Kari Bruffett: State planned for hospital moratorium

Some recent news stories have implied that Osawatomie State Hospital abruptly stopped admitting patients without advance notice to district courts, community mental health centers and law enforcement agencies. I would like to clarify this situation.

The hospital serves a vital role in providing acute care for mentally ill individuals living in about half of the state. In the summer of 2014, its resources were stretched to their limits to provide for an unprecedented number of patients. The situation was untenable. The Kansas Department for Aging and Disability Services, with the help of community mental health centers, took steps to reduce the census at the hospital.

The hospital diverted voluntary patients to other facilities, and KDADS dispatched mental health professionals working in the agency’s central office to assist Osawatomie staff in finding appropriate community placements for patients who were ready for discharge.

In October 2014, the federal Centers for Medicare and Medicaid Services (CMS) conducted an inspection at Osawatomie. Many of the concerns CMS noted could be addressed while patients were still living in the hospital. However, some of the structural changes required by CMS were impossible to make with patients in residence. The fewest number of beds we could vacate for the hospital to remain certified during construction was 60.

Construction began in mid-May, and shortly thereafter the hospital reached its licensed capacity of 146, making it necessary to declare a moratorium as provided for in state law.

Long before the moratorium was declared, KDADS began planning for that possibility. KDADS asked the mental health centers to develop community resource plans and identify what could be done at the local level to provide as much care as possible.

At the agency’s request, the governor and the Legislature made available funds to pay for patients to be treated in alternate community facilities. (However, state law allows private hospitals to decline involuntary patients.)

All of these efforts were well underway by early April.

As the census increased, the chief justice of the Kansas Supreme Court and district courts were notified that a moratorium was imminent. That notice was sent on June 19. Another notice formalizing the declaration was sent to the courts on June 22.

Since then the hospital has admitted nearly 80 patients.

These are the facts, but the solutions are not as easy to identify. Under state law, Kansas has one unified public mental health system. What affects part of it affects all of it.

Everyone involved is committed to improving care and solving problems. We know we cannot continue to go on as now, lurching from crisis to crisis. We need broad, pragmatic solutions, and the agency has convened meetings of experienced people from across the state and asked them the most difficult questions imaginable: What should the public mental health system be able to do, and what is the role of each part in that system?

This story was originally published July 18, 2015 at 7:02 PM with the headline "Kari Bruffett: State planned for hospital moratorium."