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Archive for Sunday, December 9, 2001

Mentally ill may lose beds in crunch

Plan to reduce facilities sharply criticized

December 9, 2001

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Caught in a budget crunch, welfare officials have proposed eliminating 55 state-hospital beds for the mentally ill next year.

If enacted, the proposal would trim the Department of Social and Rehabilitation Services' budget by about $2.7 million.

But advocates for the mentally ill are calling the plan "a very bad idea" that is premature, ill-planned and shortsighted.

"By increasing the number of services available in the community, we've been able to reduce the need for and number of state hospitals beds that's true, and that's good," said Steve Feinstein, president of the Kansas Chapter of the National Alliance for the Mentally Ill.

"But it's also true that the remaining beds are being fully utilized, and that the patients in those beds are of a much more acute nature than they were, say, five years ago."

Pulling 55 beds out of an already strained system, Feinstein said, is sure to harm those in need of hospitalization.

"SRS has no data to back what it's proposing," said Feinstein, a former superintendent at Osawatomie State Hospital.

Declining admissions

But Laura Howard, assistant SRS secretary in charge of health care policy, defended the cuts, noting that as community-based programs' abilities to care for those with chronic mental illness continue to rise, the need for state hospital beds will decline.

Already, SRS is looking for ways to curb hospital admissions and stabilize the hospitals' daily censuses, Howard said.

"It goes up and down quite a bit," she said. "A couple months ago, Osawatomie was at 190. Today, it's at 170."

The proposal calls for closing a 30-bed unit at Osawatomie State Hospital, which serves patients from Douglas and other eastern Kansas counties. The plan also is to reduce the average daily census at Larned State Hospital by 25 patients.

The reductions would reduce Osawatomie State Hospital's average daily census from to 160 patients from 185. Larned State Hospital's daily average would drop to 223 from 253.

Also, Howard said, federal officials are pressuring SRS to reduce the number of patients at Larned State Hospital.

"We're operating at over-capacity, that's been pointed out in several (federal) surveys," she said. "It really needs to be addressed."

Questioning assumptions

Doug Witt, clinical director at Lawrence's Bert Nash Community Mental Health Center, said SRS should not assume that local programs can absorb the closing of 55 state-hospital beds.

"Here at Bert Nash we've not seen a (state) plan for putting more money into community mental health services. Instead, we're being told to expect further cuts in funding," Witt said.

"It's unrealistic to expect us to provide the intense kinds of services (state hospital patients) need while, at the same time, being told to spend less."

Howard said the bed-cutting plan is part of the proposed budget forwarded to Gov. Bill Graves. If Graves approves, SRS will begin closing beds early next year.

If enough legislators object to the cuts, she said, they could order SRS to restore either some or all of the beds.

SRS in October announced that to maintain the current level of services in fiscal year 2002, which ends June 30, 2002, it needs an additional $123 million. Officials attributed most of the overrun to rising health-care costs and increasing numbers of children enrolled in HealthWave, the state's federally mandated health insurance program for low-income families.

SRS closed Topeka State Hospital in 1997, reducing the system's patient capacity by 160.

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