Sedgwick County budget presenters seek 10 care-coordinator positions for Comcare, funded from CCBHC revenue

Joan Tammany, a Comcare official, told the Sedgwick County Commission on May 9 that Comcare is asking the commission to approve a decision package for 10 full‑time care‑coordinator positions at a total cost of $812,229. The request, she said, is not funded by local property tax dollars but is intended to be paid from revenue the department receives as a certified community behavioral health clinic (CCBHC).

Why it matters: Commissioners were told the care coordination positions are a CCBHC requirement and would support linking clients to medical care, transportation and other social supports — work Comcare officials said frees clinical staff to deliver direct services and, by increasing encounters, helps sustain the CCBHC revenue fund. Joan Tammany said, “If your basic needs aren't met, treatment is gonna be difficult,” as she described the role care coordinators play connecting people to services.

Comcare officials described workforce and funding context. Tim Kaufman, speaking for the Division of Public Services, and Joan said workforce shortages remain a primary constraint for mental‑health and crisis services, especially for licensed clinical staff. Comcare projects a sizable revenue increase tied to a change in the CCBHC prospective payment system (PPS): officials reported an estimated $8 million increase in revenue beginning January 1, 2026, due to higher encounter payments.

Uncertainties and pressures: Commissioners repeatedly pressed staff on risks to the CCBHC fund. Kaufman noted several potential pressures: the commission’s existing contract with a mental health association that was “not included in the rebasing” and that will be renegotiated later in the year; staffing and operating costs for the new community crisis center; and potential debt service the county could allocate to repay a proposed $39 million “concierge complex.” He also flagged federal grant timing: “our federal SAMHSA grant expires in September of 2026,” a lapse he said would move roughly $1 million per year onto the revenue fund.

Kaufman and Joan also pointed to federal and state uncertainty. Kaufman said there is discussion at the federal level about Medicaid and possible cuts, but “we don't know. We won't know for some time.” Joan said the county’s CCBHC model has improved revenue and capacity but recommended cautious planning because grant and reimbursement changes could reduce available funds.

Program context and other Comcare items: Comcare reported that the department is expanding medication‑assisted treatment for opioid dependence and investing in electronic health record enhancements. Officials noted prior investments created a growing “pipeline” of clinicians through a school‑tuition program and fellowship hires; they said several trainees have moved into county clinical roles. Comcare also supports the child advocacy center (see separate item in this meeting) and continues to operate multiple crisis and diversion programs funded by a mix of Medicaid reimbursement, state contracts and county support.

Commissioner questions: Commissioners pressed on whether the 10 positions might be staged, whether additional care coordination would reduce other costs (e.g., hospitalizations or jail bookings), and whether there is existing caseload to justify new hires. Tammany said positions would be filled only once caseloads existed and that care coordination reduces providers’ administrative burdens and helps increase billable encounters. A commissioner expressed caution about rapidly expanding a revenue‑funded staff pool given the multiple uncertainties affecting the fund balance.

Where this stands: The care‑coordinator request was presented as a decision package; no formal vote or final action was recorded during the May 9 hearing. Commissioners asked for further detail on implementation and fund forecasts before approving the package.