City on a Hill still working toward new facility




The fate of the Scott County Hospital is still undetermined, as Scott County Commissioners seek proposals from interested parties. Chris Lund, executive director of City on a Hill, a substance abuse treatment program for women, is one such party who made his interest known in October.

At that time, Lund told commissioners he was interested in using the building as a reintegration facility, so that patients coming out of his Marienthal facility, a 30-day drug abuse treatment program for women, could continue treatment at a longer-term facility where they could reside while continuing treatment and pursuing employment.

Since his initial proposal, Lund said state and federal budget cuts, as well as KanCare, the state's Medicaid program which took effect Jan. 1, have impacted the organization's ability to move forward. But he intends to keep commissioners informed.

"I'm going to be meeting with them here in a couple of weeks. When we had talked last, the state was going through all their cutbacks and now the sequestration will more than likely affect the federal block grant that's administered by the state," he said.

Through the block grant, previously administered through one managed care organization, adult women, who were pregnant or had children, were able to utilize the Marienthal clinic at no cost. Under KanCare, three managed care organizations now administer the block grant and oversee Medicaid.

"We had to get credentialed through all of them (MCOs) and then go through the process of them establishing a paying network and that was all time consuming stuff for the providers actually to get the dollars for the services they provided through Medicaid. So between the block grant dollars, Medicaid, KanCare being implemented, going from one MCO to three MCOs for the administration of block grant dollars and Medicaid dollars and the possible cuts, it's really just a difficult time to take on a project of that magnitude," Lund said.

In 2011, he said for all of the free services City on a Hill provided to its patients, Medicaid reimbursed the organization at a rate of 100 percent. But in recent years, that percentage has dropped.

The decrease in reimbursement also has an impact on whether an additional facility is feasible, Lund said.

"In 2012, even though we were a designated women's program, which is supposed to be given priority and preference on the prepaid dollars or the amounts you go over, they only reimbursed us 36 percent. Well we went over by $60,000 dollars, so when they reimbursed us 36 percent, we lost almost $40,000," he said. "If they do that in two locations, what they did in one location, it would be close to $80,000 in a single year, which is really a bad business plan."

Lund said he is currently looking for alternative funding sources, including grants from the Kansas Department of Labor and Department of Commerce, as well as looking at what the county would spend, should they choose to demolish the old hospital.

"We're definitely going to still leave things open. We're going to talk to them, see where they're at, what they'd like to do and we're open to discussing it some more with them. Really, there are a lot of factors that are making it difficult, but we sure would like to see something done with the building and make use of the space and try to make it a really good project for the community as a whole," Lund said.

County Commissioner Jim Minnix said there are currently a number of possibilities on the table.

"We're still looking at the possibility of City on a Hill or the Area Mental Health Center office moving to that area," Minnix said. "There's also some discussion in the community about the need for some additional public facilities," he said, adding that a local church, one of the schools and the recreation commission are looking for additional property.

"So there are quite a few entities that are trying to work on a plan to see what works the best," he said.

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