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Lawmakers see no cure for state hospital budget woes

By Dave Ranney | February 02, 2007

By Dave Ranney
KHI News Service

TOPEKA, Feb. 2 Osawatomie State Hospital and the state"s Rainbow Mental Health Facility were each cited last year for less-than-adequate care, lawmakers were told Thursday.

"Federal surveyors with the Centers for Medicare and Medicaid Services came out to both hospitals within about a month of each other and surveyed for active treatment," said Greg Valentine, superintendent at both facilities.

"They determined that we were not providing enough treatment to the patients and gave us 90 days to fix it," Valentine said. "We did and they came back and certified us."

Active treatment refers to the facilities" programs improving patients" conditions. Not having enough active treatment means patients are being warehoused.

State officials revealed the failed inspections during an appearance Thursday before the House Social Services Budget Committee.

Earlier this week, legislators were told that in November 2006, Larned State Hospital had been cited for poor housekeeping, broken furniture, and faulty plumbing and that a female resident on a "soft diet" had choked to death while eating pancakes.

The Rainbow Mental Health Unit and Osawatomie State Hospital inspections were in April and May, respectively.

The three facilities did not fare well in Gov. Kathleen Sebelius" proposed budget for Fiscal 2008.

Valentine asked for 48 additional employees to shore up active-treatment efforts at both Osawatomie State Hospital and Rainbow Mental Health Unit. The governor proposed adding 27.

Larned State Hospital Superintendent Mark Schutter asked for $230,420 to raise starting pay for licensed practical nurses to $15.84 an hour from the current $13.68 an hour. The governor denied the request.

Records show that 41 percent of the LPN positions at Larned State Hospital are not filled even though the facility often operates at or over capacity.

Schutter and Valentine assured the committee they would find ways to make ends meet.

Advocates for the mentally ill were not as accommodating.

"We have been talking about this for years," said Amy Campbell, a spokeswoman for the Kansas Mental Health Coalition. "And every year, we get to the point where it comes down to the money and everything comes to a screaming halt. This cannot continue."

Campbell and others were upset that Sebelius" budget did not heed calls for either adding 30 beds at Osawatomie or underwriting stays in psychiatric units in community hospitals.

"Action must be taken in the short term to address the critical shortage of in-patient beds," Campbell said. "Simply adding more staff to existing wards is not an acceptable alternative."

Records show and neither Valentine nor Schutter denied that patient stays have been shortened to make room for others in crisis and needing to be admitted.

Osawatomie State Hospital, for example, recorded 1,137 admissions in 2002; it"s expected to admit 2,318 patients in 2007.

Over the same five-year span, the average stay has fallen from 72 days to 30 days.

Rick Cagan, executive director at National Alliance on Mental Illness-Kansas, reminded the committee that 900 inmates in the state"s prisons are thought to be as mentally ill as the 625 patients in the state hospitals.

"The 900 people we"re talking about here are just those in Department of Corrections system," he said. "Nobody knows how many are in the county jails."

By not adding in-patient beds to the system, Cagan said, the state ends up spending considerably more on mentally ill people in prisons.

Committee members said they weren"t sure what to do.

"I"m not sure what will fly for this year," said the committee"s chairman, Rep. Bob Bethell, R-Alden. "We"re going to have to look at what our revenues are as we go along we"ve tied up every bit of excess revenue that we"ve got so far this year."

Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at dranney@khi.org or at 785-233-5443, ext. 128.