Bert Nash warns Douglas County of growing budget shortfall as Medicaid enrollments fall

At a Douglas County Commission work session on Feb. 26, Patrick Schmitz, president and CEO of the Bert Nash Community Mental Health Center, told commissioners the center faces a budget shortfall driven by rising service demand, a larger uninsured caseload after recent Medicaid disenrollments, and lower-than-expected Medicaid prospective payment system (PPS) triggers.

Schmitz told commissioners the organization has grown substantially since 2018 — from about $13 million in annual operations to roughly $41 million in 2024 — and that its 2025 budget assumptions show expenses near $43.7 million, about $1.7 million higher than 2024. He said fee revenue is projected to cover about 59% of revenue, county funding about 17% and state funding roughly 13%, and that a mix shift away from Medicaid PPS-eligible visits toward uninsured and commercially insured visits has reduced the PPS revenue the clinic can claim.

Why it matters: Bert Nash is the region’s designated community mental health center and a Certified Community Behavioral Health Clinic (CCBHC). Commissioners were shown that the center’s cost of care outpaced what commercial insurers and Medicare reimburse, and that the Medicaid PPS rate remains the only payer source that approximates actual cost. Schmitz said the Medicaid “unwinding” — the end of continuous enrollment rules — led to state-level disenrollments (the center cited a statewide figure of about 114,000 Kansans losing Medicaid, or roughly 21% of enrollees) and a measurable rise in uninsured patients at the center.

Key takeaways from the presentation: - Service levels: The center reported…