While some renovations at Osawatomie State Hospital are nearing their end, the waiting will continue for mentally ill Sedgwick County residents.
A moratorium on involuntary hospital admissions will still be in effect as the hospital juggles bed space while federal health inspectors review the state’s progress on making its facilities safer.
“I’m not ready to say that the moratorium will be over,” Kansas Department of Aging and Disability Services spokeswoman Angela de Rocha said.
The hospital in Miami County, south of Kansas City near the Missouri state line, has been limited to 146 beds since late June because of renovations mandated by the federal Centers for Medicare and Medicaid Services. Osawatomie has still been accepting patients, but not before they are placed on a waiting list.
Patients with serious mental health or substance abuse issues have had to wait in local emergency rooms for beds to open up when people are discharged from Osawatomie.
But a local emergency room is no place for patients who are a threat to themselves or others, said Jason Scheck, director of outpatient services at Comcare, Sedgwick County’s mental health department.
“Their symptoms can certainly continue or the situation can escalate,” he said.
The 146-bed moratorium began on June 21, Scheck said.
Sixty five patients in Sedgwick County have been involuntarily admitted to Osawatomie between then and Sept. 21, according to Comcare data. The vast majority were forced to wait, Scheck says.
“Almost all of our admissions end up on a waiting list,” Scheck said. “… I don’t recall in the last couple months being able to send someone directly without them first being on a waiting list.”
Osawatomie is one of two state mental hospitals, the other being Larned State Hospital in Pawnee County. Osawatomie serves patients from 46 counties in the eastern third of the state, including the most populous Kansas counties. It’s licensed to have 206 beds.
The renovations that forced the 146 bed moratorium are scheduled to end Thursday. Architects were installing some final bathroom fixtures and lights in one of the hospital’s buildings on Wednesday, de Rocha said.
But beds won’t open up overnight. Inspectors from the Centers for Medicare and Medicaid Services, or CMS, need to visit Osawatomie first.
“We’re still not going to have those beds because we have to be reinspected by CMS. …We’re also kind of dependent when they do that inspection,” de Rocha said. “We have to have all of our i’s dotted and t’s crossed.”
The federal government will be reinspecting to see if the hospital’s construction is up to federal safety standards. Fixtures in the ceiling were a risk for people prone to suicidal tendencies, de Rocha said.
Federal inspectors will arrive at Osawatomie sometime after the renovations are completed.
“We never give exact dates. That’s for privacy reasons for the inspection to happen,” said Julie Brookhart, a spokeswoman for the Kansas City regional CMS office.
The renovations so far have focused on one building at the hospital, de Rocha said.
“We have done all the work that needs to be done in that one unit,” she said. “We will begin moving patients into the renovated unit so we can renovate the rest of them.”
If the hospital doesn’t pass inspection, CMS would weigh its options against Osawatomie.
“The facility could be terminated from participation in the Medicare program, which mean loss of funding,” Brookhart said.
But if it passes federal inspection, the hospital will gradually gain more bed space back, de Rocha said.
“We will be able to add some additional patients,” said de Rocha, while not specifying how much the bed limit could rise.
The state will then work to retrofit the ceilings of all other residential buildings.
In the meantime, the moratorium capacity remains at 146 beds.
Aging and Disability Services has worked to find bed spaces for patients outside of the ER during the course of the three-month moratorium. In the past, the state has contracted with Via Christi for beds “when Osawatomie is overflowing,” de Rocha said.
They’ve also worked with local community mental health centers to find temporary bed space.
Aging and Disability Services contracted with Kansas Health Solutions for a new inpatient psychiatric unit at Prairie Ridge Hospital in Kansas City.
But mental health counselors and advocates have been critical of the moratorium, saying some people need state hospital treatment as soon as they’re referred to it.
“The emergency department is just emergency treatment,” Scheck said. “It’s not treating the underlying psychiatric disorders.”