SGF) for FY 2022. The expenditures are detailed below.
KDADS estimates that administrative costs would be
$1.1 million from SGF for FY 2022 associated with the
creation of the CCBHC program. Included in these costs,
KDADS estimates it would require an additional 14.00 FTE
positions at a cost of $616,858 for salaries and benefits.
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These positions would include those needed to adequately
support all certification, rate setting, and monitoring functions.
Also, Medicaid support contracts would increase because of
system changes that would need to be implemented to
account for the new program. KDADS estimates the cost of
consultant work to develop and design the program structure
would be $37,500, technology system changes and rate
setting would be $277,000, and actuarial services would be
$150,000.
Medicaid services would be projected to range from
$40.8 million to $71.9 million from all funding sources,
including a range of $16.3 million to $28.8 million from SGF. It
is assumed that over time, 26 CMHCs would eventually
transition to CCBHCs. At that point, the agency estimates that
the cost would be the projected high end of the range.
Any fiscal effect associated with the bill is not reflected
in The FY 2022 Governor’s Budget Report.
Certified community mental health clinics; community mental health centers;
certification and funding; prospective payment system; mental health services;
substance abuse services; rules and regulations


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