Kansas cannot fund a bigger mental health workforce and then let plans shrink the network
Columnist Tara Wallace writes that companies shouldn't win Medicaid contracts on the promise of access, then balance budgets by trimming the same providers who make access possible. (Illustration by Getty Images)
Kansas keeps saying the quiet part out loud: We have a behavioral health crisis, and we need more providers, urgently. We’ve backed that message with real policy choices: investing in workforce training, expanding Certified Community Behavioral Health Clinics and strengthening crisis response through 988.
Yet, my colleagues across the state are reporting a different reality inside Medicaid managed care: participating provider agreements being terminated “without cause,” often in communities that already struggle to access services.
If Kansas is serious about addressing provider shortages, then a cost-cutting strategy that reduces the number of in-network clinicians is the opposite of what our own laws, budgets, and public messaging try to accomplish.
Kansas is building capacity because the shortage is real. Let’s ground this in what we know to be true. Kansas has a documented workforce problem. As summarized by the University of Kansas, Kansas ranks 37th in mental health workforce availability, and 96 of 105 counties are designated as mental health professional shortage areas.
That is not a marginal issue. That’s a statewide access emergency.
Kansas policymakers have taken steps to expand the system through workforce investment. The state budget included nearly $6 million aimed at training more mental health workers, including psychiatric residencies and other pipeline supports. Strengthening community mental health centers by transitioning to the health clinic model and, through HB 2784, setting a pathway for certification eligibility to widen beginning Feb. 1, 2027. Lastly, funding access to the 988 hotline in statute that reflects an ongoing commitment to crisis access and stabilization.
These actions all point in the same direction, increase access, stabilize services, and increase the workforce.
“No-cause” terminations reverse the momentum of these efforts. Network capacity drops immediately. Removing providers from the network undermines the very adequacy benchmarks the state uses to evaluate access. Continuity of care fractures, especially for high-need clients.
Behavioral health treatment isn’t a quick retail transaction. People stabilize through trust, consistency and relationships. When a provider is removed from network, clients may have to switch clinicians, delay care, or go without, raising risk of crisis escalation and avoidable ED utilization. Recruitment and retention take a hit.
Kansas can invest in training all day, but if the Medicaid environment signals “your contract can disappear without clinical cause,” providers will think twice about joining, especially private practice clinicians and community-based practices that serve the highest-need populations.
No-cause contradicts the state’s policy direction. Kansas is literally considering legislation that recognizes the danger of MCOs citing provider relationships to prove network adequacy, then later dropping those same providers.
In this session, legislators introduced the “Kansas managed care bid fidelity and accountability act.” Among other provisions, HB 2753 would restrict an MCO, during the first 24 months of a contract term, from terminating a “clinical service contract” with a provider it cited as evidence of network adequacy or expertise, except for cause, and it adds notice requirements to KDHE.
That matters because it reflects a growing recognition of a basic truth. You can’t win a Medicaid contract on the promise of access, then balance budgets by trimming the same providers who make access possible.
When provider contracts are cut, Kansas families pay the price. A parent waits longer for therapy while trying to keep a job. A teen loses the one clinician they finally opened up to. A rural resident drives farther or gives up. A crisis line answers the call, but there’s nowhere timely to refer the person next. We cannot build a “front door” using 988 crisis response and outpatient expansion while quietly removing the hinges of in-network providers that allow people to enter ongoing care.
If Kansas wants provider growth to be real, not just a headline, then accountability must match the investment.
Require transparent reporting of provider terminations by discipline, region and reason category, and publish the downstream network impact using Kansas’ existing network adequacy reporting structure. Protect continuity of care when a provider leaves the network with clear transition timelines, member notice and guaranteed care coordination for high-risk populations.
Tie MCO performance to behavioral health access outcomes, not just cost containment, appointment timeliness, retention in treatment, crisis follow-up and provider retention. Advance “bid fidelity” protections like those outlined in HB 2753 so network adequacy is not treated as a temporary marketing claim.
Kansas is already investing in its workforce, expanding clinics, and strengthening crisis response. We should not allow the Medicaid delivery system to work at cross-purposes with those goals. Because if Kansas says, “we need more mental health providers,” but the system pushes providers out, then we’re not solving the shortage.
We’re managing it, at the expense of the people who can least afford to wait.
Tara D. Wallace is a licensed clinician and trauma therapist in Topeka. Through its opinion section, 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.