A state official on Wednesday announced that Osawatomie State Hospital has stopped admitting patients.
Addressing a meeting in Topeka of the Kansas Mental Health Coalition, Ted Jester, assistant director of mental health services at the Kansas Department for Aging and Disability Services, said admissions were suspended Saturday evening when the hospital’s census reached 146 patients.
“This is an unprecedented time in the state of Kansas,” Jester said, noting that the law allowing the hospital to turn away involuntary-admission patients, all of whom have been found to pose a danger to themselves or others, passed in 1986.
“That law has never been used until last week,” he said.
Osawatomie State Hospital is the larger of the two state-run inpatient facilities for adults with severe and persistent mental illness. The other state hospital is in Larned.
Earlier this year, KDADS officials limited the Osawatomie hospital’s daily census to 146 patients after federal surveyors cited the facility for having too many patients, not having enough staff and not doing enough to prevent suicidal patients from hanging themselves. Previously, the hospital had a licensed capacity of 206 patients.
“Once we hit 146, we had to declare a moratorium,” Jester said.
It’s not clear how long the moratorium will remain in effect, he said, noting that on Wednesday five of the hospital’s then-145 patients were “expected discharges.”
Jester assured coalition members that hospital officials were doing everything they can to find alternate placements for those affected by the moratorium.
These efforts, he said, include asking psychiatric units at private hospitals to admit some of the patients even though the units typically resist taking patients who are uninsured, admitted “involuntary” and potentially violent.
In Kansas, hospitals in eight cities — Hutchinson, Garden City, Kansas City, Newton, Salina, Topeka, Merriam and Wichita — have inpatient psychiatric units.
Jester said KDADS has the authority to spend $3.45 million on developing alternative settings for would-be patients who are uninsured.
“This is going to be a growing process for all of us,” Jester said, referring to the department’s search for alternatives. “We’re going to learn from it, and I’m positive this will help strengthen our system overall.”
Tisha Darland, a psychologist at COMCARE, the community mental health center in Wichita, said that in recent months it’s become commonplace for involuntary-admission patients to spend 24 to 48 hours in the city’s emergency rooms, waiting for the state hospitals to approve or deny their admission.
“We have three people who were approved (for admission to Larned State Hospital) yesterday, and they’ve still not been admitted,” Darland said. “And this morning, one of the hospitals discharged a person that we felt needed to be at Larned for their own safety.”
Jester said he would find out why Larned officials were taking so long to return the Wichita hospitals’ telephone calls.
Dr. Dennis Allin, chair of the emergency medical department at the University of Kansas Hospital, said it’s not unusual for involuntary-admission patients to spend six to 10 hours in the Kansas City, Kan., hospital’s emergency room.
“That’s fairly common,” Allin said in an interview. “It’s become part of what we’ve gotten used to.”
Still, he said, KU Hospital has had “good luck” in referring would-be patients to Rainbow Services Inc., a 22-bed KDADS-funded crisis intervention facility in Kansas City.
David Elsbury, chief executive at KANZA Mental Health and Guidance Center in Hiawatha, said KDADS overtures to the state’s 26 community mental health centers, though welcomed, have been slow in generating alternatives to hospitalization.
“They’re working on it,” he said, “but not a lot of progress has been made.”
Elsbury praised KDADS efforts to expand access to crisis intervention services but added: “Crisis intervention, by definition, involves individuals who are ‘voluntary,’ but that’s not the people we’re talking about here. The people who are affected by the moratorium are the ‘involuntaries.’”
Osawatomie State Hospital imposed a moratorium on voluntary admissions late last year.
Also Wednesday, coalition members learned that Carla Drescher was no longer director of behavioral health services at KDADS. The department, Jester said, had “no immediate plans” to fill the position.
Drescher was the third director of behavioral health services for KDADS in the past four years. Her last day was June 12.
Dave Ranney is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.