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On January 1, 2017, the KHI News Service became part of KCUR public radio’s new initiative, the Kansas News Service. The Kansas News Service will continue to cover health policy news and broaden its scope to include education and politics. All stories produced by the former KHI News Service are archived here. Stories and photos may be republished at no cost with proper attribution and a link back to KHI.org.

Pilot program helps disabled Kansans leave state hospital

By Andy Marso | November 10, 2016

Pilot program helps disabled Kansans leave state hospital
Photo by Andy Marso/KHI News Service Roy Alcorn, right, was discharged a month ago from Osawatomie State Hospital so he could receive home and community-based services in Topeka from Equi-Venture Farms. Now he lives with a host, Donald “Mitch” Mitchell, left, and another person with a developmental disability. Alcorn’s new arrangement is part of a pilot program spearheaded by Ben Swinnen, executive director of Topeka-based Equi-Venture, and Tim Keck, head of the Kansas Department for Aging and Disability Services.

Roy Alcorn shot pool with friends last week as sunlight streamed through the open door of a small building at Equi-Venture Farms.

A month earlier, Alcorn was living at Osawatomie State Hospital 24 hours a day, seven days a week.

Alcorn’s new arrangement is part of a pilot program spearheaded by Ben Swinnen, executive director of Topeka-based Equi-Venture, and Tim Keck, head of the Kansas Department for Aging and Disability Services.

The program is targeted at an underserved population: Kansans with intellectual and developmental disabilities who also have severe and persistent mental illnesses. It is one of several initiatives Keck has launched to reintegrate some Osawatomie State Hospital residents into their communities.

The idea was to do a comprehensive review of patients with intellectual and developmental disabilities at Osawatomie State Hospital and determine if their mental illness was controlled enough that they could be discharged to organizations that could provide home and community-based services to support their disabilities.

“It’s a lot of work for a lot of people,” Swinnen said. “But at the end of the day if we can move someone out of a state institution, I think it’s worth it.”

Osawatomie State Hospital, one of two state-run facilities for Kansans with mental illness, has had limited capacity for more than a year amid renovations and a loss of federal funding.

Spaces at Osawatomie State Hospital are in demand, but discharging Kansans with disabilities is complicated by a gap in community-based psychiatric care for them.

Still, by working with Keck and the three insurance companies that administer Kansas Medicaid, or KanCare, Osawatomie State Hospital staff helped identify seven patients who might be ready for discharge with the right supports.

Swinnen said KDADS deemed one patient not eligible and an evaluation is pending for another, but the other five have been discharged. Two are receiving day support services at Equi-Venture in west Topeka and the other three found providers through Community Developmental Disability Organizations in other parts of the state.

“It was a happy ending,” Swinnen said. “I credit Secretary Keck for that. He was open to exploring what can be done to increase the returns to home and community-based services.”

“It’s a lot of work for a lot of people. But at the end of the day if we can move someone out of a state institution, I think it’s worth it.”

- Ben Swinnen, executive director of Topeka-based Equi-Venture Farms

Alcorn is one of the two Osawatomie patients who now receive services at Equi-Venture, which also served him before his stint in the hospital.

Alcorn was being treated for mental illness at Valeo Behavioral Health Care when he stepped out of a moving Valeo vehicle into traffic.

That incident — endangering himself and others — landed him at Osawatomie, where he stayed for nine months.

Swinnen said that once Equi-Venture and KDADS started looking into discharging Alcorn, the hospital staff “did a wonderful job” preparing Alcorn for it, in part by implementing Equi-Venture’s focus on positive reinforcement, rather than restrictions, to modify his behavior.

Swinnen also praised the KanCare companies. He said another challenge of getting people discharged from the state facilities is that they lose their Medicaid coverage for home and community-based services when they’re admitted.

Equi-Venture and KDADS were able to work with the three companies — Amerigroup, UnitedHealthcare and Sunflower State Health Plan — to get coverage restored for the five being discharged from Osawatomie so their support services would be reimbursed immediately, he said.

For Alcorn, getting out of Osawatomie meant getting day services at Equi-Venture plus a shared living arrangement with one other person with a developmental disability and a host, Donald “Mitch” Mitchell, who supports the two of them.

Mitchell also accompanies them to Equi-Venture during the day.

As he watched Alcorn shoot pool there, Mitchell said the move out of Osawatomie was a difficult transition for Alcorn, in part because he didn’t know how to react to the personal attention he was getting from his roommates.

“That’s what he told me: ‘I’m not used to this,’” Mitchell said.

But now, Alcorn said he likes living with Mitchell and being out of the hospital.

“(I) like to go to the movies,” Alcorn said. “Go for a Coke.”

The other former Osawatomie patient now receiving day services at Equi-Venture was on so many medications when she was discharged that she was nearly catatonic, staff member Sarah Feldhausen said.

Feldhausen and the rest of the staff helped wean her off some of the medications and found that she loves hip-hop music.

“We just had a dance party with her,” Feldhausen said.

That client is scheduled to move to shared living in Newton, where Equi-Venture has another office. She will also meet with her local Community Developmental Disability Organization to discuss other provider options in that area.

Meanwhile, Swinnen said he’s receiving inquiries about helping patients move out of the state’s other mental health facility in Larned, as well as the Parsons State Hospital and Training Center, which is one of two state-run residential campuses for Kansans with intellectual and developmental disabilities.

“I can’t guarantee the outcome in the long-term,” Swinnen said.

“But it’s worth a try,” Feldhausen said, and Swinnen agreed.