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TOPEKA — The Kansas Department of Social and Rehabilitation Services is diverting some patients bound for state hospitals to private psychiatric facilities as a way to deal with overcrowding at the state institutions.

The state mental hospitals over the past several months have been repeatedly filled beyond capacity.

Late last month, Via Christi Behavioral Center in Wichita began admitting patients who had been referred to Osawatomie State Hospital. Prairie View, a private psychiatric hospital in Newton began taking patients headed for Larned State Hospital.

“We used Via Christi in the past, but this is the first time we’ve used Prairie View,” said Ray Dalton, SRS deputy secretary of disability and behavioral health services.

For years, SRS has entertained the notion of contracting with private hospitals but balked because of the expense and because the hospitals insisted on being able to pick and choose which patients they would admit.

All three hospitals at capacity

But in late May and early June, all three state hospitals – Larned, Osawatomie, and Rainbow Mental Health Facility in Kansas City - were significantly over census, prompting SRS to suspend voluntary admissions. The suspension was lifted May 25, seven days after its enactment.

By contracting with Prairie View and Via Christi, SRS officials said they hope to avoid having to turn patients away.

Dalton said SRS is exploring the possibility of contracting with other psychiatric facilities, too.

State hospital admissions – voluntary and involuntary -- are limited to adults with serious and persistent mental illnesses who pose a danger to themselves or others.

Hospital admissions, Dalton, said have been difficult to predict.

“They’ve gone up, they’ve gone down, and then they’ve gone up again,” he said. “But today (July 1), Larned is at 85, and that’s as low as it’s been in a long, long time.”

Larned has capacity for 90 patients.

Earlier this week, Osawatomie had 196 patients, 20 more than its licensed capacity.

“That’s the most we’ve had since 2007, when we got up to 199,” said Greg Valentine, superintendent at the Osawatomie hospital. “It’s just been unreal; (patients) just keep coming.”

More people at the "end of their rope"

Valentine and others have struggled to explain what’s causing the increase in admissions.

“I don’t think it’s one thing in particular. It’s probably a lot of different things,” Valentine said. “But a big part of what we’re seeing has to do with the economic downturn and with what’s called the echo effect – that’s when people’s unemployment and COBRA (health insurance) benefits start to run out.

“I don’t know that we’re seeing more people with serious and persistent mental illness,” he said. “I think we’re seeing more people who’ve reached the end of their rope.”

Marilyn Cook, executive director at Comcare, the community mental health center in Wichita, said part of the increase may be driven by police departments beginning to adopt response techniques that steer would-be offenders toward mental health services rather than arrest.

Fewer sent to jail

“I know that in Wichita, they’ve been successful in getting the number of mentally ill people in jail to go down,” Cook said. “That’s good, but it also means more people are showing up in the emergency room because they’re not going to jail. It also means more state hospital admissions because all of these people are in crisis.”

The Larned and Osawatomie hospitals, Dalton said, will consider referring incoming patients to the private facilities when they are five to 10 patients over census.

“A lot of different variables are going to be involved in the process,” Dalton said. “Decisions will be made on a day-to-day basis.”

The agency plans to refer Larned-bound patients to Prairie View; Osawatomie-bound patients to Via Christi.

“It makes sense,” Dalton said, “because a lot of Osawatomie patients are from Wichita.”

Osawatomie’s catchment area covers the eastern one-third of the state; Larned’s covers the western two thirds.

So far, Dalton said, “about 10” patients have been diverted to Via Christi; six to Prairie View.

“Everybody benefits,” said Matthew Schmidt, director of community support and emergency services at Prairie View. “Patients don’t have to go to a hospital that’s over census, the state hospitals can better manage their resources, and the community mental health centers in the region benefit by their patients being treated closer to home.”

Dalton said the agency plans to pay the private hospitals a fair rate.

“It’s complicated,” he said. “It looks like Medicaid will pay some of Via Christi’s costs because it’s a hospital. Prairie View isn’t considered a (medical) hospital, so it doesn’t get Medicaid. It’ll all be done on a case-by-case basis.”

None of the three hospitals admit children. Instead, children are referred to private inpatient facilities in Hays and Kansas City. Those facilities are owned and operated by KVC Behavioral HealthCare.

The state hospitals’ licensed capacities are:

• Rainbow Mental Health facility – 50 beds.
• Larned State Hospital – 90 beds.
• Osawatomie State Hospital – 176.