The Kansas Department for Aging and Disability Services outlined a plan to limit the number of patients admitted to the state mental hospital at Osawatomie. The plan was unveiled Thursday at the first meeting of an advisory committee tasked with identifying the ideal mix of hospital and community-based services for Kansans with mental illnesses.
Federal regulators are requiring extensive renovations to make Osawatomie State Hospital safer for patients.
KDADS Secretary Kari Bruffett said the 206-bed facility will have to keep its census below 147 patients while the work is in progress, because patients can’t be housed in areas under construction. Bruffett formed the new Continuum of Care Committee to use what she called a “short-term crisis” at Osawatomie State Hospital as a springboard to re-evaluate the Kansas behavioral health system.
“Federal surveys found that we needed to replace ceilings in order to be in compliance with current code for psychiatric facilities,” Bruffett said. “We are certainly still keeping Osawatomie State Hospital open during that time, but we are having to reduce the capacity sort of building-by-building.
“So for us the urgency is, and the opportunity is, to look at, do we continue to renovate the state hospital buildings — the other buildings — after this phase of construction, or what do we want to actually have, long-term, the role of the state hospitals be in the behavioral health system overall?”
The state hospitals in Osawatomie and Larned serve Kansans with severe and persistent mental illnesses.
To keep the Osawatomie hospital census below 147 patients, people with mental health issues who may need to be hospitalized will first be screened at a community mental health center. If that process indicates inpatient care is needed but there is no room at the state hospital, Osawatomie officials and the community mental health center will try to arrange other services to meet the patient’s needs.
Those options may include admission to a private hospital, crisis stabilization services or a 24-hour structured care environment. If the selected facility refuses to accept the patient, other options will be pursued.
Carla Drescher, KDADS director of behavioral health services, said the new policy is designed to avoid declaring a moratorium on admission at Osawatomie State Hospital. State law authorizes KDADS to take that step any time the hospital is expected to exceed the limit of 146 patients.
A moratorium would mean that people declared to pose a danger to themselves or others could be put on a waiting list. Those seeking voluntary admission would only be allowed into Osawatomie State Hospital if no one is on the waiting list and the census drops below 131.
Bruffett said KDADS will help patients pay for appropriate care outside the state hospital system as needed.
“We do have right now in front of the Legislature a governor’s budget amendment to add $3.5 million to assist during the renovation phase at Osawatomie State Hospital,” she said. “That is for the diversionary funds needed for folks that might otherwise be in the state hospital. That governor’s budget amendment has support in both chambers of the Legislature.”
But for the committee, the long-term issue is determining how to allocate scarce financial resources in the mental health system. Topeka Police Captain Bill Cochran said the reality is that jails are the biggest mental health providers. But he said innovative training programs for officers and the general public are beginning to reduce the number of people with mental illnesses in the Shawnee County Jail.
“Community-based services is where it’s at, and that’s what’s going to make everything work,” Cochran said. “The whole idea behind community-based services is you keep people out of the state hospital. Money and funding is important. I would love to see more money put into the budget, but I also realize at some point community partners have got to say, ‘We’re going to do this because it’s the right thing to do.’ I think that’s what makes it work in Topeka and Shawnee County.”
Still, Bruffett said there’s no doubt that Kansas needs more mental health bed space.
“We don’t suggest that community options will fully replace the need for inpatient beds,” she said. “We also know there’s been, over the last decade and longer, a reduction in the number of inpatient beds in community hospitals throughout the state. That’s not unique to Kansas, by any means. That’s true throughout the country, and that creates a pressure on the system.”
That pressure worries Amy Campbell, a lobbyist for the Kansas Mental Health Coalition, a nonprofit group dedicated to improving the lives of Kansans with mental illness. Campbell said she’d be concerned if anyone in her own family had to cope with mental illness this summer, as the state attempts to deal with what she called “this bed crisis.” Even so, Campbell sees hope in the mission of the new Continuum of Care Committee.
“The really positive thing about what occurred at our meeting today, though, was that they brought up some very specific recommendations that have come forward out of former groups and task forces,” she said. “It doesn’t appear to me that they’re going to try and invent the wheel here. It appears to me that they’re trying to build on the recommendations that we already have in place, and I think that’s really encouraging.”
The committee’s target is to have recommendations to KDADS leadership by June 26.