Fund local inpatient care

Last week Gov. Sam Brownback proudly pointed to recent spending cuts to help explain why Kansas, according to economic experts, could collect $205 million more in revenues this fiscal year than previously expected. But he and state legislators also need to recognize and address the downside of budget cuts, including the potential harm to mentally ill Kansans who need inpatient care.

Comcare, Sedgwick County’s community mental health center, recently notified the Kansas Department of Social and Rehabilitation Services that it would be unable to afford to hospitalize perhaps 1,250 patients next year locally at Via Christi Health’s 80-bed psychiatric unit. The Kansas Health Institute News Service reported that as of Jan. 1, Comcare expects those inpatient referrals to go to Osawatomie State Hospital, saving the county agency about $400,000 a year.

Like many of the 14,000 Sedgwick Countians served by Comcare per year, those needing inpatient care either lack insurance or rely on Medicaid and Medicare. The 1,250 or so individuals who will be affected are those who have agreed to hospitalization, perhaps because they are suicidal or schizophrenic and actively psychotic.

That means vulnerable people who’d benefit from receiving inpatient care in their community will instead have to deal with a three-hour drive, unfamiliar surroundings and the stigma of being in a state hospital.

That’s a new problem for Sedgwick County, which, to its credit, long has preferred to serve such patients locally. On any given day, it has had as few as 18 or as many as 35 patients at Via Christi. “We were doing this because it was the right thing to do and we had the resources to do it until all these cuts,” Marilyn Cook, Comcare’s executive director, told The Eagle editorial board.

Comcare has seen its state funding cut by 65 percent since 2005, including a $3.2 million reduction this year.

But Comcare’s situation also creates a statewide problem, as an SRS-led stakeholders group acknowledged last week. The 176-bed Osawatomie hospital has operated at near capacity in recent months, and it exceeded its licensed capacity four days out of 10 during the fiscal year that ended June 30. And for a while, the extra Comcare admissions would be on top of 30 more admissions at Osawatomie from the Rainbow Mental Health Facility in Kansas City, Kan., which is undergoing a six- to eight-month renovation to comply with fire and safety codes.

“It’s pretty clear what’s going to happen,” Stephen Feinstein, a former superintendent at Osawatomie State Hospital, told KHI. “There will either be shorter stays, delayed admissions or closed admissions. There isn’t room for 25 more patients a day. It’s too crowded, too dangerous. SRS needs to get on top of this, because when things like this go south, they go south in a hurry.”

SRS reportedly is exploring its options. Brownback needs to ensure that it finds a suitable one, and funds it appropriately. The closer to home that seriously mentally ill Kansans can receive inpatient treatment, the better for the patients, their families and the state budget.