What’s the value in doing good for others? A Kansas nonprofit tests the market with executive pay.

Nathan Fawson, CEO of the Southeast Kansas Mental Health Center. Fawson, whose salary and benefits are currently $686,941, is under fire over executive pay at the six-county mental health center. (Max McCoy/Kansas Reflector)

IOLA — Nathan Fawson is a man under fire.

And he wants you to know he is grateful.

Sitting in a consultation room painted a calming shade of neutral, Fawson — CEO of the Southeast Kansas Mental Health Center here — uses the word or a variation of it half a dozen times in explaining why his salary and benefits are more than $628,074. That figure has raised eyebrows and tempers in the community, a fiscal Rorschach test of one’s beliefs about the value of work, the cost of expertise, and who — if anyone — should pay for the public good.

“I’m very grateful that we’ve been able to offer fair, market-competitive wages to better support the community that coincidentally increased wages for management,” he says. “I’m grateful that we’ve been able to offer those competitive wages for expert services provided by management, allowing for those with that expertise to live and enjoy southeast Kansas rather than feel the need or desire to relocate.”

During the interview in the neutral room, decorated with a soothing triptych of what may be a beach scene, Fawson smiles often, gestures broadly, and sometimes refers to a printout summarizing the exponential growth of his six-county agency over the past decade. The center’s number of employees has nearly tripled since 2015, to 583; the budget has grown from $8 million to $75 million; and the number of patients served has expanded sixfold, to 25,906. The center has also, in recent years, offered medical and dental services, as part of its mission as a Certified Community Behavioral Health Clinic and doubled its number of sites, to 30, including the clinic on Jefferson Street where our interview takes place.

But it’s not the additional employees or added services that has sparked a regional political backlash. It’s Fawson’s pay and benefits, which have more than quadrupled since 2020.

The SEKMHC serves six of the sickest and poorest counties in Kansas: Anderson, Allen, Bourbon, Linn, Neosho and Woodson. The median household income for Allen County is $57,618, according to the U.S. Census Bureau, and about 10% of its residents lack health insurance. That compares with the Kansas median income of $70,333 and an uninsured rate of 8.4%.

In Iola, the seat of Allen County, a historic town of 5,400 on the Neosho River, the need for mental health services is one of those obvious things, like the need for rain to break a drought. Some townspeople told me that just about everyone knows somebody close who died by suicide or who were lost to drugs or alcohol. Local resident Sharla Miller, whose 19-year-old son Matt killed himself in 2019, started a conversation about mental health that included a local conference with representatives from the mental health center. The SEKMHC provides school therapists for districts in all six counties it serves.

Most of the center’s revenue comes from a variety of grants and Medicare and Medicaid. Its board of directors are appointed by the county commissions in the six counties. Each county appoints two representatives and also contributes a combined total of $550,120 in funding for this year, which amounts to less than 1% of the center’s budget. The county funds are earmarked for those not on Medicaid and who could not afford to pay for services — not salaries.

But this year, because of the heat over Fawson’s compensation package, the counties began decreasing their support. Three counties — Allen, Anderson and Neosho — dropped their support to just $1 — that’s right, a single dollar — for 2026, according to reporting by the Iola Register. Anderson County also stopped its quarterly payments for the last two quarters of this year. Linn County voted to contribute $0 for 2025 and 2026. Woodson County slashed its 2026 contribution by more than half, to $35,000. Bourbon County has discussed the issue, but has not yet made a decision on funding.

Even if all six counties pulled funding, Fawson said, the center would continue to operate. Under federal law, nobody who needed emergency services would be turned away because of an inability to pay.

The controversy began in February of this year, when Allen County Commissioner David Lee called, according to Fawson. The commissioner had just seen the center’s latest available 990, from 2023. A 990 is the federal return tax-exempt 501(c)3 nonprofits are required to file annually with the IRS.

Lee asked him if the executive salary and benefits reported were accurate.

“I responded yes,” Fawson said. “Then he responded, ‘The community would disagree with those wages, and prepare yourself for a challenge.’ And that challenge has ensued.”

Fawson said he didn’t anticipate there would be a political concern about executive compensation until that call. He said he was surprised because he was confident in the wage analysis provided in 2021 and 2023 by the Hebets Co., a Phoenix-based consulting firm. The center retained Hebets, Fawson said, because its advisers are experts and would provide a reliable and objective analysis.

The center’s board of directors adopted the Hebets recommendation to increase salaries across the board. Fawson also said that because he was familiar with medical and behavioral health operations, the executive compensation packages suggested seemed appropriate to him.

Before the increases, Fawson said, wages at the center were below the 25th percentile nationally, and the goal was to bring them up to at least the 50th percentile. These increases were across the board, he said, and have improved the lives of the center employees and added to the southeast Kansas economy.

In 2023, according to the center’s 990 tax return, other top-paid executives and employees included Doug Wright, chief operating officer, $444,282; Job Springer, chief financial officer, $423,551; Holly Jerome, director of human resources and marketing, $348,614; John Robinson, urologist, $334,368; and Steven Dooley, chief information officer, $311,604.

Michelle Hoag, clinical director and Certified Community Behavioral Health Clinic grant oversight officer, made $276,555 in salary and benefits. Greta Sue McFarland Huebert, a pediatrician, was listed on the 990 at $253,481.

All executive compensation for 2023 was just more than $3 million.

A master’s level clinical therapist just starting out at the clinic, Fawson said, is paid about $71,000.

The Southeast Kansas Mental Health Center clinic at Iola in August 2025. It is one of 30 sites operated by the six-county agency. (Max McCoy/Kansas Reflector)

Fawson, a native of St. George, Utah, graduated in 1997 from Washburn University in Topeka with a master’s degree in clinical psychology. He also has an MBA in business and health service administration from the University of Utah. He began as a therapist with the SEKMHC in the 1990s, he said, and worked his way until he became associate director. In 2010 he left to become director of clinic operations at Cox Medical Center in Branson, Missouri. He returned to the Southeast Kansas Mental Health Center in 2013 and became CEO in 2016.

In a June shakeup, the Allen County Commission dismissed its two previous representatives to the SEKMHC board and replaced them with new members. One of those new members is Jerry Daniels, a Republican who is also the chair of the county commission.

“I agreed with the reduction of funding,” Daniels told me, citing Fawson’s salary as a primary reason. “It’s more than the (U.S.) president makes.”

The U.S. Code sets the salary of the president at $400,000, with an additional $50,000 in expenses. That, of course, does not represent the ever-expanding perks of being president.

“My concern, whether you agree with it or not, is that in this DOGE environment, what are they going to do if the funding runs out?” Daniels said. “I don’t know all the details, but it’s my speculation that their budget got big on Biden bucks. What are you going to do with all these employees and salaries when the money dries up?”

Daniels said he has no doubt the center is doing good work and that its therapists are dedicated to their clients. He said he wasn’t picking on the center but that oversight of management and expenditure of funds was a serious business concern.

“I’ve been a commissioner for 10 years, and I’ve never had as many phone calls as on this subject,” Daniels said. “There’s (also) a lot of text and emails and Facebook questioning.”

A question Daniels said he had, but to which he had not received a clear answer, was whether the SEKMHC was subject to the state’s open records and open meetings laws. I posed the question in an email to Bob Johnson, counselor to the Allen County Commission, but did not receive a reply.

Fawson told me board meetings were open to the public, though few community members attended, and that the center was subject to both the Kansas Open Records Act and the Kansas Open Meetings Act. He said, however, that he would not provide a copy of the Hebets wage analysis. It was propriety, he said.

Fawson also said he didn’t feel comfortable with the Hebets report going public because it might make some center employees uncomfortable. It also might draw unwanted scrutiny to organizations used for comparison, he said.

“That may well bring harm to our employees,” he said. “One thing I recognized early on in my management experience is how sensitive employees are regarding the subject of salary.”

And, he said, exposing other organizations to scrutiny would be unfair.

“I don’t want to draw this type of attention to any organization and have them experience the level of scrutiny we’ve experienced,” he said.

Some of the comparable institutions, both for-profit and nonprofit, were in Missouri and others in Oklahoma, he said, but he declined to identify them more narrowly.

“It’s not fair to them,” he said. “I realize it’s your role to do just that, but I don’t want comparison. I want the community to come to understand value, but not from a perspective of ‘they’re better than you’ or ‘you’re better than them.’ Right?”

Comparisons with other nonprofits in Kansas, including the 25 other mental health centers in the state, are difficult because of differences in size and mission. The Iroquois Center for Human Development at Greensburg, for example, has expenditures of about $2.6 million, according to a database compiled by ProPublica, while the Bert Nash Community Health Center at Lawrence had expenses of more than $34 million. Executive pay typically ranged from 2% to 4% of expenditures for the Kansas mental health nonprofits included in the database.

The Southeast Kansas Mental Health Center executive compensation was 5.8% of its $38 million in expenses in 2023, according to ProPublica. An independent audit commissioned by the organization for fiscal 2023, ProPublica noted, found a “deficiency in internal financial or governance controls that could limit the organization’s ability to track and report financial data reliably.”

Fawson said no audits or other reviews had flagged executive compensation as a cause for concern. He also referred to his information handout, which indicated the center’s executive compensation was reviewed by the Kansas Department for Aging and Disability Services.

A KDADS official told me the agency reviews all expenses that make up the cost of operating a mental health center, with an eye to the “bigger picture” of the services provided by certified community behavioral health clinics to communities.

“The goal of reviewing these reports is to ensure transparency and accountability,” said Cara Sloan-Ramos, director of communications for KDADS. “Reported salaries are also reviewed using U.S. Department of Labor statistics and evaluated for reasonableness compared to other health care salaries by a third-party contractor.”

She said, however, Fawson’s individual salary was not reviewed as part of the most recent process.

“With regard to specific salaries, in the last report from the Southeast Kansas Mental Health Center,” Sloan-Ramos said, “all administrative salaries were grouped in one line item. Additionally, it is the role of the SEKMHC Board of Directors to approve and finalize executive salaries.”

The fear among some Iola civic leaders is that the controversy about executive compensation at the mental health center will impede its ability to provide vital services to the community. The Iola Register, in a July 3 editorial signed by managing editor Tim Stauffer and publisher Susan Lynn, cited the achievements of the center, from being designated a CCBHC to having therapists embedded in the public schools to staffing an around-the-clock crisis line. The editorial made the case for scrutiny, but cautioned county officials against defunding the center. Diminishing the SEKMHC’s capacity would only result in self-inflicted harm.

“At a time when it’s abundantly clear federal and state funding cannot be counted on, it’s also a dangerous thing to do,” the editorial reads. “We know the risks. Do we want more unattended crisis, more substance abuse, more violence?”

The county should restore the center’s funding and continue to invest in the community’s mental health, the Register urged. If there was concern over executive pay, then dialogue was the answer.

Toward the end of our 90-minute interview in the consultation room, Fawson asked for my take on the salary controversy. If I were offered a salary that was more than 10 times the median household income for my area, I said, I would be uncomfortable.

“I am uncomfortable with it,” he said, and it was the first time I noted emotion in his voice. “I’m very uncomfortable with it. So tell me … I don’t know how to … I don’t know how to effectively resolve that.”

I asked if he had considered taking a salary cut.

“I’ve considered a lot of ways in which I could give back,” he said. “And yet I have some advising me not to take a salary reduction (for) the best interest of the organization. I’ll just say that I’m very conflicted in that regard, very uncomfortable with where I’m at, and I very much wish there was a solution that would both satisfy the concerns and best support the community.”

Earlier this year, Fawson said, the SEKMHC board had frozen executive salaries. But, he said, the next 990, which has not yet been filed, will likely show an increase. The Hebets salary plan the board adopted included an increase for 2024 as well, an adjustment made before the salary freeze went into effect. Fawson estimated his current pay to be $495,000 plus benefits similar to 2023.

That amounts to $686,941.

Holy smokes.

Fawson and his board were naive at best in accepting the recommendations from an out-of-state consulting firm without taking into account the mood of the community. The eye-popping salaries paid to Fawson and his top executives may be justified by the market, but they may end up doing more harm to the center than good. What Fawson and his board have traded for competitive wages is the trust of the county commissions that appoint the center’s governing board. Some of those commissioners, including David Lee, who kicked the hornet’s nest in February, already believe the center is an experiment in socialized medicine diverting patients from the local Iola hospital.

Should staff salaries have been adjusted to keep and recruit therapists and others? Of course. But quadrupling the CEO salary and benefits? Risky at any time, but downright foolish in this age of populist revolt. It’s like handing a hammer to those who, out of misunderstanding or malice, would like to beat the system to pieces.

Max McCoy is an award-winning author and journalist. Through its opinion section, the Kansas Reflector works to amplify the voices of people who are affected by public policies or excluded from public debate. Find information, including how to submit your own commentary, here.