Kansas Hospital’s Struggles Spur Mental Health Symposium

Aug 18, 2016

Experts from a variety of fields gathered Wednesday at the Kansas Statehouse for a mental health symposium spurred by an Emporia hospital’s struggle last year to find a psychiatric care bed for a suicidal patient.

House Speaker Pro Tem Peggy Mast, a Republican from Emporia, said she was inspired to convene the symposium after hearing from officials at Newman Regional Health.

That hospital nearly lost federal certification after a botched transfer of a patient who was having chest pains and thoughts of suicide.   

Robert Wright, CEO of Newman Regional Health in Emporia, says the state's mental health system is 'the biggest problem' for the hospital.
Credit Andy Marso / Heartland Health Monitor

Robert Wright, CEO of the Emporia hospital, told officials with the federal Centers for Medicare and Medicaid Services that a lack of mental health beds in the state was forcing hospitals like his to hold patients in emergency rooms for days, with little or no compensation in some cases.

During Wednesday’s symposium, Wright said he and his staff are being forced to make difficult decisions.

“The (mental health) system has worked less and less and less well, to now the point where it is really our biggest problem,” he said. “I’ve been running hospitals for decades. Used to be you worried about money. Now I worry about how do we care for these mental health patients in a way that’s appropriate for them without bankrupting my hospital.”

Wright said the mismatch between the number of psychiatric beds and the number of Kansans who need them is a problem that has been festering for decades. A move toward community-based care rather than institutionalization that began in the 1960s led to the closure of facilities like Topeka State Hospital, but the funding for community-based programs never lived up to the plan.

Deborah Stern, senior vice president of clinical services and general counsel for the Kansas Hospital Association, said fewer patient beds and an admissions moratorium at Osawatomie State Hospital — one of two mental health facilities left in the state — severely compounded the problem.

Stern said one large hospital in Johnson County reported a total of 318 hours that patients spent waiting for a bed at Osawatomie State Hospital during the first four months of 2015, with 23 hours the longest wait. During the first four months of 2016, the total number of hours waiting had jumped to 1,466, with 44-hour waits typical and the longest wait clocking in at 128 hours — or more than five days.

“Our emergency rooms, they’re really backed up,” Stern said. “They don’t have enough providers. As it is, psychiatrists are really hard to find.”

Solving the provider shortage will be difficult, she said. But expanding Medicaid eligibility under the Affordable Care Act would help, Stern said, because many Kansans with mental health issues lack insurance.

The symposium panel also included representatives from law enforcement, mental health advocacy groups, clinicians and four state agencies, as well as a handful of state legislators.

Tim Keck, secretary of the Kansas Department for Aging and Disability Services, said staffing at Osawatomie State Hospital is stabilizing thanks in part to raises approved by the Legislature. He has said the hospital is working toward federal recertification, which would open more beds.

Other possible solutions emerged to help fill cracks in the mental health system.

Susan Crain Lewis, president and CEO of Mental Health America of the Heartland, said her nonprofit could help train staff at Kansas schools now required to know suicide prevention techniques under the Jason Flatt Act.

The two Democrats at the symposium — Rep. Nancy Lusk of Overland Park and Sen. Laura Kelly of Topeka — said system needs improvements that will require more state funding, both for the state-run mental health hospitals and the less-intensive community-based therapies.

“I agree with Rep. Lusk that this is going to take money,” Kelly said. “We don’t have any right now.”

Kelly said legislators and stakeholders should focus on preparing a systemwide improvement plan in case a new Legislature changes the state’s tax structure to bring in more revenue.

Democrats like Kelly blame income tax cuts spearheaded by Gov. Sam Brownback in 2012 for throwing the state into an ongoing budget crisis that prevents investments in state services.

Mast and other Republican leaders have steadfastly supported those cuts. But in opening remarks Wednesday, she said the state is not spending enough money on mental health.

“I think we can all agree that we don’t have enough resources for the need and it’s putting a strain on a lot of different entities,” Mast said, “and we need to focus more on the individual needs of those that are mentally ill.”

Andy Marso is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach him on Twitter @andymarso