Panel finds that the Kansas mental health system is inadequate, jeopardizing patients and the public

By Dave Helling, Kansas City Star, July 29, 2015

A sign to Osawatomie State Hospital is pictured

Kansas officials began a policy of aggressive patient triage earlier
this year when Osawatomie State Hospital exceeded its 206-bed
capacity by 25 percent. Voluntary admissions to the facility
were stopped. The hospital’s capacity was further reduced this
summer as the state began a construction project at the hospital.
Osawatomie is now limited to 146 beds. (KC Star file photo)

A special task force has concluded that Kansas provides insufficient treatment for the state’s mentally ill, increasing the dangers for patients and the public.

In a report finalized last week, the Adult Continuum of Care Committee said the state’s two acute care psychiatric hospitals in Larned and Osawatomie lack sufficient bed space, smaller mental health facilities are underfunded and some communities lack needed resources for crisis intervention.

“An inadequate safety net jeopardizes the well-being of those individuals, puts communities at risk and places an undue burden on local resources, including law enforcement,” the committee found.

But finding money to solve the problems, committee members conceded Tuesday, will be much harder than identifying the shortfall.

“The reality is, our budget’s probably not going to get much better,” said Rep. Kathy Wolfe Moore, a Kansas City, Kan., Democrat. “Where are we going to get it?”

Kansas spends about $100 million to operate the acute care hospitals. But the aging facilities are usually at capacity — or beyond.

State officials began a policy of aggressive patient triage earlier this year when Osawatomie State Hospital exceeded its 206-bed capacity by 25 percent. Voluntary admissions to the facility were stopped.

The hospital’s capacity was further reduced this summer as the state began a construction project at the hospital. Osawatomie is now limited to 146 beds.

Some state officials have hinted at remaining at that level to save money, but the committee firmly rejected that idea.

“We are desperately short of mental health beds,” Moore said. “Taking 60 beds offline permanently is just disastrous.”

The report comes as the state investigates Osawatomie’s decision-making in the case of Brandon Brown, a patient at the facility in May. He was released after a week of treatment and returned to Haviland, Kan., where he allegedly beat a person to death three days later.

Brown’s father believes his son was released from Osawatomie too early. The committee found systemwide “pressure” to discharge patients, although it reached no conclusion about Brown’s treatment.

“Due to the limited capacity at the state hospitals and lack of resources in the communities, there has been increasing pressure to discharge patients quickly to make room for more,” the committee said. “Compounding this issue is a continuing challenge with staffing levels due to staff turnover, staff burnout and fatigue.”

This week, state officials and Kansas City, Kan.-based Prairie Ridge Hospital announced a contract to add 12 inpatient psychiatric care beds in an effort to help patients unable to find room at the Osawatomie facility.

The committee report comes as Brownback ponders an additional $50 million in cuts to the state’s budget. Those reductions are expected to be announced Friday and could include mental health funding.

The report does not say how much more money Kansas should spend on mental health treatment, but “the determining factors cannot solely be financial. The risk is too great.”

The group also recommended expansion of Medicaid coverage in Kansas. Lawmakers have resisted that expansion, saying it costs too much money.

Committee members included mental health professionals, state lawmakers, law enforcement personnel, legal authorities and officials from the Kansas Department for Aging and Disability Services, known as KDADS. The agency oversees mental health treatment in the state.

The committee recommended increased support for lower-level, community-based mental health treatment facilities and programs. Community-based mental health centers have seen their state funding for treating the uninsured cut in half since 2007, the report notes.

“An underfunded system is challenged to meet the basic needs of people with severe mental illness, let alone develop evidenced-based practices, enhance existing services or create needed alternatives of care,” the study says.

The state’s mental health community generally endorsed the committee’s findings but urged the state to seek additional resources to address shortfalls.

“There is more to be done,” said a statement from the Kansas Mental Health Coalition. “When we do not treat persons with mental illness, communities pay the price. Individuals pay the price.”

The report was sent to KDADS Secretary Kari Bruffett, who had appointed the task force. In an email, she called the report “an important part of the state’s decision-making process” and said some of the recommendations are already being put into place.

To reach Dave Helling, call 816-234-4656 or send email to dhelling@kcstar.com.

http://www.kansascity.com/news/government-politics/article29095024.html#storylink=cpy

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