Where is the advocacy for mentally ill?

There are crises of funding, staffing and capacity at the state’s inpatient psychiatric hospitals.
There are crises of funding, staffing and capacity at the state’s inpatient psychiatric hospitals.

The Legislature went on spring break without doing enough to address the crises of funding, staffing and capacity at the state’s inpatient psychiatric hospitals. Where is the advocacy at the Statehouse on behalf of the most critically mentally ill?

Lawmakers put a total $3 million more into the state hospitals at Osawatomie and Larned and barred their privatization without the Legislature’s consent. On Monday the Kansas Department for Aging and Disability Services announced it was raising the salary for registered nurses at Osawatomie State Hospital to try to help with staffing.

But those seem like half measures considering the size of the problems.

Osawatomie was decertified by the Centers for Medicare and Medicaid Services in December over a “systemic failure” to protect patients and employees, including an October rape of a staff member. Officials have said the action could cause the hospital to lose about $1 million a month in federal funds.

Meanwhile, Larned State Hospital, from which superintendent Tom Kinlen resigned early this month, has been dealing with understaffing and excessive overtime costs. The Topeka Capital-Journal reported last week that the Larned hospital had used up 60 percent of its annual budget in six months and taken steps since to reduce spending sharply.

The problems don’t stop at the state hospitals, either.

In January, Lawrence Memorial Hospital reported increasing staffing and security in its emergency department to handle cases of patients in need of involuntary mental health commitment who were waiting days for a bed to open at Osawatomie.

Now, Newman Regional Health in Emporia risks losing its own Medicare funding related to its process for discharging mental health patients. CEO Bob Wright tied his hospital’s situation to the mental health system’s capacity problems and specifically an admissions moratorium at Osawatomie: “Many rural hospitals like ours are in the position of trying to care for mental health patients in emergency rooms and other inpatient and outpatient settings not intended for that purpose while waiting for the next available psychiatric inpatient bed.”

Some lawmakers have complained about a lack of leadership on the state hospitals from Gov. Sam Brownback and a lack of information from KDADS, including about recommended spending levels.

With the state in serious budget trouble, a big infusion of tax dollars in Osawatomie and Larned seems like wishful thinking. But pending bills would create a tax-form checkoff for behavioral health programs and establish a year-round legislative oversight panel on the state hospitals. A task force’s recommended long-term reforms for mental health care statewide also merit attention.

But so far, actions on the state hospitals fall short of what’s needed in what increasingly looks like an emergency situation.