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State hospitals often over capacity, officials say

By Dave Ranney | February 22, 2008

By Dave Ranney
KHI News Service

TOPEKA, Feb. 22 Osawatomie State Hospital isn"t the only state-run facility for the mentally ill that"s running over capacity.

State officials revealed Friday that for the past seven months, the average daily census at the adult psychiatric unit at Larned State Hospital has been 86 patients. The unit is licensed to care for 79 patients.

The state"s 50-bed Rainbow Mental Health Facility in Kansas City has been over capacity 33 days since July 1, 2008.

"We"re full," said Rainbow Superintendent Greg Valentine, shortly before an appearance at a meeting of a Senate subcommittee charged with reviewing the state hospital budgets.

Earlier this week, Valentine, who"s also superintendent at Osawatomie State Hospital, asked community mental health centers to limit their hospital referrals to those considered absolutely necessary.

In Kansas, most patients are sent to the state hospitals by their community mental health centers. A few are sent by the courts.

State officials are at a loss to explain the increase in admissions.

"I"m not sure anyone can pinpoint exactly why patient numbers have increased like they have," said Ray Dalton, deputy secretary in charge of disability and behavioral health services at the Department of Social and Rehabilitation Services.

Some of the increase, he said, might be driven by methamphetamine use or, perhaps, because campaigns urging people to seek treatment are working.

"My guess is there are a variety of reasons not one predominant thing," Dalton said.

SRS data show that state hospital admissions increased 64 percent between fiscal years 2002 and 2007.

Dalton warned the committee that all three facilities are often understaffed while, at the same time, caring for an "increasingly violent and medically needy population."

Last fall, SRS proposed several initiatives aimed at improving conditions and adding beds. Most of these initiatives, however, were left out of Gov. Kathleen Sebelius" proposed budget for fiscal year 2009.

"We are truly at a point of crisis in our state hospital system," said David Wiebe, executive director at the Johnson County Mental Health Center.

In recent months, Wiebe said, Osawatomie State Hospital has, at times, admitted as many as 50 patients in a week.

"That is a tremendous challenge," he said.

It"s no surprise, Wiebe said, that many of the state"s mentally ill adults end up in county jails or prison.

Eighteen percent of the 1,000 inmates at the Johnson County Jail, he said, are mentally ill.

"I have six, full-time staff at the county jail," Wiebe said.

SRS data show that because Larned State Hospital is often at or near capacity, it"s not unusual for someone who"s mentally ill and charged with a crime to spend, on average, 40 days in a county jail awaiting an opening at the state hospital.

Kenny Massey, administrator at the Douglas County Correctional Facility, said he has four inmates who"ve been waiting to be transferred "since October, November and December."

Massey asked the committee to understand that while his staff "stabilizes and manages" inmates who are mentally ill, there is "very little treatment going on."

Currently, 40 percent of the jail"s population 60 inmates is mentally ill.

State law, he said, prohibits inmates from being forced to take their medications.

"You can usually tell who"s taking their meds by their behavior," he said.

The committee also heard testimony from Annette Wingerson, whose brother Steve Reitcheck shot and killed Sheridan County Sheriff Jimmy Johnson in October 2006.

Reitcheck, a former patient at Larned State Hospital, was shot and killed by a deputy who was in the room with Johnson. Reitcheck had been diagnosed paranoid schizophrenic in 2003.

Wingerson said her family"s efforts to get services for her brother were "as if a tornado was coming but no one would heed the warning."

Several times, she said, mental health workers told the family they couldn"t force Reitcheck into treatment because he had not committed a crime.

"Sometimes laws get in the way of common sense," Wingerson said. She asked committee members to fund the level of services they would expect if their family members needed to be hospitalized.

The subcommittee is expected to begin deliberations of the state hospital budgets Tuesday or Wednesday.

"The challenge before us as a committee is that, obviously, we have problems out in the field. We"re asking that more and more services be provided with less personnel and we"re adding population numbers to hospitals that are already overworked," said subcommittee chairman, Sen. Dwayne Umbarger, R-Thayer.

Umbarger also is chairman of the Senate Ways and Means Committee.

The House Social Services Budget Committee will begin its review of the state hospital budgets on Monday.


-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.