Board of County Commissioners - Regular Meeting

Well, good morning, everybody. This is staff meeting for September 15th. Tom, what do we got this morning?

Chairman, good morning and Commission. We have two items for discussion this morning. The first thing we will discuss is a K-15 corridor study. I don't know if Lynn or Daniel is going to do it, but We'll cover that item first, and then the second item will be a discussion on just an overall of Comcare CCBHC funding modeling and some questions that have come up from the state of Kansas, and Michelle is here to present on that. So we'll let Lynn or Daniel go first, and away we go.

Good morning, Chairman and Commissioners. I'm here this morning with J.B. Wilson of KDOT to present my K15 corridor study that was recently completed by KDOT. About three, three and a half years ago, Commissioner Howell approached me with concerns of the K15 corridor, specifically down by 55th and 47th Street South. We took those concerns to KDOT, and they agreed to complete a corridor study. With the help of Chad Parasa, with Wampo, we extended the study all the way down to 95th Street south, to the south, all the way up to I-135 to the north. And that allowed us to bring in two more partners with Derby and Wichita to give them some advantages with the corridor, as well as help participate in the cost. I'll note that this study is a first step in looking at the current and future needs of the corridor. And then JB is going to come up now and present on the processes and the results of that study.

Morning. Good morning. Good morning, everybody. This is a really awesome building. I haven't been in here before. This is fantastic. The view is amazing. So I'm going to go over the K-15 study, like Lynn talked about. I'm going to mostly stick to my notes, but if there's anything you guys see while we're going over concepts that have been introduced, feel free to stop me, ask questions. Why is this at grade? Why is this grade separated? Why are we closing off access to this area and the suggested concepts? I can answer that the best I can or I will have my email at the end of the presentation. You guys can email me and I will find a subject matter expert that can answer those questions as well. So I'm gonna go ahead and get started. Maybe. There we go. The study evaluates the K-15 corridor from I-135 to 95th Street and was selected based on public input. The goal of the study was to extend the useful life of the existing roadway for as long as practical while identifying improvements that can address current and future transportation needs. The study looks at both short-term and long-term operational improvements and long-term concepts that may improve safety, mobility, and corridor reliability if funding becomes available. K-15 is an important regional corridor that serves the commuters of Derby and Mulvane, major employers such as Boeing and Spirit Aerosystems, and McConnell Air Force Base. The corridor also provides connections to major transportation routes, including the Kansas Turb Pike, I-235, and I-135. The railroad and Arkansas River create challenges limiting crossing opportunities, which impacts traffic flow and contributes to congestion in certain areas. The purpose of today's presentation is to share those concepts evaluated as part of the study and gather some feedback. This public input helps us identify priorities and inform future decision making. At this time, this study is a planning effort and no funding has been identified for design, right of way acquisition or construction. At this stage of the study, there are no plans. I always have to reiterate that because whenever we do a study like this, there will be, as the public information officer, media questions, so it's always good to say it's just a concept. But at this stage of the study, there are no plans. The concepts being presented are planning-level recommendations. If the future project moves forward, any additional design work would determine specific needs. Any potential impact to property owners would be communicated through the appropriate process. This study represents the first step in a longer transportation planning process. If improvements advance in the future, they would likely be separated into multiple projects and constructed into phases based on available funding and priorities. Currently, no funding has been identified for future design right of way or construction. the key considerations of the study evaluates future traffic court conditions safety concerns and long-term capacity needs of the corridor one major consideration is access management which involves evaluating driveway driveways intersections to reduce conflict points improve traffic operations in some locations additional turn lanes or intersection improvements could help maintain access while improving safety and reducing delays so Here we have the first concept. This area represents one of the biggest challenges along the K-15 corridor due to the limited crossing at the railroad in our Kansas River. You can kind of see right here. Oh, yeah, looking for that. Ah, there we go. So right here we have the railroad crossing and we have the Arkansas River as you can see. Currently right now this is the concept, but that does affect the queuing in the area along with the exiting traffic from the GTA. So when trains block the existing crossing, traffic can become delayed on both sides of the railroad, creating impacts throughout the corridor. One concept evaluated is a diverging diamond interchange at I-35, which is intended to improve traffic operations by allowing vehicles to move more efficiently through the interchange. Another improvement being considered is grade separation at MacArthur, which would reduce conflict points between railroad traffic and railroad operations. The concept also includes potential modifications to the Kansas Turnpike Authority access to support better overall interchange movements. Because this area addresses some of the largest mobility challenges along the corridor, it would be considered a priority if future funding became available. Now I know I said the word diverging diamond. I'm going to have our friends at ODOT explain what would go into that. Ohio Department of Transportation. They're the ones that made the video. Credit where credit is due. Well, I can discuss the differences in divergent diamond interchange. So essentially, a divergent diamond interchange, a good way to think about this while they're getting the video is... Traffic will move in the middle of the interchange to the left side of the road. So just while you're going through the interchange, you're European, essentially. You're having tea with the queen. By the end of it, you're back on the right side, and you're moving through it as normal as you would in a normal diamond interchange. You might be asking yourself, that's a heck of a trade-off. We've got to be Europe for 10 seconds? It has 12 less conflict points than a typical diamond interchange. So a typical diamond interchange has 26 conflict points. A diverging diamond has 14. So that is most likely, you know, as they move forward, as they're introduced to to other areas of Kansas, that is what the typical driver can experience. They have been introduced in Kansas City, in Manhattan, Kansas, and in Junction City currently. So the traveling public in Wichita, if you do any kind of travel around the state, is relatively used to that idea and that concept.

So I'm just trying to understand this whole diamond configuration. Does that mean you don't stop? It just it's continuous?

So it does reduce the, it does reduce queuing and it reduces, by having traffic go to the left, it reduces the need for that turning left, if that makes sense. The video explained it better, kind of doing a,

But you don't have to come to a complete stop?

You will come to a complete stop. There are traffic signals at that interchange. It is typically more pedestrian friendly as well. I can send some of these concepts if you would like. But we are currently doing the K96 improvements project. And we will be building these diverging diamond interchanges at Oliver, Rock Road, Hillside. and um and so it'll be something that if this concept was to move forward the public would be relatively used to we have asked the public what they think about it and typically what they say is like it looks intimidating at first but by the time i was through the interchange i hadn't even realized anything that happens how long has ohio been using them uh i'm i'm not sure that's a fantastic question

Is this something a lot of other states are using that we just haven't grasped on, or is this a new concept?

So we do have them in Kansas, like I said. We have been using them in Kansas City and Junction City and Manhattan. But it is something fairly new, I believe, in the last decade, the 2010s, that has been introduced to Kansas. Okay. Sorry, okay, so this is an alternative concept. This area represent, sorry, backwards with the diverging diamond. So this is an alternative concept at MacArthur. It includes a bridge over K15 and a new diamond interchange along the K15 bridge over I-35. I know I just hyped up diverging diamonds and I'm like, we're putting a diamond. These improvements aim to create more efficient regional connections and reduce congestion points. At 35th Street up here, we have a continuous green proposed. This would allow southbound traffic to move without stopping. while westbound traffic would have an acceleration lane to improve merging and reduce delays. I know when it's kind of a top-down view like this, it's kind of hard to tell what's at on K15, but that would be kind of next to the quick trip once you get off of I-135 and you're moving down the corridor. And additional improvements would include adding north and southbound left turn lanes at 47th Street to improve traffic flow and reduce backups. So the proposed improvements at 55th Street focus on improving connectivity, reducing delays, and better managing access along the K15 corridor. This concept includes shifting the 55th Street interchange east of K15 to provide more direction connection to Southeast Boulevard. frontage road and the frontage road to the north. This would improve access to K15 and the surrounding residential areas while enhancing connectivity to nearby neighborhoods. West of K15 access management improvements are proposed to reduce conflict points and improve safety along the corridor. These improvements could include modifying or consolidating access points and removing the existing railroad crossing at 55th Street. Eliminating the crossing would reduce interruptions to southbound K-15, helping to improve travel reliability and reduce delays caused by train activity. So kind of to reiterate that point, as you can see here, getting rid of that railroad crossing here and here, that is helping cars that are queuing, especially at 47th Street. The less queuing there is, the less congestion there is, and the quicker traffic's moving through the K-15 corridor. This area focuses on improving local circulation, access, and safety. A roundabout at Southeast Boulevard has been constructed as a way to improve traffic flow and reduce conflict points. Additional connections to Red Powell Road provide more efficient local access. We also have here The proposed improvements at Patriot Avenue focus on improving safety and traffic operations at the intersection. Dedicated left turn lanes on north and southbound K15 are being considered to separate turning vehicles from through traffic. These improvements are intended to reduce delays. Here we are. In addition to term lane improvements, access management strategies are being evaluated near Patriot Avenue. These include consolidating closely spaced driveways, limiting future direction access onto K-15, and preserving right of way for potential future improvements. The goal is to reduce these conflict points while continuing to provide reasonable access to adjacent properties. Like I said, it's a little hard to see from this top-down angle, but if you ever go through Derby, this would be the Walgreens, just to kind of give you an idea of what this area looks like when you're traversing it. Nelson Drive improvements build on work already underway and would extend connections to Greenway Street. These improvements are intended to enhance access to nearby schools, neighborhoods, and local streets. Additional concepts include improved access to Wedgewood Street and Frontage Road connections along K15. These changes would help organize traffic movement, reduce direct access points. And then if you guys know the ARC95 study, the proposed 95th Street improvements built on concepts previously evaluated through the ARC95 study, which identified the need for improved east-west connectivity and an additional Arkansas River crossing. This would be kind of similar to, if you guys were driving through the south part of Derby, that'd be the 83rd Street crossing would be the closest. There's not like a one-for-one, but that would be the crossing at over the river there to Hillside from 83rd Street on turning from K-15. A connection at 95th Street could provide another travel option for the region helping to reduce reliance on K-15, improving access between communities such as Derby and Mulvane. The proposed interchange concept also includes an acceleration deceleration lane. This would provide a smoother transition for vehicles entering and exiting K-15. Now, I'm completely open to questions, but also if I'm not able to answer your questions, I can get the subject matter expert, the engineers that were available for this study, and I can email you at a later date those answers as well.

Thank you, Chairman. Boy, this is a lot of information, and thankfully I've spent some time looking at this already, but if they're not familiar with the area, some of this is pretty confusing to look at these. A couple of things I'd like to just point out, that first of all, the bridge over the turnpike today, the rail does not go – right now that bridge is lower than it should be, and so KTA, if I understand correctly, the entire turnpike has a height – limitation based on that specific bridge. And so if there is a new bridge there, that would be higher. It may be able to raise the height limit for the entire turnpike.

I believe that's correct, yes.

Yeah, that's something they talked about. So again, we don't realize that type of opportunity, but that is the lowest bridge of the entire turnpike from end to end. So that is one reason that should be changed. Second of all, the There are two rail stubs that go across K-15 currently, and although they're not used that much, buses do have to stop on those. Some types of fuel trucks and things have to stop on those. It does create backups, but I would also say that Spirit Air Systems, or I should say Boeing, when they do move things across there, it is... It shuts down traffic for a while. But second of all, they have to store their fuselages basically on the west side of the highway. They store them there before they take off and go to Seattle. I believe that all those red lines you see there, it moves all that storage would stay on the east side. And the way they would go under the rail to actually go to Go the other way to go past the k15 to access the actual rail line It's under that very same bridge that goes over KTA you see at the top into that slide there. You see that red line That's a new that's a new rail Access to Boeing so there's two crossings across k15 are completely gone on that on that map there And to me those are that's that's that's really good for Boeing as well. So and that's not something that's We talked about. One of my concerns, I guess, I would have is southbound traffic has less places to stop, but it also has less places to go east. So if you want to go down, say, 55th Street to the east, you're going southbound on K-15, you want to go east on 55th or east on, let's see, can you go east? There's an interchange at MacArthur, so that's not a problem. And then at 47th Street, I guess there is a actual traffic signal there still there, so that's a stop. There's a stop at 63rd Street, but other places like 55th Street, you can't go eastbound.

And I believe that was a consideration for that 47th Street interchange. We do have those communities from Oak Lawn and Oak View that are pretty much equidistant to I-135 and K-15. So maintaining access for those communities was a priority as well.

One other thing I'd say is 47th Street, if you go west of K-15, there's a lot of conflict right there with Clifton dumping into 47th Street, and of course there's still rail traffic there. Is there any intent to... One of the things I would have liked to have seen, and I've talked about this for a very long time, if there's going to be an overpass anywhere, one of the places that makes the most sense would be at 47th Street. And I actually brought this up at the briefing down at Derby when they talked about this publicly. But maybe more so than almost any other location, the K-15 traffic... has a tremendous amount of people going west to access 235. So they go basically two miles to access the South Fork. But there's a lot going on right there at 47th and K-15. In fact, Lynn, you can correct me if I'm wrong, that's one of the hottest places in the Central County for accidents. I believe it's, I don't know any way to really see that data any longer. But when the data was available, I used to watch that, and it was a hot spot right there at the intersection for, for traffic accidents, injury accidents, and even some fatality accidents. And so that was an area that we've been concerned about for a long time. So the idea was if you could exit K-15 at 47th Street and take an overpass over the trains and then basically drop back in somewhere closer to Clifton, and I would probably reroute Clifton to go under the overpass. Clifton should be rerouted, I think, to go closer to the rail. Right now, the land that's right there is not developed, so that would be really easy to reroute Clifton right now to be under the very same bridge. The bridge wouldn't have to be that long, and also on the east side of K-15, the land actually has a lot of elevation, so the On the east side, it's already higher up, and you're coming down a hill. Right now, currently, to go across K-15, that bridge would actually already have a height that needs, if you will, on the east side. So there's a lot of opportunities there at 47th Street, and I don't know if you want to talk about that at all.

no no okay so just so because I'm gonna run this by the subject matter expert I would be slave to GFT but so what you would be suggesting is kind of more similar to what we're doing here at McArthur where we have a great separation diamond interchange essentially where we're allowing traffic to kind of continue relatively um uninfluenced by the north and south sides of that of that um 47th street corridor and uh so essentially that is a great question and i am going to run that by the because it it it does seem like we're putting diamonds and interchanges and especially connecting routes there with the continuous green. And then here with the left turn lanes, I would also like to probably know why we landed on that alternative design as well.

MacArthur from this point is a whole mile to the south. And the Diamond Interchange, that picture that you have right now showing the Diamond Interchange is exactly what I have envisioned for 47th Street the only difference would be that Clifton would have to be rerouted So we go under the bridge the bridge would be just a little bit longer But you already have the height on the east side and drop back in on the west side So you have no conflict from from from quick from from k15 to go east or west on 47th Street would be completely Through the interchange it would really be Completely all the conflicts conflicts would be completely fixed if you will so to me and I've talked about this for years I actually drew up a cartoon and gave it to the people in Derby and Uh, the, again, I can't do very good at drawing, but I think you understand what I'm trying to ask. Yes.

Yes, sir.

Okay, good. And again, I'll just say this. If you're, if you're going southbound, the places to go east are very limited. Now you can only go really at 63rd or 47th and going east at MacArthur doesn't really help because you're going into the, uh, to the aircraft plant. So you think about this from one 35, all the way to Derby only have two places to go left. And that's a four mile stretch.

And that is the challenge of we want to keep traffic from queuing at too many lights, from getting congestion at that peak, 5 o'clock traffic. But we also want opportunities for that east-west connectivity.

Other than that, I think the plans are really quite good. And one thing that's on this list here that's really, I thought, probably the least expensive improvement would be to close the west leg of 55th Street. And I'm actually surprised we haven't done it already. Again, I don't like to close roads, but I know there's been so many bad accidents at the intersection I just don't know why we would not maybe do that sooner than later because it's just Though the the ramps that you show there that's expensive, but those red X's on the bottom into that slide That's almost free

And I do know that when we did this study initially last January, I want to say, I believe it was either end of 2024 or beginning of 2025, we did have a hotspot map that shows a lot of what you're saying here. That showed the crash data along the corridor as well. So that is available on the website for the K-15 study.

If we did go through. With a plan like this, have we broken it up in phases and have we looked at what phase would help the most first?

That is a great question. So we identified We identified this first alternative as moving the KTA as a primary. It would be extremely beneficial. We had Boeing reach out and complement it as well. But there is just a lot of queuing that takes place right when you get off of I-135 into this section of MacArthur and Just moving the KTA into a diverging diamond or one of the other alternative concepts would help a great deal with congestion in this area. So this would be the concept that most likely would be a primary focus if there was to be funding allocated.

You believe this would be a priority over the ARC-95 exits, or is that two separate projects? Sure.

That's two separate projects. Okay. But it does feed into these design concepts as well.

Thank you for the presentation. Yeah, good to see you. Appreciate it always. Is any of this in the WAMPO, TAC world of projects? So I have parts of it. Even part, I mean, the whole thing is probably huge, but.

So the arc 95 study was presented and then I presented these concepts as well Okay, I don't think as in depth as I have here But but like like I said this this is a these are a concept study it a lot of it would depend on funding and you know It's on the wampo Consideration of many many projects possibly, right?

Okay.

Thank you What other questions

I'll just make a comment, and that is there are only really two arteries going south into the county. One of them is Rock Road. I would argue that Rock Road, at certain times of the day especially, are at capacity. And there seems to be no discussion right now what we're going to do about that going forward. I think if we were to pave Greenwich Road and improve Greenwich Road, it would take some pressure off of Rock Road. But that right now has not really been discussed. We don't seem to have a solution to Rock Road at all. And K-15, again, certain times of the day, especially shift change hours in the morning and in the evening, there are times where this traffic backs up going north into Wichita, backs up clear past MacArthur. And so we're talking about a mile of traffic stopped. And I know it's construction right now, but it has been absolutely just horrendous. And I would just argue this is one of the areas of the county that needs to have some attention. I appreciate the study. I think it's a great first step. I had people say, well, when's this all going to happen? I don't think anybody would be able to speculate on that, but I would anticipate this may be decades worth of work at this point. So with that in perspective, it's probably not anytime soon. It's federal and state funding for this to happen, right?

I would completely agree.

I'll add onto that commissioners. Um, the nice thing about this study is it is higher level. It hasn't come down and really allocated. This will be a first phase, second phase. That's, that's for a different phase of design. But, uh, the nice thing about this is there are short term and longterm improvements that can be made. So a lot of these improvements, um, unlike, you know, like he's like JB mentioned, you know, the big, the biggest bang for your buck probably is going to be, up there at Boeing and moving the KTA interchange. That's a big bite, but it's also gonna have probably the biggest influence on the traffic out there. But a lot of the stuff can be done. For example, the cul-de-sac on 55th Street, a lot of the driveways as you go through Derby, a lot of that stuff is smaller that could happen as we're gearing up for some of the larger improvements out there.

I also should have said that the movements from southbound to eastbound, you're also limited at 31st. That's currently you can turn left at 31st going eastbound from southbound traffic. That would also be taken away with this plan. Also, if you're familiar with the area, right now there's a C and D type operation that happens on the west side of the tracks at 31st Street. And I believe that this plan showed that access is cut off and they would have to access that site from the west. And I think that maybe requires maybe a bridge or something for them to get there because so we can talk about it here, but there is another bridge that's required for that to be shut off from the current access point.

I am thrilled to be here. Like Lynn and Jim said, this was a huge labor of love. So anytime I have an opportunity to present these findings, I'm over the moon. Thank you guys so much for having me out.

Thank you for being here this morning.

Thank you.

Are you talking about Comcare? Yep.

Good morning.

Michelle Calvert with ComCare. I brought also with me Jennifer Wilson, our director of crisis services. We've had a lot going on in the ComCare world. And I'm here to share just a little bit about that with you. We have some really fast moving things going on. I won't pretend to have all of the answers. And I will be my best for you every single time. And I will always also bring my experts with me. So let's get started talking about this. What I'm here to talk to you guys about today is residential treatment restrictions that have come down from the state. I want to start just briefly with a quick timeline of what ComCare Crisis's journey has been. You can see when we started our after-hours call, 24-hour crisis care, What I want to point out is in 2014, we had our first CSU bed. So in 2013, one of the state hospitals was closing in the state. And KDADS came to the crisis centers and said, hey, we'd really like for you to start providing a level of stabilization to citizens across Kansas. So CSUs were born out of that. So across Kansas, CSUs really started in 2014. And while I wasn't in this role at that time, I believe there was funding that came from KDADS as part of that. So you kind of see where we've come from then all the way to now where we are a 988 helpline and we have broke ground on our new community crisis center. I just wanted to give you a quick picture of that. So for me today, I'm talking about a KDADS memo that has come out that really limits the use of billing codes that are happening in our residential services. So there are several implications of this. So first drawing your attention to the budget. What we have is a sustainable funding source that is now being removed from us without a plan from CADADS of how to replace that. So we don't know exactly what this will look like. There's some operational expectations that are coming without identified funding sources. So we're again working to figure that out. This could have an impact on staffing. Staffing may have new demands based on the requirements. This could require training. All of this is really immediate scheduling needs. Immediate scheduling needs could be a problem. Initially this KDADS memo had indicated that starting in October we would have limitations. So this is where we were trying to come from. We learned yesterday after 5 PM that they pushed this from October to January, which is good news, but it gives us a little bit of time to sort through this. Ultimately, this could have some unfunded labor costs and would be really hard to comply with on such a short notice. Again, it's been pushed to January, so we at least have that. This could also have some burden on the community. If we are not providing the same level of care that we have been, this puts increased pressure on hospitals, law enforcement, EMS, and the burden that they would inherit would be costly. And obviously that's a risk to our residents and our community. The way people may qualify for services within CSU could potentially change. If we don't have the ability to provide the level of service based on funding restrictions, that impacts residents getting care. So again, that puts additional burden on our community members. So reimbursements would be adjusted. We wouldn't be reimbursed in the same way we are, which again, would have funding limitations. So I know there's a lot of words on this slide. Ultimately, we've got a lot going on and we have to figure out how to manage this in a quick time. So let me talk a little about specifically what it impacts. So at ComCare Crisis, we have our crisis observation unit and our crisis stabilization unit. Essentially, this KDADS memo is limiting, as far as we are aware, the services in our stabilization unit, which is our CSU. so you can see within our csu we are licensed as a residential care facility at this point we believe the limo memo is speaking directly to the care facility but we don't have confirmation of that from kdads for history in in 2026 so far we've had 198 admissions to our csu In 2023, we had 125. Why do I say 100 or 2023? We'll get to that. But I really want to point out that you can see that this has increased from 2023 to 2026. So the cost burden increases. The number of patients needing care has increased in that time. Our big goal has been increasing access to patient care and we're seeing that happen And that's a good thing people are able to access the care that they need in our crisis observation unit or COU This is our 23 hour unit. So shorter term. It's not a residential unit and Here, we have a higher level of admission. So in 2026, we've had 540. 2023, we had 511. So the number is definitely going up. The staffing that we have in both of these units, we've got 31 full-time staff and 17 part-time staff. And they're working both of those units together. So when you look at this, you can see about 36% of our patients are in the CSU, comparative to the COU. OK? Talking about revenues and expenditures related to these units, the RCF, which, again, that's our CSU stabilization unit, you can see the funding revenue that we have, excuse me, the revenue from 2025 to 2026. We also have a KDADS grant that helps support this, that KDADS grant. Covers our Wichita Children's Home bed. So a youth can stay at the Wichita Children's Home similarly to an adult staying at our CSU. It also covers our partnership with SAC to an extent, about $500,000. And then it covers 10 CSU full-time staff. So it's not a full funding. And that funding does change year to year, up, down, kind of bounces around. The annual cost of staff, total estimate here for annual cost is about $2 million for COU CSU patients. We recognize that when this memo initially came out, we believed we wouldn't have the funding for that starting October 1st based on that memo. So you can see what the cost of staff would be in that time period. But again, we really have no confirmations from CADADS of exactly if this is impacting our CSU COU. We have a meeting with them on Friday, so we'll have some more information after Friday. Things are moving really, really quickly with this, and we're trying to prepare. I'd like to point out, across the state, a lot of the CCBHCs have been looking at stabilization of their patients. Some of the CCBHCs have developed crisis intervention clinics, so a CIC. We've talked about that here. They've opened these clinics. They bought buildings. They added staff, and this memo is going to directly impact their ability to serve their citizens. While that's not necessarily an impact that you may see immediately, our concern is if those centers close, those patients still need care. And if those patients from surrounding Sedgwick County are brought to ComCare Crisis, that may increase the number of patients that we see, and we cannot turn anybody away.

I want to clarify something because when you look at the revenue, it looks small. So you're kind of like, oh, what's the impact? One of the biggest problems is that KDADS is also telling us that we have to back the cost of the CSU out of the cost report that sets the PPS rate that we receive as being a CCBHC. We don't get to bill a lot for crisis. A lot of times the people that come in, they don't have benefits. So that's why the revenue is low. The real problem is, is CCBHC is the PBS system. It's a cost reimbursement model. So it should be reimbursing us for the cost of the CSU. Backing that out of the cost reports takes it away from the PBS rate. So we are earning no revenue to cover these costs. That's the real problem.

Can I ask a couple questions? What, what a few questions versus, you know, what's motivating this change mid? I mean, they just were in the middle of a budget with them July 1st. What's motivating this kind of change?

There's been a lot of pressure on the CCBHC system overall. If you've been watching legislative work here, well, even during legislative season last year and then currently with the Bethel Committee, we've seen a lot of pressure from the managed care organizations, from KDADS in general, really looking at the cost-benefit of CCBHC. So I think that's part of the thing that's driving this. Anna, would you like to add any more to that?

Well, I was just going to say, Kate, it hasn't told us. I'm going to be really transparent here. That's one of the problems is they're not explaining the why. They have withheld it. The Association of Community Mental Health Centers is pressuring them because one of the reasons is if they could help us understand the why this needs to occur, that will help us inform how we can come to them with potential solutions, but they've withheld that from us and they haven't explained it.

Who is making this? Is this Andy Brown? Is this KDADS? Who's making this decision? Is this the legislature? Did they give directive? Who's making these decisions?

Commissioner Adkins, who oversees the CCBHC programs and KDADS, disclosed that they were given a federal directive, but we do not have anything in writing and have not been told exactly what that directive is.

That was my question. Does this get federal down?

We're working on gaining insight to that.

You think that insight will be delivered when you meet?

They haven't given it to the other CMHCs that they've already met with.

My last question, I guess, for now is we have a $20-plus million project we're building right there. Yes. Does this impact? We have a sizable investment that is coming with this community based on the expectations of this relationship.

Right. Let's talk about that. We'll come to that here in just a moment. Okay. I want to share a little bit about a cost avoidance study first, and then we'll get right into that. You all have in front of you a cost avoidance study that was done It came out in October of 2025. You may have seen it. Now you have a printed copy to read at your leisure. But I really want to point out one specific table from that cost avoidance study. And what this looks at, if you could see, it's leaning into the cost of care for these number of citizens It's from data from 2023. So I spoke to data in 2023 and how we've increased the number of patients, consider inflation, everything else. The number of patients that were served in 2023, if EMS had served these patients, it would have cost them a total here EMS and Ascension would have cost them a total of $3.1 million. If law enforcement had been active on these number of patients, the total law enforcement cost would have been $1.5 million for a total of $4.7. Now, we at ComCare served these patients instead. And we served them for the cost of $1.8 million. So between our stabilization and mobile care, we were able to save the community $2.8 million. So if you consider, if we lose part of our funding for CSU, the cost to our community here, looking at medical and law enforcement, could potentially go up. So this is a really important study. I would say that it is a very conservative number. We didn't want it to be inflated at all. So this is a very conservative estimate of the cost savings to the community. Would you say anything further about that, Jen? So considerations here. We really want to make sure we sustain CSU through the balance fund. We were thinking we could potentially need to dive into that a little bit further from October to December. We're going to be able to continue billing as we are now, at least through January. So we've got some time to consider this. An additional memo came out yesterday, again after 5 PM, indicating that this wasn't until January 1. There will also be more of a focus between now and January 1. on developing appropriate financing for these services. They're going to be leaning into recommendations from the CCBHC Sustainability Advisory Group, which recently started to give some suggested recommendations. So hopefully we're leaning more into that to figure out what comes January. We wanted to make sure you guys were aware of this immediately. so we could see how it could potentially impact funding for us and beyond. Now, as we are looking at our new crisis center, we don't know exactly what this is considered. We were intending to expand our CSU, at the new crisis center. We were going to expand by five beds, essentially. Two of those were COU and three of those were CSU. With that comes additional staffing needs. So the staffing cost for that, if we were to increase the level of staffing to cover everything that we intended to expand in crisis, that would be about $1.7 million annually. So we really need to reconsider exactly what we're doing within the new crisis center.

Did we already approve? Didn't those positions already be approved for 2017?

So what we looked at for 2027, we submitted a CCBHC grant. And within that grant, we were focusing on expansion of CSU COU. We do not yet know if we got that grant. And that's a $1 million annual grant. So staffing in that was considerably less.

You might have hit this. I was texting a few people asking them to watch this, and then I would send them a link, and I might have blacked out in my frustration. So were we able to quantify an estimated financial impact to the county in ComCare, or we're not able to do that yet, correct?

It's tricky because we don't yet know if it impacts COU CSU and our COU staff kind of cover CSU. We go back and forth to make sure we have patient coverage.

The timing is interesting. I think all these, I think the state should be aware that we pass budgets in August and September and local governments. Um, and you know, making considerations like this that are this sizable is rather frustrating.

It is. And I just want to jump in real quick. I think it's fascinating. I mean, as recently as yesterday, there were memos. coming out from the state changing, changing their decisions. So it is the, I like to joke about, you know, when we were during cares and they were changing the rules every 11 days, it's even more with what we've been hearing out of the state on this over the last couple of months. And I understand that there are pressures, but there are two committees that are actively working this issue right now. including a group that's supposed to present on a sustainability long-term effect next July. And so the fact that all of this is happening without legislative direction, without, as I understand it, even really much awareness at the legislative level of the whole body is greatly troubling because, yes, we approve budgets, but we also hire staff and do construction projects and all kinds of things in good faith.

Yeah. Well, I'd also add that there will be a new governor. One or two people will be sitting in the governor's mansion and directing KDADs. So this just seems to be really precarious to make these sort of changes. Tom, are we, is Watkins and their group, are they in tune with what's happening here? Do we need to brief them and ask them to start turning their engines?

Legislatively, or are you talking about governor candidates?

Well... legislatively, really. I don't know. We have a very effective lobbyist who we trust a lot.

Tanya, can you fill in what we've done with Jason so far?

Sure. I just put a minute, too. Sorry. We had a phone call, Anna, the manager, and I had a phone call with Jason and Jessica, and we summarized everything that Anna and Michelle have just spoken to. What they wanted to do was have a conversation with Secretary Howard, reach out to her, have a conversation about, of course, what's happening at our level with what's going on here. They have reached out to them. They have spoken to KDAD's team. They have not had a meeting set up yet, but that's coming with Secretary Howard. So they're aware. They thought that was probably the best approach right now for what's happening and see if there could be some changes made. When we talked to them Friday, even yesterday, the change has already been made to make this effective from October to January.

Well, that's helpful. Secretary Howard's been a big supporter of ComCare and what we do down here and has been very helpful. A lot of the team, Andy, obviously Scott Bruner, very helpful for what we do down here in Sedgwick County and what ComCare is doing. Okay. I just hope they understand the anxiousness that's just creating in us as big investments are coming into this community. But again, they've been big supporters of ours and very helpful. And I'm expecting that they'll continue that sort of assistance for us. Hopefully we can land the plane and figure out exactly where we're at in 2027. But this is a bit frustrating, but concerning.

Well, as Lindsay said, there's a lot of changes coming, Michelle and I will meet with you next week to talk about some other changes they have. So it's, it's large scale decisions that they're making now, all impacting all aligning now on January 1st. So helpful. Um, It's frustrating. This model is new. We're watching it play out. One of the things that they're missing, and I think this is an important part that needs to be vocalized more, is the model is so new that a lot of the CCBHCs, their PPS rates are set on anticipated costs, not actual costs. So that's why you're seeing the revenue that we're earning, because it's our anticipated cost. That means our PPS rate right now includes costs for all staff, even if the positions are vacant. We're earning, essentially, the cost for them. That will change with our new PPS rate. It'll be just actual costs. And so we do expect the rate to go down, much like the other CCBHCs when we rebase next year. So a lot of this is being based on revenue that the CCBHCs have been earning that they won't be earning moving forward. And they're missing that.

So we're making big decisions on infrastructure projects based on that. It might be worth, Tom, Chairman, it might be worth the commission putting a letter, Secretary Howard, maybe copying the governor and her staff. I think it's that serious. I mean, we're dumping a lot of dollars at the request of the state in this program into this community, and I think they need to understand. It might be worth crafting a letter to send and publicizing this a little bit louder. So I have some text flying right now, and no one's aware of these things are going on. So here we are again, the state's doing some stuff, and legislators aren't aware, and a governor candidate's not aware. So, I mean, this is frustrating. Okay, I think we should probably draft a letter.

And I think in that letter, if it's okay, as a part of your expanded ComCare crisis facility, you all might recall that you did allocate some cash toward that, but we are still expecting to sell bonds of about $16 million to fund that. That's going to have a high interest rate, and just based on what we're seeing in the market today and the fact that we expect the Fed to increase the interest rate this week. But I say that because... We are counting on in your financial forecast that there will be adequate revenues generated related to Comcare crisis and other services to pay that debt service in order to eliminate any payment from tax county property taxpayers. And so I think that may be something that's worth noting in that letter as well as you have upcoming, um, 20 year, uh, commitment. And we need to make sure that that funding stream is going to remain in place.

Well, and the reason we wanted to present this to you today is so you're aware, I think when you get chances with legislators that you should talk about this. We, Ann and I, have talked about this, and Michelle, we understand that there's going to be scrutiny on this, on CCBHC, we get it. And it needs to be data-driven and analytical, and it needs to take place over time and not with knee-jerk response in what is almost Q4 of a fiscal year for us. So, and if you're, I don't even want to get started with KDOC and what we're doing with corrections, formulations. There's decisions being made in a late part of the year where we know we're going to have a gubernatorial change that I find it's concerning. So I just wanted the Commission aware of this. Thank you, Michelle, for making this explainable so we can understand it. And we'll have to keep our eye on this from now until the end of the year. And we'll write the letter. I think that's a great idea, Commissioner Beatty.

Any other questions or comments?

And there'll be more to come. I know there's some 221 scheduled with you. We'll keep you aware of other. I'd sent an email or I think one of us had sent you an email a week or two ago with a summary of the three issues. And we'll be talking about those as we go through the remainder of the year. So thank you for your time today. And we'll keep you abreast.

All right.

Thank you very much.